Type and incidence of cracks in posterior teeth.

STATEMENT OF PROBLEM: The use of magnified vision in the operatory has enhanced the early diagnosis of structural defects in the dentition and in existing restorations. There is little in the literature to guide the clinician on the significance of cracks and other interruptions in the integrity of teeth. PURPOSE: This study characterized the type and incidence of cracks in posterior teeth and identified possible etiologic factors. MATERIAL AND METHODS: An observational cross-sectional survey of 51 patients from a private practice examined during an 18-month period was used to identify 4 types of cracks in posterior teeth. The study identified both patient- and tooth-level variables present in each patient examined. The data were subjected to statistical analysis to determine whether correlations existed between the variables and cracks. RESULTS: Cracks in teeth were shown to have chronicity and can be classified according to appearance. Variables such as the presence of a Class I or II restoration and the presence of excursive interferences were shown to significantly increase (P< .0001) the chances of a crack being present. Combinations of variables, such as interferences and a restoration, also increased the chance of a crack being present. CONCLUSION: Within the limitations of this study, the presence of cracks in teeth was associated with the placement of a Class I or II restoration and with the presence of excursive interferences. Age played a role in the presence of stained or symptomatic cracks, which suggests that cracks have chronicity. Although many questions remain regarding prevention, it is evident that protecting teeth from excursive interferences and parafunction may thwart premature breakdown.

The effectiveness of equilibration in the improvement of signs and symptoms in the stomatognathic system.

Signs and symptoms of the breakdown of the various components of the stomatognathic system, in particular the TMJ structures, masticatory muscles, dental structures, and periodontium, can have a variety of causes. Occlusal interferences have been implicated as one contributing factor in these areas of breakdown. If this is indeed the case, then elimination of these interferences should improve these signs and symptoms. A retrospective study involving 30 practicing dentists who make up part of the visiting faculty of the Pankey Institute analyzed a variety of signs and symptoms both prior to equilibration and after equilibration to elucidate signs and symptom dynamics following treatment.

The reproducibility of centric relation: a clinical approach.

This study addresses the reproducibility of the centric relation, or CR, position. Using bimanual manipulation, several dentists were randomly assigned to one of five patients to clinically determine CR and record this position by using the same wax recording technique. These bite records, which were then analyzed by using the Denar Centri-Check marking system (Teledyne Water-Pik), were found to capture condylar positions with a maximum variation of 0.1 millimeter, as measured within the tolerances of the Denar Centri-Check.

Occlusion as a causative factor in TMD. Scientific basis to occlusal therapy.

There appears to be a pendulum swing toward large epidemiologic studies questioning the role of occlusion in dentistry. This article clearly demonstrates that significant scientific evidence exists on the side of occlusal causative factors. Clinicians need this current information to base practical decisions of treatment relative to both patients and those requiring restorative procedures. It further correctly clarifies that stress-related issues have an important role, along with other host-susceptibility altering factors.

Definitive diagnostic waxing with light-cured composite resin.

The benefits of perceptive treatment planning for prosthodontics are discussed, and a method of developing diagnostic waxing with light-cured composite resin is described. The advantages of this programmed approach are illustrated with clinical examples.

Prosthodontics. Urgent care.

There are an infinite number of responses to prosthodontic urgent care situations. A knowledge of acrylic resins combined with imagination and a clear understanding of the patient's chief complaint will allow the dentist to respond in an effective manner.

Rational emotive therapy-a study of initial therapy sessions of Albert Ellis.

Because psychotherapy is what a therapist does, and not necessarily what he says he does, it is important to observe the activity of leaders in the field during their sessions. Twenty taped initial psychotherapy sessions by Albert Ellis were selected randomly from 70 recently recorded ones. Typescripts of each session were made, and two raters naive to the purposes were trained to place each of Ellis' statements into 1 of 17 categories. Each category consisted of a therapeutic technique. Some of these were ones that Ellis did during the 20 sessions examined was related very closely to what he has claimed to do, but that he did vary considerably from client to client.