Influence of Stabilization Splint Thickness on Temporomandibular Disorders.

PURPOSE: To assess the effect of stabilization splint (SS) thickness on temporomandibular disorders (TMDs). MATERIALS AND METHODS: Participants were selected from patients who applied to the clinic with a complaint of temporomandibular disorders (TMDs). Symptoms were evaluated with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Regarding the treatment plan, patients were divided into two groups: the 2-mm-thick splint group (2-mm TSG) and the 4-mm-thick splint group (4-mm TSG). They used SSs at night (8 hours) and were recalled 1, 2, 3, and 6 months after splint insertion. At the end of the study, 72 patients (2-mm TSG = 39, 4-mm TSG = 33) had completed the 6-month follow-up. The SPSS program was used for statistical analysis. The results of the analysis were evaluated at a significance level of .05. RESULTS: Pain in the muscles decreased significantly in the muscle disorders and combined groups (both 2- and 4-mm TSG) after 6 months of treatment (P < .05). In the combined group, TMJ sounds significantly decreased after 6 months of treatment, and there was a statistically significant difference between the 2-mm TSG and the 4-mm TSG (P = .045). Also, in the combined group, maximum unassisted opening (MUO) values of patients treated with 2-mm-thick splints decreased after 6 months of treatment (P = .022). CONCLUSION: Both 2-mm-thick and 4-mm-thick splints were effective in the treatment of muscle disorders and disc displacements, especially in muscle-related pain and TMJ sound symptoms.

Does anxiety have an impact on temporomandibular disorders? A study in a Turkish sample by using specific questionnaires.

OBJECTIVE: The aim of the study is to verify the impact of anxiety on temporomandibular disorders (TMD) by using specific questionnaires in a Turkish sample. METHODS: This survey was conducted on 292 patients with a mean age of 38.59 ± 10.38 using Helkimo index, Oral Health Impact Profile (OHIP-14), and State Trait Anxiety Inventory (STAI). Spearman Correlation and Fisher Freeman Halton analyses were used for the statistical analysis. RESULTS: There was no statistically significant difference between the Helkimo anamnestic dysfunction (HAD) levels in terms of OHIP-14 total scores or STAI state scores. There was, however, a statistically positive correlation between STAI state and OHIP-14 total values at 18.4%, a positive correlation between the STAI trait and OHIP-14 total values at 29.8%. CONCLUSION: No significant correlation was observed between OHIP-14 total scores, STAI state scores, and HAD levels. Therefore, this study did not find a significant relationship between TMDs and anxiety.

Oral Health-Related Knowledge, Attitudes and Behaviours of Elementary School Teachers.

BACKGROUND: elementary schoolteachers play a central role in shaping their students' beliefs, attitudes, and behaviours related to health and oral hygiene. This study was designed to evaluate Turkish schoolteachers' levels of oral health knowledge, attitudes, and behaviours. METHODS: A cross-sectional survey-based study was conducted among elementary schoolteachers in Istanbul using a validated self-administered questionnaire. The questionnaire was composed of 36 multiple-choice items categorised into six sections, and the participants were recruited using convenience sampling. (3) Results: A total of 385 elementary schoolteachers participated in this study. The majority were female (62.2%), qualified with a licensure degree (81.3%) and working in public schools (86.5%). Female gender and greater work experience were found to be promoters for oral health knowledge and positive attitudes. The correlation between their perceived knowledge and actual knowledge was very weak, thus suggesting that the teachers are inclined to overestimate their knowledge. CONCLUSIONS: The Turkish elementary schoolteachers showed satisfactory oral health knowledge and attitudes toward oral health education. The teachers' knowledge about dental trauma management was inadequate, necessitating urgent educational interventions, especially for physical education teachers, who are at the greatest risk of encountering such events during their work. The oral hygiene behaviours were not associated with teachers' oral health knowledge, attitudes, or practice, thus requiring further investigation.

Wear resistance and microhardness of various interim fixed prosthesis materials.

The aim of the present study is to evaluate the wear resistance and microhardness of various interim fixed prosthesis materials with different chemical compositions and curing methods. One heat-cured and four self-cured acrylic resins, and three self-cured, one light-cured, and one dual-cured composite-based materials were tested. For microhardness, samples from each group were tested after storing either at 37°C in artificial saliva for 7 days, followed by thermocycling, or in distilled water solution at 37°C for 24 h. For the evaluation of wear, the remaining samples were evaluated using a 3D scanner and a surface analysis program before loading in the chewing simulator and after every 10,000 cycles. There was a significant difference in wear behavior among the materials tested at both 10,000 and 20,000 cycles (P < 0.001). Microhardness and wear resistance were significantly different between acrylic and composite materials.

Comparison of digital and conventional impression techniques: evaluation of patients' perception, treatment comfort, effectiveness and clinical outcomes.

BACKGROUND: The purpose of this study was to compare two impression techniques from the perspective of patient preferences and treatment comfort. METHODS: Twenty-four (12 male, 12 female) subjects who had no previous experience with either conventional or digital impression participated in this study. Conventional impressions of maxillary and mandibular dental arches were taken with a polyether impression material (Impregum, 3 M ESPE), and bite registrations were made with polysiloxane bite registration material (Futar D, Kettenbach). Two weeks later, digital impressions and bite scans were performed using an intra-oral scanner (CEREC Omnicam, Sirona). Immediately after the impressions were made, the subjects' attitudes, preferences and perceptions towards impression techniques were evaluated using a standardized questionnaire. The perceived source of stress was evaluated using the State-Trait Anxiety Scale. Processing steps of the impression techniques (tray selection, working time etc.) were recorded in seconds. Statistical analyses were performed with the Wilcoxon Rank test, and p < 0.05 was considered significant. RESULTS: There were significant differences among the groups (p < 0.05) in terms of total working time and processing steps. Patients stated that digital impressions were more comfortable than conventional techniques. CONCLUSIONS: Digital impressions resulted in a more time-efficient technique than conventional impressions. Patients preferred the digital impression technique rather than conventional techniques.

Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers.

BACKGROUND: Facial measurements are frequently used to determine OVD. However, the reliability of neither the method nor the chosen landmarks has been cleared yet. OBJECTIVE: This study compares the reliability of two facial measurements, subnasal (SN) to chin (C) and tip of the nose (TN) to C, for determining occlusal vertical dimension (OVD). MATERIALS AND METHODS: Thirty edentulous subjects with adequate neuromuscular co-ordination, without signs and symptoms of temporomandibular disorders and who had been wearing complete dentures for at least 5years were enrolled. A modified central bearing device was used to alter the OVD and facial measurements were made with a digital caliper. Student's t-test was used to compare the two measurements. Interobserver and intraobserver reliability were evaluated with Spearman's rho correlation test. RESULTS: TN-C distance had an improved correlation with the changes in intraoral alterations than SN-C distance. While the means of the changes in facial measurements were in good agreement with the intraoral alterations, the ranges were wide. Both interobserver and intraobserver reliability of the measurements were high. CONCLUSION: While facial measurement is not a good predictor of OVD, TN-C distance appears to be more reliable than SN-C distance.

An adult case of temporomandibular joint osteoarthritis treated with splint therapy and the subsequent orthodontic occlusal reconstruction.

Herein we report treatment for a 19-year-old female patient with severe osteoarthritis of the temporomandibular joint. The patient had severe open bite with a Class II molar relationship. She had limited mouth opening and pain. Clinical examination and magnetic resonance imaging revealed that she had anterior disc displacement without reduction. By splint therapy, limited mouth opening and pain was eliminated, but an anterior open bite developed after the treatment. By orthodontic treatment, an acceptable occlusion was achieved with a Class I molar relationship.

The effects of two methods of Class III malocclusion treatment on temporomandibular disorders.

The aim of this research was to evaluate, within a controlled clinical study, the effects of a Delaire-type facemask or a modified Jasper Jumper (JJ) used in the treatment of children with Class III malocclusions due to maxillary retrognathia on temporomandibular disorders (TMDs). Forty-six patients with Class III malocclusions referred for orthodontic treatment were divided into two groups, a test and a control. The test group comprised 33 randomly chosen patients (15 females, 18 males) aged 8-11 years. The control group included 13 patients (eight females, five males) with similar features. TMD assessment was performed before and after treatment using a two-axis questionnaire, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs). Qualitative data were evaluated using chi-square and McNemar tests. No statistically significant differences related to the presence of TMD were observed pre- or post-treatment (P > 0.05). The most commonly encountered diagnosis was arthralgia in the JJ group both before and after treatment. Evaluation of joint and muscle regions showed decreased symptoms, apart from the diagnosed discomforts, in the JJ group (P < 0.05). Reduced symptoms were observed in the Delaire group; however, this reduction was not statistically significant. An increase, not considered to be statistically significant, was observed in the control group. The Delaire-type facemask and modified JJ used in the early phase of Class III malocclusion treatment did not result in TMD.

Interdisciplinary treatment of a patient with amelogenesis imperfecta, a skeletal Class III relationship, and an anterior open bite.

An adult woman with amelogenesis imperfecta, a skeletal Class III relationship, long face syndrome, and a severe anterior open bite received interdisciplinary treatment (orthodontics, orthognathic surgery, and prosthodontics). Presurgical orthodontic treatment was followed by a maxillary posterior impaction with anterior advancement and a mandibular setback. After surgery, the patient received ceramic crowns. Function and esthetics were successfully re-established.

Prosthetic rehabilitation of a Crouzon patient: A case report.

Crouzon syndrome is a rare genetic disorder, which can be defined as a variation of craniofacial dysostosis caused by the premature obliteration and ossification of two or more sutures. The growth pattern results in pseudoprognathism and malocclusions including an overcrowded or a widely spaced dentition. Specifically maxillary arch is narrow, high, and V-shaped. Cleft palate and bifid uvula are other possible features in the oral cavity. This report describes a non-surgical treatment model to overcome the remaining significant Class III intermaxillary relation and excessive tooth loss to recover function and aesthetics for a 25-year-old Crouzon patient.

Arthrocentesis versus nonsurgical methods in the treatment of temporomandibular disc displacement without reduction.

OBJECTIVE: The aim was to compare the short- and medium-term results of arthrocentesis and conventional treatment (splint, heat, and exercise) in patients with early temporomandibular joint (TMJ) disc displacement without reduction (DDw/oR). STUDY DESIGN: One hundred twenty consecutive patients (104 female, 16 male), who had been followed by a multidisciplinary TMJ unit with the diagnosis of DDw/oR were enrolled in this single-blind prospective study. Patients either underwent arthrocentesis or they were given a combination of splint, hot pack, and home exercise program. Visual analog scale (VAS) was used for pain assessment. Maximal mouth opening (MMO), lateral movement, and protrusion were measured. Repeat measurements were performed on the first, third, and sixth months following treatments. RESULTS: Arthrocentesis group consisted of 54 individuals (51 female, 3 male), and the conventional treatment group consisted of 56 individuals (49 female, 7 male). The mean age values of the groups were 33.4 years (range 15-63 years) and 34.8 years (range 17-61 years), respectively. Baseline VAS and MMO values of the arthrocentesis and conventional treatment groups were similar (P > .05). Regarding VAS and MMO, lateral movement, and protrusion, the intragroup analyses showed a statistically significant reduction in both groups compared with baseline values (all P < .01). Regarding VAS values, the difference values between each evaluation and the baseline measurement were significantly higher in the arthrocentesis group, except for the first-month difference. Regarding MMO, lateral movements, and protrusion, the differences between the baseline values and each evaluation thereafter were statistically similar between the 2 groups (P > .05). CONCLUSION: We conclude that early treatment either with conservative methods or with arthrocentesis is beneficial in DDw/oR. However, arthrocentesis seems to be superior regarding pain management. Therefore, arthrocentesis may be indicated in patients where painful complaints overwhelm despite other conservative treatments.

The role of Candida albicans hyphae and Lactobacillus in denture-related stomatitis.

Denture-related stomatitis (DRS) is still a dilemma in removable prosthodontics. The aim of this study was to investigate the relationship of DRS with the presence of Candida albicans hyphae and Lactobacillus. A total of 91 patients wearing maxillary and mandibular complete dentures were included in the present study and tested mycologically as well as bacteriologically. A statistically significant association of DRS was found with denture age (p = 0.003) and continuous denture wearing (p = 0.015). Presence of C. albicans hyphae was shown to be significantly higher in DRS cases (p < 0.01), and there was a statistically significant positive correlation between presence of hyphae and C. albicans (p < 0.01). Another interesting finding was that DRS patients showed higher Lactobacillus counts in their saliva (p = 0.04), as well as in the palate (p = 0.028). C. albicans is an important factor in the development of DRS. Hyphae seem to facilitate the rise of C. albicans counts and be related to the inflammatory response of the tissues. Lactobacillus seems to play an important role in the presence of DRS, as well. In agreement with many other studies, the results of this study confirm the importance of denture age and continuous denture wearing in the development of DRS.