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Extensive caries in early man circa 110,000 years before present.

The example of Rhodesian man, who was approximately 35 years at time of death, had severe caries but physiologically adaptive attrition and periodontal status. Hypoplasia was not evident. Extensive caries seems to have occurred in the absence of modern bacterial strains and refined carbohydrates. It is suggested that the dentition was highly susceptible to caries because of a deficiency in elemental composition. Of the teeth examined, only the central incisors were free of caries and apparently resistant to disease. It is postulated that, as dental disease progressed, the Rhodesian man's diet changed and his techniques and abilities in processing food developed.

Adult↗

Oral hygiene.

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Dentifrices↗

Excessive wear of natural tooth structure by opposing composite restorations.

Extreme care must be taken to evaluate the probable effect of using certain restorative materials to oppose existing tooth structure, particularly when dentin is exposed. In addition, frequent recall examination, every one or two months, is necessary to catch any problems in their beginning stages and to solve them before greater damage can be caused. It is also suggested that evaluation of any occlusal habits be made before deciding on a plan to alter vertical dimension and to carefully consider the effects of the materials used in a restoration on the opposing arch.

Aged↗

A critical evaluation of orthopedic interocclusal appliance therapy: effectiveness for specific symptoms.

This paper reviews the effectiveness of occlusal splints on specific symptoms that are often associated with TM disorders. The research has shown the clicking TMJ is sometimes helped but not cured by the traditional stabilization interocclusal appliance and that TMJ clicking is the least responsive to treatment. Questions have been raised about the need to specifically treat the clicking joint; more research on this issue is necessary. Painful TMJs have been shown to respond to occlusal appliance therapy, but questions still exist about the effectiveness of interocclusal appliances for this symptom. There is little scientific proof available about the ability of splints to effectively slow down or reverse degenerative TMJ changes that are evident on radiographs. Masticatory muscle pain is by far the symptom that has the best experimental evidence to support occlusal splints as a highly effective method of treatment. These changes are probably mediated via an alteration in the patient's muscle activity patterns. Those patients with more severe symptoms are less likely to be helped with splints as a sole treatment modality. The effect of occlusal appliances in muscle trismus has been discussed but not effectively evaluated in the literature. Occlusal splints have been shown to have a distinct influence on improving mandibular muscle coordination. Inter-occlusal splints are a commonly used method of controlling attrition and adverse tooth loading, and few questions have been raised in the literature about this therapeutic application.

Bruxism↗

The optimum placement-site of the electrode in electric pulp testing of the 12 anterior teeth.

The present study of 2,387 recordings of 12 anterior teeth in 53 patients indicates that the incisal edge is the optimal placement-site for the electric pulp tester to determine the lowest response threshold. The results show significant individual variations in the lowest threshold responses of the cervical-third, middle-third, incisal one-third, and incisal edge sites on a tooth, with a confidence level of 99%, according to the analysis of variance. The maxillary teeth gave a higher response threshold than the mandibular teeth and different types of teeth (canines and incisors) had statistically significant different response thresholds. The application of the electric pulp tester to the incisal-edge region with exposed dentin produced the most significant decrease in the threshold response.

Adolescent↗

The validity of tooth grinding measures: etiology of pain dysfunction syndrome revisited.

The current study explores the proposition that a treating clinician's etiologic model influences patients' reports of tooth grinding, the validity of, and subsequent research findings relying on these measures. The investigation compares self-reports of tooth grinding and related clinical variables for 151 cases of temporomandibular pain and dysfunction syndrome (TMPDS) treated by a clinician who does not explicitly support the grinding theory of the etiology of TMPDS, and 139 healthy controls. Cases were no more likely than well controls to report ever-grinding, but were actually significantly less likely than well controls to report current grinding. They were also significantly more likely to report that a dentist had told them they ground. Findings suggest that studies using self-report, clinician-report of tooth grinding (or both) are methodologically inadequate for addressing the relationship between tooth grinding and TMPDS.

Adult↗

Amalgam.

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Ceramics↗

TMD observed.

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Dental Occlusion, Traumatic↗

Smokeless tobacco use: how it affects the performance of major league baseball players.

The authors examined the effect of smokeless tobacco use on the athletic performance of major league baseball players during the 1988 season. They evaluated performance records of 158 players on seven major league teams who played or pitched at least 10 games or innings during the 1988 season. ST use, they concluded, is not related to player performance in major league baseball but does place players at significantly increased risk for mucosal lesions and other oral pathology.

Adult↗

Evaluating the antagonistic wear of restorative materials when placed against human enamel.

Several clinical and laboratory studies have reported data on the nature of tooth wear against restorative materials (that is, amalgam, gold, glass ceramic and various composite resin systems). Several antagonistic substrates are known to cause various in vitro wear rates when placed in opposition to enamel. In this study, the authors evaluated 10 commercially available posterior composite resin systems and a gold alloy control. The findings showed that posterior composite resins containing zirconium silicate or quartz fillers caused greater antagonistic enamel wear than did microfilled or barium silicate-filled composite resins.

Analysis of Variance↗

Capricious nonsense.

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American Dental Association↗

Treating severe bruxism with botulinum toxin.

BACKGROUND: Locally administered botulinum toxin, or BTX, is an effective treatment for various movement disorders. Its usefulness in treating bruxism, however, has not been systematically evaluated. SUBJECTS AND METHODS: The authors studied 18 subjects with severe bruxism and whose mean duration of symptoms was 14.8 +/- 10.0 years (range three-40 years). These subjects audibly ground their teeth and experienced tooth wear and difficulty speaking, swallowing or chewing. Medical or dental procedures had failed to alleviate their symptoms. The authors administered a total of 241 injections of BTX type A, or BTX A, in the subjects' masseter muscles during 123 treatment visits. The mean dose of the BTX A was 61.7 +/- 11.1 mouse units, or MU (range 25-100 MU), per side for the masseter muscles. RESULTS: The mean total duration of response was 19.1 +/- 17.0 weeks (range six-78 weeks), and the mean peak effect on a scale of 0 to 4, in which 4 is equal to total abolishment of grinding, was 3.4 +/- 0.9. Only one subject (5.6 percent) reported having experienced dysphagia with BTX A. CONCLUSION: The results of this study suggest that BTX administered by skilled practitioners is a safe and effective treatment for people with severe bruxism, particularly those with associated movement disorders. It should be considered only for those patients refractory to conventional therapy. Future placebo-controlled studies may be useful in further evaluating the potential of BTX in the treatment of bruxism.

Adolescent↗