| 11. |
|
|
| 12. |
- Alstergren, Per
(författare)
-
Rheumatoid Arthritis with Temporomandibular Joint Involvement
- 2017
-
Ingår i: Clinical Cases in Orofacial Pain. - : John Wiley & Sons. - 9781119194798 ; , s. 67-73
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Expand your knowledge and put it into practice with this unique, case-based guide Clinical Cases in Orofacial Pain is a valuable resource for undergraduate dental students as well as residents working towards board certification. Individual cases cover temporomandibular joint disorders, masticatory muscle disorders, headache, neuropathic pain, dental pain, tooth wear, and dystonia. Following the popular Clinical Cases series style, cases are presented with associated academic commentary, including background information, diagnostic criteria and fundamental points that might influence the diagnosis, treatment planning or management of the case. Well-illustrated throughout, each chapter features self-assessment study questions to help foster independent learning. Clinical Cases in Orofacial Pain is an excellent primer for undergraduate dental students and an invaluable study guide for postgraduate students and residents. Dental practitioners will also want to keep this unique, case-based guide as a ready reference in their working libraries.
|
|
| 13. |
- Alstergren, Per
(författare)
-
Temporomandibular joint pain, hyperalgesia and allodynia in relation to interleukin-1ß and serotonin
- 1998
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis had two main aims and comprises a methodological and a clinical part. The aims were to develop a temporomandibular joint (TMJ) synovial fluid (SF) sampling method that enables the determination of the true SF level of various substances and, by using the developed TMJ SF sampling method, investigate the hypothesis that circulating as well as SF content of interleukin-1ß (IL-1ß) and serotonin (5-HT) influence different TMJ pain entities and signs of tissue destruction in patients with TMJ inflammatory disorders. In the methodological part of this thesis hydroxocobalamin (HCA; vitamin B12) was used as external marker. HCA mixed with saline is a dark red solution that was used in order to determine the dilution of the washing solution by SF. The difference in light absorbance of the aspirate and the washing solution was used as a measure of the dilution. This method was optimized for use with a spectrophotometric capillary tube system and the optimal wavelength, reproducibility and accuracy were determined. In addition, interaction between HCA and the analysis of various proinflammatory substances were investigated. Patients with TMJ inflammatory disorders (local synovitis/capsulitis or polyarthritis) as well as healthy individuals were clinically examined concerning spontaneous TMJ pain, TMJ palpatory tenderness, pressure pain threshold and tolerance level, number of painful mandibular movements, mandibular mobility and degree of anterior open bite. TMJ SF samples were obtained and the SF samples as well as the plasma serum samples were analyzed with respect to concentration of IL-1ß and 5-HT. The methodological part showed that the investigated vitamin B12-method was useful for determination of the washing solution dilution by SF. This information provides an estimate of the recovery of SF that can be used to determine the absolute SF concentration of a certain substance. The method was found to be precise as well as accurate and very small sample volumes were sufficient, which is an advantage in clinical studies of TMJ SF. The vitamin B12-method is reliable for measurement of SF concentrations of substances such as IL-1ß and 5-HT. With the most useful set of sample quality criteria applied, there was a recovery of TMJ SF of approximately 0.1 - 0.2 g. IL-1ß and 5-HT seem to be undetectable in TMJ synovial fluid from healthy individuals. The higher SF levels in the diseased TMJ (polyarthritis) compared to the healthy joint and with respect to IL-1ß and 5-HT is of clinical diagnostic relevance. Presence of IL-1ß and 5-HT in TMJ SF thus seems to indicate a pathological joint condition of inflammatory nature. IL-1ß in the TMJ SF was found to be associated with spontaneous pain, hyperalgesia and allodynia in the TMJ region of patients with TMJ inflammatory disorders. IL-1ß was also a factor involved in the development of anterior open bite and the presence of IL-1ß in the TMJ SF seems to be a warning signal for TMJ tissue destruction. 5-HT in the SF was associated with pain perceived upon movement of the joint (allodynia) and to decreased mandibular mobility. The serum concentration of 5-HT was positively related to TMJ allodynia in patients with seropositive rheumatoid arthritis.
|
|
| 14. |
|
|
| 15. |
- Alstergren, Per
(författare)
-
What and how : Workflow of the management of joint disorders in the clinical practice
- 2024
-
Ingår i: Seminars in orthodontics. - : Elsevier. - 1073-8746. ; 30:3, s. 267-270
-
Tidskriftsartikel (refereegranskat)abstract
- This narrative review isl describing the most common TMJ conditions and suggest a straightforward, clinically relevant and feasible treatment workflow for each of these. The suggestions for treatment will be based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), the Swedish National Board of Health and Welfare National guidelines for general dentistry as well as the Swedish Academy for Temporomandibular Disorders’ National guidelines for TMD screening, diagnosis and treatment with the target audience of general practitioners.
|
|
| 16. |
- Carlsson, Alexandra Dimitrijevic, et al.
(författare)
-
Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations
- 2019
-
Ingår i: Pediatric Rheumatology. - : BioMed Central (BMC). - 1546-0096. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background The aim of this study was to investigate relations between psychosocial factors, signs and symptoms of orofacial pain and jaw dysfunction in patients with juvenile idiopathic arthritis (JIA). Methods Forty-five patients with JIA (median age 12 years) and 16 healthy matched controls (median age 13 years) were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered the DC/TMD questionnaires regarding psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophizing, pain locations and jaw function). Results JIA patients with orofacial pain had higher degree of stress, depression, catastrophizing and jaw dysfunction compared to subjects without. In turn, these factors were associated with orofacial pain intensity. Also, patients with orofacial pain had higher systemic inflammatory activity. Conclusions Orofacial pain in patients with JIA is associated with stress, psychological distress, jaw dysfunction and loss of daily living activities. Pain intensity seems to be the major pain aspect related to these factors. In addition, systemic inflammatory activity appears to be an important factor contributing to orofacial pain in JIA.
|
|
| 17. |
- Cederhag, Josefine, et al.
(författare)
-
Comparison of absorbed doses and organ doses measured with thermoluminescent dosimeters and Gafchromic film for cone beam computed tomography examination of the posterior mandibular region in a head phantom
- 2023
-
Ingår i: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 136:6, s. 769-776
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to map the correlation between thermoluminescent dosimeters (TLDs) and Gafchromic film for measuring absorbed doses and to compare minimum, maximum, and mean absorbed doses over larger regions of interest and at various craniofacial organs and tissues during cone beam computed tomography (CBCT) exposure of the mandibular third molar region. Study Design: We positioned TLDs at 75 measurement points in a head phantom. Gafchromic film was cut to the same shape as the 5 levels of the phantom and was placed on top of the TLDs. Both dosimetry methods thus included the surface of each level simultaneously. CBCT scans were made using a 5 × 5 cm field of view and a rotation angle of 200°. Measurements included absorbed dose distributions, doses at all 75 points, and minimum, maximum, and mean doses within organs and tissues. Results: The correlation of point-dose measurements at all TLD sites with doses measured on film was strong (R2 = 0.9687), with greatest correlation at lower doses (<2 mGy). Large deviations between TLD and film measurements of minimum and maximum doses and absorbed doses to the organs occurred at all 5 levels. TLD positioning failed to cover several organ sites; for these, only absorbed dose measurements from the film were available. Conclusions: TLDs were unable to sample dose distributions and gradients accurately. The characteristics of Gafchromic LD-V1 film make it a favorable alternative in dental CBCT dosimetry.
|
|
| 18. |
- Cederhag, Josefine, et al.
(författare)
-
Evaluation of Panoramic Radiographs in Relation to the Mandibular Third Molar and to Incidental Findings in an Adult Population
- 2021
-
Ingår i: European journal of dentistry. - : Thieme Medical Publishers. - 1305-7456 .- 1305-7464. ; 15:2, s. 266-272
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning.MATERIALS AND METHODS: From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used. The third molars' characteristics and relation to inferior alveolar nerve were evaluated. Incidental findings and patient positioning were recorded.STATISTICAL ANALYSIS: Frequency analysis was used to investigate the occurrence of all findings and their possible interconnections. Whether the patients' age or gender had an impact or not was also analyzed.RESULTS: The third molars were erupted in vertical position among 73% regardless of age. When retained or semi-retained, they were most commonly in mesioangular positions. The inferior alveolar nerve was located inferior to the roots in 52%, whereas an overlapped position was most common if the third molar was retained (90%), semi-retained (83%) or the age was less than 30 years (66%). Common incidental findings were apical radiolucencies, idiopathic osteosclerosis, and tooth fragments. Suboptimal patient positioning was found in one-third of the radiographs.CONCLUSIONS: Panoramic radiography is a useful method to evaluate third molar prior to surgical removal and may be the only image required. Most incidental findings on panoramic radiographs does not seem to require any further odontological management.
|
|
| 19. |
- Cederhag, Josefine, et al.
(författare)
-
Radiographic imaging in relation to the mandibular third molar : a survey among oral surgeons in Sweden
- 2022
-
Ingår i: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 26, s. 2073-2083
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To query the experience of oral surgeons concerning referral routines and preferences for radiographic imaging modality before surgical removal of mandibular third molars and investigate factors that influence imaging modality preferences.MATERIALS AND METHODS: Members of the Swedish Association of Oral and Maxillofacial Surgeons (n = 280) were invited to participate in a web-based digital survey concerning their experiences and use of three imaging modalities in pre-surgical assessment of mandibular third molar removal. The survey comprised multiple-choice questions and four cases depicted in images; respondents reported whether they would supplement the cases with other images and, if so, from which modality.RESULTS: The response rate was 64%. Panoramic radiographs were most commonly used in pre-surgical planning (response options: always or often), significant difference between professions (p = 0.039), and considered to facilitate treatment planning (87%), as was CBCT (82%); for 51%, CBCT reduced post-operative complications. Preferred modality for localizing the mandibular canal was fairly evenly distributed and for non-complex case, significant difference between subgroups of OMFS surgeons was found (p = 0.003) as to preference for intraoral radiographs.CONCLUSIONS: A majority of respondents received a report within 2 weeks of their referral for CBCT and would read the report and view the images before surgery. Image modality preference differed depending on case complexity, with a greater perceived need for CBCT. Profession and practical experience affected choice.CLINICAL RELEVANCE: Choice of imaging modality in mandibular third molar assessment is also important from dose delivery and social economy standpoints.
|
|
| 20. |
- Cederhag, Josefine, et al.
(författare)
-
Visibility of anatomical landmarks in the region of the mandibular third molar, a comparison between a low-dose and default protocol of CBCT
- 2023
-
Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis Group. - 0001-6357 .- 1502-3850. ; 81:6, s. 449-455
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Optimization of radiographic examinations is essential for radiation protection. The objective of the study was to investigate the clinical applicability of a low-dose CBCT protocol as compared to the default for pre-surgical evaluation of mandibular third molars.MATERIAL & METHODS: Forty-eight patients (62 teeth) referred for pre-surgical mandibular third molar investigation were recruited after justification for CBCT. Two CBCT scans of each site were made using a default protocol and a low-dose protocol (Veraviewepocs 3D F40, J Morita Corp, Kyoto, Japan). The low-dose protocol had the same tube potential (90 kV) and exposure time (9.4 s) as the default, but with reduced tube current, from 5 mA to 2 mA. Four observers evaluated the visibility of five relevant anatomical variables. Image quality was ranked on a 3-point scale as diagnostically acceptable, doubtful, or unacceptable. The Wilcoxon signed-rank test compared differences between the two protocols. The significance level was set at p ≤ .05.RESULTS: No significant differences were found between the two protocols for any observer regarding the visibility of the relationship and proximity between the roots and the mandibular canal; root morphology; and possible root resorption of the second molar. The periodontal ligament differed significantly in visibility between the two protocols (p ≤ .05).CONCLUSIONS: This study indicates that a low-dose CBCT protocol with a 60% reduction of the tube current provides, in most cases, acceptable image quality for pre-surgical assessment of mandibular third molars. Optimization of CBCT protocols should be a priority according to recommended guidelines.
|
|
