The 3-year cumulative survival rates of posterior monolithic zirconia crowns and their antagonist teeth, and their influencing factors.

PURPOSE: The purpose of this study was to evaluate the 3-year cumulative survival rates of posterior single monolithic zirconia crowns (MZCs) and their antagonists, and to analyze the influencing factors. METHODS: The clinical outcomes of posterior single MZCs and their abutment teeth with antagonists, and the antagonists between April 2014 and September 2020 were evaluated retrospectively. The 3-year cumulative survival rates were calculated and associations between the survival time and predictor variables ("Jaw", "Tooth", and "Pulpal condition") were also verified using Cox proportional hazards models and hazard ratios (HRs). RESULTS: The 3-year cumulative survival rate of single MZCs was 89.8% (9 of 177 MZCs, 95% confidence interval (CI): 80.0-95.1%). Cox proportional hazards models showed non-vital teeth were significantly associated with failure (HR: 2.76e + 9, P = 0.012). The 3-year cumulative survival rate of antagonists was 94.8% (7 of 171 antagonists, 95% CI: 89.3-97.6%). Non-vital antagonists were also identified as an independent predictor for failure in Cox proportional hazards models (HR: 7.83, P = 0.03). CONCLUSION: Although posterior single MZCs were clinically acceptable, non-vital pulpal condition could be a potential risk factor for failures in the abutment and antagonist teeth of MZCs.

Assessment of the Accuracy in Measuring the Enamel Thickness of Maxillary Incisors with Optical Coherence Tomography.

Although the clinical assessment of enamel thickness is important, hardly any tools exist for accurate measurements. The purpose of this study was to verify the precision of enamel thickness measurements using swept-source optical coherence tomography (SS-OCT). Human extracted maxillary central and lateral incisors were used as specimens. Twenty-eight sites were measured in each specimen. The optical path length (OPL) at each measurement site was measured on the OCT images, and enamel thickness (e1) was calculated by dividing OPL by the mean refractive index of enamel, 1.63. The specimens were then sectioned, and a light microscope was used to measure enamel thickness (e2). e1 and e2 were then compared. Measurement errors between e1 and e2 for the central and lateral incisors were 0.04 (0.02; 0.06) mm and 0.04 (0.02; 0.07) mm [median value: (25%, 75% percentile)], respectively. No significant differences between measurement sites were noted for measurement errors between e1 and e2. These results demonstrate that OCT can be used for noninvasive, accurate measurements of enamel thickness.

Prognosis of Implants with Implant-Supported Fixed Dental Prostheses in the Elderly Population: A Retrospective Study with a 5- to 10-Year Follow-Up.

This retrospective study aimed to investigate the survival rate of implants from 5 to 10 years after the placement of implant-supported fixed dental prostheses (ISFDPs) and the management of implant loss in the elderly population. Elderly patients (≥65 years old) who had been treated with ISFDPs and followed up with for at least 5 years between October 2009 and March 2020 were enrolled. Patient profiles and implant-related data were extracted. The survival rate of implants up to 5 years as well as the 10-year cumulative survival rate were evaluated. The management of implant loss and prosthetic interventions were also investigated. In total, 195 patients (mean age: 70.1 ± 4.5 years old) and 687 implants (287 ISFDPs) were assessed. The 5-year survival rate was 99.0% and the 10-year cumulative survival rate was 98.1%. Seven of the eleven implants lost were lost due to peri-implantitis. Only three implants in two patients were placed after the loss of the implants; most were restored using non-invasive procedures. Two patients underwent a conversion from ISFDPs to removable prostheses. This study showed that high survival rates were observed in an elderly population with ISFDPs and that non-invasive procedures were often applied after the loss of an implant.

Managements of sleep bruxism in adult: A systematic review.

This systematic review aimed to update the management of sleep bruxism (SB) in adults, as diagnosed using polysomnography (PSG) and/or electromyography (EMG). Management methods covered were oral appliance therapy (OAT) with stabilization splints, cognitive-behavioral therapy (CBT), biofeedback therapy (BFT), and pharmacological therapy. A comprehensive search was conducted on MEDLINE, Cochrane Library, and Web of Science up to October 1st, 2021. Reference list searches and hand searches were also performed by an external organization. Two reviewers for each therapy independently performed article selection, data extraction, and risk of bias assessment. The reviewers resolved any disagreements concerning the assortment of the articles by discussion. Finally, 11, 3, 14, and 22 articles were selected for each therapy. The results suggested that OAT tended to reduce the number of SB events, although there was no significant difference compared to other types of splints, that the potential benefits of CBT were not well supported, and that BFT, rabeprazole, clonazepam, clonidine, and botulinum toxin type A injection showed significant reductions in specific SB parameters, although several side effects were reported. It can be concluded that more methodologically rigorous randomized large-sample long-term follow-up clinical trials are needed to clarify the efficacy and safety of management for SB.

The Significance of Posterior Occlusal Support of Teeth and Removable Prostheses in Oral Functions and Standing Motion.

The purpose of this study was to evaluate the effect of posterior occlusal support of natural teeth and artificial teeth on oral functions and standing motion. Patients who had been treated with removable prostheses were enrolled as the subjects. Their systemic conditions (body mass index (BMI) and skeletal muscle mass index (SMI)) were recorded. The subjects were classified into two groups according to a modified Eichner index: B1-3 (with posterior occlusal support) and B4C (without posterior occlusal support). Maximum occlusal force (MOF), masticatory performance (MP), and standing motion (sway and strength) were evaluated for cases with and without removable prostheses. There were no significant differences in BMI and SMI between the B1-3 group and the B4C group. The subjects with removable prostheses demonstrated significantly higher values in MOF, MP, and sway and strength than the subjects without removable prostheses. The comparison of oral functions between the B1-3 group and the B4C group revealed that the positive effect of posterior occlusal support of natural teeth and removable prostheses and the significant positive effects of posterior occlusal support on standing motion were partly observed in these comparisons. Posterior occlusal support of natural teeth and even of removable prostheses may contribute to the enhancement of oral functions and standing motion.

A Prospective Comparative Study of Mastication Predominance and Masticatory Performance in Kennedy Class I Patients.

Mastication predominance in Kennedy class I (KC I) patients has not been well defined. This study aimed to investigate mastication predominance and masticatory performance in KC I patients, including the significance of remaining posterior teeth and removable partial-denture (RPD) treatment. KC I patients who had differences in the number of posterior teeth between left and right sides (D+) and KC I patients who had no differences (D-) were enrolled. Healthy dentate (HD) subjects were also registered as a positive control. Mastication predominance, defined by mastication predominance index (MPI; range 0-100%) calculated from electromyogram activities during voluntary chewing, and masticatory performance were evaluated at pre- and post-RPD treatment. Pre-MPI in KC I D+ was significantly higher than in HD. RPD treatment could significantly improve MPI and masticatory performance in both KC I groups. However, there were significant differences in masticatory performance between each KC I group and HD, regardless of RPD treatment. It was considered that the mastication predominance in KC I patients was affected by the difference in the number of remaining posterior teeth. RPD treatment could improve mastication predominance and masticatory performance in KC I patients, although the latter was not similar to HD group.

The impacts of prosthetic interventions on mastication predominance in Kennedy Class â ¡ patients.

Purpose The purpose of this study was to investigate the effects of prosthetic interventions in patients with Kennedy Class Ⅱ (unilateral missing posterior teeth) on mastication predominance.Methods The subjects comprised patients with Kennedy Class II and healthy dentate volunteers (HD group). The subjects were asked to freely chew the test foods (chewing gum, beef jerky, and peanuts). Electromyographic activity of the bilateral masseter muscles was recorded twice (before and after prosthetic intervention). The chewing side (right or left) was judged by the level of the root mean square electromyographic amplitude. Mastication predominance was assessed using the mastication predominance index (MPI; range 0-100%). Each patient was restored with a removable partial denture (RPD) or an implant-supported fixed prosthesis (IFP). The effects of prosthetic interventions were statistically evaluated by the differences between MPI before and after prosthetic interventions (pre-MPI and post-MPI , respectively).Results There was a significant difference between pre-MPI of patients with Kennedy Class II and MPI of the HD group (HD-MPI) for all test foods (P < 0.0001). Statistical analysis also demonstrated a significant difference between pre-MPI and post-MPI measured with each of the three food items in both the RPD and IFP groups (P < 0.0001). Multiple comparisons revealed that post-MPI in the IFP group, but not in the RPD group, was statistically comparable with HD-MPI, although there were no significant differences among the three groups when MPIs were calculated using peanuts.Conclusions Prosthetic interventions improved mastication predominance in patients with Kennedy Class Ⅱ patients. Depending on the food type, IFP might contribute to better improvement of mastication predominance than RPD depending on food.

Objective assessment of actual chewing side by measurement of bilateral masseter muscle electromyography.

OBJECTIVE: The aim of this study was to examine the validity of objective assessment of actual chewing side by measurement of electromyographic (EMG) activity of the bilateral masseter muscles upon chewing test foods. DESIGN: The sample consisted of 19 healthy, dentate individuals. The subjects were asked to chew three types of test foods (peanuts, beef jerky, and chewing gum) for 10 strokes on the right side and then on the left side, and instructed to perform maximum voluntary clenching for 3s, three times. EMG activity from the bilateral masseter muscles was recorded. The data were collected in three different days. The root mean square EMG amplitude obtained from the maximum clenching task was used as the maximum voluntary contraction (MVC). Then, the level of amplitude against the MVC (%MVC) was calculated for the right and left sides on each stroke. The side with the larger %MVC value was judged as the chewing side, and the concordance rates (CRs) for the instructed chewing side (ICS) and the judged chewing side (JCS) were calculated. Intraclass correlation coefficients (ICCs) of the CRs were calculated to evaluate the reproducibility of the method. RESULTS: High CRs between the ICS and JCS for each test food were recognized. There were significant ICCs for beef jerky (R=0.761, P<0.001) and chewing gum (R=0.785, P<0.001). CONCLUSIONS: The results suggested that the measurement of EMG activity from the bilateral masseter muscles may be a useful method for the objective determination of the actual chewing side during mastication.