| 1. |
- Alstergren, Per, et al.
(författare)
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Kroniska orofaciala smärtor i allmänpraktiken
- 2016
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Ingår i: Tandläkartidningen. - : Tandläkarförbundet. - 0039-6982. ; 108:3, s. 78-83
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Tidskriftsartikel (refereegranskat)abstract
- Det är viktigt att ha ett praktiskt material tillgängligt för diagnostik och behandling av patienter med kroniska orofaciala smärtor. Denna artikel innehåller en checklista för diagnostik av de vanligaste smärttillstånden. Konservativa reversibla behandlingsmetoder är minst lika effektiva som invasiva behandlingar och innebär långt mindre risk för att skada patienten, så de bör vara förstahandsalternativ för de allra flesta patienter med kroniska orofaciala smärtor.
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| 2. |
- Anastassaki-Köhler, Alkisti
(författare)
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On temporomandibular disorders : Time trends, associated factors, treatment need and treatment outcome
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- During the last few decades, and especially during the 1990s, an increase in musculoskeletal pain conditions and stress-related ill-health has been observed in Sweden. At the same time, an improvement in the oral health of the population has been noted. The overall aim of this thesis was to acquire knowledge relating to possible time trends for the presence of temporomandibular disorders (TMD) in the population. A further objective was to study factors that possibly influence the presence of these disorders and the outcome of their treatment.Studies I–III are based on a series of repeated cross-sectional population-based investigations. Three independent samples of 130 individuals in the age groups of 3, 5, 10, 15, 20, 30, 40, 50, 60 and 70 years were randomly selected from the inhabitants of the city of Jonkoping, Sweden in 1983, 1993 and 2003. The total participation rate was 21%, 22% and 29% respectively. The participants were examined using a questionnaire, interview and a clinical examination of the stomatognathic system regarding the presence of symptoms and signs indicative of TMD. Study IV is a retrospective survey of a clinical sample of patients referred to and treated at the Department of Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jonkoping, in 1995–2002. The overall frequencies of symptoms and the rates for some clinical signs and consequently of an estimated treatment need in adults increased during the study period. In 2003, the prevalence of frequent headache in 20-year-olds, mainly females, had markedly increased. The reports of bruxism among adults increased from 1983 to 2003. Awareness of bruxism and self-perceived health impairment were associated with TMD symptoms and signs. A favourable treatment outcome was observed for the majority of patients with common TMD sub-diagnoses and no strong predictors of treatment outcome were found.In conclusion, the results suggest some time trends towards an increased prevalence in the overall symptoms and some signs indicative of TMD in the Swedish adult population during the time period 1983–2003. A profound understanding of the social determinants of health is recommended when planning public health resources.
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| 3. |
- Doepel, Marika, et al.
(författare)
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Effectiveness of Prefabricated Occlusal Appliance in TMD Patients with Headache
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To compare the short- and long-term effectiveness of a prefabricated occlusal appliance with a stabilization appliance for the treatment of headache in myofascial pain patients. Methods: Sixty-five myofascial pain patients of whom 57 reported headache were included in a randomized controlled trial at two centres for Stomatognathic Physiology in Sweden and Finland. Patients were randomly assigned to a prefabricated appliance (R-group, 27 women, 5 men, mean age 38 years) or a stabilization appliance group (S-group, 31 women 2 men, mean age 37 years). RDC/TMD was used for history-taking and clinical examination. Frequency and intensity of headache were assessed using a verbal scale (1=continuous, 2=recurrent, 3=rarely) and a numeric rating scale (NRS) respectively at baseline, 10-week, 6-and 12-month follow-ups. Results: At baseline there were no differences between the groups regarding frequency and intensity of headache. At the follow-ups a statistically significant decrease in both frequency and intensity was observed within the two groups without any differences between the groups. At baseline 72% and 70% in the R and S groups reported recurrent or continuous headache which decreased significantly (p< .01) within both groups to 44% and 31% at 10-week and to 26% and 18% at the 12-month follow-up. Mean intensity (NRS) of headache at baseline decreased within both groups from 6 to 3 at 10-week follow-up and to 2 and 3 in the R and S groups respectively (p< .001) at 12-month follow-up. Conclusions: In both short- and long-term the prefabricated appliance seemed to have a similar effectiveness in the treatment of headache in myofascial pain patients.
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| 4. |
- Doepel, Marika, et al.
(författare)
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Salivary cortisol and IgA levels in myofascial pain patients treated with occlusal appliances in a short term perspective (Stockholm)
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: In many studies the endocrinological response of individuals to different kind s of stresses has been tested. There seems to be widespread agreement that stress, depression, disability and dysfunctional illness behaviors are critical aspects of patients suffering from TMD (temporomandibular disorders) symptoms like pain. We wanted to explore treatment-induced changes in salivary cortisol, IgA and flow rate values in TMD patients suffering from myofascial pain. Methods: TMD paitents (n=39) were randomized into two groups and treated with two different occlusal appliances. Percieved stress regarding family work, economy, relationships, general health and stress in general was wvaluated at baseline according to a verbal scale. Paraffin stimulated saliva samples were collected before treatment and during follow-up at 6 and 10 weeks. Flow rate was measured immediately after the saliva collection while salivary sortisol, and IgA were determined from -70° C-stored samples. Results: No clear association between reported stress and cortisol or IgA values could be observed at baseline. At 10 weeks´ follow-up 92% of the patients felt better-much better-symptom free and no difference was found between the two appliance groups. Cortisol, IgA and flow-rate values showed no systematic between-appliance groups differences. All salivary parameters showed interindividual differences but stayed intraindividually on a similar level throughout the study and no statistically significant changes could be observed when comparing before and after treatment levels. Conclusion: To conclude, there were no treatment induced changes in saliva parameters despite successful appliance therapy in myofascial pain patients.
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| 5. |
- Doepel, Marika, et al.
(författare)
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Similar treatment outcome in myofascial TMD patients with localized and widespread pain.
- 2018
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Ingår i: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 76:3, s. 175-182
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the outcome of oral appliance treatment in myofascial Temporomandibular disorder (TMD) patients with and without comorbid pain using pain site drawings. MATERIAL AND METHODS: This randomized, controlled multicentre study comprised 65 myofascial TMD patients diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Pain-site drawings were filled in at the baseline examination. The patients were treated with oral appliances. Treatment outcome was followed up for 1 year and analysed according to the recommendations by the Initiative on Methods, Measurement and Pain assessment in Clinical Trials (IMMPACT) on an intent-to-treat basis. The data were analysed for two pain profiles, localized pain (face and head, n = 26) versus widespread pain group (pain sites outside the face and head, n = 39). RESULTS: Statistically significant improvement was registered within both groups for all outcome variables (characteristic pain intensity, 30% pain reduction of worst reported pain, graded chronic pain, depression, and somatization scores) during the follow-up with only small differences between the groups. CONCLUSIONS: Oral appliance treatment had a positive effect on all outcome measures during the 1-year follow-up in patients suffering from myofascial TMD pain, regardless of whether the pain was localized or widespread. Multiple pain sites seemed to have surprisingly little influence on the outcome variables. However, some indications of more challenges when treating patients with widespread pain compared to local pain could be observed. Pain-site drawings seem to be useful in the clinical situation and could support the clinicians in decision-making regarding treatment planning.
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| 6. |
- Ekberg, EwaCarin, et al.
(författare)
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Effectiveness of a prefabricated occlusal appliance, Relax, in the long-term (Helsinki)
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To compare the long-term effectiveness of a prefabricated occlusal appliance with a stabilization appliance in myofascial pain patients. Methods: Sixty-five patients with the diagnosis myofascial pain at two centres for Stomatognathic Physiology in Sweden and Finland were included in a randomized controlled trial. Patients were randomly assigned to a prefabricated appliance (R-group, 27 women, 5 men, mean age 38 years) or a stabilization group (S-group, 31 women 2 men, mean age 37 years). General practitioners performed the treatment. History and clinical examination was performed according to RDC/TMD. At the 6 months- and 1 year follow-up the treatment outcome regarding pain according to the visual analogue scale and overall rating of pain according to the verbal scale was evaluated. Results: At baseline there were no differences between the groups regarding frequency of myofascial pain, number of years suffering from the pain, worst or mean pain during the last six months. At the 12-months follow-up 30% and 50% pain relief in the R- and S-groups were reported in 24 and 21 patients and 23 and 17 patients respectively. According to a verbal scale 26 and 21 patients in the two groups reported themselves to be better, much better or symptom-free. All calculations were done per protocol. An increased open bite was registered in one patient. Conclusions: In a long-term perspective both appliances seemed to have an equal effectiveness in the treatment of patients suffering from myofascial pain. The prefabricated appliance, Relax, can be recommended as a long-term treatment modality when used night time only. Frontal open bite should be regarded as a contraindication.
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| 7. |
- Lindfors, Erik, et al.
(författare)
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Jaw Exercises in the Treatment of Temporomandibular Disorders : An International Modified Delphi Study
- 2019
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence Publishing. - 2333-0376 .- 2333-0384. ; 33:4, s. 389-398
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises.Methods: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from “strongly agree” to “strongly disagree.” The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts’ earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement.Results: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality.Conclusion: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.
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| 8. |
- Nilner, Maria, et al.
(författare)
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Short-term Effectiveness of a Prefabricated Occlusal Appliance in Patients with Myofascial Pain
- 2008
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 22:3, s. 209-218
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To compare the short-term effectiveness of a stabilization appliance with a prefabricated occlusal appliance in myofascial pain patients in a randomized controlled trial. Methods: Sixty-five patients at 2 centres were assigned to a stabilization appliance group (S group, n = 33) or a prefabricated appliance (Relax) group (R group, n = 32). The patients had been suffering from temporomandibular disorder (TMD) pain for 3 months to 40 years. The patients were examined for symptoms and signs of temporomandibular disorders according to the Research Diagnostic Criteria for TMD and treated by a general practitioner. Treatment outcomes regarding pain, registered on a visual analogue scale, and overall ratings of pain, registered on a verbal scale, were evaluated at 6- and 10- week follow-up appointments, and the data from the groups were compared statistically, results: The main treatment outcome in the 2 groups was a positive improvement of overall symptoms without any statistically significant differences between groups at either 6 or 10 weeks. At the 6-week follow-up, 72% of ala patients reported a 30% reduction of the worst pain, and 55% of the patients reported a 50% reduction of the worst pain, whereas at the 10-week follow-up, the percentages were 69% and 61%, respectively. According to the verbal scale, 85% of all patients reported themselves to be “better,” “much better,” or “symptom-free” at the 6-week follow-up, and 83% reported this at the 10-week follow-up. Conclusion: The effectiveness of the prefabricated occlusal appliance seemed to be the same as that of the stabilization appliance. The prefabricated appliance can therefore be recommended as a short-term therapy in adult patients with myofascial pain.
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