Influences of Different Torques on the Size of the Microgap and Bacterial Leakage in Different Implant Systems: An In-vitro Study.

PURPOSE: To evaluate the adherence of three types of bacteria [Staphylococcus (S) aureus, Escherichia (E) coli, Pseudomonas (Ps) aeruginosa] and the size of the microgap of three different implant systems (JD, ORA, and Ankylos) under four different screw torque values. MATERIALS AND METHODS: Ten samples for each tested implant system were used under different torques to determine the width of the gaps. The abutments were connected to the fixtures using a universal digital wrench. A torque value of 10 N/cm was applied for all samples. After the assessment of the microgap, the fixture was repositioned into the Bench Vice, and the torque was increased to 20, 30, and, finally, 40 N/cm. The microgap assessment was done using a Scanning Electron Microscope. Before the torque increased to 40, eleven samples for each tested implant system were used under 30 N/cm torque to determine the leakage in the tested implants for S. aureus, E. coli, and Ps. aeruginosa. Data were analyzed with multiple one-way ANOVA, Post Hoc, and chi-square tests. RESULTS: The Ankylos system showed the widest gap under all torques (p < 0.005), whereas the JD system demonstrated the lowest (p < 0.005). Regarding the bacteria leakage, JD showed the highest adherence to the bacteria, and the adherence was mainly to the Ps. Aeruginosa, while the Ankylos system showed the lowest (p < 0.005). CONCLUSION: Within limits, the higher torque provides a higher fit to the IAI, offering more stability. Ankylos implant showed the widest gap, while JD showed the narrowest. Regarding the bacteria leakage, JD showed the highest adherence to Ps. Aeruginosa, while the ORA system showed the highest adherence to E. coli.

The Evaluation of Clinical Signs and Symptoms of Malignant Tumors Involving the Maxillary Sinus: Recommendation of an Examination Sieve and Risk Alarm Score.

This observational study was conducted to evaluate the clinical signs and symptoms of maxillary sinus tumors and to propose a clinical examination sieve and a unique risk alarm score to be used for timely patient referral and vigilance. The study consisted of 70 patients between 20 to 82 years of age from both sexes. The clinical information gained was collected from the upper dentoalveolar segment, orbit, and nasal sites. Regarding the early clinical sign and symptoms of patients, nasal obstruction was found in 67 patients (95.7%), facial swelling in 69 patients (98.6%), paresthesia in 41 patients (58.6%), and epistaxis in 50 patients (71.4%). Furthermore, in terms of the late signs and symptoms, a palpable mass in buccal sulcus was observed in 65 (92.9%) of the patients, lymphadenopathy in 24 (34.3%), paresthesia in 38 (54.3%), and diplopia in 22 (31.4%). Furthermore, general sign and symptoms like exophthalmos was present in 35 patients (50%), anosmia was observed in 37 patients (52.9%), and oroantral fistula was noted in 37 patients (55.9%). Additionally, 67 (95.7%) of the patients complained of nasal obstruction. Similarly, facial asymmetry was observed in 69 (98.6%) of the patients and double vision was observed in 24 (34.4%). Tumors of the maxillary sinus have a very insidious course of spread and uncertain clinical signs and symptoms. What makes diagnosis worse is the fact that the symptoms of these tumors are so well hidden in the sponge-like nature of the midfacial region that they are easily misinterpreted by patients. Therefore, diagnoses must be made early, dentists must be vigilant, and patients must be fully investigated at the slightest suspicion of a tumor, albeit benign.

3D CBCT human adult odontometrics: Comparative assessment in Saudi, Jordan and Egypt population.

OBJECTIVES: To inspect the human adult odontometrics by the assistance of 3D cone beam computerized tomography (CBCT) imaging in Saudi, Jordan and Egypt population. MATERIALS AND METHODS: Data of this cross sectional study from 252 subject were analysed by 3D CBCT volumetric data in college of dentistry, Aljouf University, from December 2016 to May 2017. All measurements were done by 3D on demand software. The tooth size from 2nd molar to 2nd molar of maxillary and mandibular arch was measured. Independent t test and ANOVA were used to examine the differences between gender and among Arabic population (Saudi, Jordan and Egypt) on the all tooth size. RESULTS: Comparison between the right and left side odontometrics were significantly dissimilar in 9 out of 14 pairs (p < 0.05). The odontometrics of the 2nd molar to 2nd molar tooth of maxillary and mandibular arch between gender and among Saudi, Jordan and Egypt population were insignificant (p > 0.05). CONCLUSION: 3D CBCT imaging permits us to measure the tooth size effectively and accurately. Based on results, significant asymmetry was revealed in 9 out of 14 pairs in relation to side disparities. No significant differences in tooth size between gender and among races were found. CBCT can elevate the record keeping problem, human adult odontometrics for the analysis can be obtained directly from the digital image.

Randomized controlled clinical investigation on the association between personality profiles and the impacts of two types of maxillary anterior implant-supported crown restorations on daily living and dental satisfaction.

BACKGROUND: Personality factors might influence participants' satisfaction and the effects of dental management on daily living. PURPOSE: This randomized controlled clinical trial aimed to assess the impacts of two types of implant-supported maxillary anterior crown restorations on daily living and participants' satisfaction, and its correlations with personality profiles. MATERIALS AND METHODS: One hundred and seventy participants (84 males and 86 females; mean age = 35 ± 9 years) obtained maxillary anterior implant-supported crowns. They were allocated into two treatment groups (85 participants each: 43 females and 42 males). Group 1 was treated with titanium abutment-supported porcelain fused to metal (PFM) restorations. Group 2 was treated with zirconium abutment-supported ceramic restorations. A control group (85 participants each: 43 females and 42 males) that matched the treatment groups in gender and age was recruited. Precise clinical standards were followed to judge the clinical success of treatment. The NEO Five-Factor Inventory was used to evaluate participants' personality profiles. The dental impact on daily living questionnaire (DIDL) was used to evaluate restoration impacts on daily living and participants' satisfaction. Statistical analysis was carried out with probability of α = .05. RESULTS: Higher DIDL scores were reported after crown treatments (P < .001). Group 2 participants reported highest levels of satisfaction with appearance (P = .007). DIDL scores were significantly associated with neuroticism, extraversion, and openness scores (P < .05) before restoration, and, with neuroticism, extraversion, agreeableness, openness, and conscientiousness scores (P < .05) after restoration. CONCLUSION: Implant-supported crown restorations in anterior maxillary region were associated with positive impacts on daily living and participants' satisfaction. Implant-supported ceramic crowns and abutments were accompanied with higher levels of satisfaction with appearance than implant-supported PFM crowns and titanium abutments. Certain personality and psychological features (neuroticism, extraversion, agreeableness, openness, and conscientiousness) might affect and predict dental satisfaction and impacts on daily living.

Management of denture-related traumatic ulcers using ozone.

STATEMENT OF PROBLEM: Management of denture-related traumatic ulcers using ozone may improve tissue healing and reduce patient pain and discomfort. PURPOSE: The purpose of this clinical investigation was to assess the efficacy of ozone in the treatment of denture-related traumatic ulcers. MATERIAL AND METHODS: Seventy-five participants (study group) with denture-related traumatic ulcers were evaluated in this blinded, controlled cohort observational investigation. A control group (n=75) of participants with denture-related traumatic ulcers who matched the study group in sex and age were also recruited. Ulcers were treated with ozone gas for 60 seconds in the study group and with air for 60 seconds in the control group. Pain levels were evaluated by means of a visual analog scale (VAS), and ulcer sizes were measured in each participant at experiment baseline and each day for 15 days. Ulcer duration was established by calculating the period it took to completely heal and disappear. Major outcome measurements were ulcer duration, ulcer size, and levels of pain. RESULTS: Ulcer size decreased from day 2 in the study group (after ozone application) (P≤.01) and from day 4 in the controls (P≤.001). Recorded pain levels decreased from the first day soon after ozone application in the study group (P≤.001) and from day 3 in the controls (P<.001). Ulcer duration, ulcer size from day 3 to day 10, and reported pain levels from day 1 to day 10 decreased more in the study group (P≤.004). CONCLUSIONS: Exposure of denture-related traumatic ulcers to 60 seconds of ozone gas was associated with better ulcer healing and decreased pain levels, ulcer size, and ulcer duration.

3D CBCT morphometric assessment of mental foramen in Arabic population and global comparison: imperative for invasive and non-invasive procedures in mandible.

BACKGROUND: Recent advancements in clinical dentistry have increased the possibilities of surgical procedures in the mental region. A detailed knowledge of mental foramen (MF) morphometry is significant to preserve integrity of the mental nerve trunk in surgical interventions such as orthognathic surgery, implant placement and anaesthetic block. OBJECTIVE: The aim of this study was to determine the most accurate position of the mental foramen by using new assessment approach in a sample of dental patients presenting to the specialist dental clinic, College of Dentistry, Al Jouf University, Saudi Arabia. STUDY DESIGN: A retrospective study was performed using cone beam computed tomography (CBCT) of 600 patients (40.1 ± 11.78 years old). Following inclusion and exclusion criteria, 395 CBCT were finally obtained and analyzed for the most accurate position of the mental foramen (MF) by OnDemand 3D software (Seoul, Korea). Prevalence of shape of MF and accessory MF were also assessed. Pearson chi-square test was employed to test significant differences between genders and races. RESULTS: The most common horizontal and vertical position of the mental foramen was in line with the long axis of 2nd premolar (41.3%) and below the root apex level (93.2%), respectively. The most common shape of MF was round type (72.66%). The prevalence of accessory 2MF and 3MF was 2.28% and 0.25%, respectively. CONCLUSION: New information about MF presented in this article can help anatomists, prosthodontists, orthodontists, surgeons, forensic odontologists and paleoanthropologists to predict the position of the MF and perform safer surgeries.

Dental prosthetic status and prosthetic needs of geriatric patients attending the College of Dentistry, Al Jouf University, Kingdom of Saudi Arabia.

OBJECTIVE: To evaluate the dental prosthetic status and prosthetic needs of geriatric patients attending the College of Dentistry, Al Jouf University, Kingdom of Saudi Arabia. MATERIALS AND METHODS: Patients aged 60 years and above were included in this study. The World Health Organization oral health assessment pro forma was employed to record the data pertaining to the prosthetic status and prosthetic treatment needs of participants. Data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS, Chicago, IL, USA) Version 20.0. Differences in proportions were compared using the Chi-square test. RESULTS: Out of 286 edentulous patients, 69.06% needed some form of prosthetic treatment, 73.77% did not have any prosthesis in upper arch, and 80.06% did not have any prosthesis in lower arch. Out of 162 males, 32.09% and 26.54% had prosthesis in upper and lower arch, respectively. Among 124 females, 18.54% and 19.35% had prosthesis in upper and lower arch, respectively. In males, the need for any type of prosthesis in upper and lower arch was 68.51% and 75.92%, respectively. In females, the need for prosthesis in upper and lower arch was 57.25% and 72.58%, respectively. The need for multiunit prosthesis was more in both arches in both genders. The need for complete denture and combination of single- or multiunit prosthesis was more among the males as compared to females in maxilla and vice versa for mandible. CONCLUSION: The observations of this study propose that the greater part of the prosthetic needs were insufficient among the geriatric people.

Oral health related quality-of-life outcomes of partially edentulous patients treated with implant-supported single crowns or fixed partial dentures.

BACKGROUND: Oral health-related quality of life (OHRQoL) is afflicted by different variables. Limited information is available regarding the impact of different phases of implant therapy on OHRQoL of edentulous patients. This study was carried out to assess the OHRQoL of patients treated with implant-supported single crowns or fixed partial dentures. MATERIAL AND METHODS: A total of 79 healthy partially edentulous subjects needing implant therapy were incorporated in this study. Before placement of the implants, the subjects were instructed to fill the original version of OHIP questionnaire. Subsequently patients received titanium oral implants of the ITI® Dental Implant System. After 1st, 2nd and 3rd year of implant placement, patients filled the same OHIP-49 questionnaire. In this manner the impact of implant therapy on OHRQoL by putting in comparison pre- and post-treatment OHIP-49 scores was assessed. Statistical analyses were performed using Statistical Package for the Social Science software (SPSS, version 22, Chicago, IL, USA). Paired t test and Unpaired t test were performed and a statistical significance was set at 5% level of significance (p<0.05). RESULTS: Functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability were significantly decreased from baseline to 1st year (p<0.05) except handicap (p>0.05). All variables were also significantly decreased from baseline to 2nd year and 3rd year (p<0.05). There were no significant differences dependent on gender with respect to OHIP (p>0.05). Patients aged less than 60 years and more than 60 years of age groups differed significantly with respect to OHIP scores measured at 1st year, 2nd year and at 3rd year of implant placement (p<0.05). CONCLUSIONS: Decrease in pre- and post-treatment OHIP scores OHIP demonstrated the significant increase in the OHRQoL after the therapy, which suggested increased levels of patient satisfaction. Key words:Edentulism, dental implants, Oral health-related quality-of-life.

Dental and Oral Problem Patterns and Treatment Seeking Behavior of Geriatric Population.

BACKGROUND: The manifestations of oral changes and disorders affecting the geriatric population are different from the rest of the population. Inaccessibility to dental care is a compelling impediment to avail oral health services. OBJECTIVE: The aims were to assess the dental and oral problems and to find out the determinants of oral health seeking behaviour among elderly population of Al-Jouf province, Saudi Arabia. METHODS: The present cross sectional study included geriatric patients of 60 years and above, who visited the College of Dentistry, Al-Jouf University. A simple pre-structured questionnaire was filled by the patients, which comprised of demographic details and the different oral complaints of elderly and the type of health care utilized for those complaints. RESULTS: Out of total 892 elderly persons included, 51.79% were males and 48.21 were females. The most common oral problem was missing tooth (78.69%) followed by gum problems (74.21%). 39.5% males and 28.0% females visited general dental practitioners for oral health care. Majority of the participants (32.8%) suggested accessibility as a basic factor in determining the health care source. The difference in the distribution of male and females or association between the type of care and gender and distribution for choosing a health care source was found to be statistically significant (p < 0.05). CONCLUSION: Inaccessibility to dental care emerged as an important barrier to avail oral health services. Adequate access to medical and dental care can reduce premature morbidity and mortality, preserve function, and enhance overall quality of life.

Prevalence and pattern of the elongated styloid process among geriatric patients in Saudi Arabia.

OBJECTIVE: The objectives of this study were to assess the elongation of the styloid process on digital panoramic radiographs and to evaluate the prevalence of the elongation according to age, sex and types. PATIENTS AND METHODS: Digital panoramic radiographs of 198 geriatric edentulous patients were analyzed. The radiographic length of the styloid process was measured on both sides using the measurement toolbars on the accompanying analysis software. For statistical analysis, Student's t-test, chi-square test and analysis of variance test were used. RESULTS: The elongated styloid process was seen in 87 of the 198 patients. It was observed that as age increased, elongation of the styloid process increased with a male predominance. Type I elongation was more common than other types of elongation. Bilateral elongation was most commonly found than unilateral elongation, and both types of elongation were frequently seen in males compared with females. CONCLUSION: The prevalence of the elongated styloid process in the present study was higher in comparison to the other reports from edentulous patients.

Effects of combining ozone and hydrogren peroxide on tooth bleaching: A clinical study.

OBJECTIVES: The purpose of this study was to evaluate the efficiency of bleaching after combining ozone and 38% H2O2 in comparison to the sole use of 38% H2O2. METHODS: Consecutive 26 participants (13 males and 13 females) were recruited into this study. They were randomly allocated into 2 groups (n=13 for each group). In group 1 (test group); the participants' upper anterior teeth were treated with 38% H2O2 for 20min then the teeth were exposed to ozone for 60s (healOzone(®) X4, KaVo Dental, Biberach, Germany). In group 2 (controls); the upper anterior teeth were treated with 20min of 38% H2O2 only. The shade of teeth was evaluated by recording the L* a* b* values and Vita Classic shades at study baseline and after bleaching in both groups. The statistically significant changes were set at P≤0.05. RESULTS: Tooth sensitivity and teeth shades were comparable between groups at study baseline (p>0.05). Controls reported more tooth sensitivity following bleaching (p<0.001). Teeth achieved better Vita shades, higher L* values (lighter shades), and lower a* and b* values (lighter shades) after bleaching in both groups (P≤0.05). However, teeth bleached with H2O2 and ozone achieved better Vita shades, higher L* values and lower a* values (lighter shades) than those bleached with H2O2 alone (p<0.001). Changes in b* values were not significantly different between groups. CONCLUSIONS: Bleaching with 38% H2O2 for 20min followed by 60s of ozone application would result in teeth with lighter shades than bleaching with 38% H2O2 alone.

Ozone treatment of recurrent aphthous stomatitis: a double blinded study.

This study aimed to evaluate the use of ozone to treat recurrent aphthous stomatitis (RAS). Consecutive sixty-nine participants with RAS were recruited into this non-randomized double blind, controlled cohort observational study (test group). A control group of 69 RAS patients who matched test group with age and gender was recruited. RAS lesions in test group were exposed to ozone in air for 60 seconds while controls received only air. Ulcer size and pain were recorded for each participant at baseline and daily for 15 days. Ulcer duration was determined by recording the time taken for ulcers to disappear. The main outcome measures were pain due to the ulcer, ulcer size and ulcer duration. 138 RAS participants (69 participants and 69 controls) were analyzed. Ulcer size was reduced starting from the second day in test group and from the fourth day in controls (p ≤ 0.004). Pain levels were reduced starting from the first day in the test group and from the third day in controls (p ≤ 0.001). Ulcer duration, ulcer size after day 2 and pain levels were more reduced in the test group. In conclusion, application of ozone on RAS lesions for 60 seconds reduced pain levels and enhanced ulcers' healing by reducing ulcers' size and duration.

Assessment and Evaluation of Quality of Life (OHRQoL) of Patients with Dental Implants Using the Oral Health Impact Profile (OHIP-14) - A Clinical Study.

INTRODUCTION: Peri-implant tissue health is a requisite for success of dental implant therapy. Plaque accumulation leads to initiation of gingivitis around natural teeth and peri-implantitis around dental implants. Peri-implantitis around dental implants may result in implant placement failure. For obtaining long-term success, timely assessment of dental implant site is mandatory. AIM: To assess and evaluate Quality of Life (OHRQoL) of individuals with dental implants using the Oral Health Impact Profile (OHIP-14). MATERIALS AND METHODS: Total 92 patients were evaluated for assessment of the health of peri-implant tissues by recording, Plaque Index (PI), Probing Pocket Depth (PD), Bleeding On Probing (BOP) and Probing Attachment Level (PAL) as compared to contra-lateral natural teeth (control). In the same patients Quality of Life Assessment was done by utilizing Oral Health Impact Profile Index (OHIP-14). RESULTS: The mean plaque index around natural teeth was more compared to implants and it was statistically significant. Other three dimensions mean bleeding on probing; mean probing attachment level and mean pocket depth around both natural teeth and implant surfaces was found to be not statistically significant. OHIP-14 revealed that patients with dental implants were satisfied with their Oral Health-Related Quality of Life (OHRQoL). CONCLUSION: Similar inflammatory conditions are present around both natural teeth and implant prostheses as suggested by results of mean plaque index, mean bleeding on probing, mean pocket depth and mean probing attachment level, hence reinforcing the periodontal health maintenance both prior to and after incorporation of dental implants. Influence of implant prostheses on patient's oral health related quality of life (as depicted by OHIP-14) and patients' perceptions and expectations may guide the clinician in providing the best implant services.

Prevalence and pattern of torus palatinus and torus mandibularis among edentulous patients of Saudi Arabia.

BACKGROUND: The most remarkable exostoses of the human jaws are torus palatinus (TP) and torus mandibularis (TM). The aim of the present study was to actuate the prevalence of TP and TM in relation to age and sex among the edentulous patients of Saudi Arabia. METHODS: The present study included 847 edentulous subjects (458 men and 389 women) aged between 51 and 79 years. The subjects were examined for the existence of tori by clinical inspection and palpation. Statistical analysis was performed using SPSS for Windows version. RESULTS: Among the 847 subjects, 149 (17.59%) had either TP or TM. Sixty six (7.79%) subjects had TP, whereas 83 (9.80%) had TM. The maximum percentage (36.36%) of tori was observed in the age-group of 60-69 years. The percentage of males with either tori was higher (19.0%) when compared to females (15.94%). According to shape, the occurrence of flat-shaped TP (57.58%) and bilateral solitary TM (39.76%) was more common. CONCLUSION: No significant difference in the presence of tori with respect to sex and age was observed. A comparatively increased prevalence of TP and TM was however observed, and this should be taken into consideration while planning for prosthodontic and periodontal therapy in these patients.

Improved tooth bleaching combining ozone and hydrogen peroxide--A blinded study.

OBJECTIVES: To evaluate the efficacy of tooth bleaching using ozone after hydrogen peroxide (H2O2) in comparison to the use of H2O2 alone. METHODS: 70 extracted teeth were randomly distributed into two groups. Teeth surfaces in group 1 (n=35) were treated using 38% H2O2 and then were exposed to ozone for 60s and this ozonated peroxide mixture was left on the teeth for 20 min. Meanwhile, teeth in group 2 (n=35) were treated with H2O2 38% for 20 min. The L* a* b* and Vita Classic shade values of teeth were evaluated in both groups at base line, after application of H2O2 and ozone in group 1, and after application of H2O2 and then again after another application of ozone in group 2. The statistically significant changes were set at P ≤ 0.05. RESULTS: Baseline L* a* b* and Vita shade values were comparable between groups (P>0.05). Teeth obtained lighter shades following bleaching with both H2O2 and ozone or with H2O2 alone (P ≤ 0.05). Further bleaching with ozone for teeth already bleached with H2O2 alone showed further improvement of the shades of teeth (P<0.001). Teeth treated with H2O2 and ozone had more shade improvements than those only treated with H2O2 (P<0.001). Also, L* values were increased while b* values were decreased (teeth obtained lighter shades) following bleaching in both groups (P ≤ 0.05). More changes were obtained when both ozone and H2O2 were used (P ≤ 0.05). CONCLUSIONS: Bleaching with 38% H2O2 and ozone resulted in teeth with lighter shades than bleaching with 38% H2O2 alone.

Comparison of dental bleaching effects of ozone and hydrogen peroxide: An ex vivo study.

PURPOSE: To compare the efficacy of using ozone versus hydrogen peroxide (H2O2) for tooth bleaching. METHODS: 90 extracted teeth were allocated into two groups. Teeth in Group 1 (n= 45) were exposed to ozone for 60 seconds; ozone was produced by healOzone x4 machine (healOzone x4), and was applied to teeth through special disposable silicone cups. The silicone cups allowed total seal and avoided gas escape as the machine is devised to work only if the cup guarantees perfect seal and thus secure the safety of the machine for human use. Teeth in Group 2 (n= 45) were treated with 38% H2O2 for 20 minutes. The shade of teeth was recorded for both groups at base line, after application of ozone in Group 1, and after application of H2O2 in Group 2. The reading for L* a* b* values and Vita Classic shades were recorded using the Colorimeter Konica-Minolta CR-400. The statistically significant differences were set at P≤ 0.05. RESULTS: The teeth in both groups acquired lighter shades after bleaching (P< 0.001). In addition, baseline L* shade values were increased and b* shade values were decreased (means lighter shades) after bleaching in both groups (P< 0.01). However, baseline a* shade values were not significantly changed after bleaching with ozone in Group 1 (P= 0.682). In contrast, a* shade values were significantly decreased after bleaching with H2O2 in Group 2 (P= 0.005). Furthermore, final shades achieved after bleaching were not significantly different between groups (P> 0.05). In conclusion, application of ozone for 60 seconds or application of 38% of H2O2 for 20 minutes resulted in teeth with lighter shades. Bleaching by application of ozone for 60 seconds would result in similar outcomes to bleaching with 38% H2O2. CLINICAL SIGNIFICANCE: This is the first study to compare bleaching effects of ozone and hydrogen peroxide on natural human teeth. It might be suitable to consider ozone for dental bleaching since comparing to H2O2 it could potentially reduce the time, side effects and cost of treatment. Also, application of ozone is better controlled and more convenient and measurable as it is delivered by a machine that can manage the concentration, volume, delivery site and timing of delivered ozone.

Temporomandibular Disorders (TMD) in Edentulous Patients: A Review and Proposed Classification (Dr. Bader's Classification).

Temporomandibular disorders (TMD) are a collective term given to a number of clinical problems that involve the masticatory musculature, the temporomandibular joints and associated structures, or both. Although the aetiology of TMD has not been fully understood, in general it is considered to be multifactorial. The signs and symptoms of TMD which present in patients with natural teeth may also occur in edentulous patients. These symptoms may appear in various combinations and degrees. TMD has attained a prominent role within the context of dental care due to its high prevalence. The present paper is a review of the current literature on TMD in edentulous patients; with an attempt to propose a classification for the same.

Quantification of incisal tooth wear in upper anterior teeth: conventional vs new method using toolmakers microscope and a three-dimensional measuring technique.

OBJECTIVES: This study aimed to quantify tooth wear in upper anterior teeth using a new CAD-CAM Laser scanning machine, tool maker microscope and conventional tooth wear index. METHODS: Fifty participants (25 males and 25 females, mean age = 25 ± 4 years) were assessed for incisal tooth wear of upper anterior teeth using Smith and Knight clinical tooth wear index (TWI) on two occasions, the study baseline and 1 year later. Stone dies for each tooth were prepared and scanned using the CAD-CAM Laser Cercon System. Scanned images were printed and examined under a toolmaker microscope to quantify tooth wear and then the dies were directly assessed under the microscope to measure tooth wear. The Wilcoxon Signed Ranks Test was used to analyze the data. RESULTS: TWI scores for incisal edges were 0-3 and were similar at both occasions. Score 4 was not detected. Wear values measured by directly assessing the dies under the toolmaker microscope (range = 113 - 150 µm, mean = 130 ± 20 µm) were significantly more than those measured from Cercon Digital Machine images (range=52-80 µm, mean = 68 ± 23 µm) and both showed significant differences between the two occasions. CONCLUSIONS: Wear progression in upper anterior teeth was effectively detected by directly measuring the dies or the images of dies under toolmaker microscope. Measuring the dies of worn dentition directly under tool maker microscope enabled detection of wear progression more accurately than measuring die images obtained with Cercon Digital Machine. Conventional method was the least sensitive for tooth wear quantification and was unable to identify wear progression in most cases.