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Purpose To assess if Dutch children with Autism Spectrum Disorder (ASD) regularly visit a dentist and to evaluate parent’s satisfaction on the care provided. Methods Parents of ASD children (2–18 years) were invited to fill out a survey. The survey consisted of questions regarding ASD severity, frequency of dental visits, history of dental pain, type of dental practice and parents’ satisfaction. Results were analysed using Chi square and Mann–Whitney U tests (α = 5%). Results Of the 246 returned questionnaires, 19 were excluded (incomplete or unconfirmed ASD diagnosis). All children visited a dentist at least once and 5% of them had their last visit more than 12 months ago. According to parents, 15% of the children did not receive the needed care when they had toothache and 21% of the parents were unsatisfied with the current dental care provided. No difference was found between satisfied and unsatisfied parents in type of dental practice visited (p > 0.05). The children of unsatisfied parents reported more often pain during the last year (p = 0.013) and had a more severe type of ASD (p = 0.016). Conclusions The majority of Dutch ASD children investigated regularly visit a dentist and 21% of the parents is unsatisfied with the dental care provided.

BACKGROUND: To review the literature on the effect of dental implant surface roughness in patients with a history of periodontal disease. The present review addresses the following focus question: Is there a difference for implant survival, mean marginal bone loss, and the incidence of bleeding on probing in periodontally compromised patients receiving a machined dental implant or rough surface dental implant?METHODS: Electronic and manual literature searches were conducted on PubMed/MEDLINE and the Cochrane Library on studies published until May 2018 to collect information about the effect of machined, moderately rough, and rough dental implant surfaces in patients with a history of periodontal disease. The outcome variables implant survival, mean marginal bone level, and the incidence of peri-implantitis and bleeding on probing were evaluated. Meta-analysis was performed to obtain an accurate estimation of the overall, cumulative results.RESULTS: Out of 2411 articles, six studies were included in this systematic review. The meta-analysis of the implant survival and implant mean marginal bone loss revealed a risk ratio of 2.92 (CI 95% 0.45, 18.86) for implant failure and a total mean difference of - 0.09 (CI 95% - 0.31, 0.14) for implant mean marginal bone loss measured in a total group of 215 implants, both not statistically significant.CONCLUSIONS: Due to lack of long-term data (> 5 years), the heterogeneity and variability in study designs and lack of reporting on confounding factors, definitive conclusions on differences in implant survival, and mean marginal bone loss between machined and moderate rough implants in periodontally compromised patients cannot be drawn. Future well-designed long-term randomized controlled trials are necessary to reveal that machined surfaces are superior to moderately rough and rough surfaces in patients with a history of periodontal disease.

Objective: To examine the intra- and interexaminer reliability of assessing rotation of teeth on photographed study casts. In addition, the reliability parameters of two examiners scoring in mutual consultation were compared with the reliability parameters by one observer.Materials and Methods: Standardized photographs of sets of maxillary and mandibular plaster casts of 10 patients before treatment (T1), after treatment (T2), and a long time after retention (T3) were digitized. Tooth rotation was assessed relative to a correct position in the ideal dental arch form. A computer analysis program was used to process the measurements. Two examiners assessed each study cast twice with a washout period of 3 weeks. A third examiner assessed each cast, together with one of the other examiners. The intra- and interexaminer agreements were calculated using intraclass correlation coefficients (ICCs). Wilcoxon signed-rank tests were used to determine significant differences between the intra- and interexaminer reliability coefficients of the three examiners.Results: The ICCs ranged from 0.430 to 0.991. Incisors showed the highest ICCs and molars showed the lowest ICCs. Intraexaminer ICCs of the experienced examiners were significantly higher than those of the examiner with less experience. No significant differences in the reliability between a single examiner and the combination of two examiners were found.Conclusion: The method of assessing tooth rotation in the present study has proved to be reproducible, except for the molars. This method can be helpful for clinicians assessing tooth rotation from photographed study casts.

Berggren's (1984) model of dental fear and anxiety predicts that dentally anxious individuals postpone treatment, leading to a deteriorating dental state and subsequently to fear of negative evaluations in relation to their oral condition. The present study aimed to test one of the core assumptions of this model, namely that deterioration of dental health status would mediate the effects of avoidance of dental care on self-reported fear of negative evaluation. Participants were 73 patients (mean age 38.5 yr) meeting the diagnostic and statistical manual of mental disorders - 4th edn - Text Revision (DSM-IV-TR) criteria of dental phobia. Variables in the theoretical model were operationalized with multiple measures. A series of Sobel tests indicated that mediation was present for the relationship between years of avoidance and fear of negative self-evaluation when dental health status was based on the assessment of dentists or patients' opinion of their own dental state, but not when dental health status was operationalized as decayed, missing or filled surfaces (DMFS). Although the findings are supportive of Berggren's model, other causal pathways that contribute to the perpetuation of anxiety and fear still need to be tested. The results suggest that individuals with high levels of dental anxiety would particularly benefit from interventions specifically designed to break their avoidance pattern.

The presence of dental anomalies has been rated radiographically in a number of studies. However, since the reliability of the assessment of these anomalies has rarely been investigated, the aim of this study was to examine inter- and intraexaminer agreement in identifying morphological dental anomalies, such as tooth agenesis, dilacerated, pipette-shaped, blunt, pointed, and short roots. Pre-treatment panoramic radiographs of 40 patients (13 males and 27 females; mean age 27.7 ± 10.8 years) treated between 1983 and 2008 were selected. Four examiners independently assessed the radiographs twice. For a dilacerated root and agenesis, a definition was given. For pipette-shaped, blunt, or pointed roots, a drawing was shown, and for a short root, a ratio was used to identify the anomaly. Intraexaminer agreement of the assessments of the dental anomalies was presented by Cohen’s Kappa and varied between −0.01 for short roots and 1.00 for agenesis. With respect to short roots, three of the examiners did not rate them to be present on at least one measurement occasion. This implies that intraexaminer agreement could not be calculated for these three examiners. Interexaminer agreement for dilacerated roots varied between 0.14 and 0.50, for pipette-shaped roots between −0.01 and 0.33, for blunt roots between 0.05 and 0.32, and for pointed roots between 0.17 and 0.37. All values for agenesis were 1.00. It can be concluded that assessing agenesis on panoramic radiographs is reliable. Rating the presence of dilacerated, pipette-shaped, blunt, pointed, and short roots on panoramic radiographs, however, does not result in a reliable assessment.

General dental practitioners (GDPs) act as gatekeepers for specialist dental care since they generally decide whether, when, and where to refer patients. It is important for orthodontists to understand the factors influencing the referral decision in order to be able to satisfy both the referring dentists and the patients. A specifically designed questionnaire was sent to a random sample of 634 GDPs in The Netherlands. In part A, general characteristics of the GDPs such as gender, years in practice, number of patients in the practice, possibilities to refer to an orthodontist, and number of patients referred to the orthodontist per year were collected. Part B assessed the importance of 20 various factors related to the GDPs’ usual referral decision. Intraclass correlation coefficients (ICC) were calculated to assess the relationship in rank scores of the items of the various groups.The response rate was 60 per cent. Most GDPs (38 per cent) had the possibility to refer to three to four orthodontists, 22 per cent could choose between five and six, and 21 per cent could refer to one or two. Most GDPs (55 per cent) actually referred to one to two orthodontic specialists, while 34 per cent choose between three and four orthodontists. The rank order of the items for male and female dentists was nearly equal (ICC = 0.99, P < 0.001). The most important factors governing the choice of an orthodontic treatment provider by GDPs were patient satisfaction, favourable experience in the past, and oral hygiene monitoring by the orthodontist.

Objectives: To determine appearance concerns of patients presenting for cosmetic treatment.Methods: This cross-sectional comparative study included consecutive patients of six different cosmetic clinics (n = 170), and a sample of the general population (n = 878). A study-specific self-report questionnaire was administered to document demographic and appearance concerns. Presence of body dysmorphic disorder (BDD) was assessed based on DSM-IV criteria.Results: Cosmetic dental patients did not differ from the reference sample with regard to happiness and satisfaction as regards their appearance. However, differences were found with regard to frequency of previous general cosmetic (16.5% versus 5.9%) and cosmetic dental (47.9% versus 24.8%) procedures. Furthermore, a significantly higher proportion of the cosmetic dental patients sufficed for the two key screening criteria of BDD (9.5% versus 5.5%), and for the full diagnostic screening of BDD (4.2% versus 1.5%) compared with the respondents of the reference group.Conclusions: The results suggest that symptoms of BDD are relatively common among patients attending cosmetic clinics. It is important to assess the long-term effects of comprehensive cosmetic procedures, particularly in patients with disproportionate appearance concerns.

To understand the development of dental anxiety better and to identify those at increased risk of developing dental anxiety, the Level of Exposure-Dental Experiences Questionnaire (LOE-DEQ) was developed. The aim of the current study was to determine the psychometric properties (i.e. factor structure, reliability, and validity) of the LOE-DEQ and to determine its suitability as an additional screening instrument for dentally anxious patients. Five different samples were used: (i) highly dentally anxious patients (n = 119); (ii) general dental patients (n = 480); (iii) students (n = 186); (iv) psychiatric outpatients (n = 17); and (v) oral surgery patients (n = 34). Results of the factor analysis revealed a four-factor solution. The LOE-DEQ has sufficient internal consistency (Cronbach's alpha values ranging from 0.69 to 0.85) and satisfactory test-retest reliability (intraclass correlation coefficient = 0.78). The results further suggest that this instrument has adequate discriminant, concurrent, and predictive validity. It is concluded that the LOE-DEQ is a useful tool for assessing patients' background in terms of previous exposure to distressing dental events, which is considered a vulnerability factor in the development of dental anxiety.

The aim of this study was to evaluate the survival of single- and two-surface atraumatic restorative treatment (ART) restorations in the primary and permanent dentitions of children from a high-caries population, in a field setting. The study was conducted in the rainforest of Suriname, South America. ART restorations, made by four Dutch dentists, were evaluated after 6 months, 1, 2, and 3 years. Four hundred seventy-five ART restorations were placed in the primary dentition and 54 in first permanent molars of 194 children (mean age 6.09 +/- 0.48 years). Three-year cumulative survivals of single- and two-surface ART restorations in the primary dentition were 43.4 and 12.2%, respectively. Main failure characteristics were gross marginal defects and total or partial losses. Three-year cumulative survival for single-surface ART restorations in the permanent dentition was 29.6%. Main failure characteristics were secondary caries and gross marginal defects. An operator effect was found only for two-surface restorations. The results show extremely low survival rates for single- and two-surface ART restorations in the primary and permanent dentitions. The variable success for ART may initiate further discussion about alternative treatment strategies, especially in those situations where choices have to be made with respect to a well-balanced, cost-effective package of basic oral health care.

SUMMARY Dental age was studied in a sample of 451 Dutch children (226 boys and 225 girls) according to the method of Demirjian. They were born between 1972 and 1993 and were between 3 and 17 years of age at the time a dental pantomogram (DPT) was obtained. All children were placed in the age group closest to their chronological age. All 451 DPTs were scored by one examiner. A subset of 52 DPTs was scored by a second examiner and the intra-class correlation coeffi cient (ICC) and Cohen’s kappa were calculated. The ICC was 0.99 and Cohen’s kappa 0.68. Boys and girls were analysed separately. A signifi cant difference was found between chronological age and dental age. On average, the Dutch boys were 0.4 years and the girls 0.6 years ahead of the French–Canadian children analysed by Demirjian. Therefore, the French–Canadian standards were not considered suitable for Dutch children. New graphs for the Dutch population were constructed using a logistic curve with the equation Y = 100*{1/(1 + e–α(x – x0))} as a basis. The 90 per cent confi dence interval was calculated. To determine whether the logistic curve was correct, a residual analysis was carried out and scatter plots of the differences were made. The explained variance was 93.9 per cent for the boys and 94.8 per cent for the girls. Both the residual analysis and the scatter plots indicated that the logistic curve was appropriate for use with Dutch children. In addition to the graphs, tables were produced which transfer the maturity scores calculated by the method of Demirjian into Dutch dental age.

Objectives:This study aimed to evaluate the association between the extracranial and intracranial calcification depiction of the internal carotid artery (ICA), incidentally found in CBCT examinations in adults, and to discuss the conspicuous clinical implications.Methods:Out of a series of 1085 CBCT examinations, 705 CBCT scans were selected according to pre-defined criteria. The extra- and intracranial calcifications depicted along the course of the ICA were documented according to a comprehensive set of descriptive criteria.Results:In total, 799 findings were detected, 60.1% (n = 480) were intracranially and 39.9% (n = 319) were extracranially allocated. The χ2 test showed associations between all variables (p Conclusions:We found that a significant correlation exists between extra- and intracranial calcifications of the ICA. It is clear that in cases of the presence of a calcification in the ICA extracranially, the artery's intracranial portion has an increased risk of showing the same findings. CBCT imaging is widely used as a diagnostic tool, thus, our results contribute to the identification of a subgroup of patients who should undergo further medical evaluation of the atherosclerosis of the ICAs.

ObjectivesOral leukoplakia is a potentially malignant disorder of the oral mucosa. The aim of this retrospective study was to identify the factors that possibly predict malignant transformation in a well-defined cohort of patients with a long-term follow-up. All leukoplakias were staged according to a clinicopathological classification and staging system. Furthermore, a certainty factor has been used with which the diagnosis has been established.Material and methodsThe group consisted of 144 patients. The size, presence and degree of epithelial dysplasia were incorporated into a clinicopathological classification and staging system. Initial management consisted of surgical excision, CO2 laser vaporisation or observation only. The mean follow-up period was 51.2 months (s.d. = 39.33, range 12-179 months).ResultsIn 16 of 144 patients (11%), malignant transformation occurred between 20 and 94 months (mean 57.0 months) after the first visit, the annual malignant transformation rate being approximately 2.6%. A large size of the lesion (≥ 4 cm) showed to be the only statistically significant predictor of malignant transformation (P = 0.034).ConclusionA size of ≥ 4 cm showed to be the only significant predicting factor of malignant transformation in oral leukoplakia. No other epidemiological, aetiological, clinical or histopathological parameters were of statistical significance.

The objective of this study was to investigate the effect of different cone beam CT scan parameters on trabecular bone microstructure measurements. A human mandibular cadaver was scanned using a cone beam CT (3D Accuitomo 170; J.Morita, Kyota, Japan). 20 cone beam CT images were obtained using 5 different fields of view (4X4 cm, 6x6 cm, 8X8 cm, 10x10 cm and 10X5 cm), 2 types of rotation steps (180 degrees and 360 degrees) and 2 scanning resolutions (standard and high). Image analysis software was used to assess the trabecular bone microstructural parameters (number, thickness and spacing). All parameters were measured twice by one trained observer. Intraclass correlation coefficients showed high intraobserver repeatability (intraclass correlation coefficient, 0.95-0.97) in all parameters across all tested scan parameters. Trabecular bone microstructural measurements varied significantly, especially in smaller fields of view (p = 0.001). There was no significant difference in the trabecular parameters when using different resolutions (number, p = 0.988; thickness, p = 0.960; spacing, p = 0.831) and rotation steps (number, p = 1.000; thickness, p = 0.954; spacing, p = 0.759). The scan field of view significantly influences the trabecular bone microstructure measurements. Rotation steps (180 degrees or 360 degrees) and resolution (standard or high) selections are not relevant.

SummaryThe estimated prevalence of oral leukoplakia is worldwide approximately 2%, with an annual malignant transformation rate of approximately 1%. The aim of the present study was to evaluate the possible contribution of ploidy measurement to the prediction of the clinical course, in a well defined cohort of patients with oral leukoplakia. Ploidy was measured by both flow cytometry (FCM-DNA) and image cytometry (ICM-DNA) and we focussed on the comparison of the two different techniques to determine ploidy. A total of 41 patients have been included, with a mean age of 59years (range 36–78years). With FCM-DNA, three lesions were aneuploid, with ICM-DNA, 19 lesions were aneuploid. DNA ploidy was compared with clinicopathological and patients parameters. There were no statistically significant differences between DNA ploidy and any patient factor with both FCM-DNA and ICM-DNA. Using FCM-DNA, DNA aneuploid lesions showed statistically significant more dysplasia (p=0.04) than diploid lesions. Furthermore, DNA aneuploid lesions were more frequently encountered at high-risk locations (p=0.03) as being determined with FCM-DNA. These relations were not found when DNA ploidy was determined with ICM-DNA.

The aim of the present study is to examine all cases of intraosseous benign ameloblastomas treated between 1970 and 2010 in a single institution and to look for a possible correlation between the histopathological aspects and the demographical and clinical parameters, as well as the treatment outcome. The data of a total number of 44 patients were retrieved from the records. Nine patients were excluded because of doubt about the correct diagnosis (8 patients) or because of an extra-osseous presentation (1 patient). No statistically significant differences were found between the histopathological (sub)types of ameloblastomas and the demographical and clinical parameters, nor between the histopathological (sub)types and treatment outcome. Of the 28 patients treated by enucleation, in 17 patients one or more recurrences occurred, with no significant predilection for any histopathological (sub)type, including the unicystic type. There were no significant differences in the recurrence rate after enucleation in patients below and above the age of 20 years either. In six out of 17 patients with a recurrence, the recurrent lesion showed a different histopathological subtype than was encountered in the primary. In two cases a change from solid/multicystic to desmoplastic ameloblastomas was noticed. In conclusion, the current histopathological classification of benign intraosseous ameloblastoma does not seem to have clinical relevance with the possible exception of the luminal unicystic ameloblastoma that has been removed in toto, unfragmented. Since no primary desmoplastic ameloblastomas were encountered in the present study no further comments can be made on this apparently rare entity. Key words: Odontogenic tumours, ameloblastoma, histopathology.

Previous studies showed discrepant findings regarding the factor structure of common fears. The purpose of the present study was to expand on these findings and contribute to the development of a descriptive framework for a fear classification. Using data from the Dutch general population (n = 961; 50.9% women), an exploratory factor analysis was performed to delineate the multidimensional structure of 11 common fears previously used in a factor analytic study by Fredrikson, Annas, Fischer, and Wik (1996). An independent sample (n = 998; 48.3% women) was used to confirm the newly derived model by means of confirmatory factor analysis. In addition, the model was tested against the DSM-IV-TR model and a model found earlier by Fredrikson et al. (1996). Although support was found for a 3-factor solution consisting of a blood-injection-injury factor, a situational-animal factor, and a height-related factor, confirmatory factor analysis showed that this 3-factor model and the DSM-IV-TR 4-factor model fitted the data equally well. The findings suggest that the structure of subclinical fears can be inferred from the DSM classification of phobia subtypes and that fears and phobias are two observable manifestations of a fear response along a continuum.

The aim of this study was to examine the potential relationship between the occurrence of orthodontic root resorption and presence of dental anomalies such as tooth agenesis and pipette-shaped roots. Dental anomalies and root resorption were assessed on dental panoramic tomographs (DPT) of 88 subjects, 27 males and 61 females, mean age 28.4 (SD = 11.3 years), selected from orthodontic patients on the basis of the following exclusion criteria: previous fixed appliance treatment, bad quality of the DPTs and no visibility of the periodontal ligament of every tooth, and younger than 15 years of age at the onset of treatment with fixed edgewise appliance lasting at least 18 months. A pipette-shaped root was identified as defined by a drawing. Tooth agenesis was assessed on DPTs and from subjects' dental history. Root resorption was calculated as the difference between the root length before and after treatment, with and without a correction factor (crown length post-treatment/crown length pre-treatment). If one of the four upper incisors showed root resorption of ≥2.3 mm with both formulas, the patient was scored as having root resorption. Chi-square tests indicated that there was no relationship between orthodontic root resorption and agenesis (P = 0.885) nor between orthodontic root resorption and pipette-shaped roots (P = 0.800). There was no relationship between having one of the anomalies and root resorption either (P = 0.750). In the present study, it was not possible to confirm on DPTs a relationship between orthodontic root resorption and dental anomalies, such as agenesis and pipette-shaped roots.

To examine temporomandibular disorder (TMD) patients' illness beliefs and self-efficacy in relation to bruxism, and to examine whether these beliefs are related to the severity of patients' self-perceived bruxing behavior.A total of 504 TMD patients (75% women; mean age ± SD: 40.7 ± 14.6 years), referred to the TMD Clinic of the Academic Centre for Dentistry Amsterdam, completed a battery of questionnaires, of which one inquired about the frequency of oral parafunctional behaviors, including bruxism (clenching and grinding). Patients' illness beliefs were assessed with a question about the perceived causal relationship between bruxism and TMD pain; patients' self-efficacy was assessed with questions about the general possibility of reducing oral parafunctional behaviors and patients' own appraisal of their capability to accomplish this.Sleep bruxism or awake bruxism was attributed by 66.7% and 53.8% of the patients, respectively, as a cause of TMD pain; 89.9% believed that oral parafunctions could be reduced, and 92.5% believed themselves capable of doing so. The higher a patient's bruxism frequency, the more bruxism was believed to be the cause of TMD pain (Spearman's rho 0.77 and 0.71, P.001) and the more pessimistic the self-efficacy beliefs were about the reducibility of oral parafunctions (Kruskal-Wallis ?2 = 19.91, df = 2, P.001; and Kruskal-Wallis ?2 = 7.15, df = 2, P = .028).Most TMD patients believe in the harmfulness of bruxism and the possibility of reducing this behavior. Bruxism frequency is associated with illness beliefs and self-efficacy.

OBJECTIVES:In this study we evaluated the possible epidemiologic changes of oral cancer patients in the Netherlands between the years 1980-1984 and 2000-2004. We specifically studied the differences in male-female ratio, age, TNM-stage, site distribution, and alcohol and tobacco use.MATERIALS AND METHODS:Patients from the VU University Medical Center with an oral squamous cell carcinoma of the oral cavity registered in 1980-1984 (n=200), group 1, were compared to patients registered in 2000-2004 (n=184), group 2. Trends in prevalence, site distribution, TNM-stage, alcohol and tobacco use, age and gender were studied.RESULTS:The male-female ratio has decreased from 1.8 to 1.2. There were no differences in age between the two groups of patients. The site distribution was similar in both groups. The most commonly involved sites were the tongue and the floor of mouth. In group 2 more patients were diagnosed with a T1 tumour. There were no differences in tobacco use between the two different groups. There were much more light drinkers (0-2 drinks per day) in group 2 than in group 1, whereas there were more heavy drinkers (>4 per day) in group 1 than in group 2 (pCONCLUSION:In our study there were no significant differences between the patients registered in the years 1980-1984 and 2000-2004 regarding the mean age of the patients, site distribution and smoking habits. The male-female ratio has decreased. In the recent group more patients were staged T1N0 and there was a strong decrease of the patients who were heavy drinkers.

To examine the associations between the ethnic backgrounds of temporomandibular disorder (TMD) patients in the Netherlands and the level of TMD pain complaints and psychological/behavioral factors and whether these associations are influenced by socioeconomic factors.A sample of 504 consecutive patients from a TMD clinic completed the Research Diagnostic Criteria for TMD (RDC/TMD) Axis II questionnaire (pain intensity, pain-related disability, somatization, depression, ethnic background, and socioeconomic status), an oral parafunctions questionnaire, and questions related to stress. Ethnic background was classified, following the method of Statistics Netherlands (CBS), using the country of birth from subject and both parents. This resulted in a classification into three subgroups: Native Dutch (ND; 69.6%), Non-Native Western (NNW; 14.8%), and Non-Native Non-Western (NNNW; 15.6%). Statistics used were chi-square, one- and two-way ANOVA, and Kruskall-Wallis tests; for post-hoc interpretation, standardized residual values, Bonferroni, and Mann-Whitney U tests were used.No differences in age or gender were found between the three ethnic groups, nor were there any differences in characteristic pain intensity or oral parafunctions. However, TMD patients from the NNNW subgroup had significantly higher scores on psychological factors, namely pain-related disability, disability days, somatization, depression, and stress. These patients had a lower incidence of employment, a lower level of education, and a lower income level than patients from the ND and NNW ethnic backgrounds. Analysis of variance showed no interaction effects between ethnic background and socioeconomic factors in relation to the psychological variables mentioned.Ethnic background of TMD patients in the Netherlands is associated with psychological factors, regardless of socioeconomic status, but not with TMD pain complaints or oral parafunctions.

Background It has been estimated that among patients presenting for cosmetic treatments up to 15% suffer from Body Dysmorphic Disorder (BDD), a psychiatric condition characterised by a preoccupation with an imagined defect in appearance. Objectives The main purpose of the current study was to establish the relationship between presence of BDD characteristics and interest in aesthetically motivated dental treatments. Methods Data were obtained by means of a survey within a sample of 879 Dutch citizens of 16 years and older. Characteristics of BDD were assessed based on DSM-IV criteria. Results Only one of the BDD features (ie a preoccupation with a defect of appearance) emerged as a significant predictor of undergoing cosmetic dental treatments. Patients with such preoccupation were nine times more likely to consider tooth whitening, and six times more likely to consider orthodontic treatment. They were also five times more likely to be dissatisfied about their most recent treatment. Conclusions The results suggest that preoccupation with one's physical appearance is a motivating factor for undergoing certain types of cosmetic dental procedures.

To examine the relationship between different types of self-reported oral parafunctions and pain intensity in patients with temporomandibular disorders (TMD).Two cohorts of TMD pain patients, 1 comprising 303 patients and the other comprising 226 patients, completed a 12-item oral parafunctions questionnaire as well as the Research Diagnostic Criteria Axis II questionnaire, which includes a characteristic pain intensity score (CPI). Relationships between oral parafunctions and CPI were examined; age and gender were controlled for. The effects of phrasing of the oral parafunction questions were also examined. For 1 cohort, the questions were directed at the mere occurrence of the parafunctions; in the other, the questions addressed the perceived stressfulness of parafunctional behavior to the jaw.A principal component analysis of the responses to the questionnaires led to 3 factors (scales) in both cohorts: (1) a BRUX scale for bruxism activities; (2) a BITE scale for biting activities (eg, chewing gum, nails); and (3) a SOFT scale for soft tissue activities (eg, tongue, lips). Statistical significance was reached for 2 of the 6 relationships studied (P.05), but with a very low explained variance (approximately 3.5%).No clinically relevant relationships were found between different types of self-reported oral parafunctions and TMD pain complaints.

Aim: To determine, for different age groups, the approximal caries increment in a three-year longitudinal retrospective study and to investigate the relationship between the caries increment and self-reported measures for oral health behaviour, dental knowledge and attitude (cynicism, health concern and motivation). Subjects: 14, 17, 20 and 23-year-olds, who participated in a clinical epidemiological survey. Bitewings were taken of approximately 52% of the participants. Longitudinally, three cohorts were followed radiographically for three years. The self-reported measures were derived from questionnaires with sufficient reliability. Results: For all participants, on average, 3.7 enamel lesions and 1.2 dentine lesions were found. The number of sound surfaces, adequate restorations and the D1FS score showed significant differences over a three-year period, for all age groups. Stepwise regression analysis showed that for the explanation of the change in number of sound surfaces, number of enamel lesions and D1S between the age of 17 and 20, the variable ‘health concern’ contributed significantly to the regression. The change in D3FS score was explained by the variable ‘behaviour’, while the change in D1Fs score was explained by both ‘behaviour’ and ‘health concern’. Neither of the dental variables, ‘dental knowledge’ or ‘motivation’ contributed significantly. For the ages 14–17 and 20–23 no significant contributions were found. Conclusions: A considerable caries increment was found in this three-year retrospective radiographic study, which was not related to dental knowledge and motivation, and only for one age group (17–20) to oral health behaviour and health concern.

Aim The aim of this study was to assess the prevalence of approximal enamel lesions from radiographs in groups of 14, 17, 20 and 23 years old, and to determine the relation with dentine lesions and restorations present. Method Per age group, the bitewings of 120 persons were randomly selected and assessed for enamel lesions from the distal surface of the first premolar to the mesial surface of the second molar. A second examiner assessed 20% of the material for enamel lesions to determine the interexaminer agreement (Cohen's kappa = 0.63). Results An enamel lesion was found in 12-15% of the unfilled surfaces. The mean number of surfaces with enamel lesions was almost three per person. For all age groups it was found that about 20% of the persons had at least four enamel lesions and the number of enamel lesions was significantly correlated with the number of dentine lesions. Of all enamel lesions 20% were found in persons without any dentinal lesions or restorations. Conclusion The bitewing radiographs showed a considerable number of enamel lesions for these age groups. This seems to justify its use on a routine base as a diagnostic tool at the age of 14-16 years.

The aim of this study was to assess the influence of different object locations in different fields of view (FOVs) of two cone beam CT (CBCT) systems on trabecular bone microstructure measurements of a human mandible. A block of dry human mandible was scanned at five different locations (centre, left, right, anterior and posterior) using five different FOVs of two CBCT systems (NewTom™ 5G; QR Verona, Verona, Italy and Accuitomo 170; Morita, Kyoto, Japan). Image analysis software (CTAn software v. 1.1; SkyScan, Kontich, Belgium) was used to assess the trabecular bone microstructural parameters (thickness, Tb.Th; spacing, Tb.Sp; number, Tb.N; bone volume density, BV/TV). All measurements were taken twice by one trained observer. Tb.Th, Tb.Sp and Tb.N varied significantly across different FOVs in the NewTom 5G (p