Assessment of Color Parameters on Maxillary Right Central Incisors Using Spectrophotometer and RAW Mobile Photos in Different Light Conditions.

OBJECTIVES: The aim of the study was to compare three color parameters assessed on the maxillary right central incisors using a spectrophotometer as the gold standard, along with RAW mobile calibrated and non-calibrated photos in different light conditions. MATERIALS AND METHODS: A total of 30 dental students participated in the study. CIE L*a*b* values were measured in the middle third of each maxillary right central incisor spectrophotometrically and digitally on RAW mobile dental photos using different light conditions (F-frontal light; L-lateral light; D-lateral light with diffusers; P- polarizing filter on frontal light; H-hybrid filter as combination of frontal light with polarizing filter and lateral lights with diffusers) with LEDs (light emitting diode) in full power, and with gray card calibration. The obtained results were compared. RESULTS: Mean a* and b* values on calibrated, as well as mean L* values on non-calibrated RAW mobile photos did not significantly differ in different light conditions (P>0.05). CIE L*a*b* values on non-calibrated polarizing RAW mobile photos completely matched the same values obtained using a spectrophotometer on the subject's maxillary right central incisor (P>0.05). CONCLUSIONS: Different light conditions and measuring procedures affected CIE L*a*b* values on RAW mobile photos in this study. Within the limitations, non-calibrated RAW mobile photos using a lightening device with polarizing filters on frontal LED light in standardized conditions can be a useful tool for digital dental shade determination.

Comparison of Parameters for Programming Adjustable Dental Articulators by Using Wax Eccentric Records and Arcus Digma Device.

OBJECTIVES: Programming of joint mechanism/parameters (sagittal condylar inclination and Bennett angle) of adjustable dental articulators is a prerequisite for performing positions and movements of the mandible. The aim of the study was to test significant differences between the two methods (wax eccentric records and Arcus Digma device) of measuring these joint parameters by using three different dental articulators (SAM 3, Protar 7; and Artex CR). MATERIALS AND METHODS: Thirty asymptomatic younger (age 25.7 ± 2.9 years) subjects (dental medicine students) divided by gender, with normal occlusion (Angle class I) participated in the study. After taking anatomical impressions of both dental arches, master casts were made of hard dental plaster for each subject. The values of the left and right sagittal condylar inclination and Bennett angle by the two methods of wax eccentric protrusive and lateral records and Arcus Digma device were measured for the purpose of programming the mentioned joint parameters in three different articulator systems. RESULTS: The average values of the measured parameters of sagittal condylar inclination and Bennett angle of wax eccentric records were higher (ranging from 5ºto 10º) in relation to the values measured by Arcus Digma device. Statistically significant differences found between the measured joint parameters (p <0.025) were influenced by the articulator system design and measurement methods (t-test for dependent samples and MANOVA). CONCLUSION: The use of Arcus Digma device should be considered reliable and valid for individualized programming of dental articulators, rather than the use of wax eccentric records.

Effect of Clinical Experience on the Shade Matching Accuracy in Different Dental Occupational Groups.

OBJECTIVES: The aim of this study was to evaluate the effect of clinical experience level on the shade matching accuracy in different dental occupational groups. MATERIALS AND METHODS: A total of 80 participants, assigned to one of four groups depending on the level of their clinical experience in shade matching: dental technicians (DTs), residents in prosthodontics (RPs), specialists in prosthodontics (SPs) and dental students (DSs) took part in the study. They were asked to use Tooth guide Training Box (TTB) and determine 15 standardized shade tabs using VITA 3D-Master shade guide. The number of mistakes in final test for each participant was recorded and accuracy was calculated. Color difference (ΔE) values for each shade were calculated from L*, a* and b* values. Differences in accuracy, mean ΔE values and mean error ΔE values between four different groups were examined. RESULTS: No statistically significant differences were found between the groups regarding accuracy and mean ΔE values (p>0.05). The accuracy rate in four groups was 0.51±0.20 (DTs), 0,54±0.18 (RPs), 0.49±0.16 (SPs) and 0.55±0.14 (DSs), respectively. Mean ΔE values were 2.10±0.98 (DTs), 2.18±0.97 (RPs), 2.51±0.97 (SPs) and 2.08±0.86 (DSs), respectively. Regarding mean error ΔE values, DTs made errors with significantly less deviations compared to other groups (p<0.05). CONCLUSIONS: This study has shown that clinical experience is not found to be a significant factor to the shade matching accuracy. With regard to the mean error ΔE values, DTs were more successful in shade matching than other participants.

Reproducibility of Centric Relation Techniques by means of Condyle Position Analysis.

PURPOSE: The aim of this study was to determine the reproducibility of clinical centric relation (CR) registration techniques (bimanual manipulation, chin point guidance and Roth's method) by means of condyle position analysis. MATERIAL AND METHODS: Thirty two fully dentate asymptomatic subjects (16 female and 16 male) with normal occlusal relations (Angle class I) participated in the study (mean age, 22.6 ± 4.7 years). The mandibular position indicator (MPI) was used to analyze the three-dimensional (anteroposterior (ΔX), superoinferior (ΔZ), mediolateral (ΔY)) condylar shift generated by the difference between the centric relation position (CR) and the maximal intercuspation position (MI) observed in dental arches. RESULTS: The mean value and standard deviation of three-dimensional condylar shift of the tested clinical CR techniques was 0.19 ± 0.34 mm. Significant differences within the tested clinical CR registration techniques were found for anteroposterior condylar shift on the right side posterior (Δ Xrp; P ≤ 0.012); and superoinferior condylar shift on the left side inferior (Δ Zli; P ≤ 0.011), whereas between the tested CR registration techniques were found for anteroposterior shift on the right side posterior (ΔXrp, P ≤ 0.037) and superoinferior shift on the right side inferior (ΔZri, P ≤ 0.004), on the left side inferior (ΔZli, P ≤ 0.005) and on the left side superior (ΔZls, P ≤ 0.007). CONCLUSION: Bimanual manipulation, chin point guidance and Roth's method are clinical CR registration techniques of equal accuracy and reproducibility in asymptomatic subjects with normal occlusal relationship.

Oral Health-Related Quality of Life in Different Types of Mandibular Implant Overdentures in Function Longer Than 3 Years.

PURPOSE: The aim of this study was to evaluate the oral health-related quality of life (OHRQoL) of patients treated with three different types of mandibular implant overdentures (IOD) after at least 3 years in function. MATERIALS AND METHODS: A total of 122 patients treated with mini implant (50), locator (56), or bar (16) mandibular IODs participated. Modified plaque (PI) and gingival (GI) indices were also assessed. RESULTS: Older patients and patients with mini mandibular IODs were the most satisfied with their OHRQoL. The bar overdenture presented the worst PI and GI results. CONCLUSION: The mini mandibular overdenture patients were assessed with a better OHRQoL than those with bar and locator IODs.

Influence of the Hinge Axis Transfer Modality on the Three-Dimensional Condylar Shift Between the Centric Relation and the Maximum Intercuspation Positions.

PURPOSE: The purpose of the study was to determine whether the hinge axis registration and the transfer modality (facebow transfer vs. average mounting) from the subject to the articulator affect the three-dimensional condylar shift between the centric relation (CR) and the maximum intercuspation (MI) position. MATERIAL AND METHODS: The study was comprised of 32 fully dentate subjects (16 male and 16 female). Only the asymptomatic participants with normal occlusal relations (Angle class I) aged 20 - 33 (mean age 22.6 ± 4.7) met the inclusion criteria. Three-dimensional condylar shift (anteroposterior, superoinferior and mediolateral shift) between the centric relation position (CR) and the maximum intercuspation (MI) position was analyzed by means of Mandibular Position Indicator (SAM Prazisionstechnik GmbH, Muenchen, Germany). RESULTS: The average three-dimensional condylar shift was 0.13 ± 0.12 mm for facebow transfer and 0.22 ± 0.23 mm for average mounting. There were no statistically significant differences noted between genders. The results of the Mann-Whitney test showed statistically significant differences for anteroposterior and superoinferior condylar shift (P < 0.001). However, the difference in the mediolateral shift was not statistically significant. CONCLUSIONS: In order to find discrepancies within the three-dimensional condylar shift, facebow transfer proved to be more accurate than the average mounting in the semi-adjustable articulator. However, the average value of three-dimensional shifts of the condyle did not differ from normal values and they did not have clinical significance. Thus, both ways of transfer modalities (facebow transfer and average mounting) in asymptomatic subjects with normal occlusion can be considered reliable.

Influence of depression and somatization on acute and chronic orofacial pain in patients with single or multiple TMD diagnoses.

To examine whether psychological variables such as depression and non-specific physical symptoms (somatization) influence pain entity among acute and chronic TMD patients with one or more TMD diagnoses (muscle disorders, MD; disc displacements, DD; and arthralgia, arthritis, arthrosis, AAA). One hundred and fifty-four patients (37 male and 117 female; mean age, 39.0 +/- 14.5 years) with Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) protocol were selected. Differences in mean depression and somatization scores between acute and chronic TMD patients, as well as TMD patients with one or multiple TMD diagnoses were compared by using the parametric T-test for independent samples. The majority of patients were acute TMD patients (81.8%), while the remaining 28 patients (18.2%) were chronic TMD patients. 62% of patients had only one TMD diagnosis (MD or DD or AAA), 31% of patients had two diagnoses (MD+DD, MD+AAA, DD+AAA) and, finally, 7% of patients had three diagnoses (MD+DD+AAA) according to the RDC/TMD protocol. According to the SCL-90 psychometric evaluation, 19.5% of patients presented a severe depression score (> 1.105), 27.3% of participants presented a severe somatization score with pain items included (> 1.000). The results of the t-test for independent samples showed statistically significant differences between acute and chronic TMD patients (p < 0.001), as well as between patients who were assigned one diagnosis (p = 0.019) and patients who had two or more diagnoses (p < 0.001); for mean levels of depression and somatization scores. Chronic TMD patients and patients with multiple TMD diagnoses had higher rates of depression and somatization in this study. These results could be used in a tailored strategy of TMD treatment.

Natural head position and inclination of craniofacial planes.

PURPOSE: To assess the angles between craniofacial planes and the gravity horizontal plane (GHP). MATERIALS AND METHODS: The plumb line was hung from the ceiling, the Fox plane (FoxP) was placed in the mouth, and 56 Angle Class I subjects were photographed in a natural head position. FoxP represents the extraoral view of the occlusal plane. RESULTS: In frontal view, bipupilar plane (BP) and occlusal plane (FoxP) were almost parallel to GHP. In lateral view, FoxP was almost parallel to GHP, but Frankfort horizontal plane (FHP) and Camper's plane (CP) were not. FoxP and CP were not parallel. CONCLUSION: CP is not a reliable landmark for occlusal plane reconstruction. FHP does not represent GHP.

Psychologic status in patients with temporomandibular disorders.

PURPOSE: The aim of this study was to investigate diferrences in the prevalence of depression and somatization scores in temporomandibular disorder (TMD) patients. MATERIALS AND METHODS: One hundred fifty-four patients with single and/or multiple RDC/TMD diagnoses were classified into 7 groups based on Axis I criteria. Somatization and depression scores from the Symptom Checklist-90 were compared between groups. RESULTS: The results of this investigation indicate that patients with myofascial pain and arthralgia psychologically differed from those with disc displacement. These results were in accordance with findings that support the notion that the pain induces psychologic sequelae, at least in relation to depression and somatization. CONCLUSION: It was concluded that psychologic factors play an important role in etiopathogenesis of TMD, as demonstrated by an increase in levels of depression and somatization in TMD patients.

Relationship of slightly limited mandibular movements to temporomandibular disorders.

Mandibular movements have been analyzed extensively in the past for prosthodontic reasons, and more recently to study the function of the masticatory system. This study investigated the range of mandibular movements in a young male population, and analyzed the difference in range of mouth opening, right and left lateral movements, and protrusive movement between asymptomatic subjects (control group) and patients with clinical diagnoses of temporomandibular disorders. A total of 180 subjects, aged 19-28 years, were included in the study. The TMD sample comprised 90 patients (30 patients with muscle disorders; 30 patients with disc displacement with reduction; 30 patients with muscle disorders and disc displacement with reduction) and was compared with 90 healthy control subjects. All participants were evaluated by the attending dentist at baseline with a complete physical examination and history questionnaire, which included the Research Diagnostic Criteria for Temporomandibular Disorders Axis I measures. Analysis of variance (ANOVA) showed significant differences in ranges of mandibular movements between and within the groups of healthy control subjects and patients with muscle and temporomandibular joint disorders. It is suggested that there are differences in the range of mandibular movements that clearly separate asymptomatic subjects and patients with temporomandibular disorders in this young male population.

Relationship of slightly limited mandibular movements to temporomandibular disorders

Movimentos mandibulares têm sido extensivamente analisados no passado por razões protéticas, e mais recentemente para analisar a função do sistema mastigatório. Este estudo investigou a amplitude dos movimentos mandibulares em uma população masculina de jovens, e analizou a diferença na amplitude de movimento mandibular em movimentos laterais direito e esquerdo e em movimentos protrusivos, entre pacientes assintomáticos (grupo controle) e pacientes com diagnóstico de desordem temporomandibular. Um total de 180 pacientes, com idades de 19-28 anos, foram incluídos neste estudo. A amostra com DTM consiste em 90 pacientes (30 pacientes com disfunção muscular; 30 pacientes com deslocamento de disco com redução; 30 pacientes com disfunção muscular e deslocamento de disco com redução) e foi comparada com 90 pacientes saudávies no grupo controle. Todos os pacientes foram avaliados por um dentista com um exame físico completo e anamnese, que incluiu medidas de "Research Diagnostic Criteria for Temporomandibular Disorders Axis I". A análise de variância (ANOVA) mostrou diferenças significantes na amplitude de movimentos entre e dentro do grupo de pacientes saudáveis do grupo controle e pacientes com desordens temporomandibulares e de disco articular. Encontrou-se diferenças significantes na amplitude dos movimentos mandibulares que separaram os pacientes assintomáticos e pacientes com desordens temporomandibulares em uma população masculina de jovens.

Measurement of mandibular movements in patients with temporomandibular disorders and in asymptomatic subjects.

The aim of the study was to investigate the range of mandibular movements and to analyze the difference in range of mouth opening, right and left lateral movements, and protrusive movement between patients with clinical diagnoses of temporomandibular disorders and asymptomatic subjects (control group) in a young male population. A total of 240 subjects, aged 19-28, were included in the study. The TMD sample comprised 180 patients (60 patients with muscle disorders; 60 patients with disc displacement with reduction; and 60 patients with muscle disorders and disc displacement with reduction) and was compared with 60 healthy control subjects. All participants were evaluated by the attending dentists at baseline by means of a physical examination of the masticatory system and a history questionnaire which included the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I measures. Analysis of variance (ANOVA) with the post hoc Bonferroni criteria showed significant difference in ranges of mandibular movements between and within the groups of asymptomatic subjects and TMD patients for active mouth opening (p = 0.001), right lateral movement (p = 0.002), left lateral movement (p = 0.006), and protrusive movement (p = 0.05). It has been found that there are statistically significant differences in the range of mandibular movements that separate asymptomatic subjects and patients with muscle disorders and disc displacements with reduction in this young male population. However, we cannot conclude that measurements of active mandibular movements can discriminate one group (TMD patients) from the other (asymptomatic subjects), because the mean ranges of these active movements between the groups were measured in clinically "normal" values.

Incidence of temporomandibular disorders at tooth loss in the supporting zones.

Although the literature reports that occlusal disorders can be associated with temporomandibular disorders (TMD), their direct scientific correlation is still mainly unproved. The aim of this study was to establish the incidence of symptoms and signs of TMD and tissue-specific diagnoses in a population of subjects with tooth loss in the supporting zones. The study was conducted on 196 partially edentulous subjects (Eichner's class II and III) at the average age of 51.2. Manual functional analysis was used as a diagnostic procedure. Chi-square test for independent samples was used for establishing the significance of the differences between the variables. In the total sample, 16.3% of the subjects had symptoms and signs of temporomandibular disorders (TMD), while in 46.9% of the subjects a tissue-specific diagnosis of TMD was found. The most frequent tissue-specific diagnoses were osteoarthrosis and total or partial anterolateral disc displacement. A statistically significant difference between Eichner's class II and III was found for the tissue-specific diagnoses of myofascitis of the lateral pterygoid muscle, partial anterolateral disc displacement and capsulitis. The results of this study suggest that the incidence and intensity of TMD are higher in subjects with greater tooth loss in the supporting zones, regardless of their sex.

A study of the influence of occlusal factors and parafunctional habits on the prevalence of signs and symptoms of TMD.

PURPOSE: The purpose of this study was to investigate the prevalence of the clinical signs and symptoms of temporomandibular disorders (TMD) and the relationship between occlusal factors, parafunctional habits, and TMD in a young adult nonpatient population. MATERIALS AND METHODS: A questionnaire including data from a history and clinical functional examination was used in the study. All 230 subjects were male recruits, from 19 to 28 years of age (mean 21.3 years). RESULTS: Thirty-eight percent of the subjects reported at least one symptom, while in 45% of the subjects at least one sign of TMD was recorded. Temporomandibular joint clicking (40%) and pain on palpation (34%) were the most commonly recorded signs. Multivariate logistic regression analysis showed several weak but statistically significant correlations between the occlusal factors, parafunctional habits, and TMD in this nonpatient population. TMD signs were thus weakly correlated with malocclusion traits (angle Classes II/1, II/2, III, and cross bite), interferences in retruded contact position, midline discrepancy > or = 2 mm, < or = 10 contacts during maximal biting pressure, nonworking-side interferences, horizontal overlap > or = 5 mm, and parafunctional habits (teeth clenching and teeth grinding). CONCLUSION: Some association between occlusal factors and TMD signs was found. However, this association cannot be considered unique or dominant in defining subjects with TMD in the population.