Determination of the Color Change of Various Esthetic Monolithic Monochromatic Computer-Aided Design/Computer-Aided Manufacturing Materials.

Dental technology has developed materials for prosthetics that are very similar to natural teeth and offer a good balance between durability and esthetics; however, some of these materials are not very color-stable under the influence of external factors. Therefore, the aim of this study is to determine and compare the color change (∆E00) of different esthetic monolithic monochromatic CAD/CAM materials after they have been thermocycled and treated with staining solutions. The color parameters were determined using a spectrophotometer on a white and black background. Five CAD/CAM materials were used for this study-CAD/CAM nanoceramic (GC Cerasmart270), CAD/CAM lithium disilicate ceramic (IPS e.max CAD), CAD/CAM polymer (Telio CAD), CAD/CAM composite (Tetric CAD) and CAD/CAM polymer-infiltrated ceramic (Vita Enamic). The test specimens produced were divided into groups and were thermocycled in distilled water. They were then stored for four weeks at 37 °C in either distilled water as a control liquid, black tea, instant coffee or red wine. The aim is also to evaluate the color changes as a function of the exposure time of the staining solutions. The results obtained were analyzed statistically. All CAD/CAM materials tend to discolor to varying degrees. Among the factors contributing to discoloration, red wine proved to be the most significant influencing factor. The conclusion from the results is that the color change is influenced by the type of material, the staining solution, the sample thickness, the color background and the aging time.

The Asymmetry of the Mandible in Patients with Unilateral Temporomandibular Joint Disc Displacement Confirmed by Magnetic Resonance Imaging.

Objectives: The study aimed to determine the relationship between the mandibular asymmetry index according to Kjellberg between patients with painful unilateral anterior disc displacement (DD) and asymptomatic volunteers without disc displacement. Vertical measurements were performed on a panoramic single-image radiograph, and the disc status was confirmed by magnetic resonance imaging (MRI). Material and methods: Two groups of subjects were retrospectively selected, 40 patients (the overall mean age was 35.5 years; 75% female) with temporomandibular disorder symptoms confirmed by RDC/TMD axis I and manual functional analysis. Unilateral DD was determined by MRI. A comparative group of asymptomatic volunteers (20 dental students with a mean age of 23.4 years; 72% female) had the physiological position of the disc determined by MRI. The vertical asymmetry of the condyle was determined by the method of Kjellberg et al. The symmetry of the gonial angle of the mandible was also measured. Results: A comparison of the mean of the asymmetry index between patients (average 90.89±7.08%) and asymptomatic volunteers (mean 95.86±4.44%) showed a statistically significant difference (p=0.0029). There was no difference (p=0.088) in gonial angle symmetry between the patients (mean 96.48±2.96°) and the asymptomatic volunteers (mean 97.52±2.31°). The distribution of the presence of individual DD diagnoses (partial and total displacement with reduction, displacement without reduction) in patients diagnosed with asymmetry of the mandible was without statistical significance (p>0.05). Conclusion: This study actually points to the asymmetry of the mandible as a potential morphological risk of anterior DD.

Significance of Calcifications in Projection of Carotid Arteries on Orthopantomography for Detection of Carotid Artery Stenosis.

Introduction: Orthopantomography is amongst the most commonly used dental imaging modalities. Calcifications in the projection of carotids on orthopantomographs are found in 3-15% of general population and commonly represent calcified atherosclerotic plaques. Carotid atherosclerotic changes are one of the most frequent causes of stroke, which is the second most common cause of death and the leading cause of disability globally. Our aim was to determine the relationship between calcifications in the projection of carotids on orthopantomographs, carotid stenosis and stroke, and the correlation between stroke risk factors, calcifications on orthopantomographs and the degree of carotid stenosis. Materials and methods: Doppler ultrasound and brain MRI were performed in 41 patients with unilateral or bilateral calcifications on orthopantomographs. Anamnestic data relevant to stroke risk were gathered. Results: Significant stenosis >50% was found in almost 15% of our patients. There was a significant correlation between hypertension and carotid calcifications. No statistically significant correlation between calcifications and significant stenosis was found. Patients with previous stroke were approximiately 5 years older than those without stroke. Conclusion: Preliminary results show no statistically significant correlation between calcifications on orthopantomography and significant carotid stenosis, but further investigation is needed.

EVAULATION OF BLINK REFLEX BETWEEN PATIENTS WITH IDIOPATHIC TRIGEMINAL NEURALGIA AND HEALTHY VOLUNTEERS.

The purpose of the study was to find differences in the parameters of the response to the blink reflex (BR) between patients with idiopathic trigeminal neuralgia (TN) and health volunteers. A prospective cohort study was conducted over 2 years. The TN-subgroup included 15 patients (mean age / SD 62.3 ± 10.7 years). Pain-free and healthy volunteers as a HV-subgroup (mean age / SD: 30.8 ± 8.1 years) were recruited from asymptomatic students of dental medicine. Diagnostic parameters were determined by measuring latency to the onset of the BR components from electric stimulation. The following branches of the trigeminal nerve were affected: maxillary branch only (26.7%), mandibular branch only (20%), combined: ophthalmic branch with maxillary branch (6.7%), and ophthalmic branch with mandibular branch (6.7%) respectively, combined maxillary and mandibular branch (26.7%) and affected all three branches (13.4%). The latencies of the BR, left and right side together, between subgroups were significantly higher for values R1 (homolateral early response), R2 (homolateral late response), R2c latency (contralaterally expressed response) in the TN-subgroup (p < 0.05). On the basis of the presence of R1c and R3 latencies and upon considering the abnormal findings of the BR, no statistically significant differences were found between the examined subgroups (p > 0.05). Blink-reflex parameters (R1, R2 and R2c) were significantly abnormal comparing TN-patients with healthy volunteers. The R3 component of the BR was related to noxious stimuli, likewise by innocuous stimuli.

Alcohol Abuse in the Dental Patient and Temporomandibular Disorder Caused by Trauma.

The aim of the paper was to describe the multidimensional character of alcoholism and its effects on oral health, with a review of the relation between the traumatogenic factor of temporomandibular disorders (TMDs) and bruxism development. The difference between moderate drinking and the development of alcohol addiction which leads to alcoholism-related medical, social, legal and economic issues is not always clear. Alcoholism is often hidden within the private and wider social framework of a patient. Oral diseases are easy to notice in recorded alcoholics as well as in, for example, smokers. TMDs consist of a disorder of masticatory muscles and/or a disorder of temporomandibular joint (TMJ). Since the traumatogenic factor of individuals under the influence of alcohol is clearly evident, it can potentially become an initializing factor of TMJ disorder's clinical signs and symptoms development. A modern approach to the etiopathogenesis is to include the multifactorial model, that is, combinations of potential factors with various individual importances. In everyday dental practice, co-morbidities of oral diseases and alcoholism are expected more often, as well as oral diseases with their etiopathogenesis partially related to alcohol use.

OROFACIAL PAIN - DIAGNOSTIC AND THERAPEUTIC CHALLENGES.

The concept of diagnostics and therapy of musculoskeletal and neuropathic diseases of the stomatognathic system, which are the subject of this paper, has been developing for decades. It can be said that in order to avoid misunderstanding, the orofacial pain as a clinical problem, in the narrower sense, involves non-odontogenic and non-malignant causes of orofacial region. In this study, the results of clinical diagnosis of the population of 557 consecutive patients with orofacial pain based on multidisciplinary diagnostics were evaluated. 15.6% of patients have given up on the participation in the study. It has been shown that the patients who dropped out of the study were significantly older (p=0.0411) than those who agreed to participate, but there was no difference in gender ratio (p=0.185) since the proportion of female patients prevailed. In an analysis of 84.4% of patients participating in the study, the elevated anxiety values were established (mean value on STAI 1 was 39.2 and STAI 2 was 41.1) and statistical significance was found in correlation between elevated anxiety and intensity of pain as shown on visual analogue scale on open mouth (p<0.0001). Compared to the age, the statistical significance was for STAI 1 (p=0.0097) but not for STAI 2 (p=0.5599). The most common form of therapy is Michigan stabilization splint: for disc displacement of temporomandibular joint (TMJ) in 38.9% of patients and in combination with physiotherapy in 18.7% of patients; for osteoarthritis of TMJ in 28.4% and in combination with physiotherapy in 26.4% of patients. The treatment with anticonvulsant drugs for trigeminal neuralgia predominates in 54.3% of patients, which is combined with acupuncture in 25.7% of patients and only acupuncture in 17.1% of patients. In this study, a multidisciplinary co-operation in initial diagnostics and differential was designed to develop subspecialist knowledge on orofacial pain.

Salivary Oxidant/Antioxidant Status in Chronic Temporomandibular Disorders Is Dependent on Source and Intensity of Pain - A Pilot Study.

Temporomandibular disorders (TMD) have been associated with altered salivary oxidative status, but the relation with pain source and pain severity isn't clarified. With the aim to assess their interaction with TMD, we compared levels of selected salivary oxidative stress (OS) markers (glutathione peroxidase, superoxide dismutase, total antioxidant capacity (TAC), uric acid, 8-hydroxydeoxyguanosine, malondialdehyde) and salivary cortisol (SC) as a stress indicator, between 20 TMD patients and 15 healthy control subjects. In order to record differences relating to pain source and severity, patients were respectively classified according to specific diagnoses (myofascial pain or disc displacement (DD)), and pain intensity (high or low). TAC was significantly higher in TMD patients than in controls (morning p = 0.015; afternoon p = 0.005). Significant differences were also observed when TAC levels between high-intensity pain patients and controls were compared, as well as between DD patients and controls. In logistic regression analysis, higher levels of TAC were related to DD (morning OR: 1.66, 95%CI: 1.05-2.64, p = 0.029; afternoon OR: 2.10, 95%CI: 1.11-3.98, p = 0.021) and to high-intensity pain (morning OR: 1.81, 95%CI: 1.04-3.15, p = 0.037; afternoon OR: 1.79, 95%CI: 1.02-3.14, p = 0.043). We also found that morning SC was positively correlated with antioxidant parameters in TMD patients. Our data suggest compensatory mechanism as response to higher level of stress. This stress could be extrinsic and lead toward TMD, or intrinsic, emerging from established TMD, or could be both. The intensity and the source of pain should be considered important factors in future investigations evaluating salivary OS markers in TMD patients.

Zygomatic Air Cell Defect - Magnetic Resonance Imaging of the Temporomandibular Joint Compared with Panoramic Radiographs.

The aim of the study was to analyze zygomatic air cell defect (ZACD) incidence using magnetic resonance imaging (MRI) and validity of panoramic radiograph as a comparative method of ZACD diagnostics. The connection between ZACD incidence, age, left/right temporomandibular joint (TMJ) and comorbidity with diagnosis of TMJ disorder was analyzed. Panoramic radiographs and MRIs of 140 TMJs of 70 consecutive patients with previously confirmed TMJ diagnosis were compared in the study. A grading system (4-point scale from '0' for absence to '3' for most extended pneumatization) was used to determine low signal on MRIs as pneumatization of temporal bone. ZACD was diagnosed in 22 joints of 15 patients (incidence, 20.4%), with seven patients having bilateral appearance. In the joints of nine patients, ZACD was identified as extensive accord-ing to the grading scale. The validity of ZACD findings on panoramic radiographs compared with MRI findings yielded 0.45 sensitivity and 0.98 specificity. There was no relation (p>0.05) between comorbidity of ZACD and TMJ disorder, either by age or side of the body. More prevalent ZACD in our MRI analysis than in other researches based on panoramic radiographs could be explained by the expected superimposed osseous structures in the area of articular eminence.

SOCIOECONOMIC INFLUENCE OF TOBACCO USE AND DENTAL CARIES EXPERIENCE IN DIFFERENT MALE CROATIAN POPULATIONS.

- The purpose was to evaluate dental caries experience in different male subpopulations of Croatian Army recruits and dental students, and subsequently, smoking habits related to the level of education and place of residence. Croatian army recruits (n=248; mean age 20.2) and male dental students (n=56; mean age 21.5) were evaluated according to DMFT and FST indices, divided according to age and place of residence, and interviewed about their dietary habits and smoking of tobacco. In the subpopulation of recruits, the median value of DMFT was 6 and of FST index 25. A statistically significant difference was recorded between DT and FST index (p<0.05) according to dietary role of carbohydrates reflected in caries development. The number of recruits with finished elementary school coming from a rural area who smoked (in total 57.66% of smokers) was significantly larger (p=0.0041). In dental students, the median value of DMFT was 5, with statistical significance in comparison with recruits (p=0.03). There was a difference in FST index (median 28) (p<0.0001). Students were mostly nonsmokers (71.43%) and had urban residence (p<0.0001). FST index was a more specific indicator in the socioeconomically heterogeneous sample of recruits (more subjects coming from rural areas and with a lower level of education) than in the sample of dental students (more subjects coming from urban areas).

Within-Subject Reliability and between-Subject Variability of Oxidative Stress Markers in Saliva of Healthy Subjects: A Longitudinal Pilot Study.

The present study evaluated diurnal variations and day-to-day fluctuations of salivary oxidative stress (OS) markers in healthy adult individuals. Whole unstimulated saliva was collected at 2 time intervals over 3 consecutive days. Glutathione peroxidase (GPX), superoxide dismutase (SOD), total antioxidant capacity (TAC), and uric acid (UA) were analyzed using spectrophotometric methods, while 8-hydroxydeoxyguanosine (8-OHdG) and malondialdehyde (MDA) were determined using immunoassays. No significant differences for salivary OS markers between men and women were observed. For all examined OS markers, no significant day-to-day variations were demonstrated. Significant diurnal variations were found in salivary GPX, TAC and MDA levels. For SOD, TAC, GPX, and UA, good-to-moderate intraindividual coefficients of variations (CVs) were observed in more than 75% of the subjects. For MDA and 8-OHdG, intraindividual CVs > 35% were observed in 60% and 40% of the subjects, respectively. Between-subject variance was wide for all examined OS markers (CV% 30.08%-85.70%). Due to high intraindividual variability in the salivary concentrations of MDA and 8-OHdG, those markers cannot be reliably verified based on single measurements and multiple measurements over several days would provide more reliable information. Salivary SOD, TAC, GPX, and UA proved stable across three days of measurement. Trial Registration. ClinicalTrials.gov NCT03029494. Registered on 2017-01-19.

The relationship between periodontal disease, tooth loss and decreased skeletal bone mineral density in ageing women.

AIM: Osteoporosis and periodontitis are both chronic diseases characterised by bone loss. Potential association is of great clinical importance because of multifactorial aetiology and common risk factors. The aim of this study was to determine relationship between bone mineral density (BMD), tooth loss and periodontal status taking into account age, number of years since onset of menopause and educational level. With increasing age, number of years since onset of menopause and lower educational level, decreased BMD, deteriorating periodontal status and greater tooth loss are expected. MATERIALS AND METHODS: Cross-sectional study included 112 women aged 45-80 years (mean 58.3 years). BMD was determined for lumbar spine region and proximal femur by DEXA technology. Dental status and periodontal status were evaluated clinically and on panoramic radiographs. For the analysis of tooth loss frequency, participants were divided into four age groups. RESULTS: Significant inverse correlation was found between number of lost teeth and BMD at hip region (r = -.227; P = .028) but not at the lumbar spine (r = -.05; P = .669). Several indicators of the periodontal condition were significantly correlated with BMD, but not with postmenopausal period length. Important result is that participants missing one or more incisors or canines had significantly lower mean value of BMD comparing to those who had all the incisors and canines remained. CONCLUSION: Although osteoporosis is not the main cause of periodontitis, it may be a factor that leads to enhanced periodontal pocket depth and greater risk of tooth loss in ageing women.

Undergraduate Students' Knowledge on Temporomandibular Disorders in Croatia.

The aim of this study was to evaluate Croatian undergraduate students' knowledge based on what they learned in the recent course, as well as the students' own judgment and opinions about geriatric dentistry education concerning temporomandibular disorders (TMDs) of the elderly. The study was carried out by means of a questionnaire administered in the last study year to students of the School of Dental Medicine, University of Zagreb and students of the Department of Dental Medicine at the School of Medicine, University of Rijeka. Th e questionnaire included questions about relevant specific knowledge on TMD, and statements related to their own opinion about geriatric dentistry education received during the study. Regarding students' knowledge related to TMDs, students from Rijeka gave more positive answers (p=0.012). Students from Rijeka gave more positive answers regarding physical therapy for treatment of TMD (p=0.004) and disc displacement and osteoarthritis as the most common disorders of the temporomandibular joint (p=0.031). Students from Zagreb were more unsatisfi ed with the skills in the field of geriatric dentistry (disagreed 57.45%) than students from Rijeka (45.83% had neutral standpoint and 37.50% agreed) (p=0.005). The level of the participants' knowledge pointed to the need of improving undergraduate dental teaching about the specific geriatric education, including knowledge about TMD.

Centric slide in different Angle's classes of occlusion.

The purpose of this study was to test the possible differences in centric slide values between different Angle's classes of occlusion. The study included 98 participants divided into four groups: Angle's class I, Angle's class II, subdivision 1, Angle's class II, subdivision 2 and Angle's class III. All recordings were obtained using an ultrasound jaw tracking device with six degrees of freedom. The distance between the maximum intercuspation (reference position) and the centric occlusion was recorded at the condylar level. Anteroposterior, superoinferior and transversal distance of the centric slide were calculated for each participant, and the data were statistically analyzed (analysis of variance and Newman-Keuls post hoc test). No statistically significant difference was found in the anteroposterior and transversal distance of the centric slide between tested groups, while Angle's class II, subdivision 2 showed smaller vertical amount of the centric slide compared to Angle's class I and class II, subdivision 1. None of the 98 participants showed coincidence of centric occlusion and maximum intercuspation. Our results suggest that coincidence of the maximum intercuspation with the centric occlusion should not be expected. Smaller extent of the vertical distance of the centric slide could be morphological and a functional expression characteristic of the Angle's class II, subdivision 2.

Timing of emergence of the first primary tooth in preterm and full-term infants.

Variations in the timing of emergence of primary teeth are under strong genetic control, but there is also a significant contribution from external factors. The aim of this study was to evaluate the influence of preterm birth, birth weight and length, and feeding practices during the first 6 months of life on the timing of emergence of the first primary tooth. Data on pregnancy duration, birth weight and length, feeding practice, time of emergence and first emerged primary tooth were collected by electronic questionnaires. The study included 409 parents and 592 children of both genders. The sample was divided into two groups according to pregnancy duration (<37 weeks and ≥37 weeks), three groups according to feeding practice (exclusively breastfed, exclusively bottle fed, and a combination of breast feeding and bottle feeding), three groups by birth length (<50, 50-53, >53cm), and four groups by birth weight (<1500, 1500-2500, 2501-3500, >3500g). Data were analyzed considering chronological and postmenstrual age-which is the gestational age plus the infant's chronological age at the month of emergence of the first primary tooth. The mean time of first primary tooth emergence was 7.55±2.67 months when chronological age was considered. The first emerged tooth in most cases was a lower incisor (82.33%). There was a statistically significant difference in the timing of the first tooth emergence between preterm and full-term groups when chronological age was considered (p<0.005). However, no difference was found when age was adjusted. The age of emergence of the first tooth differed significantly when feeding, weight, and length groups (p<0. 05) were taken into account. In conclusion, the study indicates that shortened gestational age and very low birth weight are predictors for later ages of emergence of the first primary tooth.

Movements of temporomandibular condyles during swallowing.

There have been studies that investigated mandibular movements and positioning during swallowing, but the results were inconsistent, and still the exact position of the condyles during swallowing is unknown. The purpose of this investigation was to study the kinematics of the mandible and the condyles, and to determine the actual movement paths and position of mandible and condyles during the process of swallowing. The study was performed on a sample of 44 dental students. Measurements were done with an electronic axiograph. After non-occlusing attachment was fixed in the mouth, every subject swallowed for five times from the rest position. The final swallowing position of the left and the right condyles was measured in the sagittal plane. The final swallowing position of the sagittal incisal point was measured in sagittal, frontal and horizontal plane, and data was statistically analyzed. The condyles showed average movement toward posterior (left 0.17 mm, SD 0.28, right 0.16 mm, SD 0.25) and superior (left 0.14 mm, SD 0.20, right 0.14 mm, SD 0.23). Anterior and/or inferior position had 20% of participants. The average sagittal incisal point movement during swallowing was toward anterior (0.30 mm, SD 0.53) and superior (0.81 mm, SD 0.84). The mean mandibular lateral movement was 0.1 mm (SD 0.1). The results of the study suggest that retrusion during swallowing is not the rule, although on average there is a slight tendency of condylar movement toward posterior. Swallowing can be used as auxiliary method for determining vertical dimension of occlusion.

Metric evaluation of partially displaced temporomandibular joint disc.

The objective was to determine the quantitative relationship between the condyle and disc position in the glenoid fossa between two different slices of the same temporomandibular joints (TMJs) with partial anterior disc displacement (DD). The study was conducted on 40 patients with DD of TMJs (mean age, 35.5 years). The clinical diagnosis of DD was confirmed by magnetic resonance imaging. Joints from the patient groups were analyzed according to the laterality and depending on disc displacement (a total of 80 joints). Comparison was made between two different slices of 9 joints with partial DD with reduction: partial DD was analyzed in the representative centrolateral or centromedial parasagittal slice of the TMJ (TMJ partial DD--slice DD). The contralateral slice of the same joint was without DD (TMJ partial DD--slice NDD). The analysis also included 34 healthy joints without DD (TMJ NDD) of the same patients. The position of the condyle and disc was calculated using the Kurita et al. method on the parasagittal view of the TMJ. A statistically significant difference was recorded for different slices of the same TMJs with partial DD (TMJ partial DD--slice DD and TMJ partial DD--slice NDD) (p < 0.01), but no difference was found in condyle positions depending on the existence of partial DD (p > 0.05). The compared values between slice TMJ partial DD--slice NDD with the group of TMJ NDD showed no significant difference in either disc position or condyle position (p > 0.05). There were differences of disc position in various slices of the same joint with visually confirmed partial DD. The dorsocranial condyle position could not indicate partial anterior DD.

Psoriatic arthritis and temporomandibular joint involvement - literature review with a reported case.

In addition to psoriasis, between 5% and 24% of patients will develop psoriatic arthritis simultaneously after or even prior to skin manifestations. Psoriatic arthritis belongs to the group of seronegative spondyloarthritis. Collaboration between a dermatologist and a rheumatologist plays a more important role in cases where there is a complete absence of clinical signs of psoriasis. Since rheumatic diseases may also involve the temporomandibular joints (TMJ), psoriatic arthritis can cause problems that are an aspect of systemic disease. In general, the clinical and radiological description of a population of patients suffering from psoriasis and/or psoriatic arthritis does not mention TMJ involvement. However, as is the case with intraoral psoriasis, psoriatic changes to the TMJ also show characteristic signs of erosion, deplaned condyles, and articular effusion. Magnetic resonance imaging has shown itself to be the gold standard in the diagnostics of joints afflicted by psoriatic arthritis and TMJ disorders, regardless of the existence of a systemic disease. This paper aims to present a review of the relevant literature describing different epidemiological, clinical, and radiological characteristics of psoriasis and psoriatic arthritis, with emphasis on the involvement of TMJs in the general manifestation of the disease, illustrated by a description of the clinical case of a 77-year-old female patient.

Dental caries experience and tobacco use in 19-year-old Croatian army recruits.

The aim of this study is to investigate caries prevalence and smoking habit in the population of 19-year-old Croatian male recruits. Dental examination of 505 male recruits was conducted in 2001 in the military centre in Koprivnica. Caries status was described by the FS-T (Filled and Sound Teeth) index and DMFT (Decayed, Missing and Filled Teeth) index. Mean DMFT scores were 7.32 and FST 23.56. There was a significant statistical difference in comparison of smoking habits depending on the reason to visit the dentist (p = 0.001). The subjects who do not smoke tobacco have less decayed teeth (DT index with p < 0.001), and more teeth with fillings and/or sound teeth (FT with p = 0.005 and FST with p = 0.004). There is no statistically significant difference for the DMFT (p = 0.657) and MT (p = 0.703). In conclusion, it showed that FS-T is a more appropriate index for describing variation in the population with higher caries experience. In the population of Croatian recruits, there were an astonishing 58.6% of smokers.

Measurements of the sagittal condylar inclination: intraindividual variations.

AIMS: Sagittal condylar inclination is an important parameter during fabrication of prosthetic restorations. Existing data about intraindividual variations of sagittal condylar inclination are scarce. The purpose of this study was to investigate intra- and interindividual variations of the sagittal condylar inclination, depending on the position of the condyle in the temporomandibular joint. METHODOLOGY: The study included 51 subjects with Angle's Class I occlusion (21-32 years of age, mean 25.1). Measurements were done using an electronic axiograph. After a paraocclusal tray was fixed in the mouth, every subject had to make three protrusive movements, from which the device's software calculated the mean left and mean right sagittal condylar path. The mean left and right condylar path of each subject was divided into three equal sequences, based on whole condylar path length. Condylar inclination values for the first, second and third movement sequences were calculated. RESULTS: Results showed significant differences between movement sequences (P < 0.05). For the left joint, condylar inclination values in the first condylar movement sequence demonstrated, on the average, 14.4% higher values compared to the second movement sequence, and 39.2% higher values than in the third movement sequence. For the right joint, the first condylar movement sequence demonstrated, on the average, 15.8% higher values compared to the second movement sequence, and 41.5% higher values than the third movement sequence. CONCLUSIONS: Results suggest that condylar movement in the sagittal direction is not uniform. Mean left and mean right condylar inclination values do not necessarily describe the actual condylar path, nor do they give adequate information for articulator setup. Left-right side condylar inclination differences greater than 10 degrees can be considered as normal.

Clinical view of the temporomandibular joint disorder.

Temporomandibular pain has a musculoskeletal origin because it occurs as a consequence of masticatory muscle function disorder and temporomandibular joint disorder. Most common diagnoses of disorders are disc displacement and osteoarthritis, but their comorbidity can also occur. Pain is the most common symptom, where chronic temporomandibular pain may con- tribute to the occurrence of psychological disorders in the patient population. Splint is the most widespread dental method of treatment but other, noninvasive methods of musculoskeletal pain treatment are also recommended. Electronic axiography is used for visualization of mandibular movements, in particular pathologic sounds in the joints. Mental health, although not so obvious in dental practice, can influence the need of a multidisciplinary approach to the patient with disorder of the temporomandibular joint.