Diagnostic accuracy of clinical signs to detect erosive tooth wear in its early phase.

BACKGROUND: Agreement exists about most of the clinical features of erosive tooth wear, though no evidence supports their validity in diagnosing the condition. OBJECTIVE: This study aimed to determine the accuracy of clinical signs for diagnosing erosive tooth wear in a young adult general population. METHODS: We conducted a cross-sectional study of dental students. In the first session, two examiners independently determined the presence of erosive tooth wear based on glazed enamel surfaces, morphological changes on non-occlusal surfaces, flattening of convex areas, or any type of concavity. In the second session, one examiner recorded the presence of clinical signs according to the Tooth Wear Evaluation System. The diagnostic accuracy of each clinical sign, both alone and combined, was assessed by calculating their sensitivity and specificity for detecting erosive tooth wear and performing multivariate logistic regression models. RESULTS: Of the 147 participants (78 women and 69 men; median age, 22 years) we included, 76.2% had erosive tooth wear. The single clinical signs with greatest balance between the sensitivity and specificity were 'convex areas flatten' (63% and 71%, respectively) and 'dull surface' (47% and 89%, respectively). Multivariate logistic regression revealed that 'preservation of the enamel cuff' (odds ratio, 22) and the combination of 'smooth silky shining, silky glazed appearance, and dull surface' (odds ratio, 68) had the best predictive values. CONCLUSIONS: The most accurate clinical signs for detecting early erosive tooth wear were dull surface, flattened convex areas and preservation of the enamel cuff.

Reference values and reliability of occlusal force distribution and occlusal time measured by the T-Scan system in adults with healthy dentition.

PURPOSE: Reference values of occlusal characteristics are needed to interpret the data obtained using the T-Scan System. This study aimed to establish reference values for and to assess the reliability of, occlusal force distribution in the maximal intercuspal position and the occlusion time in young adults with healthy dentition. MATERIALS AND METHODS: In total 178 adults with natural dentition participated in this retrospective cross-sectional study, of whom 76 performed a retest session. Several occlusal recordings were obtained from each participant using the T-Scan system while asking them to bite two or three consecutive times (multi-bite) or only once (single-bite) at the maximal intercuspal position. The lateral and anteroposterior occlusal force distribution were determined as percentages in the right and posterior teeth . Occlusion time was measured in seconds. After the occlusal force distribution and occlusion time percentiles were calculated, reliability was assessed by the intraclass correlation coefficient. RESULTS: The 5th-95th percentiles for occlusal force distribution were 34%-67% on the right teeth and 55%-94% on the posterior teeth. The 90th percentile for multi-bite occlusion time was 0.17 s and for single-bite occlusion time was 0.27 s. The intraclass correlation coefficients for lateral occlusal force distribution, anteroposterior occlusal force distribution, multi-bite occlusion time, and single-bite occlusion time were 0.70, 0.68, 0.58, and 0.67, respectively. CONCLUSIONS: This study generated reference values for key occlusal characteristics (occlusal force distribution and occlusion time) when using the T-Scan system. These values showed moderate reliability.

Sex-specific reference values for the crown heights of permanent anterior teeth and canines for assessing tooth wear.

OBJECTIVE: We propose sex-specific reference values for the clinical crown height of anterior teeth and canines. MATERIAL AND METHODS: In this cross-sectional study, 1426 teeth were analysed from 169 undergraduate and postgraduate dental students (83 women and 86 men, median age 22 years). Teeth with worn or totally restored incisal edges, or gingival inflammation were excluded. Age, gender and body height were recorded and the degree of tooth wear was scored according to the quantification module of the Tooth Wear Evaluation System. The clinical crown heights of all anterior teeth and canines were measured from the gingival margin to the incisal edge with a digital calliper. Reference values for tooth groups were obtained at the percentiles 10, and expressed by sex if there was a significant difference between men and women. RESULTS: Mean crown heights were bigger in men than in women for each tooth group (p = .028). Clinical crown heights showed sexual dimorphism at the 10th percentiles for all tooth groups except for mandibular anterior teeth. CONCLUSIONS: For assessing tooth wear, the sex-specific reference values for the clinical crown height of young adults Caucasoids range from 7.5 mm to 9.0 mm in women and from 7.5 mm to 9.5 in men.

Influence of masticatory side switch frequency on masticatory mixing ability and sensory perception in adults with healthy dentitions: A randomized crossover trial.

STATEMENT OF PROBLEM: The advantages and disadvantages of frequently changing sides while masticating remain unclear. PURPOSE: The purpose of this clinical study was to determine the effect of varying the frequency of masticatory side switches on masticatory mixing ability and sensory perception in dentate adults. MATERIAL AND METHODS: This nonblinded, randomized 12-period crossover study, conducted at Barcelona Dental School from January to March 2022, included 36 healthy adults with natural dentitions (median age, 23.5 years; 26 women). Participants were randomly allocated to 12 sequences and performed 12 masticatory assays masticating a 2-colored gum for 40 cycles each using the following masticatory styles as interventions: freestyle, unilateral right, unilateral left, and switching sides 5%, 15%, and 25%. The primary outcome was the mixing ability index (MAI), defined as the standard deviation of the red channel intensity of the masticated gum in the color-histogram plugin of the ImageJ software program. Participants also rated the perceived flavor intensity and salivary flow on a visual analog scale. Data were analyzed by repeated measures analysis of variance (α=.05). RESULTS: The MAI was similar for all masticatory styles (P=.63). Participants perceived greater flavor intensity (mean difference: 8%, 95% CI: 1% to 15%) and salivary flow (mean difference: 11%, 95% CI: 0% to 21%) with 25% side switching compared with freestyle or unilateral mastication. CONCLUSIONS: Frequently switching the masticatory side while masticating gum does not alter the mixing ability, but it appears to enhance salivary flow and flavor intensity.

Accuracy of digital and conventional systems in locating occlusal contacts: A clinical study.

STATEMENT OF PROBLEM: The accuracy of methods used for locating occlusal contacts throughout the entire clinical procedure has been poorly studied. PURPOSE: The purpose of this clinical study was to determine the reproducibility and criterion validity for different methods of locating occlusal contacts. MATERIAL AND METHODS: Thirty-two adults with natural dentitions participated in this cross-sectional test-retest study. In total, occlusal contacts at maximum intercuspation were recorded by using 15 methods: silicone transillumination with Occlufast Rock (40, 50, 100, and 200 µm) and Occlufast CAD (40 and 50 µm); virtual occlusion (100, 200, 300, and 400 µm); articulating film (12-, 40-, 100-, and 200-µm-thick); and T-Scan III. Images of the occlusal records were scaled and calibrated spatially, and the occlusal contacts of the right posterior mandibular teeth were delimited by using the FIJI software program. Reproducibility was expressed as 95% confidence intervals (95% CI) of the percentage of agreement in the location of the occlusal contacts between images from the test sessions against retest sessions using the same method. Criterion validity was expressed as 95% CI of the percentage of agreement in the location of the occlusal contacts between images from the test sessions against images from Occlufast Rock (criterion standard). RESULTS: Occlufast Rock achieved 85% to 95% agreement in the location of the occlusal contacts between the 2 sessions, whereas Occlufast CAD, 200-µm articulating film, and T-Scan offered 79% to 86%, 68% to 75%, and 65% to 75% agreement, respectively. The most valid method was Occlufast CAD (74% to 80%) followed by the 200-µm articulating film (57% to 63%), 400-µm virtual occlusion (53% to 62%), 100-µm articulating film (52% to 60%), and T-Scan (48% to 56%). CONCLUSIONS: Conventional methods, such as 100- and 200-µm articulating film and digital methods, including 400 µm virtual occlusion and T-Scan, offer sufficient accuracy in locating the occlusal contacts. However, strategies are needed to improve accuracy.

Effect of side switch frequency on masticatory performance and rhythm in adults with natural dentition: A randomised crossover trial.

BACKGROUND: The relationships between the frequency of masticatory side switches (MSS) and other aspects of masticatory function are not clear. OBJECTIVES: In this study, we determined the effect of MSS frequency on masticatory performance and rhythm in dentate adults and explored the between-subject relationships among side switch frequency, masticatory rhythm and laterality. METHODS: In this crossover study, subjects performed six masticatory patterns of five trials each, chewing bagged silicone for 20 cycles. The six patterns were freestyle, unilateral right, unilateral left, and switching sides one, three and five times. Masticatory performance and rhythm were determined for each style by median particle size (MPS) and chewing cycle duration, respectively. In the freestyle mastication pattern, masticatory laterality was assessed by the unilateral chewing index, and the frequency of MSS was assessed by the MSS Index. Data were analysed using Friedman's test and repeated measures analysis of variance. RESULTS: We included 29 participants (15 women; median age, 23 years). No significant between-subjects differences in the MPS were detected obtained by switching one, three or five times per trial. Chewing cycle duration increased with the MSS number per trial. During freestyle mastication, the MSS Index was inversely correlated with the unilateral chewing index (Rho -0.569; 95% CI -0.25 to -0.78; p = .001; Spearman test), but not with the MPS or chewing cycle duration. CONCLUSION: Differences in MSS frequency do not affect masticatory performance, but they do alter the masticatory rhythm. Individuals with a higher MSS frequency also have a more symmetrical chewing pattern.

Variation in Dental Occlusal Schemes Two Years After Placement of Single-Implant Posterior Crowns: A Preliminary Study.

Some authors have recommended that implant-supported single crowns should only contact during heavy clenching. However, a lack of occlusal contact with moderate clenching may cause supraeruption of antagonist natural teeth. The main objective of this study was to assess changes in the occlusal contacts of posterior implant-supported single crowns with natural antagonist teeth 2 years after placement. The occlusal schemes of 14 patients who received 16 implant-supported single crowns in molar and premolar regions were assessed in this prospective study. Just after crown placement, at 6 months and after 2 years, a silicone maxillomandibular relationship and T-scan records were obtained during the intercuspal position with light and heavy clenching, determined using near half of the maximum force and maximum force, respectively. Occlusal contacts were assessed quantitatively and qualitatively in the implant-supported single crowns, contralateral tooth, and adjacent tooth; the latter 2 were used as controls. After 6 months and 2 years, no significant variations were observed in any region of the occlusal scheme in any assessments, including silicone record or T-Scan, using light or heavy clenching, and qualitative or quantitative occlusal contact assessment. In this preliminary study, the occlusal scheme did not vary at the intercuspal position 2 years after placing posterior implant-supported single crowns.

Attitudes and opinions towards the prevention of orofacial injuries among water polo coaches in Catalonia: A cross-sectional study.

BACKGROUND/AIM: Although orofacial injuries are frequent in water polo, fewer than 10% of players use mouthguards. The aim of this study was to determine the degree to which coaches and sports club managers encourage mouthguard use in water polo and to explore their opinions regarding other strategies designed to reduce the prevalence of orofacial injuries. MATERIAL AND METHODS: This was a cross-sectional study in which the coaches and sports club managers of 16 water polo clubs in Catalonia were invited to participate. An online questionnaire was administered to the coaches to obtain general data, to determine whether they had recommended mouthguard use to their players and to record their opinions on other strategies designed to reduce the prevalence of orofacial injuries. Sports club managers were interviewed about the facilities offered by their clubs for players to obtain mouthguards and about their attitudes regarding the prevention of orofacial injuries. RESULTS: The questionnaire was administered to 72 coaches who trained 111 teams during the 2019-2020 season, together with 14 sports club managers. Coaches of only 11 teams (10%) recommended mouthguard use to their players. Two clubs (14%) offered some facilities to their players to obtain mouthguards. Interestingly, only 18% of the coaches believed that mouthguard use should be mandatory, in contrast to 50% of the sports club managers (p = 0.017; Fisher's exact test). Most coaches and sports club managers believe that a video monitoring system should be used to identify dangerous play and that orofacial injuries should be reported under a surveillance programme. CONCLUSIONS: Few water polo coaches recommend mouthguard use to their players and very few clubs offer facilities to obtain custom-made oral protection. However, most coaches and sports club managers agree that the rules should be modified to protect players from aggressive play.

Masticatory rhythm 3 months after treatment with unilateral implant-supported fixed partial prosthesis: A clinical study.

STATEMENT OF PROBLEM: Whether treatment with an implant-supported fixed partial prosthesis (ISFPP) affects the masticatory rhythm in patients with unilateral posterior missing teeth is unclear. PURPOSE: The purpose of this prospective clinical study was to determine the change in masticatory rhythm in participants with unilateral posterior missing teeth 3 months after treatment with an ISFPP and to assess whether treatment influenced the stability of the masticatory rhythm. MATERIAL AND METHODS: Thirty participants (mean age 59 years; 17 women) with unilateral posterior missing teeth were treated with 1-, 2-, or 3-unit ISFPPs. Ten healthy individuals (mean age 36 years; 8 women) with a complete natural dentition were included in a control group. In this prospective study, each participant performed 3 masticatory assays (freestyle, unilateral right, and unilateral left) at baseline and at the 3-month follow-up. Each assay comprised 5 trials of 20 cycles masticating pieces of silicone placed in a latex bag. The time needed to complete the 20 masticatory cycles per trial was measured, and the mean masticatory frequency was calculated for each assay. Coefficients of variation were then calculated from the 5 mean values of the masticatory trials. Differences in the data at 3 months and baseline were analyzed by using the Wilcoxon or paired t tests. The control and treated groups were compared by analysis of variance or Mann-Whitney U tests (α=.05). RESULTS: After 3 months, participants treated with ISFPPs showed an increase of 8.7% in masticatory frequency during freestyle mastication (P<.001) and an 8.0% increase during unilateral mastication on the treated side (P<.01). At baseline, the coefficient of variation of masticatory frequency on the treated side was higher in the ISFPP group than in the control group during unilateral mastication (P=.033). Three months after treatment, there was a significant reduction in the coefficient of variation during unilateral mastication on the treated side of the ISFPP group (P<.001). The treatment group also reached a masticatory frequency similar to that of the control group (75 and 78 cycles per minute, respectively). CONCLUSIONS: Treatment with ISFPPs accelerated the masticatory rhythm of individuals with unilateral posterior missing teeth, who achieve similar rhythms to those with complete natural dentitions. The stability of the masticatory rhythm was also restored, indicating an improvement in masticatory function.

Changes in masticatory laterality 3 months after treatment with unilateral implant-supported fixed partial prosthesis.

OBJECTIVE: This study assessed changes in masticatory laterality in patients with unilateral posterior missing teeth 3 months after treatment with an implant-supported fixed partial prosthesis (ISFPP). METHODS: Thirty patients with unilateral posterior missing teeth participated in this prospective study. They were treated with one-, two- or three-unit ISFPPs. The control group comprised 10 healthy individuals with complete natural dentition. Each participant performed masticatory assays at baseline and at 3-month follow-up, chewing pieces of silicon inside a latex bag. Masticatory laterality was determined using three different methods: assessment of the first chewing cycle, of all cycles and application of a visual analogue scale. Data were compared using the Kruskal-Wallis or the Mann-Whitney U test as appropriate. RESULTS: Three months after treatment, a significant change in the asymmetry index towards the treated side and a significant reduction in the Unilateral Chewing Index were observed in the ISFPP group. No significant differences in masticatory laterality between groups were detected at 3-month follow-up, regardless of the method assessed. CONCLUSION: Treatment with ISFPPs alters the masticatory laterality, moving it to the treated side and increasing the degree of bilateral chewing in patients with unilateral posterior missing teeth.

Effect of thickness and occlusal accommodation on the degree of satisfaction with mouthguard use among water polo players: A randomized crossover trial.

BACKGROUND/AIM: The optimal mouthguard type and design for each player and sport are currently unknown. The aim of this study was to assess the effect of using a thicker custom-made mouthguard with occlusal accommodation on the degree of satisfaction among water polo players. MATERIAL AND METHODS: Twenty-five elite water polo players participated in this randomized four-period crossover trial conducted from February to May 2019. For each participant, two customized mouthguards were fabricated using 4-mm ethyl vinyl acetate foil: Type A included no occlusal accommodation, and Type B included a 2-mm occlusal accommodation. Players wore each mouthguard during training sessions and competitions for 2 weeks in one of two randomized sequences. After each match or training session, players were asked to evaluate the mouthguards on 10-point scales across three domains: discomfort or interference with function, protection, and general satisfaction. Mouthguard preference was also recorded. RESULTS: The mouthguard with occlusal accommodation was reported to interfere more with speech and swallowing (P < .001) and with esthetics, breathing, and athletic performance (P < .05) compared with the conventional mouthguard. Although occlusal accommodation was associated with a higher perceived degree of protection (mean difference 0.5; 95% CI: 0.2-0.8), players were still more satisfied with the conventional mouthguard (mean difference 1.5; 95% CI: 0.8-2.3). Two players preferred the occlusal mouthguard, whereas 22 preferred the conventional mouthguard (P = .007). CONCLUSIONS: Among water polo players, occlusal accommodation increasing the thickness of the custom-made mouthguards may offer a greater perceived sense of protection, but this comes at the cost of greater discomfort and reduced overall satisfaction. Dentists can recommend conventional mouthguards for most water polo players.

Experience with mouthguards and prevalence of orofacial injuries among field hockey players in Catalonia.

BACKGROUND/AIM: Orofacial injuries are a serious problem in field hockey. The aim of this study was to determine the prevalence of orofacial injuries in field hockey players in Catalonia, the frequency of mouthguard use, the types of mouthguards used and the degree of interference with oral function. MATERIAL AND METHODS: In this cross-sectional study, 325 field hockey players (28% women) from all age categories completed a questionnaire about orofacial injuries occurring during their sporting lives, including dental injuries, oral lacerations and episodes of acute temporomandibular disorder (TMD) pain. The questionnaire also asked about the experience of using a mouthguard, the type of mouthguard used and any adverse effects of use. The degree of interference with oral function was compared by type of mouthguard (mouth-formed, custom-made and pre-fabricated mouthguards) using the Kruskal-Wallis test. RESULTS: Half of the players (50.2%) reported at least one orofacial injury during their sporting lives. The mean number of oral lacerations, TMD pain episodes and dental injuries were 1.59, 0.24 and 0.18, respectively. In total, 310 players (95.7%) had tried a mouthguard, and of these 269 (86.8%) and 283 (91.3%) still used a mouthguard habitually during training and competition, respectively. Only 11 players (3.5%) had tried all three types of mouthguards, and 71 players (22.9%) had tried two types of mouthguard. By type, 217 players (70.0%) had tried mouth-formed (boil-and-bite) mouthguards, 156 (50.3%) had tried custom-made mouthguards and 30 (9.7%) had tried pre-fabricated mouthguards. Custom-made mouthguards were rated as more comfortable than the mouth-formed type (P < .05). CONCLUSIONS: The prevalence of orofacial injuries among field hockey players is relatively high. Most players habitually use a mouthguard during training and competition, typically preferring custom-made or a mouth-formed types. Custom-made mouthguards were considered the most comfortable.

Reliability and Validity of T-scan and 3D Intraoral Scanning for Measuring the Occlusal Contact Area.

PURPOSE: To determine the reliability of T-scan and 3D intraoral scan techniques for assessing the occlusal contact area (OCA), compared to occlusal registration and also to assess the validity of the techniques. MATERIALS AND METHODS: Thirty-one dentate adults participated in this cross-sectional study. T-scan records were used to measure the OCA at maximum bite force and at 50% of maximum force using the software's bite force selection tool. A second method measured the OCA between 2 virtual models scanned intraorally using a 3D surface scan and considering the occlusal contact at 2 interocclusal distances (0-100 and 0-200 µm). The third method measured OCA using occlusal registration at moderate and maximum occlusal force, and considering contact at the 2 interocclusal distances (0-100 and 0-200 µm). Images obtained using the 3 methods were analyzed using ImageJ software. Test-retest reliability was assessed by the intraclass correlation coefficient (ICC) and validity by Pearson correlations. RESULTS: ICCs ranged from 0.56 to 0.79 (p < 0.001) for the T-scan; 0.37 to 0.61 (p < 0.05) for 3D surface scan; and 0.92 to 0.95 (p < 0.0005) for occlusal registration. The highest OCA values were obtained using the T-scan, and the lowest using the 3D surface scan. Occlusal registration measurements had the highest correlations with those of the other techniques. CONCLUSIONS: T-scan is a reliable method for measuring the OCA, but the 3D surface scan is not. Occlusal registration showed a high validity.

Do implant-supported fixed partial prostheses improve masticatory performance in patients with unilateral posterior missing teeth?

OBJECTIVES: The purpose of this study was to determine the improvement in masticatory performance and satisfaction with chewing ability in partially edentulous patients after treatment with an implant-supported fixed partial prosthesis (ISFPP). MATERIAL AND METHODS: This prospective study included 30 patients (mean age 59 years; 17 women) with unilateral posterior missing teeth treated with one-, two- or three-unit ISFPPs and 10 healthy individuals (mean age 36 years; 8 women) with complete natural dentition to establish the normal levels of mastication. Three variables were determined at baseline and at 3-months' follow-up in all participants: masticatory performance according to the median particle size (MPS) during freestyle mastication and unilateral mastication on each side, and satisfaction with chewing ability using a visual analog scale. Paired samples t test and Kruskal-Wallis test were used for intra-group and inter-group comparisons. RESULTS: The MPS following freestyle mastication decreased significantly at 3 months in both groups. Significant reductions of 21%, 30%, and 42% in the MPS were obtained from unilateral mastication on the treated side after treatment with 1, 2, or 3 restorative units, respectively. Three months after ISFPP, satisfaction with chewing ability improved by 40% in the treatment group. CONCLUSIONS: Freestyle masticatory performance may improve slightly within three months of treatment with an ISFPP and may be similar to that of subjects with complete natural dentition. Patients may obtain a 21%-38% improvement in unilateral mastication on the treated side and a 26%-54% improvement in satisfaction with chewing ability.

Satisfaction with shortening the palatal extension of a mouthguard for water polo players: A randomized crossover study.

BACKGROUND/AIM: Approximately 50% of water polo players have suffered orofacial injuries. However, fewer than 8% of players wear a mouthguard. A more comfortable mouthguard design is therefore needed to increase compliance. The aim of this study was to assess the effect of reducing the palatal extension of a custom-made mouthguard on the degree of satisfaction with a mouthguard among water polo players. MATERIALS AND METHODS: Eighteen elite water polo players participated in this randomized crossover trial. Two custom-made mouthguards were fabricated for each participant using 4-mm-thick ethyl vinyl acetate foils, defined by the extension of the palatal margin from the cervical line: conventional (6 mm) and shortened (2 mm). The mouthguards were worn during all training sessions and matches, in a randomized sequence (one mouthguard type for the first and fourth weeks and the other for the second and third weeks). Mouthguards were evaluated on 10-point scales for discomfort, interference with oral functions, protection, and general satisfaction after each training session or match. RESULTS: Players evaluated the shortened mouthguard as having less interference with speech (Effect 1.30; P < 0.001), breathing (Effect 0.98; P = 0.004), swallowing (Effect 1.30; P < 0.001), and athletic performance (Effect 0.61; P = 0.03) compared with the conventional mouthguard. The perceived degree of protection was similar among participants when wearing each type of mouthguard. Overall, players were more satisfied with the shortened mouthguard (Effect 0.64; P = 0.03). CONCLUSIONS: Reducing the palatal extension of a custom-made mouthguard from 6 to 2 mm improves the overall satisfaction of elite water polo players without affecting the perceived degree of protection.

Satisfaction of patients with amyotrophic lateral sclerosis with an oral appliance for managing oral self-biting injuries and alterations in their masticatory system: A case-series study.

STATEMENT OF PROBLEM: About 10% of patients with amyotrophic lateral sclerosis (ALS) are candidates for oral treatment specifically because of traumatic injuries in the lips, cheeks, or tongue due to self-biting. However, patients with ALS have a prevalence of temporomandibular disorder (TMD) similar to that in the general population. PURPOSE: The purpose of this case-series study was to determine the degree of satisfaction of patients with ALS with an oral appliance for managing oral self-biting lesions or symptoms related to TMDs. This study also assessed the degree of improvement of the chief complaint and the compliance with and adverse effects of this treatment. MATERIAL AND METHODS: Eleven patients with ALS who sought oral treatment because of oral self-biting or TMD-related symptoms were included. A custom complete-coverage acrylic resin device was fabricated and fitted to each participant. A follow-up visit was planned for 3 months after the placement of the oral appliance, at which point the patients would rate the degree of improvement or worsening of the chief complaint and their degree of satisfaction with the treatment. A 1-sample t test was used to assess whether the degree of improvement of the chief complaint was significant. RESULTS: Participants reported a mean of 61% (95% confidence interval [CI] 38% to 84%) improvement of the chief complaint and a mean of 84% (95% CI 72% to 97%) satisfaction with the treatment. The mean rate of compliance was 62% (95% CI 40% to 84%) of the recommended time, and only a few adverse effects were reported. CONCLUSIONS: Participants with ALS were highly satisfied with the use of an oral appliance to manage oral self-biting or TMD-related symptoms. Adherence to this treatment was high, and no major adverse effects were observed.

Risk of orofacial injuries and mouthguard use in water polo players.

BACKGROUND/AIM: The incidence of orofacial injuries and the use of mouthguards in water polo players have not been well established. The aim of this study was to determine the incidence of orofacial injuries in water polo players. Frequency of mouthguard use, the types of mouthguards used and the degree of interference with oral functions were also assessed. MATERIAL AND METHODS: In this cross-sectional study, 347 water polo players completed a questionnaire about the orofacial injuries suffered in the 2015-2016 season and the experience of using a mouthguard, such as the type of mouthguard used and the degree of interference with oral functions. RESULTS: In the 2015-2016 season, 57.9% of the players reported at least one orofacial injury, with mean numbers of 2.7 oral lacerations, 0.4 episodes of temporomandibular pain and 0.06 dental injuries. Among the 35 players (10.1%) who had tried a mouthguard, only four (1.2%) used it habitually. Some players had tried more than one type of mouthguard; 26 had tried the mouth-formed type; 11 the custom-made type; and 7 the prefabricated mouthguard. Custom-made mouthguards were rated as more comfortable than the mouth-formed type (P < 0.05). The main disadvantages of mouth-formed mouthguards were interferences with speaking, breathing and swallowing. CONCLUSIONS: The incidence of orofacial injuries in water polo players is high. Although some players had tried a mouthguard, mainly the mouth-formed type, most of them do not wear them routinely for training and competition.

Status of Removable Dentures and Relationship with Oral Candida-Associated Factors in a Geriatric Population in Catalonia.

PURPOSE: Colonization by Candida is related to wearing a denture. How denture type, status, and maintenance play a role in determining Candida colonization remains unknown. This work evaluated removable denture status in an elderly population and explored the association between denture-related factors and oral Candida colonization as determined by systemic and local factors. MATERIALS AND METHODS: Socio-demographic, general health, and behavioral data and oral factors were registered by means of a questionnaire. Oral, dental, and denture-related factors were assessed by clinical examination, and yeasts were isolated from oral and denture specimens. Multiple logistic regression analysis was used to explore the relative relevance of risk factors. RESULTS: Overall, 52.4% of subjects used complete dentures in both lower and upper arches, and 90% of the prostheses were in good condition. Denture plaque index was high in most cases, and 75% of subjects had yeasts in their oral cavities. Oral Candida colonization was significantly associated with low saliva pH, sugar consumption, and the fault of a denture component; however, only sugar consumption was found to be an independent factor related with oral Candida colonization, showing an odds ratio of 3.04 in a multiple logistic regression model. CONCLUSIONS: Elderly people in this study used a complete denture in good condition, with a median age of 15 years. Daily or weekly sugar consumption was found to be highly associated with oral colonization by Candida.

Relationship between jaw movement and masticatory performance in adults with natural dentition.

OBJECTIVE: This study determines the relationship between several characteristics of jaw movement and masticatory performance determined by multiple regression analysis and adjusted for occlusal contact area and bite force. MATERIALS AND METHODS: Forty-two young adults with natural dentition participated in this cross-sectional study. Occlusal contact area was determined at the maximum intercuspal position by scanning interocclusal records. Maximum unilateral force was measured by means of a gnathodynamometer. The height and amplitude of mastication, occlusal glide length, lateral guidance angle, anterior-posterior distance and cycle duration were recorded using the ARCUSdigma II system. Masticatory performance was determined by sieving the Optosil particles resulting from 20 chewing cycles. RESULTS: Median particle size was negatively associated with height of mastication, maximum bite force, occlusal contact area and amplitude of mastication. Stepwise multiple linear regression analysis revealed that the height of mastication and dental guidance angle are the characteristics of jaw movement most closely related to masticatory performance. CONCLUSIONS: In adults with natural dentition, a large vertical height of mastication and a small dental guidance angle are the characteristics of jaw movement most closely associated with good masticatory performance, determined by multiple regression analysis and adjusted for occlusal contact area and bite force.

Reliability of a visual analog scale for determining the preferred mastication side.

STATEMENT OF PROBLEM: Although the visual analog scale (VAS) is a simple tool for quantitatively measuring symptom perception, no studies have used the VAS to assess the degree of subjective masticatory laterality. PURPOSE: The purpose of this study was to assess the reliability of the VAS for determining the preferred mastication side (PMS) and to compare it with other methods. MATERIAL AND METHODS: A cross-sectional study was conducted in which 42 adults with natural dentition performed 2 masticatory sessions. Eight different methods were used to determine the PMS by combining different definitions, food tests, measurements, and number of cycles assessed. A test-retest was performed in 10 participants to evaluate the reliability of each method using the intraclass correlation coefficient. To assess the validity of the different methods, the Pearson correlations were performed (α=.05) between the 8 methods. RESULTS: Self-assessment using the VAS had the highest reliability; it also had a positive and significant relationship with 6 of the 7 other methods. The method that showed the best validity used bagged silicone as the test food, determined the PMS by video recording, and assessed all masticatory cycles using the asymmetry index. Low reliability was found for methods using the location of gum bolus at standardized time intervals or electromyographic recordings. CONCLUSIONS: The VAS provided a highly reliable means of assessing the degree of masticatory laterality perceived by the participant, with a positive and significant correlation with the majority of the other methods.