Use of the universal pain assessment tool for evaluating pain associated with TMD in youngsters with an intellectual disability

BACKGROUND: The Universal Pain Assessment Tool (UPAT) was used to assess the level of pain in people with limited communication skills. The UPAT enables clinicians to consult a specialized pain management team more often and lead to earlier interventions. The purpose of this study was to determine, whether the UPAT could be used as an extra tool to collect data on functional TMJ pain and to assess orofacial pain levels related to temporomandibular disorder(s) (TMD) in people with intellectual disabilities (ID). MATERIAL AND METHODS: Non-down syndrome ID Athletes were screened during the Special Olympics European games in 2014. The clinical scores of possible functional jaw pain were collected using the UPAT, to indicate pain severity on a visual scale during different jaw movements (opening, closing and lateral). RESULTS: Two hundred and four youngsters were screened by calibrated dentists. The majority (65%) of participants were male (133 male and 71 female athletes); age distribution ranged from 15 to 23 years (mean 19.25 ± 2.53). The results of the UPAT have shown the existence of functional TMJ pain in 32% (n=65) of the athletes without significant prevalence (P > 0.05) in this survey group. CONCLUSIONS: According to the results of the present study, the UPAT demonstrated that it could be a useful tool to detect the existence of functional jaw pain possibly associated with TMD and also a valid instrument to score pain intensity associated with TMD in people with ID

A retrospective cohort study of metal-cast resin- bonded fixed dental prostheses after at least 16 years.

PURPOSE: This retrospective cohort study evaluated metal-cast silan-coated three-unit resin-bonded fixed dental prostheses (RBFDPs) after at least 16 years and identified covariates affecting the survival. MATERIALS AND METHODS: A total of 37 patients with 42 RBFDPs placed by one operator between 1986 and 1993 were recalled and invited for a clinical examination in conjunction with scrutiny of clinical records. RESULTS: Thirteen RBFDPs were lost to follow-up after an average of 58.5 months (SD = 39.4) and considered unaccounted for, 10 failed prior to the research recall and had a survival of 130.2 months (SD = 68.3), and 19 were still in function with a mean survival of 236.2 months (SD = 24.7). The estimated, cumulative survival via Kaplan-Meier analysis of the total number of 43 RBFDPs resulted in 95% (SE = 4%) survival after 5 years, 88% (SE = 6%) after 10 years and 66% (SE = 9%) after 20 years. No covariates were found having a significant effect on the survival rates. CONCLUSIONS: RBFDPs have an acceptable clinical survival although lower than conventional FDPs and single implants. They should therefore be considered as a temporary provision, as a provision for geriatric or medically-compromised patients because of the simplicity of the provision, as a less expensive alternative, and for patients where the amount of bone loss impedes the use of dental implants.