Clinical value of 12 occlusal features for the prediction of disc displacement with reduction (RDC/TMD Axis I group IIa).

The purpose of this study is to quantify the clinical value of 12 occlusal variables for the prediction of disc displacement with reduction diagnosed according to research diagnostic criteria (RDC)/temporomandibular disorder (TMD). Twelve occlusal features were clinically assessed by the same three operators. The sample consisted of 165 TMD patients (65 males, 100 females; mean age: 32.55 +/-11.685 years) with only disc displacement with reduction (RDC/TMD Axis I group IIa) and a control sample of 145 healthy subjects (65 males, 80 females; mean age:31.24+/-12.436 years) diagnosed with RDC/TMD Axis I group 0. A stepwise multiple logistic regression model was used to identify the significant correlation between occlusal features and disease. The odds ratio for disc displacement was 2.84 for absence of canine guidance, 2.14 for mediotrusive interference and 1.75 for retruded contact position (RCP)/maximum intercuspation (MI) slide >or=2 mm. Other occlusal variables did not reveal to be statistically significant. The percentage of the total log likelihood for disc displacement explained by the significant occlusal factors was acceptable with a Nagelkerke's R(2) = 0.124. The final model including the significant occlusal features revealed an optimal discriminant capacity to predict patients with disc displacement with a sensitivity of 63.6% or with a specificity of 64.8% for healthy subjects and an accuracy of 64.2%. Occlusal features showed a low predictive value for detecting disc displacement. Multifactorial complex pathologies such as TMD should be investigated using a multivariate statistical analysis; moreover,the future of aetiopathogenic research in this matter requires a multifactorial approach.

Anxiety symptoms in clinically diagnosed bruxers.

The present work was an attempt to investigate for the existence of an association between anxiety psychopathology and bruxism. The presence of bruxism was investigated according to validated clinical criteria in 98 subjects, who also filled out a self-report questionnaire (PAS-SR) for the assessment of panic-agoraphobic spectrum. 34.7% (n = 34) of participants were diagnosed as bruxers. The prevalence of anxiety psychopathology was similar between bruxers and non-bruxers, but Mann-Whitney U-test revealed significant differences in total PAS-SR (P = 0.026) score, indicating that subclinical symptoms of the anxiety spectrum might differentiate bruxers from controls. In particular, significant differences emerged in scores of domains evaluating panic (P = 0.039), stress sensitivity (P = 0.006) and reassurance sensitivity symptoms (P = 0.005) of panic-agoraphobic spectrum. Support to the existence of an association between bruxism and certain psychopathological symptoms has been provided.

Urinary cobalt as a measure of exposure in the hard metal industry.

Twenty-six workers in a hard metal manufacturing plant were monitored by cobalt urinary and ambient air measurements during the first month after summer holidays. Cobalt determinations were performed utilizing AAS, with a preliminary chelation and extraction procedure for urinary samples. Almost all personal ambient air samples turned out to be under the cobalt dust TLV of 0.1 mg/m3. When restarting work after the holidays, urinary values did not differ from the control group. At the end of the first working week, urinary cobalt had increased four fold, then decreased to the original values on the following Monday before restarting work. Thereafter, the weekend was no longer sufficient to reduce the levels to normal urinary cobalt values. The values rose to the same level observed before the holidays, and dit not substantially decrease even after the weekend. End-shift urinary cobalt values showed a good relationship with present as well as with mean past exposure on the first and the fifth weekday, but the third day did not. The correlation was better with present exposure on Monday and with mean past exposure on Friday. The observed differences may be explained by the minor influence of recent exposure on present exposure on Monday. The highest values were found on Wednesday. We suggest the utilization of end-shift urinary cobalt determination as a measure of the present exposure on Monday, and of mean recent or preceding exposure on Friday.