Three-dimensional positional changes of teeth adjacent to posterior edentulous spaces in relation to age at time of tooth loss and elapsed time.

The purpose of this study was to study the stability of teeth adjacent to posterior edentulous spaces and correlate it with patient age and time lapse since tooth loss. Dental casts, panoramic radiographs, and questionnaires of patients treated in a University setting were employed. Teeth adjacent and opposing posterior edentulous spaces were examined for the following parameters: Supraeruption, rotation, space closure, and axial inclination. One hundred twenty three patients with 229 edentulous spaces were analyzed. Statistical analysis showed that the effects of "jaw", "gender", and "age group at the time of tooth loss" were not significant for any of the variables tested. The effect of time lapse since tooth loss was significant regarding the "amount of distal tooth inclination" (P<0.001), the "amount of distal tooth rotation" (P=0.004), and "space closure" (P=0.038). Post-hoc analysis of the "amount of distal tooth inclination" revealed a marked increase in inclination 5 years after tooth loss. Within the limitations of this study, it was concluded that in the group of patients studied, minor positional changes in teeth opposing or adjacent to posterior edentulous spaces had occurred. The greatest changes in position were recorded for mandibular teeth distal to edentulous spaces.

Association between self-reported bruxism activity and occurrence of dental attrition, abfraction, and occlusal pits on natural teeth.

STATEMENT OF PROBLEM: It is unclear whether subjects who report tooth clenching and/or grinding have more noticeable clinical signs of dental attrition, abfractions, and occlusal pits on their natural teeth than subjects who do not report bruxism activity. PURPOSE: The purpose of this study was to determine whether there was an association between self-reported (or not reported) bruxism activity and occurrence of dental attrition (anterior, posterior), abfractions, and occlusal pits on natural teeth. MATERIAL AND METHODS: One hundred and two volunteer adult Greek subjects (mean age 44.6 +/-5.7 years) were classified into 2 groups (50 self-reported bruxers and 52 nonbruxers) according to 2 inquires regarding grinding and/or clenching of their teeth. Dental attrition (anterior, posterior) was assessed by 2 calibrated experienced examiners on diagnostic casts on a tooth-by-tooth basis, using a previously well established ordinal scale. Abfraction lesions (V-shaped, in the cervical region) and occlusal pits were recorded if these clinical signs were found on at least 2 natural teeth. Statistical comparisons between the 2 groups relative to the distribution of the occurrence of the 4 clinical signs were performed by means of the exact version of the chi-square test. The Fisher's exact test was used for the comparison of percentages. The intra- and interexaminer reliability was assessed by means of the Cohen's kappa coefficient (alpha=.05). RESULTS: The results demonstrated that there was a significant association between self-reported bruxism and occurrence of the 4 clinical signs. Although the 2 groups were significantly different according to the distribution of the 4 clinical signs, the greatest differences occurred for the anterior and posterior attrition signs. CONCLUSIONS: In this study, the occurrence of 4 clinical signs (posterior or anterior dental attrition, abfractions, and occlusal pits) was associated with self-reported bruxers. It is suggested that, primarily, signs of dental attrition may differentiate self-reported bruxers from nonbruxer subjects.

Evaluation of the relationship between subjects' perception and professional assessment of esthetic treatment needs.

PURPOSE: The purposes of the present study were to (1) evaluate the esthetic dental treatment need by means of two special questionnaires, (2) determine the reliability and the construct validity of the measurement scales derived from these questionnaires, and (3) investigate the relationship between Greek subjects' perception and a professional examiner's assessment regarding the esthetic treatment need. MATERIALS AND METHODS: Participants in this survey consisted of 132 subjects (48 males with mean age 39.0 +/- 14.5 years old, 84 females with mean age 41.7 +/- 14.5 years old) with natural teeth and fixed restorations. Subjects were asked to complete a special self-evaluation questionnaire consisting of 12 items. During the next stage, all participants were clinically examined by an experienced examiner and the data collected were used to fill out a second special professional assessment questionnaire consisting of 20 items. The forms structure used were in accordance with well-established indices used in orthodontics for assessing esthetic treatment need. RESULTS: The reliability of the multiple correspondence analysis (MCA) analysis-derived scales was very satisfactory (Cronbach's a coefficient: a =0.82) for the total scale of the self-evaluation measurement. For the professional assessment scale, the reliability of the total scale was almost perfect (a=0.92). The MCA revealed one reliable factorial construct for the self-evaluation measurement scale and two reliable constructs for the professional measurement scale. Pearson's correlation coefficient indicated a very low agreement between self-evaluation and professional measurement scales. CONCLUSION: The findings of this survey suggest that there was a relative disagreement between subjects' perception and professional assessment regarding the need for esthetic dental treatment. CLINICAL SIGNIFICANCE In the present survey, the agreement between subjects' perception and clinical assessment of esthetic dental treatment need was found to be very low, which highlighted the discrepancies between patients' and dentists' perceptions of esthetic needs.

Considerations for services from dental technicians in fabrication of fixed prostheses: A survey of commercial dental laboratories in Thessaloniki, Greece.

STATEMENT OF PROBLEM: Effective communication and cooperation between dentists and dental technicians are essential in providing quality services. There has been a lack of information regarding dentist-dental technician communications and current methods and materials used for the fabrication of fixed partial dentures (FPDs). PURPOSE: This cross-sectional study identified the materials and techniques used for fabrication of FPDs, as well as the status of communication between dentists and dental technicians in Thessaloniki, Greece. MATERIAL AND METHODS: A questionnaire was developed with 7 sections pertaining to procedures and materials used for the fabrication of fixed prostheses: general questions, infection control, impressions/interocclusal records, die technique/mounting, information from final casts, prostheses design/materials, and communication/shade selection. The questionnaire was anonymous and distributed by the Association of Dental Technicians of Thessaloniki to all member laboratories (228) in the wider province of Thessaloniki, Greece. Due to the absence of normal distribution of the results, frequencies and medians were reported. RESULTS: Ninety-six of 228 dental laboratories responded (42.1% response rate). Twenty-six percent of dental laboratories did not routinely disinfect incoming items. The dental technicians considered 30% of incoming final impressions and 20% of interocclusal registrations as inadequate. Half of the time (55%) final casts were mounted by technicians on simple hinge articulators. Only 20% of tooth preparations had adequate finish lines. The majority (70%) of fixed restorations were metal-ceramic. Fifty-seven percent of dental technicians considered the delivery time requested by dentists as insufficient. CONCLUSION: The information provided in this study indicates areas of weakness in communication between dentists and dental technicians, along with areas where both parties should use greater care during clinical and laboratory procedures.