Occlusal trauma is associated with periodontitis: A retrospective case-control study.

BACKGROUND: Excessive occlusal forces and occlusal trauma have been implicated as co-destructive factors for periodontitis in animal models. The objective of this study was to assess the association between occlusal trauma and periodontitis. METHODS: A total of 167 cases and 205 controls were included for analysis. Occlusal trauma was the exposures of interest and was registered for cases and controls. Additional clinical co-variables were registered as well for further analysis. The association of the exposure and periodontitis was determined by the odds ratio and logistic regression analysis adjusted for confounders. RESULTS: Amalgam restorations, pathogenic occlusion and occlusal trauma were more frequent in cases as compared to controls (P ≤ 0.05). The distribution of pathogenic occlusion and occlusal trauma was similar according to the stage and class of periodontitis. Logistic regression analysis showed a significant association for cigarette smoking, systemic conditions, amalgam restorations, pathogenic occlusion, and occlusal trauma with periodontitis (P ≤ 0.05). After adjusting for confounding variables in the model, amalgam restorations and occlusal trauma remained strongly associated with periodontitis (P ≤ 0.05). CONCLUSIONS: Occlusal trauma is strongly associated with periodontitis. Additional long-term prospective studies are necessary to further understand the impact of the occlusal condition and periodontitis.

Oclusión traumática y Bruxismo en la Disfunción Temporomandibular / Traumatic occlusion and Bruxism in the temporomandibular dysfunction

Introducción: los tejidos de la articulación temporomandibular, así como las demás partes del Sistema Estomatognático se encuentran normalmente protegidos por reflejos nerviosos básicos y por el control neuromuscular a través de la coordinación de las fuerzas musculares. Por tanto, todo lo que pueda producir sobrecarga muscular repetitiva como la oclusión traumática y hábitos parafuncionales como el bruxismo pueden ocasionar desórdenes funcionales a este nivel conocidos como Disfunción Temporo-Mandibular. Objetivo: describir la relación existente entre un hábito parafuncional como el bruxismo y la oclusión traumática en la presencia de Disfunción Temporomandibular. Método: La presente investigación es un trabajo descriptivo, observacional y transversal realizada en el Hospital Clínico Quirúrgico Docente Celia Sánchez Manduley en el periodo de Septiembre de 2014 a febrero de 2015. La muestra estuvo constituida por 45 pacientes en las edades comprendidas entre 35 y 59 años, que acudieron a consulta de Prótesis de dicho Hospital para ser rehabilitados protésicamente. Resultados: El grupo de mayor representación fue el de 48 a 59 años. Se encontró relación directa entre las variables estudiadas y la Disfunción Temporo Mandibular. Conclusiones: Existe una relación directa entre la oclusión traumática y el bruxismo en la Disfunción Temporo Mandibular(AU)

Introduction: the tissues of the temporomandibular joint, as well as other parts of the Stomatognathic System are normally protected by basic nerve reflexes and the neuromuscular control through the coordination of muscle strength. Therefore, anything that might cause muscle strain and repetitive traumatic occlusion and parafunctional habits such as bruxism can cause functional disorders at this level known as temporomandibular dysfunction. Objective: to describe the relationship between a parafunctional habit as bruxism and the traumatic occlusion in the presence of temporomandibular dysfunction. Method: this research is an observational, transversal and descriptive study performed at the Clinical Surgical Teaching Hospital Celia Sánchez in the period of September 2014 to February 2015. The sample consisted of 45 patients about 35 to 59 years old, who attended to the Prosthesis consultation of this hospital to be rehabilitated. Results: the group with the greatest representation was about 48-59 years. It was found a direct relationship between these variables and the temporomandibular dysfunction. Conclusions: there is a direct relationship between traumatic occlusion and bruxism in the temporomandibular Dysfunction(EU)

[Relations between extraction of wisdom teeth and temporomandibular disorders: a case/control study]. / Relations entre les extractions de dents de sagesse et les dysfonctionnements de l'appareil manducateur : étude cas / témoins.

The aim of this study was to assess the impact of extraction of third molars on the occurrence of temporo-mandibular disorders (TMD). A review of the literature and a case-control study have been conducted. The case-control study compares the frequency of extraction of third molars between the sample with TMD (case) and the sample without TMD (control). The proportion of patients who had undergone extractions of wisdom teeth was higher in the case group than in the control group. The difference was statistically significant when patients had undergone extraction of all four wisdom teeth or when the extraction of four wisdom teeth underwent in one sitting or under general anesthesia. The study of patients in case sample shows that all signs of TMD were more common in patients who had undergone extractions in several sessions and under local anesthesia. The temporomandibular joint sounds are significantly more frequent with local anesthesia. In the case group, 85 to 92% of patients have parafunctions and 5 to 11% have malocclusion. This demonstrates the multifactorial etiology of temporomandibular disorders.

Interferencias oclusales en niños con dentición temporal y mixta temprana / Occlusal interferences in children with temporary and early mixed dentition

Se realizó una investigación descriptiva y de prevalencia en 80 niños de 5-6 años de edad, que asistieron al Círculo Infantil Ana de Quesada de Santiago de Cuba desde octubre de 2010 hasta septiembre de 2011, para precisar la influencia de algunos factores de riesgo en la aparición de interferencias dentarias en escolares con dentición temporal y mixta temprana. La prevalencia de interferencias dentarias fue elevada en la serie objeto de estudio, en cuyos integrantes se determinaron como factores predisponentes para la aparición de alteraciones morfológicas y funcionales de la oclusión: lactancia y dieta no adecuada, hábitos deformantes como ingerir la leche en biberón, hábito postural sobre la cara y disfunción lingual. De todo ello se infiere que la detección precoz de las interferencias oclusales permite interceptar las maloclusiones dentarias, así como prevenir anomalías dentomaxilofaciales y trastornos de la articulación temporomandibular(AU)

A descriptive and prevalence investigation was carried out in 80 children between 5-6 years who attended Ana de Quesada day care center in Santiago de Cuba from October, 2010 to September, 2011, to specify the influence of some risk factors in the emergence of tooth interferences in school children with early temporary and mixed dentition. The prevalence of tooth interferences was high in the studied series, in whom predisposing factors for the emergence of morphological and functional changes of the occlusion: nursing and non appropriate diet, deforming habits such as to ingest milk in baby bottle, postural habit on the face and lingual dysfunction were determined. It is inferred from this that the early detection of the occlusal interferences allows to intercept the teeth malocclusions, as well as to prevent dentomaxillofacial anomalies and dysfunctions of the temporomandibular articulation(AU)

Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey.

BACKGROUND: Associations between temporomandibular disorder (TMD) and psychological variables, pain conditions, and daily activities have been reported more commonly in middle-aged individuals than in children. However, to determine factor-specific preventive programs for TMD, it is important to evaluate the associations between multiple factors and TMD symptoms during childhood. The aim of this study was to assess the relationship between TMD symptoms and other orofacial pain conditions, daily activities, and trait anxiety in a population-based cross-sectional survey of Japanese children and adolescents. METHODS: A total of 1,415 subjects (11-15 years old) self-reported their TMD symptoms, headache, neck pain, and toothache, and completed questionnaire scales that assessed 15 daily activities. Trait anxiety was assessed using the State Trait Anxiety Inventory for Children-Trait (STAIC-T) scale. Subjects were dichotomized into a TMD group or control group, based on whether they reported at least 1 TMD symptom: the TMD group (≥1 TMD symptom, n = 182) and the control group (no TMD symptoms, n = 1,233). Data were analyzed using the chi-square test and multivariate logistic regression analysis. RESULTS: The prevalence rates for headache and neck pain were significantly higher in the TMD group than in the control group (44.0% vs. 24.7% and 54.4% vs. 30.0%, respectively; both P < 0.001). The odds ratios for TMD symptoms in subjects with neck pain and frequent diurnal clenching were 2.08 (P < 0.001) and 3.69 (P = 0.011), respectively. Moreover, high STAIC-T scores were weakly associated with TMD symptoms. CONCLUSIONS: In this young Japanese population, TMD symptoms were associated with other orofacial pain conditions, particularly neck pain, although they were only weakly associated with trait anxiety. Diurnal clenching was strongly associated with TMD symptoms. Health professionals should carefully consider these factors when developing appropriate management strategies for TMD in children and adolescents.

Prevalence of sleep bruxism and associated factors in preschool children.

PURPOSE: The purpose of this study was to evaluate the prevalence of sleep bruxism and associated factors in three- to five-year-olds. METHODS: A representative cross-sectional study was conducted with a sample of 749 preschool children during immunization campaigns. Data acquisition involved an oral clinical exam, anthropometric measures, and a questionnaire administered in interview form. All data were analyzed using the chi-square test and Poisson regression with robust variance with the aid of SPSS software. RESULTS: The prevalence of sleep bruxism among preschool children was approximately 14 percent. Statistically significant associations were found: between sleep bruxism and lower dental crowding (prevalence ratio=3.38; 95% confidence interval=1.9-5.7); for the habit of biting on objects (PR=2.49; 95% CI=1.4-4.4); for duration of breast-feeding for a period longer than 12 months (PR=1.98; 95% CI=1.2-3.2); and for bottle-feeding for more than 24 months (PR=1.93; 95% CI=1.2-3.1). CONCLUSIONS: Lower arch crowding, the habit of biting on objects, and prolonged breast-feeding and bottle-feeding were associated with sleep bruxism in the preschool children analyzed in the present study.

Malocclusion in preschool children: prevalence and determinant factors.

PURPOSE: To evaluate the prevalence of malocclusion and associated factors in the primary dentition of preschoolers in the city of Diamantina, Brazil. METHODS: A cross-sectional study was carried out with 381 children aged 3-5 years treated at the 10 basic health care units in the city during immunisation campaigns. The dependent variables (presence of malocclusion, open bite, crossbite and crowding) were evaluated through a clinical oral exam. The independent variables (gender, age, health problems, breastfeeding, bottle feeding, harmful oral habits, mother's schooling, household income and number of children in the home) were collected through interviews. Statistical analysis involved descriptive analysis, Chi square test and Poisson regression. RESULTS: The prevalence of malocclusion was 32.5%. Open bite was the most frequent type of malocclusion. Children with a history of bottle feeding (PR 1.74; 95% CI 1.24-2.44) and those with harmful oral habits (PR 1.49; 95% CI 1.23-1.99) had greater prevalence rates of malocclusion. Greater prevalence rates of open bite were also found in children with a history of bottle feeding (PR 5.00; 95% CI 1.99-12.5) and those with harmful oral habits (PR 2.90; 95% CI 1.59-5.29), whereas greater prevalence rates of crossbite were found in boys (PR 1.79; 95% CI 1.10-2.91) and were associated with mother's schooling (PR 1.91; 95% CI 1.20-3.06). CONCLUSION: A history of bottle feeding and the presence of harmful oral habits were identified as determinants for the occurrence of malocclusion in preschoolers.

The prevalence of dentin hypersensitivity in general dental practices in the northwest United States.

BACKGROUND: The prevalence of dentin hypersensitivity is uncertain, yet appropriate diagnosis and treatment of dentin hypersensitivity require accurate knowledge regarding its prevalence. The authors conducted a study to estimate the prevalence of dentin hypersensitivity in general dental practices and to investigate associated risk factors. METHODS: The authors conducted a cross-sectional survey of 787 adult patients from 37 general dental practices within Northwest Practice-based Research Collaborative in Evidence-based DENTistry (PRECEDENT). Dentin hypersensitivity was diagnosed by means of participants' responses to a question regarding pain in their teeth and gingivae, and practitioner-investigators conducted a clinical examination to rule out alternative causes of pain. Participants recorded their pain level on a visual analog scale and the Seattle Scales in response to a one-second air blast. The authors used generalized estimating equation log-linear models to estimate the prevalence and the prevalence ratios. RESULTS: The prevalence of dentin hypersensitivity was 12.3 percent; patients with hypersensitivity had, on average, 3.5 hypersensitive teeth. The prevalence of dentin hypersensitivity was higher among 18- to 44-year olds than among participants 65 years or older; it also was higher in women than in men, in participants with gingival recession than in those without gingival recession and in participants who underwent at-home tooth whitening than in those who did not. Hypersensitivity was not associated with obvious occlusal trauma, noncarious cervical lesions or aggressive toothbrushing habits. CONCLUSIONS: One in eight participants from general practices had dentin hypersensitivity, which was a chronic condition causing intermittent, low-level pain. Patients with hypersensitivity were more likely to be younger, to be female and to have a high prevalence of gingival recession and at-home tooth whitening. PRACTICAL IMPLICATIONS: Given dentin hypersensitivity's prevalence, clinicians should diagnose it only after investigating all other possible sources of pain.

Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: a case-control study.

Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or less commonly in daytime. The aim of this study was to investigate the association between clinical signs and symptoms, parafunctions and associated factors of sleep bruxism in children. A population-based case-control study was carried out involving 120 children, 8 years of age, with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from public and private schools in the city of Belo Horizonte, MG, Brazil. Groups were matched by gender and social class. The Social Vulnerability Index (SVI) drawn up by the city of Belo Horizonte was employed for social classification. Data collection instruments included clinical forms and pre-tested questionnaires. The diagnosis of sleep bruxism was supported by the American Association of Sleep Medicine (AASM) criteria. The McNemar test, binary and multivariate logistic regression models were used for statistical analysis. The risk factors associated with sleep bruxism included: primary canine wear (OR=2.3 IC 95% 1.2-4.3), biting of objects like pencils or pens (OR=2.0 IC 95% 1.2-3.3) and wake-time bruxism (tooth clenching) (OR=2.3 IC 95% 1.2-4.3). Children that present the parafunctions of object biting and wake-time bruxism were more susceptible to sleep bruxism.

Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: a case-control study

Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or less commonly in daytime. The aim of this study was to investigate the association between clinical signs and symptoms, parafunctions and associated factors of sleep bruxism in children. A population-based case-control study was carried out involving 120 children, 8 years of age, with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from public and private schools in the city of Belo Horizonte, MG, Brazil. Groups were matched by gender and social class. The Social Vulnerability Index (SVI) drawn up by the city of Belo Horizonte was employed for social classification. Data collection instruments included clinical forms and pre-tested questionnaires. The diagnosis of sleep bruxism was supported by the American Association of Sleep Medicine (AASM) criteria. The McNemar test, binary and multivariate logistic regression models were used for statistical analysis. The risk factors associated with sleep bruxism included: primary canine wear (OR=2.3 IC 95% 1.2-4.3), biting of objects like pencils or pens (OR=2.0 IC 95% 1.2-3.3) and wake-time bruxism (tooth clenching) (OR=2.3 IC 95% 1.2-4.3). Children that present the parafunctions of object biting and wake-time bruxism were more susceptible to sleep bruxism.

Bruxismo é o ato não funcional de ranger os dentes enquanto se dorme ou apertar os dentes em vigília. O objetivo deste estudo foi investigar a associação entre sinais e sintomas clínicos associados ao bruxismo noturno em crianças. Foi desenvolvido um estudo de base populacional com desenho caso-controle, envolvendo 120 crianças, de 8 anos de idade, com bruxismo e 240 crianças sem bruxismo. A amostra foi selecionada de forma randomizada em escolas públicas e particulares da cidade de Belo Horizonte, Brasil. Os grupos caso e controle foram pareados por gênero e classe social. O Índice de Vulnerabilidade Social (IVS) desenvolvido pela prefeitura da cidade de Belo Horizonte foi utilizado para a classificação social. Como instrumentos de coleta foram utilizados: uma ficha clínica e um questionário pré-testados. O diagnóstico de bruxismo noturno foi baseado nos critérios da American Association of Sleep Medicine (AASM). Os testes estatísticos de McNemar, regressão logística binária e multivariada com modelo de regressão foram utilizados para análise dos dados. Foram considerados fatores de risco para o bruxismo noturno: desgaste em caninos decíduos (OR=2,3 IC 95% 1,2-4,3), morder objetos como lápis e canetas (OR=2,0 IC 95% 1,2-3,3) e apertar os dentes em vigília (OR=2,3 IC 95% 1,2-4,3). Crianças que apresentam outras parafunções tais como: morder objetos e apertar os dentes em vigília são mais susceptíveis ao bruxismo noturno.

The prevalence of occlusal disharmony and its associated causes in complete dentures.

AIM: Occlusal disharmony is frequently observed among edentulous patients. With the side effects of occlusal disharmony in mind, the goal of this research was to investigate the prevalence of occlusal disharmony in inserted complete dentures and its associated causes. METHODS AND MATERIALS: This cross-sectional study was conducted on 107 selected patients. Factors such as age, gender, ridge relationship on the articulator, occlusal scheme, and the performance of a clinical remount from patients' treatment records were investigated. The presence and/or status of any occlusal disharmony was determined by a calibrated prosthodontist extraorally and qualitatively. Occlusal disharmony is defined as the absence of simultaneous bilateral contacts between the opposing posterior teeth in centric relation. The prevalence of occlusal disharmony was determined and the roles of the aforementioned factors were studied and analyzed using a Chi-square analysis. The results were considered significant at p<0.05. RESULTS: Out of 107 patients, 31 patients (28.8%) showed occlusal disharmony. No statistically significant relationship was found between occlusal disharmony and age, gender, ridge relationships, or occlusal scheme (p<0.5). Twenty-five (81%) out of 31 complete dentures with occlusal disharmony were not clinically remounted. There was a highly significant relationship between the absence of clinical remounting and occlusal disharmony (p<0.001). CONCLUSION: Within the limits of this study, the prevalence of occlusal disharmony was noticeable. A randomized clinical trial is strongly recommended to investigate factors related to the incidence of occlusal disharmony. CLINICAL SIGNIFICANCE: It is important to refine the occlusion of a complete denture after laboratory processing of the denture before it is delivered to the patient.

Occlusal status and prevalence of occlusal malocclusion traits among 9-year-old schoolchildren.

The aim of this study was to provide detailed information concerning clinically relevant occlusal traits and the prevalence of occlusal anomalies in an orthodontically relevant period of dental development. Four hundred and ninety-four German schoolchildren (237 males and 257 females), median age 9 years, were orthodontically examined. Overjet and overbite were measured to the nearest 0.5 mm, and sagittal molar relationships were registered clinically to the nearest quarter unit. In addition, crossbites, scissor bites, and midline displacements were evaluated. Descriptive statistics was complemented by testing gender differences and differences between groups with Class I and Class II anomalies (Mann-Whitney U-test) as well as a statistical evaluation of differences between the three dental stages (Kruskal-Wallis test). Overjet exhibited an extreme range between -2 and 12 mm (median values 3-3.5 mm). An increased overjet was more prevalent than a reduced or reverse overjet, and a severely increased overjet greater than 6 mm was a common finding affecting around 5-10 per cent of the children. Similarly, overbite showed considerable variations of between -1 and 9 mm (medians 3-3.5 mm) and males exhibited a significantly larger overbite than females. In Class II malocclusion subjects, overbite was significantly enlarged (on average between 0.5 and 1 mm) when compared with those with a Class I malocclusion. Traumatic contact of the gingiva affected every 14th child. A Class II molar relationship of three-quarter units or more was a frequent finding affecting more than one child in five. In addition, at 9 years of age, 3 per cent of the children exhibited a Class III molar relationship of at least a half unit. The wide range of orthodontically relevant occlusal traits found in the present study underlines the need for orthodontic screening at 9 years of age (or earlier).

The relationship between jaw injury, third molar removal, and orthodontic treatment and TMD symptoms in university students in Japan.

AIMS: To determine the association between temporomandibular disorders (TMD) and experiences of jaw injury, third molar removal, and orthodontic treatment, controlling for confounding factors such as age, sex, emotional stress, and oral parafunction. METHODS: First-year university students (n = 2,374) were instructed to answer a questionnaire regarding symptoms of TMD, jaw injury, third molar removal, orthodontic treatment, stress, and parafunctional habits. All subjects were classified according to the level of TMD symptoms. Logistic regression was applied to assess the associations of experiences of jaw injury, third molar removal, and orthodontic treatment with presence of TMD symptoms after controlling for age, sex, stress, and parafunctional habits. RESULTS: Of the 2,374 students, 715 students were TMD symptom-positive. They were classified into 7 groups consisting of those with only clicking (group 1), only pain in the temporomandibular joint (group 2), only difficulty in mouth opening (group 3), clicking and pain (group 4), clicking and difficulty in mouth opening (group 5), difficulty in mouth opening and pain (group 6), and all 3 symptoms (group 7). TMD symptoms were significantly associated with jaw injury. Odds ratios were 2.25, 2.47, 3.38, and 2.01 for groups 2, 3, 6, and 7, respectively. Experience of third molar removal was significantly associated with TMD (odds ratio = 1.81 for group 1). No association was found between orthodontic experience and TMD. CONCLUSION: Experiences of jaw injury and third molar removal might be cumulative and precipitating events in TMD.

In vivo evaluation of noncarious cervical lesions in sleep bruxism subjects.

STATEMENT OF PROBLEM: Occlusal load has frequently been suggested to be involved in the development of a noncarious cervical lesion (NCL). However, there is a lack of clinical studies evaluating NCLs and occlusal parameters in sleep bruxism (SB) subjects. PURPOSE: The purpose of this clinical study was to assess the frequency of NCLs and determine potential occlusal differences between SB subjects and healthy control subjects. MATERIAL AND METHODS: A total of 91 volunteers, 58 women and 33 men, with a mean (SD) age of 28.37 (4.89) years (range of 20 to 39 years), participated in this investigation. The clinical assessment of SB was based on the criteria of the American Academy of Sleep Medicine. The participants were divided into 2 groups; 58 subjects were assigned to the SB group and 33 subjects to the control group, following a thorough dental examination that was performed by a single trained dentist. Additionally, the following parameters were recorded: mean number of teeth present, existence/absence of NCLs, frequency of NCLs relating to the type of tooth, type of occlusal guidance scheme, existence of a slide from centric occlusion (CO) to maximum intercuspation (MI), length of the slide, and report of tooth hypersensitivity. Group differences were statistically analyzed using chi-square tests for the qualitative variables and Mann-Whitney U tests for the quantitative variables (alpha=.05). RESULTS: NCLs were significantly more prevalent in SB subjects (39.7%) than in the control subjects (12.1%) (P=.006). In SB subjects, the first premolars were the teeth most affected, and in control subjects, the first molars were most affected. Tooth hypersensitivity was reported in 62.1% of the SB subjects and in 36.4% of the control subjects (P=.018). The evaluation of occlusal guidance schemes revealed no significant difference between the groups. In SB subjects (70.7%), a slide from CO to MI was significantly more prevalent than in control subjects (42.4%) (P=.008). Moreover, SB subjects demonstrated a significantly longer mean (SD) slide of 0.77 (0.69) mm compared to that of control subjects of 0.4 (0.57) mm (P=.008). CONCLUSIONS: Within the limitations of this study, SB subjects demonstrated significantly more NCLs than the control group; whereas, the type of occlusal guidance scheme seems to be of minor importance in the development of NCLs.

Examination of a large patient population for the presence of symptoms and signs of temporomandibular disorders.

Temporomandibular Disorder (TMD) is a term generally applied to a condition or conditions characterized by pain and/or dysfunction of the masticatory apparatus. Its characterization has been difficult because of the large number of symptoms and signs attributed to this disorder and to variation in the number and types manifested in any particular patient. For this study, data on 4,528 patients, presenting over a period of 25 years to a single examiner for TMD treatment, was made available for retrospective analysis and determination of whether the TMD care-seeking patient can be profiled, particularly pain difficulties. All patients in this database filled out a questionnaire and were examined for the prevalence of a range of symptoms and clinical examination findings (signs) commonly attributed to TMD. There was no attempt in this study to assign patients to TMD diagnostic subcategories. The data collected were analyzed to determine which of these symptoms and signs were sufficiently "characteristic of the TMD condition" that they might be used in diagnosis, research and treatment, especially in patients needing relief from pain and discomfort. All 4,528 patients reported symptoms and all but 190 of them also showed signs upon examination. Symptoms most commonly reported on the questionnaire included (i) pain (96.1%), (ii) headache (79.3%), (iii) temporomandibular joint discomfort or dysfunction (75.0%) and (iv) ear discomfort or dysfunction (82.4%). In the 4,338 patients who showed signs, the most prevalent was tenderness to palpation of the pterygoid muscles (85.1%), followed by tenderness to palpation of the temporomandibular joints (62.4%). Pain symptoms and signs were often accompanied by compromised mandibular movements, TMJ sounds and dental changes, such as incisal edge wear and excessive overbite. Clearly prevalence of pain disclosed by the symptoms and signs examinations was high. Patients showed variable prevalence and nonprevalence of eight categories of painful symptoms and seven categories of painful signs. Despite the variability, these might be developed in the future into TMD scores or indices for studying and unraveling the TMD conundrum.

The influence of dynamic occlusal interferences on probing depth and attachment level: results of the Study of Health in Pomerania (SHIP).

BACKGROUND: The purpose of this study was to investigate potential associations between dynamic occlusal interferences and signs of periodontal disease in posterior teeth based on dental and medical measurements obtained from a population-based sample in the cross-sectional epidemiological study entitled, "Study of Health in Pomerania" (SHIP). METHODS: Medical history and dental and sociodemographic parameters of 2,980 representatively selected dentate subjects, 20 to 79 years of age, were collected. The analysis was performed on posterior teeth only using a mixed linear model that considers the clustered structure of the data. The model also was adjusted with respect to known risk factors for periodontal disease. RESULTS: The presence of non-working side contacts only was significantly related to probing depth (P<0.0001) and attachment loss (P=0.001). The presence of non-working side contacts and working side contacts on the same tooth was significantly related to increased probing depth (P=0.004) but not attachment level. The effect magnitude was a mean increase of 0.13 mm for probing depth and 0.14 mm in attachment loss. Known risk factors for periodontal disease that also showed significant associations with probing depth and attachment loss included male gender, age, smoking, education, and plaque score. Other factors significantly related to probing depth and/or attachment loss were tilted teeth, restored occlusal surfaces versus sound surfaces, elongated teeth, and tooth type (molar versus premolar). CONCLUSION: The effect of non-working contacts on periodontal disease status was discernible, but weak in terms of magnitude and specificity.

Prevalencia de signos y síntomas de los trastornos temporomandibulares en un grupo de adultos mayores / Prevalence of signs and symptoms of temporomandibular joint disorders in a group of older adults

Se realizó un estudio observacional, prospectivo, transversal y descriptivo de 37 ancianos de 60 a 80 años para conocer los signos y síntomas de los trastornos temporomandibulares que se presentan con mayor frecuencia en este grupo etario. Los signos y síntomas que se valoraron fueron: dolor, ruidos articulares, bloqueos, limitación funcional de la apertura mandibular, desgaste dental, pérdida de dientes, dimensión vertical, colapso posterior de la mordida y rehabilitación prostésica, entre otros. El 46 por ciento (n=17) de la población presentó patología dolorosa de la ATM acompañada por los menos con un síntoma , por ej. chasquido, bruxismo o apertura limitada; el 43.2 por ciento (n=16) tiene signos positivos de pérdida de la dimensión vertical; el 81 por ciento (n=30) presenta colapso de la mordida; el 54 por ciento (n=20) de los ancianos que no presentó dolor, está expuesto por lo menos a un factor de riesgo

A study of the incidence of overeruption and occlusal interferences in unopposed posterior teeth.

OBJECTIVES: To determine the incidence and extent of overeruption in unopposed posterior teeth; to determine the incidence of occlusal interferences associated with unopposed posterior teeth; and to detect an association between the extent of overeruption and the presence of occlusal interference. DESIGN: The study was a single centre clinical retrospective analysis. Setting The setting was in the Combined Care Clinic of Leeds Dental Institute. The patients were undergoing routine restorative care by final year undergraduate dental students during 2000. SUBJECTS AND METHODS: All patients over18 years of age with one or more unopposed posterior tooth, were invited to participate. A sample group of 120 subjects were recruited. A clinical occlusal examination was carried out and the presence of initial retruded contact position (RCP) contacts and excursive interferences were recorded. Study models were made and digitally scanned. OUTCOME MEASURES: Measurements of overeruption from the curve of Spee were made from the images obtained, by a single observer. Reliability of the measurements was assessed by means of a Bland Altman Plot. The presence and site of RCP contacts and excursive interferences were recorded by a single observer. Reliability of the measurements was assessed by means of Kappa scores. The association between overeruption and the presence of occlusal interference was examined using Spearmans Correlation Coefficient. RESULTS: A total of 120 subjects were recruited, with a total of 155 unopposed sites. Eighty-one of the sites belonged to male subjects, 74 to female subjects. The mean age of the group was 50.9 years, Standard deviation 13.9 Eighty-three per cent of sites displayed overeruption (95% CI 78-90), ranging from under 0.5 mm to 5.4 mm. The reliability of the observations was found to be good. A total of 51.6% (95% CI 44-60) of unopposed teeth were involved in RCP contacts or excursive interferences. Thirty-two sites were involved in more than one contact or interference. The intra-examiner agreement was found to be good, using Kappa. The findings of the Spearman's correlation, show that if an association exists between overeruption and occlusal interference, it is weak, and of no statistical significance. CONCLUSIONS: Eighty-three per cent of unopposed teeth are likely to overerupt, and the extent of the overeruption may be marked. The incidence and extent of overeruption is of clinical significance, not only in terms of treatment planning to prevent undesirable vertical movement, but also in the restoration of the edentulous space. The reliability of observations made in the study was found to be good, justifying the methodology. Fifty-one point six per cent of unopposed teeth are likely to be involved in RCP contacts or excursive interferences. The incidence is of clinical significance when planning the restoration of unopposed teeth, or the associated edentulous space. Only a weak statistical association was demonstrated between the degree of overeruption and the presence of occlusal interferences.

Distribución y gravedad de las infraoclusiones de molares temporales / Distribution and gravity of infraocclusion in temporary molars

Introducción. La infraoclusión es una manifestación cuyo origen es la anquilosis del diente o anquilosis alvéolo dentaria. El crecimiento vertical del diente afectado se encuentra inhibido, y se aprecia por debajo del nivel de oclusión con respecto a los dientes vecinos. El rango de prevalencia de las infraoclusiones es muy amplio. Debido a la importancia clínica que puede tener esta condición se considera conveniente ahondar en la investigación de la frecuencia con que se observa esta anomalía. Material y método. El estudio se realizó utilizando como referencia las radiografías de aleta de mordida de ambos lados y para estimar los milímetros de infraoclusión se tomo como referencia el primer molar permanente. Resultados. De los 849 expedientes revisados, el 10,48 por ciento presentaban infraoclusiones. No hubo diferencias significativas entre sexos. El rango en el cual se presentan mayor número de infraoclusiones es entre los 6 y 8 años. Los primeros molares temporales fueron los dientes más afectados, y las infraoclusiones se consideraron leves en el 69,7 por ciento de los casos. Conclusiones. Se puede destacar que las infraoclusiones son una patología común que no tiene predilección por un sexo concreto y se observa con mayor frecuencia en pacientes en dentición mixta, entre la población infantil estudiada (AU)

Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period.

AIMS: To analyze predictors of bruxism, other oral parafunctions, and tooth wear in a group of subjects who had been examined 20 years earlier. METHODS: Originally, 402 randomly selected 7-, 11-, and 15-year-old subjects were examined clinically and by means of a questionnaire. Twenty years after the first examination, 94% of the original group could be traced, and 320 (85%) completed and returned the questionnaire. Of the oldest group, 100 (81%) also underwent a clinical examination focusing on occlusal factors and function and dysfunction of the masticatory system. For analyses of predictors of some oral parafunctions and tooth wear registered at the 20-year follow-up, logistic regression was used with recordings at the first examination as independent variables. RESULTS: Subjective reports in childhood of bruxism (defined as tooth clenching during daytime and/or tooth grinding at night), clenching only, grinding at night only, nail biting, and/or other parafunctions were predictors of the same oral parafunctions 20 years later. There were different predictors of the 2 components of bruxism, daytime tooth clenching and tooth grinding at night. Postnormal occlusion (Angle Class II malocclusion) and tooth wear in childhood predicted increased tooth wear in adulthood. Subjects with nonworking-side interference had less anterior tooth wear than those without such interference. CONCLUSION: Oral parafunctions in childhood may be a persistent trait in many subjects. Postnormal occlusion and tooth wear in childhood predicted increased anterior tooth wear 20 years later, whereas nonworking-side interference reduced the risk for such wear in 35-year-old subjects.