Identification of psychological comorbidity in TMD-patients.

OBJECTIVES: The aim of the current study was to access the prevalence of depression among patients with Temporomandibular Joint Disorder (TMD) compared to patients with no current TMD. METHOD: Patients (92) and controls (90) answered questionnaires on subjective pain, severity of chronic pain, jaw disability, emotional well-being and depression, and a clinical examination was performed. RESULTS: Temporomandibular Joint Disorder patients reported higher disability of jaw function, compared to controls (p<0.001). The myoarthopathy subgroup (67.4%) had slightly more jaw disability than the myopathy subgroup (p>0.05). While 51% of TMD patients reported poor emotional well-being, only 7.8% of controls were affected (p<0.001). Clinical symptoms of depression were reported by 16% of TMD patients and not in the controls (p<0.001). Among TMD patients, a higher prevalence of depression was observed in the myopathy subgroup. DISCUSSION: A regular screening for psychological problems, using standardized questionnaires, should be integrated in clinical examination of TMD patients.

Establishment of prevention: what do dentists in northern Germany suggest?

OBJECTIVE: Dentists' suggestions for the establishment of preventive care were investigated on 3 levels; dentist, dental associations and unions (DAU), and health care system (HCS). Associations between categories of suggestions and dentists' characteristics were explored. METHODS: A postal survey was sent to 2,075 dentists practicing in Bremen and Lower Saxony. The answers on 3 open-ended questions were analysed in a qualitative manner based on the quality control protocol (QCP) of the Federal Joint Committee. Quantitative methods were used for exploring associations between categories of suggestions and gender as well as age. RESULTS: Response rate was 33% (n=685). Dentists made 2,120 suggestions (dentist=752, DAU= 574, HCS= 794). The majority of dentists (90%) suggested educating and motivating patients. Dentists stated that support from DAU is needed in educating the public (50%), offering preventive-oriented training (35%), and in advertising for prophylaxis (18%). On the HCS level, about 60% of the suggestions concerned remunerating prophylaxis and expanding the existing bonus system. Significantly more female (p=0.010) and younger dentists (p=0.031) contributed to educating patients than male and older dentists. CONCLUSION: Education is the key message of this work. Essential topics such as prevention for elderly and risk groups were not a focal point. Education on the DAU and HCS levels can be realised through organising nation-wide health campaigns. Funding options for prevention and regulating multidisciplinary work between dentists and other health-care providers should be examined. These changes can contribute enormously to further establish prevention.

Embedded ferroelectric nanostructure arrays.

Ferroelectrics hold promise for high-density non-volatile data storage device use. Their eventual performance will strongly depend on the available displacement current, which primarily scales with the area but might to some extent be enhanced by substrate-induced homogeneous strain while the interface at the same time controls the coercive field. As the lateral dimensions persistently decrease, the only way to keep track of the real figures of merit with realistic electrodes is to use a macroscopic configuration instead of scanning probe approaches with undefined interfaces. We report on a novel approach to integrating arbitrarily patterned, highly registered ferroelectric nanoislands fabricated by a template controlled chemical solution deposition approach into a matrix of a low-k dielectric spin-on glass. These structures with a narrow lateral size distribution below 100 nm are subsequently polished in a chemical-mechanical polishing step to expose their very tops, whose piezoelectrically active area depends on the polishing time. At this stage our findings indicate a full piezoelectric functionality of the locally exposed nanoislands. The structures are ready for macroscopic top electrodes to average the displacement current over hundreds of almost identical structures, to provide a nanoscale scaling behaviour of the individual ferroelectric capacitors.

Registered Deposition of Nanoscale Ferroelectric Grains by Template-Controlled Growth.

Regular patterns of ferroelectric PbTiO3 nanostructures with lateral dimensions down to 30-60 nm have been grown onto platinized Si substrates by chemical solution deposition. The high registration of the grains is achieved by "top-down"-generated templates of TiO2 dots as seeds for their deposition. Ferroelectricity was verified by piezoresponse force microscopy.

Chemistry in Interphases-A New Approach to Organometallic Syntheses and Catalysis.

Combining the advantages of homogeneous and heterogeneous catalysis is still a problem that has not been satisfactorily solved. Chemistry in interphases offers a new approach for overcoming the difficulties, as is described in this article. Owing to the swellable or porous matrix, an interphase represents a state which in the most favorable case is similar to that of a solution. Moreover the proper choice of a mobile hybrid copolymer enables the control of the density and accessibility of the reactive centers, which results in a distinct improvement of the activity of the catalysts (two examples are shown schematically).

Speech, deglutition and life quality after intraoral tumour resection. A prospective study.

The aim of the present prospective study was to evaluate the functional sequelae and postoperative development of quality of life after intraoral tumour surgery in 40 consecutive patients with a squamous cell carcinoma of the floor of the mouth. Immediate reconstruction of intraoral soft tissues after tumour resection was accomplished by local flaps (cheek and tongue) (n=27) and by revascularized transfer of small bowel grafts (n=5) and myocutaneous/fasciocutaneous flaps (n=8). Mobility of the tongue was assessed by ultrasound. Quality of speech was analysed using the Freiburg speech intelligibility test. Life quality was assessed by the functional living index-cancer preoperatively and six months postoperatively. A significant decrease in both mobility of the tongue and quality of speech was registered. The most substantial effect on quality of speech resulted from decreased movement of the base and the dorsum of the tongue. A significant increase in life quality at the end of the study period occurred only in the group of patients without substantial reduction of intelligibility of speech, while no significant improvement of postoperative life quality of patients with more severe deterioration of speech quality was found.

Prospective study of the quality of life of cancer patients after intraoral tumor surgery.

PURPOSE: The aim of this prospective study was to determine the quality of life of patients with oral cancer after intraoral ablative surgery. PATIENTS AND METHODS: Eighty-five consecutive patients with squamous cell carcinoma of the floor of the mouth were enrolled in the study. Reconstruction of intraoral soft tissues was accomplished by local tissue (67.8%), jejunal grafts (16.9%), and cutaneous and myocutaneous flaps (15.3%). Soft tissue resections were combined with resections of the alveolar process of the mandible in 35.0% and mandibular discontinuity resections in 31.7% of the cases. A self-administered, standard questionnaire consisting of 22 visual analog scale items with a maximum index value of 154 was used to determine the physical functional status, the psychological status, and social functioning of cancer patients (Functional Living Index--Cancer). The questionnaire was administered preoperatively and 3, 6, and 12 months postoperatively. RESULTS: The Functional Living Index score increased significantly toward the end of the first postoperative year because of an increase in all three factors of the scale. All modes of soft tissue reconstruction achieved nearly equal levels of life quality in patients with median or lateral defects at the end of the observation period. Only patients with large bilateral defects exhibited lower preoperative and postoperative values because of extensive loss of functionally important soft tissue. Patients with discontinuity resections of the mandible took longer to regain the same level of life quality as patients without bone resections. Persistence of dysphagia, reflux of liquids, limitations to liquid food, and sleep disorders had a significant negative effect on the score. CONCLUSIONS: It is concluded that rehabilitation of oral cancer patients is particularly difficult in the case of large soft tissue defects and is not always accomplished completely even with primary microsurgical tissue repair.

[Psychological aspects of post-implant patients]. / Psychologische Aspekte bei Patienten nach Implantatversorgung.

The purpose of this study was to compare the expectations and emotions of patients after dental implant treatment with the clinical peri-implant findings. 96 patients treated with Brånemark implants and fixed-removable dentures in the edentulous lower jaw were interviewed in retrospective regarding their preoperative attitudes and their postoperative assessments and were examined clinically. The data of 73 patients (76%) were evaluated. While the clinical periimplant findings were comparable, the majority of these patients were satisfied with this form of oral rehabilitation. Apart from improved oral function, 90% of these patients reported a decrease in psycho-social problems. 88% of the patients felt more secure and reported a higher self-esteem. In contrast to the previous denture, the implant-anchored fixed complete prostheses were perceived rather as an own "organ" by 88% of the patients. 93% would not hesitate undergoing this procedure again, if necessary.

[Position of health education knowledge concerning pregnancy]. / Stand der Mundgesundheitserziehung während der Schwangerschaft.

In order to determine the level of oral hygiene education during pregnancy, 700 questionnaires from 39 hospitals were evaluated. Of the tested persons, 51% had failed to have any dental examination during their pregnancy, although approximately 65% suffered from bleeding, swelling and inflammation of the gingiva. In total 71% received no information regarding oral hygiene during pregnancy. Oral hygiene education during pregnancy either is not provided or at best inadequately available.

[Effects of different periodontal treatment strategies on patient cooperation]. / Auswirkungen unterschiedlicher Strategien in der PAR-Behandlung auf die Mitarbeit der Patienten.

Two groups of patients with moderate, slowly progressing periodontitis received individually tailored periodontal pretreatment. The experimental group (20 patients) was treated by three dental school assistants according to a plan of behavioral therapy. The control group (30 patients) was treated by students according to the usual procedure of motivation and instruction. Results were documented clinically and by x-rays. The results demonstrate that with both procedures oral hygiene and periodontal status can be improved during periodontal pretreatment. However, after six months the behavioral approach was clearly superior to the traditional methods.