Interactions between occlusion and human brain function activities.

There are few review articles in the area of human research that focus on the interactions between occlusion and brain function. This systematic review discusses the effect of occlusion on the health of the entire body with a focus on brain function. Available relevant articles in English from 1999 to 2011 were assessed in an online database and as hard copies in libraries. The selected 19 articles were classified into the following five categories: chewing and tongue movements, clenching and grinding, occlusal splints and occlusal interference, prosthetic rehabilitation, and pain and stimulation. The relationships between the brain activity observed in the motor and sensory cortices and movements of the oral and maxillofacial area, such as those produced by gum chewing, tapping and clenching, were investigated. It was found that the sensorimotor cortex was also affected by the placement of the occlusal interference devices, splints and implant prostheses. Brain activity may change depending on the strength of the movements in the oral and maxillofacial area. Therefore, mastication and other movements stimulate the activity in the cerebral cortex and may be helpful in preventing degradation of a brain function. However, these findings must be verified by evidence gathered from more subjects.

Pressure pain threshold of mucosa after tooth extraction under removable denture bases.

This study explored the pressure pain threshold (PPT) of the mucosa after tooth extraction. The PPTs of the wounded mucosa of eight volunteer subjects were observed at 7, 30, and 90 days after tooth extraction. The PPTs at 30 days and 90 days were approximately two and three times higher respectively, than those at 7 days. As time passed, the values for the PPTs after tooth extraction increased in all regions. At 90 days after tooth extraction, the PPTs are about 97% recovered compared to the PPTs of the contralateral points.

Does the presence of antagonist remaining teeth affect implant overdenture success? A systematic review.

Many patients who need implant overdentures are not completely edentulous; they still have antagonist natural teeth or implant fixed prostheses. In such cases, however, little is known about whether existing natural teeth affect the success of implant overdentures positively or act as a complicating factor. This systematic review attempts to clarify the correlation between existing remaining teeth and the survival/success rate of maxillary and mandibular implant overdentures. An assessment of available relevant articles published in English from 1990 to 2009 was performed using an online database and a manual search in libraries. Although the opposing natural dentition was not sufficiently described in the literature, 10 articles about the mandible and 10 articles about the maxilla were selected. As there was no controlled study on the natural teeth opposing implant overdentures, this review could not reach a clear conclusion. The review did reveal a remarkably high success/survival rate for mandibular implant overdentures; maxillary implant overdentures showed a lower rate. The presence of antagonist teeth hardly seems to be a risk factor for success for mandibular implant overdentures. For maxillary implant overdentures, the existence of antagonist teeth might act negatively for implant survival, but they are certainly not a contraindication. Although a few articles stated this relationship, we could not find an apparent correlation between the remaining antagonist teeth and the success of the implant overdentures. A detailed description of the opposing dentate status and results of randomized controlled clinical trials would be required to characterize this evidence-based implant overdenture treatment.

Investigation of trends and characteristics in patients with obstructive sleep apnea.

BACKGROUND: Oral appliance (OA) therapy for obstructive sleep apnea (OSA) has only been part of Japan's National Health care coverage plan since 2004. Subsequently, not enough time has passed to establish the medical trends and characteristics of OSA patients in Japanese Dental Hospitals. AIM: The aim of this study was to investigate the medical trends and the characteristics in patients with OSA who visited our clinic, and to compare our findings with previous studies. SETTING AND DESIGN: Epidemiological survey (retrospective study). MATERIALS AND METHODS: Two hundred and one patients were recruited at the Internal Medicine Division in the Tsurumi University Dental Hospital from February 2006 to December 2008, consecutively. Patients received a medical interview, and a detailed sleep analysis that included a polysomnography (PSG) to verify the exact nature of their condition. The efficacy of OA was assessed in 49 patients who wore an OA and underwent PSG. RESULTS: Of all subjects, 141 patients visited the Prosthodontic Division to receive OA therapy, 38 patients were treated or received a follow up examination in the Internal Medicine Division. The dropout rate was 10.4% in the all subjects, 17.0% in patients who visited the Prosthodontic Division. The male-to-female ratio was 3.3:1, 3.0:1 in patients who visited the Prosthodontic Division. In addition, females had a lower rate of OAS severity than males. In our patients, the major complication was hypertension and cardiac disease. The success rate of OA was 75.5%. CONCLUSION: This approach allowed us to reveal some of the trends and characteristics in our patients.

Present status of titanium removable dentures--a review of the literature.

Although porcelain and zirconium oxide might be used for fixed partial dental prostheses instead of conventional dental metals in the near future, removable partial denture (RPD) frameworks will probably continue to be cast with biocompatible metals. Commercially pure (CP) titanium has appropriate mechanical properties, it is lightweight (low density) compared with conventional dental alloys, and has outstanding biocompatibility that prevents metal allergic reactions. This literature review describes the laboratory conditions needed for fabricating titanium frameworks and the present status of titanium removable prostheses. The use of titanium for the production of cast RPD frameworks has gradually increased. There are no reports about metallic allergy apparently caused by CP titanium dentures. The laboratory drawbacks still remain, such as the lengthy burn-out, inferior castability and machinability, reaction layer formed on the cast surface, difficulty of polishing, and high initial costs. However, the clinical problems, such as discoloration of the titanium surfaces, unpleasant metal taste, decrease of clasp retention, tendency for plaque to adhere to the surface, detachment of the denture base resin, and severe wear of titanium teeth, have gradually been resolved. Titanium RPD frameworks have never been reported to fail catastrophically. Thus, titanium is recommended as protection against metal allergy, particularly for large-sized prostheses such as RPDs or complete dentures.

Effect of implant support on distal extension removable partial dentures: in vitro assessment.

The implants in implant-supported removable partial dentures (RPDs) are placed in the edentulous ridge to stabilize the RPD and minimize the resultant rotational movement. This study investigated the effect of implant placement on RPD stability. A model simulating a mandibular bilateral distal extension missing was fabricated using epoxy resin and silicone impression material as thin (1 mm) and thick (2 mm) soft tissues. Five pressure sensors (PS-10K, Kyowa, Tokyo, Japan) were attached near the left and right first molars (#36 and #46), first premolars (#34 and #44) and medio-lingual alveolar crest. Five bilateral distal extension RPDs with Co-Cr frameworks were conventionally fabricated. After the implants were placed at the bilateral second molar areas, healing caps (4.5 mm high) were connected to the denture base with autopolymerized resin to support the RPD. As in a conventional RPD, sealing screws were placed without connecting them. Loads up to 5 kg were applied, and the pressure and displacement of the RPDs (n = 5) were simultaneously measured and analysed using the Wilcoxen test (alpha = 0.05). There was less pressure on both thin and thick soft tissues, the #36, #46 and the medio-lingual alveolar crest from the implant-supported RPD than from the conventional RPD (P < 0.05). There were no significant differences in pressure on #34 and #44 between the two RPDs (P > 0.05). There was significantly less denture displacement of the implant-supported RPD than of the conventional denture (P < 0.05). Implant support helped prevent the displacement of distal extension RPDs and decreased the pressure on soft tissues.

Evaluation of transitional implant stabilized overdentures: a case series report.

Transitional implants (TI) can immediately improve the stability and retention of existing unstable mandibular complete dentures. This study evaluated the improvement of mandibular complete denture stability and retention with the use of TI. Three TIs were placed in the intraforaminal region of the edentulous mandible of seven patients (three men, four women; mean age 69.7 years). The patients' existing mandibular complete dentures were immediately modified to TI-stabilized overdentures. Their masticatory movements (mandibular movements during mastication) were measured using a commercially available tracking device (BioPACK, Bioresearch, Japan), both before TI placement and about 1 month after delivery of the TI-stabilized overdentures. The mean time of each chewing phase (opening, closing, and occluding) and coefficients of variation were calculated. The patients also completed a questionnaire about the foods they could chew and indicated on a 100 mm Visual Analog Scale (VAS) their personal levels of comfort, ease of chewing, speech, and stability. For masticatory movements, there were no significant differences (P > 0.05) between the TI-stabilized overdentures and existing complete dentures. However, the number of foods that could be chewed increased, and the stability and comfort were reported as improved with the TI-stabilized overdentures. Using TIs, the stability and comfort of the existing mandibular complete dentures studied in this report could be immediately improved.

Clinical marginal and internal gaps of In-Ceram crowns fabricated using the GN-I system.

The marginal and internal gaps of ceramic crowns with alumina copings fabricated using a computer-aided design, computer-aided manufacturing system, were evaluated in vivo using silicone materials. Black and white silicone materials were used to record the marginal and internal gaps of 82 In-Ceram crowns before final cementation. The silicone materials were sectioned bucco-lingually and mesio-distally and viewed under a microscope to measure the thickness of the white silicone layer. Sixteen reference points were measured on each specimen. The mean marginal gaps were compared among the anterior, premolar and molar teeth, and the mean gaps at the reference points within the groups were compared by analysis of variance and the Dunnett T3 test. The mean marginal gap was 66.8 mum. There were no differences in marginal gaps among the three groups. In all the groups, the marginal gaps were the smallest, whereas the occlusal gaps were the largest. The mean marginal gaps of the In-Ceram crowns with the alumina copings fabricated using the GN-I system were within the range of clinically acceptable values.

Clinical marginal and internal gaps of Procera AllCeram crowns.

This study evaluated the marginal and internal gaps of Procera AllCeram crowns in vivo using silicone materials. Ninety Procera AllCeram crowns were evaluated before final cementation. White and black silicone materials were used to record the marginal and internal fit; then the crowns were sectioned bucco-lingually and mesio-distally to measure the thickness of the silicone layer using a microscope. Sixteen reference points were measured on each specimen. Mean marginal gaps among anterior, premolar and molar teeth, and mean gaps at the reference points within the groups were compared by analysis of variance and Dunnett T3 test. The mean values at the margins were the smallest in all tooth groups, whereas those at the rounded slope of the chamfer were the largest. There were significant differences (P < 0.001) in the mean gaps at the four reference points (margin, rounded slope of the chamfer, axial wall and occlusal surface) in each group, except for the molar teeth. The mean marginal gaps of the Procera AllCeram crowns were within the range of clinical acceptance.

Wear resistance of experimental Ti-Cu alloys.

After using cast titanium prostheses in clinical dental practice, severe wear of titanium teeth has been observed. This in vitro study evaluated the wear behavior of teeth made with several cast titanium alloys containing copper (CP Ti+3.0 wt% Cu; CP Ti+5.0 wt% Cu; Ti-6Al-4V +1.0 wt% Cu; Ti-6Al-4V+4.0 wt% Cu) and compared the results with those for commercially pure (CP) titanium, Ti-6Al-4V, and gold alloy. Wear testing was performed by repeatedly grinding upper and lower teeth under flowing water in an experimental testing apparatus. Wear resistance was assessed as volume loss (mm(3)) at 5kgf (grinding force) after 50,000 strokes. Greater wear was found for the six types of titanium than for the gold alloy. The wear resistance of the experimental CP Ti+Cu and Ti-6Al-4V+Cu alloys was better than that of CP titanium and Ti-6Al-4V, respectively. Although the gold alloy had the best wear property, the 4% Cu in Ti-6Al-4V alloy exhibited the best results among the titanium metals. Alloying with copper, which introduced the alpha Ti/Ti(2)Cu eutectoid, seemed to improve the wear resistance.

Machinability of cast commercial titanium alloys.

This study investigated the machinability of cast orthopedic titanium (metastable beta) alloys for possible application to dentistry and compared the results with those of cast CP Ti, Ti-6Al-4V, and Ti-6Al-7Nb, which are currently used in dentistry. Machinability was determined as the amount of metal removed with the use of an electric handpiece and a SiC abrasive wheel turning at four different rotational wheel speeds. The ratios of the amount of metal removed and the wheel volume loss (machining ratio) were also evaluated. Based on these two criteria, the two alpha + beta alloys tested generally exhibited better results for most of the wheel speeds compared to all the other metals tested. The machinability of the three beta alloys employed was similar or worse, depending on the speed of the wheel, compared to CP Ti.

Modulatory effects of static magnetic fields on blood pressure in rabbits.

Acute effects of locally applied static magnetic fields (SMF) on pharmacologically altered blood pressure (BP) in a central artery of the ear lobe of a conscious rabbit were evaluated. Hypotensive and vasodilator actions were induced by a Ca(2+) channel blocker, nicardipine (NIC). Hypertensive and vasoconstrictive actions were induced by a nitric oxide synthase (NOS) inhibitor, N(omega)-nitro-L-arginine methyl ester (L-NAME). The hemodynamic changes in the artery exposed to SMF were measured continuously and analyzed by penetrating microphotoelectric plethysmography (MPPG). Concurrently, BP changes in a central artery contralateral to that of the exposed ear lobe were monitored. SMF intensity was 1 mT and the duration of exposure was 30 min. A total of 180 experimental trials were carried out in 34 healthy adult male rabbits weighing 2.6-3.8 kg. Six experimental procedures were chosen at random: (1) sham exposure without pharmacological treatment; (2) SMF exposure alone; (3) decreased BP induced by a single intravenous (iv) bolus injection of NIC (100 microM/kg) without SMF exposure; (4) decreased BP induced by injection of NIC with SMF exposure; (5) increased BP induced by a constant iv infusion of L-NAME (10 mM/kg/h) without SMF exposure; (6) increased BP induced by infusion of L-NAME with SMF exposure. The results demonstrated that SMF significantly reduced the vasodilatation with enhanced vasomotion and antagonized the reduction of BP via NIC-blocked Ca(2+) channels in vascular smooth muscle cells. In addition, SMF significantly attenuated the vasoconstriction and suppressed the elevation of BP via NOS inhibition in vascular endothelial cells and/or central nervous system neurons. These results suggest that these modulatory effects of SMF on BP might, in part, involve a feedback control system for alteration in NOS activity in conjunction with modulation of Ca(2+) dynamics.

Comparative study of maxillary complete dentures constructed of metal base and metal structure framework.

A removable denture designed using a three-dimensional cast metal framework (hereafter referred to as the 'structurally designed' denture) could extend denture longevity because it is unbreakable and easy to adjust. The aim of the present clinical study was to compare two types of maxillary removable dentures: conventional dentures and structurally designed denture. One edentulous and five partially dentate patients were fitted with two maxillary dentures made from the same impression and same occlusal relationship. About 20 days after delivery of the denture, masticatory analysis was conducted chewing phase (open, closed, and occluded); coefficients of variation and average variation were calculated. Denture vibration during tapping was then measured using an accelerometer. The patients were also interviewed about comfort, ease of chewing, speech, stability, aesthetics and preference for regular use. For both masticatory movements and denture vibration, there were no significant differences (P>0.1) between the conventional denture and the structural design denture. In evaluating the dentures according to each criteria, the significant superiority of one denture over the other could not be determined. However, all patients subjectively preferred the structurally designed dentures for regular use. According to these findings, structurally designed dentures do not appear to have any particular physiological problems as compared with the conventional dentures.

Acute effects of whole-body exposure to static magnetic fields and 50-Hz electromagnetic fields on muscle microcirculation in anesthetized mice.

Acute microhemodynamic effects of static and alternating magnetic fields at a threshold level were investigated on modulating the muscle capillary mirocirculation in pentobarbital-anesthetized mice. The skin in a tibialis anterior was circularly removed with 1.5 mm diameter for intravital-microscopic recording of the capillary blood velocity in the tibialis anterior muscle. Fluorescein isothiocyanate (FITC)-labeled dextran (MW 150 kDa) was used for an in vivo fluorescent plasma marker of the muscle capillaries. Following a bolus injection of FITC-dextran solution into the caudal vein, the peak blood velocity in the muscle capillaries was measured prior to, during, and following exposure to static magnetic fields (SMF) or 50-Hz electromagnetic fields (EMF) using a fluorescence epi-illumination system. The whole body of experimental animals, placed on the observing stage of a fluorescence microscope, was exposed to SMF (0.3, 1 and 10 mT) or 50-Hz EMF (0.3 and 1 mT) for 10 min using a specially devised electromagnet. For sham exposure, the electromagnet was not energized. During exposure and post-exposure to SMF of 10 mT, the peak blood velocity significantly increased as compared to sham exposure. After the withdrawal of SMF and 50-Hz EMF of 1 mT, significant similar effects on the blood velocity were present or enhanced. These findings suggest that field intensity of 1 mT might be considered as a threshold level for enhancing muscle microcirculation under pentobarbital-induced hypnosis.

Neutral zone approach for denture fabrication for a partial glossectomy patient: a clinical report.

According to the neutral zone concept, an appropriate denture form can be molded into a physiologic tooth arrangement by using a narrow rim bar occlusion, tissue conditioner, and a direct relining technique for both intaglio and cameo surfaces by using VLC reline resin. Denture stability can be obtained with this "border molding" technique, not only for edentulous patients but also for those with oral deformities.

Cutting efficiency of air-turbine burs on cast titanium and dental casting alloys.

OBJECTIVE: The purpose of this study was to investigate the cutting efficiency of air-turbine burs on cast free-machining titanium alloy (DT2F) and to compare the results with those for cast commercially pure (CP) Ti, Ti-6Al-4V alloy, and dental casting alloys. METHODS: The cast metal (DT2F, CP Ti, Ti-6Al-4V, Type IV gold alloy and Co-Cr alloy) specimens were cut with air-turbine burs (carbide burs and diamond points) at air pressures of 138 or 207 kPa and a cutting force of 0.784 N. The cutting efficiency of each bur was evaluated as volume loss calculated from the weight loss cut for 5 s and the density of each metal. The bulk microhardness was measured to correlate the machinability and the hardness of each metal. RESULTS: The amounts of DT2F cut with the carbide burs were significantly (p < 0.05) greater than for the other titanium specimens at either 138 or 207 kPa. The diamond points exhibited similar machining efficiency among all metals except for Type IV gold alloy. The increase in the volume loss of Co-Cr alloy (Vitallium) cut with the diamond points showed a negative value (-29%) with an increase in air pressure from 138 to 207 kPa. There was a negative correlation between the amounts of metal removed (volume loss) and the hardness (r2 = 0.689) when the carbide burs were used. SIGNIFICANCE: The results of this study indicated that a free-machining titanium alloy (DT2F) exhibited better machinability compared to CP Ti and Ti-6Al-4V alloy when using carbide fissure burs. When machining cast CP Ti and its alloys, carbide fissure burs possessed a greater machining efficiency than the diamond points and are recommended for titanium dental prostheses.

The machinability of cast titanium and Ti-6Al-4V.

This study investigated the machinability (ease of metal removal) of commercially pure (CP) titanium and Ti-6Al-4V alloy. Both CP Ti and Ti-6Al-4V were cast into magnesia molds. Two types of specimens (with alpha-case and without alpha-case) were made for CP Ti and Ti-6Al-4V. Machinability (n = 5) was evaluated as volume loss (mm3) by cutting/grinding the 3.0 mm surface using fissure burs and silicon carbide (SiC) under two machining conditions: (1) two machining forces (100 or 300 gf) at two rotational speeds (15000 or 30000 rpm) for 1 min, and (2) constant machining force of 100 gf and rotational speed of 15000 rpm for 1, 2, 5, 10, and 30 min. As controls, conventionally cast Co-Cr and Type IV gold alloys were evaluated in the same manner as the titanium. When fissure burs were used, there was a significant difference in the machinability between CP titanium with alpha-case and without alpha-case. On the other hand, there was no appreciable difference in the amount of metal removed for each tested metal when using the SiC points.

Shear bond strengths of polymethyl methacrylate to cast titanium and cobalt-chromium frameworks using five metal primers.

STATEMENT OF PROBLEM: Poor chemical bonding of a denture base resin to cast titanium frameworks often introduces adhesive failure and increases microleakage. PURPOSE: This study examined the shear bond strengths of a denture base resin to cast pure titanium, Ti-6Al-4V, and a cobalt-chromium alloy using various adhesive primers. MATERIAL AND METHODS: Disks (6.0 mm diameter, 2.5 mm thick) were cast of the 3 alloys. The disk surfaces were grit-blasted with 50 microm alumina and treated with 5 different metal primers (Metal Primer II ¿MP]; Cesead Opaque primer ¿OP]; Meta Base ¿MB]; experimental primer ¿EP]; Siloc bonding system ¿SI]). A denture base resin (Palapress Vario) was then applied on the disks with hole-punched sticky tape (bonding area of 5.0 mm) and a Teflon (PTFE, New Age Industries Inc, Willow Grove, Pa.) ring (6.0 mm diameter x 2.0 mm thick). Specimens without primer were also prepared as controls. All specimens were immersed in 37 degrees C water and thermocycled up to 2,000 cycles. Shear bond strength values were determined at a crosshead speed of 0.5 mm/min. Data were statistically analyzed using 3-way ANOVA, followed by 1-way ANOVA and the Scheffé multiple range test. RESULTS: Primers significantly (P <.05) improved shear bond strengths of denture base resin to all metals, among which no significant differences were found. Specimens primed with OP, MP, and EP showed higher bond strengths than did those primed with MB. After thermocycling, the bond strengths of MB and SI decreased substantially; MB showed the least durability (22.8% to 35.5% decrease) among the primers. CONCLUSION: The application of 5 primers significantly improved the shear bond strengths of a denture base resin to cast CP titanium, Ti-6Al-4V, and Co-Cr alloy. OP and MP primers exhibited greater bond strength and durability than did MB and SI.

Anti-pressor effect of a Chinese-Japanese herbal medicine, saiko-ka-ryukotsu-borei-to on hemodynamics in rabbits.

Saiko-ka-ryukotsu-borei-to (TJ-12) is a traditional Chinese-Japanese medicinal mixture clinically used for the treatment of hypertension and/or atherosclerosis concurrent with neurotic disorders. Study on the effect of TJ-12 on the vasoconstriction of cutaneous arterioles induced by nor-adrenaline (NA) was carried out using a rabbit ear chamber (REC) under conscious conditions. Before and after oral administration of TJ-12 everyday for 2 weeks, the same position of an arteriole within a REC was analyzed using an image shearing monitor every minute up to 15 min after varying doses (0.3, 1.0, 3.0 and 10.0 micrograms/kg i.v.) of NA. The changes of mean arteriolar diameter and vasomotion amplitude, before and after feeding of TJ-12 (1% w/w) supplemented diet were compared in the same position. Consequently, the pretreatment with TJ-12 significantly attenuated the changes of mean diameter of NA-induced vasoconstriction and also shortened its duration. In addition, concurrent with its cutaneous microcirculatory response, the pretreatment with TJ-12 systemically suppressed the increase of blood pressure under NA-induced vasoconstriction. These results suggest that the anti-pressor effect of TJ-12 might be apparently attributable to the inhibition of NA-induced vasoconstriction.

Effect of weight change of mandibular complete dentures on chewing and stability: A pilot study.

STATEMENT OF PROBLEM: Little is known as to whether denture weight contributes to the retention and stability of mandibular complete denture. PURPOSE: This study compared the jaw movements and denture retention, stability, and comfort of heavy and light weight mandibular complete dentures. MATERIAL AND METHODS: Mandibular complete dentures of 12 subjects were duplicated using an autopolymerized polymethyl methacrylate (PMMA) resin. The heavy weight denture was set with weights (20 or 60 g) and the lightweight denture was packed with wax instead of weights. Masticatory movements (3 times each) and denture stability (5 times each) were measured. The subjects expressed their denture preference for comfort and chewing. Results were analyzed using ANOVA and Wilcoxon tests at significance level of alpha=.10. RESULTS: Masticatory movements and denture retention were not significantly (P >.10) affected by increasing the weight. Five subjects preferred the heavy denture and 4 subjects preferred light denture for comfort; 3 subjects had no preference. CONCLUSION: The weight of a well-fitting mandibular complete denture did not affect jaw movements, denture stability, or patient preference.