Reproducibility of the Obtained Centric Relation Records in Patients with Disc Displacement with Reduction.

OBJECTIVE: The aim of this study was to investigate reproducibility of the position of centric relation in patients with disc displacement with reduction. MATERIALS AND METHODS: The test group included 30 subjects, diagnosed with disc displacement with reduction in right, left or both joints. The control group included 12 individuals with no signs and symptoms of temporomandibular disorders. Using chin point guidance with a jig, centric relation record was made three times by every participant, in a single session. Left and right condylar position for each centric relation record was determined and recorded using the electronic ultrasonic measuring device. The data were transferred to the computer, processed and analyzed. Condylar distances between centric relation records were measured (anteroposterior, vertical, transversal and linear values), and the data were statistically analyzed using the t and the F tests. RESULTS: No statically significant difference was found between the test and the control groups. Two thirds of study participants demonstrated condylar position of the repeated centric relation recording within the area of 0.3 mm in diameter. For more than 90% of participants that area was within 0.4 mm. CONCLUSIONS: There is no difference in reproducibility of the centric relation between patients with disc displacement with reduction and healthy temporomandibular joint individuals (p>0.05). When doing centric relation record on a patient with disc displacement with reduction there is no need for previous splint therapy and standard precautions are acceptable. The obtained results must be interpreted within the experimental group, and not projected on the other groups of temporomandibular disorders.

Multivariate analysis of different factors affecting the patient general satisfaction with complete dentures.

The aim of the study was to investigate different factors that affect the level of patient's general satisfaction with maxillary and mandibular complete dentures (CDs) using a multivariate analysis. A total of 100 CD wearers participated in this study. There were 46 men (37-77 years old; mean age 62.6 +/- 9.2) and 54 women (34-77 years old; mean age 60.9 +/- 9.3). In the questionnaire the patients answered the questions regarding gender, age, number of previous CDs worn, the present dentures' age and denture-wearing habits. Participants rated the level of their satisfaction with the esthetics, retention, speech, mastication, sense of taste, comfort and general satisfaction with their CDs. More than 70% of the examined patients claimed all the examined variables to be the best-score category. Of the 9 factors examined, satisfaction with the mastication and esthetics, denture-wearing habits and satisfaction with retention in the maxilla explained the variability of the patients's general satisfaction with their CDs by 72%. Satisfaction with the mastication, denture-wearing habits and satisfaction with speech and comfort in mandible explained the variability of the patients's general satisfaction with their CDs by 79%. These findings suggest that the general patient satisfaction with maxillary CDs is related more to the mastication and retention abilities, as well as with esthetics and denture-wearing habits, while in the mandible CDs is related to mastication and speaking abilities, denture-wearing habits and comfort of wearing.

Alterations in the masseter muscle and plasma IL-6 level following experimentally induced occlusal interference and chronic stress--a study in rats.

This study was undertaken to examine the alteration of masseter and plasma interleukin-6 after inducing occlusal interference and chronic stress. Male Wistar rats were submitted to chronic stress procedure, exposed to occlusal interference, or exposed to both mentioned procedures. Whole blood and masseter tissue were collected to determine interleukin-6 level, measured by means of ELISA. Masseter pain was evaluated using the orofacial formalin test. Masseter interleukin-6 level was significantly higher in animals submitted to combination of occlusal interference and chronic stress than in the control group (p<0.05). There was positive and significant correlation between pain response and masseter interleukin-6 level (r=0.5741; p<0.0003). No significant differences in plasma interleukin-6 level were found between groups (p>0.05), as well as no correlation with pain (p>0.05). Combination of occlusal interference and chronic stress leads to strong local reaction characterized by high levels of masseter interleukine-6. High concentrations of muscle interleukin-6 and its correlation with pain point to inflammatory background of masticatory muscle pain.

Masticatory muscle and temporomandibular joint pain in Croatian war veterans with posttraumatic stress disorder.

The aim of this study was to investigate the prevalence and intensity of masticatory muscle and temporomandibular joint (TMJ) pain in Croatian war veterans with posttraumatic stress disorder (PTSD). The examined group consisted of 100 Croatian war veterans, in whom PTSD had previously been diagnosed. Patients were compared with 92 subjects who had not taken part in the war and in whom PTSD was excluded by psychiatric examination. The clinical examination consisted of palpation of the masticatory muscles, the prominent neck musculature, and TMJ. The examination technique used and the definition of items were previously tested for reliability and validity. 93% of the subjects with PTSD had masticatory muscle tenderness compared to 45.65% of the subjects in the control group (chi2 = 51.46, p < 0.0001). The most frequent painful location in the subjects with PTSD was the left lateral pterygoid site in 88%, and in subjects of the control group the right lateral pterygoid site in 28.26% of cases. The most painful location in the PTSD group was the left lateral pterygoid site in 72%, and in the control group the left posterior digastric in 4.35% of cases. 58% of the subjects with PTSD had TMJ tenderness compared to 3.26% of subjects in the control group (chi2 = 66.23, p < 0.0001). The most frequent painful location of TMJ in both groups was the left posterior capsule; in the PTSD group 38% and in subjects in the control group 2.17% of cases. The most painful location was the left posterior capsule in 28% of subjects with PTSD, while not one subject in the control group reported severe painful sensitivity. The very high frequency and intensity of pain in subjects with PTSD confirms the effect of stress on muscle and joint sensitivity, i.e. perception of pain.