| 1. |
- Norlin, Maria, et al.
(författare)
-
Drug-mediated gene regulation of vitamin D3 metabolism in primary human dermal fibroblasts
- 2017
-
Ingår i: Basic & Clinical Pharmacology & Toxicology. - : Wiley. - 1742-7835 .- 1742-7843. ; 120:1, s. 59-63
-
Tidskriftsartikel (refereegranskat)abstract
- Vitamin D metabolism was studied in primary human dermal fibroblasts with focus on drug-mediated gene regulation related to adverse side effects of antiretroviral drugs used in HIV therapy. The fibroblasts expressed mRNA for cytochrome P450 (CYP) enzymes catalysing bioactivating (CYP2R1, CYP27A1 and CYP27B1) and catabolic reactions (CYP24A1). The cells produced both 25-hydroxyvitamin D3 and 1a,25-dihydroxyvitamin D3. The results demonstrate that primary dermal fibroblasts have an active vitamin D3 metabolising system. High incidence of low bone mineral density is a concern for HIV-infected patients treated with antiretroviral drugs. Osteomalacia and severe vitamin D deficiency have been reported. We investigated whether drug-mediated gene regulation could be a possible mechanism behind these adverse drug effects. Fibroblasts were treated with different drugs used in HIV therapy and the 1a,25-dihydroxyvitamin D3 levels and relative mRNA-levels for crucial enzymes were determined. Efavirenz, stavudine and ritonavir significantly downregulated the bioactivating CYP2R1 and upregulated the catabolic CYP24A1. The drugs reduced bioactivating enzyme activities and cellular levels of 1a,25-dihydroxyvitamin D3. The current results indicate that effects on gene expression may lead to disturbed vitamin D-metabolism and decreased cellular levels of active vitamin D3. The data are consistent with the impaired bone health in patients treated with certain antiretroviral drugs.
|
|
| 2. |
- Alkhateeb, Noor, et al.
(författare)
-
Patient-perceived features and clinical characteristics of tooth pain : A comparison between apical periodontitis and persistent dento-alveolar pain disorder (PDAP) – preliminary results
- 2017
-
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.
|
|
| 3. |
- Alstergren, Per, et al.
(författare)
-
Clinical diagnosis of temporomandibular joint arthritis
- 2018
-
Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 45:4, s. 269-281
-
Tidskriftsartikel (refereegranskat)abstract
- Evidence-based clinical diagnostic criteria for temporomandibular joint (TMJ) arthritis are not available. To establish (i) criteria for clinical diagnosis of TMJ arthritis and (ii) clinical variables useful to determine inflammatory activity in TMJ arthritis using synovial fluid levels of inflammatory mediators as the reference standard. A calibrated examiner assessed TMJ pain, function, noise and occlusal changes in 219 TMJs (141 patients, 15 healthy individuals). TMJ synovial fluid samples were obtained with a push-pull technique using the hydroxycobalamin method and analysed for TNF, TNFsRII, IL-1, IL-1ra, IL-1sRII, IL-6 and serotonin. If any inflammatory mediator concentration exceeded normal, the TMJ was considered as arthritic. In the patient group, 71% of the joints were arthritic. Of those, 93% were painful. About 66% of the non-arthritic TMJs were painful to some degree. Intensity of TMJ resting pain and TMJ maximum opening pain, number of jaw movements causing TMJ pain and laterotrusive movement to the contralateral side significantly explained presence of arthritis (AUC 0.72, P<.001). Based on these findings, criteria for possible, probable and definite TMJ arthritis were determined. Arthritic TMJs with high inflammatory activity showed higher pain intensity on maximum mouth opening (P<.001) and higher number of painful mandibular movements (P=.004) than TMJs with low inflammatory activity. The combination TMJ pain on maximum mouth opening and Contralateral laterotrusion <8mm appears to have diagnostic value for TMJ arthritis. Among arthritic TMJs, higher TMJ pain intensity on maximum mouth opening and number of mandibular movements causing TMJ pain indicates higher inflammatory activity.
|
|
| 4. |
- Baad-Hansen, Lene, et al.
(författare)
-
Reliability of intra-oral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls : a multicentre study
- 2015
-
Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 42:2, s. 127-135
-
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.
|
|
| 5. |
|
|
| 6. |
- Gudmundsson, Sanna, et al.
(författare)
-
Revertant mosaicism repairs skin lesions in a patient with keratitis-ichthyosis-deafness syndrome by second-site mutations in connexin 26
- 2017
-
Ingår i: Human Molecular Genetics. - : OXFORD UNIV PRESS. - 0964-6906 .- 1460-2083. ; 26:6, s. 1070-1077
-
Tidskriftsartikel (refereegranskat)abstract
- Revertant mosaicism(RM) is a naturally occurring phenomenon where the pathogenic effect of a germline mutation is corrected by a second somatic event. Development of healthy-looking skin due to RM has been observed in patients with various inherited skin disorders, but not in connexin-related disease. We aimed to clarify the underlying molecular mechanisms of suspected RM in the skin of a patient with keratitis-ichthyosis-deafness (KID) syndrome. The patient was diagnosed with KID syndrome due to characteristic skin lesions, hearing deficiency and keratitis. Investigation of GJB2 encoding connexin (Cx) 26 revealed heterozygosity for the recurrent de novo germline mutation, c. 148G>A, p. Asp50Asn. At age 20, the patient developed spots of healthy-looking skin that grew in size and number within widespread erythrokeratodermic lesions. Ultradeep sequencing of two healthy-looking skin biopsies identified five somatic nonsynonymous mutations, independently present in cis with the p. Asp50Asn mutation. Functional studies of Cx26 in HeLa cells revealed co-expression of Cx26-Asp50Asn and wild-type Cx26 in gap junction channel plaques. However, Cx26-Asp50Asn with the second-site mutations identified in the patient displayed no formation of gap junction channel plaques. We argue that the second-site mutations independently inhibit Cx26-Asp50Asn expression in gap junction channels, reverting the dominant negative effect of the p. Asp50Asn mutation. To our knowledge, this is the first time RM has been reported to result in the development of healthy-looking skin in a patient with KID syndrome.
|
|
| 7. |
|
|
| 8. |
- Mikkilä, Hanna, et al.
(författare)
-
A comparison of two different methods to measure pressure pain thresholds : An experimental study
- 2017
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Assessment of somatosensory function is recommended in orofacial pain investigations. Quantitative Sensory Testing (QST) is a comprehensive method in which pressure pain threshold (PPT) measurement is included. PPT is usually obtained with a conventional Algometer Type II. A new computer-controlled and potentially more user-friendly algometer, the SENSEBox, could replace the conventional device provided that threshold values and other properties are similar between devices. Aim: Compare two algometers regarding absolute PPT, variability, time, and test-retest-reliability. Materials and methods: PPT was measured with both devices on thenar, masseter muscle and gingiva (upper premolar region) in twenty healthy adults. For each anatomic site and device, the mean value of three registrations was calculated. Paired t-test and Wilcoxon sign-rank test compared mean PPT, variability and time duration. Intraclass Correlation Coefficient (ICC) analyzed test-retest reliability. Results: The SENSEBox showed overall lower PPTs (p<0.05). No significant differences in variability and time duration were found (p>0.05). Both devices showed very good to excellent test-retest-reliability (ICC 0.75–0.88) for thenar and masseter. On gingiva, Algometer Type II showed poor (ICC 0.38) and SENSEBox good reliability (ICC 0.43). Conclusion: The Algometer Type II and SENSEBox are not readily interchangeable in PPT assessment and QST in orofacial pain investigations.
|
|
| 9. |
- Närhi, Matti, et al.
(författare)
-
Acute dental pain I : pulpal and dentinal pain
- 2016
-
Ingår i: Tandlægebladet. - : Tandlægeforeningen. - 0039-9353. ; 120:2, s. 110-119
-
Forskningsöversikt (refereegranskat)abstract
- Den specialiserede anatomi i pulpa-dentin-organet samt den rige pulpale innervation fra trigeminusnerven forklarer de forskellige typer af smertefølelser i en tand. En kort skarp smerte er typisk for en A-(nerve) fibermedieret smerte, imens en langvarig, bankende smerte indikerer C-(nerve) fiberaktivitet. A-fibre reagerer på termiske eller mekaniske stimuli, såsom kolde drikke eller tandbørstning, imens C-fibre hovedsagelig aktiveres ved inflammatoriske mediatorer. Således vil en dvælende smerte indikere en irreversibel pulpal inflammation. Ved pulpitis vil der opstå strukturelle ændringer i de pulpale nerver, der samtidig frigiver neuropeptider, som udløser et immunrespons: neurogen inflammation. Smertefornemmelser under pulpitis kan variere fra hypersensibilitet overfor termiske stimuli til svære dunkende og uudholdelige smerter. Smerterne kan være meddelte og ofte vanskelige at lokalisere, hvorfor diagnostik af inflammation i pulpa er en klinisk udfordring. En biofilm forstærker hypersensitivitet af eksponerede dentinoverflader, fordi de mikrobielle irritamenter kan nå pulpa gennem åbne dentintubuli, hvorved der fremkaldes inflammation. Fjernelse af biofilm reducerer isninger i tænderne, men supplerende behandling er ofte nødvendigt med det formål at opnå en reduktion af dentinens permeabilitet. Cariesekskavering samt fyldningsterapi er en tilstrækkelig behandling ved en klinisk bedømt reversibel pulpitis, hvorimod endodontisk behandling er nødvendigt, når pulpitis har nået et irreversibelt stadium.
|
|
| 10. |
- Närhi, Matti, et al.
(författare)
-
Akut tandvärk I : Pulpasmärta och dentinsmärta
- 2016
-
Ingår i: Tandläkartidningen. - : Tandläkarförbundet. - 0039-6982. ; 108:1, s. 64-71
-
Forskningsöversikt (refereegranskat)abstract
- Pulpasmärta och dentinsmärta kan orsaka patienten avsevärda besvär, och många faktorer påverkar utvecklingen av smärtan och hur länge den kvarstår. Diagnos och behandling är därför ofta ett problem för tandläkaren. Goda kunskaper om de underliggande strukturerna och smärtmekanismerna är en förutsättning för lyckad smärtbehandling.
|
|
| 11. |
- Olsson, Sara R, et al.
(författare)
-
Demographic factors in the choice of coronal restoration after root canal treatment in the Swedish adult population
- 2017
-
Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 50:S1, s. 33-33
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To compare demographic characteristics between individuals choosing an indirect coronal restoration (crown, inlay/onlay) and individuals receiving other restorations after completion of a root filling. The hypothesis was that there are demographic differences for individuals who chose an indirect and those who chose another coronal restoration after root canal treatment. Methodology: This was a registry study of a cohort consisting of all root filled upper first molars that were reported to the tax-funded Swedish Social Insurance Agency (SSIA) during 2009. The root filled teeth were identified by tooth position 16 and 26, and by specific registry codes applied to root fillings. After registration of the root filling, any subsequent coronal restorations within two years was identified. The study group consisted of individuals registered with a root filling followed by an indirect coronal restoration and the control group was the remaining individuals with a root-filled tooth and a direct coronal restoration or no registration of any coronal restoration. Data on nationality, disposable income, educational level, civil status, age and gender were received from Statistics Sweden or SSIA. Chi-square test, t-test and logistic regression compared groups. P<0.05 was considered statistically significant. Results: 7 806 individuals (21.9%) received an indirect coronal restoration and 27 886 individuals (78.1%) comprised the control group. All demographic variables but gender and nationality differed significantly between groups A significantly larger proportion of individuals in the study group had higher education, higher disposable income, were older and were less likely to be living on their own. Conclusions: The identified demographic differences between individuals having their newly root filled teeth restored with an indirect restoration compared to those receiving other restorations indicate that the tax-funded Swedish dental insurance fails to provide dental care on equal terms for Swedish citizens.
|
|
| 12. |
- Olsson, Sara R, et al.
(författare)
-
Demographic factors in the choice of coronal restoration after root canal treatment in the Swedish adult population
- 2019
-
Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 46:1, s. 58-64
-
Tidskriftsartikel (refereegranskat)abstract
- Background: After root canal treatment, a choice is made between different coronal restorations which in the long run could affect the survival of the tooth. Objective: To compare demographic characteristics between individuals choosing an indirect coronal restoration (crown, inlay/onlay) and individuals choosing other restorations after completion of a root filling. Methods: The cohort consisted of all root-filled upper first molars that were reported to the tax-funded Swedish Social Insurance Agency (SSIA) during 2009. After registration of the root filling, any subsequent coronal restorations within 2 years were identified. The crown group consisted of individuals registered with an indirect coronal restoration and the restoration group was the remaining individuals with a direct coronal restoration or lacking registration. Demographic data (gender, disposable income, age, educational level, civil status and country of birth) were received from Statistics Sweden or the SSIA. Statistical analyses included chi-square test, t test and logistic regression analysis. P < 0.05 was considered statistically significant. Results: An indirect coronal restoration was received by 7806 individuals (21.9%), and 27 886 individuals (78.1%) received a direct restoration. All demographic variables except gender differed significantly between groups. Logistic regression analysis found significant associations for all demographic variables and the registration of an indirect restoration except for country of birth and gender. Conclusions: The identified demographic differences between individuals choosing to restore their newly root-filled teeth with an indirect restoration compared to those receiving other restorations may indicate that the tax-funded Swedish dental insurance fails to provide dental care on equal terms for Swedish citizens.
|
|
| 13. |
|
|
| 14. |
- Pigg, Maria, et al.
(författare)
-
Distinguishing pulpal from periapical pain by pain characteristics : National Dental PBRN
- 2016
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective Root canal treatment (RCT) is often initiated upon pain caused by inflammation of pulpal or periapical tissues. To explore to what extent certain clinical signs and symptoms differ between these two conditions, we compared pain of pulpal and periapical origin with regard to symptoms, clinical signs and diagnostic findings. Methods 62 dentists within the National Dental PBRN (www.NationalDentalPBRN.org) enrolled consecutive patients requiring RCT. Preoperative data were collected from patients (symptoms, pain characteristics) and dentists (examination findings) by questionnaires. Patients with average pain intensity >0 (0–10 numeric rating scale; NRS) for >1 day in the week preceding treatment were eligible. The definition for pain of pulpal origin was tooth pain with bleeding within the pulp chamber in the absence of periapical radiolucency. The definition for pain of periapical origin was tooth pain without bleeding pulp and presence of radiolucency. Pearson's chi-square test and t-test compared groups, and sensitivity and specificity were calculated. Results 370 patients met criteria; 234 (63%) exhibited pulpal pain and 136 (37%) had periapical pain. Patients with pain of pulpal origin more often reported sharp (p=0.004), dull (p=0.039), or shooting pain (p=0.026), provoked pain onset (p=0.002), pain aggravated by cold/hot food or drink (p<0.001) and prolonged response to cold (p<0.001). Patients with pain of periapical origin more often had tenderness to percussion (p<0.001) and biting pressure (p<0.001), as well as swelling (p<0.001). To identify pain of pulpal origin, prolonged response to cold had 71% sensitivity and 92% specificity. To identify pain of periapical origin, tenderness to percussion had 89% sensitivity and 38% specificity and for biting pressure, 81% sensitivity and 42% specificity. Conclusion Clinical characteristics and symptoms clearly differed between conditions. Although no single factor had adequate validity to be used as an indicator of the source of pain, several should be considered for inclusion in future diagnostic algorithms.
|
|
| 15. |
|
|
| 16. |
- Pigg, Maria, et al.
(författare)
-
Neuropatisk orofacial smärta : diagnostik och hantering
- 2015
-
Ingår i: Tandläkartidningen. - : Sveriges tandläkarförbund. - 0039-6982. ; 107:3, s. 56-62
-
Forskningsöversikt (refereegranskat)abstract
- Ofta är det tandläkaren som först träffar patien ten med svårtolkad smärta i det orofaciala om rådet. För att kunna bedöma om patienten kan behandlas framgångsrikt hos tandläkaren eller bör remitteras till annan vårdgivare krävs kän nedom och aktuella kunskaper om en rad mer sällsynta tillstånd, däribland neuropatisk smärta. Målet med denna artikel är att öka tandläka rens möjligheter att känna igen – och därmed att diagnostisera – neuropatiskt betingad smärta och verkställa korrekt hantering av patienten.
|
|
| 17. |
- Pigg, Maria, et al.
(författare)
-
Validity of preoperative clinical findings to identify dental pulp status : A National Dental Practice-Based Research Network Study
- 2016
-
Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 42:6, s. 935-942
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Endodontic diagnostic tests are often used clinically to assess pulp status as a basis for the diagnosis and determination of whether root canal treatment (RCT) is indicated. Response to cold and pain on percussion are 2 common tests, yet their validity in identifying nonvital pulp in regular dental practice has not been reported. METHODS: We assessed the validity of cold and percussion tests to identify nonvital pulp in teeth requiring RCT in a dental practice setting performed by 46 general dentists and 16 endodontists in the National Dental Practice-Based Research Network. The influence of patient-, tooth-, and dentist-related characteristics was investigated. Observed bleeding from the pulp chamber was the clinical reference. Sensitivity (SN), specificity (SP), overall test accuracy (TA), positive (PPV) and negative (NPV) predictive values, and likelihood and diagnostic odds ratios (LR+, LR-, dORs) were calculated for each single test and the combined cold and percussion tests. RESULTS: Seven hundred eight patient teeth were included. Cold test showed high validity to identify a nonvital pulp status (SN = 89%, SP = 80%, TA = 84%, PPV = 81%, NPV = 88%, LR+ = 4.35, LR- = 0.14, dOR = 31.4), whereas pain on percussion had lower validity (SN = 72%, SP = 41%, TA = 56%, PPV = 54%, NPV = 60%, LR+ = 1.22, LR- = 0.69, dOR = 1.78). Combining the 2 tests did not increase validity, whereas preoperative pain, medication intake, patient age and sex, and dentist training level affected test validity significantly. CONCLUSIONS: In regular dental practice, the cold test exhibits higher validity to discriminate between vital and nonvital pulp than the tooth percussion test.
|
|
| 18. |
|
|
| 19. |
- Sjogren, J. J., et al.
(författare)
-
The frequency and characteristics of pain and discomfort associated with root filled teeth: a practice-based study
- 2019
-
Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 52:9, s. 1264-1273
-
Tidskriftsartikel (refereegranskat)abstract
- Aim To (i) investigate the frequency and characteristics of pain and discomfort associated with root filled teeth in adult patients regularly attending the Public Dental Service in orebro County, Sweden; (ii) assess the association between symptoms and clinical and radiographic findings; and (iii) explore the impact of pain and discomfort from root filled teeth on daily life. Methodology Patient records of adult patients (>= 20 years) scheduled for routine check-ups in April 2015 were screened to identify individuals with root filled teeth; all patients with >= 1 root filled tooth were asked to participate. The examination comprised of clinical and radiographic examinations and questionnaires on general health, on pain symptoms from root filled teeth and on the impact of pain on daily activities. In a general estimating equation (GEE), examination findings and patient-related factors were independently analysed in relation to the outcome 'presence of pain'. Results In total, 550 patients with 1256 root filled teeth participated. Fifty-three patients (9.6%) experienced pain or discomfort from 62 (4.9%) root filled teeth. Lower age, percussion tenderness and apical tenderness were significantly associated with pain (P > 0.001 to P = 0.044). The average pain intensity was 2.1 on a (0-10) Numeric Rating Scale, and average duration was 28.4 months. The impact on daily life was low. Conclusions On average, pain associated with root filled teeth was of mild intensity, >2 years of duration and had low impact on daily life. Although the significantly associated clinical findings may indicate apical periodontitis as the most probable explanation in some teeth, the origin of pain from root filled teeth remains partly unexplained.
|
|
| 20. |
- Sjögren, Jakob, et al.
(författare)
-
Pain and discomfort from root-filled teeth : Aspects of prevalence and characteristics
- 2017
-
Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 50:S 1, s. 47-47
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim was to examine the prevalence and characteristics of pain and discomfort from root-filled teeth in an adult Swedish population regularly attending dental care. A further aim was to examine if symptoms could be related to (i) periapical radiographic appearance and (ii) clinical findings.Methodology: This cross-sectional observational study screened all adult patients scheduled for routine check-up in the public dental service, Örebro County, Sweden in April 2015. All (798) individuals with at least one root-filled tooth were asked to participate. The examination included (i) clinical examination, (ii) radiographic examination (intraoral periapical images), (iii) interviewer-assisted questionnaire covering general health and presence and characteristics of pain. Descriptive statistics were performed and Fisher’s exact test analysed correlations.Results: 549 patients with 1256 root-filled teeth participated (292 women, 257 men; mean age 61.1 years, range 20–94). 55 (10.0%) of the patients experienced pain or discomfort from at least one root-filled tooth. On tooth level, 66 (5.3%) of all root-filled teeth were symptomatic. The average pain intensity was 2.2±1.9 on a 0–10 Numeric Rating Scale, and mean pain duration was 32.6 months. The pain was continuous for 21.3%, recurrent for 44.3%, and occasional for 34.4% of the teeth, and the teeth had been painful on average 9.6 of the last 30 days. Apical radiolucency was recorded at 264 (21.6%) of the root-filled teeth. Symptoms were significantly associated with presence of radiolucency (P=0.004), sinus tract (P=0.023), and pocket depth >5mm (P=0.038). Conclusions In the examined population, one in ten adults with a root-filled tooth experienced pain or discomfort associated with this tooth. The pain was generally of low intensity and long lasting. In most cases, the patient experienced recurrent or occasional pain, but one in five with painful teeth had continuous pain.
|
|
| 21. |
- Suzuki, Kayo, et al.
(författare)
-
Assessment of Mechanical Pain Thresholds in the Orofacial Region : A Comparison Between Pinprick Stimulators and Electronic Von Frey Device
- 2016
-
Ingår i: Journal of Oral and Facial Pain and Headache. - : Quintessence. - 2333-0384. ; 30:4, s. 338-345
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: To compare mechanical pain thresholds (MPTs) in the orofacial region assessed with two different approaches: with an electronic von Frey (EvF) device and with custom-made weighted pinprick stimulators. The test-retest reliability, variability of MPTs, and time duration of each test were also compared, as well as the ability of each test to create stimulus-response (S-R) curves. Methods: A total of 16 healthy volunteers participated. The MPT and S-R curve measurements were done with the two different techniques at three sites: on the skin of the right cheek (face), on the buccal gingival mucosa of the right upper premolar region (gingiva), and on the tip of the tongue (tongue). The same protocol was repeated 1 to 2 weeks later to determine test-retest reliability. Results: The MPT measurements with the EvF device were significantly faster (74.4 ± 20.8 seconds) than those with the pinprick stimulators (196.1 ± 33.0 seconds; P < .001). The absolute MPT values obtained with the EvF device were significantly higher than the values obtained with the pinprick stimulators at all test sites (P < .001). MPTs assessed with the EvF device showed higher reliability (intraclass correlation coefficient [ICC] = 0.77–0.94) than MPTs assessed with the pinprick stimulators (ICC = 0.57–0.84; P = .041). The reliability of the S-R curves was excellent for both methods with no significant differences between the methods (P = .403). Conclusion: This study indicates that MPTs tested in the orofacial region with the EvF device were significantly higher than MPTs tested with the pinprick stimulators. However, the EvF device can be used with higher reliability and less time consumption for assessment of MPTs in the orofacial region than the pinprick stimulator technique, and also allows comparable construction of S-R curves.
|
|
| 22. |
- Vase, Lene, et al.
(författare)
-
How May Placebo Mechanisms Influence Orofacial Neuropathic Pain?
- 2019
-
Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 98:8, s. 861-869
-
Forskningsöversikt (refereegranskat)abstract
- The conceptualization of placebo has changed from inactive pills to a detailed understanding of how patients' perception of receiving a treatment influences pain processing and overall treatment outcome. Large placebo effects were recently demonstrated in chronic neuropathic pain, thereby opening the question of whether placebo effects also apply to orofacial neuropathic pain. In this article, we review the new definitions, magnitude, and social, psychological, neurobiologic, and genetic mechanisms of placebo effects in pain, especially neuropathic pain, to illustrate that placebo effects are not simply response bias but psychoneurobiological phenomena that can be measured at many levels of the neuroaxis. We use this knowledge to carefully illustrate how patients' perceptions of the treatment, the relationship with the health care provider, and the expectations and emotions toward a treatment can influence test and treatment outcome and potentially skew the results if they are not taken into consideration. Orofacial neuropathic pain is a new research area, and we review the status on definition, diagnosis, mechanisms, and pharmacologic treatment of neuropathic pain after trigeminal nerve injury, as this condition may be especially influenced by placebo factors. Finally, we have a detailed discussion of how knowledge of placebo mechanisms may help improve the understanding, diagnosis, and treatment of orofacial neuropathic pain, and we illustrate pitfalls and opportunities of applying this knowledge to the test of dental treatments.
|
|
