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PubMed1994

Temporomandibular joint osteoarthritis: a comparative clinical and tomographic study pre- and post-treatment.

Nineteen patients with definite and suspected temporomandibular joint (TMJ) osteoarthritis participated in this study. All patients were treated by dental care including bite plane therapy. By comparing the pre-treatment clinical symptoms and TMJ tomograms with those post-treatment, efficacy of the dental treatment applied for these patients has been assessed. Since TMJ pain and limitation of mouth opening were considerably improved in almost all patients post-treatment, this suggests that the clinical prognosis of TMJ osteoarthritis can be favourable. On the other hand, radiographic changes post-treatment were variable. The longitudinal changes found in the TMJ tomograms were classified into four types. The frequency of Type 2 and Type 3, which indicate the occurrence of TMJ remodelling during the observation period, was fairy high (20 TMJs and 14 patients).

Adult↗
PubMed1995

Asymmetry of masticatory muscle activity during intercuspal maximal clenching in healthy subjects and subjects with stomatognathic dysfunction syndrome.

The present study investigated the asymmetry of masticatory muscle activity during maximal intercuspal clenching in healthy subjects and subjects with stomatognathic dysfunction syndrome. Stomatognathic dysfunction syndrome, unilateral mastication and the asymmetry of masticatory muscle activity appear to be related to each other. The asymmetry of masseter muscle activity was greater as stomatognathic dysfunction became increasingly severe. Because fatigue and pain are produced more quickly by unilateral clenching than bilateral clenching, clenching under conditions of left and right muscular imbalance can further aggravate stomatognathic dysfunction. It is suggested the asymmetry of masseter muscle activity during maximal clenching correlates with the onset of the stomatognathic dysfunction syndrome. Stomatognathic dysfunction syndrome is closely related to the asymmetry of masseter muscle activity and only slightly related to the asymmetry of temporal muscle activity. The asymmetry of anterior temporal muscle activity appears to have little clinical significance.

Adolescent↗
PubMed2004

The effect of an interocclusal appliance on bite force and masseter electromyography in asymptomatic subjects and patients with temporomandibular pain and dysfunction.

The aims of this study were to assess the effect of clenching with or without the presence of an interocclusal appliance (IOA) on bite force (BF) and masseter electromyography (EMG) in patients with temporomandibular pain dysfunction disorders (TMPD) and to compare these results with an asymptomatic age- and gender-matched control group. Ten patients with TMPD (mean age 26.9 years) were compared with eight healthy controls (mean age 25.3 years). Bilateral masseter EMG activity was recorded at rest, while clenching on the BF meter, while clenching on an IOA and while clenching on an IOA together with the BF meter. Significant left to right EMG activity asymmetry was found in the patient group at rest and during multiple clenching tasks in the control group. The patient group had significantly greater EMG activity at rest than controls. For all other tasks, the control group EMG activity was greater than the patient group. Use of an IOA significantly decreased EMG activity in both patient and control groups. BF was significantly greater in the control group on the right side for the different clenching tasks. Insertion of the IOA significantly increased BF in the control group. The results of this study indicate differences in EMG activity and BF during different clenching tasks and between patients with TMPD and asymptomatic subjects.

Adult↗
PubMed2007

Pivot appliances - is there a distractive effect on the temporomandibular joint?

The purpose of this study was to investigate the distractive effect of posterior occlusal pivots on the temporomandibular joint. The study comprised 23 healthy subjects. None of them had a third molar and none of them had a missing tooth or showed tooth mobility. All subjects clenched (i) on 1 mm tin foil positioned between the teeth 17/47 and 27/37; (ii) on a stiff bite registration material of 1 mm thickness that prevented protrusion because of its bold occlusal relief. During clenching on the tin foil and on the protrusion preventing bite registration material, respectively, the vertical and horizontal condylar position was measured using a 6 d.f. ultrasonic motion analyser. Clenching with maximal force on the tin foil lead to a noticeable anterior downward directed movement of the condyle. Clenching on the protrusion preventing pivot, however, caused a statistically significant upward condylar movement of about 0.3 mm. These results indicate that occlusal pivots have no distractive effect on the temporomandibular joint but can lead to unwanted joint compression, if they are designed in a way that is preventing protrusion.

Adult↗
PubMed2006

Dental implants in patients with bruxing habits.

Bruxism (teeth grinding and clenching) is generally considered a contraindication for dental implants, although the evidence for this is usually based on clinical experience only. So far, studies to the possible cause-and-effect relationship between bruxism and implant failure do not yield consistent and specific outcomes. This is partly because of the large variation in the literature in terms of both the technical aspects and the biological aspects of the study material. Although there is still no proof for the suggestion that bruxism causes an overload of dental implants and of their suprastructures, a careful approach is recommended. There are a few practical guidelines as to minimize the chance of implant failure. Besides the recommendation to reduce or eliminate bruxism itself, these guidelines concern the number and dimensions of the implants, the design of the occlusion and articulation patterns, and the protection of the final result with a hard occlusal stabilization splint (night guard).

Biomechanical Phenomena↗
PubMed1992

Fabrication of an obstructive sleep apnea prosthesis.

Obstructive sleep apnea, a sleep disorder, is becoming more prevalent and requires prompt and effective treatment by the dental and medical specialties. Conservative treatment modalities (ie, intraoral devices that prevent or minimize airway obstruction by the tongue) are recommended for treating mild to moderate forms of OSA. This article describes a simplified technique for fabricating an intraoral OSA prosthesis.

Humans↗
PubMed1993

A one-appointment mouthstick appliance.

Quadriplegics rely on mouthstick appliances to perform a variety of tasks to establish more self-sufficiency. Present techniques to fabricate a quality mouthstick applicance requires professional expertise, time, and laboratory expense. A technique for providing an inexpensive, durable mouthstick appliance in one appointment is described.

Equipment Design↗
PubMed1998

An alternative technique for mandibular advancement prosthesis fabrication.

One of the conservative and successful modalities of treatment for obstructive sleep apnea is the mandibular advancement prosthesis. This prosthesis engages teeth on both dental arches for retention and stability. This article describes a technique that allows the fabrication of such a prosthesis in one piece and in a single laboratory step. This may be beneficial in reducing the laboratory time required for fabrication of such a prosthesis.

Dental Prosthesis Design↗
PubMed2000

Dental erosion and aspirin headache powders: a clinical report.

The causes of tooth erosion are varied, but all are associated with a chemical attack on the teeth and resulting loss of tooth structure. Etiologic factors related to erosion cited in the literature include bulimia, eating acidic foods, soft drink consumption, acid reflux, and swimming, among others. This clinical report suggests that chronic use of headache powders can also be a factor leading to tooth erosion.

Administration, Sublingual↗
PubMed2004

Mechanical failure of an implant-retained bar: a clinical report.

This clinical report describes the mechanical failure of an implant-retained bar where the bar fractured midway between two implants. The location of the fracture is not typical for implant-retained bars. Possible causes of the fracture are discussed. The prosthodontic treatment provided to manage the mechanical failure and prevent it from recurring is also discussed.

Dental Implants↗
PubMedDate not supplied

Fixed rehabilitation of an ACP PDI Class IV dentate patient.

This clinical report describes the prosthodontic rehabilitation of a Class IV dentate patient. Maxillary and mandibular fixed restorations were constructed for the therapy. Canine-protected occlusion was developed in the definitive restorations to decrease lateral forces on the posterior dentition. Protrusive guidance was developed to distribute protrusive forces to the maxillary and mandibular incisors.

Adult↗
PubMed1980

Impact of a periodontal course on oral hygiene and gingival health among senior dental students.

This survey attempted to determine the impact of the periodontal course on oral hygiene and gingival health among 50 senior dental students. The course included the following: patient motivation, instruction in oral hygiene procedures and plaque control, scaling and curettage, temporary splinting and occlusal adjustment. Without advance notice, plaque deposits were scored using the Plaque Index and gingival health was determined using the Gingival Index. The results were collected at the beginning and at the end of the periodontal course (about 2 months). The results were analyzed using the paired t-test. No improvement of either oral hygiene or gingival health was noted at the end of the periodontal course. It seems that even some dental students, who should know the direct relationship between bacterial plaque and periodontal diseases and should be better motivated than the average patient, failed to demonstrate effective oral hygiene. It is difficult to expert an improvement of patient oral hygiene, when the patients have been motivated by students who are unable to perform satisfactory personal oral hygiene themselves. It is suggested that a greater emphasis be placed on patient motivation and instruction in oral hygiene throughout the dental curriculum.

Adult↗
PubMed1998

Buccinator window anomaly.

Four patients, three women and one man, with a mean age of 32 years, presented with a history of recurrent parotid swelling. In the women the swelling was unilateral. All had previously undergone sialography using a hand injection technique and no structural abnormality was demonstrated. Sialography was repeated using a continuous-infusion pressure-monitored system. In all cases an initial very high filling pressure (>200 mmHg) was recorded followed by a rapid reduction in pressure and a more normal filling pressure pattern. The duct system and glands all appeared morphologically normal. Treatment with acrylic appliance therapy and an intraductal catheter was attempted with some success.

Adult↗
PubMed1995

Synovectomy and diskectomy of the temporomandibular joint in patients with chronic arthritic disease compared with diskectomies in patients with internal derangement. A 3-year follow-up study.

Twenty-five temporomandibular joints (TMJs) in 15 patients with chronic arthritic disease were treated with synovectomy and diskectomy. Twenty patients with internal derangement of 27 TMJs treated with diskectomy served as a control group. A response in pain relief was seen in 73% of the patients with chronic arthritic disease and in 80% of the patients with internal derangement 3 yr postoperatively. In both groups of patients a significant increase in mouth opening capacity and lateral movement of the mandible was seen postoperatively, with no significant difference in the improvement between the two groups. Four patients with chronic arthritic disease were reoperated within the 3-yr observation period. This study indicates that synovectomy and diskectomy of the TMJ may reduce pain and improve mandibular function in patients with severe chronic arthritic TMJ disease.

Adolescent↗
PubMed1997

Impact of nocturnal bruxism on mercury uptake from dental amalgams.

The mercury (Hg) release from dental amalgam fillings increases by mechanical stimulation. The aim of this study was to investigate the possible impact of nocturnal bruxism on Hg exposure from dental amalgams and to evaluate the effect of an occlusal appliance. 88 female patients from an orofacial pain clinic with a complete maxillary and mandibular dentition, a normal frontal vertical overbite with cuspid guidance, and at least 4 occlusal amalgam fillings in contact with antagonists in intercuspidal position, were examined with the Bruxcore bruxism monitoring device to measure the level of on-going nocturnal bruxism. Based on the degree of abrasion recorded, the subjects were divided into a group defined as bruxists, (n = 29), another group defined as non-bruxists, (n = 32), serving as controls, the intermediate group being discarded. The Hg exposure was assessed from the Hg concentration in plasma and urine, corrected for the creatinine content. In a regression model with bruxism as the only explanatory variable, no significant effect of bruxism was found, but when the number of amalgam fillings, chewing gum use, and other background variables were taken into account, there was a limited impact of bruxism on Hg in plasma. The nocturnal use of an occlusal appliance did not, however, significantly change the Hg levels. This study indicates that mechanical wear on amalgams from nocturnal bruxism may increase the Hg uptake, but the magnitude of this effect seems to be less than from the use of chewing gum.

Absorption↗
PubMed2002

Diagnosis and management of maxillary incisors affected by incisal wear: an interdisciplinary case report.

UNLABELLED: In the attempt to restore anterior teeth affected by erosion and bruxism, many clinicians have been frustrated with the constant restorative failures. Frequently, these failures are attributed to the restorative materials employed, especially in cases in which composite resins are used. However, some flaws of the restorations are related to the oversight of occlusal principles. The purpose of this article is to discuss the etiology, signs, and symptoms of incisal wear, with special attention to that caused by bruxism and chemical erosion. Relatively simple management techniques (e.g., occlusal adjustment, adhesive restorations) are proposed, and the diagnosis and management of a representative clinical case is presented. CLINICAL SIGNIFICANCE: In some cases of bruxism and/or dental erosion, it is possible to acquire space to recuperate the esthetics and function of maxillary incisors affected by incisal wear through a conservative treatment associated with the control of the etiologic factors.

Adult↗