Peter Svensson

Aarhus University | AU · Department of Dentistry

This study compared the degree of secondary hyperalgesia and somatosensory threshold changes induced by topical capsaicin between spinal and trigeminal innervation. This crossover clinical trial included 40 healthy individuals in which 0.25 g of 1% capsaicin cream was randomly applied for 45 minutes to a circular area of 2 cm² to the skin covering...

Background This study assessed the effect of expectation of analgesia on conditioned pain modulation (CPM) in healthy participants stratified into inhibitors and non‐inhibitors. Methods A parallel CPM protocol was assessed on 21 women and 22 men across two sessions: baseline and expectation of analgesia, which was induced by a standardized audiovi...

Gender differences in pain reporting and prevalence have been demonstrated. As gender of examiner also affects reporting of pain on palpation, the aim of this study was to evaluate the effects of examiner gender on palpation performance using three different palpation methods. Examiners of both genders were instructed on the correct technique for e...

Aim To evaluate conditioned pain modulation (CPM) in burning mouth syndrome (BMS) patients with different pain mechanisms. Materials and Methods Twenty BMS patients (52.0 ± 6.8 years, 17 women and 3 men) and age‐ and gender‐matched 22 healthy controls were enrolled in this randomised controlled trial. The patients received an active lingual nerve...

Aims To investigate the effect of a lingual nerve block on spontaneous pain in patients with burning mouth syndrome (BMS) and to estimate associated somatosensory abnormalities by quantitative sensory testing (QST). Protocol and Methods A standardised QST battery including cold detection threshold (CDT), warmth detection threshold (WDT), thermal s...

Background Neuroplasticity induced by mandibular advancement appliance (MAD) in patients with obstructive sleep apnoea (OSA) is poorly documented. Objective This randomised placebo‐controlled crossover mechanistic study assessed the effects of short‐term use of a MAD on corticomotor excitability of the masseter and tongue in patients with OSA. Me...

The co-occurrence of bruxism, temporomandibular disorders (TMDs), and headache is common in patients. However, there is conflicting evidence regarding whether this association is simply a result of their high prevalence or whether there are indeed causal relationships. This review provides an overview of the current state of research while taking i...

Background Electromyographic activity (EMG) of masticatory muscles during wakefulness is understudied. It is unclear if single channel ambulatory EMG devices are sensitive enough to detect masticatory muscle activity (MMA) during wakefulness. Objectives To compare the MMA of various oral tasks recorded with a single channel EMG device ((Grindcare4...

Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies. Objective Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients. Ma...

Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies. Objective: Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients. M...

Background Bruxism is a jaw-muscle activity characterized by teeth grinding and clenching. While many of its negative consequences (e.g., jaw-muscle pain, tooth fractures) are of particular interest to dentists, new insights underline the need for physicians to be knowledgeable about bruxism. In order to facilitate transfer of knowledge across disc...

This cross-sectional school-based study explored the influence of malocclusion on temporomandibular disorders (TMD) pain complaints, and whether this association would be mediated by sleep bruxism in a representative sample of 7- to 8-year-old children. Path analysis estimated direct, indirect, and total effects of occlusal features on sleep bruxis...

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 inte...

Background The evaluation of muscle pain and sensitivity by manual palpation is an important part of the clinical examination in patients with myalgia. However, the effects of clinical experience and visual feedback on palpation of the masticatory muscles with or without a palpometer are not known. Objective To estimate the effects of clinical exp...

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 the diagnoses with the most utility in general dentistry settings. M...

Background: Primary headache syndromes such as migraine are among the most common neurological syndromes. Chronic facial pain syndromes of non-odontogenic cause are less well known to neurologists despite being highly disabling. Given the pain localization, these patients often consult dentists first who may conduct unnecessary dental intervention...

Objective: Excessive jaw muscle activity is a frequent complication after acquired brain injury (ABI). The study aimed to identify the occurence and severity of jaw muscle activity and its association with altered state of consciousness in patients with ABI. Methods: A total of 14 severe ABI patients with varied altered state of consciousness we...

Referred sensation (RS) as a specific clinical phenomenon has been known for a long time, although the underlying mechanisms remain unclear. The aims of this study were to assess if (1) healthy individuals who experienced RS had a less active endogenous pain system when compared with those who did not; (2) activation of descending pain inhibition m...

Objective: In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, i.e. better assessment and more efficient management. Methods: We summarised current strategies for AB...

Background: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed. Objective: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clini...

Background: Orthognathic surgery has been performed with increasing frequency for the treatment of severe malocclusion, yet the postsurgical neuromuscular recovery of patients has been inadequately studied. Objective: To investigate the effect of short-term and simple jaw motor training on accuracy and precision of jaw motor control in patients...

Background: Sleep Bruxism (SB) occurring during nREM sleep and increase in microarousals per hour have been described in adults, but not in children. Objective: To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. Materials and methods: Forty-three children aged 7-12 y...

Objective This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. Methods The rationale for creating the tool and the road map that led to the selection of items i...

Objective To evaluate the self-reported SB prevalence and explore associated risk factors in puerperal women who had given birth in Rio Grande, Southern Brazil.MethodsA single, standardized questionnaire was given within the 48 h postpartum period. Self-reported SB was the main outcome investigated. Chi-square test was used to compare proportions,...

To investigate whether the location, area and frequency of referred sensations occurring during palpation of the masseter muscle can be influenced by application of a conditioning painful stimulus to the temporalis muscle. Thirty healthy participants were included in this cross-over study, performed in two sessions with > 48 h in between. At each s...

Background: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed. Objective: To present comprehensive and short-form adaptations of Axis I and II of the DC/TMD for adults that are appropriate for use with children in clinical and research set...

Introduction Masticatory function is often impaired in patients with painful temporomandibular disorders (TMD) therefore more detailed studies on comminution and mixing ability are warranted in well-defined TMD patients with chronic myalgia. Moreover, there is a need to explore the correlation between any changes in perceived pain or fatigue in suc...

Recently, it has been proposed that bruxism could represent an overlearned behavior due to the absence of corticomotor plasticity following a relevant tooth-clenching task (TCT). This study assessed the modulatory effects of a nerve growth factor (NGF) injection on masseter muscle corticomotor excitability, jaw motor performance, pain, and limitati...

Referred sensations (RS) are a common clinical phenomenon in patients with musculoskeletal pain, however the underlying mechanisms of RS and implications for diagnosis and management are poorly understood. The location of referral seems to have a preferred site but studies have suggested it can be redirected to a site of previous injury and pain. H...

This paper summarizes the background reasoning and work that led to the selection of the items included in the Standardized Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on‐field comprehension. The underlying premise is that the different motor activitie...

Monosodium glutamate induces behaviors thought to reflect headache and nausea in rats. We explored the effects of the N-methyl-d-aspartate receptor antagonist (2R)-amino-5-phosphonovaleric acid, the inotropic glutamate receptor antagonist kynurenic acid, and the CGRP receptor antagonist olcegepant, on monosodium glutamate-induced increases in nocif...

Introduction: Treatment for malocclusion can cause discomfort and pain in the teeth and periodontium, which may impair masticatory efficiency. The glucose concentration method is widely used to assess masticatory efficiency for its convenience in the clinical situation, although its validity has not been shown. Objective: The aims were to determ...

This chapter summarizes what is known about temporomandibular disorders (TMD) pain problems with implications for orthodontics. It points out significant questions and issues which may not be answered or guided by the highest level of evidence yet, but where patient‐based concerns and clinical experience must be used in the prudent management of in...

Background: Studies addressing the training-induced neuroplasticity and interrelationships of the lip, masseter, and tongue motor representations in the human motor cortex using single syllable repetition are lacking. Objective: This study investigated the impact of a repeated training in a novel PaTaKa diadochokinetic (DDK) orofacial motor task...

Objectives To assess changes in mechanical sensitivity of the pericranial muscles in healthy individuals after a local anesthetic block of the temporalis tendon. In addition, to assess, if experimentally induced temporalis tendon pain, can lead to an increase in mechanical sensitivity of the pericranial muscles and reports of headache. Methods 40...

Objectives This study aimed to determine if standardized palpations of the temporalis muscle evoke referred pain and/or sensations in individuals without TMD. Materials and methods This was a randomized, single-blinded study. The mechanical sensitivity of the right temporalis muscle was assessed in 32 participants without TMD with nine different s...

This study aimed to systematically review the literature to identify clinical studies assessing neuroplasticity changes induced by or associated with bruxism or a tooth-clenching task using neurophysiological techniques. Searches were performed in five electronic databases (PubMed, EMBASE, Scopus, Web of Science, and Google Scholar) in April 2020....

Ingestion of monosodium glutamate (MSG) causes headache, nausea and craniofacial tenderness in healthy individuals. The present study explored whether MSG produces behavioural signs of headache, nausea and changes in craniofacial sensitivity in rats. The behavior of male and female Sprague Dawley rats was video recorded before and after intraperito...

Classification of musculoskeletal pain based on underlying pain mechanisms (nociceptive, neuropathic, and nociplastic pain) is challenging. In the absence of a gold standard, verification of features that could aid in discrimination between these mechanisms in clinical practice and research depends on expert consensus. This Delphi expert consensus...

Orofacial pain patients often report that the painful facial area is “swollen” without clinical signs - known as perceptual distortion (PD). The neuromodulatory effect of facilitatory repetitive transcranial magnetic stimulation (rTMS) on PD in healthy individuals was investigated, to provide further support that the primary somatosensory cortex (S...

Background: Slow stroking touch is generally perceived as pleasant and reduces thermal pain. However, the tactile stimuli applied tend to be short-lasting and typically applied to the forearm. This study aimed to compare the effects of a long-lasting brushing stimulus applied to the facial region and the forearm on pressure pain thresholds (PPTs) t...

The individual inclination to lead an autonomous life until death is associated with requirements that may be of physiological, psychosocial, and environmental nature. We aim to describe a conceptual Orofacial Health Model with emphasis on orofacial function, taking the domains of quality of life and patient-centered values into account. In the con...

There is a need to further develop telemedicine approaches due to the immediate and perhaps long-term consequences of the coronavirus disease 2019. Thus, a remote protocol for assessment of patients with temporomandibular disorders (TMD) was developed, and the agreement of this protocol was compared to the guidelines of the diagnostic criteria for...

Objectives: Musculoskeletal disorders (MSDs) in the neck and shoulder region may be associated with significant impairment of quality of life and well-being. The study was to determine the prevalence of painful MSDs in Chinese dentists and evaluate somatosensory function and neck mobility compared with non-dental professional controls. Methods:...

Objectives This study aimed to monitor the recovery of somatosensory function and oral health-related quality of life after tongue reconstruction using a non-innervated radial forearm free flap (RFFF). Methods Twenty patients (9 men, age: 42–67 years) underwent tongue reconstruction with non-innervated RFFFs, and twenty age- and sex-matched contro...

Nocifensive behavior induced by injection of glutamate or nerve growth factor (NGF) into rats masseter muscle is mediated, in part, through the activation of peripheral NMDA receptors. However, information is lacking about the mechanism that contributes to pain and sensitization induced by these substances in humans. Immunohistochemical analysis of...

[This corrects the article DOI: 10.1155/2019/9593464.].

Aim Headache attributed to temporomandibular disorders and myalgia are two diagnoses included in the diagnostic criteria for temporomandibular disorders (DC/TMD). However, it is not clear if these two diagnoses are different clinical entities given their similar presentation and way in which they are diagnosed, when the myalgia is within the tempor...

The neurophysiological mechanisms underlying NGF-induced masseter muscle sensitization and sex-related differences in its effect are not well understood in humans. Therefore, this longitudinal cohort study aimed to investigate the effect of NGF injection on the density and expression of substance P, NMDA-receptors and NGF by the nerve fibers in the...

Aim: This critical review describes key methodological aspects for a successful orofacial psychophysical evaluation of the somatosensory system and highlights the diagnostic value of somatosensory assessment and management perspectives based on somatosensory profiling. Methods: This topical review was based on a non-systematic search for studies...

Background: Somatosensory changes after sagittal split ramus osteotomy (SSRO) have not been fully studied in Chinese patients by the latest technologies. Objective: To provide a comprehensive analysis of somatosensory function at the lower lip and chin at different time points following SSRO in a Chinese population. Methods: A total of 22 pati...

Background: Bruxism may involve bracing and thrusting of the mandible, in addition to clenching or grinding of the teeth. It is unclear how bracing and thrusting may contribute to potential musculoskeletal symptoms associated with bruxism. Objective: To examine the effect of experimental bracing and thrusting of the mandible on the development o...

The ICD-11 chronic pain classification includes about 100 chronic pain diagnoses on different diagnostic levels. Each of these diagnoses requires specific operationalized diagnostic criteria to be present. The classification comprises more than 200 diagnostic criteria. The aim of the Classification Algorithm for Chronic Pain in ICD-11 (CAL-CP) is t...

Current pain classifications use 1.0-kg palpation of the masseter muscle to distinguish between “pain patients” and “healthy controls” but a thorough understanding of the normal physiological responses to various somatosensory stimuli is lacking. The aim of this study was to investigate somatosensory function of the skin over the masseter muscle in...

To evaluate the effect of photobiomodulation therapy (PBMT) on painful temporomandibular disorders (TMD) patients in a randomized, double-blinded, placebo-controlled manner. Participants were divided into a masseter myalgia group (n = 88) and a temporomandibular joint (TMJ) arthralgia group (n = 87) according to the Diagnostic Criteria for Temporom...

Study objectives: This study aims to investigate if the use of a mandibular advancement device (MAD) is associated with neuroplasticity in corticomotor control of tongue and jaw muscles. Methods: Eighteen healthy individuals participated in a randomized crossover study with 3 conditions for 2 weeks each: baseline, wearing an oral appliance (OA:...

Aim To develop new instruments and to adapt the diagnostic criteria for temporomandibular disorders (DC/TMD) for the evaluation of TMD in children and adolescents. Method A modified Delphi method was used to seek international consensus among TMD experts. Fourteen clinicians and researchers in the field of orofacial pain and TMD worldwide were inv...

A recent report from the European Sleep Research Society’s task force “Beyond AHI” discussed an issue that has been a long‐term subject of debate – what are the best metrics for obstructive sleep apnoea (OSA) diagnosis and treatment outcome assessments? In a similar way, sleep bruxism (SB) metrics have also been a recurrent issue for >30 years and...

Objective The aim of this study was to thoroughly phenotype a group of chronic tension-type headache (CTTH) patients. Methods Fifteen CTTH patients diagnosed according to the ICHD-3 and 15 healthy controls were included in this study. Furthermore, 70 healthy controls were included to establish normative values. Quantitative sensory testing (QST),...

Objectives The purpose of this preliminary study was to explore blood microcirculation and somatosensory profiles in periodontitis patients before and after non-surgical periodontal therapy.Materials and methodsTwenty patients (10 men and 10 women, 20 to 30 years old) and 20 age- and gender-matched healthy controls were included. Non-surgical perio...

Background: The aim of this study was to investigate if single nucleotide polymorphisms (SNPs) related to monoaminergic neurotransmission, in particular the serotonergic pathway, contribute to pain perception in patients with temporomandibular disorder (TMD) myalgia and if there is a correlation to jaw function as well as psychosocial factors such...

Background Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis, and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. Objectives A) To provide an overview of EMG signal acquisition and analysis...

Sleep bruxism (SB) is an activity characterized by teeth grinding or clenching. SB can have different dental and orofacial consequences. While in otherwise healthy individuals it is considered a behavior, when it is associated to sleep or neurological disorders and/or presenting harmful consequences it is categorized as a disorder. SB etiology and...

This study investigated the effect of a repeated and standardized jaw protrusion training (JPT) task on corticomotor excitability as assessed by motor evoked potentials (MEPs) in masseter and tongue muscle with the use of transcranial magnetic stimulation (TMS). Sixteen healthy participants performed three series of a standardized JPT task on three...

Objective To develop a beta version of a preliminary set of empirically derived research diagnostic criteria (RDC) for burning mouth syndrome (BMS) through expert consensus, which can then be taken into a test period before publication of a final RDC/BMS. Design A 6 round Delphi process with twelve experts in the field of BMS was used. The first r...

The neurophysiological mechanisms underlying NGF-induced masseter muscle sensitization and sex-related differences in its effect are not well understood in humans. Therefore, this longitudinal cohort study aimed to investigate the effect of NGF injection on density and expression of substance P, NMDA-receptor and NGF by the nerve fibers in the huma...

Background: Glutamate, as well as nerve growth factor (NGF), is involved in nociception from peripheral tissues, such as muscles. However, the potential interaction between glutamate and NGF still remains unclear. This study investigated the interaction between glutamate-induced masseter muscle pain and NGF-induced allodynia on pain perception and...

Aims: To compare two pain models of myalgic TMD, delayed-onset muscle soreness (DOMS) and injections of nerve growth factor (NGF), in terms of pain-related and motor function outcomes, as well as activity-related temporal summation. Methods: Fifty age- and gender-matched healthy participants were recruited and randomized into one of three groups...

The use of oral implants as a form of replacing missing teeth in partial or total edentulous patients is considered the gold standard in oral rehabilitation. Although considered a history of success in contemporary dentistry, surgical complications may occur, as excessive bleeding, damage to the adjacent teeth and mandibular fractures. Persistent p...

The aim of this investigation was to evaluate the effects of local anaesthesia on nerve growth factor (NGF) induced masseter hyperalgesia. Healthy participants randomly received an injection into the right masseter muscle of either isotonic saline (IS) given as a single injection (n = 15) or an injection of NGF (n = 30) followed by a second injecti...

Statement of problem. Evidence is sparse regarding the long-term outcomes of restorative treatment of patients with extensive tooth wear. Purpose. The purpose of this long-term prospective randomized clinical trial was to evaluate the performance and success rate of pressed lithium disilicate (LD) and translucent zirconia (TZ) crowns in participan...

The objective of this study was to evaluate the biomaterial properties of nano-modified surface acupuncture needles and the effect of such needles on human pain perception by using pressure pain threshold (PPT) measurements. It is known that changing a material’s surface nano-topography or nanostructure has strong effects on its physical, chemical,...

Aims: To investigate pain sensitivity in the masseter muscle and index finger in response to acute psychologic stress in healthy participants. Methods: Fifteen healthy women (23.7 ± 2.3 years) participated in two randomized sessions: in the experimental stress session, the Paced Auditory Serial Addition Task (PASAT) was used to induce acute stre...

Background Quantitative sensory testing protocols for perceptions of pleasantness and unpleasantness based on the German Research Network on Neuropathic Pain protocol were recently introduced. However, there are no reliability studies yet published. Aim To evaluate the intra-examiner (test-retest) and inter-examiner reliability for orofacial pleas...

Background and objective: Orofacial quantitative sensory testing (QST) is an increasingly valuable psychophysical tool for evaluating neurosensory disorders of the orofacial region. Here, we aimed to evaluate the current evidence regarding this testing method and to discuss its future clinical potential. Data treatment: We conducted a literature se...