Thomas List

Malmö University, Malmö, Skåne, Sweden

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Publications (129)205 Total impact

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    Full-text · Article · Jan 2016 · Journal of Oral Rehabilitation
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    ABSTRACT: To investigate the difference in diagnostic reliability between self-instructed examiners and examiners taught in a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) course and if the reliability of self-instructed examiners improves after the course. Six examiners were divided into three groups: (1) formal two-day training and calibration course at a DC/TMD training center (Course group), (2) self-teaching through documents and movie (Self group) with three examiners on each and the Self group later participated in the course (Self + course group). Each group examined sixteen subjects, total of 48 volunteers (36 patients with TMD and 12 asymptomatic) and the reliabilities in relation to the diagnoses derived by a Reference Standard Examiner were compared by Cohen's Kappa coefficient. The reliability was good to excellent in all three groups of examiners for all DC/TMD diagnoses, except for Myofascial pain with referral in the Self + course group. The course seemed to improve the reliability regarding Myalgia and Arthralgia at the same time as the examiners experienced the course to be valuable for self-perceived ability and confidence. This study shows that the diagnostic reliability of formal DC/TMD training and calibration and DC/TMD self-instruction are similar, except for subgroups of Myalgia. Thus, self-instruction seems to be possible to use to diagnose the most common TMDs in general dental practice. The course further improves the reliability regarding Myalgia and Arthralgia at the same time as the examiners experienced the course to be valuable for self-perceived ability and confidence.
    Full-text · Article · Dec 2015 · The Journal of Headache and Pain
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    ABSTRACT: This study aimed to (i) assess the prevalence and perceived need for treatment of TMD pain, and its association with socio-economic factors and gender, in adolescents in Xi᾽an, Shaanxi Province, China, and (ii) compare the prevalence and association with gender of TMD pain in Xi᾽an to an age-matched Swedish population. We surveyed Chinese adolescents aged 15 to 19 years in Xi'an, China (n = 5524), using a questionnaire with two-stage stratified sampling and the school as the sampling unit. The study included second-year students at selected high schools. It also included an age-matched Swedish population (n = 17 015) surveyed using the same diagnostic criteria for TMD pain as that used in the Chinese sample. The survey found TMD pain in 14·8% (n = 817) of the Chinese sample and 5·1% (n = 871) of the Swedish sample (P < 0·0001). Girls had significantly more TMD pain than boys in both the Chinese (P < 0·05) and Swedish (P < 0·001) samples. TMD pain increased with age in the Chinese population. Of the Chinese adolescents with TMD pain, 47% reported that they felt a need for treatment. Rural schools, low paternal education levels, poverty, living outside the home, poor general and oral health, and dissatisfaction with teeth all showed significant positive correlations with TMD pain. Prevalence of TMD pain in Chinese adolescents was significantly higher than in the Swedish sample.
    Preview · Article · Nov 2015 · Journal of Oral Rehabilitation
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    ABSTRACT: Cross-cultural differences in pain sensitivity have been identified in pain-free subjects as well as in chronic pain patients. The aim was to assess the impact of culture on psychophysical measures using mechanical and electrical stimuli in patients with temporomandibular disorder (TMD) pain and pain-free matched controls in three cultures. This case–control study compared 122 female cases of chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) with equal numbers of age- and gender-matched TMD-free controls. Pressure pain threshold (PPT) and tolerance (PPTo) were measured over one hand and two masticatory muscles. Electrical perception threshold and electrical pain threshold (EPT) and tolerance (EPTo) were recorded between the thumb and index fingers. Italian females reported significantly lower PPT in the masseter muscle than other cultures (P < 0·001) and in the temporalis muscle than Saudis (P = 0·003). Swedes reported significantly higher PPT in the thenar muscle than other cultures (P = 0·017). Italians reported significantly lower PPTo in all muscles than Swedes (P ≤ 0·006) and in the masseter muscle than Saudis (P < 0·001). Italians reported significantly lower EPTo than other cultures (P = 0·01). Temporomandibular disorder cases, compared to TMD-free controls, reported lower PPT and PPTo in all the three muscles (P < 0·001). This study found cultural differences between groups in the PPT, PPTo and EPTo. Overall, Italian females reported the highest sensitivity to both mechanical and electrical stimulation, while Swedes reported the lowest sensitivity. Mechanical pain thresholds differed more across cultures than did electrical pain thresholds. Cultural factors may influence response to type of pain test.
    Full-text · Article · Sep 2015 · Journal of Oral Rehabilitation

  • No preview · Article · Jun 2015
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    ABSTRACT: The aims were to assess the impact of the number of years since dentists' graduation on appraisement of diagnostic needs and utilization of treatment options for temporomandibular disorders (TMD) and to investigate whether increased knowledge in TMD is sufficiently considered in today's dentist's undergraduate curricula and, therefore, represented in more evidence-based TMD management in dentists with less years since graduation. A questionnaire regarding knowledge and management of TMD was developed and was subsequently applied in a random sample of 400 dentists in a region in Northern Germany. Of the 222 dentists (response rate 55.6 %), participating in the study, the frequency of TMD treatment need in the general population was estimated at 21.5 %, with lower values in dentists with more years passed since graduation. Measures regarding utilization of standardized examination forms, perceptions of insufficient specialization, and referrals of patients to TMD specialists indicated a lower quality and certainty in TMD management in participants with less time since graduation. While the provision of splints was a well-established treatment option in initial TMD management of all participants, additional TMD treatment options were mentioned less often, with lower proportions of participants making use of these options within the first decade since graduation. Evidence-based TMD management is not fully represented in dental practitioners in Germany. This might be due to an insufficient consideration of TMD management in the dentist's undergraduate curricula. Effective interventions to increase dentists' knowledge and to change dentists' practices in TMD management are required.
    Full-text · Article · Apr 2015 · Clinical Oral Investigations

  • No preview · Article · Mar 2015
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    ABSTRACT: The purpose of this study was to examine magnetic resonance imaging findings in patients with painful disc displacement without reduction of the temporomandibular joint to determine whether the findings were able to predict treatment outcome of lavage and a control group treated with local anaesthesia without lavage in a short-term: 3-month perspective. Bilateral magnetic resonance images were taken of 37 patients with the clinical diagnosis of painful disc displacement without reduction. Twenty-three patients received unilateral extra-articular local anaesthetics and 14 unilateral lavage and extra-articular local anaesthetics. The primary treatment outcome defining success was reduction in pain intensity of at least 30% during jaw movement at the 3-month follow-up. Bilateral disc displacement was found in 30 patients. In 31 patients the disc on the treated side was deformed, and bilaterally in 19 patients. Osteoarthritis was observed in 28 patients, and 13 patients had bilateral changes. Thirty patients responded to treatment and 7 did not, with no difference between the two treated groups. In neither the treated nor the contralateral temporomandibular joint did treatment outcome depend on disc diagnosis, disc shape, joint effusion, or osseous diagnoses. Magnetic resonance imaging findings of disc position, disc shape, joint effusion or osseous diagnosis on the treated or contralateral side did not give information of treatment outcome. Magnetic resonance imaging findings could not predict treatment outcome in patients treated with either local anaesthetics or local anaesthetics and lavage.
    Full-text · Article · Feb 2015
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    ABSTRACT: We aimed to evaluate the effect of painful tooth stimulation on gingival somatosensory sensitivity of healthy volunteers in a randomized, controlled design. Thirteen healthy volunteers (six women, seven men; 28.4 ± 5.0 years) were included for two experimental sessions of electrical tooth stimulation: painful tooth stimulation and tooth stimulation below the sensory threshold (control). Eight of the human subjects participated in a third session without tooth stimulation. In all sessions, the somatosensory sensitivity of the gingiva adjacent to the stimulated tooth was evaluated with a standardized battery of quantitative sensory tests (QST) before, immediately after and 30 min after tooth stimulation. Painful tooth stimulation evoked significant decreases in warmth and heat pain thresholds (P P = 0.024) and increases in mechanical detection thresholds (decreased sensitivity) (P P P > 0.086). No QST changes were detected in the session without tooth stimulation (P > 0.060). In conclusion, modest increased gingival sensitivity to warmth, painful heat and pressure stimuli as well as desensitization to non-painful mechanical stimulation were demonstrated after tooth stimulation. This suggests involvement of competing heterotopic facilitatory and inhibitory mechanisms. Furthermore, stimulation below the sensory threshold induced similar thermal sensitization suggesting the possibility of activation of axon-reflex-like mechanisms even at intensities below the perception threshold. These findings may have implications for interpretation of somatosensory results in patients with chronic intraoral pain.
    Full-text · Article · Jan 2015 · Experimental Brain Research
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    ABSTRACT: To determine the impact of oral diseases on everyday life, measures of oral quality of life are needed. In complementing traditional disease-based measures, they assess the need for oral care to evaluate oral health care programs and management of treatment. To assess the reliability and validity of the Oral Impact of Daily Performance (OIDP) and the short-form Oral Health Impact Profile (OHIP-14) among high school students in Xi'an, the capital of Shanxi province, China. Cross-sectional one-stage stratified random cluster sample using high schools as the primary sampling unit. Students completed self-administered questionnaires at school. The survey included the OHIP-14 and OIDP inventories, translated and culturally adapted for China, and global oral health and socio-behavioral measures. A total of 5,608 students participated in the study, with a 93% response rate (mean age 17.2, SD 0.8, 52% females, 45.3% urban residents).The proportion experiencing at least one impact (at any frequency) during the previous six months was 62.9% for the OHIP-14 and 45.8% for the OIDP. Cronbach's alpha measured internal consistency at 0.85 for OHIP-14 and 0.75 for OIDP while Cohen's kappa varied between 0.27 and 0.58 for OHIP-14 items and between 0.23 and 0.65 for OIDP items. Kappa scores for the OHIP-14 and OIDP additive scores were 0.52 and 0.66, respectively. Both measures varied systematically and in the expected direction, with global oral health measures showing criterion validity. The correlation between OIDP and OHIP-14 was rs +0.65. That both measures varied systematically with socio-behavioral factors indicates construct validity. Both the OIDP and OHIP-14 inventories had reasonable reliability and construct validity in relation to subjective global oral health indicators among adolescents attending high schools in China and thus appear to be useful oral health -related quality of life measures in this context. Overall, the OHIP-14 and OIDP performed equally well, although OHIP-14 had superior content validity due to its sensitivity towards less severe impacts.
    Full-text · Article · Dec 2014 · BMC Oral Health
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    ABSTRACT: Background Chronic myalgia is associated with higher muscle levels of certain algesic biomarkers. The aim of this study was to investigate if hypertonic saline-induced jaw myalgia also leads to release of such biomarkers and if there were any sex differences in this respect. Methods Healthy participants, 15 men and 15 aged-matched women (25.7 +/- 4.3 years) participated. Intramuscular microdialysis into masseter muscles was performed to sample serotonin (5-HT), glutamate, lactate, pyruvate, glucose and glycerol. After 2 hours 0.2 mL hypertonic saline (58.5 mg/mL) was injected into the masseter on one side and 0.2 mL isotonic saline (9 mg/mL) into the contralateral masseter close to the microdialysis catheter. Microdialysis continued for 1 hour after the injections. Pressure pain thresholds (PPT) and pain were assessed before and after injections. Results The median (IQR) peak pain intensity (0-100 visual analogue scale) after hypertonic saline was 52.5 (38.0) and after isotonic saline 7.5 (24.0) (p < 0.05). 5-HT, glutamate and glycerol increased after hypertonic saline injection (p < 0.05). Lactate, pyruvate and glucose showed no change. PPT after microdialysis was reduced on both sides (p < 0.05) but without side differences. Pain after hypertonic saline injection correlated positively to 5-HT (p < 0.05) and negatively to glycerol (p < 0.05). Conclusions 5-HT, glutamate and glycerol increased after a painful hypertonic saline injection into the masseter muscle, but without sex differences. Since increased levels of 5-HT and glutamate have been reported in chronic myalgia, this strengthens the validity of the pain model. Glycerol warrants further investigations.
    No preview · Article · Dec 2014 · The Journal of Headache and Pain
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    ABSTRACT: Chronic myalgia is associated with higher muscle levels of certain algesic biomarkers. The aim of this study was to investigate if hypertonic saline-induced jaw myalgia also leads to release of such biomarkers and if there were any sex differences in this respect. Healthy participants, 15 men and 15 aged-matched women (25.7 +/- 4.3 years) participated. Intramuscular microdialysis into masseter muscles was performed to sample serotonin (5-HT), glutamate, lactate, pyruvate, glucose and glycerol. After 2 hours 0.2 mL hypertonic saline (58.5 mg/mL) was injected into the masseter on one side and 0.2 mL isotonic saline (9 mg/mL) into the contralateral masseter close to the microdialysis catheter. Microdialysis continued for 1 hour after the injections. Pressure pain thresholds (PPT) and pain were assessed before and after injections. The median (IQR) peak pain intensity (0-100 visual analogue scale) after hypertonic saline was 52.5 (38.0) and after isotonic saline 7.5 (24.0) (p < 0.05). 5-HT, glutamate and glycerol increased after hypertonic saline injection (p < 0.05). Lactate, pyruvate and glucose showed no change. PPT after microdialysis was reduced on both sides (p < 0.05) but without side differences. Pain after hypertonic saline injection correlated positively to 5-HT (p < 0.05) and negatively to glycerol (p < 0.05). 5-HT, glutamate and glycerol increased after a painful hypertonic saline injection into the masseter muscle, but without sex differences. Since increased levels of 5-HT and glutamate have been reported in chronic myalgia, this strengthens the validity of the pain model. Glycerol warrants further investigations.
    Full-text · Article · Dec 2014 · The Journal of Headache and Pain
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    ABSTRACT: Chronic oro-facial pain conditions such as persistent idiopathic facial pain (PIFP), atypical odontalgia (AO) and burning mouth syndrome (BMS), usually grouped together under the concept of idiopathic oro-facial pain, remain a diagnostic and therapeutic challenge. Lack of understanding of the underlying pathophysiological mechanisms of these pain conditions is one of the important reasons behind the problems in diagnostic and management. During the last two decades, neurophysiological, psychophysical, brain imaging and neuropathological methods have been systematically applied to study the trigeminal system in idiopathic oro-facial pain. The findings in these studies have provided evidence for neuropathic involvement in the pathophysiology of PIFP, AO and BMS. The present qualitative review is a joint effort of a group of oro-facial pain specialists and researchers to appraise the literature on idiopathic oro-facial pain with special focus on the currently available studies on their pathophysiological mechanisms. The implications of the findings of these studies for the clinical diagnosis and treatment of idiopathic oro-facial pain conditions are discussed. © 2014 John Wiley & Sons Ltd.
    No preview · Article · Dec 2014 · Journal of Oral Rehabilitation
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    ABSTRACT: Abstract This double-blind, placebo-controlled, randomized cross-over clinical experimental study tested the reliability, validity, and sensitivity to change of punctuate pain thresholds and self-reported pain on needle penetration. Female subjects without orofacial pain were tested in 2 sessions at 1- to 2-week intervals. The test site was the mucobuccal fold adjacent to the first upper right premolar. Active lidocaine hydrochloride 2% (Dynexan) or placebo gel was applied for 5 minutes, and sensory testing was performed before and after application. The standardized quantitative sensory test protocol included mechanical pain threshold (MPT), pressure pain threshold (PPT), mechanical pain sensitivity (MPS), and needle penetration sensitivity (NPS) assessments. Twenty-nine subjects, mean (SD) age 29.0 (10.2) years, completed the study. Test-retest reliability intraclass correlation coefficient at 10-minute intervals between examinations was MPT 0.69, PPT 0.79, MPS 0.72, and NPS 0.86. A high correlation was found between NPS and MPS (r = 0.84; P < .001), whereas NPS and PPT were not significantly correlated. The study found good to excellent test-retest reliability for all measures. None of the sensory measures detected changes in sensitivity following lidocaine 2% or placebo gel. Electronic von Frey assessments of MPT/MPS on oral mucosa have good validity.
    No preview · Article · Dec 2014 · Anesthesia Progress
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    ABSTRACT: This video was created because of the considerable challenges associated with developing competency of the clinical examination protocol. Training and calibration within a standardized examination protocol is challenging and typically, multiple learning/training exercises are required in order to achieve mastery. The flow of the examination procedures and patient response is hard to discern from the written specifications. One barrier to learning is not having a clear image of how the standardized instructions can flow like natural language, which in turn facilitates the effectiveness of the protocol. Specifically, this video was conceptualized to address the difficulty examiners have in integrating their verbal commands, clinical procedures and responses given by patients. Download from: https://www.mededportal.org/publication/9946.
    No preview · Article · Nov 2014
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    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.
    No preview · Article · Oct 2014 · Journal of Oral Rehabilitation
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    ABSTRACT: AimsThe 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.ResultsNo 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.
    Full-text · Article · Aug 2014 · European Journal Of Dental Education
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    ABSTRACT: Noxious tooth pulp stimulation elicits changes in central neurons in the trigeminal brainstem complex in animals. Also, painful electrical tooth stimulation (TS) in humans has been shown to evoke changes in gingival blood flow suggesting an axon-reflex mediated neurogenic inflammation. No human studies have so far investigated the effect of experimental tooth pain on the somatosensory sensitivity of the gingiva adjacent to the stimulated tooth. Objective: The aim of this study was to evaluate the possible effect of painful electrical tooth stimulation on gingival somatosensory sensitivity in a randomized cross-over design. Method: Thirteen healthy volunteers (6 women, 7 men; 28.4 ± 5.0 years) participated in two experimental sessions (Pain vs. Control) in randomized order. Thirteen standardized quantitative sensory testing (QST) measures were obtained on the buccal attached gingiva of an upper central incisor before, immediately after and 30 min after 3 x 2 min of moderately painful (50 on a 0-100 numerical rating scale) electrical TS (5 Hz, 10 ms pulses). TS below the individual sensory threshold served as the non-painful control. Result: Painful TS evoked significant decreases in warmth and heat pain thresholds (increased sensitivity) (P < 0.001) and increases in mechanical detection thresholds as well as pressure pain thresholds (decreased sensitivity)(P < 0.050). Similar thermal threshold changes (P < 0.019) but no changes in mechanical sensitivity (P > 0.086) were found in the control session. No significant somatosensory changes were found in either session regarding cold detection and cold pain thresholds, thermal sensory limen, mechanical pain threshold, mechanical pain sensitivity, wind-up, or vibration detection (P > 0.061). Conclusion: Subtle differential effects on in gingival thermal and mechanical somatosensory sensitivity were detected up to 30 min after short-term painful TS, indicating involvement of competing facilitatory and inhibitory mechanisms. Only effects on mechanical sensitivity were specific to painful TS.
    No preview · Conference Paper · Jun 2014
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    ABSTRACT: Objective: Results from several studies indicate that serotonin (5-HT) may have a role in the pathogenesis of chronic muscle pain. The aim of this study was to investigate if the 5-HT3 receptor antagonist granisetron reduces experimental myalgia induced by hypertonic saline. Method: Sixty healthy subjects (30 women and 30 men) participated in the study. Blood or saliva was sampled for later genetic analyses to investigate if polymorphisms of the HTR3A and HTR3B genes, coding for the 5-HT3A and 5-HT3B receptors respectively, contribute to pain perception and the efficacy of granisetron. A bilateral injection of hypertonic saline (5.5%, 0.2 mL) was administered into the masseter muscle as an internal control (injection 1). Thirty minutes later 0.5 mL granisetron (1 mg/mL) was injected into the masseter muscle on one side and 0.5 mL isotonic saline (9 mg/mL) on the contralateral side in a randomized, double-blind order. This followed by another bilateral hypertonic saline injection (injection 2) after 2 min. Pain induced by each saline injection was assessed on a visual analogue scale (VAS) immediately after the injections and then every 15 sec until pain subsided. Result: The first injection of hypertonic saline induced pain of similar intensity on both sides (median 37.9) that lasted for less than 5 min. However, the second injection of hypertonic saline induced pain of significantly less intensity (P < 0.001) and shorter duration (P < 0.05) on the side pretreated with granisetron compared with the control side. The genetic analyses are ongoing. Conclusion: This study showed that blocking of the 5-HT3 receptor with granisetron decreased experimental pain induced by intramuscular injection of hypertonic saline in healthy subjects and thus that granisetron may serve as a potential analgesic drug for myalgic conditions. Further studies are needed to explore the effect of granisetron in chronic myalgia.
    No preview · Conference Paper · Jun 2014
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    ABSTRACT: Objective: Dopaminergic pathways could be involved in the pathophysiology of myofascial TMD. Therefore, the aim of this study was to investigate the levels of dopamine as well a serotonin (5-HT) in plasma between patients with myofascial temporomandibular disorders (M-TMD) and healthy subjects. Method: Fifteen M-TMD patients (mean age: 31.8 ± 13.4 yrs) and 15 age and sex-matched healthy subjects (mean age: 31.6 ± 12.4 yrs) were included in this study. The Diagnosis M-TMD was established according to the research Diagnostic Criteria for TMD. A venous blood sample was collected and present pain intensity (0-10 numeric rating scale) and the pressure pain threshold (PPT, kPa) over the masseter muscles were assessed. Independent samples t-test and Pearson’s correlation test was used for statistical analyses. Result: The plasma level of dopamine differed significantly between M-TMD patients (4.98 ± 2.55 nM) and healthy controls (2.73 ± 1.24 nM; P < 0.01). A significant difference for plasma 5-HT was not observed between groups (P = 0.75). The M-TMD patients had significantly higher present pain intensity (P < 0.001), and lower PPT (P < 0.01) compared to the healthy controls. Importantly, the level of dopamine correlated significantly with pain intensity (r = 0.518, n = 28, P < 0.01), but not with PPT (r = -0.133, n = 28, P = 0.498). Conclusion: The M-TMD patients had significantly higher levels of dopamine, present pain intensity and lower PPT, but a significant difference for 5-HT was not observed. Dopamine had a significant positive correlation with pain intensity. This and previous studies suggest that dopaminergic pathways could play a role in the pathophysiology of M-TMD but more research is required.
    No preview · Conference Paper · Jun 2014

Publication Stats

3k Citations
205.00 Total Impact Points

Institutions

  • 2003-2016
    • Malmö University
      • Faculty of Odontology (OD)
      Malmö, Skåne, Sweden
  • 2012-2015
    • Skåne University Hospital
      Malmö, Skåne, Sweden
    • Akademiska Sjukhuset
      Uppsala, Uppsala, Sweden
  • 2014
    • University of Sydney
      • Jaw Function and Orofacial Pain Research Unit
      Sydney, New South Wales, Australia
  • 2012-2014
    • Aarhus University
      • Department of Dentistry
      Aarhus, Central Jutland, Denmark
  • 2010-2014
    • Mid Sweden University
      Härnösand, Västernorrland, Sweden
  • 2013
    • University of Minnesota Duluth
      Duluth, Minnesota, United States
  • 2011
    • Karolinska Institutet
      • Institutionen för odontologi
      Solna, Stockholm, Sweden
  • 1998
    • University Hospital Linköping
      • Department of Rheumatology
      Linköping, Östergötland, Sweden
  • 1991-1995
    • Jönköping University
      Jönköping, Jönköping, Sweden