| 1. |
- Rizell, Sara, 1963, et al.
(author)
-
45,X/46,XX karyotype mitigates the aberrant craniofacial morphology in Turner syndrome
- 2013
-
In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 35:4, s. 467-474
-
Journal article (peer-reviewed)abstract
- The aim of this project was to study the impact on craniofacial morphology from Turner syndrome (TS) karyotype, number of intact X chromosomal p-arms, and age as well as to compare craniofacial morphology in TS with healthy females. Lateral radiographs from 108 females with TS, ranging from 5.4 to 61.6 years, were analysed. The TS females were divided into four karyotype groups: 1. monosomy (45,X), 2. mosaic (45,X/46,XX), 3. isochromosome, and 4. other, as well as according to the number of intact X chromosomal p-arms. The karyotype was found to have an impact on craniofacial growth, where the mosaic group, with presence of 46,XX cell lines, seems to exhibit less mandibular retrognathism as well as fewer statistically significant differences compared to the reference group than the 45,X karyotype. Isochromosomes had more significant differences versus the reference group than 45,X/46,XX but fewer than 45,X. To our knowledge, this is the first time the 45,X/46,XX and isochromosome karyotypes are divided into separate groups studying craniofacial morphology. Impact from p-arm was found on both maxillary and mandibular length. Compared to healthy females, TS expressed a shorter posterior and flattened cranial base, retrognathic, short and posteriorly rotated maxilla and mandible, increased height of ramus, and relatively shorter posterior facial height. The impact of age was found mainly on mandibular morphology since mandibular retrognathism and length were more discrepant in older TS females than younger.
|
|
| 2. |
- Rizell, Sara, 1963, et al.
(author)
-
Palatal height and dental arch dimensions in Turner syndrome karyotypes
- 2013
-
In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 35:6, s. 841-847
-
Journal article (peer-reviewed)abstract
- The aim of this project was to study the impact from Turner syndrome (TS) karyotype and age on dental arch morphology and palatal height and to compare the variables in TS with reference data from non-TS females with normal occlusion. Plaster casts from 76 females with TS (6-50 years) were analysed with respect to dentoalveolar arch dimensions and palatal height. The TS females were divided into the karyotype categories: i) 45, X ii) 45, X/46, XX iii) isochromosome, and iv) other. The 45, X/46, XX karyotype exhibited fewer statistically significant variables differing from the reference group compared with other karyotypes. TS females showed increased dentoalveolar depths, decreased maxillary but increased mandibular width, decreased posterior segments, and decreased mandibular circumference compared with the reference group. In opposition to previous reports, the palatal height did not differ compared with non-TS females. Age had an impact on nine of the variables. We conclude that the present dental arch deviations are reflecting the high frequency of malocclusions reported in TS and the subsequent need for orthodontic treatment, which might possibly be lower in the 45, X/46, XX karyotype. The palatal height did not differ from the reference group, but instead the narrow maxilla might contribute to an illusion of a higher palate. We therefore suggest using the nomination 'narrow palatal vault' instead of the commonly used term 'high palatal vault'.
|
|
| 3. |
- Kjellberg, H., et al.
(author)
-
Apical root resorptions in girls with Turner syndrome: a controlled longitudinal study
- 2022
-
In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210.
-
Journal article (peer-reviewed)abstract
- Objectives To study, longitudinally, the development of apical root resorptions (ARRs) in Turner syndrome (TS) and to correlate these to the karyotype and orthodontic treatment. Materials and methods Thirty girls with TS participated in the study, mean age 10.8 years (6.6-23.4) at the first registration (T1), and 14.3 years (9.2-25.2) at the second registration (T2). Forty girls without TS, orthodontically untreated, served as controls. ARR was diagnosed in panoramic radiographs, and root/crown ratios of the lower permanent first molar were measured at T1 and T2 with a mean follow-up period of 42 (11-89) months. Results During the follow-up period, ARR was seen in 40% of all TS patients and in 2.5% in the control group. The majority displayed ARR on the distal root of the mandibular first permanent molars (30%). ARR at T2 was seen in 56% of 45,X and isochromosome karyotype and 21% of every other TS karyotype patients. AAR was seen in 5 out of 12 TS patients with orthodontic treatment. No statistically significant differences in root/crown ratios between T1 and T2 were found. Limitations The number of patients studied is limited, thus possible differences might be disguised for this reason. Spatial projection errors in panoramic radiograph recordings might have influenced measurement, resulting in an underestimation of ARR. Conclusions There is a higher risk for ARR in girls with TS and probably the risk is therefore probably also higher during orthodontic treatment. Thus, if treated, frequent radiographic follow-ups should be taken during the treatment. Protocol The protocol was not published before trial commencement.
|
|
| 4. |
- Örtegren, Sara, et al.
(author)
-
A qualitative study on self-image, mental well-being and fertility among female young adult childhood cancer survivors.
- 2023
-
In: Reproductive, Female and Child Health. - : Wiley. - 2768-7228. ; 2:2, s. 103-111
-
Journal article (peer-reviewed)abstract
- Introduction Young female adult childhood cancer survivors have frequently been reported to be concerned about their health, in particular their future fertility. The aim of this study was to examine how self-image, mental health and perceptions of the fertility of young female adults are affected by the illness. Methods A qualitative study with interviewer-administered semistructured questions was performed from May 2018 to October 2020 at Sahlgrenska University Hospital, Sweden. Fourteen women participated in the study. The median age of the participants was 27 (25–31) years. Results The interviews were recorded and analysed inductively by a thematic approach. Forty-one codes were created, of these 21 initial codes were found to be related to the aim of the present study. Subsequently, four broad themes were created and these were reanalysed and constituted three main themes, resulting in the labelling: ‘An experience for better and worse’, ‘An everyday life similar and yet different from peers’ and ‘An uncertain fertility’, and a relevant number (11) of inclusive subthemes. Participants expressed that the experience of surviving childhood cancer both strengthened and impaired their everyday life and implied the lack of information about fertility. Conclusions Although a long time, over 10 years, had passed since the cancer treatment for all participants, the experiences of the illness were still present in their lives, both for better and worse. Healthcare workers need to keep this complexity in mind when facing young childhood cancer survivors. Thus, there is a need for individualized support regarding fertility and mental health.
|
|
| 5. |
- Rizell, Sara, 1963, et al.
(author)
-
Altered inorganic composition of dental enamel and dentin in primary teeth from girls with Turner syndrome.
- 2010
-
In: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 118:2, s. 183-90
-
Journal article (peer-reviewed)abstract
- In Turner syndrome (TS) one X-chromosome is missing or defective. The amelogenin gene, located on the X-chromosome, plays a key role during the formation of dental enamel. The aim of this study was to find support for the hypothesis that impaired expression of the X-chromosome influences mineral incorporation during amelogenesis and, indirectly, during dentinogenesis. Primary tooth enamel and dentin from girls with TS were analysed and compared with the enamel and dentin of primary teeth from healthy girls. Qualitative and quantitative changes in the composition of TS enamel were found, in addition to morphological differences. Higher frequencies of subsurface lesions and rod-free zones were seen in TS enamel using polarized light microscopy. Similarly, scanning electron microscopy showed that the enamel rods from TS teeth were of atypical sizes and directions. Using X-ray microanalysis, high levels of calcium and phosphorus, and low levels of carbon, were found in both TS enamel and dentin. Using microradiography, a lower degree of mineralization was found in TS enamel. Rule induction analysis was performed to identify characteristic element patterns for TS. Low values of carbon were the most critical attributes for the outcome TS. The conclusion was that impaired expression of the X-chromosome has an impact on dental hard tissue formation.
|
|
| 6. |
- Rizell, Sara, 1963, et al.
(author)
-
Functional appliance treatment outcome and need for additional orthodontic treatment with fixed appliance.
- 2006
-
In: Swedish dental journal. - 0347-9994. ; 30:2, s. 61-8
-
Journal article (peer-reviewed)abstract
- The objectives of this study were to investigate (1) the results of treatment with functional appliances in mixed dentition run by general practitioners, (2) factors associated with a final treatment result of overjet of > or = 5 mm and (3) the need of additional treatment with fixed appliances. The study was designed as a retrospective, cross sectional survey and conducted in one of the Public Dental Clinics and the Orthodontic Clinic in Lidk?ping, Sweden. 122 patients (aged 7.6 -13.2 years) with an overjet of > or = 7 mm and consecutively collected for treatment with functional appliance therapy. Patient files were analysed with regard to gender, age, initial class II severity, type of functional appliance, co-operation, overall growth, number of missed appointments and treatment time. The treatment results were studied and correlated with the above-mentioned variables. The need for additional treatment with fixed appliances was evaluated. A final overjet of < or = 5 mm was observed in 61.5% of the patients, 48.4% interrupted treatment prematurely and 33.6% received additional treatment with fixed appliances. Good co-operation and extended treatment time was found to be correlated with a final overjet of < or = 5 mm. Other factors not associated with treatment outcome were age, gender, overjet, overbite, molar relation, type of functional appliance, overall growth and number of missed appointments. Activator treatment was successful in reducing overjet to 5 mm or less in almost two thirds of the treated patients. Mainly because of poor functional appliance treatment results or relapse, one third of the patients were retreated with fixed appliance. Since good co-operation is one of the main factors for successful treatment outcome, evaluation of the motivational level of both the parents and the patient before treatment start is crucial.
|
|
| 7. |
- Rizell, Sara, 1963, et al.
(author)
-
Turner syndrome isochromosome karyotype correlates with decreased dental crown width
- 2012
-
In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 34:2, s. 213-218
-
Journal article (peer-reviewed)abstract
- The aim of this project was to study possible influences of Turner syndrome (TS) karyotype and the number of X chromosomes with intact short arm (p-arm) on dental crown width. Primary and permanent mesio-distal crown width was measured on plaster casts from 112 TS females. The influence on crown width of four karyotypes: 1. monosomy (45,X), 2. mosaic (45,X/46,XX), 3. isochromosome, and 4. other, and the number of intact X chromosomal p-arms were investigated. In comparisons between karyotypes, statistically significant differences were found for isochromosome karyotype maxillary second premolars, canines, laterals, mandibular first premolars, and canines, indicating that this karyotype was the most divergent as shown by the most reduced crown width. When each karyotype group were compared versus controls, all teeth in the isochromosome group were significantly smaller than controls (P < 0.01-0.001). The 45,X/46,XX karyotype expressed fewer and smaller differences from controls, while 45,X individuals seemed to display an intermediate tooth width compared with 45,X/46,XX and isochromosomes. No significant difference in crown width was found comparing the groups with one or two intact X chromosomal p-arms. Both primary and permanent teeth proved to have a significantly smaller crown width in the entire group of TS females compared to healthy females. We conclude that the isochromosome group deviates most from other karyotypes and controls, exhibiting the smallest dental crown width, while individuals with 45,X/46,XX mosaicism seemed to have a less affected crown width. An influence of the number of intact p-arms on crown width could not be demonstrated in this study.
|
|
| 8. |
- Nilsson, Sofia, et al.
(author)
-
EXPERIENCES OF COMMUNICATION AND INFORMATION FROM HEALTH CARE STAFF REGARDING REPRODUCTIVE HEALTH: A QUALITATIVE STUDY OF FEMALE CHILDHOOD CANCER SURVIVORS IN SWEDEN
- 2024
-
In: Journal of Cancer Rehabilitation. - 2704-6494. ; 7, s. 53-56
-
Journal article (peer-reviewed)abstract
- Background With increasing number of childhood cancer survivors, there is a growing population of adult survivors that reach reproductive age. Long-term side effects of cancer treatment can include damage to the reproductive organs and lead to premature ovarian failure. The purpose of the study was to examine female childhood cancer survivors’, participating in long-term follow-up, experiences of communication and information regarding fertility and reproductive health outcomes. We also aimed to investigate how they experienced the transition from pediatric to adult health services. Methods Participants for the study were all part of a longitudinal project, identified through the Long-Term Follow-Up Clinic at the Oncology Department at Sahlgrenska University Hospital, Sweden. Fifty-four female childhood cancer survivors treated with chemotherapy and/or radiotherapy before 18 years of age were included between 2016 and 2018. During the years 20182022, twenty-five of the participants reached the age of 25 and were invited to conduct a semi-structured interview. Twenty-two agreed to participate. The interview includes questions about fertility, collaboration with healthcare and communication regarding reproductive options when diagnosed with cancer. Interview data was analysed inductively using a thematic analysis. Results The analysis of the data resulted in three main themes; (1) Communication challenges, (2) Information about potential infertility and (3) Follow-up – a broader perspective, with a total of 9 subthemes. Many of the women expressed lack of information regarding reproductive health and a disappointment in their follow-up. Conclusion It is evident that the young women have felt a lack of information regarding fertility, reproductive health outcomes and options after their cancer treatment. The results of our study also indicate that transition from pediatric health care to adult health care needs to be facilitated and supported.
|
|
| 9. |
|
|
