Retrospective analysis of trauma incidence in patients with temporomandibular disorders.

BACKGROUND/AIM: The relationships between direct trauma, whiplash injuries, and temporomandibular disorders (TMD) have not been well established. The aim of this study was to evaluate the percentage of direct and/or whiplash trauma in patients with TMDs. MATERIAL AND METHODS: The clinical records of 237 patients with temporomandibular disorders who had sought treatment at the Orofacial Pain Clinic were reviewed. Clinical data for age and gender of the patients, history of trauma, temporomandibular joint (TMJ) sounds, and TMD diagnosis were extracted from the medical records of all included patients. The presence of TMJ sounds and TMD diagnosis had been determined based on the Research Diagnostic Criteria for TMDs. RESULTS: The mean age of patients with osteoarthritis was significantly higher than that of patients with disk displacement with reduction (P = .001, P Ë‚ .05). There was no statistically significant gender-based difference in diagnosis, clicking, crepitus, and trauma frequency (P > .05). A history of direct and whiplash trauma was observed in 18.6% and 14.8% of patients, respectively. Statistical analysis for the relationship between clicking and crepitus, and trauma showed no significant correlation (P > .05). CONCLUSION: Direct and/or whiplash trauma in patients with temporomandibular disorders were not associated with the diagnostic records and temporomandibular joint sounds.

Investigation of the effect of different prefabricated intracanal posts on fracture resistance of simulated immature teeth.

AIM: The aim of this study was to assess fracture resistances of simulated immature single-rooted teeth whose roots have been backfilled using 3 different post systems after a 4 mm apical mineral trioxide aggregate (MTA) placement. MATERIALS AND METHODS: Forty-eight maxillary anterior teeth were assigned into four groups. The lengths of each root were standardized by cutting off the coronal and apical portions to obtain 13 ± 1 mm samples and root canals were enlarged. The #6 Peeso reamers were allowed to protrude 1 mm beyond apex to simulate immature teeth. Apical 4 mm of each tooth was filled using MTA. The remaining portions were treated as follows: Group 1 (Control): AH Plus + Gutta-percha cold lateral compaction. Group 2: Glass fiber posts (FRC Postec Plus post) cemented using self-adhesive resin cement. Group 3: Quartz fiber posts (D.T. Light post) cemented using self-adhesive resin cement. Group 4: Zirconia posts (Cosmopost) were placed using self-adhesive resin cement. Specimens were embedded in self-curing acrylic. A compressive load was applied lingually at a crosshead speed of 1 mm/min at an angle of 45º until fracture in a universal testing machine. RESULTS: The mean fracture resistances were 823.17 ± 188.80, 1155.50 ± 190.37, 1208.00 ± 254.32, and 1153.25 ± 195.71 Newtons for Groups 1, 2, 3, and 4, respectively. All experimental groups had significantly higher fracture resistance compared with the control group (P < 0.01). No statistically significant difference was noted between the experimental groups (P > 0.05). CONCLUSIONS: All post systems exerted a similar reinforcing effect to a simulated immature tooth and may be preferred specifically in situations which require additional reinforcement.

Evaluation of reasons for extraction of crowned teeth: a prospective study at a university clinic.

OBJECTIVE: The aim of this study was to determine and classify the major reasons for extraction of teeth with full crowns belonging to patients admitted to a university clinic within a specific time frame. METHODS: Two hundred and eight extracted teeth with full crown belonging to 75 patients were included. Apart from demographic information, reasons for presenting to the hospital, the major reason for extraction, the type of the crown (single crown, bridge abutment, abutment for removable prosthesis), presence of posts, age of restorations, presence of an endodontic treatment and quality were recorded. Comparable data were statistically analyzed using the chi-square test. RESULTS: Forty-three (57.3%) of the patients were females, whereas 32 (42.7%) were males with an average age of 63.21 ± 13.56. A statistically significant relationship was determined between age groups and rate of extractions, with the lowest extractions detected in the 35-44 years age group and the highest in the 55-64 years age group (p = 0.001). Tooth mobility was the predominant reason for patients' initial presentation (52.9%). The most encountered reason for extraction was periodontal reasons with a prevalence of 59.1%, followed by caries (26.9%) and periapical lesions (12%); 35.6% of extracted teeth had endodontic treatment. Sixty teeth (81.1%) had incomplete root fillings. There was a significant relationship between extractions and incomplete root fillings (p = 0.001). CONCLUSION: Studies comprising other faculty clinics as well as general practices will be complementary in making more generalized statements regarding the etiology of extractions of crowned teeth.

Impact strength of denture polymethyl methacrylate reinforced with different forms of E-glass fibers.

OBJECTIVE: The purpose of this in vitro study was to determine the reinforcing effect of different forms and concentrations of E-glass fibers on impact strength of denture polymethyl methacrylate. MATERIALS AND METHOD: A total of 91 rectangular specimens (84 specimens for test groups and seven for control group) of a heat-cured acrylic resin were fabricated. The test specimens were prepared by modifying the polymethyl methacrylate with the addition of different concentrations (2.5%, 3%, 4%, 5% by volume) of three types (chopped strand mat, woven and continuous unidirectional fibers) of E-glass fibers. The impact strength was evaluated using the Charpy method. RESULTS: While the 5% continuous glass fiber added test group showed the highest mean impact strength, the lowest value belonged to the 2.5% woven glass fiber containing group. When the impact strength values of chopped strand mat and continuous unidirectional glass fiber added groups at all concentrations were compared with the control group, the differences were statistically significant. The impact strength values of the woven glass fiber added groups at all concentrations were higher than that of the control group. However, the difference was non-significant. CONCLUSION: The impact strength of PMMA was enhanced by including E-glass fibers, increasing parallel with the fiber concentration.

Alternative restorative approach for treatment of patient with extremely worn dentition.

Changes in tooth structure, missing teeth and decreased vertical dimension of occlusion severely deteriorate the stomatognathic system. This case report describes the treatment of a patient with loss of vertical dimension due to severe wear of maxillary and mandibular teeth. An occlusal splint was used to create an optimum maxillomandibular relationship and to provide restorative space prior to restoration of the remaining teeth. The restoration was accomplished with a hybrid composite material. This treatment has been a less-expensive alternative to full-mouth, fixed porcelain/metal-porcelain restoration while conserving the remaining tooth tissue.

Color stability of different denture teeth materials against various staining agents.

The purpose of this in vitro study was to evaluate the color stability of two brands of porcelain teeth and three brands of acrylic denture teeth. Samples were immersed into three staining drinks as test groups and distilled water as a control. Color measurements of teeth were performed by using a spectrophotometer. Before immersion, the initial color value of each tooth was recorded. Color change values were determined after 1 day, 1 week, 2 weeks, and 4 weeks of immersion. Color differences were characterized using the CIE L*a*b* color space. The color stability of all teeth was significantly affected by the immersion period (p<0.0001). Instant coffee was found to be the most chromogenic agent among the solutions tested (p<0.0001). Among the materials tested, porcelain was found to be more resistant to discoloration. It was concluded that acrylic teeth showed a higher degree of color change and that the amount of color change for each group increased proportionally with time.

Evaluation of the effect of different ferrule designs on the fracture resistance of endodontically treated maxillary central incisors incorporating fiber posts, composite cores and crown restorations.

AIM: The purpose of this study was to evaluate the fracture resistance of endodontically treated maxillary central incisors restored with quartz fiber posts, composite cores, and crowns when different types of ferrule designs were incorporated. METHODS AND MATERIALS: Sixty maxillary incisors were divided into six groups: Group 1 (control): teeth with root canal treatments having a full crown prosthesis; Group 2: teeth with a 2 mm circumferential ferrule; Group 3: teeth with a 2 mm ferrule only in the vestibular region; Group 4: teeth with a 2 mm ferrule only in the palatal region; Group 5: teeth with a 2 mm ferrule in the vestibular and palatal region, having cavities in both proximal areas; and Group 6: teeth with no ferrule. The teeth in the experimental groups were restored with quartz fiber posts-composite cores and full metallic crowns. All experimental teeth were subjected to an increasing compressive force with a crosshead speed of 1 mm/min, until fracture occurred. RESULTS: The median fracture values of groups were as follows: Group 1: 574.4 N, Group 2: 472.4 N, Group 3: 474.3 N, Group 4: 480.7 N, Group 5: 463.1 N, and Group 6: 297.9 N. A statistically significant difference was found between Group 1 and Group 6 (p< 0.01). CONCLUSION: It was concluded different ferrule designs did not have any influence on the fracture resistance of teeth with fiber posts. The results of this study indicate fiber posts can safely be used for their reinforcing properties. Furthermore, there is no significant change in the resistance of teeth with fiber posts regardless of which ferrule design is incorporated. The property of these types of posts is an additional advantage in clinical practice.

Fabricating sectional-collapsible complete dentures for an edentulous patient with microstomia induced by scleroderma.

Patients with microstomia who have to wear removable dental prostheses often face the difficulty of being unable to insert or remove the prosthesis because of the constricted opening of the oral cavity. This clinical report describes in detail the prosthodontic management of an edentulous patient with microstomia induced by scleroderma. Sectional-collapsible maxillary and sectional mandibular complete dentures were fabricated by means of sectional trays. With the use of palatal midline hinge and stud attachments, the sectional dentures were successfully and easily inserted and removed.

Effect of mica and glass on acrylic teeth material's color.

The purpose of this study was to evaluate the effect of two different ratios of silanized mica filler and milled glass fiber reinforcement on the color of acrylic denture teeth materials. Ten acrylic resin discs made of acrylic denture teeth material (PMMA) obtained from the manufacturer were used as the control group. Four experimental groups were modified from the control group's PMMA material by adding a ratio of 5% or 10% by weight of silane-treated mica filler or milled glass fibers. Each group consisted of 10 specimens. Measurements were performed using a spectrophotometer CM-2600d, and the color changes were characterized in the Commission Internationale d'Eclairage L*a*b* color space. deltaE* values of 5% mica-, 10% mica-, 5% glass-, and 10% glass-containing sample groups were 2.46, 3.03, 2.16, and 2.59 respectively. There were statistically significant differences in L*, a*, and b* values between the control group and each test group. It was shown that when PMMA denture teeth material was modified with silane-treated mica filler or silane-treated milled glass fibers for the purpose of reinforcement, it would also cause significant changes to the original color of the material.

Investigation of the cleanliness of dentures in a university hospital.

PURPOSE: The purpose of this study was to determine denture cleanliness of a population sample, as well as to investigate denture cleaning habits and attitudes. MATERIALS AND METHODS: Two hundred thirty-four denture-wearing patients were surveyed via a questionnaire to identify types and frequency of use of denture cleaning methods. Patients were also clinically examined to determine denture cleanliness. Dentures were classified as clean, dirty, or extremely dirty based on the level of debris and stain present. The oral mucosa was also examined and rated. RESULTS: The most common regimen employed was brushing with toothpaste (40.59% of patients), while only 1 patient reported soaking the denture in mouthwash. Results showed that 38.9% of patients were not satisfied with their cleansing methods, and 82.9% of patients claimed their dentists did not inform them how to clean their dentures. Only 11.9% of patients had clean dentures. Older dentures tended to be dirtier than newer ones (P = .0001) and had a higher incidence rate of accompanying denture stomatitis (P= .0001). CONCLUSION: In this population sample, most denture wearers did not clean their dentures satisfactorily.