Pre-restorative crown lengthening surgery: influence of restorative treatment timing on clinical outcomes-a pilot study.

OBJECTIVES: Aim of this study was to assess the influence of restorative treatment timing on the periodontal, patient and operator-reported outcomes following crown lengthening surgery (CLS). MATERIALS AND METHODS: Eighteen study participants requiring CLS were divided into two groups based on prosthetic rehabilitation timing (6 or 14 weeks postoperatively). Clinical parameters were recorded around treated and neighboring teeth before and after surgery, 6 and 14 weeks postoperatively, at prosthesis delivery, and three and six months after. Soft tissue and radiographic bone changes were evaluated. Patients assessed their perception of the procedure by means of a questionnaire. The final treatment outcome was rated by both patients and prosthodontists. RESULTS: CLS resulted in statistically significant and stable apical displacement of the gingival margin, at both treated and adjacent sites. Plaque and bleeding scores remained low throughout. No statistically significant differences were observed between groups for any clinical or radiographic parameter examined. Healing was uneventful and treatment outcome was satisfying for both patients and prosthodontists, without statistically significant differences between groups. CONCLUSIONS: The present study has been characterized as pilot, because it was not possible to reach the sample size indicated by the a priori power analysis. CLS is an effective pre-prosthetic procedure as long as it is performed under a certain surgical protocol which predicts for at least a 3 mm distance between bone crest and the flap margin at suturing. Within the limitations of this study, six weeks after surgery may be an adequate healing time for the onset of prosthetic restoration. CLINICAL RELEVANCE: Crown lengthening surgery is commonly performed in daily clinical practice with the aim to restore teeth with short clinical crowns. Based on periodontal, patient and operator-reported criteria, 6 weeks after CLS may be adequate healing time before the onset of prosthetic restoration. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03947658, 13/05/2019, retrospectively registered.

Clinical evaluation of removable partial dentures with digitally fabricated metal framework after 4 years of clinical service.

This case report describes the clinical outcomes of three patients who received removable partial dentures with a completely digitally designed and manufactured metal framework. The initial intraoral impressions were prepared, and the resulting standard tessellation language files were sent to a dental laboratory, where the alloy framework was designed using inLab software and printed using a 3D printer or milled directly from a Co-Cr disc. The quality of fit of the framework was evaluated intraorally to confirm the laboratory design. The acrylic teeth were set, and the definitive partial dentures were delivered after the acrylic resin bases were processed. The follow-up time was 4 years. No complications or failures related to the components of the partial dentures were observed.

Characteristics of intraoral scan bodies and their influence on impression accuracy: A systematic review.

OBJECTIVE: The aim of this systematic review was to evaluate the influence of the characteristics of intraoral scan bodies (ISBs) on the accuracy of intraoral scanning. MATERIALS AND METHODS: An electronic search was conducted through PubMed (MEDLINE), Scopus and Cochrane Library, up to March 2023. The literature search intended to retrieve all relevant clinical and in vitro studies about the effect that the various properties of ISBs may have on the accuracy (trueness and precision) of intraoral scanning. Only publications in English language were selected with animal studies, case reports, case series, technique presentation articles and expert opinions being excluded. RESULTS: A total of 28 studies met the inclusion criteria and were included in this systematic review. They were published between 2019 and 2023 and were all in vitro studies. Among the parameters described, the scan body material, position, geometry, height, diameter, and fixation torque were evaluated. The most common materials used for ISBs were polyetheretherketone (PEEK) and titanium alloys. The diameter and position of ISBs seemed to affect the trueness of implant impressions. Subgingival implant position and decreased ISB height affected negatively the trueness of scanning. Geometrical characteristics of ISBs also affect the implant impression accuracy, especially the bevel location and the types of designing modifications. CONCLUSIONS: The characteristics of the currently used ISBs vary widely and the available scientific evidence is not yet conclusive about the optimal design of ISB. The implant impression accuracy achieved by any of the studied parameters is encouraging. Clinical studies are however necessary for more concrete conclusions. CLINICAL SIGNIFICANCE: ISBs play a vital role in the digital workflow and influence significantly the accuracy and fit of implant restorations. More clinical trials are needed in order to conclude to the optimal characteristics of ISBs which would further enhance the success of the restorations.

Effectiveness of conservative therapeutic modalities for temporomandibular disorders-related pain: a systematic review.

PURPOSE: The aim of this systematic review was to evaluate the effectiveness of conservative different therapeutic modalities for temporomandibular disorders (TMD) pain. MATERIALS AND METHODS: An electronic systematic search was conducted in the MEDLINE (PubMed) database to identify the randomized clinical trials (RCTs) published between 2001 and 2021. The following, simple or multiple conjunctions, search keywords were selected: TMD pain, TMD management or conservative treatment or treatment strategies and TMD pain, therapeutic modalities or interventions and TMD. Studies included must have patients older than 18 years, with painful TMD, which diagnosis was performed by Research Diagnostic Criteria for TMD or Diagnostic Criteria for TMD. Outcome variables were pain relief and post treatment pain intensity reduction. Data were analysed with non-parametric tests and the level of significance was set at p<.05. RESULTS: Out of 1599 articles obtained, 28 RCTs fulfilled all selection criteria and were included. The results of this study show that there was a significant decrease in short-term post-treatment TMD pain with the use of occlusal splint alone or in combination with other therapeutic modalities when compared with the control group. Statistically significant differences were also detected between laser and photobiomodulation group and the control, in short-term treatment TMD-related pain. CONCLUSIONS: The primary findings of the present systematic review showed that the occlusal splint alone or combined with other therapeutic intervention presented positive effect on short-term TMD pain reduction. Secondary outcome suggests that laser and photobiomodulation therapy had, also, a significant role in short term pain relief.

Evaluation of marginal/internal fit of fixed dental prostheses after digital, conventional, and combination impression techniques: A systematic review.

Advances of digital technology are rapidly adopted in dental practice. This systematic review aimed to collect evidence on the accuracy of fit of different types of fixed dental prostheses (FDPs) fabricated through digital, conventional, or combination impression techniques. Data collection was based on the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Two databases (PubMed, Scopus) were searched for articles in English published between 2010 and 2021 resulting in 480 articles. Of those, 35 studies fulfilled the inclusion criteria. These articles referred to three groups of materials/techniques including all-ceramic (zirconia; lithium disilicate) and porcelain-fused-to-metal (PFM) restorations. Results showed clinically acceptable marginal fit (< 120 µm) for all materials and impression techniques. Α fully digital workflow appears more promising for the construction of short-span zirconia FDPs. Nevertheless, most articles evaluated marginal/internal fit of single crowns or short-span FDPs in vitro, while clinical data are limited for long-span FDPs. The necessity for gingival retraction remains a major drawback of all impression techniques, increasing procedural time and patient discomfort. Besides, factors related to the fabrication process, including milling and 3D printing of working models significantly influence the outcome. Overall, there still some way to go before digital technology can be incorporated in complex treatment plans in prosthodontics.

Evaluation of Elastomeric Impression Materials' Hydrophilicity: An in vitro Study.

INTRODUCTION: Hydrophilicity of dental impression materials is crucial for obtaining an accurate impression and necessary for the production of a well-fitting cast restoration. The most common technique for evaluation of hydrophilicity is a contact angle measurement. The aim of the present in vitro study was to compare the water contact angles of four groups of elastomeric impression materials, before and during setting. MATERIAL AND METHODS: Flattened specimens (n=10) of tested impression materials were prepared by the use of a Teflon mold with specific dimensions. A 5µl droplet of deionized water fell on the specimen, and photos were taken using a Nikon D3200 DSLR camera and a 105 mm macro lens (Nikorr, Nikon) in specific time points. RESULTS: The CAD/CAM material showed the highest contact angle measurements. The light body polyvinylsiloxane (PVS) material 1, polyether and vinylsiloxanether material showed comparable contact angle measurements especially at the initial time point. A statistically significant reduction of contact angles was reported during setup time for all PVS, PE and vinylsiloxanether materials, while the most expressed reduction of contact angle measurements, and thus the most significant increase of hydrophilicity were reported for light wash PVS material 2. CONCLUSIONS: The CAD/CAM impression material showed the most hydrophobic behavior. PVS materials showed excellent hydrophilicity. Polyether and polyvinyloxanether impression materials presented lower contact angle measurements, and thus superior hydrophilicity, compared with other tested materials initially and during setting. All tested impression materials presented a stepwise development of hydrophilicity during the setting stage.

Fracture strength of endodontically treated premolars restored with different post systems and metal-ceramic or monolithic zirconia crowns.

The purpose of this study was to investigate the fracture strength of endodontically treated human maxillary premolars (ETP) restored with posts and metal ceramic (MC) or monolithic zirconia (MZ) crowns. Sixty ETP were randomly divided into 3 groups. Teeth in control group (C) received a resin filling. ETP in the MC group were restored with prefabricated metal posts, composite cores and MC crowns while in the MZ group with glass-fiber posts, composite cores and MZ crowns. Half of the specimens were loaded at a 135° angle and half under axial loading until fracture. The fracture modes were divided in repairable and irreparable using optical microscopy. Mean fracture strength was significantly higher for MC than for MZ crowns and control group only under axial loading. The distribution of repairable and irreparable failures presented no significant differences. Crown placement significantly improved the fracture strength of ETP irrespectively of post and crown type.

Investigation of the relationship between sleep disorders and xerostomia.

OBJECTIVES: To investigate the relationship between sleep disorders, morning hyposalivation, and subjective feeling of dry mouth. MATERIALS AND METHODS: A cross-sectional, observational, clinical study was carried out in a homogenous population sample which consists of Greek male soldiers without any medical history. After the application of oral modified Schirmer test, the sample was divided into a study group (n = 63) (MST < 25 mm/3 min) and a control group (n = 110) (MST ≥ 25 mm/3 min). In order to assess daytime sleepiness, risk of obstructive sleep apnea (OSA), sleep quality, sleep bruxism (SB), and subjective feeling of dry mouth, all the participants filled in the following scales in Greek version: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire (BQ), a SB questionnaire, and Xerostomia Inventory (XI) respectively. In every subgroup that came of ESS, PSQI, BQ, and SB questionnaire scoring, subjective feeling of dry mouth was evaluated, based on XI values. RESULTS: Statistically significant difference (p < 0.001) through PSQI scores was found between the study and control group. In contrast, a statistically significant difference was not obtained for the scores of ESS (p = 0.293), BQ (p = 0.089), and SB questionnaire (p = 0.730). XI scores introduced statistically significant difference between the subgroups of PSQI (p < 0.001), BQ (p = 0.001), SB questionnaire (p = 0.004)  and statistically weak between the subgroups of ESS (p = 0.049). CONCLUSIONS: This is the first research study so far suggesting that patients with morning hyposalivation exhibit poor sleep quality using an objective method. The present results have, also, shown that subjective feeling of dry mouth is related to excessive daytime sleepiness, poor sleep quality, high risk of obstructive sleep apnea, and sleep bruxism, but larger-scale studies are still needed. CLINICAL RELEVANCE: These findings should keep dentists aware of a possible association between xerostomia and sleep disorders and support larger-scale studies.

Effect of a calcium chloride solution treatment on physical and mechanical properties of glass ionomer cements.

This paper details a novel method to improve wear resistance of dental glass ionomer cement (GIC) restorations. The purpose of this in vitro study was to evaluate the effect of a calcium chloride (CaCl2) solution treatment on surface hardness, surface roughness, compressive strength, water sorption and solubility of three conventional glass ionomer cements (GICs). Additionally, the changes of the Ca composition and morphology of the surface of the tested GICs were also investigated. The experimental groups of the study were: Group 1 (control) specimens after mixing were left in the mold to set without any treatment for 5 min; Group 2 specimens were left in the mold to set for 5 min and then each specimen was immersed in 10 ml of 42.7 wt% CaCl2 solution for 60 s. Statistical analysis was performed using one-way ANOVA and Tukey post hoc tests (a = 0.05). Calcium chloride solution treatment increased surface hardness of the GICs compared to control groups (P < 0.05), while surface roughness and compressive strength did not change after the treatment (P > 0.05). Reduction in water sorption and solubility was detected but not in all CaCl2 solution-treatment groups. No alterations were observed in surface morphology of the GICs, while surface calcium composition was increased after the treatment (P < 0.05). The use of a CaCl2 solution immediately after initial setting of GICs may be advantageous for some properties of the materials and possibly leads to improved prognosis and wear resistance of their restorations.

Psychopathologic Profiles of TMD Patients with Different Pain Locations.

PURPOSE: The aim of this study was to examine whether psychopathologic profile is related to the location of pain in temporomandibular disorder (TMD) patients with myofascial and/or temporomandibular joint pain. MATERIALS AND METHODS: A total of 75 painful TMD patients (39 women and 36 men) participated in the study. Participants were divided into three groups (myogenous, arthrogenous, and mixed) using the Research Diagnostic Criteria for TMD (RDC/TMD) Axis I guidelines for assessment of TMD signs and symptoms. Three psychometric instruments were used to assess the psychopathologic profile of the TMD subgroups. Patients' state and trait anxiety were assessed using the State-Trait Anxiety Inventory (STAI-S, STAI-T), depression was measured with the Center for Epidemiological Studies Depression Scale (CES-D), and psychosocial functioning was evaluated using the Global Disability Scale (Glo.Di.S). The three TMD groups were compared with Kruskal-Wallis test followed by pairwise Mann-Whitney tests relative to the psychometric scores. Statistical analyses were performed with SPSS 15.0 software. RESULTS: No significant differences were detected among the different TMD groups in the three psychometric scales; STAI-T, CES-D, Glo.Di.S (P > .05). When the psychometric scale of state anxiety (STAI-S) was considered, significant differences were revealed between the myogenous and the arthrogenous pain groups (P = .008) and also between the mixed and the arthrogenous groups (P < .001). CONCLUSION: These findings suggest that the psychopathologic profile is not related to the location of pain in TMD patients. However, anxiety was found to be higher in TMD patients with myogenous pain alone or combined with arthrogenous pain compared to those with only arthrogenous pain.

Relationship Between Sleep Bruxism and Stress Determined by Saliva Biomarkers.

PURPOSE: The aim of this study was to evaluate the relationship between sleep bruxism (SB) and perceived stress through the estimation of stress-related biomarkers (cortisol, α-amylase) in saliva. MATERIALS AND METHODS: Forty-five volunteers (20 men, 25 women) participated in this study. Participants were divided into two groups (bruxers and nonbruxers) according to their answers in a standard bruxism assessment questionnaire outlined by the American Academy of Sleep Medicine. To confirm the preliminary diagnosis and to determine the severity of SB in the group of patients who had a positive self report for SB, a miniature, single-use electromyographic (EMG) device for SB detection (BiteStrip) was used. The perceived stress of the 45 participants was measured using the Perceived Stress Scale questionnaire. Unstimulated whole saliva was collected and levels of salivary cortisol and α-amylase were determined by enzyme-linked immunosorbent assay test and enzyme kinetic reaction, respectively. Nonparametric statistical methods were applied for data analyses. RESULTS: Bruxers showed higher levels of perceived stress than nonbruxers (P < .001). There was a moderate positive correlation between the 25 bruxers' BiteStrip scores and the salivary cortisol levels (Spearman rank correlation = 0.401, P = .047). Additionally, bruxers showed higher levels of cortisol than nonbruxers (P < .001). On the contrary, salivary α-amylase levels were not significantly different in bruxers and nonbruxers (P = .414). CONCLUSIONS: These findings suggest that SB activity was related to higher levels of perceived psychological stress and salivary cortisol. Despite the limitations of the EMG recording device, a moderate positive correlation between BiteStrip score and cortisol levels was observed in bruxers.

Accuracy of 3 different impression techniques for internal connection angulated implants.

STATEMENT OF PROBLEM: Making implant impressions with different angulations requires a more precise and time-consuming impression technique. PURPOSE: The purpose of this in vitro study was to compare the accuracy of nonsplinted, splinted, and snap-fit impression techniques of internal connection implants with different angulations. MATERIAL AND METHODS: An experimental device was used to allow a clinical simulation of impression making by means of open and closed tray techniques. Three different impression techniques (nonsplinted, acrylic-resin splinted, and indirect snap-fit) for 6 internal-connected implants at different angulations (0, 15, 25 degrees) were examined using polyether. Impression accuracy was evaluated by measuring the differences in 3-dimensional (3D) position deviations between the implant body/impression coping before the impression procedure and the coping/laboratory analog positioned within the impression, using a coordinate measuring machine. Data were analyzed by 2-way ANOVA. Means were compared with the least significant difference criterion at P<.05. RESULTS: Results showed that at 25 degrees of implant angulation, the highest accuracy was obtained with the splinted technique (mean ±SE: 0.39 ±0.05 mm) and the lowest with the snap-fit technique (0.85 ±0.09 mm); at 15 degrees of angulation, there were no significant differences among splinted (0.22 ±0.04 mm) and nonsplinted technique (0.15 ±0.02 mm) and the lowest accuracy obtained with the snap-fit technique (0.95 ±0.15 mm); and no significant differences were found between nonsplinted and splinted technique at 0 degrees of implant placement. CONCLUSIONS: Splinted impression technique exhibited a higher accuracy than the other techniques studied when increased implant angulations at 25 degrees were involved.

Effect of a crown ferrule on the fracture strength of endodontically treated canines restored with fiber posts and metal-ceramic or all-ceramic crowns.

The aim of this study was to comparatively evaluate the fracture strength of endodontically treated canines restored with glass-fiber posts (GFPs) and either metal-ceramic (MC) or all-ceramic (AC) crowns in the presence or absence of 2 mm of ferrule height. Fifty human maxillary canines were endodontically treated and randomly divided into five groups of 10 specimens each. The first group remained intact (control), while the remainder were restored with GFPs and composite cores with either MC or AC crowns. Each of the AC and MC groups was equally divided between teeth with or without ferrule. Teeth were embedded in acrylic resin and loaded at a 135-degree angle to their long axis until fracture. Fracture strength was not significantly different between ferrule and no ferrule groups (P = .571), but was significantly larger for the MC groups compared with the control and AC groups (P = .009 and P = .024, respectively). A significant effect of the type of restoration was found as teeth restored with MC crowns presented significantly higher fracture strength, independently of ferrule.

The effect of impression technique and implant angulation on the impression accuracy of external- and internal-connection implants.

PURPOSE: The purpose of this in vitro study was to investigate the effect of impression technique and implant angulation on the impression accuracy of external- and internal-connection implants using a novel experimental device. MATERIALS AND METHODS: An experimental device was designed and fabricated to make in vitro impressions by means of open- and closed-tray techniques. Impressions of eight implants with two different connections (four external-hex and four internal-hex) at three angulations (0, 15, and 25 degrees) were made using a medium-consistency polyether material. Evaluation of implant impression accuracy was carried out by directly measuring the difference in coordinate values between the implant body/impression coping positioned on the base and the impression coping/laboratory analog positioned in the impression using a touch-probe coordinate measuring machine. Experimental data were analyzed by two-way analysis of variance. The significance level of all hypothesis testing procedures was set at P<.05. RESULTS: The results showed that: (1) for implants with external connections, impression accuracy is not significantly affected by the impression technique, implant angulation, or their interaction; and (2) for implants with internal connections, impression accuracy is significantly affected only by implant angulation: Impression inaccuracy was greater at the 25-degree implant angulation. CONCLUSIONS: Within the limitations of this in vitro study, the open- and closed-tray techniques had no effect on the accuracy of multiple implant impressions. The interaction between impression technique and implant angulation was also not significant. However, implant angulation significantly affected the impression accuracy when implants with internal connections were used.

Survival of ceramic veneers made of different materials after a minimum follow-up period of five years: a systematic review and meta-analysis.

PURPOSE: The purpose of this systematic review was to compare the survival and complication rates of ceramic veneers produced with different techniques and materials after a minimum follow-up time of 5 years. MATERIALS AND METHODS: A literature search was conducted, using electronic databases, relevant references, citations and journal researching, for clinical studies reporting on the survival of ceramic veneers fabricated with different techniques and materials with a mean followup time of at least 5 years. The search period spanned from January 1980 up to October 2010. Event rates were calculated for the following complications associated with ceramic veneers: fracture, debonding, marginal discoloration, marginal integrity, and caries. Summary estimates, and 5-year event rates were reported. Comparison between subgroups of different materials, as well as statistical significance, was calculated using a mixed effects model. RESULTS: Nine studies were selected for final analysis over an initial yield of 409 titles. No study directly compared the incidence of complications between ceramic veneers fabricated from different materials. Four of the included studies reported on the survival of ceramic veneers made out of feldspathic ceramics; four studies were on glass-ceramic veneers and one study included veneers fabricated from both materials. The mean observation time ranged between 5 and 10 years. Overall, the 5-year complication rates were low, with the exception of studies reporting on extended ceramic veneers. The most frequent complication reported was marginal discoloration (9% at 5 years), followed by marginal integrity (3.9-7.7% at 5 years). There was no statistically significant difference in the event rates between the subgroups of different materials (feldspathic vs. glass-ceramic). CONCLUSION: The results of this systematic review showed that ceramic veneers fabricated from feldspathic or glass-ceramics have an adequate clinical survival for at least 5 years of clinical service, with very low complication rates.

The effect of ferrule on the fracture mode of endodontically treated canines restored with fibre posts and metal-ceramic or all-ceramic crowns.

OBJECTIVES: The aim of this study was to evaluate the fracture mode of endodontically treated canines (ETC) restored with glass-fibre posts (GFP) and either metal-ceramic (MC) or all-ceramic (AC) crowns, in the presence or absence of 2 mm ferrule height. METHODS: Fifty recently extracted human maxillary canines were endodontically treated and randomly divided into 5 groups of 10 specimens each. Four groups (with or without ferrule) were restored with GFP, composite cores and either MC or AC crowns. The fifth group with intact ETC served as control. Teeth were loaded to fracture at a 135° angle to their long axis, at a cross-head speed 0.5 mm/min. The fracture modes were divided through optical microscopy to repairable and irreparable. Statistical analysis was performed by means of the Fisher's Exact test. RESULTS: All groups presented brittle fracture following bending deformation. Irreparable root fractures were the primary fracture mode independently of ferrule. The percentages (%) of repairable fractures were not statistically significant different amongst the MC and AC restored teeth independently of ferrule. However the 2 mm ferrule was associated to a higher percentage of repairable fractures, especially in teeth restored with AC crowns. CONCLUSIONS: The percentage (%) of repairable fractures was higher in all-ceramic compared to metal-ceramic ETC and in restorations with ferrule, although the differences were not statistically significant. CLINICAL SIGNIFICANCE: This in vitro study supports evidence that neither the type of crown restoration nor the presence of ferrule affects statistically significantly the mode of fracture of ETC restored with GFP.

Attitudes of dentists regarding the restoration of root canal treated teeth: a survey in Greece.

OBJECTIVES: To investigate attitudes of Greek dentists regarding the restoration of root canal treated (RCT) teeth and to compare them to recommended guidelines. Additionally, to examine relationships between degree of dentists' professional experience or region of practice location and attitudes of restoring RCT teeth. METHOD: Data were collected from 302 dentists using a structured self-administered questionnaire. For each dentist a score was assigned reflecting the level of compliance with scientific recommendations for restoration of RCT teeth. RESULTS: 89.4% of the respondents reported that not every RCT tooth requires a post while the 46.4% stated that a post reinforces it. 76.2% of the participants believed that the ferrule design provides a reinforcement to RCT teeth. Dentists with 6-20 years of experience showed a higher level of compliance with the principles in the literature than their colleagues with less or more years of practising. No significant difference was detected between dentists practising in urban and rural areas. CONCLUSIONS: The majority of Greek dentists had knowledge in accordance with recommended guidelines, except the aspect of the reinforcement effect by the post. In contrast to the region of practice location, the degree of professional experience influenced the restoration of root-treated teeth.

Association between self-reported bruxism activity and occurrence of dental attrition, abfraction, and occlusal pits on natural teeth.

STATEMENT OF PROBLEM: It is unclear whether subjects who report tooth clenching and/or grinding have more noticeable clinical signs of dental attrition, abfractions, and occlusal pits on their natural teeth than subjects who do not report bruxism activity. PURPOSE: The purpose of this study was to determine whether there was an association between self-reported (or not reported) bruxism activity and occurrence of dental attrition (anterior, posterior), abfractions, and occlusal pits on natural teeth. MATERIAL AND METHODS: One hundred and two volunteer adult Greek subjects (mean age 44.6 +/-5.7 years) were classified into 2 groups (50 self-reported bruxers and 52 nonbruxers) according to 2 inquires regarding grinding and/or clenching of their teeth. Dental attrition (anterior, posterior) was assessed by 2 calibrated experienced examiners on diagnostic casts on a tooth-by-tooth basis, using a previously well established ordinal scale. Abfraction lesions (V-shaped, in the cervical region) and occlusal pits were recorded if these clinical signs were found on at least 2 natural teeth. Statistical comparisons between the 2 groups relative to the distribution of the occurrence of the 4 clinical signs were performed by means of the exact version of the chi-square test. The Fisher's exact test was used for the comparison of percentages. The intra- and interexaminer reliability was assessed by means of the Cohen's kappa coefficient (alpha=.05). RESULTS: The results demonstrated that there was a significant association between self-reported bruxism and occurrence of the 4 clinical signs. Although the 2 groups were significantly different according to the distribution of the 4 clinical signs, the greatest differences occurred for the anterior and posterior attrition signs. CONCLUSIONS: In this study, the occurrence of 4 clinical signs (posterior or anterior dental attrition, abfractions, and occlusal pits) was associated with self-reported bruxers. It is suggested that, primarily, signs of dental attrition may differentiate self-reported bruxers from nonbruxer subjects.

Evaluation of the relationship between subjects' perception and professional assessment of esthetic treatment needs.

PURPOSE: The purposes of the present study were to (1) evaluate the esthetic dental treatment need by means of two special questionnaires, (2) determine the reliability and the construct validity of the measurement scales derived from these questionnaires, and (3) investigate the relationship between Greek subjects' perception and a professional examiner's assessment regarding the esthetic treatment need. MATERIALS AND METHODS: Participants in this survey consisted of 132 subjects (48 males with mean age 39.0 +/- 14.5 years old, 84 females with mean age 41.7 +/- 14.5 years old) with natural teeth and fixed restorations. Subjects were asked to complete a special self-evaluation questionnaire consisting of 12 items. During the next stage, all participants were clinically examined by an experienced examiner and the data collected were used to fill out a second special professional assessment questionnaire consisting of 20 items. The forms structure used were in accordance with well-established indices used in orthodontics for assessing esthetic treatment need. RESULTS: The reliability of the multiple correspondence analysis (MCA) analysis-derived scales was very satisfactory (Cronbach's a coefficient: a =0.82) for the total scale of the self-evaluation measurement. For the professional assessment scale, the reliability of the total scale was almost perfect (a=0.92). The MCA revealed one reliable factorial construct for the self-evaluation measurement scale and two reliable constructs for the professional measurement scale. Pearson's correlation coefficient indicated a very low agreement between self-evaluation and professional measurement scales. CONCLUSION: The findings of this survey suggest that there was a relative disagreement between subjects' perception and professional assessment regarding the need for esthetic dental treatment. CLINICAL SIGNIFICANCE In the present survey, the agreement between subjects' perception and clinical assessment of esthetic dental treatment need was found to be very low, which highlighted the discrepancies between patients' and dentists' perceptions of esthetic needs.