Showing papers in "Journal of Oral Rehabilitation in 2011"
TL;DR: The result of this review of self-adhesive resin cements would suggest that these materials may be expected to show similar clinical performance as other resin-based and non-resin based dental cements.
Abstract: Self-adhesive resin cements were introduced to dentistry within the past decade but have gained rapidly in popularity with more than a dozen commercial brands now available. This review article explores their chemical composition and its effect on the setting reaction and adhesion to various substrates, their physical and biological properties that may help to predict their ultimate performance and their clinical performance to date and handling characteristics. The result of this review of self-adhesive resin cements would suggest that these materials may be expected to show similar clinical performance as other resin-based and non-resin based dental cements.
383 citations
TL;DR: Findings from literature on masticatory function for both healthy persons and patient groups are presented and the influence of oral rehabilitation, e.g. dental restorations, implant treatment and temporomandibular disorder treatment, on masticsatory function will be discussed.
Abstract: Summary During chewing, food is reduced in size, while saliva moistens the food and binds the masticated food into a bolus that can be easily swallowed. Characteristics of the oral system, like number of teeth, bite force and salivary flow, will influence the masticatory process. Masticatory function of healthy persons has been studied extensively the last decades. These results were used as a comparison for outcomes of various patient groups. In this review, findings from literature on masticatory function for both healthy persons and patient groups are presented. Masticatory function of patients with compromised dentition appeared to be significantly reduced when compared with the function of healthy controls. The influence of oral rehabilitation, e.g. dental restorations, implant treatment and temporomandibular disorder treatment, on masticatory function will be discussed. For instance, implant treatment was shown to have a significant positive effect on both bite force and masticatory performance. Also, patient satisfaction with an implant-retained prosthesis was high in comparison with the situation before implant treatment. The article also reviews the neuromuscular control of chewing. The jaw muscle activity needed to break solid food is largely reflexly induced. Immediate muscle response is necessary to maintain a constant chewing rhythm under varying food resistance conditions. Finally, the influence of food characteristics on the masticatory process is discussed. Dry and hard products require more chewing cycles before swallowing than moist and soft foods. More time is needed to break the food and to add enough saliva to form a cohesive bolus suitable for swallowing.
342 citations
TL;DR: Standardisation of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different oro-facial pain conditions and may help to guide management.
Abstract: Summary The goals of an international taskforce on somatosensory testing established by the Special Interest Group of Oro-facial Pain (SIG-OFP) under the International Association for the Study of Pain (IASP) were to (i) review the literature concerning assessment of somatosensory function in the oro-facial region in terms of techniques and test performance, (ii) provide guidelines for comprehensive and screening examination procedures, and (iii) give recommendations for future development of somatosensory testing specifically in the oro-facial region. Numerous qualitative and quantitative psychophysical techniques have been proposed and used in the description of oro-facial somatosensory function. The selection of technique includes time considerations because the most reliable and accurate methods require multiple repetitions of stimuli. Multiple-stimulus modalities (mechanical, thermal, electrical, chemical) have been applied to study oro-facial somatosensory function. A battery of different test stimuli is needed to obtain comprehensive information about the functional integrity of the various types of afferent nerve fibres. Based on the available literature, the German Neuropathic Pain Network test battery appears suitable for the study of somatosensory function within the oro-facial area as it is based on a wide variety of both qualitative and quantitative assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intra-oral mucosa. Standardisation of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different oro-facial pain conditions and may help to guide management.
153 citations
TL;DR: Tendency for gagging during dental care slightly increases the odds of both types of self-reported bruxism, but desirability of control is not associated with these phenomena.
Abstract: To examine possible associations between self-reported bruxism, stress, desirability of control, dental anxiety and gagging. Five questionnaires were distributed among a general adult population (402 respondents): the Perceived Stress Scale (PSS), Desirability of Control Scale (DC), Dental Anxiety Scale (DAS), Gagging Assessment Scale (GAS), and Bruxism Assessment Questionnaire. A high positive correlation between DAS and GAS (R = 0·604, P < 0·001) was found. PSS was negatively correlated with DC (R = -0·292, P < 0·001), and was positively correlated with GAS (R = 0·217, P < 0·001) and DAS (R = 0·214, P < 0·001). Respondents who reported bruxing while awake or asleep showed higher levels of GAS, DAS and PSS than those who did not. There were no differences between the bruxers and the non-bruxers (sleep and aware) with regard to the DC scores. The best predictors of awake bruxism were sleep bruxism (OR = 4·98, CI 95% 2·54-9·74) and GAS (OR = 1·10, CI 95% 1·04-1·17). The best predictors of sleep bruxism were awake bruxism (OR = 5·0, CI 95% 2·56-9·78) and GAS (OR = 1·19; CI 95% 1·11-1·27). Self-reported sleep bruxism significantly increases the odds for awake bruxism and vice versa. Tendency for gagging during dental care slightly increases the odds of both types of self-reported bruxism, but desirability of control is not associated with these phenomena.
145 citations
TL;DR: Very high survival/success rates have been reported for implant treatment, irrespective of the prosthetic type of reconstruction, but these are commonly reported in simple Cumulative Survival/Success Rate (CSR) tables only that may overestimate the true clinical outcome.
Abstract: Very high survival/success rates have been reported for implant treatment, irrespective of the prosthetic type of reconstruction, be those full arcs, partial dentures, combined tooth implants or single crowns. However, survival/success is commonly reported in simple Cumulative Survival/Success Rate (CSR) tables only that may overestimate the true clinical outcome; furthermore, future challenges to clinical success may originate from too rapid launching of untested novelties or recommendations to apply too bold clinical procedures, potential problems that are summarised in the present paper.
110 citations
TL;DR: It is concluded that there was no significant difference between the two different designs of implant-supported overdentures with respect to the soft tissue health status or patient satisfaction, although the bar- supported overdentURES have been shown to need less prosthetic maintenance.
Abstract: The objective of this systematic review was to assess the influence of splinted and unsplinted oral implants in the mandibular and maxillary implant-supported overdenture therapy, concerning the implant survival, the peri-implant parameters, the prosthetic complications and the patient satisfaction. An electronic MEDLINE search complemented by manual searching was conducted to identify randomized clinical trials, prospective and retrospective cohort studies on implant-supported overdentures with a mean follow-up of at least 3 years. Twelve studies from an initial yield of 1022 titles were finally selected and data were extracted. After an observation period of more than 3 years, there was no difference in implant survival rates between splinted and unsplinted design. From most of the investigations included in this study, it was mentioned that the unsplinted design needs more prosthetic maintenance. In more of the studies that were dealing with the satisfaction of the patients wearing implant-supported overdentures, no significant difference in the preference of the patients was reported. No significant difference in the peri-implant outcome between splinted and unsplinted design was found. Within the limits of this systematic review, it is concluded that there was no significant difference between the two different designs of implant-supported overdentures with respect to the soft tissue health status or patient satisfaction, although the bar-supported overdentures have been shown to need less prosthetic maintenance.
109 citations
TL;DR: Evidence-based knowledge in the field of TMD diagnosis and treatment was summarised in this article with the aim of providing useful suggestions for a medical legal approach to TMD.
Abstract: SUMMARY Temporomandibular disorders (TMD) are a frequent finding in cases of facial trauma or dental malpractice, and legal claims for TMD damage have been increased over the years. Temporomandibular disorders assessment in the medical legal setting is complicated by the peculiarities of these disorders, whose symptoms are heterogeneous, fluctuant, and recognise a multifactorial origin. A systematic Medline search in the National Library of Medicine’s PubMed database pointed out that, despite the medical legal aspects of the dental profession are gaining a growing attention, there is a paucity of literature dealing with patients with TMD assessment. For these reasons, evidence-based knowledge in the field of TMD diagnosis and treatment was summarised in this article with the aim of providing useful suggestions for a medical legal approach to
107 citations
TL;DR: The literature does not provide accurate information about the clinical outcome of cement-retained implant-supported fixed restorations nor about the ideal type of cement that facilitates stability and maintains retrievability, so standardised randomised clinical trials will provide valuable information to this issue.
Abstract: The aim of the article is to assess the current literature in terms of the prosthetic outcome of cement-retained implant-supported fixed restorations, as well as to determine the type of cement that can be recommended for clinical application. A review of the literature published up to May 2010 was conducted to identify clinical studies about cement-retained implant-supported fixed restorations. The search strategy applied was a combination of MeSH terms and free text words, including the following keywords: implants, implant-supported fixed dental prostheses (FDPs), bridges, implant-supported single crowns (SCs), cement-retained, cement fixation, cement, cementation, cement failure, retention, and loss of retention, technical complications, mechanical complications, prosthetic complication, retrievability and maintenance. Thirty-two studies met the inclusion criteria. The studies were divided into two categories: 15 short-term clinical studies with an observation period of less than 5 years, and 17 long-term clinical studies with an observation period of 5 years and more. The most common technical complications of cement-retained implant-supported fixed restorations were loss of retention, chipping and abutment screw loosening. The results of the current review revealed no guidelines about cement or cementation procedures. It may be stated that despite the questionable retrievability of cement-retained implant-supported fixed restorations, this treatment modality is a reliable and effective option, especially for implant-supported SCs and short-span FDPs. The literature does not provide accurate information about the clinical outcome of cement-retained implant-supported fixed restorations nor about the ideal type of cement that facilitates stability and maintains retrievability. Standardised randomised clinical trials will provide valuable information to this issue.
105 citations
TL;DR: Clinicians should not use sEMG and KG devices as diagnostic tools for individual patients who might have myofascial pain in the jaw muscles because such instruments do not meet the standard of reliability and validity required for such usage.
Abstract: SUMMARY The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices for myofascial pain of jaw muscles. Thirty-six (n = 36) consecutive patients with a research diagnostic criteria for temporomandibular disorders (RDC ⁄TMD) axis I diagnosis of myofascial pain and an age- and sex-matched group of 36 TMD-free asymptomatic subjects underwent sEMG and KG assessments to compare EMG parameters of the masseter and temporalis muscles as well as the jaw range of motion and the interarch freeway space. EMG data at rest were not significantly different between myofascial pain patients and asymptomatic subjects, while the latter achieved significantly higher levels of EMG activity during clenching tasks. Symmetry of muscle activity at rest and during clenching tasks, KG parameters of jaw range of motion and the measurement of the interarch vertical freeway did not differ between groups. Receiver operating characteristics curve analysis showed that, except EMG parameters during clenching tasks, all the other outcome sEMG and KG measures did not reach acceptable levels of sensitivity and specificity, with a 30AE6‐88AE9% percentage of false-positive results. Therefore, clinicians should not use sEMG and KG devices as diagnostic tools for individual patients who might have myofascial pain in the jaw muscles. Whether intended as a stand-alone measurement or as an adjunct to making clinical decisions, such instruments do not meet the standard of reliability and
84 citations
TL;DR: Results suggest that lower angles of approach to intercuspation and faster speed during closing duration are associated with colour changes in the colour-changeable chewing gum.
Abstract: The purpose of this study was to investigate the relationship between masticatory performance as determined using a colour-changeable chewing gum and mandibular movements. Subjects comprised 45 fully dentate adults (23 men, 22 women; mean age, 28·1 years). The gum was chewed for a specified number of chewing strokes (20, 40, 60, 80, 120 or 160 strokes) without any instructions as to chewing side. A colourimeter was used to measure L*, a* and b* values (CIE-L*a*b* colour system) for the chewed gum, then the difference between two colours in the CIE-L*a*b* colour space (ΔE) for each number of chewing strokes was calculated according to a formula. Index of masticatory performance (ΔE60) for each subject was obtained using ΔE for 20, 40, 60, 80, 120 and 160 strokes. Mandibular movements were recorded using an opto-electric system with six degrees of freedom. Twelve parameters of mandibular movements relating to amplitude, duration, velocity and angle were computed for each cycle, and mean values for 10 cycles (from cycle 11 to 20) were calculated separately. Stepwise multiple regression analysis identified maximum closing velocity and closing angle as predictors accounting for 18% of the variation in ΔE60. These results suggest that lower angles of approach to intercuspation and faster speed during closing duration are associated with colour changes in the colour-changeable chewing gum.
79 citations
TL;DR: The present investigation provides support to the hypothesis that the duration of sleep-time masticatory muscle activity, especially during the early phases of a night's sleep, may be related to anxiety trait and not to anxiety state, depression or anger.
Abstract: The present investigation attempts to describe the correlation between sleep-time masticatory muscle activity (MMA) and psychological symptoms by the use of a four-channel electromyography (EMG) home-recording device in a group of 15 healthy volunteers completing a battery of psychometric questionnaires for the assessment of anxiety, depression and anger. The integrated EMG signal was adopted to quantify the work (μV × s) produced by each of the four muscles (bilateral masseter and temporal) during the 5-h recording span and per each 1-h increment. The duration of MMA events and the muscle work during the first hour of sleep was related to trait anxiety scores for both masseter (P = 0·007) and temporalis muscles (P = 0·022). Trait anxiety was also significantly correlated to the total amount of MMA duration (in seconds) of the temporalis muscles (r = 0·558; P = 0·031). The present investigation provides support to the hypothesis that the duration of sleep-time masticatory muscle activity, especially during the early phases of a night's sleep, may be related to anxiety trait and not to anxiety state, depression or anger. These findings may support the view that features related to the individual management of anxiety, viz. trait, are likely to be more important than acute episodes of anxiety, viz. state, in the aetiology of sleep-time masticatory muscle activity. The role of other psychological symptoms is likely to be less important.
TL;DR: It is indicated that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity and more large sample-sized, high-quality randomised controlled clinical trials are needed before definitive conclusions were made.
Abstract: The aim of this systematic review was to compare the effectiveness of laser therapy with that of topical desensitising agents in treating dentine hypersensitivity. A secondary objective was to determine the safety of laser application according to the relevant studies. A systematic search was performed in the MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the National Research Register, the Cochrane Oral Health Group's Trials Register database to retrieve all articles that were about randomised controlled trials involving the application of laser desensitising procedures and topical desensitising agents in the treatment of dentine hypersensitivity. A total of eight trials that met all inclusion criteria involving 234 participants were reviewed. Based upon the 'quality' of evidence, one study was classified as A level, five as B level and two as C level. Owing to the heterogeneity of the studies, a meta-analysis was not performed. Half of the included studies compared GaALAS laser with topical desensitising agents, but the findings were conflicting. The remaining studies involved Nd:YAG laser, Er:YAG laser and CO2 laser, and all showed that the three types of lasers were superior to topical desensitising agents, but the superiority was slight. A systematic review of the literature indicates the likelihood that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity. More large sample-sized, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions were made.
TL;DR: Clinical and radiographic peri-implant tissue responses of immediately loaded MDIs supporting a mandibular overdenture were favourable after 3 years, however, randomised, controlled clinical trials are needed to compare these responses to that of conventional-diameter implants.
Abstract: This article aimed to examine the clinical and radiographic outcome of mini dental implants (MDIs) supporting a mandibular overdenture Twenty-eight patients (16 men and 12 women) complaining from insufficient retention of their mandibular denture received a total of 112 MDIs (four per patient) in the interforaminal area of the mandible using the non-submerged flapless surgical approach Implants were immediately loaded with mandibular overdentures after implant insertion Each implant was evaluated at the time of initial prosthetic loading, 6, 12, 24 and 36 months thereafter Clinical evaluation was performed using plaque index (PI), gingival index (GI), probing depth (PD) and periotest values (PTVs) Radiographic evaluation was performed in terms of vertical (VBLO) and horizontal (HBLO) alveolar bone loss Cumulative success and survival rates were calculated using life table analysis Plaque index, GI, PD, VBLO and HBLO increased significantly in the first year after overdenture insertion, and no significant difference between subsequent observations was noted Periotest values demonstrated no significant difference between observation times The cumulative survival and success rates of MDIs were 96·4% and 92·9%, respectively Within the limitations of this study, clinical and radiographic peri-implant tissue responses of immediately loaded MDIs supporting a mandibular overdenture were favourable after 3 years However, randomised, controlled clinical trials are needed to compare these responses to that of conventional-diameter implants
TL;DR: It is suggested that edentulous patients who choose mandibular implant overdentures have significantly greater improvements in satisfaction, despite their relatively higher cost, than those who choose new conventional dentures.
Abstract: The purpose of this multicentre observational study was to determine patient satisfaction with either conventional dentures or mandibular 2-implant overdentures in a 'real world' setting. Two hundred and three edentulous patients (mean age 68·8 ± 10·4 years) were recruited at eight centres located in North America, South America and Europe. The patients were provided with new mandibular conventional dentures or implant overdentures supported by two implants and ball attachments. At baseline and at 6 months post-treatment, they rated their satisfaction with their mandibular prostheses on 100-mm visual analogue scale questionnaires. One hundred and two (50·2%) participants had valid baseline and 6-month satisfaction data. Although both groups reported improvements, the implant overdenture group reported significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew. These results suggest that edentulous patients who choose mandibular implant overdentures have significantly greater improvements in satisfaction, despite their relatively higher cost, than those who choose new conventional dentures.
TL;DR: Findings suggest that CAP phase A3 may act as a permissive window rather than a generator of RMMA/SB activity in predisposed individuals.
Abstract: Rhythmic masticatory muscle activity (RMMA) is the characteristic electromyographic pattern of sleep bruxism (SB), a sleep-related motor disorder associated with sleep arousal. Sleep arousals are generally organised in a clustered mode known as the cyclic alternating pattern (CAP). CAP is the expression of sleep instability between sleep maintaining processes (phase A1) and stronger arousal processes (phases A2 and A3). This study aimed to investigate the role of sleep instability on RMMA/SB occurrence by analysing CAP and electroencephalographic (EEG) activities. The analysis was performed on the sleep recordings of 8 SB subjects and 8 controls who received sensory stimulations during sleep. Baseline and experimental nights were compared for sleep variables, CAP, and EEG spectral analyses using repeated measure ANOVAs. Overall, no differences in sleep variables and EEG spectra were found between SB subjects and controls. However, SB subjects had higher sleep instability (more phase A3) than controls (P= 0·05). The frequency of phase A3 was higher in the pre-REM sleep periods (P < 0·001), where peaks in RMMA/SB activity were also observed (P = 0·05). When sleep instability was experimentally increased by sensory stimuli, both groups showed an enhancement in EEG theta and alpha power (P = 0·04 and 0·02, respectively) and significant increases in sleep arousal and all CAP variables. No change in RMMA/SB index was found within either groups (RMMA/SB occurred in all SB subjects and only one control during the experimental night). These findings suggest that CAP phase A3 may act as a permissive window rather than a generator of RMMA/SB activity in predisposed individuals.
TL;DR: The balloon probe method enables objective manometric evaluation of oral functions and could be an effective tool for clinical epidemiological studies and evidence-based decision-making in nursing care.
Abstract: Summary Tongue pressure measured with a disposable hand-held balloon probe has been used for assessing tongue function; however, no diagnostic standard for assessing other oral functions exists currently. In this study, to develop a method for multifactorial manometric evaluation of oral functions, 20 men and 20 women (21–32 years of age) were instructed to apply 7-s maximal voluntary muscular effort on a hand-held balloon probe placed against the anterior and lateral parts of the palate, buccal surface of the molars on the habitual chewing side and labial surface of the anterior teeth for measuring anterior and posterior tongue, cheek and lip pressures (LPs), respectively. Intra-session reproducibility was determined by three repeated measurements, and associations between the obtained and the conventional data on oral diadochokinesis were tested. The men exhibited higher values of all the pressure types. Further, both genders showed a positive correlation between anterior and posterior tongue pressures (PTPs) (P < 0·05), but only the women exhibited positive correlations between anterior tongue and cheek pressures, cheek and PTPs, anterior tongue and LPs, and cheek and LPs (P < 0·05). No statistically significant correlation was found between the pressures and the number of syllabic articulations, except between LP and the number of /pa/ articulations in the women (r = 0·524, P < 0·05). In conclusion, the balloon probe method enables objective manometric evaluation of oral functions and could be an effective tool for clinical epidemiological studies and evidence-based decision-making in nursing care.
TL;DR: A putative OHIP-TMDs outcome measure has been generated which requires further testing especially in relation to its responsiveness to change.
Abstract: The aim of this study was to generate a putative patient-based outcome measure specifically for Temporomandibular Disorders (TMDs) using a mixed-method approach. A combined quantitative-qualitative methodology was used to identify the most relevant items in the Oral Health Impact Profile (OHIP-49) for TMDs. The quantitative study involved 110 patients with TMDs diagnosed using the Research Diagnostic Criteria for TMDs (RDC/TMD) and 110 age- and sex-matched controls. All subjects completed the OHIP-49. The qualitative study involved semi-structured interviews with a separate sample of patients with TMDs (n = 29). The two resultant data sets were analysed blinded and separately. Each data set used predetermined rules to select candidate items for the putative OHIP for TMDs. The two sets of selected items were then compared using a priori rules to make a final item selection for OHIP TMDs. Eighteen pre-existing items were selected through the quantitative process and fourteen by the qualitative process. On comparison of the two selections all but two of the items selected by the qualitative process had also been selected by the quantitative process. Two new candidate items emerged from the qualitative data that were not covered by OHIP-49. A 22 item putative OHIP-TMDs outcome measure emerged from the final selection process. A putative OHIP-TMDs outcome measure has been generated which requires further testing especially in relation to its responsiveness to change.
TL;DR: LDF can reliably discriminate the vitality of the teeth with a sensitivity and specificity of 1·0 for this sample and was found to be a more reliable and effective method than PO and EPT of assessing the pulpal status of human teeth.
Abstract: This study was designed to evaluate and compare the reliability of laser Doppler flowmetry (LDF), pulse oximetry (PO) and electric pulp tester (EPT) for assessing the pulpal status as a vitality test method by calculating their sensitivity, specificity and predictive values. Data were collected from 59 pairs of maxillary anterior teeth (38 pairs of central, 21 pairs of lateral incisors) in 51 patients (range 12-18years, mean age 14·6±1·73years, 28 women, 23 men). The teeth with complete endodontic fillings constituted the study group, and the healthy, contralateral teeth of the same patients were constituted the control group. The calculated sensitivity was 0·915 for the EPT and 0·813 for the PO. And the specificity of EPT was 0·881 and PO was 0·949. The difference between the LDF values obtained from the study, and control group was statistically significant (P=0·0001). The findings of this study indicated that LDF can reliably discriminate the vitality of the teeth with a sensitivity and specificity of 1·0 for this sample. Laser Doppler flowmetry was found to be a more reliable and effective method than PO and EPT of assessing the pulpal status of human teeth.
TL;DR: Among the four materials tested, G4 demonstrated the best clinical performance and provided the fastest treatment to reduce DH pain, and Distilled water proved to be an adequate vehicle to disperse Biosilicate®.
Abstract: The aim of this comparative clinical study was to evaluate a novel bioactive glass-ceramic (Biosilicate® 1-20 μm particles) to treat dentine hypersensitivity (DH) Volunteers (n = 120 patients/ 230 teeth) received the following treatments: G1-Sensodyne® , G2-SensiKill®, G3-Biosilicate® incorporated in a 1% water-free-gel and G4-Biosilicate® mixed with distilled water at 1:10 ratio G1 and G3 were applied at home, daily for 30 days; G2 and G4 were applied once a week by a dentist (four applications) A visual analogue scale (VAS) was employed to evaluate pain for each quadrant in one sensitive tooth at baseline, weekly during treatment and during a 6-month follow-up period Dentine hypersensitivity values (G1/n= 52), (G2/n =62), (G3/n = 59) and (G4/n = 59) were analysed with Kruskal-Wallis/Dunn tests All the products were efficient in reducing DH after 4 weeks Among the four materials tested, G4 demonstrated the best clinical performance and provided the fastest treatment to reduce DH pain Distilled water proved to be an adequate vehicle to disperse Biosilicate® Low DH scores were maintained during the 6-month follow-up period The hypothesis that the novel bioactive glass-ceramic may be an efficient treatment for DH was confirmed
TL;DR: It is suggested that dietary acid, gingival recession and erosion were significantly associated with DH, while desensitising toothpastes was the key management strategy used for DH in this patient population.
Abstract: Although dentine hypersensitivity (DH) has been widely investigated, studies based on randomly selected general practice populations are scarce. This study aimed to examine the intra-oral distribution of DH and its association with age, sex, symptoms, stimuli, pre-disposing factors and management strategies in a private practice patient population in Australia. A randomly selected sample of 800 Australian private dental practice dentists was invited to participate in a questionnaire-based survey. A log diary about the total number of patients seen during a typical week in practice and the details of patients with DH were recorded. The details included teeth and sites involved with DH and the age and sex of people affected, symptoms, stimuli, pre-disposing factors and management strategies. The prevalence of DH was 9·1% among patients seen over the typical week with 2·3 teeth/person and 1·2 surfaces/tooth affected. Women (60·7%) were more affected than men (39·3%) whilst 30- to 49 -year-olds (48·8%) were the most common among those affected. Premolars (36·5%) and buccal surfaces (54·8%), respectively, were the most commonly affected teeth and tooth sites. Although cold stimulation (80·1%) was the commonest stimulus, dietary acid was the only stimulus that was significantly associated with DH. Gingival recession and erosion emerged as significant pre-disposing factors, whereas using desensitising toothpastes was the most important management strategy. The findings suggested that dietary acid, gingival recession and erosion were significantly associated with DH, while desensitising toothpastes was the key management strategy used for DH in this patient population.
TL;DR: Signs of TMD are a risk factor for the development of tinnitus, according to a cross-sectional analysis of data from the Study of Health in Pomerania, where temporomandibular disorders were the strongest predictors for tinnitis beside headache.
Abstract: Summary In a cross-sectional analysis of data from the Study of Health in Pomerania (SHIP 0), temporomandibular disorders (TMD) were the strongest predictors for tinnitus beside headache. The aim of this study was to investigate whether signs and symptoms of TMD can be identified as risk factors for developing tinnitus. The SHIP 1 is a population-based 5-year longitudinal study intended to systematically describe the prevalence of and risk factors for diseases common in the population of Pomerania in northern Germany. A total of 3300 subjects (76% response) were reevaluated after 5 years for tinnitus and signs and symptoms of TMD using the same questionnaires and examination tools as baseline. To estimate the relative risk (RR) appropriately, a modified Poisson regression was used. After exclusion of prevalent cases with diagnosed tinnitus, 3134 subjects were analysed. Among the 191 exposed subjects with palpation pain in the temporomandibular joint (TMJ), 24 subjects (12·6%) received diagnosed tinnitus after 5 years, whereas among the 2643 unexposed subjects 142 subjects (5·8%) received tinnitus yielding a risk difference of 7·7% (95% confidence interval [CI]: 3·0%–12·5%) and a risk ratio of 2·60 (95% CI: 1·7–3·9). The risk ratio was 2·4 (95% CI: 1·6–3·7) after adjustment for gender, age, school education and frequent headache. Pain on palpation of the TMJ, however, did not worsen the prognosis for tinnitus in prevalent tinnitus cases (RR = 0·8, P = 0·288). Signs of TMD are a risk factor for the development of tinnitus.
TL;DR: A need for studies that meet methodological standards for diagnostic efficacy of CBCT in the diagnosis of impacted teeth is revealed, with only limited evidence for diagnose efficacy expressed as sensitivity, specificity and predictive values.
Abstract: This review evaluates the evidence for the diagnostic efficacy of cone beam computed tomography (CBCT) for impacted teeth and associated features. PubMed, Embase and the Cochrane Library were searched using specific indexing terms and reference lists were hand searched. Two reviewers selected relevant publications on the basis of pre-determined inclusion criteria. Original studies were assessed using a modification of the quality assessment of diagnostic accuracy studies (QUADAS) tool. The literature search yielded 96 titles, of which 7 were included in the review. There was only limited evidence for diagnostic efficacy expressed as sensitivity, specificity and predictive values. Only two studies compared CBCT and panoramic radiographs with a valid reference method and presented the results in terms of percentage of correct diagnoses. This review reveals a need for studies that meet methodological standards for diagnostic efficacy of CBCT in the diagnosis of impacted teeth.
TL;DR: The study showed that the masticatory muscles are remarkably prone to motor adaptation if demanding CT must be accomplished, and a robust significant long-term training effect was detected.
Abstract: Neuromuscular adaptations during skill acquisition have been extensively investigated for skeletal muscles. Motor rehabilitation is the main target for application of motor training. Such measures are also relevant for the musculature of the jaw, but few data are available for motor adaptation of the masticatory system. The objective of this study was to evaluate and compare long-term training effects of different motor tasks on masseter and temporal muscles. In 20 healthy subjects, the electromyographic response to unilateral and bilateral maximum voluntary tooth clenching, balancing the mandible on a hydrostatic system under force-feedback-controlled conditions, and unilateral chewing was investigated in an initial session and then in two follow-up sessions separated by 2 and 10 weeks from baseline. Motor tasks were repeated three times for chewing, nine times for maximum biting (MB) and 24 times for the coordination tasks (CT). The sequences of the various motor tasks were applied once in the first session and twice in the second and third sessions. No effects of training were observed for MB tasks except for MB in intercuspation, for which significant yet transient avoidance behaviour occurred in the second session. No significant effects were found for chewing tests. For the CT, however, a robust significant long-term training effect was detected which reduced the electric muscle activity in session 2 by approximately 20% and in session 3 by approximately 40% compared with the initial measurements. The study showed that the masticatory muscles are remarkably prone to motor adaptation if demanding CT must be accomplished.
TL;DR: It was concluded that simulated mastication resulted in minor changes for the ball attachment tested, Nevertheless, it reduced the retention of Locator attachments to 40% of the baseline values, what suggests that mastication is a major factor associated with maintenance needs for this system.
Abstract: Summary This study assessed the effect of simulated mastication on the retention of two stud attachment systems for 2-implants overdentures. Sixteen specimens, each simulating an edentulous ridge with implants and an overdenture were divided into two groups, according to the attachment system: Group I (Nobel Biocare ball-socket attachments) and Group II (Locator attachments). Retention forces were measured before and after 400 000 simulated masticatory loads in a customised device. Data were compared by two-way anova followed by Bonferroni test (α = 0·05). Group I presented significantly lower retention forces (Newtons) than Group II at baseline (10·6 ± 3·6 and 66·4 ± 16·0, respectively). However, differences were not significant after 400 000 loads (7·9 ± 4·3 and 21·6 ± 17·0). The number of cycles did not influence the measurements in Group I, whereas a non-linear descending curve was found for Group II. It was concluded that simulated mastication resulted in minor changes for the ball attachment tested. Nevertheless, it reduced the retention of Locator attachments to 40% of the baseline values, what suggests that mastication is a major factor associated with maintenance needs for this system.
TL;DR: The prevalence of TMD symptoms in the Italian population was consistent with data reported from similar studies, and gender and age differences were found for jaw pain and limitation in jaw movements.
Abstract: Summary The aim of this study was to estimate the prevalence of temporomandibular disorders (TMD) symptoms in an Italian population sample, focusing on gender and age differences. We selected 2005 individuals by telephone survey and asked them about TMD symptoms like difficulty in jaw movement, jaw pain and joint sounds. Also, tooth-clenching and/or tooth-grinding habits were investigated. Of the study population, 8·1% reported limitations in jaw movements, 5·1% reported jaw pain and 33·3% reported joint sounds. Furthermore, 37·3% reported tooth-clenching/tooth-grinding. Confidence intervals of proportions were calculated. Significant gender differences were found for jaw limitation and pain (chi-square test; P < 0·05). Symptoms reduced with increasing age. The prevalence of TMD symptoms in the Italian population was consistent with data reported from similar studies. Gender and age differences were found for jaw pain and limitation in jaw movements.
TL;DR: Results indicate that, in edentulous community-dwelling elderly, oral health rehabilitation might play an important role in the maintenance of consumption of adequate amounts of fruit and vegetables, which is an important component of a healthy diet and also in the prevention of chronic diseases.
Abstract: There is evidence suggesting that edentulous older persons modify their diet, avoiding foods that are difficult to chew, such as fruit and vegetables; meanwhile, the consumption of these foods is associated with prevention of chronic diseases. However, few studies evaluated whether a poor oral status without prosthetic rehabilitation is associated with a reduction in the consumption of fruit and vegetables in community-dwelling older persons. We evaluated the association of oral status with emphasis on complete dentures use with the daily consumption of at least 400 g of fruit and vegetables, following the recommendations of the WHO. A random sample of 282 south Brazilians ≥60 years of age was evaluated. Measurements included a questionnaire to assess sociodemographic, behaviour, and health data; consume of fruit and vegetables by means of a 24-h diet recall, and oral status assessment, by means of oral examinations assessing the number of teeth and use of dental prosthesis. Multivariate Poisson regression showed that the only variable significantly associated with inadequate consumption of fruit and vegetables was edentulism with the use of only one denture [PR=1·75 (1·11-2·74)]. Edentulous participants wearing only one denture were less likely to consume at least 400 g day(-1) of fruit and vegetables. These results indicate that, in edentulous community-dwelling elderly, oral health rehabilitation might play an important role in the maintenance of consumption of adequate amounts of fruit and vegetables, which is an important component of a healthy diet and also in the prevention of chronic diseases.
TL;DR: The objective of this study was to evaluate the changes in the airway dimensions of class II retrognathic children who received treatment with either Klammt or Bionator on a pre-pubertal stage and found a statistically significant increase in theAirway dimensions was found at the space where the adenoid tissue was located.
Abstract: Class II skeletal malocclusion and respiratory disorders owing to the obstruction of the upper airway at early growth stages have been correlated. The retro/micrognathism can be treated with functional appliances. However, the effects of an early functional orthopedic treatment on the airway dimensions have not been evaluated before the growth peak. Therefore, the objective of this study was to evaluate the changes in the airway dimensions of class II retrognathic children who received treatment with either Klammt or Bionator on a pre-pubertal stage. The sample consisted of 50 lateral cephalograms of class II retrognathic patients in a pre-puberal stage, before and after the use of a Klammt or Bionator II treatment for 1 year. The data were evaluated by Student's t-test or Mann-Whitney test, and significance was set at 5% (P < 0·05). When the measurements before and after treatment were compared, a statistically significant increase in the airway dimensions was found at the space where the adenoid tissue was located. The only airway dimensions that increased after treatment with functional appliances were the ones located at the nasopharynx. The adenoid tissue is still in the peak of growing at the ages of the subjects included in this study. However, the measurements along the nasopharynx increased when compared with the initial ones. Still, similar retrospective and prospective studies are needed at older stages.
TL;DR: Mastication in humans: finding a rationale A. WODA*, M. HENNEQUIN* & M. PEYRON.
Abstract: Mastication in humans: finding a rationale A. WODA*, M. HENNEQUIN* & M. A. PEYRON § *Clermont Universite, Universite d’Auvergne, Deficiences incapacites et desavantages en sante orale, Clermont-Ferrand, CHU, Clermont-Ferrand, Service d’Odontologie, Clermont-Ferrand, INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand and Clermont Universite, Universite d’Auvergne, Unite de Nutrition Humaine, Clermont-Ferrand, France
TL;DR: It can be concluded that dentist's and patients' assessment of dentures were not correlated, and no correlation was observed between these variables and masticatory function.
Abstract: The aim of this study was to evaluate the correlation between patients' and dentist's assessment of dentures and to correlate these variables with objective measures of masticatory function. A sample of 28 edentulous individuals was selected, all wearing both complete dentures for at least 6 months and with no signs or symptoms of temporomandibular joint disorders. They rated their level of satisfaction with their dentures from 0 to 100 by means of a visual analogue scale, and dentures were scored by a dentist from 0 to 9 considering functional aspects. Tooth wear was evaluated on the posterior teeth of dentures considering the lack of occlusal anatomy. Masticatory performance and swallowing threshold tests were performed with an artificial test food (Optocal), and the median particle size was determined by the sieving method. The results showed that the mean satisfaction value of volunteers with their dentures was 49·1 and the median score of dentist's evaluation was 6. The Spearman correlation coefficient revealed no significant correlation between patients' and dentist's assessment of dentures (P>0·05). The median particle size for masticatory performance and swallowing thresholds was 5·5 ± 1·0 and 4·9 ± 1·2 mm, respectively. Data of both masticatory tests showed no significant correlation with patients' satisfaction or with dentist's evaluation of dentures. There was no difference of food comminution between subjects with and without excessive posterior tooth wear. It can be concluded that dentist's and patients' assessment of dentures were not correlated, and no correlation was observed between these variables and masticatory function.
TL;DR: Occlusal indicators can change SEMG activity during occlusion which may affect the validity of the measurements they provide, and the very plastic T-Scan(®) sensor and very thick articulating paper may not provide valid tooth contact information for dental treatment.
Abstract: Occlusal indicators are widely used in dental treatment to measure tooth contacts that occur during occlusion. However, the presence of an indicator may affect the mechanics of occlusion and lead to invalid tooth contact data. The objective of this study was to determine the effect of four indicators (Parkell, silk, T-Scan(®) sensor and paper) on surface electromyography (SEMG) activity during occlusion. Twenty-three subjects performed strong bites and maximum clenches onto the four indicators and natural dentition. Surface electromyography recordings of anterior temporalis and superficial masseter activity and the subjects' perception of each indicator were measured. SEMG activity with the T-Scan(®) sensor and paper was significantly different (higher masseter activity; P < 0·05) compared to that for natural dentition. The Parkell and silk gave no significant differences to natural dentition. Similarly, subjects perceived that T-Scan(®) sensor and paper had the greatest effect on occlusion and were the least comfortable (P < 0·05). Thus, the very plastic T-Scan(®) sensor and very thick articulating paper both affected SEMG activity during occlusion and, therefore, may not provide valid tooth contact information for dental treatment. In conclusion, occlusal indicators can change SEMG activity during occlusion which may affect the validity of the measurements they provide.