| 1. |
- Adèrn, Bengt, et al.
(author)
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Orsaker till remisser till bettfysiolog : en jämförelse mellan fyra specialistkliniker
- 2003
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In: Tandläkartidningen. - 0039-6982. ; 95:10, s. 50-55
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Journal article (other academic/artistic)abstract
- Specialistinstanser i bettfysiologi möter i huvudsak patienter som har en långvarig och svårt smärtproblematik. Under 1900-talet har dock även behandling av obstruktiv sömnapné tillkommit. Ofta är det en läkare som remitterat patienten till den bettfysiologiska kliniken. Denna studie visar att bettfysiologen är en viktig länk mellan tandvården och sjukvården vid utredning och behandling av orofacial smärta. Syf-tet med studien var att jämföra orsakerna till remisser till bettfysiologi. En jämförelse gjordes mellan fyra specialistkliniker i bettfysiologi un-der en 4-månadersperiod år 2001. De flesta remitterade patienter var kvinnor i åldern 20 år och uppåt. Bland de remitterade kvinnorna var smärta den dominerande orsaken medan männen lika ofta remittera-des för sömnstörning som för smärta. 86 procent av patienterna som remitterats för smärta värderade smärtans intensitet som måttlig till väldigt svår. Hos 80 procent av dessa patienter var smärtan långvarig.
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| 2. |
- Larsson, Pernilla, et al.
(author)
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Reliability and validity of a Swedish version of the Oral Health Impact Profile (OHIP-S)
- 2004
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In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:3, s. 147-152
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Journal article (peer-reviewed)abstract
- The aim of this study was to translate the Oral Health Impact Profile (OHIP) into Swedish and evaluate the reliability and validity of the Swedish version (OHIP-S). The CHIP is a 49-item, self-administered questionnaire divided into 7 different subscales. The original version in English was translated into Swedish, accompanied by back-translation into English, after which the Swedish version was revised. A total of 145 consecutive patients participated and answered a questionnaire. The patients comprised five clinically separate groups: temporomandibular dysfunction (TMD) (n = 30), Primary Sjogren's Syndrome (SS) (n = 30), burning sensation and pain in the oral mucosa (oral mucosal pain, OMP) (n = 28), skeletal malocclusion (malocclusion) (n = 2 7), and healthy dental recall patients (Controls) (n = 30). The TMD group and the control group participated in a test-retest procedure. The internal reliability of each subscale was calculated with Cronbach's alpha and found to be high and to range from 0.83-0.91. The stability (test-retest) of the instrument, calculated using the intraclass correlation coefficient, ranged from 0.87 to 0.98. The construct validity of OHIP-S was compared with subscales of the Symptom Check List (SCL-90) (rho 0.65) and the jaw Function Limitation Scale JFLS) (rho 0.76) and analyzed with Spearman's correlation coefficient. Convergent validity was evaluated by comparing CHIP with self-reported health using Spearman's correlation coefficient and was found to be acceptable (rho 0.61). In the evaluation of the discriminative ability of the instrument, significant differences were found in the total OHIP-S score between the controls and the other four groups (P < 0.001). We conclude that the reliability and validity of OHIP-S is excellent. The instrument can be recommended for assessing the impact of oral health on masticatory ability and psychosocial function.
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| 3. |
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| 4. |
- List, Thomas, et al.
(author)
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Pharmacologic interventions in the treatment of temporomandibular disorders, atypical facial pain, and burning mouth syndrome. A qualitative systematic review
- 2003
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 17:4, s. 301-310
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Research review (other academic/artistic)abstract
- AIMS: To carry out a systematic review of the literature in order to assess the pain-relieving effect and safety of pharmacologic interven-tions in the treatment of chronic temporomandibular disorders (TMD), including rheumatoid arthritis (RA), as well as atypical facial pain (AFP), and burning mouth syndrome (BMS). METHODS: Study selection was based on randomized clinical trials (RCTs). Inclusion criteria included studies on adult patients (> or = 18 years) with TMD, RA of the temporomandibular joint (TMJ), AFP, or BMS and a pain duration of > 3 months. Data sources included Medline, Cochrane Li-brary, Embase, and Psych Litt. RESULTS: Eleven studies with a total of 368 patients met the inclusion criteria. Four trials were on TMD patients, 2 on AFP, 1 on BMS, 1 on RA of the TMJ, and 3 on mixed groups of patients with TMD and AFP. Of the latter, amitriptyline was effective in 1 study and benzodiazepine in 2 studies; the effect in 1 of the benzodiazepine studies was improved when ibuprofen was also given. One study showed that intra-articular injection with glucocorti-coid relieved the pain of RA of the TMJ. In 1 study, a combination of paracetamol, codeine, and doxylamine was effective in reducing TMD pain. No effective pharmacologic treatment was found for BMS. Only minor adverse effects were reported in the studies. CONCLUSION: The common use of analgesics in TMD, AFP, and BMS is not sup-ported by scientific evidence. More large RCTs are needed to deter-mine which pharmacologic interventions are effective in TMD, AFP, and BMS.
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| 5. |
- Marcusson, Agneta, 1956-, et al.
(author)
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Reliability of a multidimensional questionnaire for adults with treated complete cleft lip and palate
- 2001
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In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 0284-4311 .- 1651-2073. ; 35:3, s. 271-278
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Journal article (peer-reviewed)abstract
- The purpose of this study was to evaluate the reliability of a multidimensional questionnaire for Swedish adults with treated complete unilateral or bilateral cleft lip and palate (CLP). The questionnaire was designed to be used in the evaluation of adults with treated CLP after treatment. Before any conclusions were drawn from the results of the study we assessed the test-retest reliability of the questionnaire. The questionnaire included 168 questions and assessed the following domains: aesthetics, functions associated with CLP, satisfaction with treatment and perceived need for treatment, quality of life, depression and non-specific physical symptoms, body image, and jaw function. The subjects answered the questionnaire twice at a 2-3-week interval. Sixty-one adults (38 men, 23 women) mean age 24 years (range 20-29) participated in the study. The response rate for the questionnaire was acceptable at 75%. The test-retest reliability varied among the different domains. The reliability of questions regarding aesthetics, functions associated with CLP, and treatment satisfaction was good to excellent (intraclass correlation coefficient (ICC) = 0.51 to 0.89). Good to excellent (ICC = 0.61 to 1.0) reliability was also found for the quality of life in various life domains and the wellbeing scales. The reliability of the body image scale was moderate (kappa = 0.43-0.60) for most items and lower than that of other scales used in this study. The reliability of the mean depression symptom score (ICC = 0.93) and the mean non-specific physical symptoms score (ICC = 0.85) were excellent. The reliability of the mandibular function impairment was good (ICC = 0.67). The conclusion of the study is that an overall reliability was good for the multidimensional questionnaire.
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| 6. |
- Marcusson, Agneta, 1956-, et al.
(author)
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Temporomandibular disorders in adults with repaired cleft lip and palate : a comparison with controls
- 2001
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In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 23:2, s. 193-204
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Journal article (peer-reviewed)abstract
- The purpose of this study was to investigate the prevalence of temporomandibular disorders (TMD), and assess psycho‐social distress in adult subjects with repaired complete cleft lip and palate (CLP). Sixty‐three adults (42 males and 21 females, mean age 24.2 years, range 19.5–29.2) with repaired CLP (CLP group) were compared with a group of 66 adults without cleft (non‐cleft group, 49 males and 17 females, mean age 25.5 years, range 20.2–29.9). All subjects underwent a clinical TMD examination, which followed the guidelines in the Research Diagnostic Criteria for TMD (RDC/TMD). Jaw function was assessed by evaluating answers to the mandibular function impairment questionnaire (MFIQ).Tension‐type headache was diagnosed according to the International Headache Society (IHS) classification. Psychological status was assessed using the depression score and the non‐specific physical symptom score with subscales of the Revised Symptom Checklist‐90 (SCL‐90‐R).The prevalence of reported pain in the face, jaws and/or TMJs was 14 and 9 per cent for the CLP and non‐cleft group, respectively, and did not differ significantly between the groups. The CLP group exhibited a significantly reduced jaw‐opening pattern (P < 0.001) and a higher frequency of crossbites (P < 0.05) compared with the non‐cleft group. Whilst jaw function was similar in both groups, a few items, e.g. speech and drinking, were significantly more impaired (P < 0.01) in the CLP group than in the non‐cleft group. There were no significant differences between the two groups concerning tension‐type headache or psycho‐social distress.The study found that overall TMD pain or psycho‐social distress was not more common in this CLP group than in a non‐cleft group.
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| 7. |
- Sandberg, Margareta, 1947-
(author)
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Acupuncture - effects on muscle blood flow and aspects of treatment in the clinicla context
- 2004
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to elucidate and investigate psychophysiological aspects and effects of acupuncture and needle stimulation. Within this framework emphasis was directed toward the effects of needle stimulation (acupuncture) on muscle blood flow in the tibialis anterior and trapezius muscles in healthy subjects and patients suffering from chronic muscle pain. This study also included evaluation of a new application of photoplethysmography in noninvasive monitoring of muscle blood flow. The evaluation was based on experiments known to provocate skin or muscle blood flow. The psychological aspects studied comprised the effects of manual acupuncture on pain in fibromyalgia patients and the effects of electro-acupuncture on psychological distress and vasomotor symptoms in postmenopausal women in the clinical context.The results showed that photoplethysmography have potential to noninvasively monitor muscle blood flow and to discriminate between blood flow in skin and muscle, although some considerations still have to be accounted for. It was further shown that muscle blood flow change in response to needle stimulation differed between healthy subjects and patients. Deep needle stimulation in the muscle of healthy subjects consistently increased muscle blood flow more than subcutaneous needle stimulation. In the painful trapezius muscle of FMS patients, however, subcutaneous needling was equal or even more effective in increasing muscle blood flow than deep intramuscular stimulation. Generally, needle stimuli had weak effect on blood flow in the trapezius muscle of the severely affected trapezius myalgia patients, possibly depending on older age and lesser number of patients included in the study. The different patterns of blood flow response to needle stimulation between healthy subjects and patients with chronic muscle pain might be a manifestation of altered somatosensory processing in the patients.The clinical studies showed that best pain relief of acupuncture in FMS patients was achieved in the neck-shoulder region, while the effect on the generalised symptoms was of short duration. Well-being and sleep was found to best predict treatment outcome. The results suggest that acupuncture treatment may be used for the alleviation of neck-shoulder pain, primarily, but it is not an alternative as the sole treatment. Electro-acupuncture, significantly decreased psychological distress and climacteric symptoms in postmenopausal women, but not better than a (near-) placebo control, implying pronounced non-specific effects.
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| 8. |
- Wahlund, K., et al.
(author)
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Treatment of temporomandibular disorders among adolescents : A comparison between occlusal appliance, relaxation training, and brief information
- 2003
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In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 61:4, s. 203-211
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Journal article (peer-reviewed)abstract
- In a randomized trial the effects of occlusal appliance and relaxation therapy, each combined with brief information, were compared with brief information only, in adolescents with temporomandibular disorder (TMD) pain. One-hundred-and-twenty-two adolescents (93 F and 29 M aged 12-18 years) were randomly assigned to one of the following 3 groups: brief information + occlusal appliance (BI + OA), brief information + relaxation therapy (BI + RT), or brief information (BI). Included were subjects reporting pain once a week or more often, in addition to receiving a diagnosis of TMD according to the Research Diagnostic Criteria (RDC/TMD). They were evaluated before and after treatment and at a 6-month follow-up by means of self-reports and clinical assessment. The result revealed a significantly higher reduction in frequency of pain, in pain intensity (visual analog scale [VAS]), and in a composite pain index (intensity × frequency) for patients treated with BI + OA compared with those treated with BI alone. In the BI + OA group, 60% of the patients attained a clinically significant improvement (at least 50% or more) on the pain index, a significantly higher proportion compared to that obtained in the other 2 treatment groups. Analgesic consumption was also significantly more reduced in the BI + OA group compared to the BI group. However, no significant differences were found between the treatment groups in jaw opening or in muscle and TMJ tenderness scores. Occlusal appliance was found to be superior to both relaxation therapy and brief information regarding pain reduction and can therefore be recommended when treating adolescents with TMD pain.
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| 9. |
- Yap, AUJ, et al.
(author)
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Prevalence of temporomandibular disorder subtypes, psychologic distress, and psychosocial dysfunction in Asian patients
- 2003
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 17:1, s. 21-28
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Journal article (peer-reviewed)abstract
- Aims: To use the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) to investigate the physical diagnoses, psychologic distress, and psychosocial dysfunction in Asian TMD patients. The RDC/TMD Axis I and II findings were compared to those of Swedish and American TMD patients. Methods: One hundred ninety-one patients (53 male and 138 female) referred to 2 institutionalized TMD clinics in Singapore were enrolled in the study. The mean age of the predominantly Chinese population (83.2%) was 33.6 +/- 9.3 years. Data from a RDC/TMD history questionnaire and clinical examination were fed directly by patients and clinicians into a computerized diagnostic system (NUS TMDv1.1). Axis I and II findings were generated on-line, based on RDC/TMD rule engines. Data were automatically exported to SPSS for statistical analysis. Results: Group I (muscle) disorders were found in 31.4% of the patients, Group II (disc displacement) disorders were found in 15.1 % and 15.7% of the patients in the left and right temporomandibular joints, respectively, and Group III (arthralgia, arthritis, and arthrosis) disorders were found in 12.6% and 13.0% of the patients in the left and right joints, respectively. Axis II assessment of psychologic status showed that 39.8% of patients experienced moderate to severe depression and 47.6% had moderate to severe nonspecific physical symptom scores. Psychosocial dysfunction was observed in only 4.2% of patients based on graded chronic pain scores. Conclusion: Axis I and II findings of Asian TMD patients were generally similar to their Swedish and American cohorts. In all 3 populations, women of child-bearing age represented the majority of patients. Muscle disorders were the most prevalent type of TMD. A substantial portion of TMD patients were depressed and experienced moderate to severe somatization.
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