Association of Masticatory Efficiency and Reduced Number of Antagonistic Contacts Due to Extraction, Changing Dentition or Malocclusion in Children.

BACKGROUND: Tooth extraction, changing dentition and malocclusion can decrease area of occlusal contact and negatively affect masticatory efficiency. Aim of this study was to evaluate difference in masticatory efficiency in association with previously named factors. MATERIALS AND METHODS: In this cross-sectional study masticatory efficiency parameters (number of particles, mean diameter and mean surface of particles) determined with optical scanning method were compared between children with healthy dentition (12 girls, 12 boys, age 3 to 14) and children with lost antagonistic contacts due to tooth extraction, changing dentition and malocclusions (12 girls, 12 boys, age 3 to 14). RESULTS: Number of chewed particles is significantly higher in a group of children with healthy dentition (p < 0.001), and chewed particles' mean diameter and surface are significantly higher in the Group 2 (p < 0.001; p < 0.001). Number of lost occlusal contacts is not in correlation with masticatory efficiency parameters (p= 0.464; p= 0.483; p= 0.489). CONCLUSIONS: Children with lost antagonistic contacts have an impaired masticatory efficiency in comparison to children with complete dentition, but there is no difference regarding the aetiology of contact loss.

Pandemic Financial Stress in Dental Medicine in Croatia.

The aim of this cross-sectional research was to investigate how the COVID-19 pandemic affected the activity of dental medicine in the Republic of Croatia in 2020. It included 136 doctors of dental medicine who completed an online survey regarding their personal and professional information; work in dental offices; and level of fear for their own health, the health of others, and financial existence; and their attitude about vaccination. There was a significantly higher decrease in patient visits in dental offices that do not have a contract with public health insurance (70% vs. 37%; p < 0.001) and in dental offices that have a higher percentage of profit from dental tourism (32% vs. 14%; p < 0.001). Fear of financial existence was significantly higher in the group of dentists who do not have a contract with public health insurance (p = 0.0) and is positively correlated with the percentage of profit from dental tourism (r = 0.299; p < 0.001). Dentists with a higher level of fear that they or their loved ones would get infected due to the nature of their job are more likely to get vaccinated (p ≤ 0.007). The decision to get vaccinated and wearing a disposable coat/apron was related to fear when all other parameters were controlled for (R = 0.44; p = 0.037). In conclusion, the COVID-19 pandemic had a minimal impact on the profession of dental medicine in Croatia but represented a larger financial stress for dentists working in dental offices that do not have a contract with public health insurance and have a higher percentage of income from dental tourism.

Translation and validation of the Croatian version of the Oral Impacts on Daily Performances (OIDP) scale.

Background/Aim: Among numerous sociodental indicators the Oral Impacts on Daily Performance (OIPD) is one of the most broadly applied. The aim of this study was to develop and test psychometric properties of a Croatian version of OIDP scale. Methods: The OIDP instrument was translated from English to Croatian in a forward-backward method. The Croatian version was tested for reliability, construct validity and responsiveness on a sample of 702 participants (255 men), aged 18-86 years. Results: Internal consistency of Croatian version of the OIDP was acceptable (alpha = 0.80) and 69.4% of the examinees had oral impacts relating to one or several performances. The most frequently affected performance was eating (53.7%). The test-retest reliability was high (r = 0.99; 95% CI: 0.97-0.99), the mean difference between the OIDP summary scores in two-week interval was not statistically significant. In construct validity testing there was statistically significant correlation between OIDP and self-assessed general and oral health, somatisation, depression and Oral Health Impact Profile ranging from 0.157 to 0.516. Responsiveness was confirmed by a significant reduction of oral impacts on daily performances in subjects before and after treatment of acute dental pain (p < 0.001). Conclusion: The Croatian OIDP index showed good psychometric properties in terms of construct validity, internal consistency, test-retest reliability and responsiveness confirming its appropriateness for use among Croatian population.

The Comparison of Malocclusion Prevalence Between Children with Cerebral Palsy and Healthy Children.

This study sets out to examine the prevalence of malocclusion and habits in a group of children with cerebral palsy and to compare it with a control group of healthy children. The presence of an anterior open bite was statistically significantly higher in the cerebral palsied group. The presence of aposterior crossbite was not significantly different between the examined groups, as was the case for a lingual crossbite. The occurrence of visceral swallowing, incompetent lips and oral respiration was significantly higher in the cerebral palsied group. The current study cannot satisfactorily sustain the issue of a higher prevalence of posterior and lingual crossbite in children with cerebral palsy because of no significant differences between groups, but it certainly can for an anterior openbite. The present study also adds to the evidence that there is an increased prevalence of oral breathing, visceral swallowing and lip incompetence in children with cerebral palsy.

Influences of age and maxillary anterior teeth status on patient's satisfaction with dental appearance and tooth colour.

OBJECTIVES: To study the impact of age, gender, tooth colour and maxillary anterior teeth status on patient's satisfaction with their dental appearance. MATERIAL AND METHODS: A total of 259 Caucasian subjects participated in the study (119 men, mean age 56 years; 140 women, mean age 61 years) divided into three age groups (young <35 age; middle aged 35-54 age; old ≥55 age). Their maxillary anterior teeth status was classified into three groups: (1) natural teeth (NTG) group; (2) composite filling group (CFG) and (3) porcelain-fused-to-metal fixed prosthodontic restoration group (FPDG). The participants judged appearance and tooth colour using a scale with three categories: completely dissatisfied, moderately dissatisfied and completely satisfied. RESULTS: Almost half of the participants were completely satisfied with their dental appearance and tooth colour. Half of the 'young' and 'middle-aged' participants with natural maxillary anterior teeth were completely satisfied and half of the 'old' participants were moderately satisfied with their dental appearance and tooth colour. The majority of participants with composite restorations (45-51%) were moderately satisfied with their dental appearance, one-third of 'young' and 'middle-aged' participants were moderately satisfied or dissatisfied with their tooth colour and more than 70% of older participants were dissatisfied with their tooth colour (p > 0.05). CONCLUSIONS: Satisfaction with the appearance of the maxillary anterior teeth differed both between individuals of different age and different dental status.

Factors influencing a patient's decision to choose the type of treatment to improve dental esthetics.

BACKGROUND/AIM: Interest in dental esthetics has increased rapidly during the last few decades among both patients and dentists, and the creation of a natural dental appearance has become an important task in all fields of dentistry, especially in prosthodontics and restorative dentistry. The aim of this research was to investigate factors influencing a patient's decision to choose the type of treatment to improve dental esthetics. METHODS: A total of 700 Caucasian subjects participated in the cross-sectional study (261 men, 439 women, aged 18-86 years, mean age 46.2 +/- 18.6). The study included clinical examination and a self-administrated questionnaire based on self-perceived esthetics, satisfaction with the appearance of their maxillary anterior teeth and previous dental experience. Multiple logistic regression was used in statistical analysis. RESULTS: Hiding teeth during smile was the most important predictor for choosing fixed prosthetic restorations (OR 9.1), followed by self-perceived bad fixed prosthesis, malpositioned teeth and female gender (OR 2.9, 2.4, and 1.5, respectively). The increase in satisfaction with dental appearance and previous orthodontic therapy reduced chances for seeking prosthetic therapy (each OR 0.4). The significant predictors for bleaching choosing were hiding teeth during smiling, already done bleaching, female gender, lower levels of satisfaction with dental appearance and the absence of the previous orthodontic therapy (OR 5.8, 2.4, 1.8, 0.5 and 0.4, respecitively). Hiding teeth during smile, self-perceived malposition and crowding, and lower levels of satisfaction, were significant predictors for choosing orthodontic treatment (OR 3.1, 2.4, 2.2 and 0.6, respectively). None of current dental statuses was statistically significant predictor for choosing prosthodontic, bleeching nor orthodontic therapy. CONCLUSION: The psychological elements and female gender are the main predictors of seeking dental therapy. Understanding the prevalence of dissatisfaction with the present esthetics and desired treatments to improve esthetics can be a guide for strategies for intervention to improve esthetics.

Dental health and dental care in children with cerebral palsy.

The aim of this study was to determine a difference between children with cerebral palsy (CP) and healthy children, regarding health condition of teeth and oral tissuses. Disfunction of masticatory system, in children with CP, causes many problems with mastication. Nonfunctional mastication is related with the consumption of mushy food and decreased selfcleaning of occlusal and aproximal surfaces. All that leads to higher incidence of dental caries. Comparing the DMTF/dft (decayed, missing, filled tooth) index, it is evident that there is no statistically significant difference in a tooth morbidity between the group of healthy children and group of children with CP. The healthy children have statistically significant more teeth with fillings with respect to children with CP. Extractions are more common in children with CP. There is no statistically significant difference between those two groups regarding decayed teeth, one of components of DMFT index. Decayed components are more common than the extractions and fillings in both groups, which shows the insufficient curative care for all children in both groups. It can be concluded that there is a certain need of early beginning and a better organization of the preventive pediatric and dental care, in order to decrease the appearence of dental decay and increase the level of dental health, in this challenged population.

Depression, somatization and anxiety in female patients with temporomandibular disorders (TMD).

The aim of this research was to determine the possible differences in degrees of depression, somatization and anxiety between the acute and chronic female patients with temporomandibular disorders (TMD), and whether these differences exist in healthy female patients. Ninety female patients were involved in this research; 60 of them were TMD patients of the Dental Polyclinic, while other 30 females came for a routine recall visit and had no problem related to TMD. Patients were aged 22 to 67 years, the average age being 38.5 +/- 12 years. All patients were asked to fill in the RDC/TMD protocol and three psychological tests (Emotions Profile Index, Somatization Scale and life Events Scale). Following the analysis of the RDC/TMD protocol and psychological tests, it was determined that the chronic female patients had higher depression and somatization scores in comparison with the acute patients (p < 0.01); the acute patients self-perceive higher levels of anxiety in relation to the control group; furthermore, the patients reporting higher levels of depression were more inclined to somatization and had experienced a greater number of stress events in the past six months. It is beyond doubt that patients suffering from the TMD's exhibit higher levels of depression, somatization and anxiety compared to the healthy ones, which proves that physiological factors may play a predisposing role in combination with reduced level of body tolerance to pain, and a decreased tolerance to stress.

Salivary levels of TNF-alpha and IL-6 in patients with denture stomatitis before and after laser phototherapy.

OBJECTIVE: The aim of this study was to monitor therapeutic response by determining the level of proinflammatory cytokines TNF-alpha and IL-6 in whole unstimulated saliva in patients with denture stomatitis (DS), before and after laser phototherapy (LPT). BACKGROUND: DS is an inflammatory condition that occurs in subjects who wear dentures, and it is a common oral mucosal lesion. A potential noninvasive treatment for DS patients is LPT. MATERIALS AND METHODS: A sample consisting of 40 consecutive subjects was selected on a voluntary basis from patients who presented for the diagnosis and treatment of DS at the Oral Medicine Unit of the Medical Faculty at the University of Rijeka. A clinical examination was performed according to the standard clinical criteria. Lesions described as palatal inflammation were diagnosed as Newton type II denture stomatitis. The patients were randomly assigned to either an experimental group (20 patients receiving real LPT) or a control group (20 patients receiving inactive/placebo laser treatment). In order to determine the salivary levels of TNF-alpha and IL-6, ELISA (Sigma Immunochemicals, St Louis, MO) was performed. RESULTS: Following treatment with LPT for 4 wk, the levels of TNF-alpha and IL-6 decreased significantly (p < 0.001) and were significantly different from controls (p < 0.001). CONCLUSION: The results of this study suggest that LPT may be an efficacious choice of therapy.

Detection of salivary interleukin 2 and interleukin 6 in patients with burning mouth syndrome.

The etiology of BMS remains unknown. Role of various cytokines has been implicated in the development of BMS. The aim of this study was to evaluate levels of salivary IL-2 and IL-6 in patients with BMS, compared with age-matched healthy volunteers (control group). Whole saliva from 30 patients with BMS, age range 55-65, was tested for the presence of IL-6 and IL-2 by enzyme immunoassay. Control group consisted of 30 healthy participants, aged 55-65 years. Saliva IL-2 concentrations in BMS were significantly increased in patients compared to healthy subjects: mean 34.1 +/- 9.7 versus 7.3 +/- 3.0 pg/mL; P < .001. Patients with BMS had significantly higher concentrations of IL-6 compared to control: mean 30.8 +/- 5.6 versus 5.2 +/- 2.8 pg/mL; P < .001. In patients with BMS, IL-2 and IL-6 levels in saliva are elevated, correlating with the severity of illness.

Oral health status and temporomandibular disorders in multiple sclerosis patients.

Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system. Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia, sensory neuropathy of the trigeminal nerve and facial palsy. The aim of this study was to determine the oral health status, the frequency of subjective symptoms and temporomandibular disorders (TMD) subtype according to Research diagnostic criteria for temporomandibular disorders (RDC/TMD) among MS patients. Examinees in this study were 50 patients suffering from MS, who were at least once treated during their disease in the Clinic Hospital Center, Rijeka, Clinic for Neurology. All examinees had to meet the diagnostic criteria for clinically and laboratory confirmed MS, according to Poser. The results show the difference in mean DMFT (decayed, missing, filled teeth) between MS and the control group. The number of decayed and missing teeth was higher, but the number of filled teeth was significantly lower in MS group. Eighty-two per cent of the subjects with MS had a least one symptom of dysfunction compared with 24% of the subjects in the healthy control group. In the present study, pain, the pain during mouth opening, the difficulty with mouth opening and temporomandibular joint (TMJ) sounds were more commonly reported in the MS group than in the control group. This study shows a statistically significant excess of dental caries and temporomandibular disorders among MS patients compared with the control group. These results suggest that MS is a possible etiological factor in temporomandibular disorders.

Evaluation of craniometric methods for determination of vertical dimension of occlusion--Part 2.

The study examines the relationships between different craniometric distances and the nasion-gnathion (N-Gn) distance which represents the lower two thirds of the face in vertical dimension determination. The highest degree of correlation (r = 0.9217; p < 0.05) was observed between the N-Gn and zygion-zygion (Zy-Zy) distances. The N-Gn distance could be determined using the formula N-Gn = Zy-Zy/1.15 or by means of regression analysis: N-Gn = 0.54749 + 0.82822 x Zy-Zy. Considering that the coefficient of correlation between N-Gn and Zy-Zy was higher than the one between the eye-ear (E-E) and the subnasale-gnathion (Sn-Gn) distances reported earlier (r = 0.8676) it was concluded that calculating the N-Gn distance from the Zy-Zy distance was more reliable. The fact that none of the calculated correlation coefficients was 1, but was lower than 1, points to the presence of individual variations of the cephalometric parameters. Although the method cannot be taken as absolutely reliable, owing to its simplicity and practical applicability it can be recommended for use in everyday clinical practice in combination with other methods for the determination of the vertical dimension of occlusion.