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1.
Ann Anat ; 235: 151675, 2021 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-33515689

RESUMEN

BACKGROUND: The prevalence of hard tissue formations in the dental pulp varies considerably. Beside ageing processes and irritations of the dental pulp, etiological associations with cardiovascular disease and dietary habits have been discussed, which are of particular research interest. The aim of this pilot study is to provide new insights on structural and etiological factors involved in the development of pulp calcifications by investigating skeletal remains from different (pre)historic periods. METHODS: The jaws of 46 skeletons excavated in central Germany, were examined for the presence of pulp stones using digital volume tomography (DVT). A total of 1122 teeth were examined with all tooth types considered. To obtain information about the three-dimensional structure of pulp calcifications, micro-CT images were taken. Thin sections of three molars were histologically analysed. Potential dietary effects were studied by analysing stable isotope ratios of nitrogen (δ15N) in bone samples collected from each individual. RESULTS: The analysis indicates that pulp stones affect molars in particular and increase slightly with age and dental wear. The micro-CT scans and the histological analysis show that the structures are much more complex than presumed on the basis of DVT imaging. Individuals with lower δ15N-isotope values and thus with a potentially lower proportion of animal protein in their diet appear to be less affected by pulp stones. CONCLUSION: When comparing between archaeological and recent data, DVT analysis provides qualitatively comparable results. Micro-CT and histological images illustrate the excellent preservation of pulp calcifications and their complex structure. Differences in prevalence rates and δ15N-isotope values of Neolithic and historical individuals support the assumption that dietary habits and living conditions could have an influence on the development of pulp calcifications. Due to the small sample size these results require further validation.

2.
J Clin Med ; 9(12)2020 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-33287339

RESUMEN

To date, risk factors for temporomandibular joint (TMJ) sounds are still not completely understood, and anatomical factors are suspected to influence their occurrence. This study aimed to evaluate the impact of body constitution on temporomandibular joint sounds of adolescents. 10- to 18-year-old participants of the LIFE Child Study were examined for TMJ sounds, and physical parameters such as body height, body weight, and general laxity of joints were measured. Odds ratios (OR) for associations of TMJ sounds and standard deviation scores (SDS) of body height and body weight were calculated by using binary logistic regression, including cofactors such as age and number of hypermobile joints. The OR for TMJ sounds and SDS of body height was 1.28 (95% confidence interval (CI) 1.06; 1.56) in females when the age-adjusted height value was above 0. SDS of body weight indicated significant ORs for TMJ sounds in males with values of 0.81 (95% CI 0.70; 0.94). No correlation was detected for SDS values and TMJ crepitus. Tall female adolescents seem to be more prone to TMJ clicking sounds, while their occurrence seems less likely in male adolescents with higher body weight.

3.
Materials (Basel) ; 13(24)2020 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-33302336

RESUMEN

The aim of this study was to compare the clinical properties of tooth-colored computer-aided design/computer-aided manufacturing (CAD/CAM) materials for the fabrication of a 3-unit fixed dental prostheses (FDPs) in the same clinical scenario. A 53-year-old female patient was supplied with a 3-unit FDP to replace a second premolar in the upper jaw. Restorations were fabricated from 3 mol%, 4 mol%, and 5 mol% yttrium oxide zirconia, zirconia with translucency gradient, indirect composite resin, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Milling time, weight, and radiopacity were investigated. Esthetics were examined following the US Public Health Service criteria (USPHS). The milling time for zirconia was twice as high as for the indirect composite resin, PEEK, or PEKK. The latter materials had a weight of 2 g each, while zirconia restorations yielded 5 g. Zirconia presented intense radiopacity. PEEK and PEKK required veneering and an opaquer was applied to the PEKK framework. All FDPs showed acceptable esthetics. PEEK and PEKK restorations were featured by a grayish shimmering. A variety of CAD/CAM materials are available to fabricate 3-unit FDPs with esthetically acceptable results. In the esthetic zone, PEEK and PEKK require veneering and an opaquer might be applied. Milling time, weight, and radiopacity were relatively high for zirconia FDPs.

4.
Eur J Dent Educ ; 2020 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-33053252

RESUMEN

INTRODUCTION: Competencies in the clinical examination of patients with temporomandibular disorders (TMD) can be achieved by self-instruction. This study aimed to identify the impact of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) instructional video on the practical examination skills of undergraduate students. MATERIALS AND METHODS: One week prior to completing an objective structured clinical examination (OSCE) addressing the examination of patients with TMD, undergraduate students in their third year received either the DC/TMD manual (control group) or additionally watched the instructional video once (intervention group). After passing the OSCE, a feedback questionnaire was completed by the students. RESULT: Fifty undergraduates were recruited to take part in the OSCE prior to their first clinical course. The sum scores achieved in the stations were higher in the intervention group, but missed significance. Participants of the intervention group more often agreed that completing the OSCE stations was easy, which was significant for one station (P = .023). 95.8% of the participating students supported the implementation of the video in dental education. DISCUSSION: Due to the conception of the study, the video was only presented once to ensure that the control group had no access to the medium at all. However, it might be interesting to investigate whether repeated watching of the video enhances its effect. CONCLUSIONS: Clinical competencies in the examination of TMD patients can be achieved by self-instruction with the DC/TMD manual and instructional video. Watching the video for educational purposes was highly recommended by undergraduate students.

5.
BMC Oral Health ; 20(1): 267, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-32998738

RESUMEN

BACKGROUND: The etiology of temporomandibular disorders (TMD) can be explained on the basis of a biopsychosocial model. However, psychosocial assessment is challenging in daily dental practice. The purpose of the current study was to field-test the practicability of a novel psychosocial assessment scoring form regarding the reliability of scoring procedures and the opinion of examiners. The working hypotheses were that the scoring results of inexperienced undergraduate students were similar to the results collected by a gold standard and that the scoring form was easy to use. METHODS: A psychosocial assessment scoring form was developed in accordance with guidelines of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), including results of the Graded Chronic Pain Scale (GCPS), Patient Health Questionnaires (PHQ), and Generalized Anxiety Disorders (GAD). Inexperienced operators (undergraduate students) examined patients with TMD-associated complaints and rated the practicability of the scoring form. The scoring results were recalculated by two experienced operators and a consensus was defined as a gold standard. Reliability coefficients were determined comparing results of the gold standard and the inexperienced operators. RESULTS: Sixty-five examiners used the scoring form to obtain results for patients with TMD-associated complaints. Of the patients, 78.8% received a diagnosis according to DC/TMD decision trees. Two-thirds of the operators (62.9%) stated that the form was easy to complete, and 83.0% would use it in their dental practice. The reliability coefficients ranged between 0.81-1.00. CONCLUSIONS: Within the limitations of the present study, the psychosocial assessment scoring form seems to be an easy-to-use and practicable tool. The vast majority of the inexperienced examiners recommended the application.

6.
J Oral Sci ; 62(4): 430-434, 2020 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-32863318

RESUMEN

Perception of tooth shades is subjective and not rated exactly the same by different individuals. In terms of dental esthetics, chairside individualization of dental restorations might help to improve patient satisfaction. This investigation aimed to validate the practicability of a chairside approach for staining resin-based composite restorations. Thirteen inexperienced and 13 experienced participants were recruited to first individualize two CAD/CAM resin-based composite crowns in randomized order with light-curing characterization material using two reference crowns as templates. They then evaluated the characterization procedure. The processing times were recorded, and the clinical quality of the individualized crowns was evaluated by two blinded master dental technicians. Of the 52 crowns examined, 90.4% were assessed as suitable for insertion; there was no difference in quality attributable to the different degrees of experience of the operators. The average time required for characterization of the second crown was significantly shorter than for the first crown (30.9/43.0 min), indicating that the procedure can be implemented using a chairside approach. Among the operators, 80.8% said they would use the individualization technique and staining material again. Chairside staining of CAD/CAM resin-based composite restorations with light-curing characterization materials is practicable and can be recommended for both experienced and inexperienced users.


Asunto(s)
Porcelana Dental , Diseño de Prótesis Dental , Cerámica , Resinas Compuestas , Diseño Asistido por Computadora , Coronas , Materiales Dentales , Humanos
7.
J Oral Rehabil ; 2020 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-32648606

RESUMEN

AIM: Verification of the interrater reliability of axis I diagnoses of the German version of the DC/TMD. The hypothesis was that the DC/TMD protocol yields comparable results, if examiner instructions are closely followed. MATERIAL AND METHODS: A culturally equivalent German translation of the DC/TMD was developed. During a 1-day calibration workshop at the University of Heidelberg, three examiners were trained by the DC/TMD Training and Calibration Center. According to the calibration guidelines, 16 models (11 cases, five non-cases) were examined by four experienced TMD specialists. Reliability was calculated with reference to the reference standard examiner as percentage agreement and kappa coefficients for DC/TMD diagnoses and intraclass correlation coefficients (ICCs) for findings. RESULTS: Excellent reliability was achieved for the diagnoses myalgia, myofascial pain with referral, arthralgia, headache attributed to TMD, disc displacement (DD) with reduction, DD without reduction without limited opening (κ = 0.85…1.00). Degenerative joint disease was diagnosed with substantial agreement (κ = 0.64), DD with reduction with intermittent locking and DD without reduction with limited opening were not present in our sample. Overall percentage agreement was 94%-100% for all diagnoses. CONCLUSION: The German version of the DC/TMD shows very good reliability and can be recommended for the use in clinical and research settings.

8.
GMS J Med Educ ; 37(4): Doc39, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32685667

RESUMEN

Objectives: The aim of this project was to develop an instructional video that demonstrates a standardized clinical examination on patients with suspected temporomandibular disorders (TMD). After viewing the video, the learner should be knowledgeable about the examination steps and application of the examination techniques. Methods: The instructional video was created by two dentists who are experienced in assessing patients with suspected TMD. Additionally, both examiners were calibrated according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The instructional video was divided into chapters. Various camera angles, key points, image enlargements, and replays were used to better depict essential aspects of the assessment. Background noise was reduced to a minimum. Results: The instructional video was modified and completed in two phases: the first by an experienced dentist and the second by a dentist specialized in TMD. The final video includes nine chapters and is 26.5 minutes in length (https://doi.org/10.5061/dryad.k8r7qc1). Conclusion: Divided into chapters, this German instructional video shows an optimally timed, standardized clinical assessment of patients with suspected TMD.

9.
Clin Oral Investig ; 2020 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-32556660

RESUMEN

OBJECTIVES: This study aimed to survey dentists in Germany to identify their favored materials for the fabrication of tooth-supported single crowns (SCs) depending on the location of the abutment teeth and the preparation margin. MATERIALS AND METHODS: The survey included questions regarding demographic characteristics of dentists/their dental practice and preferred restorative materials for the fabrication of SCs for abutment teeth 16, 11, 34, and 36 with either supra- or subgingival preparation margins. RESULTS: Between August 2019 and February 2020, 721 dentists participated in the survey; responses from 33 dentists were excluded from data analysis because the dentists did not work in Germany or provided less than one fixed dental prosthesis/month. Dentists favored ceramic materials independent of the location of the abutment tooth and preparation margin (56.6-92.2%). CAD/CAM resin composites or full metals were preferred by only a few participants. A significantly higher proportion of dentists recommended porcelain fused to metal for subgingival preparation margins than for supragingival margins (p < 0.001). Characteristics of dentists/dental practices influenced a single scenario (11 subgingival) that was dependent on the dentist's time since graduation. When asked to specify the ceramic materials, numerous participants wrote a free response (5.7-7.8%) or did not answer (0.7-4.8%). CONCLUSIONS: Dentists in Germany selected restorative materials for SCs depending on the clinical scenario. Since numerous dentists did not specify the ceramic materials, postgraduate information and education might help to extend expertise. CLINICAL RELEVANCE: The results of this survey provide insight into the favored materials of dentists for the fabrication of tooth-supported SCs.

10.
J Oral Rehabil ; 2020 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-32333415

RESUMEN

Patients perceive the impact of oral disorder in four major areas, the dimensions of oral health-related quality life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. The functional aspect is essential given the need of chewing, biting, speech and swallowing. The objective of this study was to identify OHRQoL information for dental subjects with functional oral health problems. In a systematic review, distinct and clinically relevant groups of dental subject samples, in this study called "population groups," with such functional OHRQoL information based on the Oral Health Impact Profile (OHIP) were identified (PROSPERO registration: CRD42017064033). The search strategy was "Oral Health Impact Profile" or OHIP. Searches were conducted in the PubMed interface of the Medline database, EMBASE, Cochrane, CINAHL and PsyINFO on 8 June 2017 and updated on 14 January 2019. Published OHIP domain data of different versions were recalculated into OHIP-14`s Physical Disability domain score, characterising the subject's Oral Function impact. 3,653 potentially abstracts were screened. We identified 78 publications reporting dimensional information on 154 subject samples with 52 populations. A typical mean functional impact for partially dentate subjects was 1.6 units on a 0 to 8 unit metric, while for edentate subjects, the mean functional impact was 2.6 units. The functional impact score ranged from 0 to 7.9 units with 50% of the patient samples located between 0.8 and 2.6 units. For the first time, we provide normalised and therefore comparable metric information about the functional OHRQoL impact for a substantial number of functional oral conditions.

11.
J Oral Rehabil ; 47(4): 425-431, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31841219

RESUMEN

BACKGROUND: Prevalence values for symptoms and signs of temporomandibular disorders (TMD) in adolescents vary within the literature due to differences in set-ups of examination protocols. OBJECTIVES: The objective was to present prevalence values for symptoms and signs of TMD in German adolescents that were observed within a standardised examination. Prevalence values comparing gender or pubertal status should be investigated. METHODS: A cross-sectional sample of the LIFE Child Study aged 10 to 18 was examined. A questionnaire gathering anamnestic symptoms of TMD was completed, and an examination according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was performed by trained dentists. Pubertal status according to Tanner stages was documented. Descriptive statistics, Mann-Whitney U and Wilcoxon signed-rank tests were performed. RESULTS: A total of 1.116 participants (mean age 12.9 years, 51.4% female) were consecutively recruited. Most prevalent anamnestic symptoms were headaches (55.7%) and temporomandibular joint (TMJ) sounds (17.6%). The major clinical sign was TMJ sounds (31.9%). Both the examination of muscles or TMJs showed that pain to palpation was statistically significantly higher than familiar pain (P < .001). Gender comparisons revealed higher prevalence values and an increase in TMD symptoms and signs during pubertal development in females. CONCLUSION: The prevalence of self-reported headaches, as well as anamnestic and clinical TMJ sounds, was high in German adolescents. Prevalence values for pain to palpation and familiar pain obtained relevant differences. Considering the DC/TMD, females are more affected by TMD signs and symptoms that increase during pubertal development, than male adolescents.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Adolescente , Niño , Estudios Transversales , Dolor Facial , Femenino , Cefalea , Humanos , Masculino , Dolor , Prevalencia
12.
J Adhes Dent ; 22(6): 567-571, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33491401

RESUMEN

Purpose: To survey dentists in Germany regarding their preferred cementation regimen for fixed dental prostheses (FDPs) fabricated from various restorative materials. Materials and Methods: An online survey was developed for completion by dentists in Germany between 08/2019 and 02/2020. The questionnaire gathered information about the cementation regimen (conventional, including the acid-base cements zinc-oxide phosphate or any glass-ionomer cement; self-adhesive; adhesive; don't know) that the participant would preferably select for the insertion of single- or multi-unit FDPs fabricated from various restorative materials. Data were also collected on demographic and personal characteristics. Results: A total of 721 dentists completed the survey, and the data from 688 questionnaires were included in the analysis. Conventional cementation was the option of choice for restorations fabricated from alloy/porcelain-fusedto- metal among 91.0% of the participants and for restorations fabricated from polycrystalline ceramics among 42.9% of the participants. Adhesive cementation was preferred for restorations fabricated from feldspathic/leucitereinforced glass ceramics (77.9%), lithium-disilicate glass ceramics (67.5%), zirconia-reinforced lithium-silicate glass ceramics (42.0%), and CAD/CAM resin composites (63.8%). Uncertainties regarding the appropriate cementation protocol for restorations fabricated from CAD/CAM resin composites were reported by 15% of the participants. More than 20% of the participants selected a technique that is less or not at all recommended for the cementation of restorations fabricated from zirconia-reinforced lithium-silicate glass ceramic and CAD/CAM resin composites. Conclusion: The results of the survey suggest that dentists in Germany select the cementation regime depending on the restorative material. Some of the participating dentists selected cementation regimens that are less or not at all recommended for restorations fabricated from zirconia-reinforced lithium-silicate glass ceramic and CAD/CAM resin composites, or were not sure about the appropriate cementation protocol.


Asunto(s)
Cementación , Cementos de Resina , Cerámica , Diseño Asistido por Computadora , Coronas , Porcelana Dental , Diseño de Prótesis Dental , Odontólogos , Alemania , Humanos , Ensayo de Materiales , Encuestas y Cuestionarios
13.
Int J Prosthodont ; 32(5): 389-392, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31486808

RESUMEN

PURPOSE: To investigate changes in oral health prior to and after conversion of fractured abutment teeth in double crown-retained removable dental protheses (DC-RDPs) into root-anchored ball attachments. MATERIALS AND METHODS: Twenty patients were supplied with one root-anchored ball attachment after abutment tooth fracture. The Oral Health Impact Profile (OHIP-49) was completed by the patients prior to and after treatment to assess changes in perceived oral health. RESULTS: Changes in OHIP were statistically and clinically significant (28.90 points prior to treatment and 13.80 points after treatment), especially in cases with a minor number of remaining double crowns. CONCLUSION: The conversion of fractured abutment teeth in DC-RDPs into root-anchored ball attachments can be an effective strategy for improving perceived oral health.


Asunto(s)
Dentadura Parcial Removible , Fracturas de los Dientes , Coronas , Pilares Dentales , Humanos , Salud Bucal , Calidad de Vida
14.
J Oral Rehabil ; 46(11): 1023-1030, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31206205

RESUMEN

OBJECTIVES: The aim of this cross-sectional study was to investigate whether sex hormones (testosterone, oestradiol, sex-hormone-binding globulin = SHBG) are associated with general joint laxity (GJL) and hypermobility or derangements of the temporomandibular joint (TMJ) in adolescents. METHODS: Within the LIFE Child study, 970 adolescents (10-18 years) were included. GJL was assessed using the Beighton test. Maximum mouth opening (MMO) and clinical clicking sounds as signs of disc displacement (DD) in the TMJ were assessed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum levels of sex hormones were assessed using standardised laboratory analyses. RESULTS: Hypermobile joints were found in 54.9% (N = 532) of the sample; females were more affected than males (61.4% vs. 51.8%, P < 0.001). Using logistic regression analyses, the odds ratio (OR) for having >1 hypermobile joints increased to 1.15 (95% confidence interval [CI]: 1.04-1.27) in males and 1.09 (95% CI: 1.02-1.17) in females per 10 units of the SHBG serum level, compared to those without hypermobile joints-after controlling for the effect of age, adjusted BMI, pubertal development (Tanner scale), testosterone as well as oestradiol levels. Female subjects with >1 hypermobile joints showed a higher OR (1.89; 95% CI: 1.05-3.43) for having clinical clicking sounds in the TMJ and a 3.28 times higher OR (95% CI: 1.44-7.44) for MMO ≥ 55 mm. CONCLUSIONS: We observed age- and gender-independent associations of higher SHBG serum levels with GJL in adolescents. Moreover, hypermobile female adolescents show a more frequent hypermobility of the TMJ and clinical signs of DD.


Asunto(s)
Inestabilidad de la Articulación , Trastornos de la Articulación Temporomandibular , Adolescente , Niño , Estudios Transversales , Femenino , Hormonas Esteroides Gonadales , Humanos , Masculino , Articulación Temporomandibular
15.
J Contemp Dent Pract ; 20(1): 3-7, 2019 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31058610

RESUMEN

AIM: The aim of this study was to identify the influence of dental fear, pain, and impaired oral health-related quality of life (OHRQoL) on patients seeking care in a German emergency dental service. MATERIALS AND METHODS: Patients attending the emergency dental service at the University of Leipzig (Germany) were consecutively recruited and completed three questionnaires, including a visual analog scale for pain, the dental fear survey (DFS), and the oral health impact profile (OHIP-49). RESULTS: A total of 307 patients attended the emergency dental service and 286 agreed to take part in the study. The mean age was 41.7 years (50.4% males). The pain was reported by 87.2 % of the subjects, and their main reason for seeking care was a toothache (52.6 %). Regarding psychosocial characteristics, the mean OHIP and DFS scores were 40.0 and 47.6, respectively. For dentally fearful patients, a significantly higher impairment of OHRQoL was identified than for subjects with less or no fear. 33.2% of the participants irregularly consulted a dentist, and 58.4% of these patients were categorized as dentally fearful. CONCLUSION: The current investigation identified a high pain intensity as well as a high prevalence of dental fear, and a high impairment of OHRQoL in patients seeking care in an emergency dental service. CLINICAL SIGNIFICANCE: The results of the current study might help to develop specific services for patients with dental fear, which can successively reduce the number of emergency dental treatments.


Asunto(s)
Ansiedad al Tratamiento Odontológico , Calidad de Vida , Adulto , Atención Odontológica , Femenino , Alemania , Humanos , Masculino , Salud Bucal , Encuestas y Cuestionarios
16.
Cranio ; 37(1): 60-67, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28854058

RESUMEN

OBJECTIVE: Valid and reliable recording is a key requirement for accurately simulating individual jaw movements. METHODS: Horizontal condylar inclination (HCI) and Bennett's angle were measured using a digital jaw tracker (Cadiax® Compact 2) in 27 young adults. Three mounting methods (paraocclusal tray adapter, periocclusal tray adapter, and tray adapter with mandibular clamp) were tested. RESULTS: The mean values of the HCI differed by up to 10° between the mounting methods; however, the values for Bennett's angle did not differ substantially. While the intersession reliability of the Bennett's angle assessment did not depend on the mounting method, the reliability of the HCI assessment was only fair to good for the paraocclusal mounting method but poor for both periocclusal mounting methods. DISCUSSION: For attaching the tracing bow of jaw trackers to the mandible, a paraocclusal tray adapter should be applied, to achieve the most reliable results.


Asunto(s)
Computadores , Registro de la Relación Maxilomandibular/métodos , Cóndilo Mandibular/fisiología , Movimiento , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Adulto Joven
17.
J Dent ; 80: 55-62, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30355509

RESUMEN

OBJECTIVES: To compare oral health-related quality of life (OHRQoL) in patients with either molar replacement by partial removable dental prostheses (PRDP) or with restored shortened dental arches (SDA) over a period of 10 years. METHODS: In this multi-center RCT, a consecutive sample of 215 patients with bilateral molar loss in at least one jaw was initially recruited in 14 prosthodontic departments. Of those patients, 150 could be randomly allocated to the treatment groups (SDA: n = 71; PRDP: n = 79), received the allocated treatment, and were available for follow-up assessments. OHRQoL was assessed using the 49-item version of the Oral Health Impact Profile (OHIP) before treatment (baseline) and at follow-ups after treatment (4-8 weeks and 6, 12, 24, 36, 48, 60, 96, and 120 months). To investigate the course of OHRQoL over time, we longitudinally modelled treatment and time effects using mixed-effects models. RESULTS: OHRQoL substantially improved from baseline to first follow-up in both groups indicated by a mean decrease in OHIP scores of 20.0 points (95%-CI: 12.5-27.5). When compared to the SDA group, OHRQoL in the PRDP group was not significantly different (-0.6 OHIP points; 95%-CI: -7.1 to 5.9) during the study period when assuming a constant time effect. OHRQoL remained stable over the 10 years with a statistically insignificant time effect (p = 0.848). CONCLUSIONS: For patients requesting prosthodontic treatment for their lost molars, treatments with SDA or PRDP improve clinically relevantly OHRQoL and maintain it over a period of 10 years with no option being superior to the other. CLINICAL SIGNIFICANCE: Since there was no significant difference between the two treatment options over the observation period of 10 years, and since results have stayed stable over time, patients can be informed that both treatment concepts are equivalent concerning OHRQoL.


Asunto(s)
Arco Dental , Dentadura Parcial Removible , Humanos , Salud Bucal , Calidad de Vida , Encuestas y Cuestionarios
18.
Cranio ; 36(3): 156-160, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-28502221

RESUMEN

OBJECTIVE: This study determines the effect of temporomandibular disorders (TMD) on the reliability of mandibular movement assessments. METHODS: The vertical and horizontal jaw movements, as well as overjet and overbite, were measured twice in 56 consecutively recruited adult subjects with TMD according to the RDC/TMD and 29 controls without TMD diagnosis by experienced dentists utilizing a millimeter ruler. The reliability was determined by intraclass correlation coefficient (ICC). RESULTS: Neither statistically nor clinically relevant differences in the repeatability between both subgroups could be detected (all p ≥ 0.077). The mouth opening and overjet proved an excellent reliability (ICC 0.85-0.92). Overbite and laterotrusion showed good to excellent reliable results (ICC 0.74-0.82). The second measurement of the vertical jaw movement resulted in systematically higher values (p < 0.003). DISCUSSION: The assessment of the mandibular movement with a millimeter ruler is a reliable procedure irrespective of TMD. To decrease the variances in the mouth opening measurements, the patient should be asked beforehand to practice this movement.


Asunto(s)
Mandíbula/fisiopatología , Trastornos de la Articulación Temporomandibular/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Maxilares/fisiopatología , Persona de Mediana Edad , Movimiento , Sobremordida/fisiopatología , Reproducibilidad de los Resultados , Adulto Joven
19.
Qual Life Res ; 27(3): 775-782, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29063350

RESUMEN

PURPOSE: Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance. METHODS: In this prospective clinical study, a sample of 126 adult patients (age 17-83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients' ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments. RESULTS: Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment. CONCLUSION: Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.


Asunto(s)
Salud Bucal/normas , Calidad de Vida/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Sesgo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios , Adulto Joven
20.
Clin Oral Investig ; 22(4): 1763-1769, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29103104

RESUMEN

OBJECTIVES: Nowadays, all-ceramic materials are routinely used within the treatment of patients in dentistry. The objective of this prospective clinical trial was the evaluation of chair-side generated monolithic lithium disilicate crowns after 10 years. MATERIALS AND METHODS: Forty-one posterior full contour crowns made of lithium disilicate ceramics were inserted with a self-adhesive resin cement in 34 patients (20 university/14 private practice) using a chair-side CAD/CAM technique. One crown per patient was randomly selected for evaluation according to the modified US Public Health Service criteria. RESULTS: After a mean examination time of 10.1 years, 26 crowns were available for re-examination. Within the observation period, five failures occurred due to one crown fracture after 2.9 years, an abutment fracture after 6.0 years, one severe endodontic problem after 6.1 years, a root fracture after 7.0 years, and a replacement of one crown caused by a carious lesion after 10 years. Complications occurred as retention loss of one crown, two carious lesions, and a change in sensibility perception of two abutment teeth. All events were associated with molars. The Kaplan-Meier analysis revealed a survival rate of 83.5% and a complication-free rate of 71.0% after 10 years. CONCLUSION: Due to the small amount of technical complications and failures, the clinical performance of monolithic lithium disilicate crowns was completely satisfying. CLINICAL RELEVANCE: The insertion of chair-side fabricated monolithic lithium disilicate crowns can be recommended for long-term use in the posterior region.


Asunto(s)
Coronas , Diseño de Prótesis Dental , Adulto , Anciano , Diseño Asistido por Computadora , Porcelana Dental , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cementos de Resina , Resultado del Tratamiento
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