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PubMed2004

Efficacy of full-mouth disinfection vs quadrant root planing.

This article addresses the capability of full-mouth disinfection, full-mouth root planing, and partial-mouth disinfection to improve periodontal health. A basic premise of full-mouth therapy (full-mouth disinfection or full-mouth root planing) is to eradicate or diminish bacterial reservoirs in the mouth that could impede optimal healing or initiate periodontal disease or disease progression. Several investigations conducted at one university indicated that full-mouth disinfection and full-mouth root planing achieved greater therapeutic improvements compared with partial-mouth disinfection regarding decreased probing depths, gained clinical attachment, diminished bleeding from probing, and reduced subgingival microflora. In contrast, other studies from 2 treatment centers demonstrated that there were no statistically significant differences when the effectiveness of quadrant-by-quadrant root planing was compared with full-mouth root planing and full-mouth disinfection regarding probing depth reduction, gains of clinical attachment, and impact on the magnitude and quality of the immune response. Theoretically, full-mouth therapy could decrease the number of patent visits and allow more efficient use of treatment time. Furthermore, no major adverse reactions to full-mouth root planing with or without adjunctive chemotherapy are evident. Nevertheless, small study populations and noncorroborating data from different treatment centers indicate that more clinical trials are required to determine whether full-mouth therapy provides clinically relevant improvements compared with partial-mouth disinfection.

Anti-Infective Agents, Local↗
PubMed2003

Facial approximation: an evaluation of mouth-width determination.

Facial approximation techniques rely on the prediction of soft tissues from the skull, yet few prediction methods have been scientifically evaluated, despite being frequently used in the past. This study tests several published and commonly used methods for determining mouth width from the skull. The methods tested are: 1) that mouth width is equal to the distance between the pupils; 2) that mouth width is equal to the distance between the medial borders of the iris; and 3) that mouth width is equal to the distance between the most lateral junctions of the canines and the first premolars. The study primarily examines living Australian European and Central/South East Asian participants (of both sexes) using photogrammetric methods. The results of this study indicate that methods 1 and 3 are highly inaccurate. Method 1 overestimated mouth width, on average, by approximately 11 mm (SD, 4 mm), while method 3 underestimated mouth width by approximately 13 mm (SD, 3 mm). Method 2 was the most accurate of the methods evaluated, but on average underrepresented mouth width by approximately 2 mm (SD, 4 mm). All three methods produced mouth-width predictions that, in general, were statistically different from actual mouth widths (P < 0.05). A new guideline, describing mouth width as canine width plus 57% of the cumulative distance between the lateral canine borders and the pupil centers on each side was found not to differ at statistically significant levels from actual mouth widths (P > 0.05). On average, this guideline did not under/overestimate actual mouth width, with the difference between them being 0 mm (SD, 3 mm). The increased accuracy of this new guideline in comparison to others suggests that it is the most appropriate for facial approximation. However, it should be further tested using independent samples. The finding that commonly used mouth-width prediction guidelines are not accurate suggests that many facial approximations previously made have incorrect mouth widths. This could reduce the recognition of these facial approximations and may, especially if other guidelines are inaccurate, render the facial approximations unrecognizable as their respective target individual (individual to whom the skull belongs).

Adult↗
PubMed2000

A survey of mouth pain and dryness in patients with advanced cancer.

An 11-item face-to-face survey was conducted in 99 consecutive patients with advanced cancer to determine the prevalence, intensity, reporting and treatment, presumed cause(s), and importance of mouth pain and dryness. Sixteen of the 99 patients (16%) reported experiencing mouth pain at a mean intensity corresponding to 5.5 +/- SD 2.21 on a 0 (no pain) to 10 (worst possible pain) numerical scale, and 88 (88%) patients reported dry mouth at a mean intensity corresponding to 6.2 +/- SD 2.21. Nine (56%) of the 16 patients with mouth pain and 39 (44%) of the 88 patients with mouth dryness reported these symptoms to their attending physician(s). Sixty-nine percent (27/39) of patients who reported having a dry mouth were advised by their physician(s) to pursue one or more treatments. The most common treatments recommended (and frequencies) were drinking water/taking sips of fluid (13), gargling with bicarbonate mouthwash (4), using an artificial saliva spray (4), and using an oral fungal suspension for thrush (4). The most common findings on oral examination included: possible thrush (53 patients), upper and lower dentures (33 patients), and multiple dental restorations (23 patients). The causes most frequently assumed to be responsible were ill-fitting dentures for mouth pain, and medications and possible oral fungal infections for mouth dryness. The mean values given for the importance of the symptoms of mouth pain and dryness relative to other symptoms or problems experienced by the patients were 4.4 +/- SD 1.84 and 3.6 +/- SD 1.67, respectively, on a Likert scale ranging from 1 (not important) to 7 (great importance). Mouth dryness was more frequently reported than mouth pain. The mean rating for the intensity of mouth pain was higher than that for mouth dryness, although both were of moderate importance to patients relative to other symptoms or problems experienced at the time. Patients tended to underreport mouth pain and dryness, and physicians tended to address such complaints inadequately.

Adult↗
PubMed2002

The applicability of half-mouth examination to periodontal disease assessment in untreated adult populations.

BACKGROUND: Data from whole-mouth examinations are the gold standard for accurate assessment of periodontal disease. Since periodontal destruction exhibits left-right symmetry, however, it is hypothesized that a half-mouth exam provides an appropriate alternative to whole-mouth assessment, with considerable advantage over a more limited partial-mouth assessment of index teeth. METHODS: Data from 2 untreated populations were utilized in the analyses. Half-mouth (random diagonal quadrants) and Ramfjord teeth assessment was compared with whole-mouth assessment as follows. Intraclass correlation coefficients (ICCs) were calculated for mean plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) and for percentage of sites with PD > or = 4, 5, or 6 mm; CAL > or = 3, 4, 5, or 6 mm; and recession > or = 3 mm to determine the agreement between the whole- and partial-mouth assessment. Disease prevalence was also determined for both whole- and partial-mouth assessments. RESULTS: For mean PI, GI, PD, and CAL, both half-mouth and Ramfjord teeth assessment provided an acceptable alternative to whole-mouth assessment (ICCs > 0.92). For percentage of sites above a specified threshold, ICCs were generally greater than 0.90 in all age cohorts for half-mouth assessment, but consistently lower for Ramfjord teeth assessment. Ramfjord teeth assessment also considerably underestimated disease prevalence compared with half-mouth assessment. CONCLUSIONS: These results support the use of a half-mouth examination procedure, to conserve time, limit cost, and reduce patient and examiner fatigue while providing maximal clinical information. Ramfjord teeth assessment was not as suitable for evaluation of either disease extent or prevalence.

Adolescent↗
PubMed1994

Lip component of burning mouth syndrome.

To our knowledge there has been no previous study of factors specifically involved in the pathogenesis of patients who complain of burning sensation of the lips when the lips appear clinically normal. The complaint is akin to patients who complain of a burning sensation of the mouth when it appears clinically normal, a condition known as burning mouth syndrome. This study therefore studied precipitating factors in patients with burning mouth syndrome who reported lip involvement. Previous studies have shown that the lips are the third most common site reported as involved in patients who have burning mouth syndrome. Indeed patients with burning mouth syndrome often report multiple oral site involvement. To investigate the precipitating factors involved in the lip component of burning mouth syndrome, we studied 104 patients who reported the lips as a site affected by the condition from a total population of 312 patients with burning mouth syndrome. Hematologic, biochemical, and microbiologic parameters were studied in these patients. Sialometry, patch testing, psychological testing, and examination of denture status as well as questioning of parafunctional habits were also undertaken. No clear differences were noted in relationship to the frequency of abnormalities in burning mouth syndrome alone or burning mouth syndrome with lip involvement suggesting that similar precipitating factors apply. The precipitating factors in patients with lip involvement were found to be the same as burning mouth syndrome in general. Treatment of patients with lip involvement alone in burning mouth syndrome or lip involvement in burning mouth syndrome in conjunction with other intraoral sites gave an equally good response.(ABSTRACT TRUNCATED AT 250 WORDS)

Bruxism↗
PubMed2002

Frequency of mouthing behavior in young children.

Young children may be more likely than adults to be exposed to pesticides following a residential application as a result of hand- and object-to-mouth contacts in contaminated areas. However, relatively few studies have specifically evaluated mouthing behavior in children less than 5 years of age. Previously unpublished data collected by the Fred Hutchinson Cancer Research Center (FHCRC) were analyzed to assess the mouthing behavior of 72 children (37 males/35 females). Total mouthing behavior data included the daily frequency of both mouth and tongue contacts with hands, other body parts, surfaces, natural objects, and toys. Eating events were excluded. Children ranged in age from 11 to 60 months. Observations for more than 1 day were available for 78% of the children. The total data set was disaggregated by gender into five age groups (10-20, 20-30, 30-40, 40-50, 50-60 months). Statistical analyses of the data were then undertaken to determine if significant differences existed among the age/gender subgroups in the sample. A mixed effects linear model was used to test the associations among age, gender, and mouthing frequencies. Subjects were treated as random and independent, and intrasubject variability was accounted for with an autocorrelation function. Results indicated that there was no association between mouthing frequency and gender. However, a clear relationship was observed between mouthing frequency and age. Using a tree analysis, two distinct groups could be identified: children < or = 24 and children >24 months of age. Children < or = 24 months exhibited the highest frequency of mouthing behavior with 81+/-7 events/h (mean+/-SE) (n=28 subjects, 69 observations). Children >24 months exhibited the lowest frequency of mouthing behavior with 42+/-4 events/h (n=44 subjects, 117 observations). These results suggest that children are less likely to place objects into their mouths as they age. These changes in mouthing behavior as a child ages should be accounted for when assessing aggregate exposure to pesticides in the residential environment.

Age Factors↗
PubMed2004

Mouth breathing compromises adherence to nasal continuous positive airway pressure therapy.

STUDY OBJECTIVES: Mouth leak compromises nasal continuous positive airway pressure (CPAP) therapy. We hypothesized that patients who breathe mainly through their mouths during sleep, compared to those who breathe mainly through their noses, would have more mouth leak during CPAP and therefore lower adherence to CPAP. DESIGN: A case-control study to compare adherence to CPAP at 1 year in mouth breathers (MBs) with nose breathers (NBs). SETTING: University teaching hospital with a sleep laboratory. PATIENTS: Fifty-one CPAP-naive patients (4 women), with a respiratory disturbance index (RDI) > 15/h. Of the 51 patients, 30 patients breathed through their mouths (mouth breathing > 70% of total sleep time [TST]), and 21 patients breathed through their noses (mouth breathing < 30% of TST). MBs between 30% and 70% of TST were excluded. INTERVENTIONS: Overnight polysomnography was performed at baseline, during CPAP titration, and at 3 months. Patients were followed up for 1 year after beginning CPAP. MEASUREMENTS AND RESULTS: To measure mouth breathing, nasal and oral thermistors during polysomnography were separated by a 3 x 6-cm silicon transverse diaphragm. RDI decreased from (mean +/- SD) 37.8 +/- 21.5 to 1.8 +/- 2.6/h at 3 months. Throughout the study, adherence to CPAP (mean daily CPAP use in hours) was better in NBs. Most NBs (71%) but only 30% of MBs used CPAP daily for > 4 h at 1-year follow-up. Mouth breathing decreased significantly from 84 +/- 8.9% at baseline to 22 +/- 14.4% at 3 months. CONCLUSION: Patients with moderate-to-severe sleep-disordered breathing and a high percentage of mouth breathing during sleep were less adherent to CPAP therapy than patients exhibiting a low percentage of mouth breathing.

Case-Control Studies↗
PubMed1999

Shock absorption potential of different mouth guard materials.

STATEMENT OF PROBLEM: Clinical stresses and situations in the mouths of patients are substantially different; thus, it is not possible to make an exact in vivo comparison of the efficiency of various mouth guards. PURPOSE: This study developed a device and a method to test and quantify the potential of mouth guards to absorb shock and evaluated and compared 5 designs for mouth guards. MATERIAL AND METHODS: Strain gauges and accelerometer sensors were mounted in various positions on the maxilla and inside an artificial skull. Sensors quantified the response of several areas of the skull to inputs of force on the maxillary teeth protected by the mouth guard being investigated. Input of force was applied to the maxillary teeth with a modal hammer equipped with a load cell. Five mouth guards of each of 5 designs were manufactured and placed in position before force was applied to the maxillary teeth. All inputs were measured and analyzed and, from those results, a method was developed to quantify the relative potential of the mouth guards to absorb shock. This method was then used to quantify the shock absorption potential of the 5 types of mouth guard designs. RESULTS: All 5 types of mouth guards provided some measure of protection and were better than no protection. However, the level of protection provided by the 5 mouth guard designs differed.

Dental Stress Analysis↗
PubMed2005

Children's mouthing and food-handling behavior in an agricultural community on the US/Mexico border.

Children's mouthing and food-handling activities were measured during a study of nondietary ingestion of pesticides in a south Texas community. Mouthing data on 52 children, ranging in age from 7 to 53 months, were collected using questionnaires and videotaping. Data on children's play and hand-washing habits were also collected. Children were grouped into four age categories: infants (7-12 months), 1-year-olds (13-24 months), 2-year-olds (25-36 months) and preschoolers (37-53 months). The frequency and type of events prompting hand washing did not vary by age category except for hand washing after using the bathroom; this increased with increasing age category. Reported contact with grass and dirt also increased with increasing age category. The median hourly hand-to-mouth frequency for the four age groups ranged from 9.9 to 19.4, with 2-year-olds having the lowest frequency and preschoolers having the highest. The median hourly object to mouth frequency ranged from 5.5 to 18.1 across the four age categories; the frequency decreased as age increased (adjusted R(2)=0.179; P=0.003). The median hourly hand-to-food frequency for the four age groups ranged from 10.0 to 16.1, with the highest frequency being observed in the 1-year-olds. Hand-to-mouth frequency was associated with food contact frequency, particularly for children over 12 months of age (adjusted R(2)=0.291; P=0.002). The frequency and duration of hand-to-mouth, object-to-mouth and food-handling behaviors were all greater indoors than outdoors. Infants were more likely to remain indoors than children in other age groups. The time children spent playing on the floor decreased with increasing age (adjusted R(2)=0.096; P=0.031). Parental assessment was correlated with hand-to-mouth activity but not with object-to-mouth activity. The highest combined (hand and object) mouthing rates were observed among infants, suggesting that this age group has the greatest potential for exposure to environmental toxins.

Agriculture↗
PubMed2006

Relationships of video assessments of touching and mouthing behaviors during outdoor play in urban residential yards to parental perceptions of child behaviors and blood lead levels.

Childrens' touching and mouthing behaviors during outdoor play in urban residential yards were measured using video observations. Descriptions were made of childrens' outdoor residential play environments. Behaviors assessed were used to examine (1) validity of parental responses to questions on childrens' oral behaviors and outdoor play and (2) relationships of mouthing behaviors to blood lead levels (BLLs). Thirty-seven children aged 1-5 years were recruited for 2 h of video recording in their yard and blood lead measurement. Video assessments included hourly rates of hand touches to ground/walking-level surfaces (cement/stone/steel, porch floor/steps, grass, and bare soil) and oral behaviors. Parental questionnaires assessed their child's outdoor activities, behaviors, and home environment. The children were: mean 39 months; 51% male; 89% Hispanic; and 78% Medicaid or uninsured. Twenty-two children had a blood lead measured (mean 6 microg/dl). During taping, all children had access to cement, 92% to grass, 73% to bare soil, and 59% to an open porch. Children had frequent touching and mouthing behaviors observed (median touches/h: touches to surfaces 81; hand-to-mouth area (with and without food) 26; hand-in-mouth 7; and object-in-mouth 17). Blood lead was directly correlated with log-transformed rates of hand-in-mouth (Pearson's correlation, r=0.564, n=22, P=0.006) and object-in-mouth (Pearson's correlation, r=0.482, n=22, P=0.023) behaviors. Parental questionnaire responses did not accurately reflect childrens' observed oral behaviors, play habits, or play environment. These data confirm the direct relationship between hand-to-mouth activities and BLLs and fail to validate parental perceptions of their child's mouthing behaviors or outdoor play environment.

Child Behavior↗
PubMed1991

Effect of a volumatic spacer and mouth rinsing on systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler.

BACKGROUND: High doses of inhaled corticosteroids are absorbed systemically and may cause long term side effects. As rinsing the mouth out after use and inhaling through a spacing device may reduce systemic absorption this has been further investigated. METHODS: Three crossover studies were carried out to assess the effect of budesonide given by dry powder inhaler (Turbuhaler) with and without mouth rinsing and beclomethasone dipropionate given by metered dose inhaler with or without a spacing device (Volumatic) on serum cortisol concentrations and urinary cortisol excretion in patients with asthma taking an inhaled corticosteroid. Each treatment period was two weeks with in a two week washout period. Serum cortisol concentrations at 0800 hours on day 14 and the 24 hour urinary excretion of cortisol were measured. In study 1 24 patients taking beclomethasone dipropionate 500 micrograms twice a day inhaled with (n = 10) or without (n = 14) a Volumatic spacing device were switched to a budesonide dry powder inhaler, 600 micrograms to be taken twice a day without mouth rinsing. In study 2 10 patients took budesonide 800 micrograms twice a day with and without mouth rinsing and without swallowing the rinsing water. In study 3 17 patients took budesonide 800 micrograms twice daily with mouth rinsing and beclomethasone dipropionate 500 micrograms twice daily with the spacing device and mouth rinsing. RESULTS: In study 1 no difference was seen between budesonide without mouth rinsing and beclomethasone dipropionate without a spacer: beclomethasone with spacer caused less suppression of cortisol (mean (SD) serum cortisol concentration: beclomethasone and spacer 487(148), budesonide 368(145) nmol/l). In study 2 mouth rinsing caused less suppression of morning serum cortisol concentrations (rinsing 440(63), no rinsing 375(56) nmol/1). In study 3 there was no difference in serum or urinary cortisol concentrations between twice daily beclomethasone dipropionate 500 micrograms inhaled by Volumatic spacer or budesonide by Turbuhaler 800 micrograms twice daily, both with mouth rinsing. Individual serum cortisol values were within the normal range in all patients except one in study 1. CONCLUSION: Systemic absorption of a corticosteroid inhaled from a metered dose inhaler is reduced by using a spacing device and that from a dry powder inhaler by mouth rinsing.

Administration, Inhalation↗
PubMed2004

Mouth-opening increases upper-airway collapsibility without changing resistance during midazolam sedation.

Sedative doses of anesthetic agents affect upper-airway function. Oral-maxillofacial surgery is frequently performed on sedated patients whose mouths must be as open as possible if the procedures are to be accomplished successfully. We examined upper-airway pressure-flow relationships in closed mouths, mouths opened moderately, and mouths opened maximally to test the hypothesis that mouth-opening compromises upper-airway patency during midazolam sedation. From these relationships, upper-airway critical pressure (Pcrit) and upstream resistance (Rua) were derived. Maximal mouth-opening increased Pcrit to -3.6 +/- 2.9 cm H2O compared with -8.7 +/- 2.8 (p = 0.002) for closed mouths and -7.2 +/- 4.1 (p = 0.038) for mouths opened moderately. In contrast, Rua was similar in all three conditions (18.4 +/- 6.6 vs. 17.7 +/- 7.6 vs. 21.5 +/- 11.6 cm H2O/L/sec). Moreover, maximum mouth-opening produced an inspiratory airflow limitation at atmosphere that was eliminated when nasal pressure was adjusted to 4.3 +/- 2.7 cm H2O. We conclude that maximal mouth-opening increases upper-airway collapsibility, which contributes to upper-airway obstruction at atmosphere during midazolam sedation.

Adult↗
PubMed1998

Nestling mouth colour: ecological correlates of a begging signal.

The mouths of begging nestlings vary widely in colour, ranging from yellow in robins, Erithacus rubecula, to red in reed buntings, Emberiza schoeniclus. Two functions have been suggested for bright nestling mouth colour: (1) it may improve the detectability of chicks, particularly in poorly lit nests and (2) within species, it may signal need. We tested these hypotheses in a comparative analysis, measuring the mouth colours of nestlings from 31 species under conditions of standardized light availability and food deprivation. Changes in mouth colour signalled need only among the seed-regurgitating finches. In these species there was a 'red flush' at the onset of begging, which became redder with increasing food deprivation. No other species showed these changes, including the closely related chaffinch, Fringilla coelebs, which feeds its young insects. We found no evidence that mouth colour was correlated with the light available in the nest. We did find, however, that nestlings in darker nests improved their conspicuousness through the relative colour and size of the flange that borders their brightly coloured mouths. Nestlings from darker nests had relatively wider flanges, which were whiter and less densely coloured in relation to their mouth colour, than those of chicks reared in better illuminated nests. Clutch size was not related to mouth or flange colour, or relative flange size. We suggest that nestling mouth colour has not been selected to make chicks detectable, but that this is the function of the surrounding flange. We also discuss reasons why signals of need through mouth colour are not more widespread. Copyright 1998 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed2000

Dry mouth with conventional and controlled-release oxybutynin in urinary incontinence. The Ditropan XL Study Group.

OBJECTIVE: To compare the efficacy and safety of controlled-release oxybutynin with conventional, immediate-release oxybutynin and determine rates of dry mouth. METHODS: Patients (n = 226) who were known to be responsive to anticholinergic therapy and who had seven or more urge incontinence episodes per week were randomized to receive controlled-release oxybutynin or immediate-release oxybutynin. After an initial placebo run-in period, dosing in each began at 5 mg per day and increased weekly by 5 mg per day to a maximum of 20 mg per day or when a balance between improvement of incontinence symptoms and tolerability of side effects was achieved. Rates of urge incontinence and dry mouth were compared. Post hoc Kaplan-Meier survival analysis was used to describe elimination of incontinence episodes by dose and to analyze dry mouth risk by dose. RESULTS: Reductions in urge urinary incontinence episodes from baseline to the end of treatment were 18.6 to 2.9 per week (83% mean decrease) and 19.8 to 4.4 per week (76% mean decrease) in the controlled- and immediate-release oxybutynin groups (P =.36), respectively. At equal doses, comparable proportions of patients in both groups reported the absence of urge incontinence (P =.85). The incidence of dry mouth increased with dose in both groups, but there was no difference in dry mouth rates between the groups: 47.7% and 59.1% for the controlled- and immediate-release oxybutynin (P =.09), respectively. However, Kaplan-Meier analysis to examine first report of dry mouth at a given dose revealed that a significantly lower proportion of patients taking controlled-release oxybutynin had moderate to severe dry mouth (P =.007) or any dry mouth (P =.003) compared with those taking immediate-release oxybutynin. CONCLUSION: At the same daily dose, controlled- and immediate-release oxybutynin demonstrated comparable efficacy in reduction of urge incontinence episodes. The incidence of dry mouth was dose dependent but equal in both groups; first report of moderate to severe dry mouth was significantly lower in the controlled-release group.

Chemistry, Pharmaceutical↗
PubMed1993

Mouth dryness as reported by older Floridians.

Thirty-nine percent of 600 community-dwelling older Floridians (mean age of 78 yr) reported having mouth dryness. Seventy-nine percent of respondents reported at least one medical condition, 57% were taking at least one prescribed or over-the-counter medication, and 33% were taking at least one potentially xerostomic medication. Reported mouth dryness was highly associated with the number of potentially xerostomic medications. After stratification by medication usage, age, diabetes, arthritis, perceived medical health, and dependence in physical functioning were significantly associated with mouth dryness. Persons with dry mouth were also more likely to have reported dental symptoms, signs of dental disease, sensory changes, and other oral symptoms. Ten percent of those who reported mouth dryness also said that their mouths felt dry when eating a meal, 10% said that they had difficulties swallowing foods, and 15% of persons with dry mouth also said that the amount of saliva in their mouths was too little. Sixty-five percent of persons with dry mouth reported doing one or more dryness-related behaviors. These results suggest that the prevalence of xerostomia was high, and the impact of dry mouth on individuals' daily behaviors was significant.

Aged↗
PubMed2002

Partial- or full-mouth approaches to assessing the prevalence of and risk factors for periodontal disease in young adults.

BACKGROUND: While partial-mouth recording is often used in epidemiological studies of periodontal disease because of the efficiencies afforded in data collection, there has been no investigation of the extent to which information is lost in studies of young adults using the combined attachment loss (CAL) approach. METHODS: A random sample of 25- and 26-year-olds was periodontally examined at 3 sites per tooth in all 4 quadrants. The analysis obtained full-mouth prevalence estimates for gingival recession (GR), probing depth (PD), and CAL. The half-mouth analyses took 3 forms: 1) estimates from each of the left and right sides were obtained and compared; 2) estimates were obtained separately and compared for quadrants 1 and 3 (upper right and lower left), and quadrants 2 and 4 (upper left and lower right); and 3) estimates were obtained from a diagonal half-mouth count, whereby quadrants 1 and 3 were analyzed for study participants whose identification number was odd, and quadrants 2 and 4 were analyzed for the remainder. The utility of the half-mouth and full-mouth approaches in analytical epidemiology was examined by estimating the strength of the association between periodontitis prevalence and smoking, male gender, and episodic use of dental care. RESULTS: Of the 169 participants examined, 100 (59.2%) were female, 54 (32.0%) were smokers, and 78 (46.2%) were episodic dental visitors. The difference in prevalence estimates obtained from the different methods was considerably greater for GR than for PD and CAL. The unadjusted odds ratio (OR) for the prevalence of 1 or more teeth with > or = mm of CAL among smokers was 2.3 (95% confidence interval [CI] 1.0, 5.3) using the full data set and 2.4 (95% CI 0.9, 6.1) using the diagonal half-mouth approach. Similarly close odds ratios were observed for males and, to a lesser extent, for episodic dental visitors. CONCLUSIONS: Wherever possible, full-mouth data should be collected for descriptive epidemiological studies of periodontal disease, but where resource and time constraints mean that half-mouth examinations must be used, analytical studies of periodontitis should not be unduly affected by the loss of information. However, where the primary focus of the latter is upon gingival recession, the full-mouth design should be used in order to capture all relevant information, and attention should be directed to making economies in other areas of the data collection process.

Adult↗
PubMed2005

[Kinematic analysis of limitation of mouth opening of temporomandibular disorders by rotation and translation of the condyle].

PURPOSE: The purpose of this study was to determine whether rotation and translation of the condyle were useful parameters for identifying causes of limitation of mouth opening in patients with temporomandibular disorders (TMD). METHODS: In 7 healthy volunteers and 55 patients with TMD, rotation and translation of the condyle were measured using a 6 degree-of-freedom jaw movement tracking device. Patients were divided into two groups: those who could open their mouth 40 mm or greater, and those who could not open their mouth 40 mm. In each group, the relationship of rotation and translation of the condyle to maximum mouth opening, condition of the articular disc, and pain was determined. RESULTS: Both correlations between maximum mouth opening and rotation and translation of the condyle were strong, especially the former correlation. There was no marked difference in the distribution of range of mouth opening, and rotation and translation of the condyle with respect to condition of the artticular disc. Muscle pain was associated with reduced mouth opening. Even in patients without limited mouth opening, their range of mouth opening was actually reduced when they had muscle pain. Among the patients with limited mouth opening, joint pain correlated to limited translation of the condyle. However, in patients with Wo-Wo condition of articular disc, their translation of the condyle was not limited even with joint pain, but it was limited with muscle pain. CONCLUSIONS: Rotation of the condyle indicated strong correlation with muscle pain, and so is a useful parameter for estimating treatment methods by a surgical approach. On the other hand, translation of the condyle showed variations in correspondence with combinations of several factors such as opening limitation, condition of the articular disc, and pain.

Biomechanical Phenomena↗
PubMed2006

Development of the primary mouth in Xenopus laevis.

The initial opening between the gut and the outside of the deuterostome embryo breaks through at the extreme anterior. This region is unique in that ectoderm and endoderm are directly juxtaposed, without intervening mesoderm. This opening has been called the stomodeum, buccopharyngeal membrane or oral cavity at various stages of its formation, however, in order to clarify its function, we have termed this the "primary mouth". In vertebrates, the neural crest grows around the primary mouth to form the face and a "secondary mouth" forms. The primary mouth then becomes the pharyngeal opening. In order to establish a molecular understanding of primary mouth formation, we have begun to examine this process during Xenopus laevis development. An early step during this process occurs at tailbud and involves dissolution of the basement membrane between the ectoderm and endoderm. This is followed by ectodermal invagination to create the stomodeum. A subsequent step involves localized cell death in the ectoderm, which may lead to ectodermal thinning. Subsequently, ectoderm and endoderm apparently intercalate to generate one to two cell layers. The final step is perforation, where (after hatching) the primary mouth opens. Fate mapping has defined the ectodermal and endodermal regions that will form the primary mouth. Extirpations and transplants of these and adjacent regions indicate that, at tailbud, the oral ectoderm is not specifically required for primary mouth formation. In contrast, underlying endoderm and surrounding regions are crucial, presumably sources of necessary signals. This study indicates the complexity of primary mouth formation, and lays the groundwork for future molecular analyses of this important structure.

Animals↗