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1.
Artigo em Inglês | MEDLINE | ID: mdl-34210565

RESUMO

The aim of this study was to translate the Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) into German and validate this version in order to assess oral-health-related quality of life (OHRQoL) among head and neck cancer patients. This study was conducted at a German university clinic among patients who had completed therapy for squamous cell carcinoma of the head and neck (HNSCC). The original English-language LORQv3 was translated into German according to the forward-backward approach. Validity and reliability were evaluated using further questionnaires related to OHRQoL and psychological impairments. Subgroups were built with reference to oral rehabilitation status and type of cancer therapy. Furthermore, OHRQoL was evaluated. Test-retest reliability was assessed by weighted kappa with a 10-14 day interval. Data were analysed by using Spearman's correlation and the following tests: Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney U and Cronbach's alpha. The level of significance was set at α = 0.05. Analysis of the LORQv3 evaluations revealed excellent Cronbach's alpha and high test-retest reliability. Construct validity were supported by the data. LORQv3 summary score and domains were significantly affected by status of oral rehabilitation (p = 0.003, p = 0.008, p = 0.024) and treatment approach (p < 0.001, p = 0.025, p = 0.035). The German version of the LORQv3 showed high reliability and validity and an impaired OHRQoL of HNSCC patients. It can therefore be recommended for the assessment of OHRQoL.

2.
Int J Prosthodont ; 2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33751007

RESUMO

PURPOSE: To investigate the effect of missing teeth on patients' oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: A total of 151 patients participated in this prospective bicenter clinical study (mean age: 64.7 ± 10.5 years; 71 women). Four subgroups were defined based on the number of missing teeth. OHRQoL was assessed using the German version of the Oral Health Impact Profile-49/53 (OHIP-G49/53) and visual analog scale (VAS) questionnaires. The effect of missing teeth on OHIP (total and by dimension) and VAS scores before and after prosthetic treatment was investigated at baseline (T0), 1 week (T1), and 3 months (T2) after prosthetic treatment. Scores were analyzed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. Correlations were assessed using Spearman rho correlation. The level of significance was set at P = .05. RESULTS: Initial OHIP and VAS scores were highest for patients with 11 to 28 missing teeth. Scores improved among all groups between T0 and T1/T2. After prosthetic rehabilitation (T1), improvements in total OHIP scores were greatest for patients with no missing teeth or with 11 to 28 missing teeth. Patients with no missing teeth or with 1 to 4 missing teeth before treatment had the lowest posttreatment OHIP scores. Total OHIP scores among the groups were in the same value range (P > .185). No direct correlation was found between the VAS and total OHIP scores. CONCLUSION: OHIP and VAS scores for OHRQoL were associated with the number of missing teeth. Prosthetic treatment resulted in improved OHRQoL and oral function among all groups. The use of a VAS yielded additional detailed information.

3.
Int J Prosthodont ; 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33662062

RESUMO

PURPOSE: To assess the influence of substructure and dimension on the fracture strength of ceramic discs made from both lithium disilicate ceramic and zirconia. MATERIALS AND METHODS: A total of 128 intact maxillary third molars were collected, and standardized enamel and dentin discs were fabricated. Lithium disilicate ceramic (IPS e.max CAD, Ivoclar Vivadent; n = 64) and zirconia (Katana, Kuraray; n = 64) discs with 0.5-mm (n = 32 IPS and n = 32 Katana) and 1-mm (n = 32 IPS and n = 32 Katana) thickness were produced, and each group was divided into two subgroups (n = 16 each) that were luted to the enamel or dentin discs using Panavia V5 (Kuraray). Half of the specimens in each subgroup were aged (chewing simulation and thermocycling), and all specimens were loaded until fracture in a universal testing machine (Z010, Zwick/Roell). Differences between Katana and IPS with respect to enamel and dentin as substructure and the thickness of the ceramic were analyzed by use of a nonparametric test (Mann-Whitney U test). RESULTS: In un-aged specimens, fracture loads were not significantly (P > .05) different between zirconia and IPS specimens for 1- or 0.5-mm thickness. However, fracture loads were significantly higher (P < .001) in specimens supported by enamel, independent of the ceramic material. In aged specimens, the fracture loads of all specimens were significantly (P < .01) higher when supported by enamel; however, in the 0.5-mm groups, zirconia achieved significantly higher breaking loads than IPS when luted to dentin. CONCLUSION: When 0.5-mm ceramic discs were luted to dentin, zirconia outperformed IPS with respect to breaking loads.

4.
J Oral Rehabil ; 48(1): 18-27, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32997826

RESUMO

BACKGROUND AND OBJECTIVE: Objective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is sufficient for use among schoolchildren aged 8-12 years. METHODS: This prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8-12 years, with and without TMD symptoms, selected randomly from the Rhein-Neckar district. Self-reporting of non-dental facial pain was used as the reference standard, against which we calculated the following for the pain-related items of the DC/TMD (index test): sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, accuracy and 95% Wilson Score confidence intervals. We also calculated the area under the receiver-operating characteristic (AUROC) curve displaying sensitivity and specificity. RESULTS: Our final sample consisted of 282 children, half of whom reported having facial pain and 3.2% reported sounds from the temporomandibular joints (TMJs). Despite high specificity (90.78%; 95% confidence interval (CI): [84.86%; 94.53%]), sensitivity of the adapted DC/TMD for pain on maximum jaw opening was poor (37.59%; 95% CI: [30.02%; 45.81%]). For pain on palpation, more similar values were recorded for sensitivity (74.47%; 95% CI: [66.69%; 80.95%]) and specificity (70.21%; 95% CI: [62.21%; 77.14%]). The diagnostic odds ratio was >1 for both examinations. The AUROC for pain on opening was 68.39% (95% CI: [62.62%; 74.16%]), and for pain on palpation, it was 74.63% (95% CI: [69.45%; 79.81%]), whereas the combination of both resulted to an AUROC of 74.09% (95% CI: [68.96%; 79.21%]). It was not possible to measure the diagnostic accuracy of the DC/TMD regarding TMJ sounds or jaw-opening limitations, as they occurred too rarely in our sample. CONCLUSION: In this study, the diagnostic accuracy of the DC/TMD for TMD-related pain in children was lower than that recorded for adults in previous studies.


Assuntos
Transtornos da Articulação Temporomandibular , Adulto , Idoso , Criança , Dor Facial/diagnóstico , Feminino , Humanos , Masculino , Estudos Prospectivos , Sensibilidade e Especificidade , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/diagnóstico
5.
Eur J Dent Educ ; 25(2): 261-270, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32954628

RESUMO

INTRODUCTION: No commercially available solution to improve the teaching of a crown preparation directly on typodont teeth exists at the moment. To fill this gap and support the supervisors of dental courses, a printable and inexpensive tooth was created for structured self-assessment. The aim of this study was to test this printable tooth under realistic pre-clinical situations. MATERIALS AND METHODS: A two-coloured, double-layer practice tooth was developed. This tooth was consisting of a layer for a correct preparation and the crown. All printed teeth were produced with a stereolithographic printer. 35 voluntary second-year dental students in the second pre-clinical course in prosthodontics were randomly divided into two groups. All students had experience with typodont teeth and models. The first group was trained on four standard model teeth. The second group used model teeth for the first and fourth attempt and printed teeth for second and third attempt. The preparations of the students were scanned by an in-lab scanner and the surface deviations in contrast to a perfect preparation were measured. The differences between the first and fourth attempt were calculated. Benefits of the printed tooth were also evaluated by a questionnaire using German school grades completed by the students (1 = Excellent, 2 = Good, 3 = Satisfactory, 4 = Adequate, 5 = Poor, 6 = Unsatisfactory). RESULTS: The workflow was feasible and cost-effective regarding the production of the printed teeth. The overall rating of the printed tooth in the questionnaire was good (Ø 2.1 ± 0.22). Students reported different advantages of this method in the free text. The comparison of the preparation between the first and fourth attempt showed that there was a significant better preparation with the printed teeth. The complete preparation had median values of 0.05 mm (Group1: standard model tooth) and -0.03 mm (Group2: printed tooth) (P = .005). Divided into single surfaces, the vestibular and occlusal regions were significantly better. The vestibular surface was 0.11 mm (Group1) and -0.04 mm (Group2) (P = .018). The occlusal surface was 0.13 mm (Group1) and -0.05 mm (Group2) (P = .009). CONCLUSIONS: The aim of this study was fulfilled. The printed tooth was tested successfully in a pre-clinical course. The feasibility of this teaching concept was confirmed by the questionnaire and the analysis of the preparation form. A significant difference to a standard model tooth was measurable. The students had the possibility to learn a correct crown preparation on a standardised two-layered tooth with included preparation. This printed tooth enabled the students to control the crown preparation directly on their own.


Assuntos
Educação em Odontologia , Dente , Coroas , Humanos , Impressão Tridimensional , Estudantes
6.
J Prosthodont ; 30(1): 51-56, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32869400

RESUMO

PURPOSE: The purpose of this study was the design, feasibility, and evaluation of a 3D printed tooth model with internal preparation for dental education in veneer preparation. MATERIAL AND METHODS: A tooth with two different colored layers for the crown and the preparation form was designed and printed by a stereolithographic printer. In a voluntary course, 40 third- to fifth-year dental students were trained with these printed teeth in the clinical course. They had the opportunity to prepare four 3D printed teeth with an integrated veneer preparation. During their studies, they used standardized model teeth. The students rated the advantage in a questionnaire according to German school grades (1 best to 6 worst). For reliability analysis, Cronbach's alpha was calculated. Significant differences between groups were calculated using the Mann-Whitney U-test. RESULTS: The production of the teeth was feasible and cost-effective. The overall mean rating of the printed teeth in the questionnaire was 1.8 ± 0.18. The students rated the learning results with the printed tooth as significantly better than the standard model tooth (mean 3.0 ± 0.86 vs. mean 2.1 ± 0.95; p < 0.001). The item "is a more suitable exercise option" in contrast to standard model teeth was evaluated with 1.9 ± 0.61. The item "the included preparation was clearly visible in color" was rated with 1.7 ± 0.71. "The tooth model illustrated visually an ideal preparation" was rated with 1.8 ± 0.65. Additionally, the students were interested in including more printed teeth into their studies (1.7 ± 0.86). In the open questions the students reported great benefits of this method. CONCLUSIONS: The feasibility of this teaching concept was confirmed. The students favored working on the innovative 3D-teeth with internal veneer preparation, emphasizing the usefulness of this technique in dental education. The tooth enabled the students to control their preparation permanently on their own.


Assuntos
Impressão Tridimensional , Dente , Coroas , Modelos Dentários , Humanos , Reprodutibilidade dos Testes
7.
Clin Oral Investig ; 25(3): 1265-1272, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32651646

RESUMO

OBJECTIVES: Conventional dental implants inserted in the molar region of the maxilla will reach into the sinus maxillaris when alveolar ridge height is limited. When surgery is performed without prior augmentation of the sinus floor, primary stability of the implant is important for successful osseointegration. This study aimed at identifying the impact of bone quality and quantity at the implantation site on primary implant stability of a simulated bicortical placement. MATERIALS AND METHODS: In our in vitro measurements, bone mineral density, total bone thickness and overall cortical bone thickness were assessed by micro-computed tomography (µCT) of pig scapulae, which resembled well the bicortical situation found in human patients. Dental implants were inserted, and micromotion between bone and implant was measured while loading the implant with an axial torque. RESULTS: The main findings were that primary implant stability did not depend on total bone thickness but tended to increase with either increasing bone mineral density or overall cortical bone thickness. CLINICAL RELEVANCE: Limited bone height in the maxilla is a major problem when planning dental implants. To overcome this problem, several approaches, e.g. external or internal sinus floor elevation, have been established. When planning the insertion of a dental implant an important aspect is the primary stability which can be expected. With other factors, the dimensions of the cortical bone might be relevant in this context. It would, therefore, be helpful to define the minimum thickness of cortical bone required to achieve sufficient primary stability, thus avoiding additional surgical intervention.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Animais , Implantação Dentária Endo-Óssea , Retenção em Prótese Dentária , Falha de Restauração Dentária , Humanos , Maxila/cirurgia , Seio Maxilar/cirurgia , Suínos , Microtomografia por Raio-X
8.
Dent Mater ; 37(1): 191-200, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33276956

RESUMO

OBJECTIVE: This study aimed to investigate the effects of long-term use on the retention force and wear behavior of double crown systems. METHODS: Based on a common double crown design sixty pairs of telescopic crowns were fabricated and divided into six groups, each consisting ten samples: "Gold standard" cast gold alloy primary and secondary crown (GG) and cast non-precious alloy (NN), computer-aided design (CAD)/computer-aided manufacturing (CAM)-milled zirconia primary crown and galvanoformed secondary crown (ZG), CAD/CAM-milled non-precious alloy primary and secondary crown (CC NN), CAD/CAM-milled zirconia primary crown and non-precious alloy secondary crown (CC ZN) and CAD/CAM-milled zirconia primary crown and polyetheretherketone (PEEK) secondary crown (CC ZP). In the constant presence of artificial saliva, all samples were subjected to 10,000 joining-separation cycles at a velocity of 120 mm/min. Wear was analyzed by reflected light microscopy and confocal microscopy before and after artificial aging. RESULTS: Retention force losses were observed in each group after long-term use, with significant losses in the groups ZG and CC ZP (pZG = 0.01, pCC ZP = 0.049). During artificial aging, no significant differences in pull-off force were recorded for groups GG, NN and CC ZN. Regarding wear, merely the Y-TZP primary crowns of the CC ZP group displayed no surface changes. SIGNIFICANCE: All tested production methods and material combinations seem to be suitable for clinical practice. CAD/CAM technology allows similarly predictable results to be achieved as the gold standard. Confocal microscopy is recommended for surface examinations of double crowns.


Assuntos
Coroas , Planejamento de Prótese Dentária , Desenho Assistido por Computador , Ligas de Ouro , Zircônio
9.
Pain Rep ; 5(6): e865, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33294759

RESUMO

Quantitative sensory testing is used to assess somatosensory function in humans. The protocol of the German Research Network on Neuropathic Pain (DFNS) provides comprehensive normative values using defined tools; however, some of these may not be feasible in low-resource settings. Objectives: To compare the standard DFNS devices for assessment of mechanosensory function to a low resource tool, the Sorri-Bauru-monofilaments. Methods: Mechanical detection thresholds (MDT), pain thresholds (MPT), and suprathreshold pinprick ratings (pain sensitivity: MPS) were measured over cheek, hand dorsum, and fingertip in 13 healthy subjects (7 female, aged 21-44 years). Mechanical detection threshold was assessed with DFNS standard glass monofilaments (0.25-512 mN, 0.5 mm tip) and nylon monofilaments (Sorri-Bauru; 0.5-3000 mN). MPT was assessed with DFNS standard cylindrical probes (8-512 mN, 0.25 mm tip), Sorri-Bauru monofilaments, and with ramped stimuli using an electronic von Frey aesthesiometer (10 mN/s or 100 mN/s, 0.20 mm tip). MPS was measured in response to stepped and ramped pinpricks (128 and 256 mN). Results: Mechanical detection thresholds were the same for DFNS and Sorri-Bauru monofilaments. For MPT, Sorri-Bauru filaments yielded lower values than PinPricks over face but not hand. Pain thresholds were higher at all test sites for ramped than stepped pinpricks (P < 0.01). Suprathreshold ratings were lower for ramped than stepped pinpricks (P < 0.05). Conclusion: Sorri-Bauru filaments are acceptable substitutes for DFNS standards in estimating tactile sensitivity, but are not consistent with standard probes for pinprick sensitivity because of their nonstandardized tips. Ramped stimuli overestimated MPT and underestimated MPS due to reaction time artefacts and therefore need their own normative values.

10.
Eur J Dent Educ ; 24(3): 526-534, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32319180

RESUMO

INTRODUCTION: For both students and teachers, it is challenging to learn and teach a correct crown preparation. The purpose of this study was the design, feasibility and evaluation of a 3D printed tooth model with internal preparation for dental education in crown preparation and to analyse the quality of the prepared printed teeth in comparison with prepared standard model teeth. MATERIALS AND METHODS: A printable tooth was designed and printed by a stereolithographic printer. 38 fourth-year dental students in the first clinical course in prosthodontics were trained in a voluntary course using printed teeth. Different aspects of the printed tooth were evaluated by a questionnaire using German school grades (1 best to 5 worst). The quality of the preparation with the printed teeth and standard training teeth was also rated in an evaluation form done by an expert group consisting of five experienced dentists. RESULTS: The workflow was feasible and cost-effective for the production of the teeth. The overall rating of the printed tooth was Ø 2.0 ± 0.34 in the questionnaire completed by the students. The students rated the printed tooth model (Ø 2.1 ± 0.85) as significantly better than the standard model tooth (Ø 3.3 ± 0.77; P = .000). The students reported great benefits in the use of this model tooth, for example valuable replacement of a standard model and real teeth, direct control of material loss. The quality of the preparation was evaluated by the expert group as significantly better with an overall mean grade of Ø 2.6 ± 0.37 for the printed teeth compared to Ø 2.9 ± 0.42 for the standard model teeth (P = .000). CONCLUSIONS: The feasibility of this teaching concept was confirmed. The students favoured to work on the innovative 3D-teeth with internal preparation, emphasising the usefulness of this technique in dental education. The expert group confirmed also the significant training effect of this tooth model in contrast to a standard model tooth.


Assuntos
Educação em Odontologia , Dente , Coroas , Modelos Dentários , Humanos , Impressão Tridimensional
11.
Artigo em Alemão | MEDLINE | ID: mdl-32166336

RESUMO

BACKGROUND: Caries and periodontitis are highly prevalent worldwide. Because detailed data on these oral diseases were collected within the framework of the German National Cohort (GNC), associations between oral and systemic diseases and conditions can be investigated. OBJECTIVES: The study protocol for the oral examination was designed to ensure a comprehensive collection of dental findings by trained non-dental staff within a limited examination time. At the mid-term of the GNC baseline examination, a first quality evaluation was performed to check the plausibility of results and to propose measures to improve the data quality. MATERIALS AND METHODS: A dental interview, saliva sampling and oral diagnostics were conducted. As part of the level­1 examination, the number of teeth and prostheses were recorded. As part of the level­2 examination, detailed periodontal, cariological and functional aspects were examined. All examinations were conducted by trained non-dental personnel. Parameters were checked for plausibility and variable distributions were descriptively analysed. RESULTS: Analyses included data of 57,967 interview participants, 56,913 level­1 participants and 6295 level­2 participants. Percentages of missing values for individual clinical parameters assessed in level 1 and level 2 ranged between 0.02 and 3.9%. Results showed a plausible distribution of the data; rarely, implausible values were observed, e.g. for measurements of horizontal and vertical overbite (overjet and overbite). Intra-class correlation coefficients indicated differences in individual parameters between regional clusters, study centres and across different examiners. CONCLUSIONS: The results confirm the feasibility of the study protocol by non-dental personnel and its successful integration into the GNC's overall assessment program. However, rigorous dental support of the study centres is required for quality management.


Assuntos
Coleta de Dados/normas , Cárie Dentária , Doenças da Boca , Saúde Bucal , Estudos de Coortes , Cárie Dentária/epidemiologia , Alemanha , Humanos , Garantia da Qualidade dos Cuidados de Saúde , Controle de Qualidade
12.
Eur J Dent Educ ; 24(3): 499-506, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32222026

RESUMO

INTRODUCTION: The preparation for dentin posts is difficult and hard to learn. There are currently no reproducible simulation models to train this clinical procedure. The purpose of this study was the design, feasibility and evaluation of a three-dimensional (3D) printed tooth model for the pre-clinical teaching of students. MATERIALS AND METHODS: A printable tooth was designed and printed by a stereolithographic printer. A total of 48 fourth-year dental students in the first clinical course in prosthodontics were trained in a voluntary hands-on course on 4 similar printed teeth. The students used standard model teeth and real-teeth models during their education. They had experience in caries removement and root canal treatment on real patients. Root perforations were counted for every attempt. The different benefits of the 3D printed tooth were evaluated by a questionnaire using German school grades from 1 (best) to 6 (worst). RESULTS: The overall rating of the printed tooth was Ø1.9 ± 0.3. The item "suitable exercise option" was rated Ø2.0 ± 0.8, and the teeth were "easy to use" Ø1.9 ± 0.9. The item "realistic approach to dentin post preparation" was rated Ø2.1 ± 0.8, and the teeth showed the "shortcomings at a root perforation" Ø1.5 ± 0.6. The students reported to have much more motivation and enthusiasm to improve their skills with the printed teeth Ø2.1 ± 0.9. They had a strong desire to include these teeth in their pre-clinical education before the first patient treatment Ø1.6 ± 0.8. The success rate of the dentin post preparation was significantly better for the second 25% (P = .047) and fourth 48% (P = .04) attempt. CONCLUSIONS: The feasibility of this teaching concept was confirmed. The students had the possibility to learn a correct dentin post preparation on a printed tooth model. The learning effect with this tooth model was rated as good to very good by the questionnaire.


Assuntos
Educação em Odontologia , Impressão Tridimensional , Modelos Dentários , Dentina , Humanos , Prostodontia
13.
J Oral Rehabil ; 47(5): 651-658, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32080883

RESUMO

BACKGROUND: The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remain a major challenge for dental practitioners and affected patients. OBJECTIVES: To present the results of a literature-based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients. METHODS: In 2018, electronic literature searches were carried out in PubMed, Cochrane Library and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant papers. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus. RESULTS: Based on the contents of the 77 articles identified in the search, the current knowledge about clinical characteristics, epidemiology, aetiology, diagnostic process, differential diagnosis and management of OD is summarised. CONCLUSIONS: Occlusal dysesthesia exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counselling, defocusing, cognitive behavioural therapy, supportive drug therapy and certain non-specific measures. Irreversible, specifically an exclusively dental treatment approach must be avoided.


Assuntos
Má Oclusão , Parestesia , Oclusão Dentária , Odontólogos , Humanos , Papel Profissional
14.
J Clin Med ; 9(2)2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32102466

RESUMO

The aim of this study was to identify correlations between sleep bruxism (SB) and temporomandibular disorders (TMD) as diagnosed by means of the research diagnostic criteria for temporomandibular disorders (RDC/TMD). Sleep bruxism was diagnosed on the basis of I) validated questionnaires, II) clinical symptoms, and III) electromyographic/electrocardiographic data. A total of 110 subjects were included in the study. Fifty-eight patients were identified as bruxers and 52 as nonbruxers. A psychosocial assessment was also performed. An RDC/TMD group-I diagnosis (myofascial pain) was made for 10 out of 58 bruxers, whereas none of the nonbruxers received a diagnosis of this type. No significant differences were found between bruxers and nonbruxers with regard to RDC/TMD group-II (disc displacement) and group-III (arthralgia, arthritis, arthrosis) diagnoses. Somatization was significantly more common among bruxers than nonbruxers. Multivariate logistic regression analysis revealed that somatization was the only factor significantly correlated with the diagnosis of myofascial pain. The results of this study indicate a correlation between myofascial pain, as diagnosed using the RDC/TMD, and somatization. It seems that somatization is a stronger predictor of an RDC/TMD diagnosis of myofascial pain than sleep bruxism is.

15.
Dent Mater ; 36(5): e143-e148, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32014338

RESUMO

OBJECTIVE: The production of similar specimens for material testing is very difficult and crucial. This has much influence on the results of an experiment. With CAD design and new printing technologies it is possible to create individual devices to produce specimens for different testing situations. In this study different devices were designed for the standardized production of tooth discs for testing with bonded materials. METHODS: The different devices were designed using optimized CAD for 3D printing. After the design, the different parts of the devices were printed using a desktop SLA 3D printer with high precision. Three different tools were needed for the generation of a standardized disc. After the production, the different devices were tested on natural teeth. RESULTS: It is possible to generate very precise tools for the creation of round tooth discs. 40 tooth discs divided into 4 groups with a thickness of 2.0 mm, 2.5 mm, 3.0 mm and 3.5 mm and a constant diameter of 5 mm were produced. For all groups the median of the diameter and thickness was under +/-0.05 mm and the lower and the upper quartile were all under +/-0.06 mm. SIGNIFICANCE: With this new approach the creation of very precise and uniform tooth discs is possible. The whole process for the creation of the tooth discs was standardized.


Assuntos
Desenho Assistido por Computador , Esmalte Dentário , Dentina , Teste de Materiais , Impressão Tridimensional
16.
J Oral Rehabil ; 47(7): 783-795, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32077514

RESUMO

BACKGROUND AND OBJECTIVE: The aim of this single-centre, two-arm, parallel-group, double-blinded, randomised controlled trial was to investigate the disputed specific effectiveness of acupuncture by comparing acupuncture on specific and non-specific points among patients with non-chronic, painful TMDs. METHODS: Following predefined eligibility criteria, 49 consecutive patients of both sexes were recruited to the study. All subjects were diagnosed with a non-chronic (Graded Chronic Pain Scale grade <3) painful TMD, as assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Patients were randomly assigned to group A (acupuncture on specific points) or group B (acupuncture on non-specific points) after the initial examination (T0). Both acupuncture treatment sessions were conducted by a trained dentist once a week for four weeks. The examination was repeated five weeks (T5) after T0 by one calibrated examiner who was unaware of the study groups. Characteristic pain intensity (CPI) was evaluated as the main outcome criterion and compared between times and treatment groups by means of non-parametric tests (significance level set at P = .05). Secondary outcomes comprised the maximum corrected active mouth-opening without pain (MAO); patients' expectations regarding acupuncture treatment and pain development; depressivity; and oral health-related quality of life (OHRQoL). RESULTS: A total of 41 patients (38 female) successfully completed the study (mean age: 40.17 ± 16.61). The two groups did not differ significantly at any time in terms of age and CPI. However, CPI was significantly (P < .05) lower at T5 than at T0 for both groups (29.66 and 30.35% lower in group A and group B, respectively). An increase in MAO was observed at T5 for both groups but was significant for group B only (P = .016). All patients had positive expectations of acupuncture therapy, and the two groups did not differ significantly at T5 with regard to the extent to which their expectations had been fulfilled by the treatment (P = .717). Comparison of T0 and T5 showed a statistically significant reduction of depressivity for group A (P = .0205), but no significant change for group B (P = .329). At T5, OHRQoL had improved significantly for both groups (group A, P = .018; group B, P < .001) compared with at T0. CONCLUSIONS: Acupuncture on both specific and non-specific points reduces the non-dysfunctional pain of TMD patients. The effect of acupuncture on painful TMD cannot be attributed to the specific point selection.


Assuntos
Terapia por Acupuntura , Dor Crônica , Transtornos da Articulação Temporomandibular , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Qualidade de Vida , Resultado do Tratamento , Adulto Jovem
17.
J Mater Sci Mater Med ; 31(1): 9, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31872290

RESUMO

OBJECTIVES: The purpose of this study was to investigate the fracture resistance, flexural strength and Weibull modulus of an innovative CAD/CAM polymer and to compare its fracture resistance with that of glass ceramics. MATERIALS AND METHODS: A total of 32 (n = 16 IPS e.max CAD (LIDI); n = 16 LuxaCam Composite (LUXA)) first mandibular molar crowns were fabricated and cemented onto metal dies by use of luting composite. Half of the specimens were loaded until fracture without prior artificial ageing. The other half were subjected to thermal (5°/55 °C) and mechanical (1,200,000 cycles, 80 N) cycling before fracture loading. Scanning electron microscopy was used to analyse fracture behaviour. A three-point bending test of the flexural strength of LUXA was performed according to ISO 6872:2008. Data were analysed by means of the Kolmogorov-Smirnov test, Mann-Whitney U-test (p < 0.05) and Weibull statistical analysis. RESULTS: Initial fracture resistance of LIDI was significantly higher than that of LUXA. However, the initial fracture resistance of LIDI decreased significantly after artificial ageing. After ageing, fracture resistance was 1050.29 ± 325.08 N for LUXA and 1250.09 ± 32.53 N for LIDI. Three-point bending test yielded a mean flexural strength value for LUXA of 145.28 ± 18.21 MPa and a Weibull modulus of m = 9.51. CONCLUSIONS: Polymer-based material tested in this study had a lower fracture resistance than that of the glass-ceramic material. Fracture resistance and flexural strength of LuxaCam Composite are sufficient for use in the first molar region. CLINICAL RELEVANCE: The mechanical properties of this innovative polymer-based material indicate it can be used in the first molar region as a suitable alternative to glass ceramics. Further clinical studies are required to confirm this. The study presents an innovative material as an alternative to glassceramic for the clinical use in dentistry. The materials investigated were differently affected by artificial aging. Clinical use for patients with bruxism may be considered.


Assuntos
Materiais Biocompatíveis , Cerâmica , Desenho Assistido por Computador , Coroas , Polímeros , Coroas/normas , Materiais Dentários , Humanos , Teste de Materiais , Fatores de Tempo
18.
Artigo em Inglês | MEDLINE | ID: mdl-31434329

RESUMO

A cross-sectional study was performed with 251 individuals, consisting of 127 Germans, 68 migrants from Turkey, and 56 resettlers (migrants from the former Soviet Union with German ancestors) to compare periodontal health status, with a special focus on associations with lifestyle and anthropometric factors, and use of dental health services. Maximal pocket depth was used as a clinical surrogate marker for periodontitis. Other variables were obtained by questionnaires administered by a Turkish or Russian interpreter. The age- and sex-adjusted prevalence of periodontitis was significantly higher in Turks (odds ratio (OR) 2.84, 95% CI = 1.53-5.26) and slightly higher in resettlers (OR = 1.33, 95% CI = 0.71-2.49). These differences are partly explained by a differential distribution of known risk factors for periodontitis. A full model showed a higher prevalence of maximal pocket depth above 5 mm in Turks (OR = 1.97, 95% CI = 0.99-3.92). Use of oral health services was significantly lower in the two migrant groups. Individuals who reported regular visits to a dentist had significantly less periodontitis, independent of migrant status. A reasonable conclusion is that, since oral health causes major chronic diseases and has a major effect on total health system expenditures, public health efforts both generally and specifically focused on migrant groups are warranted.


Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Saúde Bucal , Periodontite/diagnóstico , Migrantes , Adulto , Estudos Transversais , Feminino , Alemanha , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Federação Russa , Inquéritos e Questionários , Turquia
19.
J Dent Educ ; 83(12): 1457-1463, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31451556

RESUMO

Commonly used model teeth are so far uniform in color and hardness. There is no discrimination between enamel and dentin part of a tooth. This condition makes it difficult to train a preparation technique, which is adapted to real tooth substance. The aim of this study was to design and establish a 3D printed tooth with different layers for enamel and dentin for education in crown preparation. A printable tooth with different layers for enamel and dentin was designed, and all 38 fourth-year dental students in the first clinical course in prosthodontics and 30 experienced dentists were trained during a voluntary hands-on course in 2019. Prior to the study, the students had used standard model teeth and real-teeth models in their preclinical education. They had experience in caries removal and preparation on real patients. The perceived benefits of the 3D printed tooth were evaluated by a questionnaire. All individuals in both groups completed the questionnaire, for a 100% response rate. The results showed that the printed tooth was given an overall mean grade of 2.3 (students) and 2.0 (experts) on a scale from 1=excellent to 5=poor. The difference in hardness between the dentin and enamel layer was given a mean of 2.4 (students and experts) and the difference in color a 1.7 (students) and 1.8 (experts). The tooth model with the prepared tooth illustrating an ideal preparation was graded 1.6 (students and experts). In this study, the students had the opportunity to learn a correct crown preparation on a printed tooth with different material properties for enamel and dentin. The learning effect with this tooth model was rated as good on the questionnaire by both students and expert dentists.


Assuntos
Esmalte Dentário , Estudantes de Odontologia , Coroas , Dentina , Humanos , Impressão Tridimensional
20.
J Dent Educ ; 83(9): 1100-1106, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31133619

RESUMO

A need for more realistic tooth models for education has often been expressed by dental students. The aim of this study was to design and create 3D printed teeth with anatomical details for use in preclinical dental education. A tooth with realistic carious lesions and pulp cavity was designed, and this tooth was used in 2018 with 47 dental students for preclinical education in caries excavation, direct capping of the pulp, core build-up, and crown preparation. The students had the ability to identify the carious lesions by a simulated radiograph and by tactile sense of the consistency. The benefits of the 3D printed tooth were evaluated by a questionnaire. The printed tooth was evaluated by grades (1=excellent, 2=good, 3=satisfactory, 4=adequate, 5=poor). The students gave the tooth an overall mean grade of 1.9, with a grade of 2.0 for the haptic impression, 1.5 for the exercise, 1.9 for the examination, and 1.5 for high practical relevance in contrast to a standard model tooth. The new features of the printed tooth were given a mean grade of 2.0 for the radiograph, 2.3 for consistency of the caries, 2.0 for the tooth filling, and 1.7 for the pulp capping as realistic. The students had the possibility to generate a complete concept for prosthodontic tooth treatment on an artificial 3D printed tooth.


Assuntos
Modelos Dentários , Educação em Odontologia , Impressão Tridimensional , Estudantes de Odontologia/psicologia , Simulação por Computador , Desenho Assistido por Computador , Coroas , Cárie Dentária , Planejamento de Prótese Dentária , Cavidade Pulpar , Humanos , Prostodontia/educação , Tratamento do Canal Radicular , Inquéritos e Questionários , Dente/anatomia & histologia , Preparo Prostodôntico do Dente/métodos
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