Impact of sound production by wind instruments on the temporomandibular system of male instrumentalists.

BACKGROUND: Playing a wind instrument can be either a reason for overuse or a protecting factor against certain diseases. Some individuals have many findings but low morbidity while others have few findings but high morbidity. This contradictory phenomenon should be researched. OBJECTIVE: The temporomandibular system (TMS) is a functional unit which comprises the mandible, associated muscles and bilateral joints with the temporal bone. The TMS is responsible for the generation of sound when wind instruments are played. Over the long-term and with intensive usage, this causes changes in the musculature and in the temporomandibular joint (TMJ) of wind musicians, often resulting in temporomandibular disorders (TMD). The aim of this study is to examine evidence that TMD constitute an occupational disease in wind musicians. PARTICIPANTS: TMD patients and wind musicians were examined by dental clinical functional analysis. 102 male subjects were divided into three groups: "healthy" individuals, wind musicians, and patients with TMD. METHODS: Dental Examination was carried out based on focused inclusion of the research diagnostic criteria - TMD [1,7]. Findings were evaluated for statistical significance by first transferring data into a digital database [2,15], then generating T-Test und Wilcoxon-Test when non-Gaussian distribution appears and applying the Mann-Whitney rank sum test using Sigmaplot Version 1.1 software (Systat Software Inc, Washington, USA). RESULTS: The evaluation revealed that wind instrument musicians show a high incidence of developing TMD as the researchers found almost 100% morbidity regarding parafunctional habits and preauricular muscle pain of each adult and highly active musician. The result is highly significant (p< 0.001) for protrusion distance of the mandible. CONCLUSIONS: A higher prevalence of functional disorders of the musculoskeletal system has previously been demonstrated in wind musicians. New research results and the typical functions of various wind instruments provide evidence that playing a wind instrument generates occupational risks to the TMS.

Refinement of the GINGF3 locus for hereditary gingival fibromatosis.

Hereditary gingival fibromatosis (HGF) is a rare, clinically variable disorder characterized by slowly progressive fibrous overgrowth of the gingiva. Four gene loci have been mapped for autosomal dominant non-syndromic HGF (adHGF). The molecular basis of adHGF remains largely unknown, with only a single SOS1 gene mutation identified so far at the gingival fibromatosis 1 (GINGF1) locus in one family. We identified an adHGF family with ten affected individuals in whom onset of gingival fibromatosis concurred with the eruption of the primary teeth. In order to identify the molecular basis in this family, we tested for linkage of the disease to known adHGF loci. A maximal multipoint logarithm of the odds score of 3.91 was obtained with marker D2S390 (theta = 0) at the GINGF3 locus on chromosome 2p23.3-p22.3, and linkage to other known loci was excluded. Sequencing two candidate genes, ALK and C2orf18, and a single nucleotide polymorphisms array analysis did not reveal a mutation or copy number variation in a patient from the family. We refined the GINGF3 locus to a 6.56-cM, 8.27-Mb region containing 112 known and hypothetical genes, and our data and a search of the literature suggest that GINGF3 is a major adHGF locus.

A prosthodontic technique to improve the simplicity and the efficacy of angled abutments for divergent implant situations: a technical note.

Esthetic demands and nonparallel situations between the axial direction of the suprastructure and the implant require angulation of the abutment. The Conical Seal design avoids microleakage and micromovements after the abutment has been seated and finally retained via screw. However, there is no protection against rotation during the fixation procedure. Therefore, a control device and/or method for a reproduction of correct seating during each treatment step of permanent prosthesis fabrication is desirable. The purpose of this investigation was to develop a device to ensure the correct seating by less expensive, safer, easier, and more precise methods. The sequence of components and the standard procedure required modification: in the modified procedure, the impression is made at the implant level, and the straight implant replica is embedded in the laboratory cast. The angled abutment needs modification by grinding to create small margins in the mesial, distal, and palatal walls. Three materials that are used in daily dental practice are combined to fabricate an individual transfer device. Direct waxup of the restoration onto the angled abutment without a prefabricated component shortens the laboratory processing. The modified sequence and procedure, small alterations of the angled abutment, and an individual transfer device can simplify the transfer procedures, improve clinical performance and applicability, and shorten chair time.