Dental Hygiene and Orthodontics: Effect of Ultrasonic Instrumentation on Bonding Efficacy of Different Lingual Orthodontic Brackets.

Dental hygienists are often faced with patients wearing lingual orthodontic therapy, as ultrasonic instrumentation (UI) is crucial for oral health. As the application of external forces can lead to premature bonding failure, the aim of this study was to evaluate the effect of UI on shear bond strength (SBS) and on adhesive remnant index (ARI) of different lingual orthodontic brackets. 200 bovine incisors were divided into 10 groups. Four different lingual (STB, Ormco; TTR, Rocky Mountain Orthodontics; Idea, Leone; 2D, Forestadent) and vestibular control (Victory, 3M) brackets were bonded. UI was performed in half of specimens, whereas the other half did not receive any treatment. All groups were tested with a universal testing machine. SBS and ARI values were recorded. Statistical analysis was performed (significance: P = 0.05). TTR, Idea, and 2D lingual brackets significantly lowered SBS after UI, whereas for other braces no effect was recorded. Appliances with lower mesh area significantly reduced their adhesion capacity after UI. Moreover groups subjected to UI showed higher ARI scores than controls. UI lowered SBS of lingual appliances of small dimensions so particular care should be posed avoiding prolonged instrumentation around bracket base during plaque removal. Moreover, UI influenced also ARI scores.

Dental enamel defects in adult coeliac disease: prevalence and correlation with symptoms and age at diagnosis.

BACKGROUND: Coeliac disease is a condition characterized by a wide spectrum of clinical manifestations. Any organ can be affected and, among others, dental enamel defects have been described. Our aims were to study the prevalence of dental enamel defects in adults with coeliac disease and to investigate a correlation between the grade of teeth lesion and clinical parameters present at the time of diagnosis of coeliac disease. METHODS: A dental examination was performed in 54 coeliac disease patients (41 F, mean age 37 ± 13 years, mean age at diagnosis 31 ± 14 years). Symptoms leading to diagnosis were diarrhoea/weight loss (32 pts.), anaemia (19 pts.), familiarity (3 pts.); none of the patients was diagnosed because of enamel defects. At the time of evaluation, they were all on a gluten-free diet. Enamel defects were classified from grade 0 to 4 according to its severity. RESULTS: Enamel defects were observed in 46/54 patients (85.2%): grade 1 defects were seen in 18 patients (33.3%) grade 2 in 16 (29.6%), grade 3 in 8 (14.8%), and grade 4 in 4 (7.4%). We also observed that grades 3 and 4 were more frequent in patients diagnosed with classical rather than non-classical coeliac disease (10/32 vs. 2/20). However, this was not statistically significant. CONCLUSION: This study confirms that enamel defects are common in adult coeliac disease. Observation of enamel defects is an opportunity to diagnose coeliac disease.

Distribution of diagnoses in a population of patients with temporomandibular disorders.

OBJECTIVES: The objective of this study was to describe the frequency of TMD diagnoses in a patient population for comparison with the available literature. METHODS: Five hundred twenty consecutive patients seeking TMD treatment underwent a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) assessment. The prevalence and age distribution of the different RDC/TMD axis I and II diagnoses were described. RESULTS: Muscle disorders, disk displacements, and other joint disorders were diagnosed respectively in 56.4%, 42.0%, and 57.5% of patients. Sixty percent of patients had depression symptoms, 76.6% had somatization, and 21.8% presented high levels of pain-related impairment. Disk displacements were more frequently diagnosed in the younger-aged, other joint disorders in the older-aged, and muscle disorders in the middle-aged subjects (ANOVA for mean age comparison, F = 3.355; P = .002). CONCLUSIONS: These distribution frequencies of TMD diagnoses provide insight into the epidemiology of this disease.

Cross-cultural validation of a short form of the Oral Health Impact Profile for temporomandibular disorders.

OBJECTIVES: We set out to develop and validate an Italian version of the Oral Health Impact Profile Questionnaire (OHIP) that is appropriate for use in temporomandibular disorders (TMD). METHODS: At first, we had the questionnaire translated from English into Italian by three bilingual individuals whose mother tongue was Italian and thus had three different versions of the questionnaire. These were translated back into English by a native English speaker and the version closest to the original English OHIP was selected. The validation of a questionnaire generally involves the study of the psychometric properties of the instrument: its validity and reliability. Before studying these properties, we assessed the factorial structure of the questionnaire. RESULTS: The number of eigenvalues >1, computed by exploratory factor analysis, was seven. The percentage of cumulative variability explained by a model with six dimensions is 66, whereas that explained by a model with seven dimensions is 70. Therefore, considering that the increment of explained variability due to the seventh dimension is low (3.68%) and that the seventh eigenvalue is very close to 1, we considered a six-factor model capable of explaining the factorial structure of the data. Content analysis suggested eliminating the item 'Felt Self-conscious', as most of the subjects did not understand its meaning. Spearman correlation coefficients showed an association between the scores of all the different subscales and the variable for pain. All the coefficients were significantly different from 0 (P < 0.05). Cronbach's alpha value, always >0.70, showed quite a good reliability for each of the six subscales. CONCLUSIONS: These results reveal a reasonable degree of cross-cultural consistency between the two versions of the OHIP, and thus indicate that our Italian version is valid.