A comparison of change in condylar position in asymptomatic volunteers utilizing a stabilization and a pivot appliance.

Although different occlusal appliances with various designs have been described in the literature, little is known about their influence on condylar position. The purpose of the present study was to compare the effect of two occlusal appliances (pivot appliance, stabilization appliance) on condylar position with respect to normal and maximum clenching force. Electronic-positioning-analysis was performed in 22 healthy volunteers with an ultrasound-based registration system. After randomized insertion of the appliances, the volunteers were asked to clench five times using normal and then maximum force. Data was compared using ANOVA for repeated measurements, with occlusal design and clenching force as covariables (alpha = 0.05). Insertion of appliances caused an anterior-downward movement of the condylar reference point (pivot appliance: 0.3 mm +/- 0.5 mm sagittally, 0.8 mm +/- 0.5 mm vertically; stabilization appliance: 0.2 mm +/- 0.5 mm sagittally, 0.8 mm +/- 0.5 mm vertically). In both appliances, maximum clenching force enhanced the anterior and reduced the downward position (pivot appliance: 0.4 mm +/- 0.5 mm sagittally, 0.6 mm +/- 0.5 mm vertically; stabilization appliance: 0.4 mm +/- 0.5 mm sagittally, 0.4 mm +/- 0.6 mm vertically). Within groups, the positions for normal and maximum clenching force were significantly different (p<0.001 in the sagittal and vertical dimension for both appliances). Comparison of occlusal design with respect to clenching force revealed no significant differences between both appliances. Insertion of both appliances induced an anterior-downward movement of the condylar reference point, whereas the two different occlusal designs had no influence on condylar position.

WHO-5 well-being index as screening instrument for psychological comorbidity in patients with temporomandibular disorder.

OBJECTIVES: The aim of the study was to compare the WHO-Five Well-Being Index (WHO-5) with the Oral Health Impact Profile-49 (OHIP-49) questionnaire as screening tools to detect psychological comorbidity in TMDs. METHODS: A TMD group (92 patients, 42.8 ± 17.1 yrs) and a control group (90 patients of the Department of Prosthetic Dentistry, 38.9 ± 10.1 yrs) completed the WHO-5 and the OHIP-49 questionnaire. RESULTS: The patients with TMD reported significantly greater OHIP-49 sum scores than controls (47.5 ± 34.7 vs. 7.7 ± 12.1; p < 0.001). The mean raw score of the WHO-5 was significantly less, with 45.6 ± 20.6 points for patients with TMD than the 73.2 ± 15.6 points found for controls (p < 0.001). The OHIP sum score and the WHO-5 raw score were significantly associated (r = 0.705, p < 0.001). Both instruments exhibited excellent internal consistency (Cronbach's α = 0.967 and 0.883, respectively). CONCLUSIONS: WHO-5 proved to be an effective and economic screening instrument to detect psychological comorbidity in TMDs. Implementing WHO-5 in standard care could contribute to more individualized interdisciplinary psychotherapy and/or functional therapy.

The single mandibular implant study - Short-term effects of the loading protocol on Oral Health-related Quality of Life.

PURPOSE: A single implant can be placed to retain an overdenture in the edentulous mandible. This study aimed at the development of Oral Health-related Quality of Life comparing immediate and delayed implant loading, i.e., loading after 3 months of submerged healing. METHODS: In a randomized controlled trial, 158 participants received a single mandibular implant in the midline. Quality of life was measured using the summary score of the German 49-item Oral Health Impact Profile at baseline, one month after implant placement (direct loading group) as well as one and four months after loading. RESULTS: Mean scores at baseline were comparable. Four months after implantation, a decrease of mean scores was recognized for both groups, indicating a significantly enhanced quality of life after treatment. When comparing the groups after both 1 and 4 months of loading, quality of life was insignificantly higher in the delayed loading group (1 month: 42.1 vs. 32.3; 4 months: 33.6 vs. 27.7). For immediate loading, an insignificant tendency to an earlier improvement was recognized (Δ1month-baseline: 9.7, compared to Δ1month-baseline: 6.4). CONCLUSIONS: The single mandibular implant concept was associated with a positive impact on quality of life. However, no statistically significant influence of implant loading on quality of life was found.

The oral cavity is not a primary source for implantable pacemaker or cardioverter defibrillator infections.

BACKGROUND: To test the hypothesis that the oral cavity is a potential source for implantable pacemaker and cardioverter defibrillators infections, the bacterial diversity on explanted rhythm heart management devices was investigated and compared to the oral microbiome. METHODS: A metagenomic approach was used to analyze the bacterial diversity on the surfaces of non-infected and infected pacemakers. The DNA from surfaces swaps of 24 non-infected and 23 infected pacemaker were isolated and subjected to bacterial-specific DNA amplification, single strand conformation polymorphism- (SSCP) and sequencing analysis. Species-specific primer sets were used to analyze for any correlation between bacterial diversity on pacemakers and in the oral cavity. RESULTS: DNA of bacterial origin was detected in 21 cases on infected pacemakers and assigned to the bacterial phylotypes Staphylococcus epidermidis, Propionibacterium acnes, Staphylococcus aureus, Staphylococcus schleiferi and Stapyhlococcus. In 17 cases bacterial DNA was found on pacemakers with no clinical signs of infections. On the basis of the obtained sequence data, the phylotypes Propionibacterium acnes, Staphylococcus and an uncultured bacterium were identified. Propionibacterium acnes and Staphylococcus epidermidis were the only bacteria detected in pacemeaker (n = 25) and oral samples (n = 11). CONCLUSIONS: The frequency of the coincidental detection of bacteria on infected devices and in the oral cavity is low and the detected bacteria are highly abundant colonizers of non-oral human niches.The transmission of oral bacteria to the lead or device of implantable pacemaker or cardioverter defibrillators is unlikely relevant for the pathogenesis of pacemaker or cardioverter defibrillators infections.