Mauno Könönen

University of Helsinki, Helsinki, Uusimaa, Finland

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Publications (57)81.63 Total impact

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    ABSTRACT: Aims: To evaluate the association between signs of temporomandibular disorders (TMD) and psychological distress in a general population-based sample of Finnish adults. Methods: The Health 2000 Survey was conducted in 2000-2001 by the National Institute for Health and Welfare in Finland. Of the sample of adults aged 30 or over (n = 8,028), 79% participated in a clinical oral health examination, which included examination of TMD signs. The participants (n = 6,155) also completed questionnaires, including the 12-item General Health Questionnaire (GHQ-12), which measured psychological distress. Associations between TMD signs and psychological distress measured by the GHQ-12 were examined in both genders. Statistical measures included chi-square tests, t tests, and logistic regression analyses. Results: The prevalence of the TMD signs (limited opening, clicking, crepitation, temporomandibular joint [TMJ] palpation pain, and muscle palpation pain) was 11.2%, 17.6%, 10.5%, 5.1%, and 18.9% in women, and 6.1%, 12.9%, 5.3%, 2.4%, and 7.2% in men, respectively. High GHQ-12 scores, measured as continuous variables and in quartiles by distress level, were significantly associated with masticatory muscle pain on palpation in both genders (P < .05) and with TMJ pain on palpation in women (P < .05). Additionally, high GHQ-12 scores as continuous were associated with TMJ crepitation in men (P < .05). The logistic regression analyses showed that higher GHQ-12 scores were associated significantly with masticatory muscle pain on palpation both in women (odds ratio [OR] = 2.18; 95% confidence interval [CI] = 1.6-2.9) and men (OR = 2.03; 95% CI = 1.3-3.1). Conclusion: TMD signs and psychological distress appear to be associated. However, due to the limitations of the study, the findings can be regarded as preliminary.
    No preview · Article · Oct 2015

  • No preview · Article · Jan 2013 · Health
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    ABSTRACT: Objectives: The aims were to analyze whether the levels of self-reported bruxism and anxiety associate among otherwise healthy subjects, and to investigate the independent effects of anxiety and stress experience on the probability of self-reported bruxism. Study Design: As part of a study on irregular shift work, a questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (number of subjects: n=750) and to an equal number of randomly selected employees in the same company with regular eight-hour daytime work. Results: The response rates were 82.3% (56.6 % men) and 34.3 % (46.7 % men), respectively. Among the 874 respondents, those aware of more frequent bruxism reported significantly more severe anxiety (p<0.001). Adjusted by age and gender, frequent bruxers were more than two times more likely to report severe stress (odds ratio 2.5; 95% confidence interval 1.5-4.2) and anxiety (odds ratio 2.2; 95% confidence interval 1.3-3.6) than non-or-mild bruxers. Conclusions: Present findings suggest that self-reported bruxism and psychological states such as anxiety or stress may be related in working age subjects. Key words:Bruxism, self-report, anxiety, stress, adult.
    Full-text · Article · Aug 2012 · Medicina oral, patologia oral y cirugia bucal
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    ABSTRACT: Studies concerning the role of denture status on in temporomandibular disorders (TMD) are scarce. The aim of this study was to evaluate the association of tooth loss and denture status with clinical findings of TMD. The data were obtained from 6316 subjects aged ≥30 years from the Finnish Health 2000 Survey. The associations between clinically assessed TMD findings and number of teeth, wearing of removable dentures, need for denture repair and age of the dentures were analysed by means of chi-square test and logistic regression. Among women after adjusting for age, having fewer teeth or wearing complete dentures associated with restricted maximum interincisal distance and pain on palpation of the temporomandibular joints (TMJ) and masticatory muscles. After adding education level and depression in the model, the associations between TMJ pain and explanatory variables were weakened. Among men, having a higher number of teeth associated with occurence of TMJ crepitation. Subjective need for repair of dentures and having a denture aged ≥5 years associated with pain on palpation in masticatory muscles among women. Among men, both the objective and subjective need for denture repair and having at least one denture aged ≥5 years or been repaired during the past 5 years associated negatively with the presence of TMJ crepitation. It can be concluded that edentulousness, wearing of complete dentures and poor condition of dentures associate with pain-related TMD findings among women. Psychosocial factors have a modifying effect on these associations.
    No preview · Article · Aug 2012 · Journal of Oral Rehabilitation
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    ABSTRACT: Temporomandibular disorders (TMD) can be related to self-reported musculoskeletal pains. The aim of the study was to investigate the association of clinical findings of TMD with self-reported pain in other parts of the body, and to discriminate pain clusters according to definite profiles of pain conditions including TMD among subjects in general population. A nationally representative Health 2000 Survey was carried out in 2000-2001 in Finland. The data were obtained from 6227 subjects aged ⩾30years. Information about pain in different parts of the body was collected from a questionnaire. The associations between clinically assessed TMD findings and pain in other areas were analyzed using chi-square test and logistic regression analyses. Latent class analysis (LCA) was used to form natural clusters, i.e., groups in which the individuals had similar profiles of pain conditions. Masticatory muscle pain on palpation associated with back, neck and shoulder pain and pain in joints. Temporomandibular joint (TMJ) pain on palpation associated with back, neck, shoulder and other joint pain. These associations did not change essentially after adjustment for confounders. After clustering of the study population with the LCA, 5.8% of the study population showed a multiple pain condition linked with TMD findings. Female gender, intermediate/poor self-reported health and presence of a longstanding illness increased the probability to belong to this cluster. TMD findings associate with pain in several locations. Female gender and presence of impaired health were particularly related to occurrence of multiple pain conditions.
    No preview · Article · Jun 2011 · European journal of pain (London, England)

  • No preview · Article · Sep 2009 · European journal of pain (London, England)
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    ABSTRACT: To investigate the association of sense of coherence (SOC) with clinical findings of temporomandibular disorders (TMD) among 30- to 64-year-old subjects. A nationally representative health examination survey called the Health 2000 Survey was carried out from 2000 to 2001. The data for this study were obtained from 4859 subjects aged 30 to 64 years who had participated in an interview, been clinically examined, and returned a self-administered questionnaire. The questionnaire included a SOC scale which was a 12-item version of the SOC-13 scale. Based on a clinical examination for TMD, the following variables were formed: maximum interincisal distance <40 mm, clicking, crepitation, pain in the temporomandibular joints (TMJs), and pain in the masticatory muscles. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models. Subjects with low SOC had higher odds to have distinct TMD findings, especially masticatory muscle pain, than those with high SOC. After adjustment for confounders, those with low SOC had more than twofold odds to have masticatory muscle pain (in at least one painful site) compared to those with high SOC (OR 2.2, 95% CI 1.4-3.6). Low SOC was also associated with TMJ pain on palpation (OR 3.2, 95% CI 1.5-6.6). Low SOC associates with myogenous TMD findings. SOC as a psychosocial aspect has a role in the background of TMD.
    No preview · Article · Mar 2009 · Journal of orofacial pain
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    ABSTRACT: The aims were to investigate the prevalence of perceived sleep quality and insufficient sleep complaints, and to analyze whether self-reported bruxism was associated with perceptions of sleep, and awake consequences of disturbed sleep, while controlling confounding factors relative to poor sleep. A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls in the same company with regular eight-hour daytime work. The response rate in the irregular shift work group was 82.3% (56.6% men) and in the regular daytime work group 34.3% (46.7% men). Self-reported bruxism occurred frequently (often or continually) in 10.6% of all subjects. Altogether 16.8% reported difficulties initiating sleep (DIS), 43.6% disrupted sleep (DS), and 10.3% early morning awakenings (EMA). The corresponding figures for non-restorative sleep (NRS), tiredness, and sleep deprivation (SLD) were 36.2%, 26.1%, and 23.7%, respectively. According to logistic regression, female gender was a significant independent factor for all insomnia symptoms, and older age for DS and EMA. Frequent bruxism was significantly associated with DIS (p = 0.019) and DS (p = 0.021). Dissatisfaction with current work shift schedule and frequent bruxism were both significant independent factors for all variables describing insufficient sleep consequences. Self-reported bruxism may indicate sleep problems and their adherent awake consequences in non-patient populations.
    Full-text · Article · Feb 2008 · Head & Face Medicine
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    ABSTRACT: To study the age- and gender-related prevalence of signs of temporomandibular disorders (TMD) in the Finnish adult population. A clinical health examination was performed as a part of a Health 2000 Health Examination Survey in 2000 and 2001. A nationally representative sample included 8,028 Finns at least 30 years of age, of whom 79% participated also in an oral health investigation, including examination of the stomatognathic system in order to assess the presence of certain TMD signs: maximum interincisal distance < 40 mm, pain in temporomandibular joints or masticatory muscles, and sounds in temporomandibular joints (crepitation, clicking). Thirty-eight percent of the subjects had at least 1 sign of TMD. All the signs studied were more common in women than men. Overall, signs of TMD were also associated with age; the older the subject, the higher the prevalence of the TMD signs. However, when stratified by gender, the association with age was not as clear, and gender differences were observed in the prevalence of the single TMD signs at different ages. Signs of TMD may be more common among the elderly than is usually reported.
    No preview · Article · Jun 2006 · Journal of orofacial pain
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    ABSTRACT: Using a planimetric method, the size of horizontal wear facets on maxillary anterior teeth was studied longitudinally in the permanent dentition of 35 subjects at ages 14, 18, and 23?years. The study subjects had not previously undergone any orthodontic treatment and had Class I occlusion. We studied the association between the amount of wear and reported parafunctions and maximal bite force. Total wear areas in age groups 14, 18, and 23 years were 29.5 mm2 (SD 11.4), 39.1 mm2 (SD 12.7), and 45.0 mm2 (SD 13.0), respectively. The total wear area increased significantly both from 14 to 18 years of age and from 18 to 23 years of age (p <0.0001). Between 18 and 23?years of age, the maxillary canines showed strongest wear, although the central incisors had largest wear facets. It can be concluded that wear of permanent anterior teeth is a continuous phenomenon in adolescence and young adulthood.
    Full-text · Article · Mar 2006 · Acta Odontologica Scandinavica
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    ABSTRACT: Several studies have reported that musculoskeletal disorders of the stomatognathic system, commonly known as temporomandibular disorders (TMD) resemble musculoskeletal disorders and chronic pain disorders in general. There is also general consensus that combined biomedical and biopsychosocial methods best support the assessment and management of the cardinal features of TMD, i.e., pain and dysfunction or physical (peripheral) and psychosocial (central) factors. This overview of the aetiology of TMD will outline conceptualizations of past models and present the current view that patients with TMD should be assessed according to both the physical disorder and the psychosocial illness impact factors. The conceptual theories outlined in this review include biomedical models related to temporomandibular joints, muscles of mastication and occlusal factors, psychological models and the biopsychosocial models. An integrated and multidimensional approach concerning physical and psychosocial factors in temporomandibular pain and dysfunction is presented as an example of how the biopsychosocial model and information processing theory may apply in the conceptualization and management of TMD for various health care professionals.
    No preview · Article · Jan 2006 · European Journal of Pain
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    ABSTRACT: Body height is an alleged risk factor for low back pain in adulthood, but its importance regarding non-specific neck pain is obscure during childhood and adolescence. We studied anthropometric measurements for their associations with the incidence of neck pain in a population study of 430 children who were examined five times: at the age 11-14 and 22 years. Body height and weight and the degrees of trunk asymmetry, thoracic kyphosis and lumbar lordosis were measured at every examination. The history of neck pain was obtained by a structured questionnaire at the final examination. The incidence of neck pain was defined as pain occurring in eight or more days during the past year. Short stature at 11 years of age predicted the incidence of neck pain. Adjusted for sex, the odds ratio (with 95% confidence interval) per an increment of one standard deviation of body height was 0.78 (0.62-0.97). At 22 years of age there was accordingly an inverse association between current body height and neck pain history, the odds ratio being 0.62 (0.45-0.86). Male sex was found to protect against neck pain; the odds ratio was 0.28 (0.18-0.44). Anthropometric measurements other than body height were not found to predict neck pain. The role of anthropometric factors in the development of neck pain at young adulthood seems only modest. Short stature may be a risk determinant of neck pain.
    No preview · Article · Jan 2006 · European Spine Journal
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    ABSTRACT: Spinal posture and the resultant changes during the entire pubertal growth period have not been reported previously. No cohort study has focused on the development of spinal posture during both the ascending and the descending phase of peak growth of the spine. The growth and development of a population-based cohort of 1060 children was followed up for a period of 11 years. The children were examined 5 times, at the ages of 11, 12, 13, 14 and 22 years. A total of 430 subjects participated in the final examination. Sagittal spinal profiles were determined using spinal pantography by the same physician throughout the study. Thoracic kyphosis was more prominent in males at all examinations. The increasing tendency towards thoracic kyphosis continued in men, but not in women. The degree of lumbar lordosis was constant during puberty and young adulthood. Women were more lordotic at all ages. Thoracic hyperkyphosis of > or =45 degrees was as prevalent in boys as girls at 14 years, but significantly (P<0.0001) more prevalent in men (9.6%) than in women (0.9%) at 22 years. The degree of mean thoracic kyphosis and the prevalence of hyperkyphosis increased in men during the descending phase of peak growth of the spine, but decreased in women.
    Full-text · Article · Oct 2005 · European Spine Journal
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    ABSTRACT: In the oral cavity, Actinomyces form a fundamental component of the indigenous microflora, being among initial colonizers in polymicrobial biofilms. However, some differences may exist between different species in terms of their attachment not only to teeth but also to biomaterials. In this study we investigated the distribution of Actinomyces in 33 dental implant fixtures explanted from 17 patients. The identification was based on comprehensive biochemical testing and gas-liquid chromatography and when needed, 16S rRNA sequencing. Actinomyces was the most prevalent bacterial genus in these failed implants, colonizing 31/33 (94%) of the fixtures. Proportions of Actinomyces growth of the total bacterial growth in the Actinomyces-positive fixtures varied from 0.01% up to 75%. A. odontolyticus was the most common Actinomyces finding, present in 26/31 (84%) Actinomyces-positive fixtures. Actinomyces naeslundii and A. viscosus were both detected in 10/31 (32%) and A. israelii in 7/31 (23%) fixtures. Other Actinomyces species, including A. georgiae, A. gerencseriae and A. graevenitzii, were detected less frequently. Our results suggest that Actinomyces species are frequent colonizers on failed implant surfaces, where A. odontolyticus was the far most prominent Actinomyces species.
    No preview · Article · Sep 2005 · Anaerobe
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    ABSTRACT: Body height is an alleged risk factor for low-back pain (LBP) in adulthood, but its importance is obscure during childhood and adolescence. We studied growth for its association with the incidence of LBP in a population study of 430 children who were examined five times: at the age 11,12,13,14 and 22 years. Body height and weight and the degrees of trunk asymmetry, thoracic kyphosis and lumbar lordosis were measured at every examination. The history of LBP was obtained by a structured questionnaire at the ages of 14 and 22 years. The incidence of LBP was defined as pain, which occurred on eight or more days during the past year among those 338 children who had been free from LBP until 14 years of age. Growth of body height between 11 years and 14 years of age predicted the incidence of LBP. Adjusted for sex, the odds ratio (with 95% confidence interval) per an increment of one SD (4.3 cm) was 1.32 (1.06--1.65), the P value for trend being 0.03. Growth after 14 years of age was inversely related to the incidence of LBP, but the association did not reach statistical significance (P for trend=0.06). Other anthropometric measurements or their changes were not found to predict LBP. Our results are not compatible with the old myth that spinal growth actually contributes to LBP. But abundant growth in early adolescence may be a risk factor for subsequent LBP.
    Full-text · Article · Sep 2005 · European Spine Journal
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    ABSTRACT: A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls in the same company with regular 8-hour daytime work. The aims were to investigate the prevalence and severity of perceived orofacial pain (Research Diagnostic Criteria for Temporomandibular Disorders Axis II) and to analyze whether current orofacial pain was associated with reported bruxism and insomnia symptoms (Diagnostic and Statistical Manual of Mental Disorders-IV and the International Classification of Sleep Disorders Revised). The response rate in the irregular shift-work group was 82.3% (56.6% men) and in the regular daytime-work group 34.3% (46.7% men). Current orofacial pain was found overall in 19.6%, of which 88.3% had experienced the pain over 6 months. All claimed that their pain fluctuated. No subjects with chronic orofacial pain reported disabling pain, and grades III and IV were not found. Insomnia symptoms and frequent bruxism were significantly more prevalent in chronic pain grade II than in lower grades. According to logistic regression, current orofacial pain was significantly positively associated with frequent bruxism (p < 0.001), female gender (p < 0.001), and disrupted sleep (p < 0.01), and significantly negatively associated with age over 45 years (p < 0.01). Our results revealed a clear-cut association between perceived orofacial pain and reported bruxism. The association held with both chronic orofacial pain intensity and current pain. Based on the multivariate analyses, it can be concluded that disrupted sleep and bruxism may be concomitantly involved in the development of orofacial pain.
    Full-text · Article · Aug 2005 · Acta Odontologica Scandinavica
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    ABSTRACT: An albumin coating on titanium implants will inhibit bacterial adhesion on the implant surface. Bacterial, protein, and platelet adhesion on otologic implants and tympanostomy tubes is a major reason for implant sequelae and can eventually lead to implant removal. The role of albumin coating of the implant in prevention of protein adhesion on implant surface has already been tested by the authors. In the present study the authors examined the in vitro adherence of Staphylococcus aureus and Pseudomonas aeruginosa on an albumin-coated and uncoated titanium surface. Human serum albumin (HSA)-coated and uncoated titanium surfaces were exposed to viable S. aureus and P. aeruginosa and, after washings, photographed by fluorescence microscopy to quantify the adhered bacteria, which was stained with acridine orange. Bacteria in the suspension adhered at a significantly lesser rate to the coated surfaces than to the uncoated surfaces, with overall bacterial adhesion dependent on bacterial concentration. Binding of S. aureus on HSA-coated surfaces was inhibited significantly (from 82 to 95% depending on concentration). Binding of P. aeruginosa was inhibited from 29 to 37%. Because albumin coating can reduce bacterial adherence on titanium surfaces in vitro, reduction is possible in bacterial contamination and infection of the HSA-coated titanium implant in vivo.
    Full-text · Article · Jun 2005 · Otology & Neurotology
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    ABSTRACT: A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls in the same company with regular 8-h daytime work. The questionnaire covered demographic items, employment details, general health experience, physical status, psychosocial status, stress, work satisfaction and performance, tobacco use, bruxism, and restless legs symptoms (RLS). The aim was to investigate among a multiprofessional media personnel the associations between reported bruxism and RLS, while simultaneously controlling the effects of gender, age, tobacco use, shift work, and dissatisfaction with current workshift schedule. The overall response rate was 58.3% (53.7% men). The response rate in the irregular shift work group was 82.3% (56.6% men) and in the regular daytime work group 34.3% (46.7% men). In the bivariate analyses, RLS was more prevalent in workers at either end of the studied age range (p < 0.05). Self-reported frequent bruxism was significantly associated with younger age (p < 0.05). Females reported RLS (11.4%) slightly more often than males (7.7%) (NS). In logistic regression, frequent bruxism (p < 0.05) and older age (p < 0.05) were significantly positively associated with RLS. Dissatisfaction with one's current workshift schedule (p < 0.05) and RLS (p < 0.05) were significantly positively associated with frequent bruxism, while age (p < 0.05) was significantly negatively associated. In conclusion, perceived bruxism may be a sign of a stressful situation or dissatisfaction, while RLS as a more stable trait may in itself negatively affect sleep quality and further enhance the problem.
    No preview · Article · May 2005 · Acta Odontologica Scandinavica
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    ABSTRACT: To investigate subjective, clinical and radiographic findings relating to the temporomandibular joint (TMJ) in patients with rheumatoid arthritis (RA), mixed connective tissue disease (MCTD), ankylosing spondylitis (AS), and spondyloarthropathy (SPA), and to compare the findings with those in age- and sex-matched control subjects. Eighty patients (24 with RA, 16 with MCTD, 19 with AS, 21 with SPA) and 80 matched controls participated in the study. Replies to a questionnaire covering oral and TMJ symptoms were analysed in conjunction with medical histories, results of clinical examination of the stomatognathic system, and panoramic and lateral panoramic radiographs. Patients with rheumatic disease reported severe TMJ symptoms significantly oftener than control subjects (P < .001). Patients with AS reported symptoms most frequently (7/19, 37%). Mean maximal opening of the mouth (SD) was significantly less in patients with rheumatic disease (46.3 mm (8.6 mm)) than in control subjects (55.0 mm (7.4 mm)) (P < .001). Marked erosions were observed in 4 RA patients (17%), 3 MCTD patients (19%), 8 SPA patients (38%), 7 AS patients (37%), and 1 control subject (1%) (P < .001). The existence of erosion was associated with evidence of restricted movement of condyle in panoramic radiographs (P < .001). There was correlation between radiographic findings relating to the TMJ and subjective and clinical stomatognathic-system symptoms in patients with rheumatic disease. Subjective TMJ symptoms were associated with evidence of restricted movement of condyle in panoramic radiographs (P < .001). Impairment of laterotrusion movement was significantly associated with erosion (P < .001). The TMJ is commonly affected in patients with RA, and in patients with other forms of rheumatic disease. There are associations between radiographic findings and subjective symptoms, and between radiographic findings and restricted TMJ movement. In screening for suspected TMJ destruction, it would be appropriate to look for restricted maximal mouth opening, masticatory muscle tenderness and restricted laterotrusion.
    No preview · Article · May 2005 · Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
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    ABSTRACT: This study aimed to determine chronic groups of myofascial pain and chronic disk displacement with reduction over a 1-year period, and to study the relationship between psychological status and these chronic subgroups of temporomandibular disorders (TMD) in non-patients. A total of 211 subjects (males 47%, mean age 46 years; standard deviation 6) attended examinations in 1999 and 2000 performed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Chronic myofascial pain was found in 7% and chronic disk displacement with reduction in 11% of subjects; new diagnoses were made in only 4% and 1% of the subjects, respectively. An increase in the level of somatization by 1 step increased the probability of having chronic myofascial pain by over 3 times (P = 0.006). Myofascial pain and disk displacement with reduction seem to be relatively common and fluctuating in nature in non-patients. As somatization associated significantly with myofascial pain, this should be borne in mind in the management of TMD. The results strengthen the rationale of the biopsychosocial orientation in health care.
    No preview · Article · Jan 2005 · Acta Odontologica Scandinavica

Publication Stats

1k Citations
81.63 Total Impact Points

Institutions

  • 1986-2015
    • University of Helsinki
      • • Institute of Dentistry
      • • Department of Prosthetic Dentistry
      Helsinki, Uusimaa, Finland
  • 2009
    • University of Oulu
      • Institute of Dentistry
      Uleoborg, Oulu, Finland
  • 2006
    • Kanta-Häme Central Hospital, Finland
      Tavastehus, Southern Finland Province, Finland
  • 2002-2006
    • Helsinki University Central Hospital
      Helsinki, Uusimaa, Finland
  • 2004
    • Fimnet
      Helsinki, Uusimaa, Finland
  • 2001-2003
    • Karolinska Institutet
      Solna, Stockholm, Sweden
  • 1999
    • Aarhus University
      • Department of Biomedicine
      Aarhus, Central Jutland, Denmark