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[Occupational differentiation in dentistry 2. From Brueghel's syndrome to a radiant smile. An advanced postgraduate programme in oral kinesiology].

Oral movement disorders, jaw pain, and tooth wear are examples of clinical problems that are part of the dental discipline 'oral kinesiology'. About half of the advanced postgraduate programme in oral kinesiology involves the diagnosis, indication, and management of patients with one or more oral kinesiologic problems. The remaining time is available for thematic courses and a research project. The breadth of the programme will hopefully lead to improved care for patients whose treatment until now has been dispersed between various dental specialists. Successful candidates will obtain an advanced postgraduate diploma in Oral Kinesiology, and can also apply to be recognized as a gnathologist.

Bruxism↗

Craniofacial identification by computer-mediated superimposition.

Mass disasters are associated with a large number of fatalities, with victims being visually unidentifiable in most cases. Dental identification, although being an important and valuable identification method, is subject to the availability and quality of antemortem and postmortem dental records. This paper presents a simple-to-use method of human identification using an antemortem photograph showing anterior teeth with superimposition onto a postmortem image using specific features of Adobe Photoshop. We present cases and discuss the benefits and difficulties of this method.

Anodontia↗

Relationship between personality and satisfaction with the dentition in tooth wear patients.

This study was undertaken to identify whether personality traits had any relationship with patients' satisfaction with their dentition in tooth wear cases. One hundred tooth wear patients and one hundred controls were recruited into the study. A Dental Impact on Daily Living questionnaire was used to assess impact of tooth wear on day to day life and satisfaction with the dentition. An ordinal scale was used to assess tooth wear severity in tooth wear patients. The NEO Five Factor inventory was used to assess personal profiles. Tooth wear patients were less satisfied with their dentition, had higher Neuroticism, lower Extraversion, and higher Openness than the controls.

Activities of Daily Living↗

Modern restorative management of advanced tooth-surface loss.

This article describes the restorative management of a case of advanced, localised tooth-surface loss using modern materials and techniques. Particular emphasis is placed on the conservation of tooth structure while providing restorations with optimum physical and aesthetic characteristics.

Adult↗

Tooth wear in three ethnic groups in Sabah (northern Borneo).

The prevalence and associated aetiologies of tooth wear were investigated in three ethnic groups in Sabah (Northern Borneo) using the Tooth Wear Index (TWI). The number of surfaces with enamel wear only, dentine exposed for less than a third or dentine exposed for more than a third were categorised into the TW minimal, moderate or severe respectively. A structured questionnaire was used to elicit medical/dental history, oral hygiene practices, satisfaction with body image, diet and other personal habits/details. The sample comprised of a self selected sample of 148 dental hospital attenders; 47 (32 per cent) each of ethnic Chinese and Malay and 54 (36 per cent) of ethnic Kadazan, matched for age and with a similar number of scoreable teeth per subject. Dentine exposure within the total sample was a common finding (95 per cent TW with moderate, 41 per cent TW severe). The Kadazan group had significantly (P < 0.05) more surfaces with severe tooth wear than the Chinese or Malay. Tobacco chewing was positively associated (rho = +0.4, P < 0.05) with both moderate and severe tooth wear, as was the habit of crushing/eating bones. Neither carbonated beverages or fresh fruit intake were associated with tooth wear, but their frequency of consumption was low. The buccal and occlusal surfaces of the posterior teeth were the most severely worn. Generally, wear was greater in the upper anterior sextant compared to the lower anterior sextant, with the exception of the lower incisal edges in the Kadazan group. Tooth wear into dentine was a common occurrence, especially among the Kadazan subjects and least among the Chinese subjects. The aetiological factors associated with this tooth wear are different to those encountered in Western cultures.

Adolescent↗

Changes of masticatory movement characteristics after prosthodontic rehabilitation of individuals with extensive tooth wear.

The masticatory cycles of 11 men (mean age 51.5 years) with extensive tooth wear were investigated before and after rehabilitation with fixed partial dentures. Parameters such as the tooth wear index (IA) and masticatory mandibular movement were recorded. Before treatment, the patients were also given a questionnaire related to possible background factors of importance to tooth wear. At baseline a mean score of 48.6 (range 0 to 100) for the tooth wear index (IA) was found. The clinical recall examination 3 years after prosthodontic rehabilitation displayed obvious wear of restorative material for two patients, and, in another patient, one of the fixed partial dentures had to be remade because of fracture of abutment teeth. Following rehabilitation, the duration of the masticatory mandibular opening movement increased and mandibular movement velocity decreased. The mandibular closing angle, near to occlusal contact, became steeper after prosthodontic treatment, indicating a changed mandibular movement pattern.

Adult↗

Oral health of Seventh Cavalry troopers: dentitions from the Custer National Cemetery.

To document the oral health of mid-nineteenth century frontiersmen, the dentitions of eight Seventh Cavalry troopers from the Little Bighorn Battlefield were examined for indications of disease. These observations are supplemented with historic records and compared with the oral health of other soldiers from the Indian Wars. The Seventh Cavalry troopers, despite their young ages, had a variety of oral problems, including abscesses, caries, periodontitis, attrition, antemortem tooth loss, and indications of tobacco use. One of the specimens had gold and tin foil fillings. Combining historic records and a dental approach to the archaeological specimens provides complementary insights which are unavailable otherwise from either of the individual fields.

Famous Persons↗

Anterior crowns in re-establishing vertical dimension of occlusion: overcoming fear of heights.

The rejuvenation of this dentition is initiated with the placement of six anterior crowns. Re-establishing the vertical dimension has allowed the restoration of pleasing proportions to the centrals. This has led to the re-assertion of the dominance of the centrals and thus corrected the reverse smile line. The restoration of these teeth demands harmonious accommodation of the requirements of esthetics, phonetics and function. These considerations are inseparable and are in fact, determinants of each other. Esthetics and phonetics help determine the degree of vertical opening and incisal edge placement. This location influences anterior guidance, lingual and labial contours, the pitch of the anterior teeth and proper lip support. The principles of proportion, so important in esthetics, allow us, to calculate incisor length. Thus, function, phonetics and esthetics are intimately intertwined and enhance one another in the restoration of vertical dimension of occlusion.

Bruxism↗