Publications by authors named "Per Alstergren"

Background: Conventional treatment for reducing pain is not always successful in patients with chronic orofacial myalgia.

Objective: The objective of this study was to investigate the pain-reducing efficacy of two botulinum toxin A injections in patients with chronic orofacial myalgia who had already received conservative treatment.

Methods: The patients included were 18 years or older and diagnosed with myalgia according to the Diagnostic Criteria for Temporomandibular Disorders.

View Article and Find Full Text PDF

Background: Proinflammatory cytokines are central to disease mechanisms and important therapeutic targets in inflammatory chronic diseases. This exploratory study aimed to compare cytokine concentrations in saliva, serum, and temporomandibular joint (TMJ) synovial fluid in children with juvenile idiopathic arthritis (JIA) and controls.

Methods: In this cross-sectional study, we included consecutive children with JIA and TMJ arthritis, planned for a TMJ corticosteroid injection, and non-JIA controls from three different centers in Norway.

View Article and Find Full Text PDF

Objectives: This paper studies the treatment effect of total joint replacement (TJR) of the temporomandibular joint (TMJ) with alloplastic joint prosthesis regarding function, symptoms and health-related quality of life compared to other surgical and non-surgical treatments in patients with TMJ disorders.

Methods: Three databases (PubMed, Cochrane Library and Web of Science) were searched up to 11 March 2025. Studies in which TJR was compared with other surgical or non-surgical methods were searched and analyzed.

View Article and Find Full Text PDF

Background: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is a biaxial instrument used worldwide for TMD assessment.

Objective: To translate, cross-culturally adapt, and assess the criterion validity and reliability of the Brazilian Portuguese version of the DC/TMD Axis I.

Methods: The translation and cross-cultural adaptation of Axis I into Brazilian Portuguese followed the recommendations of the International Network for Orofacial Pain and Related Disorders Methodology.

View Article and Find Full Text PDF

Background: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is a biaxial tool for TMD assessment. To implement a translated version in the Brazilian context, standardised adaptation and validation are necessary.

Objective (s): To translate, adapt and verify the measurement properties of the DC/TMD Axis II instruments Pain Drawing (PD), Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS) and Oral Behaviours Checklist (OBC).

View Article and Find Full Text PDF

Background: Few neuroimaging studies have investigated structural brain differences associated with variations in pain distribution.

Objective: To explore structural differences of the brain in fibromyalgia (FM), temporomandibular disorder pain (TMD) and healthy pain-free controls (CON) using structural and diffusion MRI.

Methods: A case-control exploratory study with three study groups with different pain distribution were recruited: FM (n = 16; mean age [standard deviation]: 44 [14] years), TMD (n = 17, 39 [14] years) and CON (n = 10, 37 [14] years).

View Article and Find Full Text PDF

Background: Juvenile idiopathic arthritis (JIA) often affects the temporomandibular joint (TMJ) caused by an abnormal immune system that includes overactive inflammatory processes. Salivary biomarkers may be a powerful tool that can help establishing diagnosis, prognosis and monitor disease progress.

Objective: The objective was to investigate biomarkers in parotid saliva and blood plasma in relation to temporomandibular joint (TMJ) magnetic resonance imaging (MRI) findings in patients with JIA and healthy individuals.

View Article and Find Full Text PDF

Background: Stress in patients with Juvenile Idiopathic Arthritis (JIA) has been found to be associated with orofacial pain, psychological distress, jaw dysfunction and loss of daily activities in a cross-sectional study. The aim of this study was to investigate the relations between stress and change of stress over time versus changes in orofacial pain, psychosocial factors and jaw function over a two-year period in patients with JIA.

Methods: This is a two-year prospective follow-up study involving 40 JIA patients.

View Article and Find Full Text PDF

Background: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.

Objective: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.

Methods: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare the effectiveness of two dosimetry methods, thermoluminescent dosimeters (TLDs) and Gafchromic film, in measuring absorbed doses during CBCT scans of the mandibular third molar region.
  • TLDs were placed at 75 points on a head phantom, and results showed a strong correlation with Gafchromic film measurements, particularly at lower doses.
  • However, significant discrepancies were found in minimum and maximum doses, indicating that Gafchromic film is a more reliable option for monitoring absorbed doses in dental imaging.
View Article and Find Full Text PDF
Article Synopsis
  • The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) has been adapted for adolescents, filling a gap as no previous version existed for this age group.
  • A Delphi process involving experts led to modifications that make the assessment tools developmentally appropriate for individuals aged 10-19, focusing on physical and psychosocial health.
  • The adapted DC/TMD includes revised questionnaires and additional assessments for anxiety, depression, stress, and sleep disorders, aiming for reliability and validity in clinical and research settings globally.
View Article and Find Full Text PDF

Objective: Optimization of radiographic examinations is essential for radiation protection. The objective of the study was to investigate the clinical applicability of a low-dose CBCT protocol as compared to the default for pre-surgical evaluation of mandibular third molars.

Material & Methods: Forty-eight patients (62 teeth) referred for pre-surgical mandibular third molar investigation were recruited after justification for CBCT.

View Article and Find Full Text PDF
Article Synopsis
  • - The study presents adaptations of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) specifically designed for children aged 6-9, filling a gap since no previous adaptations existed.
  • - Through expert consultation, developmental changes were made to both Axis I and Axis II, including adjustments in language for questionnaires, incorporation of general health assessments, and new protocols for assessing psychosocial factors like anxiety and sleep disorders.
  • - The newly adapted criteria are suitable for clinical and research use, requiring further reliability and validity testing, and will undergo translation for global application in various languages.
View Article and Find Full Text PDF

Involvement of the temporomandibular joint (TMJ) is common in juvenile idiopathic arthritis (JIA). TMJ arthritis can lead to orofacial symptoms, orofacial dysfunction, and dentofacial deformity with negative impact on quality of life. Management involves interdisciplinary collaboration.

View Article and Find Full Text PDF

Objective: The aim of the present systematic review was to assess the effect of testosterone on temporomandibular joint (TMJ) nociception.

Design: A systematic review of pertinent indexed literature was performed. The focused question addressed was "Is there a connection between testosterone and TMJ nociception?" Original studies were included.

View Article and Find Full Text PDF

Background: Synovial tissue is known to be the origin of inflammation in joint disease. Despite this, synovial fluid is the main biological specimen of choice in temporomandibular joint (TMJ) inflammation and pathology biomarker research. No comparison of TMJ protein content between synovial fluid and synovial tissue has been made.

View Article and Find Full Text PDF
Article Synopsis
  • There is currently no standardized psychosocial assessment for children and adolescents with temporomandibular disorders (TMD), unlike the established criteria for adults.
  • The study aims to develop a new assessment tool for young patients by adapting existing adult frameworks and incorporating additional measures for psychosocial health.
  • Using a modified Delphi method, experts reached a consensus on the assessment tools needed, resulting in a comprehensive evaluation framework that includes pain-related disability, depression, anxiety, and other psychological factors for children and adolescents with TMD.
View Article and Find Full Text PDF

Objectives: To query the experience of oral surgeons concerning referral routines and preferences for radiographic imaging modality before surgical removal of mandibular third molars and investigate factors that influence imaging modality preferences.

Materials And Methods: Members of the Swedish Association of Oral and Maxillofacial Surgeons (n = 280) were invited to participate in a web-based digital survey concerning their experiences and use of three imaging modalities in pre-surgical assessment of mandibular third molar removal. The survey comprised multiple-choice questions and four cases depicted in images; respondents reported whether they would supplement the cases with other images and, if so, from which modality.

View Article and Find Full Text PDF

Objectives: To evaluate the effect of corticosteroid injections in the painful temporomandibular joint (TMJ) of patients with rheumatoid arthritis (RA) in relation to systemic inflammatory activity.

Method: Examination of 35 patients (median age 54 years; 89% female) included maximum mouth opening capacity, degree of anterior open bite (AOB), TMJ pain intensity at rest, and crepitus. Serum levels of rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serotonin, and plasma levels of interleukine-1β (IL-1β) were determined.

View Article and Find Full Text PDF
Article Synopsis
  • The study highlights the need for a standardized approach to diagnosing temporomandibular disorders (TMD) in children and adolescents, as current methods rely heavily on self-reports and proxy reports.* -
  • Using a modified Delphi method, experts from around the world developed and adapted diagnostic criteria specifically for evaluating TMD in younger populations through discussions and surveys.* -
  • Ultimately, the study resulted in two new adapted protocols for diagnosing TMD in children and adolescents, achieving expert consensus on the updated criteria.*
View Article and Find Full Text PDF

Objectives:  The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning.

Materials And Methods:  From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used.

View Article and Find Full Text PDF

Aims: To investigate inflammatory mediator levels in TMJ synovial fluid (SF) and blood and to investigate clinical TMJ symptoms in relation to general and TMJ symptom duration in patients with rheumatoid arthritis (RA).

Methods: Examination of 80 TMJs (68 patients; median age 55 years; 85% women) included the following variables: TMJ pain at rest, maximum mouth opening, and palpation; jaw movement capacity; number of painful movements; crepitus; and degree of anterior open bite. Levels of tumor necrosis factor (TNF), TNF soluble receptor II, interleukin 1β, IL-1 receptor antagonist, IL-1 soluble receptor II, and serotonin in TMJ SF and blood; systemic disease activity; and duration of general and TMJ symptoms were assessed.

View Article and Find Full Text PDF

Background: Chronic pain from temporomandibular disorders remains an undertreated condition with debate regarding the most effective treatment modalities.

Objective: The aim of the study was to investigate the treatment effect of an internet-based multimodal pain program on chronic temporomandibular disorder pain and evaluate the feasibility of a larger randomized controlled trial.

Methods: An unblinded randomized controlled pilot trial was conducted with 43 participants (34 females, 9 males; median age 27, IQR 23-37 years) with chronic temporomandibular pain.

View Article and Find Full Text PDF

Objectives: To develop and evaluate an educational web-based programme for temporomandibular joint (TMJ) assessment using cone-beam computed tomography (CBCT).

Methods: A web-based educational programme was designed for TMJ assessment using CBCT images. Fifteen CBCT cases of the TMJ (three-dimensional reconstructed volumes) and an assessment module based on image analysis criteria in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were added to the programme.

View Article and Find Full Text PDF

Background: Juvenile idiopathic arthritis (JIA) is an autoimmune, chronic, inflammatory joint disease, affecting children and adolescents. Patients with JIA may have pain and fatigue in muscles. There are not studies evaluating the pressure pain thresholds (PPTs) of both masticatory muscles and temporomandibular joint (TMJ) in patients with JIA.

View Article and Find Full Text PDF