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John MT, Omara M, Su N, List T, Sekulic S, Häggman-Henrikson B, Visscher CM, Bekes K, Reissmann DR, Baba K, Schierz O, Theis-Mahon N, Fueki K, Stamm T, Bondemark L, Oghli I, van Wijk A, Larsson P. RECOMMENDATIONS FOR USE AND SCORING OF ORAL HEALTH IMPACT PROFILE VERSIONS. J Evid Based Dent Pract 2022; 22:101619. [PMID: 35219460 PMCID: PMC8886153 DOI: 10.1016/j.jebdp.2021.101619] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 07/11/2021] [Accepted: 07/22/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND OHIP's original seven-domain structure does not fit empirical data, but a psychometrically sound and clinically more plausible structure with the four OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact has emerged. Consequently, use and scoring of available OHIP versions need to be revisited. AIM We assessed how well the overall construct OHRQoL and its four dimensions were measured with several OHIP versions (20, 19, 14, and 5 items) to derive recommendations which instruments should be used and how to score them. METHODS Data came from the "Dimensions of OHRQoL Project" and used the project's learning sample (5,173 prosthodontic patients and general population subjects with 49-item OHIP data). We computed correlations among OHIP versions' summary scores. Correlations between OHRQoL dimensions, on one hand, and OHIP versions' domain scores or OHIP-5's items, on the other hand, were also computed. OHIP use and scoring recommendations were derived for psychometrically solid but also practical OHRQoL assessment. RESULTS Summary scores of 5-, 14-, 19- and 49-item versions correlated highly (r = 0.91-0.98), suggesting similar OHRQoL construct measurement across versions. The OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were best measured by the OHIP domain scores for Physical Disability, Physical Pain, Psychological Discomfort, and Handicap, respectively. CONCLUSION Recommendations were derived which OHIP should be preferably used and how OHIP versions should be scored to capture the overall construct and the dimensions of OHRQoL. Psychometrically solid and practical OHRQoL assessment in all settings across all oral health conditions can be achieved with the 5-item OHIP.
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Affiliation(s)
- MT John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, USA,Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, USA
| | - M Omara
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Nußdorfer Strasse 64, 1090, Vienna, Austria
| | - N Su
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - T List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Sweden,Scandinavian Center for Orofacial Neurosciences (http://www.sconresearch.eu/),Department of Rehabilitation Medicine, Skåne University Hospital, Sweden
| | - S Sekulic
- Dental Division, Department for Prosthetic Dentistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - B Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Sweden,Scandinavian Center for Orofacial Neurosciences (http://www.sconresearch.eu/)
| | - CM Visscher
- Department of Orofacial Pain and Disfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - K Bekes
- Department of Pediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - DR Reissmann
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Baba
- Department of Prosthodontics, Showa University, Tokyo, Japan
| | - O Schierz
- Department of Prosthodontics and Materials Science, University of Leipzig, Germany
| | - N Theis-Mahon
- Health Sciences Libraries, University of Minnesota, Minneapolis, MN, USA
| | - K Fueki
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - T Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - L Bondemark
- Department of Orthodontics, Faculty of Odontology, Malmö, Sweden
| | - I Oghli
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Sweden,Scandinavian Center for Orofacial Neurosciences (http://www.sconresearch.eu/),Department of Oral Basic Sciences, Taibah University, Medina, Saudi Arabia
| | - A van Wijk
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - P Larsson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Sweden,Scandinavian Center for Orofacial Neurosciences (http://www.sconresearch.eu/),Centre for Oral Rehabilitation, Folktandvården Östergötland, Linköping, Sweden
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Berlin H, List T, Ridell K, Davidson T, Toft D, Klingberg G. Postoperative pain profile in 10-15-year-olds after bilateral extraction of maxillary premolars. Eur Arch Paediatr Dent 2019; 20:545-555. [PMID: 30963511 DOI: 10.1007/s40368-019-00425-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/25/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To study pain perception in 10-15-year-olds, during and after uncomplicated extractions of bilateral maxillary premolars. The study investigated pain's natural course and made comparisons between the first and second extractions. METHODS 31 Swedish children in need of orthodontic treatment were identified and consecutively enrolled. Tooth extractions followed a standardised protocol and the two teeth were extracted with at least 10 days between. The participants rated pain intensity using visual analogue scale (VAS) at 14 different time points from treatment and 7 days forward. RESULTS The pain intensity profile followed the same pattern for all patients. Pain intensity peaked 2 h after extractions (mean VASPI 27.3, SD 20.8; median 23.0) when moderate pain intensity (VASPI ≥ 40) was registered for 16 (28%) of 57 cases. After that, there was a rapid decrease in pain intensity notable already at 4 h after extractions. There were no statistically significant differences in any VASPI measurements between the first and second extractions, sexes, or different age groups. CONCLUSIONS The majority of the participants who undergo uncomplicated bilateral extraction of maxillary premolars experience mild to moderate levels of postoperative pain during a short period of time, with no differences between the first and second extractions. Bilateral tooth extractions is a suitable model for further studies on pain management.
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Affiliation(s)
- H Berlin
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden.
| | - T List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - K Ridell
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
| | - T Davidson
- Department of Medical and Health Sciences (IMH), Linköping University, Linköping, Sweden
| | - D Toft
- Colosseum Smile Dental Group, Malmö, Sweden
| | - G Klingberg
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
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Häggman-Henrikson B, Alstergren P, Davidson T, Högestätt ED, Östlund P, Tranaeus S, Vitols S, List T. Pharmacological treatment of oro-facial pain - health technology assessment including a systematic review with network meta-analysis. J Oral Rehabil 2017; 44:800-826. [DOI: 10.1111/joor.12539] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 01/11/2023]
Affiliation(s)
- B. Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Faculty of Odontology; Health Technology Assessment - Odontology (HTA-O); Malmö University; Malmö Sweden
| | - P. Alstergren
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
- Department of Rehabilitation Medicine; Skåne University Hospital; Malmö Sweden
| | - T. Davidson
- Faculty of Odontology; Health Technology Assessment - Odontology (HTA-O); Malmö University; Malmö Sweden
- Department of Medical and Health Sciences; Division of Health Care Analysis; Linköping University; Linköping Sweden
| | - E. D. Högestätt
- Department of Laboratory Medicine; Clinical Chemistry and Pharmacology; Lund University; Lund Sweden
| | - P. Östlund
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU); Stockholm Sweden
| | - S. Tranaeus
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU); Stockholm Sweden
| | - S. Vitols
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU); Stockholm Sweden
- Department of Medicine; Division of Clinical Pharmacology; Karolinska Institute; Stockholm Sweden
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
- Department of Rehabilitation Medicine; Skåne University Hospital; Malmö Sweden
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Al-Harthy M, Michelotti A, List T, Ohrbach R. Influence of culture on pain comorbidity in women with and without temporomandibular disorder-pain. J Oral Rehabil 2017; 44:415-425. [PMID: 28244114 DOI: 10.1111/joor.12499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/30/2022]
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 < 0·01). Saudis reported higher prevalence of work reduced >50% due to back pain compared to Italians or Swedes (P < 0·01). 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 < 0·01). For both back and head pain, higher average pain intensities (P < 0·01) and interference with daily activities (P < 0·01) were reported by TMD-pain cases, compared to TMD-free controls. Among TMD-pain cases, Italians reported the highest pain-related disability (P < 0·01). 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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Affiliation(s)
- M Al-Harthy
- Department of Oral Basic and Clinical Sciences, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Orofacial Pain and Jaw Functions, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden
| | - A Michelotti
- Department of Orthodontics and Temporomandibular disorders, University of Naples Federico II, Naples, Italy
| | - T List
- Department of Orofacial Pain and Jaw Functions, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - R Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY, USA
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Louca Jounger S, Christidis N, Svensson P, List T, Ernberg M. Increased levels of intramuscular cytokines in patients with jaw muscle pain. J Headache Pain 2017; 18:30. [PMID: 28243900 PMCID: PMC5328896 DOI: 10.1186/s10194-017-0737-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/15/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate cytokine levels in the masseter muscle, their response to experimental tooth-clenching and their relation to pain, fatigue and psychological distress in patients with temporomandibular disorders (TMD) myalgia. METHODS Forty women, 20 with TMD myalgia (Diagnostic Criteria for TMD) and 20 age-matched healthy controls participated. Intramuscular microdialysis was performed to sample masseter muscle cytokines. After 140 min (baseline), a 20-minute tooth-clenching task was performed (50% of maximal voluntary contraction force). Pain (Numeric rating scale 0-10) and fatigue (Borg's Ratings of Perceived Exertion 6-20) were assessed throughout microdialysis, while pressure-pain thresholds (PPT) were assessed before and after microdialysis. Perceived stress (PSS-10) and Trait Anxiety (STAI) were assessed before microdialysis. RESULTS The levels of IL-6, IL-7, IL-8 and IL-13 were higher in patients than controls (Mann Whitney U-test; P's < 0.05) during the entire microdialysis. IL-6, IL-8 and IL-13 changed during microdialysis in both groups (Friedman; P's < 0.05), while IL-1β, IL-7 and GM-CSF changed only in patients (P's < 0.01). IL-6 and IL-8 increased in response to tooth-clenching in both groups (Wilcoxon test; P's < 0.05), while IL-7, IL-13 and TNF increased only in patients (P's < 0.05). Patients had higher pain and fatigue than controls before and after tooth-clenching (P < 0.001), and lower PPTs before and after microdialysis (P < 0.05). There were no correlations between cytokine levels, pain or fatigue. Also, there were no differences in stress or anxiety levels between groups. CONCLUSIONS In conclusion, the masseter levels of IL-6, IL-7, IL-8 and IL-13 were elevated in patients with TMD myalgia and increased in response to tooth-clenching. Tooth-clenching increased jaw muscle pain and fatigue, but without correlations to cytokine levels. This implies that subclinical muscle inflammation may be involved in TMD myalgia pathophysiology, but that there is no direct cause-relation between inflammation and pain.
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Affiliation(s)
- S Louca Jounger
- Section for Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE 14104, Huddinge, Sweden. .,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
| | - N Christidis
- Section for Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE 14104, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - P Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE 14104, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.,Section of Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark
| | - T List
- Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden
| | - M Ernberg
- Section for Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE 14104, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
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Oghli I, List T, John M, Larsson P. Prevalence and oral health-related quality of life of self-reported orofacial conditions in Sweden. Oral Dis 2016; 23:233-240. [PMID: 27770603 DOI: 10.1111/odi.12600] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 10/07/2016] [Accepted: 10/10/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To (i) determine the prevalences of self-report in a Swedish adult population, of temporomandibular disorders, burning mouth syndrome, dry mouth, and bad breath and (ii) determine oral health-related quality-of-life impairment in subjects reporting these conditions. SUBJECTS AND METHODS A cross-sectional, randomized sample of the adult Swedish population (response rate: 46%, N = 1309 subjects) self-reported their condition from the preceding month to assess prevalences of self-report for the studied conditions together with comorbidity group of subjects who reported more than one condition. The 49-item Oral Health Impact Profile (OHIP) used to assess oral health-related quality of life. RESULTS The most prevalent condition was bad breath (39%), followed by dry mouth (22%), temporomandibular disorders (18%) and burning mouth syndrome (4%). High comorbidity of conditions occurred in 27% of the population. Quality-of-life impairment increased with the number of comorbid conditions. Among individual conditions, burning mouth syndrome and temporomandibular disorders (57% and 40% OHIP points) presented higher impairment than dry mouth and bad breath (32% and 26% OHIP points). CONCLUSIONS Orofacial conditions were common and often coexist. The comorbidity group experienced the highest impact on oral health-related quality of life: the more the comorbid conditions, the greater the negative impact.
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Affiliation(s)
- I Oghli
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmo University, Malmo, Sweden.,Department of Oral Basic Sciences, Taibah University, Medina, Saudi Arabia.,Scandinavian Centre for Orofacial Neurosciences, Malmö
| | - T List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmo University, Malmo, Sweden.,Scandinavian Centre for Orofacial Neurosciences, Malmö.,Department of Rehabilitation Medicine, Skane University Hospital, Lund, Sweden
| | - M John
- Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN, USA
| | - P Larsson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmo University, Malmo, Sweden.,Scandinavian Centre for Orofacial Neurosciences, Malmö.,Centre of Oral Rehabilitation, Norrkoping, Sweden
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Durham J, Al-Baghdadi M, Baad-Hansen L, Breckons M, Goulet JP, Lobbezoo F, List T, Michelotti A, Nixdorf DR, Peck CC, Raphael K, Schiffman E, Steele JG, Story W, Ohrbach R. Self-management programmes in temporomandibular disorders: results from an international Delphi process. J Oral Rehabil 2016; 43:929-936. [DOI: 10.1111/joor.12448] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 11/27/2022]
Affiliation(s)
- J. Durham
- Centre for Oral Health Research & Institute of Health and Society; Newcastle-upon-Tyne Hospitals’ NHS Foundation Trust; Newcastle University; Newcastle-upon-Tyne UK
| | - M. Al-Baghdadi
- Oral Surgery Unit; Al-Noor Specialized Dental Care Centre; Iraqi Ministry of Health; Baghdad Iraq
| | - L. Baad-Hansen
- Section of Orofacial Pain and Jaw Function; Institute of Odontology and Oral Health; Aarhus University; Aarhus Denmark
| | - M. Breckons
- Institute of Health & Society; Newcastle University; Newcastle-upon-Tyne UK
| | - J. P. Goulet
- Faculty of Dental Medicine; Université Laval; Quebec QC Canada
| | - F. Lobbezoo
- Department of Oral Health Sciences; Academic Centre for Dentistry Amsterdam (ACTA); MOVE Research Institute Amsterdam; University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - T. List
- Department of Orofacial Pain and Jaw Function; Scandinavian Center for Orofacial Neurosciences (SCON); Faculty of Odontology; Malmö University; Malmö Sweden
| | - A. Michelotti
- Section of Orthodontics; Department of Neuroscience, Reproductive and Oral Sciences; University of Naples Federico II; Naples Italy
| | - D. R. Nixdorf
- Division of TMD and Orofacial Pain; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - C. C. Peck
- Faculty of Dentistry; The University of Sydney; Sydney NSW Australia
| | - K. Raphael
- New York University College of Dentistry; New York NY USA
| | - E. Schiffman
- Division of TMD and Orofacial Pain; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - J. G. Steele
- Centre for Oral Health Research & Institute of Health and Society; Newcastle-upon-Tyne Hospitals’ NHS Foundation Trust; Newcastle University; Newcastle-upon-Tyne UK
| | - W. Story
- Centre for Oral Health Research; Newcastle University; Newcastle-upon-Tyne UK
| | - R. Ohrbach
- Department of Oral Diagnostic Sciences; School of Dental Medicine; University at Buffalo; Buffalo NY USA
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Michelotti A, Alstergren P, Goulet JP, Lobbezoo F, Ohrbach R, Peck C, Schiffman E, List T. Next steps in development of the diagnostic criteria for temporomandibular disorders (DC/TMD): Recommendations from the International RDC/TMD Consortium Network workshop. J Oral Rehabil 2016; 43:453-67. [DOI: 10.1111/joor.12378] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- A. Michelotti
- Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - P. Alstergren
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
| | - J. P. Goulet
- Faculty of Dental Medicine; Laval University; Quebec QC Canada
| | - F. Lobbezoo
- Department of Oral Health Sciences; Academic Centre for Dentistry Amsterdam (ACTA); MOVE Research Institute Amsterdam; University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - R. Ohrbach
- Department of Oral Diagnostic Sciences; University at Buffalo; Buffalo NY USA
| | - C. Peck
- Faculty of Dentistry; University of Sydney; Darlington NSW Australia
| | - E. Schiffman
- Division of TMD and Orofacial Pain; University of Minnesota; Minneapolis MN USA
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
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Hongxing L, Astrøm AN, List T, Nilsson I, Johansson A. Prevalence of temporomandibular disorder pain in Chinese adolescents compared to an age‐matched Swedish population. J Oral Rehabil 2015; 43:241-8. [DOI: 10.1111/joor.12366] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2015] [Indexed: 12/27/2022]
Affiliation(s)
- L. Hongxing
- Department of Clinical Dentistry – Prosthodontics University of Bergen Bergen Norway
| | - A. N. Astrøm
- Department of Clinical Dentistry – Community Dentistry University of Bergen Bergen Norway
| | - T. List
- Orofacial Pain and Jaw Function Malmö University Malmö Sweden
| | | | - A. Johansson
- Department of Clinical Dentistry – Prosthodontics University of Bergen Bergen Norway
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Affiliation(s)
- M. Al-Harthy
- Department of Oral Basic and Clinical Sciences; Faculty of Dentistry; Umm Al-Qura University; Makkah Saudi Arabia
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
| | - R. Ohrbach
- Department of Oral Diagnostic Sciences; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - A. Michelotti
- Department of Orthodontics and Temporomandibular Disorders; School of Dentistry; University of Naples Federico II; Naples Italy
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
- Department of Rehabilitation Medicine; Skane University Hospital; Lund Sweden
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Alsafi Z, Michelotti A, Ohrbach R, Nilner M, List T. Achieved competences in temporomandibular disorders/orofacial pain: a comparison between two dental schools in Europe. Eur J Dent Educ 2015; 19:161-168. [PMID: 25168490 DOI: 10.1111/eje.12117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 06/03/2023]
Abstract
AIMS The aim was to study achieved competences in temporomandibular disorders (TMD)/orofacial pain (OP) at two universities by comparing student's knowledge and understanding, satisfaction with their education and confidence in their clinical competences of TMD/OP. METHODS The study was conducted in collaboration between Malmö University, Sweden—which uses problem-based learning—and the University of Naples Federico II, Italy—which uses traditional educational methods. Final-semester dental students responded to a self-report questionnaire regarding their knowledge and understanding, interpretation of cases histories, clinical experience, satisfaction and confidence in clinical examination, management and treatment evaluation. RESULTS No significant difference was found between the students regarding knowledge and understanding. Eighty-seven per cent of the Malmö students and 96% of the Naples students met the criterion on achieved competence. Malmö students had a higher per cent of correct diagnoses than Naples students in the interpretation of case histories. Overall, Malmö students reported most clinical experience and higher confidence than Naple students. CONCLUSIONS The main findings were that students from Malmö and Naples were, similar in knowledge and understanding of TMD/OP and in satisfaction with their clinical competences. However, Malmö students perceived more confidence in clinical management of patients with TMD/OP. This may reflect that, besides the theoretical part of the programme, a sufficient level of clinical exposure to patients with TMD/OP is essential to gain competences in TMD/OP.
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Affiliation(s)
- Z Alsafi
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - A Michelotti
- Oral, Dental and Maxillofacial Sciences, Section of Orthodontics and Clinical Gnathology, University of Naples Federico II, Naples, Italy
| | - R Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY, USA
| | - M Nilner
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - T List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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Forssell H, Jääskeläinen S, List T, Svensson P, Baad-Hansen L. An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management. J Oral Rehabil 2014; 42:300-22. [DOI: 10.1111/joor.12256] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 01/03/2023]
Affiliation(s)
- H. Forssell
- Department of Oral and Maxillofacial Surgery; Institute of Dentistry; University of Turku; Turku Finland
| | - S. Jääskeläinen
- Department of Clinical Neurophysiology; University of Turku and Turku University Hospital; Turku Finland
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Denmark
- Department of Rehabilitation Medicine; Skåne University Hospital; Lund Denmark
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
| | - P. Svensson
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
| | - L. Baad-Hansen
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
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Dawson A, Ljunggren L, Ernberg M, Svensson P, List T. EHMTI-0301. Effect of experimental tooth clenching on the release of beta-endorphin. J Headache Pain 2014. [PMCID: PMC4181045 DOI: 10.1186/1129-2377-15-s1-c13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Peck CC, Goulet JP, Lobbezoo F, Schiffman EL, Alstergren P, Anderson GC, de Leeuw R, Jensen R, Michelotti A, Ohrbach R, Petersson A, List T. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil 2014; 41:2-23. [PMID: 24443898 DOI: 10.1111/joor.12132] [Citation(s) in RCA: 190] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2013] [Indexed: 12/21/2022]
Abstract
There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria.
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Affiliation(s)
- C C Peck
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, The University of Sydney, Sydney, NSW, Australia
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Baad-Hansen L, Pigg M, Yang G, List T, Svensson P, Drangsholt M. Reliability of intra-oral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls - a multicentre study. J Oral Rehabil 2014; 42:127-35. [PMID: 25284726 DOI: 10.1111/joor.12245] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2014] [Indexed: 11/27/2022]
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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Affiliation(s)
- L Baad-Hansen
- Section of Clinical Oral Physiology, Department of Dentistry, HEALTH, Aarhus University, Aarhus, Denmark; Scandinavian Center for Orofacial Neuroscience (SCON), Faculty of Odontology, Malmö University, Malmö, Sweden
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Larsson P, John MT, Hakeberg M, Nilner K, List T. General population norms of the Swedish short forms of oral health impact profile. J Oral Rehabil 2014; 41:275-81. [PMID: 24447237 DOI: 10.1111/joor.12137] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2013] [Indexed: 11/29/2022]
Abstract
We reported the development and psychometric evaluation of a Swedish 14-item and a five-item short form of the Oral Health Impact Profile. The 14-item version was derived from the English-language short form developed by Slade in1997. The five-item version was derived from the German-language short form developed by John et al. in 2006. Validity, reliability and normative values for the two short form summary scores were determined in a random sample of the adult Swedish population (response rate: 46%, N = 1366 subjects). Subjects with sufficient OHRQoL information to calculate a summary score (N = 1309) were on average 50·1 ± 17.4 years old, and 54% were women. Short form summary scores correlated highly with the 49-item OHIP-S (r ≥ 0.97 for OHIP-S14, r ≥ 0.92 for OHIP-S5) and with self-report of oral health (r ≥ 0.41). Reliability, measured with Cronbach's alpha (0.91 for OHIP-S14, 0.77 for OHIP-S5), was sufficient. In the general population, 50% of the subjects had ≥2 OHIP-S14 score points and 10% had ≥11 points, respectively. Among subjects with their own teeth only and/or fixed dental prostheses and with partial removable dental prostheses, 50% of the population had ≥2 OHIP-S14 score points, and 10% had ≥11 points. For subjects with complete dentures, the corresponding figures were 3 and 24 points. OHIP-S5 medians for subjects in the three population groups were 1, 1 and 2 points. Swedish 14-item and 5-item short forms of the OHIP have sufficient psychometric properties and provide a detailed overview about impaired OHRQoL in Sweden. The norms will serve as reference values for future studies.
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Affiliation(s)
- P Larsson
- Centre for Oral Rehabilitation, Norrköping, Sweden; Department for Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden
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Iida T, Overgaard A, Komiyama O, Weibull A, Baad-Hansen L, Kawara M, Sundgren PC, List T, Svensson P. Analysis of brain and muscle activity during low-level tooth clenching - a feasibility study with a novel biting device. J Oral Rehabil 2014; 41:93-100. [DOI: 10.1111/joor.12128] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
- T. Iida
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
- Section of Clinical Oral Physiology; Department of Dentistry; Aarhus University; Aarhus Denmark
| | - A. Overgaard
- Department of Radiology/DC; Skane University Hospital; Malmö Sweden
- Department of Radiology/DC; Lund University; Lund Sweden
| | - O. Komiyama
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - A. Weibull
- Department of Radiology/DC; Skane University Hospital; Malmö Sweden
- Department of Radiology/DC; Lund University; Lund Sweden
| | - L. Baad-Hansen
- Section of Clinical Oral Physiology; Department of Dentistry; Aarhus University; Aarhus Denmark
| | - M. Kawara
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - P. C. Sundgren
- Department of Diagnostic Radiology; Clinical Sciences Lund; Lund University; Lund Sweden
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Sweden
| | - P. Svensson
- Section of Clinical Oral Physiology; Department of Dentistry; Aarhus University; Aarhus Denmark
- Mind Lab; Center for Functionally Integrative Neuroscience; Aarhus University Hospital; Aarhus Denmark
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Häggman-Henrikson B, Rezvani M, List T. Prevalence of whiplash trauma in TMD patients: a systematic review. J Oral Rehabil 2013; 41:59-68. [DOI: 10.1111/joor.12123] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- B. Häggman-Henrikson
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
| | - M. Rezvani
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
| | - T. List
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
- Department of Rehabilitation Medicine; Skåne University Hospital; Lund Sweden
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Abstract
This study reports the findings and challenges of the assessment of oro-facial aesthetics in the Swedish general population and the development of normative values for the self-reporting Orofacial Esthetic Scale (OES). In a Swedish national sample of 1406 adult subjects (response rate: 47%), OES decile norms were established. The influence of sociodemographics (gender, age, and education), oral health status and general health status on OES scores was analysed. Mean ± standard deviation of OES scores was 50.3 ± 15.6 units (0, worst score; 70, best score); <1% of the subjects had the minimum score of 0, and 11% had the maximum score of 70 OES units. Orofacial Esthetic Scale score differences were (i) substantial (>5 OES units) for subjects with excellent/very good versus good to poor oral or general health status; ii) small (2 units), but statistically significant for gender (P = 0.01) and two age groups (P = 0.02), and (iii) absent for subjects with college versus no college education (P = 0.31) or with and without dentures (P = 0.90). To estimate normative values for a self-reporting health status, instrument is considered an important step in standardisation, and the developed norms provide a frame of reference in the general population to interpret the Orofacial Esthetic Scale scores.
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Affiliation(s)
- P Larsson
- Centre for Oral Rehabilitation, Norrköping, Sweden; Department of Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abstract
This case-control study evaluated the association of headache and other co-morbid pain with temporomandibular disorder (TMD) pain in adolescents and explored the temporal co-variance of headache and TMD pain. In a population-based sample of 12- to 19-year-olds, 350 patients with self-reported TMD pain and 350 healthy age- and sex-matched individuals were mailed questionnaires. Descriptive statistics, 95% CI, and OR analyses--logistic regression models with TMD pain as the outcome variable and adjusted for age and gender--were used for the analysis of individuals' responses. Headache, whether defined as once a week or more (OR = 6.6) or as moderate or severe (categorical), was significantly related to TMD pain. Severe headache (vs. mild) showed stronger associations with TMD (OR = 10.1) than between moderate and mild headache (OR = 5.5). Neck (OR = 4.0) and back (OR = 2.6) pain was also significantly related to TMD pain. When participants were grouped according to headache onset and TMD pain, the highest association between headache and TMD pain was found in the subgroup "Headache onset before TMD pain" (OR 9.4). In conclusion, headache appears to be independently and highly associated with TMD pain in adolescents. Neck pain and somatic complaints were also significantly associated with TMD pain. Headache seems to precede TMD pain in many adolescents with pain.
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Affiliation(s)
- I-M Nilsson
- Center for Oral Rehabilitation, Norrköping, Sweden.
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Castrillon EE, Cairns B, List T, Svensson P, Ernberg M. Acidic saline-induced pain as a model for experimental masseter myalgia in healthy subjects. Eur J Pain 2013; 17:1438-46. [PMID: 23649906 DOI: 10.1002/j.1532-2149.2013.00324.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Repeated injection of acidic saline into skeletal muscles of the leg in rodents induces a prolonged bilateral mechanical hyperalgesia that persists for up to 30 days and may be useful to model widespread muscle pain conditions. In this study, repeated injection of acidic (pH 3.3) saline solution into the masseter muscle of healthy human subjects was undertaken to determine if these injections are painful and whether they would induce a prolonged period of muscle sensitization to artificial and/or natural mechanical stimulation of the masseter and temporalis muscles. METHODS Eighteen subjects (10 male, 8 female) participated in the study. Subjects received two injections of 0.5 mL acidic or regular isotonic saline 2 days apart, in a randomized, double blind, crossover design. RESULTS There was no significant difference in pain intensity ratings when acidic saline injections were compared with regular saline injections. Pain area drawings were, however, significantly larger in response to the first injection of acidic saline than to the second injection of acidic saline or to either the first or second injection of regular saline. Repeated injection of acidic saline did not significantly alter pressure pain thresholds from the masseter or temporalis muscles on either the injected side or the opposite side over the 10-day post injection monitoring period. There was also no effect of injections on chewing. CONCLUSION These findings indicate that, unlike in some rodent models, repeated injection of low pH solutions into jaw muscles of humans fails to induce a period of prolonged muscle hyperalgesia.
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Affiliation(s)
- E E Castrillon
- Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Denmark; Section of Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Ernberg M, Castrillon EE, Ghafouri B, Larsson B, Gerdle B, List T, Svensson P. Experimental myalgia induced by repeated infusion of acidic saline into the human masseter muscle does not cause the release of algesic substances. Eur J Pain 2012; 17:539-50. [PMID: 23132643 DOI: 10.1002/j.1532-2149.2012.00216.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2012] [Indexed: 11/12/2022]
Abstract
BACKGROUND Animal studies have shown that two repeated intramuscular injections of acidic saline induce mechanical allodynia that lasts for 4 weeks with spread to the contralateral side. In this study, we tested the hypothesis that two repeated intramuscular infusions of acidic saline into the human masseter muscle is associated with pain, mechanical allodynia and release of algesic substances. Eighteen healthy volunteers participated. On day 1, 2.5 mL of acidic saline (pH 3.3) was infused into one of the masseter muscles and isotonic saline (pH 6.0) into the other (randomized and single-blind). Two days later, intramuscular microdialysis was performed to sample serotonin, glutamate, pyruvate, lactate and glucose, during which the saline infusions were repeated. Pain and pressure pain thresholds (PPTs) were recorded before and after infusions on both days. RESULTS Pain intensity induced by the infusions was higher after acidic than that after isotonic saline (p < 0.05). PPTs were decreased on both sides after microdialysis compared with baseline day 1 (p's < 0.05), but there were no differences in PPTs between sides at any time point. The levels of serotonin, glutamate, pyruvate, lactate or glucose did not change significantly during microdialysis. CONCLUSION Infusion of acidic saline caused low levels of muscle pain, but no mechanical allodynia and no increased release of algesic substances. The value of this model appears modest, but future studies could be performed with larger sample size and higher flow rate before definite conclusions about the validity of the model for craniofacial myalgia can be drawn.
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Affiliation(s)
- M Ernberg
- Section of Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
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Pigg M, List T, Petersson K, Lindh C, Petersson A. Diagnostic yield of conventional radiographic and cone-beam computed tomographic images in patients with atypical odontalgia. Int Endod J 2011; 44:1092-101. [DOI: 10.1111/j.1365-2591.2011.01923.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Svensson P, Baad-Hansen L, Pigg M, List T, Eliav E, Ettlin D, Michelotti A, Tsukiyama Y, Matsuka Y, Jääskeläinen SK, Essick G, Greenspan JD, Drangsholt M. Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions--a taskforce report. J Oral Rehabil 2011; 38:366-94. [PMID: 21241350 DOI: 10.1111/j.1365-2842.2010.02196.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The goals of an international taskforce on somatosensory testing established by the Special Interest Group of Oro-facial Pain (SIG-OFP) under the International Association for the Study of Pain (IASP) were to (i) review the literature concerning assessment of somatosensory function in the oro-facial region in terms of techniques and test performance, (ii) provide guidelines for comprehensive and screening examination procedures, and (iii) give recommendations for future development of somatosensory testing specifically in the oro-facial region. Numerous qualitative and quantitative psychophysical techniques have been proposed and used in the description of oro-facial somatosensory function. The selection of technique includes time considerations because the most reliable and accurate methods require multiple repetitions of stimuli. Multiple-stimulus modalities (mechanical, thermal, electrical, chemical) have been applied to study oro-facial somatosensory function. A battery of different test stimuli is needed to obtain comprehensive information about the functional integrity of the various types of afferent nerve fibres. Based on the available literature, the German Neuropathic Pain Network test battery appears suitable for the study of somatosensory function within the oro-facial area as it is based on a wide variety of both qualitative and quantitative assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intra-oral mucosa. Standardisation of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different oro-facial pain conditions and may help to guide management.
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Affiliation(s)
- P Svensson
- Department of Clinical Oral Physiology, Aarhus University, Aarhus, Denmark.
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Affiliation(s)
- T List
- Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abstract
This 2·5-day workshop was organized by the International RDC/TMD Consortium Network of the International Association for Dental Research and the Orofacial Pain Special Interest Group of the International Association for the Study of Pain. Workshop participation was by invitation based on representation within the field, which included the Consortium Network, the Orofacial Pain Special Interest Group, the National Institute for Dental and Craniofacial Research, American Academy of Orofacial Pain, the European Academy of Craniomandibular Disorders, and the International Headache Society; other disciplines included radiology, psychology, ontology, and patient advocacy. The workshop members were divided into workgroups that reviewed core literature describing the properties of the RDC/TMD, provided recommendations for revision, and suggested relevant research directions. The goals of this workshop were to (i) finalize the revision of the RDC/TMD into a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which would be more appropriate for routine clinical implementation, (ii) provide a broad foundation for the further development of suitable diagnostic systems for not only TMD but also oro-facial pain as well, and (iii) provide research recommendations oriented towards improving our understanding of TMD and oro-facial pain. This report provides the full description of the workshop and Executive Summary, and it acknowledges the participants and sponsors.
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Affiliation(s)
- R Ohrbach
- University at Buffalo, Buffalo, NY, USA.
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Englesson Sahlstrom L, Ekberg E, List T, Petersson A, Eriksson L. O.649 Lavage questionable in treatment of painful reduced mouth opening capacity. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71773-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
OBJECTIVE This study evaluates the presence of culture and gender differences in pain thresholds and pain tolerance levels between Middle Easterners and Swedes. METHODS Sixty-four healthy individuals, 32 Middle Easterners (16 men and 16 women, mean age: 24.6 +/- 3.4 years) and 32 Swedes (16 men and 16 women, mean age: 24 +/- 3.5 years) participated in the study. Three experimental pain tests were conducted in each participant. Pain thresholds and pain tolerance levels were measured using an algometer (mechanical stimulus), the PainMatcher((R)) (electric stimulus) and cold pressor test (thermal stimulus). RESULTS While no significant differences in pain thresholds were observed between Middle Easterners and Swedes in algometer and cold pressor tests, differences in pain tolerance levels were significant (P < 0.01 for both tests). All between-culture differences in pain perception, pain threshold and pain tolerance level were non-significant when measured with the PainMatcher. Significant between-gender differences were observed only in pain threshold with the PainMatcher (P < 0.05) and in pain tolerance level with the algometer (P < 0.01) and the PainMatcher (P <0.001). CONCLUSION This study found significant differences in two out of three pain tolerance level tests - but not pain threshold tests - between the Middle Eastern and Swedish cultures and between genders. These differences were more pronounced between Middle Eastern and Swedish men than between Middle Eastern and Swedish women. Gender differences were more pronounced within the Swedish than the Middle Eastern culture. These findings indicate that culture and gender influence pain experience.
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Affiliation(s)
- A Dawson
- Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abstract
AIM The aim of the study was to map general practice dentists' (GPDs) knowledge of temporomandibular disorders (TMD) in children and adolescents. MATERIALS AND METHODS A questionnaire was mailed to 286 Swedish dentists in the Public Dental Service and 17 TMD specialists with documented research experience. The questionnaire contained 37 statements on aetiology, diagnostics, classification, chronic pain and pain behaviour, treatment, and prognosis. Each statement was judged on a 0-10 point scale with the endpoint definitions agree or disagree. RESULTS The overall response rate to the questionnaire was 87%. In 28 of all 37 statements, the TMD specialists endorsed a consensus, i.e. >75% of the specialists had the same opinion about the statement. TMD specialists differed most in opinion in the domain diagnostics and classification. In 65% of the statements, differences in knowledge between GPDs and TMD specialists were non-significant. The greatest number of significant between-group differences was found in the domain treatment and prognosis. Most of these statements were related to morphological factors. CONCLUSION There is a high degree of consensus in TMD knowledge amongst the TMD specialists and a high degree of agreement in knowledge between GPDs and TMD specialists. In some areas, however, TMD specialists still need to reach a consensus which is founded on evidence-based TMD knowledge in children and adolescents and that can be used in undergraduate teaching. It is therefore important to develop and strengthen the undergraduate dental teaching in TMD and orofacial pain.
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Affiliation(s)
- A Tegelberg
- Department of Stomatognathic Physiology , Centre for Clinical Research, Uppsala University Central Hospital, Västerås, Sweden.
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List T, Axelsson S, Leijon G. Pharmacologic interventions in the treatment of temporomandibular disorders, atypical facial pain, and burning mouth syndrome. A qualitative systematic review. J Prosthet Dent 2004. [DOI: 10.1016/j.prosdent.2004.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tegelberg A, List T, Wahlund K, Wenneberg B. Temporomandibular disorders in children and adolescents: a survey of dentists' attitudes, routine and experience. Swed Dent J 2002; 25:119-27. [PMID: 11813448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The aim of this study was to survey the experience and routine of, attitudes toward, and need for specialist resources in the treatment of temporomandibular disorders (TMD) in children and adolescents among public dentists. A questionnaire study was conducted in three counties in Sweden: Ostergötland, Västmanland, and Göteborg. The questionnaire was sent to 286 Public Dental Service dentists. It contained questions on demographic issues, quality assurance, clinical experience and expertise, attitudes, and the need for specialist resources. Eighty-seven per cent (250) of the dentists answered the questionnaire. The dentists in the three areas reported good routine and safety in occlusal splint treatments (74%-81%), occlusal equilibration (28%-55%), jaw exercise (25%-29%), and medication treatments (3%-55%). Good experience concerning diagnostics and therapy decision was reported by 25%-50% of the dentists. A significantly greater portion of the dentists in Västmanland had attended courses in TMD compared with the two other counties (p = 0.001). Registrations of quality variables such as verbal and/or written case histories with questions on facial pain and tension-type headache (1%-39%) and measurements of jaw openings were performed less frequently in the three counties (0%-5%). Fifty-five per cent of the dentists had a positive attitude toward the care of children and adolescents with TMD. A large need for specialist resources with the possibility to send referrals or to consult was reported by 98%-100% of the respondents, to participate in continuing education by 97%-98%, and to do auscultation by 61%-82%. In conclusion, many of the dentists lacked routines for making diagnoses, deciding therapy, and judging treatment results. Good routines were reported only in occlusal splint therapy. The majority of the dentists had a positive attitude toward the care of children and adolescents with TMD-related symptoms. The majority of the dentists reported a great need for TMD specialists.he
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Affiliation(s)
- A Tegelberg
- Department of Stomatognathic Physiology, Central Hospital, Västeräs, Sweden.
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Marcusson A, List T, Paulin G, Akerlind I. Reliability of a multidimensional questionnaire for adults with treated complete cleft lip and palate. Scand J Plast Reconstr Surg Hand Surg 2001; 35:271-8. [PMID: 11680395 DOI: 10.1080/028443101750523177] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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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Affiliation(s)
- A Marcusson
- Department of Dentofacial Orthopedics, University Hospital Linköping, Sweden.
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Marcusson A, List T, Paulin G, Dworkin S. Temporomandibular disorders in adults with repaired cleft lip and palate: a comparison with controls. Eur J Orthod 2001; 23:193-204. [PMID: 11398556 DOI: 10.1093/ejo/23.2.193] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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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Affiliation(s)
- A Marcusson
- Department of Dentofacial Orthopedics, University Hospital, Linköping, Sweden
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List T, Wahlund K, Larsson B. Psychosocial functioning and dental factors in adolescents with temporomandibular disorders: a case-control study. J Orofac Pain 2001; 15:218-27. [PMID: 11575192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
AIMS To examine the influence of psychosocial functioning and dental factors in adolescents with temporomandibular disorders (TMD) versus healthy subjects. METHODS The TMD sample comprised 63 patients (21 boys and 42 girls, 33% and 67%, respectively, with a mean age of 14.9 years; range 12 to 18 years) and was compared with 64 healthy control subjects (17 boys and 47 girls, 27% and 73%, respectively, with a mean age of 14.8 years). Subjects in the TMD group had to report pain once a week or more and to have a TMD pain diagnosis according to the Research Diagnostic Criteria for TMD. Participants were clinically examined and filled out a questionnaire in which self-reported psychosocial functioning was assessed on standardized measures, including the Youth Self-Report (YSR), somatic complaints, and stress. RESULTS No significant differences were found in dental factors among adolescents in the TMD group compared with those in the control group. Multiple pains in the body and fatigue were significantly more common in the TMD group compared with the control group. Adolescents with TMD also reported significantly higher levels of stress, somatic complaints, and aggressive behavior than their counterparts in the control group. In particular, young adolescents with TMD reported high levels of psychosocial problems. CONCLUSION In adolescents with TMD, psychosocial factors such as increased levels of stress, somatic complaints, and emotional problems seem to play a more prominent role than dental factors.
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Affiliation(s)
- T List
- TMD Unit, Specialist Center for Oral Rehabilitation, Torkelbergsgatan 11, SE-581 85 Linköping, Sweden.
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List T, Wahlund K, Wenneberg B, Dworkin SF. TMD in children and adolescents: prevalence of pain, gender differences, and perceived treatment need. J Orofac Pain 1999; 13:9-20. [PMID: 10425964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
AIMS The aim of this study was to determine the prevalence of pain that is related to temporomandibular disorders (TMD), gender differences, and perceived treatment need in children and adolescents at a public dental clinic in Linköping, Sweden. METHODS A total of 862 children and adolescents aged 12 to 18 years received a questionnaire and their jaw opening was measured. Those who reported pain once a week or more in the masticatory system received a more comprehensive examination, including the Research Diagnostic Criteria for TMD and a neurologic examination (group 1). Group 2 reported pain less than once a week. RESULTS Seven percent of subjects (63/862) were diagnosed with TMD pain. Both genders exhibited similar distributions of TMD diagnoses, except that myofascial pain was significantly more common in girls than in boys. Prevalence of pain once a week or more was reported as: 21% in the head; 12% in the temples; and 3% in the face, temporomandibular joint, or jaws. The prevalence of TMD-related pain was significantly higher in girls than in boys. Self-reported TMD symptoms were significantly more common (P < 0.001) in group 1. No significant gender differences were found in group 1 for pain intensity, behavioral rating scale scores, medicine consumption, reported days of school absence, or perceived need for treatment. CONCLUSION Overall, TMD-related pain was more common in girls than in boys. A majority of children and adolescents who experienced pain once a week or more perceived a need for treatment. Seven percent of the examined subjects were diagnosed with TMD pain.
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Affiliation(s)
- T List
- TMD Unit, Specialist Centre for Oral Rehabilitation, Linköping, Sweden.
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List T, Stenström B, Lundström I, Dworkin SF. TMD in patients with primary Sjögren syndrome: a comparison with temporomandibular clinic cases and controls. J Orofac Pain 1999; 13:21-8. [PMID: 10425965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
AIMS The aim of this study was to investigate the prevalence of temporomandibular disorders (TMD) in patients with primary Sjögren syndrome (1 degree SS), analyze the impact of the disease on mandibular function, and assess psychosocial distress. METHODS Sixty-three subjects, 60 women and 3 men, participated in the study; 21 1 degree SS patients were compared with age-matched and gender-matched groups of TMD subjects and controls. Patients were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders. RESULTS Results showed that the subjective, clinical, and radiographic signs of TMD are not more common in patients with 1 degree SS than in controls. The impact of the autoimmune disease on mandibular function, e.g., speech and chewing ability, revealed limitations in oral functioning similar to those in patients with TMD pain. CONCLUSION Both 1 degree SS and chronic TMD may be associated with appreciable physical discomfort and psychosocial dysfunction. However, the underlying mechanisms of the oral dysfunction of 1 degree SS and TMD are quite different and essentially unrelated.
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Affiliation(s)
- T List
- TMD Unit, Specialist Centre of Oral Rehabilitation, Linköping, Sweden.
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Ravald N, List T. Caries and periodontal conditions in patients with primary Sjögren's syndrome. Swed Dent J 1998; 22:97-103. [PMID: 9768457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The present investigation was designed to study caries and periodontal conditions in a selected group of patients with primary Sjögren's syndrome (1oSS). Twenty-one patients, 20 females and 1 male aged 44-75 years (mean 64 years), with recently diagnosed 1oSS constituted the study population. As a control group, 21 patients matched according to sex and age were randomly selected from patients at one clinic in the Public Dental Service. Clinical examinations including registrations of dental caries, restorations, and periodontal conditions were performed. Unstimulated and stimulated salivary secretion rates were recorded. The 1oSS group had a mean number of 16.4 +/- 8.9 and the control group 17.1 +/- 8.4 natural teeth. The 1oSS patients had significantly more DF crown surfaces (63 +/- 25.8 vs 43 +/- 21.3) and more inactive root caries (4.4 +/- 5.4 vs 0.5 +/- 0.9) than did the control patients. No significant differences were found between the groups in the periodontal conditions. The mean value of the unstimulated salivary secretion rate was 0.09 +/- 0.16 ml/15 min in the 1oSS group and 3.33 +/- 2.81 ml/15 min in the control group. The stimulated secretion rate was 0.16 +/- 0.15 ml/min and 1.47 +/- 0.64 ml/min respectively. This study confirms results from other studies that patients with 1oSS face a high risk of developing both coronal and root caries due to xerostomia. The periodontal conditions are similar to those found in patient groups in general dentistry.
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Affiliation(s)
- N Ravald
- Specialist Centre Oral Rehabilitation, Linköping, Sweden
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List T, Lundeberg T, Lundström I, Lindström F, Ravald N. The effect of acupuncture in the treatment of patients with primary Sjögren's syndrome. A controlled study. Acta Odontol Scand 1998; 56:95-9. [PMID: 9669460 DOI: 10.1080/00016359850136058] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Twenty-one patients, 20 women and 1 man, participated in a controlled study. All patients were diagnosed with primary Sjögren's syndrome (primary SS) according to the Copenhagen and San Diego criteria. The patients were randomly assigned to either a group receiving acupuncture treatment or a control group with no active treatment. The patients in the control group received acupuncture after 10 weeks when the acupuncture treatment was completed in the first group. A majority of the patients subjectively reported some improvement after treatment, and a significant increase in paraffin-stimulated saliva secretion was found after treatment. No statistically significant differences between the acupuncture group and the control group were seen in unstimulated salivary secretion or most of the subjective variables. The study showed that acupuncture is of limited value for patients with primary SS.
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Affiliation(s)
- T List
- Specialist Center Oral Rehabilitation, Linköping, Sweden
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Wahlund K, List T, Dworkin SF. Temporomandibular disorders in children and adolescents: reliability of a questionnaire, clinical examination, and diagnosis. J Orofac Pain 1998; 12:42-51. [PMID: 9656898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Recently developed Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) have been shown to be reliable for diagnosing and assessing TMD in U.S. and Swedish adult populations; however, few studies have focused on clinical examination methods and diagnostic criteria for use with children and adolescents. The present study used a sample of 50 Swedish children and adolescents, aged 12 to 18 years, to evaluate usefulness and reliability of existing and specially developed measures and methods for assessing and diagnosing TMD in youth. Subjects underwent repeated clinical exams by two calibrated examiners to assess signs and symptoms per the RDC/TMD, and they responded to a specially developed self-administered questionnaire that addressed location and frequency of TMD-related pain and symptoms, jaw function, effect of pain on daily activities, and use of pain medications. Interexaminer and intraexaminer reliability was assessed for clinical examination, questionnaire items, and diagnosis. Reliability values ranged from acceptable to excellent for the RDC/TMD clinical exam and questionnaire, and from good to excellent reliability for measuring virtually all modified clinical parameters of TMD assessed in these young patients.
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Affiliation(s)
- K Wahlund
- Public Dental Clinic at Ryd, Linköping, Sweden
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List T, Dworkin SF. Comparing TMD diagnoses and clinical findings at Swedish and US TMD centers using research diagnostic criteria for temporomandibular disorders. J Orofac Pain 1996; 10:240-53. [PMID: 9161229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines, originally developed in the United States, were translated and used to classify TMD patients on physical diagnosis (Axis I) and pain-related disability and psychologic status (Axis II) in a TMD specialty clinic in Sweden. The objectives of the study were to determine if such a translation process resulted in a clinically useful diagnostic research measure and to report initial findings when the RDC/TMD was used in cross-cultural comparisons. Findings gathered using the Swedish version of the RDC/TMD were compared with findings from a major US TMD specialty clinic that provided much of the clinical data used to formulate the original RDC/TMD. One hundred consecutive patients were enrolled in the study. Five patients with rheumatoid arthritis and 13 children or adolescents were excluded. The remaining 82 patients participating in the study comprised 64 women and 18 men. Group I (muscle) disorder was found in 76% of the patients; Group II (disc displacement) disorder was found in 32% and 39% of the patients in the right and left joints, respectively; Group III (arthralgia, arthritis, arthrosis) disorder was found in 25% and 32% of the patients in the right and left joints, respectively. Axis II assessment of psychologic status showed that 18% of patients yielded severe depression scores and 28% yielded high nonspecific physical symptom scores. Psychosocial dysfunction was observed in 13% of patients based on graded chronic pain scores. These initial results suggest that the RDC guidelines are valuable in helping to classify TMD patients and allowing multicenter and cross-cultural comparison of clinical findings.
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Affiliation(s)
- T List
- TMD Unit, Center for Oral Rehabilitation Linköping, Sweden
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Magnusson T, List T, Helkimo M. Self-assessment of pain and discomfort in patients with temporomandibular disorders: a comparison of five different scales with respect to their precision and sensitivity as well as their capacity to register memory of pain and discomfort. J Oral Rehabil 1995; 22:549-56. [PMID: 7472724 DOI: 10.1111/j.1365-2842.1995.tb01048.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Five different scales of self-assessment of pain were tested in patients with temporomandibular disorders. The precision and sensitivity and the capacity to register memory of pain and discomfort were compared for each of the five scales. The behaviour rating scale was found to be superior to the other four scales in respect of precision and sensitivity to pain and discomfort and when recording the memory of these two variables. This scale was also considered by the patients to be the most relevant and the simplest to understand. From these results, the behaviour rating scale can be recommended when measuring pain and discomfort in patients with temporomandibular disorders.
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Affiliation(s)
- T Magnusson
- Department of Stomatognathic Physiology, Institute for Postgraduate Dental Education, Jönköping, Sweden
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List T, Helkimo M. A scale for measuring the activities of daily living (ADL) of patients with craniomandibular disorders. Swed Dent J 1995; 19:33-40. [PMID: 7597629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
A rating scale based on methods used in medical and behavioral science was modified for specific assessment of the function of the masticatory system. Eleven common activities of daily living were recorded on a scale rated from 0 to 10. Thirty-one patients (23 women and 8 men) who had exhibited facial pain and/or headache for a duration of at least one year participated. Test-retest coefficients of reliability for the patients' assessment of pain and discomfort on two different occasions two weeks apart were high and varied (with the exception of one question) between r = 0.67 and r = 0.92. The correlations between the patients' own estimations and that which one member of the family made were high and varied (with the exception of one question) between r = 0.78 and r = 0.92.
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Affiliation(s)
- T List
- Department of Prosthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden
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List T, Helkimo M, Karlsson R. Pressure pain thresholds in patients with craniomandibular disorders before and after treatment with acupuncture and occlusal splint therapy: a controlled clinical study. J Orofac Pain 1993; 7:275-82. [PMID: 9116627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fifty-five patients (46 women and 9 men) with craniomandibular disorders and a history of pain of at least 6 months' duration participated in this trial. The patients were randomly assigned to three groups: one group to receive acupuncture; one group to receive occlusal splint therapy; and one group to act as controls. Pressure pain threshold, clinical dysfunction score, and visual analog scale measures were used to evaluate patients before, immediately after, and 6 months after treatment. A moderate, but statistically significant, correlation was found between pressure pain threshold and the number of tender spots in the masticatory muscles (tau = -.43; P < .001), degree of tenderness in the masticatory muscles (tau = -.43; P < .001), clinical dysfunction score (tau = .32; P < .001), and the visual analog scale (tau = -.25; P < .01). The short-term results showed a statistically significant improvement in all evaluations for both treatment groups. No significant differences were found in the control group. The improvements resulted in significant differences between the control and each treatment group immediately after treatment. At the 6-month follow-up, no significant differences in pressure pain threshold or clinical dysfunction score were found in the two treatment groups compared with the short-term results.
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Affiliation(s)
- T List
- Department of Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden
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Abstract
Eighty patients, of whom 22 were men and 58 women, participated in a 1-year follow-up study. All participants in the study showed signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than 6 months at treatment start. The patients were randomly assigned to either acupuncture or occlusal splint therapy. Those patients who did not respond to either of the treatment modes were offered various additional therapies. The result showed that 57% of the patients who received acupuncture and 68% of the patients treated with occlusal splint therapy benefited subjectively (p < 0.01) and clinically (p < 0.001) from the treatment over a 12-month period. No statistically significant difference was found between the two groups as to the assessment variables. Those patients who received various additional therapies after acupuncture and/or occlusal splint therapy responded favorably to additional treatment in only a few instances. The study showed that acupuncture gave positive results similar to those of occlusal splint therapy in patients with primarily myogenic CMD symptoms over a 1-year follow-up period.
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Affiliation(s)
- T List
- Department of Stomatognathic Physiology, Institute for Postgraduate Dental Education, Jönköping, Sweden
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Keshavarzian A, Doria MI, Sedghi S, Kanofsky JR, Hecht D, Holmes EW, Ibrahim C, List T, Urban G, Gaginella T. Mitomycin C-induced colitis in rats: a new animal model of acute colonic inflammation implicating reactive oxygen species. J Lab Clin Med 1992; 120:778-91. [PMID: 1431507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The mechanism of the tissue damage induced by colonic inflammation in ulcerative colitis is not established. We therefore developed and characterized a simple new rat model of acute colonic inflammation induced by a single systemic injection of mitomycin C. After an intraperitoneal injection of mitomycin-C, colon histologic examination revealed transient (3 to 14 days) diffuse, colonic inflammation and injury that, like human ulcerative colitis, was limited to the mucosal layer. The rest of the gastrointestinal tract was spared. Gut permeability, as measured by urinary excretion of orally administered lactulose and mannitol, was unchanged 3 days after injection, when inflammation was already present; permeability was increased at 7 days, when inflammation was maximal. Mitomycin C did not produce inflammation in experimentally bypassed segments of small bowel despite the presence of colonic-type bacteria, suggesting that lack of intraluminal bacteria was not responsible for the absence of inflammation in the small intestine. Chemiluminescence, a means of estimating levels of reactive oxygen species, was greater in the intact, inflamed colon of mitomycin C-treated rats than in bypassed segments. Moreover, inflamed mucosal scrapings produced more in vitro luminol-enhanced chemiluminescence. Furthermore, the reactive oxygen species scavengers allopurinol, catalase, and WR-2721 decreased inflammation severity. We therefore conclude: (1) the mitomycin C-treated rat is a novel, easy to prepare animal model of acute inflammation of colonic mucosa, with morphologic similarities to the acute phase of ulcerative colitis in human beings; (2) increased gut permeability in mitomycin C-treated rats is the result, not the cause, of the inflammation; and (3) reactive oxygen species play an important role in colonic inflammation and tissue injury in this model, and possibly in human ulcerative colitis.
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Affiliation(s)
- A Keshavarzian
- Department of Medicine, Loyola University Medical Center, Maywood, IL 60153
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Abstract
Occlusal splint therapy and acupuncture have been found to provide positive treatment in a number of studies. As with other therapies, adverse events may occur. In this paper, adverse event refers to any reaction to a treatment besides the intended treatment effect--irrespective of any correlation between the treatment and the reaction. This reaction can be positive, as well as negative, to the patient. In the present study, 61 patients with craniomandibular dysfunction (CMD) were treated with acupuncture or occlusal splint therapy and the adverse events were carefully recorded. The results show that the profile of the adverse events differed between the two treatment modes. Acupuncture seemed to have adverse events of a more general nature, e.g., relaxed feeling, improved sleep, temporarily increased pain; whereas, adverse events of occlusal splint therapy seemed to be more locally related to the orofacial region, e.g., increased/decreased salivation and tension in the teeth. The majority of the patients responded positively to both treatment modalities. Only in a few cases did the patients consider the treatment uncomfortable. No serious adverse event or complication was observed in this study.
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Affiliation(s)
- T List
- Institute for Post-Graduate Dental Education, Jönköping, Sweden
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Keshavarzian A, Sedghi S, Kanofsky J, List T, Robinson C, Ibrahim C, Winship D. Excessive production of reactive oxygen metabolites by inflamed colon: analysis by chemiluminescence probe. Gastroenterology 1992; 103:177-85. [PMID: 1612325 DOI: 10.1016/0016-5085(92)91111-g] [Citation(s) in RCA: 193] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Reactive oxygen metabolites (ROMs) are involved in inflammatory diseases and are postulated to contribute to tissue injury in colitis. To determine whether excessive ROMs are generated by inflamed colonic mucosa and to identify possible sources and type of ROMs, mucosal ROMs were estimated in rats and humans using a chemiluminescence probe. Colitis was induced in rats by intracolonic injection of acetic acid or intraperitoneal injection of mitomycin C. Intact, inflamed colon in rats produced more ultraweak chemiluminescence than normal colon. Inflamed mucosal scrapings from both rat models produced significantly more luminol-enhanced chemiluminescence. Addition of catalase, an H2O2 scavenger, or azide, a myeloperoxidase inhibitor, into the media significantly decreased chemiluminescence from inflamed mucosal scrapings. Indomethacin, an antioxidant cyclo-oxygenase inhibitor, also decreased chemiluminescence, but MK-866, a 5-lipoxygenase inhibitor, had no effect. Colonic biopsy specimens obtained during colonoscopy from patients with ulcerative colitis also produced more catalase-inhibitable chemiluminescence than normal colonic mucosa. These data indicate that excessive ROMs are produced by inflamed colonic mucosa in both humans and rats, which may contribute to tissue injury.
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Affiliation(s)
- A Keshavarzian
- Department of Medicine, Loyola University Medical School, Maywood, Illinois
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Abstract
Reactive oxygen metabolites (ROM) have been postulated to contribute to the development of various carcinomas, including colon cancer. Indeed, the effects of ROM scavengers are being tested for chemoprevention of adenocarcinoma of the colon. However, there has been no evidence to indicate that high levels of ROM are indeed present in cancerous tissue. In this study, we used a chemiluminescence probe to estimate ROM levels in cancerous and neighboring noncancerous colonic tissues from seven patients with colon cancer. Cancerous tissues contained significantly (p less than 0.05) more luminol-enhanced chemiluminescence (4,808 +/- 2,282 counts/min/mg protein) than neighboring noncancerous tissues (2,175 +/- 1,111). The addition of an ROM scavenger, catalase (2, 4, and 8 micrograms/ml), to the tissue suspension inhibited chemiluminescence produced by both noncancerous (-74%, -85%, and -71%) and cancerous (-11%, -61%, and -53%) tissues. This study shows that colonic cancerous tissue contains high levels of ROM, which may play an important role in the pathogenesis of colon cancer.
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Affiliation(s)
- A Keshavarzian
- Department of Medicine, Loyola University Medical School, Maywood, IL 60153
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