Psychosocial profiles and their correlation with physical diagnosis in temporomandibular disorders, a preliminary report.

OBJECTIVE: To assess representative psychosocial features in a group of temporomandibular disorder (TMD) patients from Jordan using Axis II of the Diagnostic Criteria for TMD (DC/TMD) protocol. METHODS: Ninety-eight TMD patients were examined according to Axis I DC/TMD protocol in addition to assessment of their pain-related disability, psychological distress, and stress reactivity. RESULTS: Just under half of the patients (49%) had high intensity of characteristic pain (self-reported TMJ-related pain) and one-third (32%) had high levels of pain-related disability. Furthermore, significant proportions of patients expressed moderate-severe degrees of distress and stress reactivity (41% and 39%, respectively). Significant correlations were identified between the Graded Chronic Pain Scale (GCPS) and each of the pain-related TMD subgroups. CONCLUSION: TMD patients are susceptible to high levels of pain-related psychosocial impairment, and clinicians should be aware of the possible correlations between the physical TMD diagnosis and specific psychosocial features during treatment planning.

Stress analysis of endodontically treated teeth restored with post-retained crowns: A finite element analysis study.

BACKGROUND: The authors conducted a study to analyze the stress concentration areas in a tooth restored with a post-retained crown under various conditions. MATERIALS AND METHODS: The authors constructed a three-dimensional finite element model describing a maxillary second premolar restored with an all-ceramic crown supported by a titanium post and a resin-based composite core. They applied static vertical and horizontal loads of 100 newton to the cusp tip of the crown and recorded Von Mises and tensile stress values. The variables investigated were the presence of the post, coronal and apical post extensions, post diameter, post shape, and post and core material. RESULTS: The study results showed that horizontal loading generated higher levels of stress than did vertical loading. The greatest stress levels were concentrated at the cervical region and at the post-dentin interface in all models. Under both loads, a higher modulus of elasticity of the post material and a wider post diameter were associated with increased stress values at the post-dentin interface. Reduction of the post extension above the level of bone was associated with increased dentinal stresses near the apex of the post. CONCLUSIONS: Although endodontic posts provide retention for coronal restorations, they result in dentinal stress values higher than those of crowns without posts. Posts that had a similar modulus of elasticity to dentin and smaller diameters were associated with better stress distribution. Resting coronal restorations on sound dental tissues affected stress distribution more than did the core material or the length of the coronal post extension. CLINICAL IMPLICATIONS: Many factors influence the distribution of stress within dentin and, consequently, the fracture resistance of teeth restored with post-retained crowns. Clinicians need to keep these factors in mind when performing endodontic procedures that involve placement of post-retained crowns to ensure optimal success.

Fracture resistance of teeth restored with post-retained restorations: an overview.

INTRODUCTION: Posts have been used efficiently to retain restorations for badly destructed teeth. This article critically analyzes the concerned topics related to the fracture resistance of teeth restored with dowel-retained restorations. METHODS: A systematic review of PubMed/MEDLINE, Cochrane, and Scopus databases was completed (from 1960 to 2010). Single or combined key words were used to obtain the most possible comprehensive list of articles. Checking the references of the relevant obtained sources completed the review along with a manual search to locate related articles on the topic. In vivo and ex vivo (laboratory, computer-based finite element, and photoelastic stress analysis studies) investigations related to the topic were included. RESULTS: Many factors have been proposed to influence the fracture resistance of post-restored teeth. Recognizing the significance of these factors on the fracture resistance of teeth would aid in choosing the suitable treatment modality for every individual case. Fracture resistance was improved if tooth structure loss was limited, a ferrule was obtained, a post with similar physical properties to natural dentine was used, and adhesive techniques for post luting and coronal restoration were used. Adhesively luted resin/fiber posts with composite cores appear to be the best currently available option in terms of tooth fracture and biomechanical behaviour. CONCLUSIONS: Most guidelines were based mainly on ex vivo studies and to a lesser extent on limited in vivo studies. The lack of long-term controlled randomized clinical studies was the main hindrance to reaching a conclusive and undisputable opinion regarding endodontic posts in terms of tooth fracture and biomechanical behaviour.

Antibiotic prescribing practices by dentists: a review.

Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, due to a number of factors ranging from inadequate knowledge to social factors. Here we review studies that investigated the pattern of antibiotic use by dentists worldwide. The main defects in the knowledge of antibiotic prescribing are outlined. The main conclusion is that, unfortunately, the prescribing practices of dentists are inadequate and this is manifested by over-prescribing. Recommendations to improve antibiotic prescribing practices are presented in an attempt to curb the increasing incidence of antibiotic resistance and other side effects of antibiotic abuse.

Differences in self-reported oral health behavior between dental students and dental technology/dental hygiene students in Jordan.

The aim of this study was to compare differences in oral health behavior between dental students and dental technology/dental hygiene students in Jordan. One hundred and five dental students and seventy-eight dental technology/dental hygiene students were recruited into this study. All subjects were recruited from the students who were receiving training at the clinics and laboratories that belong to the Faculty of Dentistry, Jordan University of Science and Technology. The Hiroshima University-Dental Behavioral Inventory (HU-DBI) was used to assess the oral heath behavior of the subjects. Significant differences were found between students from different disciplines. Dental students were found to worry more about visiting their dentist, to be less aware of bleeding gums when brushing and were less bothered by the color of their gums compared with dental technology and dental hygiene (DT/DH) students (P < 0.05, P < 0.001 and P < 0.05, respectively). Dental students tended to be more professionally educated about brushing and to have a belief that they cannot clean their teeth well without using toothpaste (P < 0.01 and P < 0.001, respectively). Most of them did not feel they have brushed well unless they brush with strong strokes (P < 0.05). A logistic regression model showed that it might be possible to distinguish dental students from DT/DH students by using three items of the HU-DBI and the level of dental education. The difference in the HU-DBI scores was not a major feature. There were significant differences in oral health attitudes/behavior between dental students and DT/DH students. The findings might reflect differences in students' training experience and education between different specialties.