Fear of pain in orofacial pain patients.

In the present study, we examined whether fear of pain, dental fear, general indices of psychological distress, and self-reported stress levels differed between 40 orofacial pain patients and 40 gender and age matched control general dental patients. We also explored how fear of pain, as measured by the Fear of Pain Questionnaire-III (J Behav Med 21 (1998) 389), relates to established measures of psychological problems in our sample of patients. Finally, we examined whether fear of pain uniquely and significantly predicts dental fear and psychological distress relative to other theoretically-relevant psychological factors. Our results indicate that fear of severe pain and anxiety-related distress, broadly defined, are particularly elevated in orofacial pain patients relative to matched controls. Additionally, fear of pain shares a significant relation with dental fear but not other general psychological symptomology, and uniquely and significantly predicts dental fear relative to other theoretically-relevant variables. Taken together, these data, in conjunction with other recent studies, suggest greater attention be placed on understanding the fear of pain in orofacial pain patients and its relation to dental fear and anxiety.

A new approach for accurate pre-planned occlusal adjustment.

Occlusal adjustment is important in prosthodontic pre-treatment procedures and in the management of some cases of craniomandibular disorders. This may involve tooth surface reduction and tooth surface addition with an appropriate restorative material. Occlusal adjustment must be distinguished from occlusal equilibration and selective grinding with clear indications and aims. A systematic pre-clinical and clinical protocol has clear advantages and the use of a thermoplastic vacuum-formed template greatly increases the clinical accuracy of a pre-planned adjustment.

Isokinetic exercise management of temporomandibular joint clicking in young adults.

Temporomandibular joint clicking is frequently a sign of craniomandibular disorders, and the etiologic predisposing, initiating, and perpetuating factors must be considered in its management. The present study assesses the usefulness of isokinetic exercises in the treatment of temporomandibular joint clicking. At the end of a 6-month test period, 18 of 22 subjects (approximately 82%) with clicks no longer had clicking, but four subjects (approximately 18%) with bilateral reciprocal clicking did not lose their clicks. A number of proposals have been suggested in the past as an explanation of the cause of temporomandibular joint clicking, but the present study has shown that clicking in young adults is predominantly neuromuscular in origin and may be a reversible condition that can be treated successfully with a conservative exercise regimen.

Investing procedures for immediate laboratory remounting of removable partial dentures.

Remounting removable partial dentures in the laboratory after deflasking and before clinical placement has several advantages. This modified investment procedure makes it easy to remount partial dentures after processing. Preliminary adjustments of laboratory errors and inaccuracies caused by dimensional changes in heart processing of acrylic resin may be made before the appointment with the patient.

Titanium for removable partial dentures (III): 2-year clinical follow-up in an undergraduate programme.

This study examined the success of titanium (Ti) removable partial dentures (RPDs) compared with that of cobalt-chromium (Co-Cr) RPDs using a randomized controlled clinical trial. Thirty-eight RPD patients were provided with either Co-Cr (20 patients) or Ti (18 patients) RPDs. The total numbers of dentures was 31 (13 maxillary, 18 mandibular) for Co-Cr and 23 (11 maxillary, 12 mandibular) for Ti. Patients were reviewed for 24 months following denture issue. After the initial 12 months, 20 clinical problems were recorded and became the criteria for subsequent assessment. Incidence of failure was analysed using both Fisher's exact test and the chi square test at a significance level of P<0.05. Fracture of retainers in both metals occurred only in the first 12 months. Some failure types presented at significantly higher levels in the first 12 months but there were no significant differences between the two in all the criteria examined between the 12- and the 24-month reviews. Although differences existed in failure types between Co-Cr and Ti RPDs during the early review stages, the overall success rate of Ti RPDs was comparable with that of Co-Cr RPDs after 24 months. The higher incidence of failures in Ti RPDs prior to the 12-month review suggests the importance of taking its lower rigidity into account when designing RPDs.