The prevalence of temporomandibular disorders in war veterans with post-traumatic stress disorder.

The purposes of this study were to assess the prevalence of temporomandibular disorders in Croatian war veterans suffering from post-traumatic stress disorder (PTSD) and to analyze the impact of the disease on mandibular function. One hundred eighty-two male subjects participated in the study. The examined group consisted of 94 subjects who had taken part in the war in Croatia and for whom PTSD had previously been diagnosed. Patients were compared with an age- and gender-matched group of subjects who had not taken part in the war and for whom PTSD was excluded by means of a psychiatric examination. The study used a clinical examination and standard questionnaire. Statistically significant differences were found in almost all measured parameters. With regard to restricted movements, overbite, and overjet, the differences obtained did not have clinical significance. The most significant differences were found in the parameters of pain. Headache was experienced by 63.83% of the subjects with PTSD, facial pain by 12.77%, and pain in the region of the jaw by 10.64%. Headache was the most intense pain, with an average intensity of 4.92 on a scale of 0 to 10. Pain on loading, temporomandibular joint clicking, and intrameatal tenderness were more prevalent in the PTSD group than in the healthy control group. The study supports the concept that PTSD patients are at increased risk for the development of temporomandibular disorder symptoms.

Oral health status and temporomandibular disorders in multiple sclerosis patients.

Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system. Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia, sensory neuropathy of the trigeminal nerve and facial palsy. The aim of this study was to determine the oral health status, the frequency of subjective symptoms and temporomandibular disorders (TMD) subtype according to Research diagnostic criteria for temporomandibular disorders (RDC/TMD) among MS patients. Examinees in this study were 50 patients suffering from MS, who were at least once treated during their disease in the Clinic Hospital Center, Rijeka, Clinic for Neurology. All examinees had to meet the diagnostic criteria for clinically and laboratory confirmed MS, according to Poser. The results show the difference in mean DMFT (decayed, missing, filled teeth) between MS and the control group. The number of decayed and missing teeth was higher, but the number of filled teeth was significantly lower in MS group. Eighty-two per cent of the subjects with MS had a least one symptom of dysfunction compared with 24% of the subjects in the healthy control group. In the present study, pain, the pain during mouth opening, the difficulty with mouth opening and temporomandibular joint (TMJ) sounds were more commonly reported in the MS group than in the control group. This study shows a statistically significant excess of dental caries and temporomandibular disorders among MS patients compared with the control group. These results suggest that MS is a possible etiological factor in temporomandibular disorders.

Evaluation of craniometric methods for determination of vertical dimension of occlusion--Part 2.

The study examines the relationships between different craniometric distances and the nasion-gnathion (N-Gn) distance which represents the lower two thirds of the face in vertical dimension determination. The highest degree of correlation (r = 0.9217; p < 0.05) was observed between the N-Gn and zygion-zygion (Zy-Zy) distances. The N-Gn distance could be determined using the formula N-Gn = Zy-Zy/1.15 or by means of regression analysis: N-Gn = 0.54749 + 0.82822 x Zy-Zy. Considering that the coefficient of correlation between N-Gn and Zy-Zy was higher than the one between the eye-ear (E-E) and the subnasale-gnathion (Sn-Gn) distances reported earlier (r = 0.8676) it was concluded that calculating the N-Gn distance from the Zy-Zy distance was more reliable. The fact that none of the calculated correlation coefficients was 1, but was lower than 1, points to the presence of individual variations of the cephalometric parameters. Although the method cannot be taken as absolutely reliable, owing to its simplicity and practical applicability it can be recommended for use in everyday clinical practice in combination with other methods for the determination of the vertical dimension of occlusion.