| 1. |
- Kanai, M, et al.
(författare)
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- 2023
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swepub:Mat__t
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| 2. |
- Schael, S., et al.
(författare)
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Electroweak measurements in electron positron collisions at W-boson-pair energies at LEP
- 2013
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Ingår i: Physics Reports. - : Elsevier BV. - 0370-1573 .- 1873-6270. ; 532:4, s. 119-244
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Forskningsöversikt (refereegranskat)abstract
- Electroweak measurements performed with data taken at the electron positron collider LEP at CERN from 1995 to 2000 are reported. The combined data set considered in this report corresponds to a total luminosity of about 3 fb(-1) collected by the four LEP experiments ALEPH, DELPHI, 13 and OPAL, at centre-of-mass energies ranging from 130 GeV to 209 GeV. Combining the published results of the four LEP experiments, the measurements include total and differential cross-sections in photon-pair, fermion-pair and four-fermion production, the latter resulting from both double-resonant WW and ZZ production as well as singly resonant production. Total and differential cross-sections are measured precisely, providing a stringent test of the Standard Model at centre-of-mass energies never explored before in electron positron collisions. Final-state interaction effects in four-fermion production, such as those arising from colour reconnection and Bose Einstein correlations between the two W decay systems arising in WW production, are searched for and upper limits on the strength of possible effects are obtained. The data are used to determine fundamental properties of the W boson and the electroweak theory. Among others, the mass and width of the W boson, m(w) and Gamma(w), the branching fraction of W decays to hadrons, B(W -> had), and the trilinear gauge-boson self-couplings g(1)(Z), K-gamma and lambda(gamma), are determined to be: m(w) = 80.376 +/- 0.033 GeV Gamma(w) = 2.195 +/- 0.083 GeV B(W -> had) = 67.41 +/- 0.27% g(1)(Z) = 0.984(-0.020)(+0.018) K-gamma - 0.982 +/- 0.042 lambda(gamma) = 0.022 +/- 0.019. (C) 2013 Elsevier B.V. All rights reserved.
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| 3. |
- Benjamin, Daniel J., et al.
(författare)
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Redefine statistical significance
- 2018
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Ingår i: Nature Human Behaviour. - : Nature Research (part of Springer Nature). - 2397-3374. ; 2:1, s. 6-10
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Berlin, Henrik, et al.
(författare)
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Effects and cost-effectiveness of postoperative oral analgesics for additional postoperative pain relief in children and adolescents undergoing dental treatment: Health technology assessment including a systematic review
- 2019
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 14:12
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Forskningsöversikt (refereegranskat)abstract
- Background There is an uncertainty regarding how to optimally prevent and/or reduce pain after dental treatment on children and adolescents. Aim To conduct a systematic review (SR) and health technology assessment (HTA) of oral analgesics administered after dental treatment to prevent postoperative pain in children and adolescents aged 3-19 years. Design A PICO-protocol was constructed and registered in PROSPERO (CRD42017075589). Searches were conducted in PubMed, Cochrane, Scopus, Cinahl, and EMBASE, November 2018. The researchers (reading in pairs) assessed identified studies independently, according to the defined inclusion and exclusion criteria, following the PRISMA-statement. Results 3,963 scientific papers were identified, whereof 216 read in full text. None met the inclusion criteria, leading to an empty SR. Ethical issues were identified related to the recognized knowledge gap in terms of challenges to conduct studies that are well-designed from methodological as well as ethical perspectives. Conclusions There is no scientific support for the use or rejection of oral analgesics administered after dental treatment in order to prevent or reduce postoperative pain in children and adolescents. Thus, no guidelines can be formulated on this issue based solely on scientific evidence. Well-designed studies on how to prevent pain from developing after dental treatment in children and adolescents is urgently needed.
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| 5. |
- Berlin, Henrik, et al.
(författare)
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Postoperative pain profile in 10-15-year-olds after bilateral extraction of maxillary premolars
- 2019
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Ingår i: European Archives of Paediatric Dentistry. - : Springer. - 1818-6300 .- 1996-9805. ; 20:6, s. 545-555
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study pain perception in 10-15-year-olds, during and after uncomplicated extractions of bilateral maxillary premolars. The study investigated pain's natural course and made comparisons between the first and second extractions. METHODS: 31 Swedish children in need of orthodontic treatment were identified and consecutively enrolled. Tooth extractions followed a standardised protocol and the two teeth were extracted with at least 10 days between. The participants rated pain intensity using visual analogue scale (VAS) at 14 different time points from treatment and 7 days forward. RESULTS: The pain intensity profile followed the same pattern for all patients. Pain intensity peaked 2 h after extractions (mean VASPI 27.3, SD 20.8; median 23.0) when moderate pain intensity (VASPI >/= 40) was registered for 16 (28%) of 57 cases. After that, there was a rapid decrease in pain intensity notable already at 4 h after extractions. There were no statistically significant differences in any VASPI measurements between the first and second extractions, sexes, or different age groups. CONCLUSIONS: The majority of the participants who undergo uncomplicated bilateral extraction of maxillary premolars experience mild to moderate levels of postoperative pain during a short period of time, with no differences between the first and second extractions. Bilateral tooth extractions is a suitable model for further studies on pain management.
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| 6. |
- Häggman Henrikson, Birgitta, et al.
(författare)
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Pharmacological treatment of oro-facial pain : health technology assessment including a systematic review with network meta-analysis
- 2017
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Ingår i: Journal of Oral Rehabilitation. - Hoboken : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 44:10, s. 800-826
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Forskningsöversikt (refereegranskat)abstract
- This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients >= 18 years with chronic (>= 3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [ temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.
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| 7. |
- Pillai, Rajath S, et al.
(författare)
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Assessment of Somatosensory and Psychosocial Function of Patients With Trigeminal Nerve Damage
- 2020
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Ingår i: Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 1536-5409 .- 0749-8047. ; 36:5, s. 321-335
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The present study assessed somatosensory changes related to trigeminal nerve damage using extensive evaluation tools and assessed the effect of such damage on the patients' psychosocial status and quality of life compared with healthy participants.METHODS: In 37 patients with intraorally or extraorally presenting trigeminal nerve damage diagnosed as painful or nonpainful posttraumatic trigeminal neuropathy, psychophysical tests like quantitative sensory testing (QST) and qualitative sensory testing and the electrophysiological "nociceptive-specific" blink reflex were performed. The patients and 20 healthy participants completed a set of questionnaires assessing their psychosocial status and quality of life.RESULTS: A loss or gain of somatosensory function was seen in at least 1 QST parameter in >88.9% of the patients. Patients in whom extraoral QST was performed showed an overall loss of somatosensory function, whereas intraoral QST showed a general gain of somatosensory function. Qualitative sensory testing identified a side-to-side difference in the tactile and pinprick stimulation in >77% of the patients. An abnormal "nociceptive-specific" blink reflex response was seen in 42.1% to 71.4% of patients dependent on the trigeminal branch stimulated, though comparisons with healthy reference values showed ambiguous results. Compared with the healthy participants, patients showed higher scores for pain catastrophizing, symptoms of depression and anxiety, limited jaw function, more somatic symptoms, and significantly impaired oral health-related quality of life (all P<0.038).DISCUSSION: The results from the present study showed presence of varied somatosensory abnormalities when assessed using psychophysical and electrophysiological investigations and a significantly impaired psychosocial status.
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| 8. |
- Sjögren, Jakob Jonsson, et al.
(författare)
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Characteristics and impact of pain from root-filled teeth : A practice-based cross-sectional study comparing painful teeth with and without signs of inflammatory dental disease
- 2024
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Ingår i: Journal of Oral and Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 38:1, s. 64-76
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Tidskriftsartikel (refereegranskat)abstract
- To compare pain characteristics, impact of pain and characteristics of patients with painful root-filled teeth with and without signs of inflammatory dental disease. This cross-sectional study was performed in the Public Dental Health services, Region orebro County, Sweden. Adult patients with >= 1 root-filled tooth identified at their regular check -up were included and assigned to one of two groups; those with >= 1 sign of inflammatory dental disease (DD+) and those without any such sign (DD-). Patients/teeth were compared regarding pain characteristics (intensity, frequency, duration, quality and provoking factors), impact of pain (medication intake, impact on life) and patient characteristics as background factors (general health, other bodily and orofacial pain). Statistics included descriptive data (frequency tables) and group comparisons (Chi-square, Fisher's Exact and Mann-Whitney U-tests). The DD+ group included 27 participants (30 teeth) and the DD- group 22 participants (23 teeth). On average, pain intensity was mild, the frequency most often recurrent, and the impact was low. Average pain duration since onset exceeded 2 years in both groups. The only observed between-group differences were average pain intensity; 3.1 (0-10 Numerical Rating Scale (NRS)) in DD- group compared to 1.6 for DD+ (p = 0.030), and tenderness to apical palpation; only reported in the DD+ group. The similarities in clinical presentation between the two groups underscore the difficulties in correctly distinguishing between pain of odontogenic and non-odontogenic origin in root-filled teeth with a standard clinical investigation. Additional diagnostic methods need to be investigated for their ability to differentiate between tooth pain or discomfort of different origins.
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| 9. |
- Abramowicz, H., et al.
(författare)
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Conceptual design report for the LUXE experiment
- 2021
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Ingår i: European Physical Journal-Special Topics. - : Springer Science and Business Media LLC. - 1951-6355 .- 1951-6401. ; 230:11, s. 2445-2560
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Tidskriftsartikel (refereegranskat)abstract
- This Conceptual Design Report describes LUXE (Laser Und XFEL Experiment), an experimental campaign that aims to combine the high-quality and high-energy electron beam of the European XFEL with a powerful laser to explore the uncharted terrain of quantum electrodynamics characterised by both high energy and high intensity. We will reach this hitherto inaccessible regime of quantum physics by analysing high-energy electron-photon and photon-photon interactions in the extreme environment provided by an intense laser focus. The physics background and its relevance are presented in the science case which in turn leads to, and justifies, the ensuing plan for all aspects of the experiment: Our choice of experimental parameters allows (i) field strengths to be probed where the coupling to charges becomes non-perturbative and (ii) a precision to be achieved that permits a detailed comparison of the measured data with calculations. In addition, the high photon flux predicted will enable a sensitive search for new physics beyond the Standard Model. The initial phase of the experiment will employ an existing 40 TW laser, whereas the second phase will utilise an upgraded laser power of 350 TW. All expectations regarding the performance of the experimental set-up as well as the expected physics results are based on detailed numerical simulations throughout.
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| 10. |
- Adèrn, Bengt, et al.
(författare)
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Orsaker till remisser till bettfysiolog : en jämförelse mellan fyra specialistkliniker
- 2003
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Ingår i: Tandläkartidningen. - 0039-6982. ; 95:10, s. 50-55
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Specialistinstanser i bettfysiologi möter i huvudsak patienter som har en långvarig och svårt smärtproblematik. Under 1900-talet har dock även behandling av obstruktiv sömnapné tillkommit. Ofta är det en läkare som remitterat patienten till den bettfysiologiska kliniken. Denna studie visar att bettfysiologen är en viktig länk mellan tandvården och sjukvården vid utredning och behandling av orofacial smärta. Syf-tet med studien var att jämföra orsakerna till remisser till bettfysiologi. En jämförelse gjordes mellan fyra specialistkliniker i bettfysiologi un-der en 4-månadersperiod år 2001. De flesta remitterade patienter var kvinnor i åldern 20 år och uppåt. Bland de remitterade kvinnorna var smärta den dominerande orsaken medan männen lika ofta remittera-des för sömnstörning som för smärta. 86 procent av patienterna som remitterats för smärta värderade smärtans intensitet som måttlig till väldigt svår. Hos 80 procent av dessa patienter var smärtan långvarig.
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| 11. |
- Al-Harthy, Mohammad, et al.
(författare)
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Cross-cultural Comparison of Pressure Pain Threshold and Pain Tolerance Levels in TMD Cases and Controls : A Preliminary Report
- 2010
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Ingår i: Abstracts of the 13th World Congress of Pain. - : IASP (International Association for the Study of Pain and Omnipress).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim was to assess the influence of culture on pain expression, pressure pain thresholds (PPTs), and pain tolerance levels (PTLs) in temporomandibular disorders (TMD) pain cases and pain-free matched controls in three cultures. Methods: This was a case-controlled study on 150 (50 Saudi Arabians, 50 Italians and 50 Swedes) cases of chronic TMD pain compared with 148 age- and gender-matched pain-free controls (50 Saudi Arabians, 50 Italians, and 48 Swedes). The cases and controls completed pain questionnaires and underwent clinical examinations per the Research Diagnostic Criteria for TMD (RDC/TMD) for classification status. PPT and PTL were measured on all participants with a pressure algometer (Somedic®) at a pressure increase rate of 30 kPa/s using a 1.0-cm diameter probe. Three body sites on the right side were investigated: the temporalis, masseter, and thenar muscles. The average of three measurements made at 1-min intervals was calculated for PPT and PTL. A one-way ANOVA compared mean values. Results: Mean characteristic pain severity among TMD cases was 54±(25) for the Saudi Arabian; 56±(20) for the Swedish; and 62.5±(21) for the Italian cases. Between-culture differences were non-significant. PPTs at the temporalis and masseter muscles in the TMD cases were highest in the Saudi Arabians compared to the Swedes and Italians (P<0.001). No between-culture differences among the TMD cases were found in the thenar muscle. Among controls, higher PPTs in the masseter muscle were found in Swedes and Saudi Arabians compared with Italians (P<0.001), while Swedes reported the highest PPT for the thenar compared with Saudi Arabians and Italians (P<0.001). No between-culture differences were observed at the temporalis muscle. PTLs at the masseter muscle in the TMD cases were similar for the Saudi Arabians and Swedes but significantly lower for the Italians (P<0.001). Thenar PTLs were significantly higher in the Swedes compared to the Italians (P<0.001). No significant between-culture differences among the TMD cases were found in the temporalis muscle. Among controls, similar PTLs were observed in the Swedes and Saudi Arabians for the temporalis and masseter muscles, while the Italians had significantly lower PTLs than these groups at the masseter muscles (P<0.01) and lower than the Swedes at the temporalis (P<0.001). A significantly higher thenar PTL was found among Swedes compared to Saudi Arabians and Italians (P<0.001). Cross-modality PPT based on clinical pain for TMD cases revealed significant differences between Saudi Arabians and both Swedes and Italians in the temporalis and masseter muscles (P<0.001). No significant differences were found in the thenar muscle. Conclusions: Preliminary data suggest that Saudis and Swedes are more similar in PPT and PTL than Italians are to either group, indicating that cultural factors may influence pain perception.
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| 12. |
- Al-Harthy, Mohammad, et al.
(författare)
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Cross-cultural differences in types and beliefs about treatment in women with temporomandibular disorder pain
- 2018
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 45:9, s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesWomen with temporomandibular disorder (TMD) pain from three cultures were assessed for type of treatment received and core illness beliefs. MethodsIn a clinical setting, 122 women patients with chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) were evaluated for patient characteristics, type of practitioner, type of treatment received and beliefs about TMD prior to consultation in TMD specialist centres. Measures included a survey of treatments received and a belief scale regarding contributing, aggravating and treatment-relevant factors related to the pain. All questionnaires were translated from English and culturally adapted. Comparisons among cultural groups were performed using a linear regression model for continuous variables and logistic regression model for dichotomous variables. A P-value
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| 13. |
- Al-Harthy, Mohammad, et al.
(författare)
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Influence of culture on pain comorbidity in women with and without temporomandibular disorder-pain
- 2017
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 44:6, s. 415-425
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Tidskriftsartikel (refereegranskat)abstract
- Evidence on cultural differences in prevalence and impact of common chronic pain conditions, comparing individuals with temporomandibular disorders (TMD) versus individuals without TMD, is limited. The aim was to assess cross-cultural comorbid pain conditions in women with chronic TMD pain. Consecutive women patients (n = 122) with the index condition of chronic TMD pain diagnosed per the research diagnostic criteria for TMD and TMD-free controls (n = 121) matched for age were recruited in Saudi Arabia, Italy and Sweden. Self-report questionnaires assessed back, chest, stomach and head pain for prevalence, pain intensity and interference with daily activities. Logistic regression was used for binary variables, and ancova was used for parametric data analysis, adjusting for age and education. Back pain was the only comorbid condition with a different prevalence across cultures; Swedes reported a lower prevalence compared to Saudis (P < 001). Saudis reported higher prevalence of work reduced >50% due to back pain compared to Italians or Swedes (P < 001). Headache was the most common comorbid condition in all three cultures. The total number of comorbid conditions did not differ cross-culturally but were reported more by TMD-pain cases than TMD-free controls (P < 001). For both back and head pain, higher average pain intensities (P < 001) and interference with daily activities (P < 001) were reported by TMD-pain cases, compared to TMD-free controls. Among TMD-pain cases, Italians reported the highest pain-related disability (P < 001). Culture influences the associated comorbidity of common pain conditions. The cultural influence on pain expression is reflected in different patterns of physical representation.
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| 14. |
- Al-Harthy, Mohammad, et al.
(författare)
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The effect of culture on pain sensitivity
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:2, s. 81-88
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Tidskriftsartikel (refereegranskat)abstract
- Cross-cultural differences in pain sensitivity have been identified in pain-free subjects as well as in chronic pain patients. The aim was to assess the impact of culture on psychophysical measures using mechanical and electrical stimuli in patients with temporomandibular disorder (TMD) pain and pain-free matched controls in three cultures. This case-control study compared 122 female cases of chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) with equal numbers of age- and gender-matched TMD-free controls. Pressure pain threshold (PPT) and tolerance (PPTo) were measured over one hand and two masticatory muscles. Electrical perception threshold and electrical pain threshold (EPT) and tolerance (EPTo) were recorded between the thumb and index fingers. Italian females reported significantly lower PPT in the masseter muscle than other cultures (P < 0001) and in the temporalis muscle than Saudis (P = 0003). Swedes reported significantly higher PPT in the thenar muscle than other cultures (P = 0017). Italians reported significantly lower PPTo in all muscles than Swedes (P 0006) and in the masseter muscle than Saudis (P < 0001). Italians reported significantly lower EPTo than other cultures (P = 001). Temporomandibular disorder cases, compared to TMD-free controls, reported lower PPT and PPTo in all the three muscles (P < 0001). This study found cultural differences between groups in the PPT, PPTo and EPTo. Overall, Italian females reported the highest sensitivity to both mechanical and electrical stimulation, while Swedes reported the lowest sensitivity. Mechanical pain thresholds differed more across cultures than did electrical pain thresholds. Cultural factors may influence response to type of pain test.
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| 15. |
- Alkhateeb, Noor, et al.
(författare)
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Patient-perceived features and clinical characteristics of tooth pain : A comparison between apical periodontitis and persistent dento-alveolar pain disorder (PDAP) – preliminary results
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Differential diagnosis between tooth pain of inflammatory and neuropathic origin is crucial since treatment strategies differ. Aim: Evaluate and compare self-reported and clinically observed pain characteristics in patients with SAP (symptomatic apical periodontitis) and PDAP (persistent dento-alveolar pain disorder). Methodology: Patients diagnosed with SAP and PDAP were recruited from Malmö University and Folktandvården Östergötland. Data collection included clinical examination and questionnaire (tooth pain characteristics, verbal pain description [short-form McGill Pain Questionnaire; SF-MPQ], factors affecting the pain). Results: Data from 24 patients with SAP and 20 with PDAP (24 females, mean age 53 years) were analyzed. Average pain intensity was 4.4 (0–10 numeric rating scale) and average duration 1527 days. 64% reported continuous and 27% recurrent pain. 58% of teeth were tender to percussion and 66% to apical palpation. 27% reported concurrent pain from jaw muscles/joints. Significant differences were found for gender (% females; PDAP>SAP;p=0.013), pain duration (PDAP>SAP;p<0.0001), pain frequency (PDAP>SAP;p<0.001), percussion tenderness (SAP>PDAP;p=0.012), muscle/joint pain (PDAP>SAP;p=0.021). SF-MPQ and affecting factors did not differ (p=0.096–1.000). Conclusion: Preliminary results indicate that pain intensity, pain description and factors affecting the pain are similar for SAP and PDAP. Female gender, long pain duration, high pain frequency, and concurrent muscle/joint pain presented more frequently in PDAP.
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| 16. |
- Alsafi, Z, et al.
(författare)
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Achieved competences in temporomandibular disorders/orofacial pain : a comparison between two dental schools in Europe
- 2015
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Ingår i: European journal of dental education. - : John Wiley & Sons. - 1396-5883 .- 1600-0579. ; 19:3, s. 161-168
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The aim was to study achieved competences in temporomandibular disorders (TMD)/orofacial pain (OP) at two universities by comparing student's knowledge and understanding, satisfaction with their education and confidence in their clinical competences of TMD/OP. METHODS: The study was conducted in collaboration between Malmö University, Sweden-which uses problem-based learning-and the University of Naples Federico II, Italy-which uses traditional educational methods. Final-semester dental students responded to a self-report questionnaire regarding their knowledge and understanding, interpretation of cases histories, clinical experience, satisfaction and confidence in clinical examination, management and treatment evaluation. RESULTS: No significant difference was found between the students regarding knowledge and understanding. Eighty-seven per cent of the Malmö students and 96% of the Naples students met the criterion on achieved competence. Malmö students had a higher per cent of correct diagnoses than Naples students in the interpretation of case histories. Overall, Malmö students reported most clinical experience and higher confidence than Naple students. CONCLUSIONS: The main findings were that students from Malmö and Naples were, similar in knowledge and understanding of TMD/OP and in satisfaction with their clinical competences. However, Malmö students perceived more confidence in clinical management of patients with TMD/OP. This may reflect that, besides the theoretical part of the programme, a sufficient level of clinical exposure to patients with TMD/OP is essential to gain competences in TMD/OP
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| 17. |
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| 18. |
- Anderson, GC, et al.
(författare)
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TMD Pain, Physical, and Emotional Functioning Related to Headache Frequency
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Temporormandibular disorders (TMD) and tension-type headaches (TTHA) share many signs and symptom and several studies have demonstrated an overlap between these conditions. Objectives: This study investigated the relationship of headache frequency with patient-reported TMD pain intensity, physical functioning, and emotional functioning in subjects with TTHA attributed to TMD. Methods: The RDC/TMD Validation Project, as a subset of 633 TMD cases, identified 153 subjects with concurrent TMD pain diagnoses (RDC/TMD myofascial pain or TMJ arthralgia) and TTHA (International Classification of Headache Disorders-II / ICHD-II) presenting in the temporal region. These subjects also demonstrated pain similar to their headache on provocation by palpation of the temporalis muscle. The headache diagnoses were sub-divided into infrequent episodic, frequent episodic, and chronic TTHA according to the ICHD-II. Outcomes of the study were self-report measures of jaw pain intensity (average pain intensity), physical functioning (Jaw Function Limitation Scale/JFLS, Ohrbach et al, 2008; Graded Chronic Pain Scale/GCPS, von Korff et al, 1992; Short Form -12/SF-12, Ware et al, 1996) and emotional functioning (depression, somatization, anxiety as measured by the Symptom Checklist-90/SCL-90). Differences in outcomes among the three headache subgroups were investigated using ANOVA. Results: Pain intensity in the temple and jaw regions was significantly associated with increased frequency of headache (p<0.01). Physical functioning as assessed with the JFLS (p<0.05) and the GCPS (p<0.01) were also significantly associated with headache frequency. Emotional functioning as assessed with the SCL-90 in terms of depression, somatization, and anxiety were all associated with frequency of headache (p<0.05). In general, the more frequent a subject's TTHA the more severe the levels of outcome. Conclusion: TMD pain intensity, physical functioning, and emotional functioning were associated with the frequency of TMD-related tension-type headache.
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| 19. |
- Baad-Hansen, Lene, et al.
(författare)
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Blink reflexes in patients with atypical odontalgia
- 2005
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 19:3, s. 223-247
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To examine the blink reflex (BR) evoked by stimulation of the trigeminal (V) nerve branches, to examine the painful V branch before and during a pain provocation test, and to compare the painful and the contra lateral non-painful branch in patients with atypical odon-talgia (AO). Methods: In thirteen patients with AO, the BR was elicited with the use of a concentric electrode and recorded bilaterally with surface EMG electrodes on both orbicularis oculi muscles. Electrical stimuli were applied to the skin above the V1, V2 and V3 nerve branches and to the V branch contralateral to the painful branch. The sensory and pain thresholds were determined. The BR examination of the painful V branch was repeated during a capsaicin pain provocation test. The data were analysed with use of non-parametric statistics. Results: The BR responses evoked by stimulation of the V3 were significantly lower than the BR responses evoked by stimulation of the V1 and V2 (P < 0.004). There were no differences in BR between the painful and non-painful side (P > 0.569), and the BR was not significantly modulated by experimental pain (P > 0.080). The sensory thresholds were significantly lower on the painful side compared to the non-painful side (P = 0.017). The pain thresholds were not different between sides (P > 0.910). Conclusion: These preliminary findings did not indicate major differences in the V nociceptive pathways between sides in AO patients. Future studies comparing the BR in AO patients with healthy volunteers are needed to provide further knowledge on the pain mechanisms in AO.
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| 20. |
- Baad-Hansen, Lene, et al.
(författare)
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Chair-side intraoral somatosensory examination in patients with atypical odontalgia and healthy subjects
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Chair-side intraoral somatosensory examination in patients with atypical odontalgia and healthy subjects L Baad-Hansen, M Pigg, S Elmasry Ivanovic, H Faris, T List, M Drangsholt, P Svensson Aim of investigation: In patients with persistent orofacial pain, assessment of somatosensory function is recommended. A chair-side qualitative examination with good reliability revealing signs of hyper-/hyposensitivity to touch, cold and painful pinprick stimulation may be performed. The aim of this multicenter study was to compare three qualitative measures of intraoral somatosensory function between patients with atypical odontalgia (AO) and healthy subjects. Methods: 31 AO patients (6 male, 25 female; mean age: 54±13) and 47 healthy age- and sex-matched controls (15 male, 32 female: mean age: 47±12) were recruited from Malmö University (Sweden), University of Washington (USA) and Aarhus University (Denmark). In AO patients, sensitivity to touch, cold, and pinprick stimuli was evaluated on the buccal gingiva adjacent to the painful site and the corresponding contralateral ‘mirror-image’ gingival site. In healthy subjects, tests were performed bilaterally on the buccal gingiva adjacent to the first maxillary premolars. Patients were asked to report hyper-, hypo-, or normo-sensitivity/- algesia to touch, cold and painful stimuli on the painful site compared with the contralateral site; healthy subjects were asked to compare sensitivity between sides. Χ2-tests were used to analyze differences in frequency of hyper-, hyposensitivity or normosensitivity between groups. Results: The frequency of subjectively reported normosensitivity to all stimulus modalities were significantly lower in patients (23-58%) than in healthy subjects (68-91%), P<0.001. Frequency of hypersensitivity to all modalities were significantly higher in patients (29-61%) than in controls (9-17%), P<0.015, whereas reports of hyposensitivity were similar between groups (2-16%), P>0.054. Conclusion: A quick and simple chair-side evaluation of intraoral somatosensory function can detect intraoral sensory disturbances in AO patients, mainly in the form of hyper-sensitivity. These tests may be useful in the initial screening of patients with persistent orofacial pain.
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| 21. |
- Baad-Hansen, Lene, et al.
(författare)
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Chairside intraoral qualitative somatosensory testing : reliability and comparison between patients with atypical odontalgia and healthy controls
- 2013
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:2, s. 165-170
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To assess intraoral inter- and intraexaminer reliability of three qualitative measures of intraoral somatosensory function and to compare these measures between patients with atypical odontalgia (AO) and healthy controls. METHODS: Thirty-one AO patients and 47 healthy controls participated. Inter- and intraexaminer reliability was tested on a subgroup of 46 subjects (25 AO; 21 healthy). Sensitivity to touch, cold, and pinprick stimuli was evaluated on the painful gingival site and the corresponding contralateral site in AO patients, and bilaterally on the gingiva of the first maxillary premolars in controls. Patients were asked to report hypersensitivity, hyposensitivity, or normal sensitivity to stimuli on the painful site compared with the nonpainful site. Kappa values were calculated, and chi-square and Fisher's exact tests were used to compare frequencies between groups. RESULTS: Kappa values ranged between 0.63 and 0.75. The frequency of hypersensitivity to either modality was significantly higher in patients (29% to 61%) than in controls (9% to 17%) (P < .015), whereas reports of hyposensitivity were similar between groups (2% to 16%) (P > .057). Only 3.2% of the AO patients had no reports of abnormal sensitivity on any of the tests, compared with 59.6% of the healthy subjects (P < .001). CONCLUSION: Intraoral qualitative somatosensory testing can detect intraoral sensory disturbances in AO patients, and the reliability is sufficient for initial screening of orofacial somatosensory function.
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| 22. |
- Baad-Hansen, Lene, et al.
(författare)
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Comparison of clinical findings and psychosocial factors in patients with atypical odontalgia and temporomandibular disorders
- 2008
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Ingår i: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To systematically compare clinical findings and psychosocial factors between patients suffering from atypical odontalgia (AO) and an age- and gender-matched group of patients with temporomandibular disorders (TMD).Methods: Forty-six AO patients (7 men and 39 women, mean age, 56 years) were compared with 41 TMD patients (8 men and 33 women, mean age, 58 years). Results: Mean pain intensity at the time of inclusion in the study was similar between the groups (TMD: 5.3 ± 0.4, AO: 5.0 ± 0.3), but pain duration was longer in AO patients (AO: 7.7 ± 1.1 years, TMD: 4.5 ± 0.1 years). Eighty-three percent of the AO patients and 15% of TMD patients reported pain onset in relation to dental/surgical procedures. Episodic tension-type headache (TTH) occurred equally in both groups (TMD: 46%, AO: 46%), but TMD patients more frequently experienced chronic TTH (TMD: 35%, AO: 18%), myofascial TMD (TMD: 93%, AO: 50%), and temporomandibular joint disorders (TMD: 66%, AO: 2%). Overall, TMD patients had lower pressure pain thresholds and poorer jaw function than AO patients. Mean depression and somatization scores were moderate to severe in both groups, and widespread pain was most common in TMD patients.Conclusion: AO and TMD share some characteristics but differ significantly in report of dental trauma, jaw function, pain duration, and pain site.
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| 23. |
- Baad-Hansen, Lene, et al.
(författare)
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Differential changes in gingival somatosensory sensitivity after painful electrical tooth stimulation
- 2015
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Ingår i: Experimental Brain Research. - : Springer. - 0014-4819 .- 1432-1106. ; 233:4, s. 1109-1118
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to evaluate the effect of painful tooth stimulation on gingival somatosensory sensitivity of healthy volunteers in a randomized, controlled design. Thirteen healthy volunteers (six women, seven men; 28.4 ± 5.0 years) were included for two experimental sessions of electrical tooth stimulation: painful tooth stimulation and tooth stimulation below the sensory threshold (control). Eight of the human subjects participated in a third session without tooth stimulation. In all sessions, the somatosensory sensitivity of the gingiva adjacent to the stimulated tooth was evaluated with a standardized battery of quantitative sensory tests (QST) before, immediately after and 30 min after tooth stimulation. Painful tooth stimulation evoked significant decreases in warmth and heat pain thresholds (P < 0.001) as well as pressure pain thresholds (increased sensitivity) (P = 0.024) and increases in mechanical detection thresholds (decreased sensitivity) (P < 0.050). Similar thermal threshold changes (P < 0.019) but no mechanical changes were found after tooth stimulation below the sensory threshold (P > 0.086). No QST changes were detected in the session without tooth stimulation (P > 0.060). In conclusion, modest increased gingival sensitivity to warmth, painful heat and pressure stimuli as well as desensitization to non-painful mechanical stimulation were demonstrated after tooth stimulation. This suggests involvement of competing heterotopic facilitatory and inhibitory mechanisms. Furthermore, stimulation below the sensory threshold induced similar thermal sensitization suggesting the possibility of activation of axon-reflex-like mechanisms even at intensities below the perception threshold. These findings may have implications for interpretation of somatosensory results in patients with chronic intraoral pain.
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| 24. |
- Baad-Hansen, Lene, et al.
(författare)
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Increased Pain Sensitivity to Intraoral Capsaicin in Patients with Atypical Odontalgia
- 2006
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 20:2, s. 107-114
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To use 2 well-characterized stimuli, the intraoral capsaicin model and the "nociceptive-specific" electrode, to compare superficial nociceptive function between patients with atypical odontalgia (AO) and matched healthy controls. Furthermore, the authors aimed to describe the sensitivity, specificity, and positive predictive values (PPV) of the techniques if group differences could be established. METHODS: Thirty-eight patients with AO and 27 matched healthy controls participated in this study. Thirty microliters of 5% capsaicin was applied to the gingiva on the left and right sides of all participants as a pain-provocation test. The participants scored the capsaicin-evoked pain continuously on a 0-to-10 visual analog scale (VAS). Furthermore, individual electrical sensory and pain thresholds to stimulation with a "nociceptive-specific" electrode on the facial skin above the infraorbital or mental nerve were determined. RESULTS: AO patients had higher VAS pain scores for capsaicin application than healthy controls (ANOVA: F > 4.88; P < .029). No differences between the painful sides and the nonpainful sides of the patients were found (ANOVA: F < 1.26; P > .262). No main effects of group or stimulation side on the electrical sensory and pain thresholds were detected (ANOVA: F < 0.309; P > .579). Sensitivity was 0.51; specificity, 0.81; and PPV, 0.77 when a VAS value of > or = 8 for capsaicin-evoked pain was used. CONCLUSION: AO patients show increased sensitivity to intraoral capsaicin but normal sensitivity to "nociceptive-specific" electrical stimulation of the face in an area proximal to the painful site. The use of the intraoral pain-provocation test with capsaicin as a possible adjunct to the diagnostic workup is hampered by the only moderately good sensitivity and specificity.
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| 25. |
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| 26. |
- Baad-Hansen, Lene, et al.
(författare)
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Intraoral somatosensory abnormalities in patients with atypical odontalgia : a controlled multicenter quantitative sensory testing study
- 2013
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Ingår i: Pain. - : Elsevier. - 0304-3959 .- 1872-6623. ; 154:8, s. 1287-1294
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Tidskriftsartikel (refereegranskat)abstract
- Intraoral somatosensory sensitivity in patients with atypical odontalgia (AO) has not been investigated systematically according to the most recent guidelines. The aims of this study were to examine intraoral somatosensory disturbances in AO patients using healthy subjects as reference, and to evaluate the percent agreement between intraoral quantitative sensory testing (QST) and qualitative sensory testing (QualST). Forty-seven AO patients and 69 healthy control subjects were included at Universities of Washington, Malmö, and Aarhus. In AO patients, intraoral somatosensory testing was performed on the painful site, the corresponding contralateral site, and at thenar. In healthy subjects, intraoral somatosensory testing was performed bilaterally on the upper premolar gingiva and at thenar. Thirteen QST and 3 QualST parameters were evaluated at each site, z-scores were computed for AO patients based on the healthy reference material, and LossGain scores were created. Compared with control subjects, 87.3% of AO patients had QST abnormalities. The most frequent somatosensory abnormalities in AO patients were somatosensory gain with regard to painful mechanical and cold stimuli and somatosensory loss with regard to cold detection and mechanical detection. The most frequent LossGain code was L0G2 (no somatosensory loss with gain of mechanical somatosensory function) (31.9% of AO patients). Percent agreement between corresponding QST and QualST measures of thermal and mechanical sensitivity ranged between 55.6% and 70.4% in AO patients and between 71.1% and 92.1% in control subjects. In conclusion, intraoral somatosensory abnormalities were commonly detected in AO patients, and agreement between quantitative and qualitative sensory testing was good to excellent.
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| 27. |
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| 28. |
- Baad-Hansen, Lene, et al.
(författare)
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Reliability of intra-oral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls : a multicentre study
- 2015
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 42:2, s. 127-135
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Tidskriftsartikel (refereegranskat)abstract
- The reliability of comprehensive intra-oral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic oro-facial pain. The aim of the present multicentre study was to examine test-retest and interexaminer reliability of intra-oral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Forty-five patients with AO and 68 healthy controls were subjected to bilateral intra-oral gingival QST and unilateral extratrigeminal QST (thenar) on three occasions (twice on 1 day by two different examiners and once approximately 1 week later by one of the examiners). Intra-class correlation coefficients and kappa values for interexaminer and test-retest reliability were computed. Most of the standardised intra-oral QST measures showed fair to excellent interexaminer (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between patients with AO and the healthy reference group. These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intra-oral QST is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region.
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| 29. |
- Baad-Hansen, Lene, et al.
(författare)
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Reliability of intraoral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls : a multicenter study
- 2014
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Reliability of intraoral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls – a multicenter study The reliability of a comprehensive intraoral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic orofacial pain. Also, the reliability of QST z-scores has not been reported. Aim of Investigation: The aim of the present multi-center study was to examine test-retest and inter-examiner reliability of intraoral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Methods: Fourty-five AO patients and 68 healthy controls were subjected to bilateral intraoral gingival QST and unilateral extraoral QST (thenar) on three occasions (twice on one day by two different examiners and once approximately one week later by one of the examiners). Interclass correlation coefficients and kappa values for inter-examiner and test-retest reliability were computed. Results: Most of the standardized intraoral QST measures (absolute values and z-scores) showed fair to excellent inter-examiner (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between AO patients and the healthy reference group. Conclusions: These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intraoral QST (absolute values as well as z-scores) is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region.
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| 30. |
- Baad-Hansen, Lene, et al.
(författare)
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Somatosensory sensitivity in patients with persistent idiopathic orofacial pain is associated with pain relief from hypnosis and relaxation
- 2013
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Ingår i: The Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 0749-8047 .- 1536-5409. ; 29:6, s. 518-526
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In a recent study hypnosis has been found to relieve persistent idiopathic orofacial pain. Quantitative sensory testing (QST) is widely used to evaluate somatosensory sensitivity, which has been suggested as a possible predictor of management outcome. The objectives of this study were to examine: (1) possible associations between clinical pain relief and baseline somatosensory sensitivity and (2) the effect of hypnosis management on QST parameters. METHODS: Forty-one patients with persistent idiopathic orofacial pain completed this randomized controlled study in 1 of 2 groups: hypnosis (hypnotic analgesia suggestions) or control (relaxation). QST at 2 intraoral (pain region and contralateral mirror image region) and 3 extraoral (hand and both cheeks) sites was performed at baseline and after the hypnosis/control management, together with pressure pain thresholds and pressure pain tolerance thresholds determined bilaterally at the masseter and temporalis muscles, the temporomandibular joints, and the third finger. RESULTS: Degree of pain relief was negatively correlated with a summary statistic of baseline somatosensory sensitivity (summed z-score), that is, high baseline somatosensory sensitivity was associated with low pain relief (r=-0.372, P=0.020). Hypnosis had no major effect on any QST measure compared with relaxation (P>0.063). CONCLUSIONS: High pain sensitivity at baseline may predict poor pain management outcome. In addition, despite clear clinical pain relief, hypnosis did not significantly or specifically influence somatosensory sensitivity. Future studies should further explore QST measures as possible predictors of different management response in orofacial pain conditions.
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| 31. |
- Bekes, Katrin, et al.
(författare)
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Pediatric patients' reasons for visiting dentists in all WHO regions
- 2021
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Ingår i: Health and Quality of Life Outcomes. - : BioMed Central (BMC). - 1477-7525. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct.METHODS: Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients' oral health problems and prevention needs were computed.FINDINGS: Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories.CONCLUSIONS: The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.
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| 32. |
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| 33. |
- Bergström, Ingalill, et al.
(författare)
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A follow-up study of subjective symptoms of temporomandibular disorders in patients who received acupuncture and/or interocclusal appliance therapy 18-20 years earlier
- 2008
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 66:2, s. 88-92
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the presence of symptoms of temporomandibular disorders (TMDs) in patients referred to a specialist clinic because of muscular problems 18-20 years earlier and who had received mainly acupuncture and/or interocclusal appliance therapy. MATERIAL AND METHODS: Sixty-five subjects who had received therapy at a TMD specialist clinic 18-20 years earlier were mailed a questionnaire with questions about TMD symptoms, their attitude towards the therapy, and their opinion about the outcome. Fifty-five subjects (85%) answered and returned the questionnaire. RESULTS: Before therapy, 87% had had severe TMD symptoms, but this figure decreased to 38% at the long-term follow-up. The mean values of the subjects' complaints at worst and at best before treatment, measured with a visual analog scale, were 66 (range 26-100) and 31 (range 0-100), respectively. The corresponding figures at the long-term follow-up were 32 (range 0-96) and 16 (range 0-70). Headache at least once a week was originally reported by 73% of the women and by 77% of the men. Headache prevalence 18-20 years later was 35% in women and 54% in men. The majority of patients were positive about the therapy they had received, and would recommend it to a friend with similar complaints. CONCLUSIONS: A majority of the patients reported a lasting improvement in their symptoms. Patients' overall opinions of the therapy received were positive.
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| 34. |
- Berlin, Henrik, et al.
(författare)
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Dentists' attitudes towards acute pharmacological pain management in children and adolescents
- 2018
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Ingår i: International Journal of Paediatric Dentistry. - : John Wiley & Sons. - 0960-7439 .- 1365-263X. ; 28:2, s. 152-160
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study aimed to investigate Swedish dentists' attitudes regarding pain management strategies for treating children and adolescents. It assessed recommendations for pre- and postoperative analgesics, and use of local anaesthesia, and whether application of these strategies differs between general dental practitioners (GDPs) and specialists in paediatric dentistry (SPDs). DESIGN: We invited all GDPs (n = 807) in southern Sweden (Region Skåne), and all registered SPDs (n = 122) working in Sweden (929 actively practising dentists under age 65 years) to participate in a postal survey on pain management in paediatric dental care. RESULTS: The SPDs reported using all types of pain-reducing strategies more frequently than GDPs except local anaesthesia when extracting a permanent premolar, which SPDs and GDPs used equally often. Preoperative analgesic use was greater among SPDs than GDPs. GDPs used local anaesthesia less frequently for filling therapy in primary teeth than in permanent teeth. CONCLUSIONS: SPDs recommend preoperative analgesics more often than GDPs do. GDPs seem to underuse local anaesthetics when treating children and adolescents. SPDs also use pain management strategies more frequently than GDPs. Among GDPs, pain management is less frequent when treating primary teeth than permanent teeth.
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| 35. |
- Bondemark, Lars, et al.
(författare)
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Funktionsstörningar och smärta
- 2008
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Ingår i: Tandläkartidningen. - 0039-6982. ; 100:9-10, s. 64-68
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Orofaciala funktionsstörningar och smärta är en sammanfattning av kliniska problem och sjukdomar som involverar bett, käkar, tuggmuskulatur, käkleder och omgivande strukturer. Orsakerna är oftast multifaktoriella för de barn, ungdomar och vuxna som drabbas.
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| 36. |
- Cairns, Brian, et al.
(författare)
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JOR-CORE recommendations on rehabilitation of temporomandibular disorders
- 2010
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 37:6, s. 481-489
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Tidskriftsartikel (refereegranskat)abstract
- In the long history of temporomandibular disorders (TMD), the term ”rehabilitation“ has been often associated with ”occlusal rehabilitation“ indicating a specific philosophy in which occlusion is the crucial factor for TMD and that intervention on the occlusion could ”cure“ the problem. In this paper, the term rehabilitation is used to denote any medical, physical, or psychological treatment which brings or restores an individual to a normal or optimal state of health, and this revised concept therefore significantly broadens the scope of rehabilitation of TMD. The purpose of the JOR-CORE in Siena, 2009 was to critically examine the current state-of-the-science in the field of TMDs. This lead to four extensive reviews and the present summaries and recommendations for future research into rehabilitation of TMDs.
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| 37. |
- Castrillon, Eduardo, et al.
(författare)
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ACIDIC SALINE-INDUCED PAIN AS A MODEL FOR EXPERIMENTAL MASSETER MYALGIA IN HEALTHY SUBJECTS : PRELIMINARY RESULTS
- 2010
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Ingår i: Abstracts of the 13th World Congress of Pain. - : IASP (International Association for the Study of Pain and Omnipress).
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Repeated intramuscular injections of acidic saline in rats are reported to induce a chronic type of muscle sensitization without causing significant tissue damage in this model two repeated injections of acidic saline (pH 4) into the gastrocnemius muscle produce short-lasting pain, but allodynia that lasts for 4 week with pain spread to the contralateral side. This may indicate that central sensitization occurs and this model is thus believed to more accurately mimic chronic myalgia. Our aim was to find out if repeated injection of buffered acidic saline into the masseter muscle causes pain and hyperalgesia and if so this would be a valid experimental model for orofacial myalgia / myofascial TMD in humans. Twenty healthy and pain-free subjects (10 male + 10 female: 25.1 ± 0.9 years) were included. Pain levels were assessed on a 0-10 numerical rating scale (NRS) and pressure pain thresholds (PPTs) were recorded using an electronic pressure algometer. The subjects received a unilateral intramuscular injection (0.5 ml) of acidic saline (pH 3) or placebo (isotonic saline, pH 6) into the masseter muscle (randomized and double-blind). Two days thereafter the injection was repeated with the same substance. Pain was assessed 5 min before the injection and at 5, 15, 30, 45 min, 1, 3, 24 hours after both injections and then at 4 and 7 days after the second injection and PPTs at 5, 15, 30, 45 min, 1 hrs after both injections and at 1, 4 and 7 days after the second injection. The experiment was repeated with the other substance after at least one week. There was no difference between substances in NRS pain scores after the injections. One way ANOVA indicated a time effect but no substance effect on PPTs. These preliminary results do not support acidic saline injections as a valid pain model for experimental masseter myalgia in healthy subjects.
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| 38. |
- Castrillon, Eduardo E, et al.
(författare)
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Acidic saline-induced pain as a model for experimental masseter myalgia in healthy subjects
- 2013
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Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 17:10, s. 1438-1446
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Repeated injection of acidic saline into skeletal muscles of the leg in rodents induces a prolonged bilateral mechanical hyperalgesia that persists for up to 30 days and may be useful to model widespread muscle pain conditions. In this study, repeated injection of acidic (pH 3.3) saline solution into the masseter muscle of healthy human subjects was undertaken to determine if these injections are painful and whether they would induce a prolonged period of muscle sensitization to artificial and/or natural mechanical stimulation of the masseter and temporalis muscles. METHODS: Eighteen subjects (10 male, 8 female) participated in the study. Subjects received two injections of 0.5 mL acidic or regular isotonic saline 2 days apart, in a randomized, double blind, crossover design. RESULTS: There was no significant difference in pain intensity ratings when acidic saline injections were compared with regular saline injections. Pain area drawings were, however, significantly larger in response to the first injection of acidic saline than to the second injection of acidic saline or to either the first or second injection of regular saline. Repeated injection of acidic saline did not significantly alter pressure pain thresholds from the masseter or temporalis muscles on either the injected side or the opposite side over the 10-day post injection monitoring period. There was also no effect of injections on chewing. CONCLUSION: These findings indicate that, unlike in some rodent models, repeated injection of low pH solutions into jaw muscles of humans fails to induce a period of prolonged muscle hyperalgesia.
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| 39. |
- Champenois, Elio G., et al.
(författare)
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Femtosecond Electronic and Hydrogen Structural Dynamics in Ammonia Imaged with Ultrafast Electron Diffraction
- 2023
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Ingår i: Physical Review Letters. - : American Physical Society (APS). - 0031-9007 .- 1079-7114. ; 131:14
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Tidskriftsartikel (refereegranskat)abstract
- Directly imaging structural dynamics involving hydrogen atoms by ultrafast diffraction methods is complicated by their low scattering cross sections. Here we demonstrate that megaelectronvolt ultrafast electron diffraction is sufficiently sensitive to follow hydrogen dynamics in isolated molecules. In a study of the photodissociation of gas phase ammonia, we simultaneously observe signatures of the nuclear and corresponding electronic structure changes resulting from the dissociation dynamics in the time-dependent diffraction. Both assignments are confirmed by ab initio simulations of the photochemical dynamics and the resulting diffraction observable. While the temporal resolution of the experiment is insufficient to resolve the dissociation in time, our results represent an important step towards the observation of proton dynamics in real space and time.
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| 40. |
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| 41. |
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| 42. |
- Dawson, Andreas, et al.
(författare)
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ASSESSMENT OF PROPRIOCEPTIVE ALLODYNIA AFTER TOOTH CLENCHING
- 2010
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Ingår i: Abstracts of the 13th World Congress of Pain. - : IASP (International Association for the Study of Pain and Omnipress).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Eccentric muscle exercise can induce delayed onset muscle soreness (DOMS). It is known that vibratory stimulus is an effective method to stimulate mechanoreceptors and that 80-Hz vibratory stimulus increases pain in an eccentric exercised muscle (Weerakkody et al. 2001). Lund (1994) suggested that bruxism is related to DOMS. This study evaluates the effects of experimental tooth clenching on vibrotactile and pressure sensitivity in healthy females. Methods: Sixteen healthy females (mean age 32 ± 10) participated in this study, which comprised three sessions. In each session participants were randomly assigned to a tooth clenching exercise, with a clenching level of 10%, 20%, or 40% of maximal voluntary clenching (MVC). The first day of each session, patients did six bouts of tooth clenching exercises, each bout lasting 5 minutes during 1 hour. Registrations were made at baseline, after each bout of tooth clenching (short perspective), and after 24 and 48 hours. A Vibrameter®was used to measure the vibration threshold (VT). A fixed vibratory stimulus (100 Hz, 399.99-μm amplitude) was applied for 15 s and the perceived intensity of vibration (PIV) and perceived discomfort (PD) were rated on 0-50-100 scales (0 = no sensation; 50 = pain threshold/discomfort; 100 = worst imaginable pain/worst imaginable discomfort). An electronic algometer was used to measure pressure pain thresholds (PPT). A 0-10 visual analogue scale (VAS) measured pain intensity (VP) and fatigue (VF). All registrations were made on the central and most prominent part of the right masseter muscle. Results: No main effects of contraction level was observed for VT (P=0.184) or PIV (P=0.628), but there were significant time effects (P<0.001; P<0.05) with significant increases in VT at 30, 40, 50 and 60 min (Dunnett: P<0.05) and significant increase in PIV at 40 min compared to baseline (Dunnett: P<0.05). There were no main effects of contraction level (P=0.524) or time (P=0.705) for PD. For PPT there was no effect of contraction (P=0.819) but a significant time effect (P<0.01) with decreases at 50 and 60 min compared to baseline (Dunnett: P<0.05). Main effects of contraction level and time were observed for VP and VF (both P<0.001). VP and VF were significantly increased at 40% MVC, and at 10-60 min and at 24 h follow-up. Conclusions: This study demonstrated that tooth clenching alters VT only in the short term perspective. Tooth clenching at different levels is associated with moderate levels of pain and fatigue and changes in PPT. The effect on PIV and PD was small, thus suggesting that tooth clenching is not directly related to DOMS.
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| 43. |
- Dawson, Andreas, et al.
(författare)
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Assessment of proprioceptive allodynia after tooth clenching exercises
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bruxism is suggested to be a risk factor of temporomandibular disorders and a contributing factor to delayed onset muscle soreness (DOMS). Assessments of proprioceptive allodynia—a phenomenon that occurs in muscles with DOMS—could indicate whether bruxism leads to DOMS. This study evaluated whether experimental tooth clenching leads to DOMS. Sixteen healthy females (mean age 32 ± 10 years) participated in three 60-min sessions with 15-min follow-ups at 24 and 48 h. Participants were randomly assigned tooth clenching exercises with clenching levels of 10%, 20%, or 40% of maximal voluntary clenching (MVC). A Vibrameter® measured perceived intensity of vibration (PIV) and perceived discomfort (PD), which were assessed on 0–50–100 numeric rating scales. An electronic algometer measured pressure pain thresholds (PPT). A 0–100-mm visual analogue scale measured pain intensity (VASpain) and fatigue (VASfatigue). Measurements were made on the right masseter muscle. Clenching level had no main effect on PIV and time effects (p < 0.05) were only observed at 40 min (Dunnet: p < 0.01). Clenching level and time had no effect on PD. Only time effects were significant for PPT (p < 0.01) with reductions at 50 and 60 min compared to baseline (Dunnett: p’s < 0.05). Clenching level and time had main effects for VASpain and VASfatigue (p < 0.001). We conclude that experimental tooth clenching at various levels is not related to DOMS—since no signs of proprioceptive allodynia were observed—but to a development of moderate levels of pain and fatigue and reduced PPT.
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| 44. |
- Dawson, Andreas, et al.
(författare)
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Assessment of Proprioceptive Allodynia After Tooth-Clenching Exercises
- 2012
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 26:1, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To (A) evaluate test-retest reliability of vibrotactile sensitivity in the masseter muscle and (B) test if (1) the vibration threshold is decreased after experimental tooth clenching, (2) intense vibrations exacerbate pain after tooth clenching, (3) pain and fatigue are increased after tooth clenching, and (4) pressure pain thresholds are decreased after tooth clenching. METHODS: In part A, 25 healthy female volunteers (mean age: 42 ± 12 years) participated, and 16 healthy females (mean age 32 ± 10 years) participated in three 60-minute sessions, each with 24- and 48-hour follow-ups in part B. Participants were randomly assigned tooth-clenching exercises with clenching levels of 10%, 20%, or 40% of maximal voluntary clenching. A Vibrameter applied to the right masseter muscle measured perceived intensity of vibration and perceived discomfort, which were assessed on 0-50-100 numeric rating scales. An electronic algometer measured pressure pain threshold (PPT). Two 0- to 100-mm visual analog scales measured pain intensity (VASpain) and fatigue (VASfatigue). Measurements were made on the right masseter muscle. Interclass correlation coefficient (ICC) was used to calculate test-retest reliability of VT measurements. Outcome variables were tested with two-way ANOVAs for repeated measures and Dunnett's post-hoc test. RESULTS: Moderate long-term (ICC 0.59) and good short-term (ICC 0.92) reliability was found for VT on the masseter muscle. Clenching level had no main effect on perceived intensity of vibration; time effects (P < .05) were only observed at 40 minutes (Dunnett's test: P < .01). Clenching level and time had no effect on perceived discomfort. Only time effects were significant for PPT (P < .01), with reductions at 50 and 60 minutes compared to baseline (Dunnett's test: P < .05). Clenching level and time had main effects for VASpain and VASfatigue (P < .001). Conclusion: Experimental tooth clenching appears to evoke moderate levels of pain and fatigue and short-lasting hyperalgesia to mechanical stimulation, but not proprioceptive allodynia. The absence of proprioceptive allodynia does not necessarily exclude delayed onset muscle soreness (DOMS) but warrants further studies on the clinical manifestations of DOMS in jaw muscles.
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| 45. |
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| 46. |
- Dawson, Andreas, et al.
(författare)
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Comparison of pain thresholds and pain tolerance levels between Middle Easterners and Swedes and between genders
- 2009
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 36:4, s. 271-278
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study evaluates the presence of culture and gender differences in pain thresholds and pain tolerance levels between Middle Easterners and Swedes. METHODS: Sixty-four healthy individuals, 32 Middle Easterners (16 men and 16 women, mean age: 24.6 +/- 3.4 years) and 32 Swedes (16 men and 16 women, mean age: 24 +/- 3.5 years) participated in the study. Three experimental pain tests were conducted in each participant. Pain thresholds and pain tolerance levels were measured using an algometer (mechanical stimulus), the PainMatcher((R)) (electric stimulus) and cold pressor test (thermal stimulus). RESULTS: While no significant differences in pain thresholds were observed between Middle Easterners and Swedes in algometer and cold pressor tests, differences in pain tolerance levels were significant (P < 0.01 for both tests). All between-culture differences in pain perception, pain threshold and pain tolerance level were non-significant when measured with the PainMatcher. Significant between-gender differences were observed only in pain threshold with the PainMatcher (P < 0.05) and in pain tolerance level with the algometer (P < 0.01) and the PainMatcher (P <0.001). CONCLUSION: This study found significant differences in two out of three pain tolerance level tests - but not pain threshold tests - between the Middle Eastern and Swedish cultures and between genders. These differences were more pronounced between Middle Eastern and Swedish men than between Middle Eastern and Swedish women. Gender differences were more pronounced within the Swedish than the Middle Eastern culture. These findings indicate that culture and gender influence pain experience.
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| 47. |
- Dawson, Andreas, et al.
(författare)
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Development of a quality-assessment tool for experimental bruxism studies : reliability and validity
- 2013
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:2, s. 111-122
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To combine empirical evidence and expert opinion in a formal consensus method in order to develop a quality-assessment tool for experimental bruxism studies in systematic reviews. METHODS: Tool development comprised five steps: (1) preliminary decisions, (2) item generation, (3) face-validity assessment, (4) reliability and discriminitive validity assessment, and (5) instrument refinement. The kappa value and phi-coefficient were calculated to assess inter-observer reliability and discriminative ability, respectively. RESULTS: Following preliminary decisions and a literature review, a list of 52 items to be considered for inclusion in the tool was compiled. Eleven experts were invited to join a Delphi panel and 10 accepted. Four Delphi rounds reduced the preliminary tool-Quality-Assessment Tool for Experimental Bruxism Studies (Qu-ATEBS)- to 8 items: study aim, study sample, control condition or group, study design, experimental bruxism task, statistics, interpretation of results, and conflict of interest statement. Consensus among the Delphi panelists yielded good face validity. Inter-observer reliability was acceptable (k = 0.77). Discriminative validity was excellent (phi coefficient 1.0; P < .01). During refinement, 1 item (no. 8) was removed. CONCLUSION: Qu-ATEBS, the seven-item evidence-based quality assessment tool developed here for use in systematic reviews of experimental bruxism studies, exhibits face validity, excellent discriminative validity, and acceptable inter-observer reliability. Development of quality assessment tools for many other topics in the orofacial pain literature is needed and may follow the described procedure.
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| 48. |
- Dawson, Andreas, et al.
(författare)
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Dopamine in plasma : a biomarker for myofascial TMD pain?
- 2016
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Ingår i: Journal of Headache and Pain. - : Springer. - 1129-2369 .- 1129-2377. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dopaminergic pathways could be involved in the pathophysiology of myofascial temporomandibular disorders (M-TMD). This study investigated plasma levels of dopamine and serotonin (5-HT) in patients with M-TMD and in healthy subjects. METHODS: Fifteen patients with M-TMD and 15 age- and sex-matched healthy subjects participated. The patients had received an M-TMD diagnosis according to the Research Diagnostic Criteria for TMD. Perceived mental stress, pain intensity (0-100-mm visual analogue scale), and pressure pain thresholds (PPT, kPa) over the masseter muscles were assessed; a venous blood sample was taken. RESULTS: Dopamine in plasma differed significantly between patients with M-TMD (4.98 ± 2.55 nM) and healthy controls (2.73 ± 1.24 nM; P < 0.01). No significant difference in plasma 5-HT was observed between the groups (P = 0.75). Patients reported significantly higher pain intensities (P < 0.001) and had lower PPTs (P < 0.01) compared with the healthy controls. Importantly, dopamine in plasma correlated significantly with present pain intensity (r = 0.53, n = 14, P < 0.05) and perceived mental stress (r = 0.34, n = 28, P < 0.05). CONCLUSIONS: The results suggest that peripheral dopamine might be involved in modulating peripheral pain. This finding, in addition to reports in other studies, suggests that dopaminergic pathways could be implicated in the pathophysiology of M-TMD but also in other chronic pain conditions. More research is warranted to elucidate the role of peripheral dopamine in the pathophysiology of chronic pain.
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| 49. |
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| 50. |
- Dawson, Andreas, et al.
(författare)
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Effect of experimental tooth clenching on the release of β-endorphin
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 28:2, s. 159-164
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To investigate the association between experimental tooth clenching and the release of β-endorphin in patients with myofascial temporomandibular disorders (M-TMD) and healthy subjects. METHODS: Fifteen M-TMD patients and 15 healthy subjects were included and assigned an experimental tooth-clenching task. Venous blood was collected and pain intensity was noted on a visual analog scale. The masseter pressure pain threshold (PPT) was assessed 2 hours before the clenching task and immediately after. A mixed-model analysis of variance was used for statistical analyses. RESULTS: Significant main effects for time and group were observed for pain intensity and PPT, with significantly lower mean values of pain intensity (P < .001) and PPT (P < .01) after the clenching task compared with baseline. M-TMD patients had significantly higher pain intensity (P < .001) and significantly lower PPT (P < .05) than healthy subjects. No significant time or group effects were observed for the level of β-endorphin. Neither pain intensity nor PPT correlated significantly with β-endorphin levels. CONCLUSION: This experimental tooth-clenching task was not associated with significant alterations in β-endorphin levels over time, but with mechanical hyperalgesia and low to moderate levels of pain in healthy subjects and M-TMD patients, respectively. More research is required to understand the role of the β-endorphinergic system in the etiology of M-TMD
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