Association of masticatory efficiency with deep carious lesions in children.

PURPOSE: Masticatory efficiency is defined as an individual ability to grind and pulverize food material, and can be influenced by many factors. This research aimed to investigate the association between masticatory efficiency and deep carious lesion. METHODS: The research included 48 children (24 male, 24 female) aged from 3 to 14 years. Participants were allocated to two groups; children with no or with only incipient carious lesions were included in the first group (ICDAS levels 0, 1, or 2), and children with bilateral deep carious lesions that are ICDAS levels 4, 5, and 6 were included in the second group. Information on dental parameters (dental status, ICDAS level of each carious lesion), and level of pain (Wong-Baker scale) were collected from each participant. Participants chewed Optosil® test food for 20 masticatory cycles, and chewed particles were analyzed by the optical scanning method. RESULTS: There is a significant difference in masticatory efficiency variables (number of chewed particles, minimal and maximal Feret diameter, Sauter mean diameter, a mean and total surface of particles) between groups. A positive significant correlation is observed between WBS level and time needed for masticatory performance in a group of children with deep carious lesions. CONCLUSION: Deep carious lesions in children are associated with a decrease in masticatory efficiency. Moreover, children with carious lesions that provoke a higher level of pain take more time for masticatory cycles.

Masticatory efficiency in children with cerebral palsy.

PURPOSE: The purpose of this investigation was to compare quality of chewing in children with CP to the healthy controls, and determine whether the functional capacity of chewing units and overall dental health affect the quality of chewing. METHODS: A total of 86 were included in the investigation: 43 children with CP and 43 controls (13 girls aged 7-16 years and 30 boys aged 9-16 years) residents of the institutions for the children with special needs. Control group included the same number of children matched by age and gender for every child from the test group according to the pairing principle. The number of functional masticatory units was expressed through the number of healthy teeth and teeth with cavities which the patients could use for chewing. Masticatory efficiency assessment was determined by the method of chewed almond transparency after ten chewing cycles. The particles were passed through 12 sieves with diameter range from 0.6 to 7.2 mm. The masticatory efficiency was expressed with the number of sieves needed to pass 50% of the total almond mass. RESULTS: Healthy children had significantly more teeth in occlusal contact, while the DMF index did not differ significantly. Both groups had the same number of functional masticatory units. Children with CP had significantly poorer quality of chewing. CONCLUSION: Children with CP had significantly poorer quality of chewing which is not affected by tooth functionality, but rather the primary condition.

What general medicine students of University of Rijeka know about dental avulsion?

INTRODUCTION: Injuries of decidouos and premanent teeth can be rather hard, esspecially in combinatin if they involve adjacent supportive tissue. Among all injuries, the loss of the teeth is considered the most stressful for both a child and its parents. Tooth injury usually involves soft tissue damage, which means severe bleeding. As parents often look for help from their family general practitioners, it is very important that general practitioner is acquainted with the first aid in order to preserve the tooth and enable further skeletal development. MATERIALS AND METHODS: This study was carried out in the form of a questionnaire, which was distributed among general medical students at the Medical studies of the Faculty of Medicine of the University of Rijeka, Croatia. The study included 86 pre-doctoral students of the 3rd, 4th and 5th years of studies. The questionnaire consisted of 23 questions, which were related to demographics, personal experience in treating dental injuries, theoretical knowledge about dental injuries and their interest in additional training on the subject. RESULTS: The results showed that only 32.6% of the students heard of 'tooth avulsion'. Replacement of the avulsed tooth in its original position in the jaw was considered by 77.6% of the students. In their entire education, 84.9% students didn't acquire any knowledge about dental injuries. CONCLUSION: The study showed that medical students have very poor knowledge about dental injuries. Also, the vast majority of the students were neither informed nor educated about it during their studies.

The influence of war stress on the prevalence of signs and symptoms of temporomandibular disorders.

The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders in patients with post-traumatic stress disorder (PTSD) occurring as a consequence of exposure to war stress. The examined group consisted of 100 male subjects, aged from 25 to 50 years, who had taken part in the War in Croatia, and in whom PTSD had previously been diagnosed. The control group comprised 100 subjects, without PTSD, of the same sex and age group, who had not taken part in the War. A functional evaluation of the stomatognathic system was performed using the Helkimo Anamnestic and Clinical Dysfunction Index. Eighty-two per cent of the group with PTSD had at least one symptom, and 98% at least one sign of dysfunction. Eight per cent reported mild symptoms and 74% severe symptoms. Twenty-eight per cent showed mild clinical signs, 22% had signs of moderate, and 48% of severe dysfunction. Twenty-four per cent of the control group of subjects had at least one symptom, and 52% at least one clinical sign of dysfunction. Twenty-two per cent reported mild and 2% severe symptoms. Mild clinical signs of dysfunction were found in 50% of subjects in the control group, moderate in 2% and none exhibited severe clinical signs. It is concluded that correlation exists between war stress and temporomandibular disorders.

The effect of occlusal relationships on the occurrence of sounds in the temporomandibular joint.

The aim of this investigation was to determine the influence of occlusal relationships on the occurrence of sounds in the temporomandibular joint. A group of 100 male subjects aged 24-52 years (X = 35.03+/-6.92) was examined. Analysis of occlusion included determination of the number of existing teeth, number of teeth in occlusion, overbite and overjet, type of occlusion, mediotrusion interferences, relationship of the retruded contact position (RCP) to intercuspal position (ICP), and the amount and direction of sliding from RCP to ICP. Sound was registered by means of a stethoscope and classified according to its character in click or crepitation. Sound was present in 29% of subjects. In 28% of cases it was registered as click and in 2% of cases as crepitation. One subject had simultaneous click and crepitation. The results of the statistical analysis indicate that overbite, type of occlusion, existence of mediotrusion interferences, the relationship of RCP to ICP, and the amount and direction of sliding from RCP to ICP do not have an influence on the occurrence of sounds. The risk of the occurrence of crepitation is significantly increased in the case of the loss of more than 5 teeth, and in the case of horizontal overbite larger than 7.5 mm (p<0.05).

Three-month change in the radiodensity of alveolar bone supporting partial-denture abutment teeth.

This study uses the intraoral microdensitometric method to examine the impact of masticatory pressure on the alveolar bone around the abutment teeth clasp. Two retroalveolar radiographs were carried out on all 30 subjects over a period of 3 months using a copper calibration stepwedge. The dental radiographs were digitized and converted into positive. Grey level values on dental radiographs in the alveolar bone area in 7 region of interest (ROI) were measured. They were converted into the equivalent thickness of the calibration stepwedge using mathematical methods and the difference of the bone density between the two radiographs was calculated. The results demonstrated that there were no statistically significant differences between the 1st and 2nd radiographs in any of ROI (p > 0.05).

Evaluation of craniometric methods for determination of vertical dimension of occlusion.

In clinical practice, fully precise method for exact determination of vertical relation of occlusion still does not exist. This study examines the relationship between different craniofacial distances and the distance subnasale-gnathion (Sn-Gn), which represents the lower third of the face in vertical relation determination. The highest coefficient of correlation was (r = 0.8678, p < 0.05) between the distance eye-ear (E-E = lateral border of the ocular orbit-medial opening of the meatus of the external auditory canal) and Sn-Gn. The prediction of the distance Sn-Gn could be determined through the formula: Sn-Gn = E-E/1.08 or through the regression analysis: Sn-Gn = 1.9197 + 0.6449 x E-E. None of the calculated coefficients of correlation was 1, but was < 1, so that the prediction of the distance Sn-Gn by craniometric distances is not absolutely reliable, although it is considerably helpful. Our results point at the variations of craniofacial distances in the Croatian population. Yet, craniometry could still be recommended in everyday clinical practice for prediction of vertical relation of occlusion, as it is a simple, economic and non-invasive method, however in combination with some other methods, which have proved to be helpful.

Kineziographic research of patients with cross bite.

The paper describes the use of an objective method for the quantitative analysis of the relationship between the posterior cross-bite and the occurrence of occlusive interferences and damages to the mandible muscle elevator. Two groups of subjects were selected for the analysis: 10 patients with unilateral cross-bite and 10 students without any symptoms of temporomandibular disorders (TMD). By means of the Robert Jenkelson K5A kinesiograph we measured maximal opening velocity of the mandible (mm/s), maximal-closing velocity (mm/s), first tooth contact velocity and displacement in the vertical plane at the maximal intercuspidation (mm). The following values were obtained: maximal-opening velocity in the first group was 349 mm/s and 380 mm/s in the control group. This difference was incidental. The maximal closing velocity in the study group was 204.9 and 345.2 in the control group (p < 0.05). The first tooth contact velocity in the study group was 75.93 and 325 in the control group (p < 0.01). Displacements in the vertical plane at the maximal intercuspidation in the investigated group was 0.24 +/- 0.01 mm, while in control group that value was 0.12 +/- 0.012 mm.