Influence of occlusal interferences on the periodontium in patients treated with fixed prosthesis

Gingival bleeding, pocket depth, and tooth mobility were recorded, and occlusal analyses were made on 147 subjects treated with fixed prostheses placed 4 years earlier. The percent of gingival bleeding was greater in teeth with interferences than in those without interferences. A slight increase in pocket depth was found in connection with interferences. However, the difference was statistically significant only in the group with no preprosthetic treatment. No differences in tooth mobility were found between teeth with and those without interferences, possibly partly because of the splinting influence of the fixed partial dentures on the mobile teeth.     

Mandibular dysfunction and periodontitis. A comparative study of patients with periodontal disease and occlusal parafunctions

Fifty-one patients (mean age, 47.3 years) with moderate to severe periodontal disease and 40 patients (mean age, 48.9 years) with symptoms related to bruxism (occlusal parafunctions such as grinding and/or clenching of the teeth) were compared with regard to periodontal conditions and signs and symptoms of mandibular dysfunction. The bruxists reported more symptoms of pain and dysfunction of the masticatory system than the periodontal patients. The clinical dysfunction index was significantly higher among the bruxists, while there was a similarity between the groups in the variation of occlusal conditions, except for occlusal wear, which was more pronounced in the bruxist group. Attrition was in general positively correlated to alveolar bone height. This correlation was stronger (and statistically significant) for the canines than for other teeth. Attrition was negatively correlated to tooth mobility. It is concluded that patients with moderate to severe periodontal disease and patients with bruxism/occlusal parafunctions are distinctly different with regard to signs and symptoms of mandibular dysfunction. The results support the opinions that there is no or only weak correlation between periodontal disease and bruxism, and between bruxism and occlusal status.     

Evaluation of scalp hair nickel and chromium level changes in patients with fixed orthodontic appliance: a one-year follow-up study

Background and objectives: The release of metal ions from orthodontic appliances is part of the dissolution and biomechanical processes of alloys. Nickel (Ni) and chromium (Cr) are the elements commonly used in the manufacture of various components of fixed orthodontic appliances, including bands, brackets and wires. This study was aimed to measure the Ni and Cr ions levels in the scalp hair of patients treated with fixed orthodontic appliances in comparison of the control group.

Materials and methods: The patient group consisted of 24 patients treated with fixed orthodontic appliances for one year, while the control group included 28 healthy individuals without orthodontic appliances. Analysis of the Cr and Ni was performed using atomic absorption spectrophotometer by graphite furnace method. The data were analyzed via student and paired samples t-test and ANOVA repeated measurement test.

Results: After one year, the levels of Ni and Cr in two groups showed significant differences (0.086?±?0.007 and 0.258?±?0.009 µg/g for control group and 0.149?±?0.010 and 0.339?±?0.013 µg/g for patient group, respectively for Ni and Cr, p?Conclusion: Due to the slightly elevated levels of Ni and Cr ions in the scalp hair of patients treated with fixed orthodontic appliances and considering the cytotoxic and allergic effects of these ions, changing the ingredients in fixed orthodontic appliances is suggested for the future.     

Effect of occlusal adjustment on mandibular dysfunction. A double-blind study

A group of headache patients who also had many signs and symptoms of mandibular dysfunction were randomly assigned to treatment and placebo groups. All 48 patients in the treatment group received occlusal adjustment and 19 of them also splint therapy. In the placebo group all 43 patients received mock adjustment. The changes in symptoms and signs of mandibular dysfunction were evaluated after 8 months in the treatment group and after 4 months in the placebo group, in a double-blind design. Placebo treatment and real treatment were equally effective in relieving symptoms of mandibular dysfunction, but there was significantly more reduction in signs of dysfunction in the treatment group than in the placebo group. When tested statistically, this reduction appeared to be independent of the use of splints as an aid to treatment. It can be concluded that the elimination of occlusal disturbances was an effective treatment for mandibular dysfunction.     

Peri-implant mucosal level in patients treated with implant-supported fixed prostheses: a 1-year follow-up study

PURPOSE: The purpose of this follow-up study was to quantify the change in the peri-implant mucosal level after treatment of edentulous patients with fixed prostheses on osseointegrated endosseous implants. MATERIALS AND METHODS: Twenty patients were included in the study: 10 were treated in the maxilla, and 10 were treated in the mandible. Both groups had fixed prostheses on osseointegrated Br?nemark implants. Peri-implant mucosal level was measured with a calibrated probe after removal of the prostheses at the 1-year follow-up. These measurements were compared to those made on the original master casts. RESULTS: A larger mean retraction (-) was observed in the mandible (-1.6 mm) compared to the maxilla (-0.8 mm), but there was great variation. The individual values varied from -4.5 to +1.0 mm in the mandible and from -6.0 to +6.0 mm in the maxilla. CONCLUSION: Peri-implant soft tissue recession occurs during the first year in edentulous jaws after treatment with implant-supported fixed prostheses and more so in the maxilla than the mandible.     

The analysis of frequency of occlusal sounds in patients with periodontal diseases and gnathic dysfunction

A study is presented of occlusosonograms obtained from healthy subjects and patients with periodontal diseases and gnathic problems. Gnathosonic examinations were carried out by means of a set of equipment whose basic elements were two piezoceramic transducers mounted on a specially made holder and an IBM PC with an ADC card. The evaluation of occlusosonograms was by means of mathematical analysis of the frequency pattern. In pathological stages, the occlusosonograms exhibit more high frequency components. In the case of healthy subjects, the recorded signal took the form of a strong impact of low frequencies and its subsequent exponential decay.     

Assessment of masticatory function in patients with non‐sagittal occlusal discrepancies

Non‐sagittal occlusal discrepancies such as posterior cross‐bite and anterior openbite are common types of malocclusion, but studies on masticatory function related to those malocclusions have been scarce. The aim of this study was to quantify the masticatory performance in patients with non‐sagittal discrepancies compared to those with normal occlusion, using both objective and subjective measures. Maximum bite force and contact area using Dental Prescale^® system as a static objective assessment, Mixing Ability Index (MAI) as a dynamic objective evaluation and food intake ability (FIA) as a subjective assessment were analysed from 21 people in normal occlusion (Group N) and 64 patients with posterior cross‐bite (Group C), anterior openbite (Group O) or both (Group B). The differences of the maximum bite force, the contact area, the MAI and the FIA were compared, and their correlations were figured out. The non‐sagittal malocclusion groups showed lower values in the maximum bite force, the contact area, the MAI and the FIA compared to those in the normal group (P < 0·0001). Compared to Group N, Groups C, O and B showed 61·5%, 42·1% and 40·1% of the maximum bite force, and 84%, 84% and 76% of hard food FIA, respectively. However, there were no significant differences among Groups C, O and B. The MAI showed higher correlation with the FIA (r = 0·38, P < 0·01), than with the maximum bite force and the contact area (both r = 0·24, P < 0·5). These results revealed that masticatory function in patients with non‐sagittal discrepancies is significantly reduced both objectively and subjectively.     

Effect of occlusal treatment on sick leaves in TMJ dysfunction patients with head and neck symptoms

The aim of the study was to test the effect of occlusal treatment on sick leaves utilized in clinically diagnosed TMJ dysfunction patients who had had sick leaves for head and neck symptoms. The patient population differed clearly from a typical TMJ dysfunction clientele. Qualitative statistical analysis disclosed a significant reduction in sick leaves granted in the treatment group (n = 28). The result was corroborated by quantitative statistical analysis. No change was observed in the control group (n = 25). The changes in the number of days on sick leave and in the signs of dysfunction during the follow-up year showed a tendency to covariation. Since there was little reason to suspect that the placebo effect would have been greater in the treatment group than in the control group, it was concluded that the occlusal treatment could have eliminated some of the causes for sick leaves.     

Reproducibility of response to a questionnaire on symptoms of masticatory dysfunction

The aim of the present investigation was to check the reproducibility of answers to multiple-choice questions used in a questionnaire. The questionnaire was concerned with symptoms in patients with dysfunction of the masticatory system. Five main types of questions were tested by repetition within 1 week by 98 patients. Comparisons were also made between questionnaire data and clinical findings. The interval between the questionnaire and the clinical examination was 1 week. The best reproducibility was found for answers to a question about previous joint radiography, which was the simplest question with the fewest alternatives. The second best was found for a question about the duration of the symptoms referable to the masticatory system. The poorest reproducibility was noted for a question about masticatory muscle pain. The comparison between the questionnaire data and clinical findings showed the best agreement for joint sounds. The reported pain symptoms and palpatory tenderness seem to be different entities.     

Short term evaluation of counselling and occlusal adjustment in patients with mandibular dysfunction involving the temporomandibular joint

The effect of counselling and occlusal adjustment was investigated in thirty patients with mandibular dysfunction involving the temporomandibular joint (TMJ). The patients were examined at three visits 6 weeks apart. At the first visit all patients received counselling. At the second visit they were divided into two groups, one receiving occlusal adjustment and the other not receiving treatment. The degree of mandibular dysfunction was assessed by the patients according to a five grade scale and by the clinical dysfunction index according to Helkimo (1974a). The score of subjective dysfunction was reduced significantly during the period following counselling and 60% of the patients improved. No effect was found on the clinical dysfunction score. The score of clinical dysfunction was reduced significantly during the period following occlusal adjustment and 67% of the patients improved. No further effect could be detected on the subjective dysfunction score. The correlation between changes in subjective and clinical dysfunction was poor, but changes in the subjective score were generally associated with changes in the clinical score. It was concluded that counselling may reduce the subjective symptoms; and occlusal adjustment the clinical signs of mandibular dysfunction involving the TMJ, but that the individual variation in response is substantial.     

固定修复体咬合过高对颞下颌关节和牙周组织的影响

因素,精神因素,个体易感性等[1,2]是引起颞下颌关节功能紊乱病的可能因素。特别是病理性因素,不仅可能引起颞下颌关节功能紊乱病,也可能导致牙体、牙周组织的疾病。国内外许多学者已经进行过各种实验研究,探讨牙髓因素对颞下颌关节、牙体、牙髓和牙周组织的致病作用[3～7]。作者在临床修复中发现了9例固定修复体过高,导致牙齿损伤,造成颞下颌关节功能紊乱病发生的典型病例。1. 病例来源及一般情况1975年、2001年有4例女性患者因固定修复体修复半个月至1个月后出现颞下颌关节区疼痛、张口困难和不敢咀嚼;另有3例男性、2例女性患者因牙齿松动…     

Aspects of the periodontal condition of temporomandibular joint pain dysfunction patients

Aspects of the periodontal condition of 50 patients referred with temporomandibular joint pain dysfunction syndrome (TMJPDS) were compared with 50 patients of matched age, sex and social status and without previous history of periodontal disorders. Oral hygiene, gingival condition attrition and radiographic features were measured.There was no evidence that the periodontal conditions of TMJPDS patients differed from those of the control group.     

Nocturnal masseter muscle activity and the symptoms of masticatory dysfunction

This study evaluated the level of nocturnal masseter activity and the symptoms of jaw dysfunction in eighty-five subjects who varied with respect to degree of jaw dysfunction. A combined jaw dysfunction index was employed which evaluated both the patients subjective report of pain as well as the clinical examination evidence of jaw dysfunction. Using this combined index, a significant correlation was found between the level of nocturnal masseter activity and the signs and symptoms of jaw dysfunction. Tooth wear was also related to signs and symptoms of jaw dysfunction as well as high levels of nocturnal masseter muscle activity (bruxism).     

Evaluation of the effect of a stabilization splint on occlusal force in patients with masticatory muscle disorders

The purpose of this study was to evaluate the effect of stabilization splint therapy on occlusal force in patients with masticatory muscle disorders (MD). Six female patients with myalgia or myofascial pain participated in this study. The occlusal points and load on the dental arch in maximum clenching was measured using the computerized system with Dental Prescale(R) before and after the use of the splint. There were no significant changes in the number of occlusal points, mean occlusal pressure, and asymmetry in occlusal balance between before and after the use of the splint. However, there were significant differences in the extent of the area of occlusion and in the integrated occlusal loads. The integrated occlusal load converged to the normal level with the use of the splint. From the results of this study, it is suggested that the use of the stabilization splint has the effect of normalizing the occlusal force.