Mandibular Overdenture Supported by Two or Four Unsplinted or Two Splinted Ti-Zr Mini-Implants: In Vitro Study of Peri-Implant and Edentulous Area Strains.

Clinical indications for the newly released Ti-Zr (Roxolid®) alloy mini-implants (MDIs) aimed for overdenture (OD) retention in subjects with narrow alveolar ridges are not fully defined. The aim of this study was to analyze peri-implant and posterior edentulous area microstrains utilizing models of the mandible mimicking a "real" mouth situation with two (splinted with a bar or as single units) or four unsplinted Ti-Zr MDIs. The models were virtually designed from a cone beam computed tomography (CBCT) scan of a convenient patient and printed. The artificial mucosa was two millimeters thick. After MDI insertion, the strain gauges were bonded on the oral and vestibular peri-implant sites, and on distal edentulous areas under a denture. After attaching the ODs to MDIs, the ODs were loaded using a metal plate positioned on the first artificial molars (posterior loadings) bilaterally and unilaterally with 50, 100, and 150 N forces, respectively. During anterior loadings, the plate was positioned on the denture's incisors and loaded with 50 and 100 N forces. Each loading was repeated 15 times. The means with standard deviations, and the significance of the differences (two- and three-factor MANOVA) were calculated. Variations in the MDI number, location, and splinting status elicited different microstrains. Higher loading forces elicited higher microstrains. Unilateral loadings elicited higher microstrains than bilateral and anterior loadings, especially on the loading side. Peri-implant microstrains were lower in the four-MDI single-unit model than in both two-MDI models (unsplinted and splinted). Posterior implants showed higher peri-implant microstrains than anterior in the four-MDI model. The splinting of the two-MDI did not have a significant effect on peri-implant microstrains but elicited lower microstrains in the posterior edentulous area. The strains did not exceed the bone reparatory mechanisms, although precaution and additional study should be addressed when two Ti-Zr MDIs support mandibular ODs.

Influence of education level and gender of dental students on perception of dental aesthetics.

BACKGROUND: Fulfilling aesthetic norms is an imperative of modern society. Accordingly, aesthetics has found its important role in dental medicine. The aim was to study whether there is a difference in the perception of tooth shade change and anatomical variations of anterior maxillary teeth among dental students depending on the level of education, gender, and experience in assisting in a dental office. METHODS: The research was conducted among dental students via the Google Forms platform. Students evaluated the aesthetic acceptability of a smile on the unaltered, reference photograph (RP) and on the other 28 photographs in which the tooth shade (lighter and darker teeth), length (shortened central incisors, elongated, and beveled lateral incisors, elongated canines) and position (atypical and typical rotations and diastemas) of the upper maxillary teeth were altered by digital manipulation. The 1-10 assessment scale was used. Statistical analysis comprised one-way Kolmogorov-Smirnov test, X2 tests, t-test, and 3-way MANOVA. RESULTS: In the research 208 students participated, 113 were preclinical students, 104 assisted in dental office and 175 were females. There were no significant effects of gender regarding length and position modifications (p > .05), while women were stricter in evaluation of lighter shade (p < .05). Clinical students were stricter in evaluating all manipulated photographs (MP) except those towards darker shade modifications, while assisting in a dental office or having a dentist in close family showed no significant effects (p > .05). CONCLUSIONS: With a higher level of targeted academic education, dental students sharpen their ability to notice deviations from the aesthetic norms of a smile.

Mini-Implants Retaining Removable Partial Dentures in Subjects without Posterior Teeth: A 5-Year Prospective Study Comparing the Maxilla and the Mandible.

Background and objectives: Long-term studies of clinical outcomes of mini-implants (MDIs) in the first premolar/canine sites retaining a bilateral free-ending removable partial dentures (RPD) in Kennedy class I subjects have not been well documented. The aim was to assess clinical outcomes in a prospective 5-year cohort study comparing the mandible and maxilla. Material and Methods: Participants (n = 92) who received two MDIs each and a new RPD were reviewed after one, three and five years. A total of 71 participants (82 mini-implants in the mandible; 58 in the maxilla) completed the study. Marginal bone level change, success, survival rates, Modified Plaque (MPI) and Bleeding Indices (MBI) were assessed. Results: The five-year success rate was 93.3% and 93.4% (p > 0.05), in the mandible and the maxilla, respectively. Mean peri-implant bone loss (MBL) increased significantly over five years (p < 0.01) to 0.50 mm in the mandible and 0.52 mm in the maxilla. Age had a significant effect on the MBL (higher rates in younger participants), while jaw of insertion, gender, and antagonistic jaw status did not. MPI and MBI were not significantly correlated with MBL. Conclusions: The insertion of two MDIs in previous first premolar/canine sites for retention of a free-end saddle RPD can be a successful treatment modality in subjects with narrow alveolar ridges.

Clinical Outcomes of Three versus Four Mini-Implants Retaining Mandibular Overdenture: A 5-Year Randomized Clinical Trial.

Background and Objectives: Due to a lack of long-term clinical studies that would clarify whether the insertion of three mini-implants (MDIs) can be as successful treatment as the insertion of four MDIs for the retention of mandibular overdentures (ODs), this 5-year prospective cohort study was set up. Materials and Methods: Participants (n = 83) randomly received either four or three MDIs and a mandibular OD. Clinical examinations were performed at the baseline, as well as after one, three, and five years, respectively. A total of 73 participants (38 in the four-MDI and 35 in the three-MDI groups) partook in the study. The marginal bone level change, success and survival rates, and prosthodontic maintenance were assessed. Results: Repeated measures showed that the mean peri-implant bone loss increased progressively at a small amount over five years in both groups (four-MDI group = -0.36 ± 0.74; three-MDI group = -0.33 ± 0.27 mm; p < 0.05). However, an ANCOVA revealed no significant effects of the group (no significant difference between the three- and the four-MDI groups; F = 0.085; p = 0.771), gender (F = 0.023; p = 0.88), or covariate age (F = 1.95; p = 0.167) on the dependent variable: the 5-year MBL change. The success rate (together with successful survival) was 93.8% in the four-MDI group and 91.7% in the three-MDI group. The log-rank (Mantel-Cox) test revealed no significant differences between them (X2 = 0.373; p = 0.541). Conclusions: In patients with narrow ridges, the insertion of three MDIs in the mandible for overdenture retention can be equally as successful as the insertion of four MDIs.

Assessment of Orofacial Esthetics among Different Specialists in Dental Medicine: A pilot study.

Objectives: Little is known whether specialists in different dental fields assess orofacial esthetics differently due to various focus of their interest. The aim was to find out if there is a difference in judgement of orofacial esthetics among specialists in three different fields of Dental Medicine, i.e. specialists in Prosthodontics (S-Prosthod), Periodontology (S-Perio), and Orthodontics (S-Ortho). Material and methods: A total of 69 specialists (23 participants in each group) assessed the same 60 photographs of the lower third of the face of young healthy people with Angle Class I and natural teeth while smiling. Moreover, the assessed anterior teeth on the photographs of similes had to be without any restorations. The assessments were made using 7 out of 8 Items of Orofacial Esthetic Scale (OES). A face profile assessment was not performed. A Likert 1-5 scale was used for assessments (1-the worst score; 5-the best score). Mean values of summary scores as well as of each OES item were calculated for each specialist for further statistical analysis. One-sample Kolmogorov-Smirnov test, descriptive statistics, one-way ANOVA, and Sheffe post-hoc tests were performed. Results: The specialists in Periodontology gave significantly lowest scores to all 7 items related to orofacial esthetics, while the specialists in Prosthodontics gave the highest scores (p<0.05). Conclusion: Assessments of orofacial esthetics differ significantly among specialists in Prosthodontics, Periodontology and Orthodontics. Further study is needed to clarify the factors which influence the judgement, and to find out if specific education in certain specialties can modify the assessment.

Adaptation to New Dentures and 5 Years of Clinical Use: A Comparison between Complete Denture and Mini-implant Mandibular Overdenture Patients based on Oral Health-Related Quality of Life (OHRQoL) and Orofacial Esthetics.

Objective of work: It is unclear how long patients need to adapt to new dentures. This study assessed adaptation and five years of clinical use, comparing complete denture wearers (CDs) and mini-implant mandibular overdenture wearers opposing a maxillary CD (MDI-OD), based on oral health reported quality of life (OHRQoL) and orofacial esthetics (OES). Material and Methods: A total of 36 subjects in the CD group (25 females) and 30 subjects in the MDI group (20 females) completed the 5-year study. All patients received new CDs, but in the MDI-OD group, four mini-implants were inserted interforaminally in the mandible before denture manufacture. Participants filled in the OHIP-EDENT and OES questionnaires one day after dentures' delivery, on the 3rd, 8th, 15th, 30th day, and at the 1-, 3- and 5-year follow-up examinations. Statistical analysis comprised descriptive methods, X 2 test, independent t-test, Friedman, and Mann-Whitney test. Results and Conclusions: Both groups' adaptation to new dentures was completed within a month. The MDI-OD group had significantly better OHRQoL in all follow-ups except for the 3rd and 8th day, probably due to soreness and pain, the reason why the MDI-OD group had limitation in functioning in the first days after new dentures' delivery. Already after the third year and at the fifth year, OHRQoL worsened (p<0.01) in both groups. However it was significantly more pronounced in the conventional CD wearers (p<0.01) than in the MDI-OD group. Orofacial esthetics was highly scored in both groups. The scores dropped down only after three years, equally in both groups. Keywords: OHRQoL, OES, prospective study, complete dentures, mini-implants, adaptation. MeSH Terms: Complete Dentures; Dental Implants; Quality of Life; Dental Esthetics.

Motivation to Follow a Career in Dentistry of Students in Three South-East European Countries.

OBJECTIVE: To investigate and compare the factors that motivated students to study dentistry in countries with similar background (Albania, Croatia and the Republic of Northern Macedonia) and to assess whether or not their motivation changed during time. MATERIAL AND METHODS: In 2014/2015, cross-sectional studies were conducted in state funded dental schools in Tirana (Albania), Zagreb (Croatia) and Skopje (Macedonia) to assess student views on their career motivation. All dental students from the first, third and final years of study were invited to participate. The participation was voluntary and anonymous. A five-item questionnaire was translated into languages of the participating countries. Ethics approval was granted by the Ethics Committee of the University of Saints Cyril and Methodius, Skopje. The Chi square test was used to test if there were statistically significant differences in answers between students in 3 countries, furthermore between years of the study. RESULTS: The total number of respondents was 739 (319 in Tirana, 211 in Zagreb and 208 in Skopje) The differences in the answers between the first-year students from all three countries were statistically significant (χ2=82.65; p<.01). The most striking answer was to the question on parents' pressure to study dentistry, which was far more frequent in Tirana (up to 27.7%). A "positive image" was the most frequent response from students from Zagreb (up to 79.7%), but it declined from the first to the final year in Skopje. There were also significant differences between the schools within the 3rdand final years of study. CONCLUSIONS: A positive image of dental profession was the main reason for students studying dentistry at all three schools; as many as 97% of the students of the final year in Croatia, a member of the European Union (EU). In the two non-EU countries (Albania, Macedonia) it seemed that dental profession does not have such good status and student expectations are not being fulfilled, especially in Skopje (up to 33.9% willing to change their vocation and up to 64.5% lost their motivation to study) One of the strategies to improve the situation could be to include more clinical practice and to better organize the study..

Assessment of esthetic characteristics of the teeth and surrounding anatomical structures.

PURPOSE: To determine the differences in the perception of aesthetic characteristics of the front teeth which include anatomic variations, appearance of the gums and dental arches, smiles and the lower third of the face between three groups of assessors. MATERIALS AND METHODS: The study included 60 patients with permanent fully toothed dentition with no prosthetic work done and with Angle class I, whose lower third of the face was photographed while smiling. Collected photos were then assessed by people of the general population (21), graduate doctors of dental medicine (20) and specialists in dental prosthetics (20) using a modified OAS questionnaire (Orofacial aesthetic scale). RESULTS: General population assessors gave weakest scores to the appearance of teeth, tooth color and appearance of the dental arches, and they gave highest scores to the appearance of the gums. Specialists in dental prosthetics gave top scores (p <0.01) for the shape and color of teeth, the appearance of the dental arches and lips and general appearance of the lower third of the face, and gave the worst scores for the appearance of the gums (p <0.01). Male assessors and people aged 36-55 are the least critical in assessing the shape and the color of teeth, appearance of the arches and lips, and the general appearance of the lower third of the face. In assessing the gums the most tolerant assessors are patients over the age of 55 (p<0.01). CONCLUSION: Considering the age and gender it can be concluded that all the criteria contribute to the assessment of the aesthetics of the teeth and surrounding structures. The results of this study may help in the planning of dental prosthetics procedures.

Psychometric properties of the Albanian version of chewing-function questionnaire CFQ-ALB.

BACKGROUND: The new Chewing Function Questionnaire (CFQ) was lately developed in Croatia to measure the chewing ability in prosthodontic patients, as a one-dimensional instrument consisting of 10-items. Therefore, the objective of this study was to develop an Albanian version of the CFQ questionnaire and to test its psychometric properties in a new typical environment among the Kosovo population. MATERIALS AND METHODS: The original version of CFQ questionnaire was translated and cross-culturally adapted from the English language into Albanian in accordance with international guidelines. Its validity (construct, convergent and discriminative) and internal consistency (reliability) were tested in 205 participants. Test-retest reliability was evaluated in 61 subjects with natural teeth, and responsiveness was evaluated in 51 prosthodontic patients with treatment needs. RESULTS: Internal consistency of CFQ-ALB indicated excellent agreement, with Cronbach's alpha values of 0.974 and average inter-item correlation of 0.792. Intraclass correlation coeficinets for test-retest were found without significant differences by 95 % of confidence intervals (p > 0.05). Construct validity was supported by a single factor that accounted for 81.711 % of the variance observed. Convergent validity was supported by the association between self-reported general satisfactions with chewing and CFQ summary scores. Discriminat validity was supported as statistically significant differences were observed between pre-defined groups. Responsiveness was confirmed by the significant difference between baseline summary scores and the after treatment scores; the mean change was 15.57 (SD =2.49) (p < 0.001). CONCLUSION: The obtained results suggest excellent psychometric properties of the CFQ-ALB questionnaire for determining chewing function in the Republic of Kosovo.

Oral Health-Related Quality of Life in Different Types of Mandibular Implant Overdentures in Function Longer Than 3 Years.

PURPOSE: The aim of this study was to evaluate the oral health-related quality of life (OHRQoL) of patients treated with three different types of mandibular implant overdentures (IOD) after at least 3 years in function. MATERIALS AND METHODS: A total of 122 patients treated with mini implant (50), locator (56), or bar (16) mandibular IODs participated. Modified plaque (PI) and gingival (GI) indices were also assessed. RESULTS: Older patients and patients with mini mandibular IODs were the most satisfied with their OHRQoL. The bar overdenture presented the worst PI and GI results. CONCLUSION: The mini mandibular overdenture patients were assessed with a better OHRQoL than those with bar and locator IODs.

Psychometric properties of the Albanian version of the Orofacial Esthetic Scale: OES-ALB.

UNLABELLED: The aim was to adapt the Orofacial Esthetic Scale (OES) and to test psychometric properties of the Albanian language version in the cultural environment of the Republic of Kosovo. METHODS: The OES questionnaire was translated from the original English version according to the accepted techniques. The reliability (internal consistency), and validity (construct, convergent and discriminative) were tested in 169 subjects, test-retest in 61 dental students (DS), and responsiveness in 51 prosthodontic patients with treatment needs (PPTN). RESULTS: The corrected item correlation coefficients of OES-ALB ranged from 0.686 to 0.909. The inter-item correlation coefficient ranged between 0.572 and 0.919. The Cronbach's alpha was 0.961 and IIC 0.758. Test- retest was confirmed by good ICCs and by no significant differences of the OES scores through the period of 14 days without any orofacial changes (p > 0.05). Construct validity was proved by the presence of one-factor composition that assumed 79.079% of the variance. Convergent validity showed significant correlation between one general question about satisfaction with orofacial esthetics and the OES summary score, as well as between the sum of the 3 OHIP-ALB49 questions related to orofacial aesthetics and the OES summary score. Discriminative validity was confirmed with statistically significant differences between DS, prosthodontic patients without treatment need and PPTN (p < 0.01). Responsiveness was confirmed by a significant increase of OES scores after PPTN patients received new fixed partial or removable dentures (P < 0.001). CONCLUSION: The results proved excellent psychometric properties of the OES-ALB questionnaire in the Republic of Kosovo.

Overdentures on Implants for Better Quality of Life Among the Fully Edentulous Patients - Case Reports.

Global aging population has brought several challenges for their medical systems and total edentulism is one of them. The fabrication of removable acrylic dentures seems to be a simple and cheap treatment solution, but a majority of patients is not satisfied with their functional instability, causing limited diets, mouth soreness, speech and psycho-social problems etc. The results in many studies indicate an impact of oral conditions associated with the full denture wearing on oral-health related quality of life, especially in lower jaw. The reason for improper denture retention could be alveolar ridge bone resorption and numerous studies about this problem are plausible. Bone resorption in lower jaw may turn the alveolar ridge into a flabby soft tissue which is unable to sustain proper denture retention. The implant-retained prosthesis is an alternative treatment option in these situations. Implants will provide retention, stability, function and aesthetics and they are not so expensive solution. The aim of this article is to show solving of retention problems of a lower denture in two different clinical cases using implants and without any special technology.

Factors related to oral health related quality of life in TMD patients.

The aims of the study were to determine the impact of temporomandibular disorders (TMD) on self-percieved oral health related quality of life (OHRQoL) and to compare OHRQoL of patients with TMD with a control group. A total of 81 TMD patients participated in a study group and 400 adults served as the control group. The mean OHIP summary scores were computed for all patients with the same diagnosis and the same subgroup of axis I according to the RDC/TMD exam form. The mean OHIP subscores for all seven domains of the OHIP questionnaire were compared between the study and the control group. The hierarchical linear regression model was used to assess the most important variables according to the RDC/TMD protocol that contribute to OHRQoL in TMD patients with the OHIP summary score as dependent variable. According to this study, TMD had a high association with reduced OHRQoL (p < 0.001). More diagnoses of axis I according to the RDC/TMD protocol (p < 0.001), higher age of TMD patients (p < 0.001) and diagnoses associated with limited jaw movements contributed to more impaired OHRQoL (p = 0.008 and p = 0.030, respectively). Female TMD patients had no significantly different OHRQoL compared to male patients (p = 0.436). According to regression analysis, higher age (p < 0.001), more physical diagnoses (p = 0.018) and diagnosis Ib (p = 0.169) explained 39.1% of the variability (p < 0.001) of the OHIP summary score in TMD patients.

Single unit attachments improve peri-implant soft tissue conditions in mandibular overdentures supported by four implants.

AIM: To evaluate the clinical performance as well as patients' and clinicians' satisfaction on two different prosthodontic retention systems for implant-overdentures in the mandible. METHODS: In this retrospective study, patients provided with four intraforaminal implants with at least 12 months of follow-up since overdenture delivery were evaluated. A total of 39 patients were treated either with Locator(®) attachment or with cad-cam milled bar. Clinical parameters such as Peri-implant Probing Depth (PPD), Plaque Index (PI), and Bleeding on Probing (BOP) were evaluated. Patients' and clinicians' perceptions regarding the outcome were assessed on visual analog scales (VAS). RESULTS: The mean follow-up was 13 months in the Locator(®) group and 18 months in the Bar group and no implants were lost. The Locator group showed better results for PPD, PI, and BOP values. Patients' satisfaction was high in both groups, whereas the clinicians found better hygienic conditions and soft tissue health in the Locator group. CONCLUSIONS: Although the patients' satisfaction was similar in both groups the Locator(®) system demonstrated better soft tissues scores because hygienic maintenance was more complicated around bars. This may increase the frequency of chronic inflammations around the implants.

Changes of the dental service delivered to patients with intellectual disability under general anaesthesia in Dental Polyclinic Split, Croatia, during the years 1985-2009.

People with intellectual disability (ID) usually have a poor quality of oral health, which include poor oral hygiene, untreated caries and high proportion of missing teeth. Due to their fear and repulsive attitude towards medical staff general anesthesia is often a useful method for dental treatment. One thousand and fifty four intellectual disability patients for the period of 1985-2009 who received dental treatment under general anesthesia in Dental Polyclinic Split, were included in the study. Patients were divided into five groups based upon the period when a specific dental treatment had been received. Each period was analyzed for the number of ID patients treated and the type of dental treatment. The results showed that the most services provided were 4006 fillings, followed by 3225 extracted teeth and finally 274 endodontic treatments. Significantly the lowest number of fillings and endodontic treatments were found among patients in group II (1990-1994), with significantly the highest number of extracted teeth. In Conclusion, the types of dental treatment have changed during twenty five years. Number of extracted teeth decreased while the number of fillings and endodontic treatment increased. However, dental status of people with intellectual disability should be improved with more restorative treatments and with better oral health prevention program.

A 3-year longitudinal study of quality-of-life outcomes of elderly patients with implant- and tooth-supported fixed partial dentures in posterior dental regions.

BACKGROUND: Clinical studies have mainly been focused on oral health-related quality-of-life (OHRQoL) outcomes of removable dentures. OBJECTIVE: To evaluate therapy of elderly patients with implant-supported fixed partial dentures (IFPD) and tooth-supported fixed partial dentures (FPD) in the posterior dental regions. PATIENTS AND METHODS: The OHIP49 was used to measure OHRQoL in 64 patients with IFPD and 38 patients with FPD, before, 3 weeks and 3 years after rehabilitation. A control group (CG) consisted of 62 individuals. RESULTS: The Oral Health Impact Profile questionnaire (OHIP) follow-up scores of the patients with FPD and the patients with IFPD were significantly smaller in comparison with the baseline scores (p < 0.01). The OHIP scores were further reduced at the 3-year follow-up. The patients with IFPD had significantly higher scores than the patients with FPD and the CG at the baseline and at the follow-ups. In the patients with FPD, both age groups (≤60 and >60) showed equal improvement of the OHRQoL. In the IFPD group, patients older than 60 years showed better improvement (p < 0.05). There were no significant differences dependent on gender and antagonistic teeth (p > 0.05). CONCLUSION: The FPD and the IFPD treatment showed significant improvement of OHRQoL. The FPD treatment improved OHRQoL equally in both age groups, while the IFPD treatment improved OHRQoL better in older patients.

Psychometric properties of the Albanian language version of the OHIP-ALB49 Questionnaire in the Republic of Kosovo.

The aim of the study was to develop and to test psychometric properties of the Albanian language version of the Oral Health Impact Questionnaire (OHIP-ALB49) in the new typical cultural context. The construct validity was tested: the convergent validity was tested on 389 subjects (general population (n = 119), removable prosthodontic patients (n = 213) and students (n = 57)), and the discriminative validity was tested in edentulous patients wearing dentures (CDWs) (n = 180) and edentulous patients having no dentures at all (n = 33). The test-retest reliability was tested on 57 subjects (27 dental students and 30 complete denture wearers), the internal consistency on 389 subjects, and the responsiveness on 33 patients with a treatment demand (complete dentures). The significant association between the OHIP summary scores and the self-reported oral health (p < 0.001) confirmed the convergent validity. The discriminative validity was confirmed by significant difference between the CDWs and the edentulous subjects without any dentures. The test-retest reliability was confirmed by high intraclass correlation coefficients and no significant differences between the two administrations (p > 0.05). The internal consistency showed high Cronbach's alpha (0.94 in general population and in prosthodontic patients, 0.96 in the student group). The responsiveness was confirmed by the statistically significant difference between the mean OHIP score at the baseline and the follow-up (p < 0.001) and by the high effect size (2.19 for the OHIP Summary Score) in the edentulous patients with a treatment demand). The psychometric properties of the OHIP-ALB49 prove that the instrument is suitable for the assessment of the Oral Health Related Quality of Life in Kosovo.

Influence of depression and somatization on acute and chronic orofacial pain in patients with single or multiple TMD diagnoses.

To examine whether psychological variables such as depression and non-specific physical symptoms (somatization) influence pain entity among acute and chronic TMD patients with one or more TMD diagnoses (muscle disorders, MD; disc displacements, DD; and arthralgia, arthritis, arthrosis, AAA). One hundred and fifty-four patients (37 male and 117 female; mean age, 39.0 +/- 14.5 years) with Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) protocol were selected. Differences in mean depression and somatization scores between acute and chronic TMD patients, as well as TMD patients with one or multiple TMD diagnoses were compared by using the parametric T-test for independent samples. The majority of patients were acute TMD patients (81.8%), while the remaining 28 patients (18.2%) were chronic TMD patients. 62% of patients had only one TMD diagnosis (MD or DD or AAA), 31% of patients had two diagnoses (MD+DD, MD+AAA, DD+AAA) and, finally, 7% of patients had three diagnoses (MD+DD+AAA) according to the RDC/TMD protocol. According to the SCL-90 psychometric evaluation, 19.5% of patients presented a severe depression score (> 1.105), 27.3% of participants presented a severe somatization score with pain items included (> 1.000). The results of the t-test for independent samples showed statistically significant differences between acute and chronic TMD patients (p < 0.001), as well as between patients who were assigned one diagnosis (p = 0.019) and patients who had two or more diagnoses (p < 0.001); for mean levels of depression and somatization scores. Chronic TMD patients and patients with multiple TMD diagnoses had higher rates of depression and somatization in this study. These results could be used in a tailored strategy of TMD treatment.

Pain relieve after impacted wisdom teeth extraction dependent on the drug therapy.

Purpose of this study was to compare the effects of combined therapy using nonsteroid anti-inflammatory analgetics and corticosteroids, and the effects of the mono-therapy with same drugs for post-operative pain after surgical removal of the impacted mandibular third molar. The study was completed at the Department of Oral Surgery and at the Department of Dental Medicine of the Public Institute Health Center Zenica in Zenica. The research included 60 patients divided into 3 groups using random selection, including both sexes. Age range was between 18 and 45 years. All participants came without any pain or other inflammatory symptoms at the time of oral surgical intervention. Two medicaments were prescribed after the impacted tooth removal: 15 mg of nonsteroid anti-inflammatory analgesic drug (Meloxicam, Bosnalijek, BiH) and 32 mg Methylprednisolone (corticosteroid, Bosnalijek, BiH). Both medicaments were applied per os, according to schedule determined by the research protocol. The level of post-surgical pain was evaluated by the 1-10 visual analog scale (VAS). One way ANOVA was made with Tuckey post-hoc tests. Statistically significant difference (p < 0.05) was found between the group treated with mono therapy and the group treated with combined therapy. Application of monotherapy using only corticosteroids or only nonsteroid anti-inflammatory pain-killers was less effective compared to the combined therapy with both medicaments after surgical removal of the impacted mandibular third molar.

Decreasing of residual alveolar ridge height in complete denture wearers. A five year follow up study.

The resorption of the residual alveolar ridges is a chronic and continuous process of bone remodeling. The aim of this study was to analyse the rate of residual ridge resorption at different sites in the both jaws in complete denture wearers, through a five-year period of denture wearing. Residual ridge changes were measured on successive lateral cephalograms at 5 measurement points of the maxilla and the mandible. The first lateral radiograph was obtained at the delivery of complete dentures. The second lateral cephalogram was obtained after five years of denture wearing. Measurements were performed using a calibrated grid. The results of this study showed the existence of a significant alveolar ridge resorption at all five measurement points of the maxilla and the mandible. The observed variables, such as body mass index and the night time denture wearing had no significant influence on the rate of residual alveolar ridge resorption (p > 0.05). The duration of edentulousness had a significant influence on the rate of residual ridge resorption with significantly higher amounts of alveolar bone height decrease in those patients who had lost the last remaining teeth more recently.