EVAULATION OF BLINK REFLEX BETWEEN PATIENTS WITH IDIOPATHIC TRIGEMINAL NEURALGIA AND HEALTHY VOLUNTEERS.

The purpose of the study was to find differences in the parameters of the response to the blink reflex (BR) between patients with idiopathic trigeminal neuralgia (TN) and health volunteers. A prospective cohort study was conducted over 2 years. The TN-subgroup included 15 patients (mean age / SD 62.3 ± 10.7 years). Pain-free and healthy volunteers as a HV-subgroup (mean age / SD: 30.8 ± 8.1 years) were recruited from asymptomatic students of dental medicine. Diagnostic parameters were determined by measuring latency to the onset of the BR components from electric stimulation. The following branches of the trigeminal nerve were affected: maxillary branch only (26.7%), mandibular branch only (20%), combined: ophthalmic branch with maxillary branch (6.7%), and ophthalmic branch with mandibular branch (6.7%) respectively, combined maxillary and mandibular branch (26.7%) and affected all three branches (13.4%). The latencies of the BR, left and right side together, between subgroups were significantly higher for values R1 (homolateral early response), R2 (homolateral late response), R2c latency (contralaterally expressed response) in the TN-subgroup (p < 0.05). On the basis of the presence of R1c and R3 latencies and upon considering the abnormal findings of the BR, no statistically significant differences were found between the examined subgroups (p > 0.05). Blink-reflex parameters (R1, R2 and R2c) were significantly abnormal comparing TN-patients with healthy volunteers. The R3 component of the BR was related to noxious stimuli, likewise by innocuous stimuli.

[Historical background of the Croatian Medical Association]. / Povijesni pregled razvoja Hrvatskoga Lijecnickog zbora.

Since the establishment of the Croatian Medical Association in 1874, continuing its socializing, collaborative, professional and scientific activities through generations of medical doctors and dental doctors down to the present time. The period has been marked by dedicated work of many generations of physicians, numerous professional and scientific achievements of the medical profession. During their mandates, many presidents guided and directed the activities of the CMA, fervently discussed and fought for progress and prosperity and proudly celebrated important anniversaries and events. Lijednicki vjesnik, the CMA journal, has always been an important factor in the education of its readers, as well as for professional and scientific advancement of many colleagues.

Analysis of the extent and efficiency of the partnership and collaboration between the dental faculties and National Dental Associations within the FDI-ERO zone: a dental faculties' perspective.

BACKGROUND AND AIM: As National Dental Associations and dental faculties can be considered as the two major institutions representing national organised dentistry, their further extended collaboration is crucial in responding to the many global oral health matters and issues. The main aim of the present study is to analyse the nature and extent of the partnership between the dental faculties and NDAs. METHODS: A questionnaire was developed focusing on the relationship between National Dental Associations and the dental faculties within the World Dental Federation-European Regional Organisation zone regarding their major professional activities such as dental education, workforce issues, improvement of national oral health, science and knowledge transfer. The questionnaire was sent to 173 dental faculties within the countries in the European Regional Organisation zone. RESULTS: Response rate was 62/173 (35.8%). Major activities of dental faculties were listed as implementation of new technologies into practice (72%), followed by improvement of national oral health (65%), while the least involved activity was dental workforce issues (42%). The dental faculties perceived their relationship with the National Dental Associations as quite satisfactory in the field of continuing education and science and knowledge transfer. However, their relationship was suggested to need significant improvement when dealing with undergraduate dental education curriculum, dental workforce issues and negotiations with the authorities regarding professional matters/issues. DISCUSSION AND CONCLUSIONS: Despite the fact that there are differences between the perceived competences and responsibilities of the two bodies, the presence of so many potential areas of collaboration, the increasing expectations from the individual dentists/dental profession and the new challenges of the dental profession give this relationship significant importance. Communication, regular contacts, more joint activities and improved collaboration is needed between dental faculties and National Dental Associations to overcome such professional matters and issues.

Orofacial injuries reported by junior and senior basketball players.

The increased popularity of sports, apart from being beneficial to health, also results in a larger number of injuries, a part of which are also injuries to the stomatognatic system. According to the data from literature orofacial injuries in basketball are frequent, but relatively minor. The World Dental Federation places basketball into the category of medium-risk sports for the occurrence of injuries to the stomatognatic system. The purpose of this investigation was to determine incidence, type and severity of orofacial injuries during basketball and the frequent of the mouthguard use in a selected sample of basketball players from the City of Zagreb and the Zagreb County. The sample consists of 195 athletes who actively participate in basketball, 61 junior and 134 senior players. A total of 2 615 injuries to the stomatognatic system were documented in this research, 529 (20.2%) of those refer to juniors and 2 086 (79.8%) to seniors. The most common injuries are lacerations and contusions of soft tissue 84.4% (21.5% juniors and 78.5% seniors), followed by temporomandibular joint injuries and oral muscles stiffness 13.4% (14.9% juniors and 85.1% seniors) and 2.2% dental injuries (3.5% juniors and 96.5% seniors). Only 6.7% of players (13 players--2 juniors and 11 seniors) have tried to wear a mouthguard, while only one 1% of them (2 players--one junior and one senior) frequently used it. Total number of injuries shows that sports injuries are common during basketball. Average number of almost 4 injuries per player is relatively high. Dental injuries and temporomandibular joint injuries and oral muscles stiffness are relatively rare, only 16%. Lacerations and contusions of soft tissues represent 84% of all injuries and that minor injuries do not require professional care.

Comparative study of condylar inclination settings in two types of semiadjustable articulators.

The purpose of this study was to research the possible influence of difference in construction of mechanical joint in arcon and nonarcon articulators, upon the adjustment of condylar inclination by intraoral protrusive record. The determination of condylar inclination by protrusive record in two types of articulators was performed on 30 examinees, and the adjustment of condylar inclination in each articulator was done for left and right joint. In arcon articulator the measured values for condylar inclination were higher and the mean difference for right joint was 7.4 degrees, and for the left joint 7.2 degrees The found differences are statistically significant for both, left and right joint, at the level of P < 0.001. There is possible influence of difference in construction of mechanical joint upon the adjustment of condylar inclination by intraoral protrusive record. The arcon articulator, due to constant relation between occlusal plane and mechanical fossa, reproduces the movements more accurately.

[Custom-made mouthguards and prevention of orofacial injuries in sports]. / Individualni sportski stitnik za zube i prevencija orofacijalnih sportskih ozljeda.

The importance of sports dentistry has become even greater due to the role that sports have in modern society. As the risk of sports-related injuries appears already in the period of children's play and is constantly present in various risk-related sporting activities, the role of dental profession has become extremely important. Custom-made mouthguards are the most highly recommended mouthguards used for successful prevention of orofacial and dental injuries. It is important to inform athletes of the best characteristics of a custom-made mouthguard such as retention, comfort, fit, ease of speech, resistance to tearing, ease of breathing as well as good protection of the teeth, gingiva and lips. The shape and surface of the mouthguard which encloses the teeth, the gingival and the hard palate can vary depending on the anatomical features of the athlete's jaw, his/her dental arch, the type of sports activity, as well as the materials used in the manufacture of the mouthguard. Mouthguards should not extend distally further than the first molars because some athletes complain of the vomiting reflex. In addition, mouthguards may interfere with breathing. They should reach the mucogingival border labially and extend a few millimeters palatally in order to provide the best protection for the labial gingival and good retention. The labial flange should extend up to 2 mm of the vestibular reflection. The palatal flange should extend about 10 mm above the gingival margin thus enclosing the greatest part of the anterior palate surface with a slight narrowing distally not further than the first molars. Materials used in the manufacture of mouthguards should satisfy a number of physical, mechanical and biological requirements. Essential properties of materials used in the manufacture of mouthguards include water absorption, density, thickness as well as temperature transmission, energy absorption and drawing strength (tensile strength) of custom-made mouthguards. Such materials should have an optimal consistency in order to cushion the traumatic impact. Currently, ethylene-vinyl acetate (EVA) is the most commonly used mouthguard material. An optimal thickness of the mouthguard is achieved by the application of vacuum forming pressure-lamination technique in two layers of a thermoplastic sheet of EVA copolymer and if needed, by placing two layers of protective air-cells against the critical area. Some investigations in the Croatian samples showed that the most common injuries in water polo occur in the orofacial region (96.4% of cases), of which 80% are injuries of lips, tongue and cheek. In the period from 1997 to 2005 the number of orofacial injuries increased by 62%. Dental trauma occurs in 7.6% of cases. In basketball players soft tissue injury in the orofacial complex was established in 69.4% and dental trauma in 11.3% of the respondents. In the selected sample of handball players, soft tissue injuries were established in 78.8%, dental trauma and loss of teeth in 13.6% and temporomandibular joint injuries in 6.8% of the cases. In tae-kwon-do players 88% of orofacial injuries were lacerations, but only 12% reported dental and temporomandibular joint trauma. Only a half of the examined professional basketball players wore mouthguards, and none of the examined tae-kwon-do players. Clinical value of intraoral custom-made mouthguards was proven. Dentists play the key role in the prevention and treatment of sports-related dental and orofacial injuries, collection and dissemination of relevant information, as well as promotion of research on the preventive procedures related to injuries of such a specific aetiology.

[Sports injuries of temporomandibular joints and oral muscles in basketball players]. / Sportske ozljedetemporomandibularnih zglobova i zvacnih misica u kosarkasa.

All sporting activities have an associated risk of orofacial injuries due to falls, collisions with players, devices, and hard surfaces. Many authors have reported about incidence of orofacial injuries during sports activities. Flanders and Bhat concluded that 34% of all injuries in basketball are orofacial injuries, while orofacial injuries account for only 0.07% of all injuries in American football. AIM, METHODS AND EXAMINEES: The aim of this investigation was to identify the incidence, type and severity of temporomandibular joint injuries, stiffness and pain in oral muscles, and pain during opening and closure of the mouth while playing basketball. The sample consisted of 195 basketball players, 135 professionals and 60 non-professionals. They filled out the questionnaire individually with help of the researchers. RESULTS: The data received by the survey revealed a total of 350 temporomandibular joint injuries and/or pain, oral muscles stiffness and pain during opening and closure of the mouth during basketball career. The incidence of injuries was higher in professional 72.6% (254) than in non-professional players 27.4% (96). Twenty-four professional and 9 non-professional players reported pain or oral muscles stiffness, while 58 professional and 15 non-professional players reported pain during opening and closing the mouth. Only 1 non-professional player and 6 professional players reported injuries of the temporomandibular joint. All basketball players who were injured during their career had more than one injury. During career, professional players reported pain while opening and closing of the mouth more often than non-professional players, on the average 1.3 and 0.9 times, respectively. Pain or oral muscles stiffness during basketball career was reported 0.6 times on the average by non-professional players, as compared to 0.5 times by professional players. Non-professional players reported 5.2% injuries of temporomandibular joints during their career, while professional players only 3.2%. With regard to positions in the team, most injuries of temporomandibular joints, stiffness and pain in oral muscles were reported by forwards, on the average 2.33 incidents. Centers were the second most frequently injured group with an average of 1.96 incidents, followed by point guards with 1.74, power forwards with 1.62 and guards with 1.55 incidents. CONCLUSION: Only 2 basketball players (1%) frequently used a mouthguard and 93.3% of them never even tried to wear a mouthguard. Implementation of mandatory mouthguard usage in sports, such as basketball, would decrease such a large number of sports injuries. Mouthguards would absorb the force of impact and consequently stiffness and pain in oral muscles so that injuries of temporomandibular joints would be reduced or even avoided. Such a low percentage of mouthguard use in basketball players reflects poor awareness and education of both athletes and coaches, as well as an insufficient role of dentists in sports medicine and education.

Specialisation and specialist education in prosthetic dentistry in Europe.

This presentation reports on the results of a meeting of prosthodontists from selected European countries. The aim of the meeting was to analyse and promote specialisation and specialist education in Prosthetic Dentistry in Europe. Representatives for Europe were selected from the European Prosthodontic Association (EPA) board, the Education and Research Committee of International College of Prosthodontists (ICP), countries with a legally recognised speciality, countries without a recognised speciality but organised training programmes and countries with neither of these situations. Data about specialisation and specialist training in Prosthodontics in Europe was scrutinised and discussed. The programmes for countries with specialist training had relatively similar content, mostly of three years duration. There was strong agreement that a recognised speciality raises the level of care within the discipline for both specialists and non-specialists. In several of the countries where a speciality had been introduced it had been initiated by pressure from public health planning authorities. The conclusions are that from a professional viewpoint an advancement of the speciality over Europe would develop the discipline, improve oral health planning and quality of patient care. A working group for harmonisation was recommended.

Effect of low-level laser therapy on Candida albicans growth in patients with denture stomatitis.

OBJECTIVE: The purpose of our report is to present the effect of low-level laser therapy on Candida albicans growth and palatal inflammation in two patients with denture stomatitis. BACKGROUND DATA: The most common oral mucosal disorder in denture wearers is denture stomatitis, a condition that is usually associated with the presence of the yeast Candida albicans. Different treatment methods have been suggested to treat this symptom, none of which is proven to be absolutely effective. METHODS: Two denture-wearing patients, both with palatal inflammation diagnosed as Newton type II denture stomatitis were treated with low-power semiconductor diode laser (BTL-2000, Prague, Czech Republic) at different wavelengths (685 and 830 nm) for 5 d consecutively. In both patients, palatal mucosa and acrylic denture base were irradiated in noncontact mode (probe distance of 0.5 cm from irradiated area) with different exposure times-5 min (830 nm, 3.0 J/cm2, 60 mW) and 10 min (685 nm, 3.0 J/cm2, 30 mW). The effect of laser light on fungal growth in vivo was evaluated after the final treatment using the swab method and semiquantitative estimation of Candida albicans colonies growth on agar plates. The severity of inflammation was evaluated using clinical criteria. RESULTS: After lowlevel laser treatment, the reduction of yeast colonies on the agar plates was observed and palatal inflammation was diminished. CONCLUSION: LLLT is effective in the treatment of denture stomatitis. Further placebo controlled studies are in progress.

Dental evidence of exhumed human remains from the 1991 war in Croatia.

The aim of this paper is to present the post mortem dental evidence and dental health of the victims exhumed throughout the territories of Croatia that was temporarily occupied during the war. A total number of 62,432 teeth out of 1,253 human bodies exhumed from 5 different counties were analyzed. The majority of victims inhabited those areas before 1991. Post mortem dental characteristics were analyzed according to the American Board of Forensic Odontology and WHO methodology. The results show the highest level of the dental health before 1991 in the Vukovarsko-Srijemska County. The decayed (D), missing (M), filling (F), teeth (T), DMFT of that County was at the lowest level i.e. at 5.2. In all of the other counties, it was always between 6 and 12. The material most frequently used for the dental fillings was amalgam. Its highest frequency level was recorded in the County 4 (8%) and lowest in the County 1 (1.5%), p<0.001. The most frequent prosthodontic appliances were acrylic dentures. Their frequency was lowest in the County 5 (1.3%) and highest in the County 3 (11.6%), p<0.001. Determination of sex and dental age showed that victims were mostly men (79%) of middle and elderly age (89%). Teeth were useful also for monitoring of the quality of exhumations--taking into consideration number of empty dental sockets. The highest number of empty dental sockets was recorded in the County 3 (40.4%) and lowest in the County 1 (13.5%), p<0.001. Even after many years in the soil, teeth proved to be the most preserved human organs and valuable indicators of identity as well as of the way of life before death.

Fungicidal effect of diode laser irradiation in patients with denture stomatitis.

BACKGROUND AND OBJECTIVE: Denture stomatitis (DS) is a common inflammatory condition that affects denture wearers. The aim of this study was to examine, in vivo, the effect of diode laser irradiation on fungal growth in both the palatal mucosa and in denture base materials, in denture wearing patients. STUDY DESIGN/MATERIALS AND METHODS: In total, 70 patients with clinical study design evidence of DS participated in this parallel, single blind, and placebo controlled study. The subjects were randomly assigned to one of four different treatment regimens: (1) irradiation with a 685 nm wavelength laser for 10 minutes (30 mW); (2) irradiation with a 830 nm wavelength laser for 5 minutes (60 mW). A semiconductor diode laser, BTL-2000 (BTL-2 Dravotnicka Technika, Prague, Czech Republic), was used in both treatment cases using an energy density of 3.0 J/cm(2) and a continuous working mode for five consecutive days; (3) placebo-sham irradiation of patients; (4) antimicotic-self treatment of patient's palatal mucosa with an antifungal oral gel and the use of an antiseptic solution for their dentures. The effect of laser light on fungal growth in vivo was evaluated after final treatment using the swab method and a semi-quantitative estimation of Candida albicans colonies cultivated on agar plates. RESULTS: A fungicidal effect was achieved in the laser treated and antimicotic treated groups, whereas most subjects in the placebo group were found to have unchanged conditions on both their palate (P = 0,004) and dentures (P < 0,001). CONCLUSIONS: Light from a low-power laser (LLLT) may be valuable in the treatment of DS. This is of great importance since the rate of recurrence of disease is high, whereas an optimal treatment modality has not yet been found.

Relationship of slightly limited mandibular movements to temporomandibular disorders.

Mandibular movements have been analyzed extensively in the past for prosthodontic reasons, and more recently to study the function of the masticatory system. This study investigated the range of mandibular movements in a young male population, and analyzed the difference in range of mouth opening, right and left lateral movements, and protrusive movement between asymptomatic subjects (control group) and patients with clinical diagnoses of temporomandibular disorders. A total of 180 subjects, aged 19-28 years, were included in the study. The TMD sample comprised 90 patients (30 patients with muscle disorders; 30 patients with disc displacement with reduction; 30 patients with muscle disorders and disc displacement with reduction) and was compared with 90 healthy control subjects. All participants were evaluated by the attending dentist at baseline with a complete physical examination and history questionnaire, which included the Research Diagnostic Criteria for Temporomandibular Disorders Axis I measures. Analysis of variance (ANOVA) showed significant differences in ranges of mandibular movements between and within the groups of healthy control subjects and patients with muscle and temporomandibular joint disorders. It is suggested that there are differences in the range of mandibular movements that clearly separate asymptomatic subjects and patients with temporomandibular disorders in this young male population.

Relationship of slightly limited mandibular movements to temporomandibular disorders

Movimentos mandibulares têm sido extensivamente analisados no passado por razões protéticas, e mais recentemente para analisar a função do sistema mastigatório. Este estudo investigou a amplitude dos movimentos mandibulares em uma população masculina de jovens, e analizou a diferença na amplitude de movimento mandibular em movimentos laterais direito e esquerdo e em movimentos protrusivos, entre pacientes assintomáticos (grupo controle) e pacientes com diagnóstico de desordem temporomandibular. Um total de 180 pacientes, com idades de 19-28 anos, foram incluídos neste estudo. A amostra com DTM consiste em 90 pacientes (30 pacientes com disfunção muscular; 30 pacientes com deslocamento de disco com redução; 30 pacientes com disfunção muscular e deslocamento de disco com redução) e foi comparada com 90 pacientes saudávies no grupo controle. Todos os pacientes foram avaliados por um dentista com um exame físico completo e anamnese, que incluiu medidas de "Research Diagnostic Criteria for Temporomandibular Disorders Axis I". A análise de variância (ANOVA) mostrou diferenças significantes na amplitude de movimentos entre e dentro do grupo de pacientes saudáveis do grupo controle e pacientes com desordens temporomandibulares e de disco articular. Encontrou-se diferenças significantes na amplitude dos movimentos mandibulares que separaram os pacientes assintomáticos e pacientes com desordens temporomandibulares em uma população masculina de jovens.

Measurement of mandibular movements in patients with temporomandibular disorders and in asymptomatic subjects.

The aim of the study was to investigate the range of mandibular movements and to analyze the difference in range of mouth opening, right and left lateral movements, and protrusive movement between patients with clinical diagnoses of temporomandibular disorders and asymptomatic subjects (control group) in a young male population. A total of 240 subjects, aged 19-28, were included in the study. The TMD sample comprised 180 patients (60 patients with muscle disorders; 60 patients with disc displacement with reduction; and 60 patients with muscle disorders and disc displacement with reduction) and was compared with 60 healthy control subjects. All participants were evaluated by the attending dentists at baseline by means of a physical examination of the masticatory system and a history questionnaire which included the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I measures. Analysis of variance (ANOVA) with the post hoc Bonferroni criteria showed significant difference in ranges of mandibular movements between and within the groups of asymptomatic subjects and TMD patients for active mouth opening (p = 0.001), right lateral movement (p = 0.002), left lateral movement (p = 0.006), and protrusive movement (p = 0.05). It has been found that there are statistically significant differences in the range of mandibular movements that separate asymptomatic subjects and patients with muscle disorders and disc displacements with reduction in this young male population. However, we cannot conclude that measurements of active mandibular movements can discriminate one group (TMD patients) from the other (asymptomatic subjects), because the mean ranges of these active movements between the groups were measured in clinically "normal" values.

1.4 Research and the dental student.

There has been significant concern that the dental curriculum and system of clinical education, in particular, is not designed to take advantage of the explosion in knowledge in biomedical science and its application to the health of the public. Although there are some examples of innovations in dental education on a global scale that have the capacity to increase the assimilation of basic and clinical knowledge, most of the dental education models are mired in the traditional '2 + 2' approach to education. This can be seen in North America and the European '2 + 3' model or the stomatological '4 + 2' approach. In each of these systems, the basic and behavioural science courses continue to be perceived as hurdles over which students must leap in order to reach the clinical programmes where there is little opportunity to use basic science information to advance patient care and treatment. Examples of issues that are not well represented include: innovations in imaging; diagnosis; bio-materials; science-based approaches to clinical practice; novel approaches to therapeutics; interactions between the oral, dental and craniofacial complex and systemic health and disorders; the role of oral infections and systemic disease; the increasing appreciation of chronic diseases and disorders such as osteoporosis and diabetes that affect oral tissues; the promise of bioengineering, tissue engineering and biomimetics; the potential use of saliva as a diagnostic tool; the understanding of oral complications of cancer treatment; the treatments of HIV/AIDS diseases and hepatitis; the use of dental and dental hygiene staff on health-care teams to deal with issues such as birth defects, orofacial trauma, head and neck cancer, chronic pain management and so on. There seems to be an excessive emphasis on restorative dentistry and, to a lesser extent, on the more biological approaches to diagnosis, prevention and therapeutics. This continued lack of integration of basic and clinical sciences in the curriculum continues to foster a dental workforce that is highly technically competent to provide specific clinical services but poorly equipped to evaluate and implement new biological approaches to diagnosis, therapeutics and intervention. Unfortunately, after many attempts by organized dental symposia aimed at the integration of basic and clinical sciences, there has been little discernible curricular change. It appears that there is an opportunity through this global congress to identify the best practices in the various global curricula that could change this paradigm in dental education and lead us toward the education of a more scientifically orientated practitioner-one who can take advantage of innovations in new and emerging technologies in their application to patient care. It is the challenge of this section to try to ascertain the best method or methods by which dental education promotes research to the dental student and what research represents in terms of critical thinking and evidence-based approaches to dental education and clinical practice.

A study of the influence of occlusal factors and parafunctional habits on the prevalence of signs and symptoms of TMD.

PURPOSE: The purpose of this study was to investigate the prevalence of the clinical signs and symptoms of temporomandibular disorders (TMD) and the relationship between occlusal factors, parafunctional habits, and TMD in a young adult nonpatient population. MATERIALS AND METHODS: A questionnaire including data from a history and clinical functional examination was used in the study. All 230 subjects were male recruits, from 19 to 28 years of age (mean 21.3 years). RESULTS: Thirty-eight percent of the subjects reported at least one symptom, while in 45% of the subjects at least one sign of TMD was recorded. Temporomandibular joint clicking (40%) and pain on palpation (34%) were the most commonly recorded signs. Multivariate logistic regression analysis showed several weak but statistically significant correlations between the occlusal factors, parafunctional habits, and TMD in this nonpatient population. TMD signs were thus weakly correlated with malocclusion traits (angle Classes II/1, II/2, III, and cross bite), interferences in retruded contact position, midline discrepancy > or = 2 mm, < or = 10 contacts during maximal biting pressure, nonworking-side interferences, horizontal overlap > or = 5 mm, and parafunctional habits (teeth clenching and teeth grinding). CONCLUSION: Some association between occlusal factors and TMD signs was found. However, this association cannot be considered unique or dominant in defining subjects with TMD in the population.