| 1. |
- Rystedt, Jenny M.L., et al.
(författare)
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Routine intraoperative cholangiography during cholecystectomy is a cost-effective approach when analysing the cost of iatrogenic bile duct injuries
- 2017
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Ingår i: HPB. - : Elsevier BV. - 1365-182X. ; 19:10, s. 881-888
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Tidskriftsartikel (refereegranskat)abstract
- Background: The total cost of bile duct injuries (BDIs) in an unselected national cohort of patients undergoing cholecystectomy are unknown. The aim was to evaluate costs associated with treatment of cholecystectomy-related BDIs and to calculate cost effectiveness of routine vs. on-demand intraoperative cholangiography (IOC). Methods: Data from Swedish patients suffering a BDI during a 5 year period were analysed. Questionnaires to investigate loss-of-production and health status (EQ-5D) were distributed to patients who suffered a BDI during cholecystectomy and who underwent uneventful cholecystectomy (matched control group). Costs per quality-adjusted-life-year (QALY) gained by intraoperative diagnosis were estimated for two strategies: routine versus on-demand IOC during cholecystectomy. Results: Intraoperative diagnosis, immediate intraoperative repair, and minor BDI were all associated with reduced direct treatment costs compared to postoperative diagnosis, delayed repair, and major BDI (all p < 0.001). No difference was noted in loss-of-production for minor versus major BDIs or between different treatment strategies. The cost per QALY gained with routine intraoperative cholangiography (ICER-incremental cost-effectiveness ratio) to achieve intraoperative diagnosis was €50,000. Conclusions: Intraoperative detection and immediate intraoperative repair is the superior strategy with less than half the cost and superior functional patient outcomes than postoperative diagnosis and delayed repair. The cost per QALY gained (ICER) using routine IOC was considered reasonable.
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| 2. |
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| 3. |
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| 4. |
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| 5. |
- Aiyar, Akila, et al.
(författare)
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Assessment of masticatory efficiency based on glucose concentration in orthodontic patients - a methodological study
- 2022
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 49:10, s. 954-960
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Treatment for malocclusion can cause discomfort and pain in the teeth and periodontium, which may impair masticatory efficiency. The glucose concentration method is widely used to assess masticatory efficiency for its convenience in the clinical situation, although its validity has not been shown.OBJECTIVE: The aims were to determine the validity of the glucose concentration method and investigate if this method can be applicable to orthodontic patients with braces.DESIGN: Sixteen healthy individuals (7 men, 9 women, and 26±5 years old) and 16 patients with malocclusions needing orthodontic treatment (5 men, 11 women, and 26±4 years old) participated. Glucose concentration was measured after 5-, 10-, and 15-s mastication of gummy jelly and compared to Hue values obtained from the color-changing gum method (reference method). In addition, all participants were asked to fill out the Oral Health Impact Profile questionnaire (OHIP) to assess differences in perception related to the mouth before and after the placement of braces.RESULTS: = 0.711, P < 0.001) Masticatory efficiency assessed by both methods was significantly lower in orthodontic patients compared to controls (P<0.05), even though it was not affected by bonding (P>0.09). In addition, OHIP scores in physical pain dimension and psychological disability were higher in orthodontic patients than in the control group (P<0.005).CONCLUSION: Measurement of glucose concentration was confirmed as a reliable and convenient method for assessing masticatory efficiency. Furthermore, it appears that this method is applicable to patients with braces whose perception in the oral cavity could change.
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| 6. |
- 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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| 7. |
- 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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| 8. |
- 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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| 9. |
- Al-Khotani, Amal A, et al.
(författare)
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Professional knowledge among Swedish and Saudi healthcare practitioners regarding oro-facial pain in children and adolescents
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Oro-facial pain (OFP) and temporomandibular disorders (TMD) in children and adolescents are a growing problem. To meet patients' healthcare needs, professionals must perform their work intuitively and with quality. Therefore, a high degree of professional knowledge is necessary. To investigate the professional knowledge regarding OFP/TMD in children and adolescents among Swedish and Saudi Arabian dental and medical specialists compared with Swedish OFP specialists. One questionnaire including the four domains Chronic pain and behaviour; Aetiology; Diagnosis and classification; Treatment and prognosis was distributed to 383 potential participants, that is physicians and dentists in Sweden and Saudi Arabia. The Swedish OFP/TMD specialists were used as a reference group. The response rates from Sweden and Saudi Arabia were 49% and 86%, respectively. The degree of agreement was highest in the domain Chronic pain and behaviour, especially for the Swedish groups. Regarding the other three domains, the agreement was modest to poor. In general, Swedish groups showed a higher agreement with Swedish OFP/TMD specialists than Saudi Arabian groups. This study shows that professional knowledge regarding OFP/TMD in children and adolescents is limited among Swedish and Saudi Arabian dental and medical professionals compared to Swedish OFP/TMD specialists. In Swedish groups, the professional knowledge is more accurate than in the corresponding Saudi Arabian. With these results in mind, and the frequent prevalence of OFP/TMD in children and adolescents, one can draw the conclusion that there is a need for modern medical education regarding OFP/TMD among both physicians and dentists, especially in Saudi Arabia.
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| 10. |
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| 11. |
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| 12. |
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| 13. |
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| 14. |
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| 15. |
- Alstergren, Per, et al.
(författare)
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Clinical diagnosis of temporomandibular joint arthritis
- 2018
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 45:4, s. 269-281
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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.
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| 16. |
- Altamash, M., et al.
(författare)
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Periodontal treatment and HbA1c levels in subjects with diabetes mellitus
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:1, s. 31-38
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Tidskriftsartikel (refereegranskat)abstract
- It has earlier been reported that individuals with poorly controlled diabetes have severe periodontal disease (PD) compared to well-controlled diabetes. This longitudinal interventional study compared periodontal treatment outcomes with HbA1c level changes in four groups of diabetic and non-diabetic patients with or without PD, respectively. HbA1c, bleeding on probing (BOP), plaque index and periodontal pocket depth (PPD) 4 < 6 mm and >= 6 mm were recorded at baseline to 3 months after non-surgical treatment and 3-6 months for surgical treatment in subjects with or without T2D, and with or without PD. A total of 129 patients were followed from baseline to 6 months. Diabetics with PD and without PD showed reductions in HbA1c levels with a mean value of 0.3% after 3 months and mean values of 1% and 0.8%, respectively, after 6 months. Diabetics with PD showed higher levels of BOP versus non-diabetics without PD (P < 0.01) and versus diabetics without PD (P < 0.05) at baseline. After 6 months, diabetics with PD showed higher number of PPD 4 < 6 mm versus diabetics without PD (P < 0.01) and non-diabetics with PD (P < 0.01). Diabetics without PD showed higher levels of PPD 4 < 6 mm versus non-diabetics without PD (P < 0.01). Surgical and non-surgical periodontal treatment in all groups improved periodontal inflammatory conditions with a decrease in HbA1c levels in a period of three and 6 months. No change was seen in the number of pockets PPD 4 < 6 mm in diabetic subjects with PD after non-surgical and surgical treatment.
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| 17. |
- Andersson, B, et al.
(författare)
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Preoperative prognostic factors associated with early mortality after upfront pancreatoduodenectomy for Pancreatic Adenocarcinoma
- 2018
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Ingår i: HPB. - : Elsevier BV. - 1365-182X. ; 20:Suppl. 2, s. 320-320
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Konferensbidrag (refereegranskat)abstract
- Introduction: Tumour related factors are well known as risk factors for survival after pancreatoduodenectomy (PD). In a time when the role for neoadjuvant treatment is discussed also in primary resectable patients, the influence of preoperative variables is of interest. The aim was to examine preoperative factors influence on early mortality following PD.Materials: Patients registered in the Swedish National Registry for Pancreatic and Periampullary Cancer that underwent PD from January 2010 until October 2017, with pancreatic ductal adenocarcinoma and a follow-up of at least 12 months, were included. Univariable and multivariable logistic regression analysis was performed to evaluate preoperatively registered predictors of early death (within 12 months).Results: In total 2,183 pancreatoduodenectomies were performed and 988 patients met the study criteria. The mean age was 67.8 years and 48% were female. A majority had weight loss (59%) and preoperative biliary drainage (78%). 241 (24%) died within 12 months. In univariable analysis age>75 years (p=0.011), CRP>10 mg/L (p=0.008), diabetes (p=0.033), respiratory disorders (p=0.001), and ASA-score >2 (p>0.001) were prognostic factors for early death. In multivariable analysis age>75 years (OR1.66, CI 1.16–2.37, p=0.006), CRP>10 mg/L (OR 1.51, CI 1.10–2.07, p=0.001), diabetes (OR 1.42, CI 1.01–1.99, p=0.045), and respiratory disorders (OR 2.40 CI 1.38–4.18, p=0.002) were independent factors.Discussion: From a national database older age, elevated CRP, diabetes, and respiratory disorders were identified as independent preoperative risk factors for early mortality following PD. This findings may be used in an individualised treatment plan.
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| 18. |
- Andersson, Roland, et al.
(författare)
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Acute pancreatitis - from cellular signalling to complicated clinical course.
- 2007
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Ingår i: HPB. - : Elsevier BV. - 1477-2574 .- 1365-182X. ; 9:6, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Acute pancreatitis (AP) is a common disease that has a mild to moderate course in most cases. During the last decade, a change in diagnostic facilities as well as improved intensive care have influenced both morbidity and mortality in AP. Still, however, a number of controversies and unresolved questions remain regarding AP. These include prognostic factors and how these may be used to improve outcome, diagnostic possibilities, their indications and optimal timing, and the systemic inflammatory reaction (systemic inflammatory response syndrome - SIRS) and its effect on the concomitant course of the disease and potential development of organ failure. The role of the gut has been suggested to be important in severe AP, but has recently been somewhat questioned. Despite extensive research, pharmacological and medical intervention of proven clinical value is scarce. Various aspects on surgical interventions, including endoscopic sphincterotomy, cholecystectomy and necrosectomy, as regards indications and timing, will be reviewed. Last, but not least, are the management of late complications and long-term outcome for patients with especially severe AP.
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| 19. |
- Andersson, Roland, et al.
(författare)
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Iatrogenic bile duct injury - a cost analysis.
- 2008
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Ingår i: HPB. - : Elsevier BV. - 1477-2574 .- 1365-182X. ; 10:6, s. 416-419
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Iatrogenic bile duct lesions following cholecystectomy represent a feared complication occurring in up to 0.9%. The aim of the present study was to estimate the total cost associated with both minor and major bile duct injuries. Material and methods. Detailed information on 24 consecutive patients, out of which 14 were considered to have minor and 10 patients considered as having major bile duct injury, provided the underlying information that rendered calculations on average individual costs for both groups of injuries. Results and discussion. Calculating individual costs for minor and major bile duct injuries with actual incidences of cholecystectomies performed and the incidence of iatrogenic bile duct injury demonstrated that the total costs, including in-hospital cost, sick leave and loss of production, were substantial. For the management of minor bile duct injuries costs were within the range of 136,787-159,585 EUR and for the management of major bile duct injuries from 336,903-449,204 EUR per million inhabitants and year. The total costs for the management of all types of bile duct injuries were thus within the range of 473,690-608,789 EUR per million inhabitants annually for the society.
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| 20. |
- Andersson, Roland, et al.
(författare)
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Immunomodulation in surgical practise
- 2006
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Ingår i: HPB. - : Elsevier BV. - 1477-2574 .- 1365-182X. ; 8:2, s. 116-123
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Tidskriftsartikel (refereegranskat)abstract
- Background. Immunomodulation may represent a potential way to improve surgical outcome. These types of interventions should be based on detailed knowledge of the underlying mechanisms involved. The aim of the present review is to summarize some experience on the acute phase response, potential ways of intervention and experiences from critical illness and HPB disease. Discussion. Mechanisms of the acute phase response are discussed including the individual parameters and local changes that take part. Mechanisms involved in failure of the gut barrier are presented and include changes in gut barrier permeability, effects on gut-associated immunocompetent cells, and systemic implications. As examples of HPB disease, mechanisms of the acute phase response and potential ways of intervention in obstructive jaundice and acute pancreatitis are discussed. Nutritional pharmacology and lessons learned from immunomodulation and immunonutrition in critical illness and major abdominal surgery, including upper GI and HPB surgery, are referred to. Overall, immunomodulation represents a potential tool to improve results but requires a thorough mapping of underlying mechanisms in order to achieve individualized treatment or prevention based on patients' specific needs.
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| 21. |
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| 22. |
- Andersson, Roland, et al.
(författare)
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Preoperative staging and evaluation of resectability in pancreatic ductal adenocarcinoma.
- 2004
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Ingår i: HPB. - : Elsevier BV. - 1477-2574 .- 1365-182X. ; 6:1, s. 5-12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cancer of the pancreas is a common disease, but the large majority of patients have tumours that are irresectable at the time of diagnosis. Moreover, patients whose tumours are clearly beyond surgical cure are best treated non-operatively, if possible, by relief of biliary obstruction and percutaneous biopsy to confirm the diagnosis and then consideration of oncological treatment, notably chemotherapy. These facts underline the importance of a standard protocol for the preoperative determination of operability (is it worth operating?) and resectability (is there a chance that the tumour can be removed?). Recent years have seen the advent of many new techniques, both radiological and endoscopic, for the diagnosis and staging of pancreatic cancer. It would be impracticable in time and cost to submit every patient to every test. This review will evaluate the available techniques and offer a possible algorithm for use in routine clinical practice. DISCUSSION: In deciding whether to operate with a view to resecting a pancreatic cancer, the surgeon must take into account factors related to the patient, the tumour and the institution and team entrusted with the patient's care. Patient-related factors include age, general health, pain and the presence or absence of malnutrition and an acute phase inflammatory response. Tumour-related factors include tumour size and evidence of spread, whether to adjacent organs (notably major blood vessels) or further afield. Hospital-related factors chiefly concern the volume of pancreatic cancer treated and thus the experience of the whole team. Determination of resectability is heavily dependent upon detailed imaging. Nowadays conventional ultrasonography can be supplemented by endoscopic, laparoscopic and intra-operative techniques. Computed tomography (CT) remains the single most useful staging modality, but MRI continues to improve. PET scanning may demonstrate unsuspected metastases and likewise laparoscopy. Diagnostic cholangiography can be performed more easily by MR techniques than by endoscopy, but ERCP is still valuable for preoperative biliary decompression in appropriate patients. The role of angiography has declined. Percutaneous biopsy and peritoneal cytology are not usually required in patients with an apparently resectable tumour. The prognostic value of tumour marker levels and bone marrow biopsy is yet to be established. Preoperative chemotherapy or chemoradiation may have a role in down-staging an irresectable tumour sufficiently to render it resectable. Selective use of diagnostic laparoscopy staging is potentially helpful in determination of resectability. Laparotomy remains the definitive method for determining the resectability of pancreatic cancer, with or without portal vein resection, and should be undertaken in suitable patients without clear-cut evidence of irresectability.
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| 23. |
- Andrèn, A, et al.
(författare)
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Effects on blood pressure after treatment of obstructive sleep apnoea with a mandibular advancement appliance - a three-year follow-up
- 2009
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 36:10, s. 719-725
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Tidskriftsartikel (refereegranskat)abstract
- P>Obstructive sleep apnoea (OSA) is a highly prevalent sleep disorder; it affects 4% of males and 2% of females. Hypertension has been shown to occur in 28-57% of OSA patients. There is a steady increase in evidence linking OSA to long-term cardiovascular morbidity including hypertension. The purpose of this study was to investigate whether mandibular advancement oral appliance (OA) treatment of OSA affects the patient's blood pressure (BP) in a 3-month and a 3-year perspective. Twenty-nine consecutive patients, with verified OSA defined as apnoea index (AI) > 5 per hour and/or apnoea/hypopnoea index (AHI) >= 10 per hour, received an OA as treatment. BP was measured on three occasions; before treatment, after 3 months of treatment, and after 3 years of treatment. BP was measured with an electronic blood pressure monitor. The treatment effect of OA was measured after 3 months by repeated somnographic registration while the patient was wearing the OA. A treatment response was defined as AHI < 10; this was achieved in 25 of 29 patients (86%) at the 3-month evaluation. Significant reductions in blood pressure were attained between baseline and the 3-month evaluation (P < 0 center dot 001) and these changes remained at the 3-year follow-up in both systolic BP of -15 center dot 4 +/- 18 center dot 7 mm Hg and diastolic BP of -10 center dot 3 +/- 10 center dot 0 mm Hg. OA therapy reduced blood pressure in both a 3-month and a 3-year perspective in patients with OSA.
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| 24. |
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| 25. |
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| 26. |
- Aronsson, Linus, et al.
(författare)
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Intraductal papillary mucinous neoplasms of the pancreas – a cost-effectiveness analysis of management strategies for the branch-duct subtype
- 2018
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Ingår i: HPB. - : Elsevier BV. - 1365-182X. ; 20:12, s. 1206-1214
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Tidskriftsartikel (refereegranskat)abstract
- Background: Branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) presents a clinical conundrum. Rigorous long-term surveillance or surgical resection is recommended. The economic consequences of the management have not been fully investigated. Methods: A Markov decision model compared 4 strategies for low-risk BD-IPMN: I = upfront total pancreatectomy, II = upfront partial pancreatectomy, III = initial surveillance, IV = watchful waiting. Surveillance was based on the Swedish Guidelines for Pancreatic Cancer. Probabilities and costs were obtained from the participating unit and from the scientific literature. The incremental cost-effectiveness ratios (ICERs) were calculated and sensitivity analyses were performed by varying relevant parameters. Survival was reported in quality-adjusted life-years (QALYs). Results: Strategy III was the most cost-effective strategy with an ICER of €31 682 compared to strategy IV. Strategy I was the most expensive but yielded the best QALY (9.32). Total number of years, annual risk of pancreatic cancer and annual risk of a low-risk BD-IPMN turning into a high-risk lesion had the greatest impact in the model. Conclusions: Initial surveillance seems to be the most cost-effective strategy in the management of low-risk asymptomatic BD-IPMN. However, the possibility of personalized approaches remains to be investigated.
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| 27. |
- Athab Abduljabbar, Zahra, et al.
(författare)
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Chewing side preference and laterality in patients treated with unilateral posterior implant-supported fixed partial prostheses
- 2022
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 49:11, s. 1080-1086
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is not clear to what extent chewing is improved by unilateral oral rehabilitation with implant-supported fixed partial prostheses (ISFPPs). Objectives: This study aimed to investigate whether patients treated with unilateral ISFPPs in the maxilla use their prostheses during mastication to the same extent as they used their contralateral natural teeth. A further aim was to investigate whether there is a correlation between preferred chewing side and laterality. Methods: Chewing side preference was assessed in 15 participants treated with unilateral ISFPPs in the maxilla. The first, second, third, fifth and tenth chewing cycles were assessed, and the test was repeated 10 times. All participants also answered a questionnaire about their chewing side preference. Results: Most of the participants presented bilateral chewing, but two (13%) chewed only on the ISFPP. There was no statistically significant association between the objectively assessed chewing side and dental status (natural teeth or ISFPPs) during any of the recorded chewing cycles (p >.1). There were statistically significant correlations between both the subjectively reported usually preferred chewing side and the subjective chewing side preference during the test and the objectively assessed chewing side for the first three chewing cycles (p <.01). No correlation was found between handedness and the objectively assessed chewing side. Conclusion: In the present study, most participants chewed bilaterally, and chewing was performed both on the ISFPP and on the natural teeth. No correlation was found between the preferred chewing side, objectively or subjectively determined and laterality.
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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. |
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| 30. |
- Baelum, V, et al.
(författare)
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A global perspective on changes in the burden of caries and periodontitis : implications for dentistry.
- 2007
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 34:12, s. 872-906; discussion 940
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Tidskriftsartikel (refereegranskat)abstract
- The structure and contents of most oral health care systems and the contents of dental curricula reflect a deep-rooted tradition for attempting to cure oral diseases by refined technological means. However, better oral health conditions for the world's populations necessitate the application of up-to-date scientific knowledge to control the major oral diseases. This review points out that not only should the structure and contents of oral health care delivery systems be based on state-of-the-art knowledge about the biology of the oral diseases; they must also take into account the trends for change in caries and periodontal diseases within and between populations, and acknowledge the impact of changes in treatment philosophies for these trends. The oral disease profiles for populations in low- and high-income countries are briefly described, and it is concluded that the rapidly changing disease profiles observed in high-income countries necessitate re-thinking of the future role and organization of dentistry in such countries. The priorities for low- and middle-income countries must be to avoid repeating the mistakes made in the high-income countries. Instead, these societies might take advantage of setting priorities based on a population-based common risk factor approach. If such an approach is adopted, the training of personnel with oral health care competence must be rethought. The authors suggest three different cadres of dental care providers to be considered for an approach that allows health care planners in different populations around the world to prioritize appropriate oral health care with due respect for the socio-economic conditions prevailing.
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| 31. |
- Baker, Z., et al.
(författare)
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Questionable effect of lavage for treatment of painful jaw movements at disc displacement without reduction : a 3-year randomised controlled follow-up
- 2015
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 42:10, s. 742-750
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Tidskriftsartikel (refereegranskat)abstract
- The present randomised controlled study compared the 3-year outcome of local anaesthetics with anaesthetics and lavage in patients suffering from painful temporomandibular joint (TMJ) locking. The study included 45 patients referred for treatment of temporomandibular disorders (TMD) to the Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmo University, Malmo, Sweden. All patients received a history questionnaire and clinical examination according to the Research Diagnostic Criteria for TMD, panoramic radiographs and magnetic resonance imaging at baseline. Twenty-five patients were randomised to anaesthetics alone and 20 patients to anaesthetics and lavage. Three years after treatment, we sent the 37 patients who were available for follow-up a questionnaire that evaluated pain intensity, physical and emotional functioning, and global improvement. Thirty-four patients responded. The primary outcome was defined as >= 30% pain relief. In an intention-to-treat analysis, 28 of 45 patients (62%) reported >= 30% pain relief at the follow-up. At 3 years, improvement in pain relief, physical functioning, emotional functioning and global improvement differed non-significantly between local anaesthetics and anaesthetics and lavage. Compared with baseline, significant improvements (P < 0.05) in pain intensity, physical functioning, emotional functioning and global changes had occurred in both groups after 3 years. Because outcome measurements in the local anaesthetics and lavage and the local anaesthetics groups differed non-significantly 3 years after treatment of painful TMJ disc displacement without reduction, use of lavage (50 mL saline) has an equivalent effect as local anaesthetics.
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| 32. |
- Balakrishnan, Anita, et al.
(författare)
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Delivery of hepato-pancreato-biliary surgery during the COVID-19 pandemic : an European-African Hepato-Pancreato-Biliary Association (E-AHPBA) cross-sectional survey
- 2020
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Ingår i: HPB. - : Elsevier BV. - 1365-182X. ; 22:8, s. 1128-1134
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Tidskriftsartikel (refereegranskat)abstract
- Background: The extent of the COVID-19 pandemic and the resulting response has varied globally. The European and African Hepato-Pancreato-Biliary Association (E-AHPBA), the premier representative body for practicing HPB surgeons in Europe and Africa, conducted this survey to assess the impact of COVID-19 on HPB surgery. Methods: An online survey was disseminated to all E-AHPBA members to assess the effects of the pandemic on unit capacity, management of HPB cancers, use of COVID-19 screening and other aspects of service delivery. Results: Overall, 145 (25%) members responded. Most units, particularly in COVID-high countries (>100,000 cases) reported insufficient critical care capacity and reduced HPB operating sessions compared to COVID-low countries. Delayed access to cancer surgery necessitated alternatives including increased neoadjuvant chemotherapy for pancreatic cancer and colorectal liver metastases, and locoregional treatments for hepatocellular carcinoma. Other aspects of service delivery including COVID-19 screening and personal protective equipment varied between units and countries. Conclusion: This study demonstrates that the COVID-19 pandemic has had a profound adverse impact on the delivery of HPB cancer care across the continents of Europe and Africa. The findings illustrate the need for safe resumption of cancer surgery in a “new” normal world with screening of patients and staff for COVID-19.
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| 33. |
- Balakrishnan, A., et al.
(författare)
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Heterogeneity of management practices surrounding operable gallbladder cancer – results of the OMEGA-S international HPB surgical survey
- 2022
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Ingår i: HPB. - : Elsevier BV. - 1365-182X. ; 24:11, s. 2006-2012
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. Conclusion: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes. © 2022 International Hepato-Pancreato-Biliary Association Inc.
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| 34. |
- Barjandi, Golnaz, et al.
(författare)
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Plasma tryptophan and kynurenine in females with temporomandibular disorders and fibromyalgia-An exploratory pilot study.
- 2020
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 47:2, s. 150-157
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Both temporomandibular disorders myalgia (TMDM) and fibromyalgia (FM) have been linked to central and peripheral changes in serotonin availability. The precursor of serotonin, tryptophan (TRP), is mainly catabolised via another pathway to produce kynurenine (KYN), but whether changes of this pathway are present in TMDM and FM are still unclear.OBJECTIVE: The aim was to explore blood plasma concentrations of TRP and KYN in TMDM and FM in an attempt to identify novel associations for future research.METHODS: Plasma of 113 female participants (17 TMDM, 40 FM and 56 healthy pain-free controls) were analysed for TRP and KYN concentrations. The degradation of TRP via the KYN pathway was indicated by the KYN to TRP ratio (KYN/TRP). Pain intensities were assessed with the Graded Chronic Pain Scale (GCPS) and Visual Analogue Scale (VAS). Psychological symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder scale (GAD-7).RESULTS: In TMDM there was a negative correlation between TRP and pain intensity (rs = -0.55 P = .023) and positive correlations between KYN/TRP and pain intensity (rs = 0.59 P = .013). In FM, KYN/TRP was negatively correlated with anxiety symptoms (rs = -0.36 P = .022) and a trend towards significantly lower TRP levels was found compared to controls (P = .05).CONCLUSION: The association between KYN/TRP and pain intensity as well as anxiety ratings in this small exploratory study may indicate that KYN/TRP could be a relevant indicator for symptom severity in TMDM and FM. Further investigations of the KYN pathway in chronic myalgia are warranted.
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Blomstrand, Hakon, et al.
(författare)
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Impact of resection margins and para-aortic lymph node metastases on recurrence patterns and prognosis in resectable pancreatic cancer - a long-term population-based cohort study
- 2023
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Ingår i: HPB. - : ELSEVIER SCI LTD. - 1365-182X .- 1477-2574. ; 25:12, s. 1531-1544
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pancreatic cancer remains a leading cause of cancer-related death. To individualise management and improve survival, more accurate prognostic models are needed.Methods: All patients resected for pancreatic ductal adenocarcinoma in a tertiary Swedish centre during 2009-2019 were thoroughly analysed with regards to pathological and clinical parameters including tumour grade, resection margin status, para-aortic lymph node engagement (node station 16), and systemic treatment.Results: The study cohort included 275 patients. Overall median survival was 21.2 months (95% CI 17.5-24.8). Year of resection, margin status (R1 subdivided into R1(1mm)/R1(ink)), perineural invasion, differentiation grade, TNM stage, and adjuvant therapy were independent factors with significant impact on survival. Margin status also significantly affected recurrence-free survival and relapse patterns, with local and peritoneal relapses being associated with R1-status (p < 0.001 and p = 0.007). Presence of paraaortic lymph node metastases was associated with shorter recurrence-free survival as compared to N1 status only.Conclusion: Survival in resected pancreatic cancer is improving over time. Resection margin status is a key factor affecting recurrence patterns and prognosis. Given the poor recurrence-free survival in node station 16 metastasised patients, the rational for resection remains in doubt, and improved treatment strategies for this patient group is necessary.
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| 39. |
- Boeskov Øzhayat, Esben, et al.
(författare)
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Impairments due to tooth loss and prosthetic expectations in patients from an urban area and a rural area in Sweden. A qualitative study
- 2020
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 47:2, s. 212-220
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore impairments due to tooth loss and expectations of prosthetic replacements in an urban group and a rural group of patients in Sweden. MATERIAL AND METHODS: Semi-structured interviews were performed on 35 partially edentulous patients from prosthodontic specialist clinics located in an urban area and a rural area in Sweden. The interviews focused on impairments due to tooth loss and expectations of prosthetic restorations. Analysis was made using the grounded theory approach, allowing in-depth investigation of the phenomenon. RESULTS: Functional, aesthetic and social impairments were mentioned, and coping strategies (eg chewing differently and laughing less) and modifications (eg age, time and social setting) of the impairments were described. The rural patient group accepted impairments somewhat better than the urban one. Otherwise, there was only minor difference between the groups. Removable prosthodontic restorations were more acceptable among rural patients. Urban patients insisted more often on implant-based restorations and had higher expectations of longevity. Patients with minor impairments still wanted treatment, based on concerns about the future of their dentition. The interviews themselves generated new thoughts in the patients and were thus considered valuable by the patients. CONCLUSIONS: Impairments due to tooth loss and expectations of prosthetic replacements were expressed in the same way in the rural and urban patient groups. However, in the rural population, there was a higher acceptance of impairments and also of removable prosthetic restorations, whereas the urban population expressed a higher demand for implant-based restorations.
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| 40. |
- Boscato, Noeli, et al.
(författare)
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Impact of oral motor task training on corticomotor pathways and diadochokinetic rates in young healthy participants
- 2022
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 49:9, s. 924-934
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Tidskriftsartikel (refereegranskat)abstract
- Background Studies addressing the training-induced neuroplasticity and interrelationships of the lip, masseter, and tongue motor representations in the human motor cortex using single syllable repetition are lacking. Objective This study investigated the impact of a repeated training in a novel PaTaKa diadochokinetic (DDK) orofacial motor task (OMT) on corticomotor control of the lips, masseter, and tongue muscles in young healthy participants. Methods A total of 22 young healthy volunteers performed 3 consecutive days of training in an OMT. Transcranial magnetic stimulation was applied to elicit motor evoked potentials (MEPs) from the lip, masseter, tongue, and first dorsal interosseous (FDI, internal control) muscles. MEPs were assessed by stimulus-response curves and corticomotor mapping at baseline and after OMT. The DDK rate from PaTaKa single syllable repetition and numeric rating scale (NRS) scores were also obtained at baseline and immediately after each OMT. Repeated-measures analysis of variance was used to detect differences at a significance level of 5%. Results There was a significant effect of OMT and stimulus intensity on the lips, masseter, and tongue MEPs compared to baseline (p < .001), but not FDI MEPs (p > .05). OMT increased corticomotor topographic maps area (p < .001), and DDK rates (p < .01). Conclusion Our findings suggest that 3 consecutive days of a repeated PaTaKa training in an OMT can induce neuroplastic changes in the corticomotor pathways of orofacial muscles, and it may be related to mechanisms underlying the improvement of orofacial fine motor skills due to short-term training. The clinical utility should now be investigated.
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| 41. |
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| 42. |
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| 43. |
- Böthun, Alicia, et al.
(författare)
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Jaw–neck motor strategy during jaw‐opening with resistance load
- 2022
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 49:5, s. 514-521
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Tidskriftsartikel (refereegranskat)abstract
- Background: The jaw and neck motor systems have a close functional integration but the effect of resistance load to the mandible during jaw opening on the jaw-neck integration is not known.Objectives: To evaluate the effect of resistance load compared to no load on integrated jaw and neck motor function in individuals free from pain and dysfunction in the jaw and neck regions.Methods: Jaw and head movements during continuous jaw opening were recorded with an optoelectronic system (MacReflex® ) in 26 pain-free individuals (14 women, 12 men, mean age 22 years). Jaw opening was performed with and without resistance load (1600 g) to the mandible. The relationship between jaw movement amplitude, head movement amplitude, head/jaw ratio (quotient of head and jaw movement amplitude) and resistance load were modelled using linear mixed-model analysis. A p-value <.05 was considered statistically significant.Results: The expected head/jaw ratio mean was increased by 0.05 (95% CI: 0.03, 0.08, p < .001) with resistance load as compared to no load. This corresponds to an increase in expected mean by 55.6%. With resistance load, expected mean head movement amplitude increased by 1.4 mm (95% CI: 0.2, 2.5, p = .018), and expected mean jaw movement amplitude decreased by 3.7 mm (95% CI: -7.0, -0.5, p = .025).Conclusion: There is a compensation and adaptation of integrated jaw-neck motor function with an altered jaw-neck motor strategy during jaw opening with resistance load compared to no load. The head/jaw ratio demonstrates increased proportional involvement of the neck during increased load on the jaw system.
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| 44. |
- 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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| 45. |
- Carlsson, Gunnar E, 1930, et al.
(författare)
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Prediction of demand for treatment of temporomandibular disorders based on a 20-year follow-up study.
- 2004
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Ingår i: Journal of oral rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 31:6, s. 511-7
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to test the hypothesis that signs and symptoms characteristic of temporomandibular disorders (TMD) at age 15 would predict demand for treatment during a 20-year follow-up period. Of originally 135 examined 15-year-old subjects, 103 completed a questionnaire and 84 were examined clinically at the 10-year follow-up (at age 25). After 20 years (at age 35), 114 completed a questionnaire and 100 were also examined clinically. During the 20-year follow-up period, 21 subjects received some kind of treatment of TMD. At baseline (age 15), the treated group reported tooth grinding at night more often than the non-treated group (P = 0.0042). At the 10-year follow-up (at age 25), the treated group reported more symptoms of TMD and oral parafunctions than the non-treated group. Among the clinical registrations, there was only one significant difference between the groups: anterior tooth wear was more extensive in the treated group. At the 20-year follow-up (at age 35), the treated group reported significantly more symptoms of TMD and oral parafunctions than the non-treated group. The clinical dysfunction index was also higher in the treated group. Logistic regression revealed tooth grinding at night as a significant predictor of received treatment of TMD. However, the positive predictive value was low whereas the negative predictive value was high (90%). The findings indicate that nocturnal tooth grinding is related to demand for treatment of TMD.
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| 46. |
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| 47. |
- Choi, Woo Jin, et al.
(författare)
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Is it safe to administer neoadjuvant chemotherapy to patients undergoing hepatectomy for intrahepatic cholangiocarcinoma? : ACS-NSQIP propensity-matched analysis
- 2022
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Ingår i: HPB. - : Elsevier. - 1365-182X .- 1477-2574. ; 24:9, s. 1535-1542
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of neoadjuvant chemotherapy (NAC) in patients with intrahepatic chol-angiocarcinoma (iCCA) is increasing. The objective of this study was to compare the 30-day post-operative complications and length-of-stay (LOS) between patients undergoing hepatectomy for iCCA with and without NAC.Methods: A retrospective study was conducted using the ACS-NSQIP database queried from 2014 to 2018. Patients with NAC receipt were propensity-score matched into 1:3 ratio with controls using the greedy-matching algorithm and a caliper of 0.2. Logistic and Poisson regression models were used to estimate the effect sizes.Results: A total of 1508 patients who underwent hepatectomy for iCCA were included. 706 patients remained after matching and balance were achieved. The NAC group had 110 (60.1%) complications vs. 289 (55.3%) complications in the non-NAC group (p = 0.29). NAC was not associated with worse 30-day postoperative complications [OR 1.24, 95% CI: 0.87-1.76; p = 0.24]. Post-operative LOS in the NAC group was 8.56 days (mean, SD 7.4) vs. non-NAC group 9.27 days (mean, SD 8.41, p = 0.32). NAC was not associated with longer post-operative LOS [RR 0.93, 95% CI:0.80, 1.08; p = 0.32].Conclusion: NAC may be safely administered without increasing the risk of 30-day complications or post-operative hospital LOS.
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| 48. |
- Chrcanovic, Bruno, et al.
(författare)
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Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 43:11, s. 813-823
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 130% (24/185) for bruxers and 46% (155/3364) for non-bruxers (P < 0001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3396; 95% CI 1314, 8777; P = 0012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure.
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| 49. |
- Chrcanovic, Bruno, et al.
(författare)
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Dental implants inserted in male versus female patients: a systematic review and meta-analysis.
- 2015
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Ingår i: Journal of oral rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 42:9, s. 709-722
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this meta-analysis was to test the null hypothesis of no difference in the failure rates, marginal bone loss (MBL) and post-operative infection for implants inserted in male or female patients, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in December 2014. Eligibility criteria included clinical human studies, either randomized or not. Ninety-one publications were included, with a total of 27203 implants inserted in men (1185 failures), and 25154 implants inserted in women (1039 failures). The results suggest that the insertion of dental implants in male patients statistically affected the implant failure rates (RR 1·21, 95% CI 1·07-1·37, P=0·002). Due to the limited number of studies reporting results on MBL, it is difficult to estimate the real effect of the insertion of implants in different sexes on the marginal bone level. Due to lack of satisfactory information, meta-analysis for the outcome 'post-operative infection' was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.
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| 50. |
- Chrcanovic, Bruno, et al.
(författare)
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Prophylactic antibiotic regimen and dental implant failure : a meta-analysis
- 2014
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 41:12, s. 941-956
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this meta-analysis was to investigate whether there are any positive effects of prophylactic antibiotic regimen on implant failure rates and post-operative infection when performing dental implant treatment in healthy individuals. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomised or not. The search strategy resulted in 14 publications. The I(2) statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used with a fixed- or random-effects model, depending on the heterogeneity. The estimates of relative effect were expressed in risk ratio (RR) with 95% confidence interval. Six studies were judged to be at high risk of bias, whereas one study was considered at moderate risk, and six studies were considered at low risk of bias. The test for overall effect showed that the difference between the procedures (use versus non-use of antibiotics) significantly affected the implant failure rates (P = 0·0002), with a RR of 0·55 (95% CI 0·41-0·75). The number needed to treat (NNT) to prevent one patient having an implant failure was 50 (95% CI 33-100). There were no apparent significant effects of prophylactic antibiotics on the occurrence of post-operative infections in healthy patients receiving implants (P = 0·520). A sensitivity analysis did not reveal difference when studies judged as having high risk of bias were not considered. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.
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