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Purpose: The aim of this study was to investigate the difference between retruded contact position (RCP) and centric occlusion (CO) at the level of mandibular condyles. Materials and methods: Study included 20 completely dentate participants (average 24.4 ± 1.2 years). All recordings of the condylar deviations were measured with the use of the ultrasound mandibular recording device with six degrees of freedom. CO was determined using active method of centric relation recording (participants were trained to stationary hinge and maintain the position of the lower jaw at the first tooth contact/contacts). RCP was determined with passive method of centric relation recording (chin point guidance). RCP and CO deviations to the reference position (habitual occlusion) were recorded with the use of the mandibular recording device at the level of x (anterior – posterior), y (vertical) and z (lateral) axes. Linear RCP and CO deviations (from the habitual occlusion) were measured. Descriptive statistics was measured, and the RCP and CO deviation values were compared using independent samples T test. Results: Average linear condylar deviation values for the CO were 1.30 ± 1.14 mm, and 2.13 ± 1.89 mm for the RCP. Independent samples T test showed statistically significant difference between RCP and CO linear deviation values (α=0.021). Conclusions: There is a difference in the positioning of the condyle within temporomandibular joint, with passive or active centric relation recording methods. CO and RCP can be identified as different occlusal positions.

Objectives of Investigation: The data about shear bond strength between digitally produced denture base materials and artificial teeth are scarce. Several studies investigated shear bond strength values between milled denture base material and different types of artificial teeth. The aim of the present study was to compare and evaluate the available evidence through a systematic review, and to enable the selection of optimal material for a given clinical situation. Methods Used: A bibliographic search was conducted in Pubmed, Scopus, and Web of Science to assess adequate studies published up to June 1st 2022. This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta- Analyses) guidelines. The studies that determined the shear bond strength values between milled denture base materials and artificial teeth were selected. The search identified 15 studies which were included in PRISMA 2020 flow diagram for new systematic reviews. Studies that scored between 0 and 3 were categorized as being at low risk of bias, studies with score between 4 and 7 as moderate risk, and scores between 8 and 10 as high risk. Results: Only 3 studies met inclusion criteria and according to PRISMA 2020 present moderate risk of bias (score 6). The risk of bias is as follows: single operator of the machine, depiction of the sample size calculation, and blinding of the testing machine operator. The scores for these parameters were basically low (score 2) when compared to other risk of bias parameters (score 0). Conclusion: Bonding agents ensure bonding strength at least similar to the conventional methods. In order to upgrade the quality of future studies, it would be advantageous to use larger number of specimens with standardized dimensions, and blinded testing machine operator to decrease the risk of bias.

Aim: to compare the trueness of 3D printed versus milled complete denture bases. Materials and methods: study used frasaco (Tettnang, Germany) edentulous model of the upper jaw which was duplicated using silicone duplicating material. Eight casts were poured with type 3 dental stone. Every cast was scanned using laboratory scanner, and on that digitalized cast in appropriate software was modeled denture base with same thickness of 3 mm everywhere. Modeled denture bases were exported as STL files. From the same STL file was denture base 3D printed (IMPRIMO® LC Denture, Scheu Dental) and also milled (IvoBase CAD, Ivoclar Vivadent) according to manufacturer’s instructions. The intaglio surface of 3D printed and milled denture bases (16 completely) were scanned with laboratory scanner. The obtained STL file od 3D printed and milled denture base was aligned with reference STL file from which denture bases were made. Deviation values between intaglio surfaces were recorded – highest values of deviation (plus and minus values) and deviation label sigma (SD of deviation values for all inspected points of mesh). Comparison was made in GOM Inspect software (GOM metrology). Independent samples T test was applied. Results: Mean value of highest minus deviation values for milled denture bases was - 0, 10 and -0, 63mm for 3D printed. Mean value of highest plus deviation values was 0, 23 for milled denture bases and 0, 47mm for 3D printed. Mean value of deviation label sigma for milled dentures was 0, 04 and 0, 14mm for 3D printed. Independent samples T test showed differences between 3D printed and milled dentures for highest minus values (p=0, 002) and deviation label sigma (p=0, 010), while in highest plus values were not proved differences (p=0, 331). Conclusions: Milled dentures show better trueness compared to 3D printed. Clinical confirmation of findings is needed.

Introduction: Existing data about potential salivary changes in pediatric patients with eating disorders (ED) are scarce. The purpose of present study was to assess differences between pediatric patients with ED and control group in the amount of saliva and the concentration of total amylase and electrolytes in saliva. Study also aimed to evaluate the correlation between saliva changes and nutritional status. Materials and methods: 101 participants (14.3 ±2.0 years) were included: ED subgroups included 50 participants, while control group included 51 participants. Obtained data were statistically processed using Mann-Whitney, Kruskal-Wallis, chi-square and Spearman rank correlation test (α=0.05). Results: Significant differences of salivary volume between groups were not determined. A significant difference of the salivary volume secreted in the 5th and 15th minute was determined between the anorexia nervosa and bulimia nervosa subgroups. Examined anthropometric parameters were marginally or significantly positively associated with salivary volume at 5th and 15th minute, with a more significant correlation of the same at 15th than at 5th minute. In patients with ED were higher concentration of inorganic phosphates in saliva while the concentrations of other electrolytes and total amylase in saliva did not differ significantly. Nutritional status can affect salivation. Conclusion: A differences in salivary volumes in pediatric patients with different ED disorders are expected. Variations in salivary electrolytes in pediatric patients with ED are possible.

Numerous oral changes develop as a result of dysfunctional eating behavior in patients with eating disorders (ED). The aim of this study was to evaluate the correlation among oral manifestations, age, disease duration and nutritional status in pediatric patients with ED. The study included 50 female ED patients, median age 14 (range 10-18) years and median disease duration 9 (range 1-42) months. Nutritional status was expressed as z-score for body mass index (BMI). Mean BMI z-score was -2.10±1.64. The most commonly observed oral findings were dental plaque, marginal gingivitis, morsicatio, dental calculus, caries, pharyngeal erythema, exfoliative cheilitis and angular cheilitis. Dental plaque and pharyngeal erythema were correlated with shorter disease duration (p=0.048; p=0.040), while frictional keratosis of tongue was correlated with longer disease duration (0.011). Linea alba and pain in the temporomandibular joint were associated with younger age (p=0.012; p=0.024), and tooth impression on tongue with lower degree of nutrition (p=0.030). This study showed that there was a link among oral manifestations, age, disease duration and degree of nutritional disorder, although further investigations comparing the groups of ED patients with different age, disease duration and nutritional status would give better, concrete and precise conclusions., Poremećen odnos prema jelu u sklopu poremećaja u jedenju rezultira brojnim promjenama u usnoj šupljini. Cilj ovog istraživanja je bio utvrditi postoji li korelacija između pojavnosti promjena u usnoj šupljini, dobi, duljine trajanja poremećaja te stupnja uhranjenosti u pedijatrijskih bolesnika s poremećajima u jedenju. U istraživanju je sudjelovalo 50 bolesnica s poremećajem u jedenju prosječne dobi od 14 (raspon 10-18) godina i prosječnog trajanja bolesti od 9 (raspon 1-14) mjeseci. Stupanj uhranjenosti izražen je standardnom devijacijom indeksa tjelesne mase (ITM z-vrijednost). Srednja ITM z-vrijednost bila je -2,10±1,64. Najčešće promjene u usnoj šupljini bile su zubni plak, marginalni gingivitis, morsikacije, kamenac, karijes, eritem farinksa, eksfolijativni heilitis i angularni heilitis. Zubni plak i eritem farinksa bili su povezani s kraćim trajanjem poremećaja (p=0,048; p=0,040), a frikcijska keratoza jezika s duljim trajanjem poremećaja (0,011). Linea alba i bolovi u temporomandibularnom zglobu su bili povezani s mlađom dobi (p=0,012; p=0,024), a impresije zubi na jeziku s nižim stupnjem uhranjenosti (p=0,030). Ovo istraživanje je pokazalo da postoji povezanost između promjena u usnoj šupljini, dobi, trajanja poremećaja i stupnja uhranjenosti, no daljnja istraživanja koja će uspoređivati skupine bolesnika različite dobi, trajanja bolesti i različitog stupnja uhranjenosti dat će bolje, konkretnije i preciznije zaključke.

Objectives: Objectives: There are few treatment options for treating symptoms of temporomandibular disorders and also for bruxism. Occlusal stabilization splints are most frequently used. The purpose of present study was to determine Croatian dental practitioners’ knowledge and attitudes about stabilization splint therapy. Methods: Methods: An online questionnaire was sent (using e-mail) to a Croatian dentists’ database. Questionnaire had 22 questions that aimed to specify Croatian dentists’ knowledge, attitudes and practice with occlusal and stabilization splints therapy. Results: Results: A total of 296 dentists filled out the questionnaire. The two most common indications for occlusal splint therapy were bruxism (79.5%) and pain or disfunction of the temporomandibular joint (41%). Most of participants (49.4%) are using both soft and hard (acrylic) splints, 29.6% are using only acrylic splints, 15.8% are using only soft splints, while 5.3% is not certain about used occlusal splint material. Over 65% of participants responded that they do not know what is stabilization splint or that are not sufficiently informed about it. Still, 89.3% of participants recommend stabilization splints to their patients. Conclusions: Conclusion: Most frequent indication for occlusal splint therapy among Croatian dentist was bruxism. As most participants considered that they are insufficiently informed about stabilization splits there is a need for motivation and additional education about occlusal splint indications and therapy.

Stabilization splint is frequently used therapy for temporomandibular disorders and bruxism. Few data exist regarding dental practitioners’ behavior with stabilization splint therapy. The purpose of this study was to examine dental practitioners’ awareness about occlusal stabilization) splints. In this cross-sectional study, an online questionnaire was administered via e-mail to a dentists’ database (Croatian). Questionnaire consisted of 22 questions which aimed to specify Croatian dentists’ knowledge, attitudes and practice with occlusal and stabilization splints therapy. A total of 296 dentists filled out the questionnaire. Most frequent indications for occlusal splint therapy were bruxism (79.5%) and pain or disfunction of the temporomandibular joint (41%). Most of participants (49.4%) are using both soft and hard (acrylic) splints, 29.6% are using only acrylic splints, 15.8% are using only soft splints, while 5.3% is not certain about used occlusal splint material. Over 65% of participants responded that they do not know what is stabilization splint or that are not sufficiently informed about it. Still, 89.3% of participants recommend stabilization splints to their patients. Most frequent indication for occlusal splint therapy among Croatian dentist was bruxism. As most participants considered that they are insufficiently informed about stabilization splits there is a need for motivation and additional education about occlusal splint indications and therapy.

Uvod: Potpune proteze koriste se dugi niz godina i predstavljaju zlatni standard u liječenju potpune bezubosti. Nedavni napredak znanosti i tehnologije omogućio je korištenje digitalnih metoda pri izradi baze proteze, uključujući oblikovanje pomoću računala/ proizvodnju pomoću računala (CAD/CAM) i trodimenzionalno (3D) printanje. Ispitivanje žilavosti nastavak je istraživanja “Comparison of Mechanical Properties of 3D- Printed, CAD/CAM, and Conventional Denture Base Materials” (1) koje je odredilo vrijednosti savojne čvrstoće i tvrdoće. Materijali i metode: Ukupno 160 pravokutnih uzoraka dobiveno je od tri konvencionalna toplopolimerizirajuća akrilata, tri CAD/CAM, jednog 3D-printanog, i jednog poliamidnog materijala za izradu baze proteze. Za testiranje savojne čvrstoće korišten je test trotočkastog opterećenja, dok je za testiranje tvrdoće korištena Brinellova metoda. Žilavost je testirana na Charpyjevom batu. Podaci su analizirani deskriptivnom i analitičkom statistikom (α = 0.05). Rezultati: Vrijednosti savojne čvrstoće bile su u rasponu od 71.7 ± 7.4 MPa do 111.9 ± 4.3 MPa (1). Vrijednosti tvrdoće bile su u rasponu od 67.13 ± 10.64 MPa do 145.66 ± 2.22 MPa (1), dok su se vrijednosti žilavosti kretale od 8.01 ± 3.52 MPa do 44.68 ± 39.37 MPa. Tijekom testiranja savojne čvrstoće, uzorci IvoBase CAD i Vertex ThermoSens materijala nisu slomljeni. CAD/CAM materijal i poliamid imali su najveće vrijednosti savojne čvrstoće. 3D-printani materijal imao je najniže vrijednosti savojne čvrstoće. Dvije skupine CAD/CAM materijala imale su najveće vrijednosti tvrdoće. Poliamid i CAD/CAM materijali pokazali su najveće vrijednosti žilavosti. Zaključci: CAD/CAM materijali pokazuju bolja mehanička svojstva od toplopolimerizirajućih i 3D- printanih akrilata. Ipak, tip polimerizacije materijala nije garancija njegovih optimalnih mehaničkih svojstava.

Svrha rada: Svrha istraživanja bila je evaluirati upotrebu procjene rizika za nastanak karijesa (PRK)kod hrvatskih općih stomatologa i procijeniti njihovo znanje i stajališta o PRK-u. Materijal i postupci: Poveznica za on-line upitnik poslana je na e-adrese 1500 stomatologa u Hrvatskoj. Dobiveni podatcianalizirani su s pomoću deskriptivne statistike, logističke regresije i Chi-kvradrat testa. Rezultati: Od257 ispitanika njih 47 % obavlja PRK rutinski, a samo se 4,5 % pritom koristi specifičnim formularima.Među ispitanicima znatno je varirala važnost različitih čimbenika pri pripremi plana terapije. Nadalje,77 % ispitanika temeljilo je individualnu prevenciju (IPK) karijesa na PRK-u. Veza između PRK i IPK tePRK i plana terapije bila je statistički značajna (p = 0,001). Praktičari koji primjenjuju PRK češće pla-niraju terapiju i provode IPK prema PRK-u. Na uporabu PRK-a nisu utjecali ni specijalizacija, ni iskustvo stomatologa. Zaključci: Velikom dijelu (53 %) hrvatskih općih stomatologa PRK nije dio rutinskeprakse i postoji značajna povezanost između njegove primjene i planiranja terapije te IPK. Potrebno je promicati uporabu PRK-a u svakodnevnoj dentalnoj praksi u Hrvatskoj., Objective: The aim of this study was to evaluate the usage of caries risk assessment (CRA) by Croatian general practitioners and evaluate their knowledge and attitudes towards CRA. Material and methods: A link to an online questionnaire was sent via e-mail to a sample of 1,500 general dentists in Croatia. The obtained data were analyzed using descriptive statistics, logistic regression analyses and chi-square tests. Results: Of 257 respondents, 47% performed CRA routinely, but only 4.5% of them used a specific CRA form. The significance of different actors in the development of a treat-ment plan varied considerably among respondents. Furthermore, in 77% of the respondents CRA was a basis for planning individual caries prevention (ICP). The association between CRA and ICP, and be-tween CRA and treatment planning was statistically significant (p=0.001). The practitioners doing CRA more often plan their treatment and ICP according to CRA. The use of CRA was not influenced by specialty and dentists’ experience. Conclusions: In a considerable percentage (53%) of Croatian general dentists, CRA is not part of their routine practice, and there is a strong association between the use of CRA and treatment plans and ICP. There is a need to promote the use of CRA in daily dental practice in Croatia.

Svrha rada: Svrha ovog pilot-istraživanja bila je ispitati utjecaj terapije okluzijskom udlagom na granične kretnje donje čeljusti te položaj kondila kod ispitanika s bruksizmom. Materijal i postupci: U istraživanje je bilo uključeno 9 ispitanika s dijagnosticiranim bruksizmom (srednja dob 28,7 godina) i 9 ispitanika u kontrolnoj skupini (srednja dob 30,5 godina). Svi su bili punoljetni, eugnati s dentoalveolarnom klasom I prema Angleu, bez postojećih protetičkih radova, bez prijašnje ili sadašnje ortodontske terapije, prijašnjih kirurških zahvata u području temporomandibularnog zgloba te bez neke sistemske bolesti. Za sve ispitanike u objema skupinama izrađena je relaksacijska okluzijska udlaga standardiziranim postupkom koju su nosili 8 tjedana. Za to su vrijeme obavljena, uz inicijalno, još 3 mjerenja incizalnog otvaranja (IO), otvaranja lijevog kondila (OLC), otvaranja desnog kondila (ORC), lijeve laterotruzije (LLI) i desne laterotruzije (LRI) (nakon 2, 4 i 8 tjedana), koristeći se ultrazvučnim uređajem za snimanje kretnji donje čeljusti Arcus Digma II (Kavo). Istim uređajem ispitana je promjena položaja kondila pri protruziji, lijeve i desne laterotruzije te u položaju centrične relacije (CR) na početku istraživanja i zatim nakon 8 tjedana koristeći se položajem maksimalne interkuspidacije kao referentnim. Kontinuirane varijable opisane su s pomoću osnovnih statističkih parametara, a statistička značajnost razlika između varijabli provjerena je t-testom i χ2 testom (p < 0,05). Rezultati: Vrijednosti za IO, OLC, ORC, LLI LRI povećane su nakon 8-tjednog nošenja udlage te je najveće povećanje zabilježeno kod OLC-a –- za 13,8 %. Ni za jednu promjenu iznosa graničnih kretnji nije utvrđena statistički značajna razlika (p < 0,05). Promjene položaja kondila pri protruziji, lijeve i desne laterotruzije te u položaju centrične relacije (CR) bile su veće u ispitnoj skupini u 10 od 14 mjerenih parametara u odnosu prema kontrolnoj skupini te je u 5 od 14 mjernih parametara ustanovljena statistič-ki značajna razlika nakon terapije udlagom. Zaključak: U ovom pilot-istraživanju dokazan je utjecaj terapije udlagom na granične kretnje mandibule kod ispitanika s bruksizmom povećanjem raspona kretnji. Također je utvrđena veća promjena položaja kondila kod ispitanika s bruksizmom u odnosu prema zdravima., Objective: The objective of this pilot study was to examine the impact of occlusal splint treatment on mandibular border movements and the condyle position in subjects with bruxism. Material and methods: The study included 9 subjects diagnosed with bruxism (mean age 28.7) and 9 subjects in the control group (mean age 30.5). All subjects were adults, eugnathic, and with a dentoalveolar Angle Class I, without prosthetic restorations, previous or current orthodontic treatments, a systemic disease or previous surgical interventions in the temporomandibular joint. All experimental and con-trol group subjects were provided with a standardized relaxation occlusal splint, which they wore for 8 weeks. During this time, an initial and three additional measurements of incisal opening (IO), left condyle opening (OLC), right condyle opening (ORC), left laterotrusion (LLI) and right laterotrusion (LRI) (after 2, 4 and 8 weeks) were performed using an Arcus Digamma II (Kavo) ultrasound device for mandibular movements recording. Using the same instrument, the condylar position during protrusion, left and right laterotrusion, and in the centric relation position (CR) was analyzed initially and after 8 weeks using the maximum intercuspation as reference point. Continuous variables were described using basic statistical parameters, and the statistical significance of differences between the variables was checked by the t-test and χ2 test (p

The objective of this study was to test microhardness of higly viscous glassionomer cement and glass-hybrid system with or without coat after various regimes of exposure to Coca-Cola during the period of seven days. For the experiment, capsulated materials were used, for three experimental groups (n=120): glass-hybrid material (Equia Forte HT Fil), with (n=40) and without the coat (EQUIA Forte Coat), (n=40), and highly viscous glassionomer, Fuji IX (n=40). All materials were mixed according to the instructions of the manufacturer and placed in custom made teflon molds, 6 mm in diameter and 2 mm in height. After seven days, samples from every of the three experimental groups were subdivided into four subgroups: 1. subgroup- control, samples in saline ; 2. subgroup- samples held in Coca-Cola once a day, 5 min, 7 days ; 3. subgroup- samples held in Coca-Cola three times a day, 5 min, 7 days ; 4. subgroup- samples held in Coca-Cola five times a day, 5 min, 7 days. After seven days (baseline) and after 3 months, Vickers microhardness test was performed. For statistical analysis, a mixed factorial ANOVA, post-hoc Tukey's and multiple paired t-tests were used. Level of significance was set at 5%. Regarding control groups, the highest microhardness value at baseline was found for Equia Forte HT Fil without the coat (59.86±11.44), (p0.05). After 3 months, Coca-Cola had no negative influence on microhardness of highly viscous glassionomer or glass-hybrid system with or without the coat .

Objectives: The purpose of this in vitro study was to compare flexural and compressive strength of composite core build up materials after cyclic fatigue conditions. Methods: Four different resin composite materials specifically intended for core build-ups were selected for this study: A: everX Posterior, GC ; B: Clearfil Core, Kuraray ; C: MultiCore Flow, Ivoclar Vivadent ; D: Unocore DC, Dental Directory. Bar shaped specimens (2x2x25 mm), were fabricated for flexural testing. For the compressive strength test specimens were fabricated in cylindrical shape (4x6 mm). n=10 for each material group. Fatigue duration was 5000 cycles (frequency 1 Hz) for each material. Flexural strength was determined using 3 point bending test with 20 mm span while compressive strength was tested on the cylindrical specimens. Statistical analysis was performed using one-way ANOVA and Tukey- Kramer post hoc test. Results: Flexural strength values were: 97.2±9.8 MPa (Clearfil Core), 124.7±15.0 MPa (everX Posterior), 97.8±16.6 MPa (MultiCore Flow) and 107.9±19.8 MPa (Unodent DC). Compressive strength values were 181.5±22.5 MPa (Clearfil Core), 246.4±16.7 MPa (everX Posterior), 233.8±19.7 MPa (MultiCore Flow) and 204.7±56.5 MPa (Unodent DC). Statistical analysis showed differences between groups in compressive strength (P

Medikamentozna osteonekroza čeljusti znači odumiranje koštanog tkiva, većinom u maksilofacijalnoj regiji. Postoje različiti predisponirajući čimbenici za nastanak medikamentozne osteonekroze čeljusti. Povezuje se uz terapiju lijekovima koji utječu na metabolizam kosti (bisfosfonati, denosumabi, antiangiogeni lijekovi). Zbog povećanja upotrebe tih lijekova povećava se pojavnost medikamentozne osteonekroze. Postoje različiti protokoli liječenja, a uključuju konzervativnu i kiruršku terapiju. Protetička rehabilitacija nakon saniranja osteonekroze važan je čimbenik u liječenju pacijenata s medikamentoznom osteonekrozom čeljusti (glavni cilj liječenja osteonekroze je podizanje kvalitete života). Zbog upotrebe lijekova koji se povezuju s medikamentoznom osteonekrozom čeljusti te zbog primarne bolesti (malignitet/komorbiditet) bitan je jasan plan protetičke rehabilitacije. Važna je i multidisciplinarna suradnja. Prema literaturi svaka 10 osteonekroza čeljusti nastane zbog dekubitusa proteze. Stoga su potrebne češće kontrole i povećan oprez (korekcija okluzije, potreba podlaganja) kod pacijenata na terapiji lijekovima koji mogu inducirati osteonekrozu čeljusti.

Uvod: Svrha ovoga istraživanja bila je procijeniti ponovljivost položaja centrične relacije kod pacijenata s dislokacijom diska s redukcijom. Materijali i metode: U ispitnoj skupini bilo je 30 ispitanika s utvrđenom dislokacijom diska s redukcijom u desnom i lijevom zglobu ili u oba. Kontrolna skupina sastojala se od 12 sudionika bez znakova i simptoma temporomandibularnih poremećaja. Koristeći se metodom vođenja brade s prednjim deprogramatorom, učinjena su tri registrata centrične relacije za svakog ispitanika i to tijekom jednog posjeta. Elektroničkim ultrazvučnim mjernim uređajem snimljen je položaj lijevoga i desnoga kondila kod svakog dobivenog registrata centrične relacije. Podatci su analizirani računalom. Izmjerena je udaljenost kondila dobivena kod različitih registrata centrične relacije (anteroposteriorne, vertikalne, transverzalne i linearne vrijednosti) te su podatci statistički analizirani t i F testom. Rezultati: Nije utvrđena statistički značajna razlika između ispitne i kontrolne skupine. Kod dvije trećine ispitanika kondilni je položaj tijekom ponavljanja određivanja centrične relacije bio unutar promjera od 0,3 milimetra. Za više od 90 posto ispitanika to je područje bilo unutar 0,4 milimetra. Zaključak: Ne postoji razlika u ponovljivosti centrične relacije između pacijenata s dislokacijom diska s redukcijom i onih sa zdravim temporomandibularnim zglobom (p > 0,05). Kada se radi registrat centrične relacije na pacijentu s dislokacijom diska s redukcijom, prije toga nije potrebna terapija udlagom, dovoljne su standardne mjere opreza. Dobiveni rezultati moraju se interpretirati unutar ispitne skupine, bez povezivanja s drugim skupinama temporomandibularnih poremećaja., Objective: The aim of this study was to investigate reproducibility of the position of centric relation in patients with disc displacement with reduction. Materials and methods: The test group included 30 subjects, diagnosed with disc displacement with reduction in right, left or both joints. The control group included 12 individuals with no signs and symptoms of temporomandibular disorders. Using chin point guidance with a jig, centric relation record was made three times by every participant, in a single session. Left and right condylar position for each centric relation record was determined and recorded using the electronic ultrasonic measuring device. The data were transferred to the computer, processed and analyzed. Condylar distances between centric relation records were measured (anteroposterior, vertical, transversal and linear values), and the data were statistically analyzed using the t and the F tests. Results: No statically significant difference was found between the test and the control groups. Two thirds of study participants demonstrated condylar position of the repeated centric relation recording within the area of 0.3 mm in diameter. For more than 90% of participants that area was within 0.4 mm. Conclusions: There is no difference in reproducibility of the centric relation between patients with disc displacement with reduction and healthy temporomandibular joint individuals (p>0.05). When doing centric relation record on a patient with disc displacement with reduction there is no need for previous splint therapy and standard precautions are acceptable. The obtained results must be interpreted within the experimental group, and not projected on the other groups of temporomandibular disorders.

Svrha rada: Udlage su okluzijske ortopedske naprave koje se koriste kao terapijsko sredstvo u liječenju temporomandibularnih poremećaja. Najčešće se izrađuju iz polimetilmetakrilata (PMMA) koji predstavlja zlatni standard. Daljnjim razvojem tehnologije omogućena je i izrada udlaga putem CAD/CAM te aditivnim tehnologijama. Svrha ovog rada bila je istražiti mehanička svojstva različitih vrsta materijala za izradu nagriznih udlaga izrađenih različitim tehnologijama s naglaskom na digitalne tehnologije (CAD/CAM i 3D printanje) Materijali i metode: Istraživanje je obuhvatilo 7 različitih materijala za izradu nagriznih udlaga na kojima su testirana mehanička svojstva: 3 vrste hladnopolimerizirajućeg akrilata (Ortocryl, Resilit S, Probase Cold), 2 vrste akrilata za 3D printanje (VarseoWax Splint, Orthorigid) i dvije vrste CAD/CAM materijala (Ceramill Splintec, Copradur). Uzorci dimenzija 64x10x3, 3mm korišteni su pri ispitivanju savojne čvrstoće i tvrdoće dok su uzorci dimenzija 39x8x4mm korišteni pri ispitivanju žilavosti (10 uzoraka za svaku ispitnu skupinu, sveukupno 140 uzoraka). Ispitivanje savojne čvrstoće provedeno je „three-point bend“ testom, ispitivanje tvrdoće provedeno je Brinellovom metodom dok je žilavost ispitana na Charpy-evom batu. Rezultati: Statistička analiza potvrdila je da između dobivenih rezultata mjerenja postoje statistički značajne razlike. Hladnopolimerizirajući akrilati imaju najviše vrijednosti tvrdoće te najniže vrijednosti žilavosti. Copradur i Varseo su imali najniže vrijednosti tvrdoće i jedini se nisu slomili pri ispitivanju savojne čvrstoće. Copradur i Probase Cold su imali veće prosječne vrijednosti udarnog rada loma. Zaključak: Svi ispitani materijali su postigli zadovoljavajuće rezultate mehaničkih ispitivanja te se smatraju prikladnima za izradu okluzijskih udlaga. Utvrđene razlike sugeriraju moguće razlike u djelovanju nagriznih udlaga proizvedenih različitim materijalima.

Cilj: Elektronski uređaji koriste se za snimanje i dijagnostičku interpretaciju kretnji donje čeljusti. Temelje se na različitim tehnologijama (optoelekronički, ultrazvučni, elektromehanički, magnetski i drugi). U novije vrijeme ultrazvučni način snimanja prevladava. Postupci: Najpreciznijima se smatraju uređaji za snimanje kretnji donje čeljusti na temelju šest stupnjeva slobode. Pojam šest stupnjeva slobode dolazi iz fizike, te označava matematičku pretvorbu podataka. Smatra se da se tek razvojem uređaja na temelju šest stupnjeva slobode omogućilo relativno precizno snimanje kretnji kondila i cijele donje čeljusti. Rezultati: Prednost elektronskih uređaja za registraciju i analizu kinematike je što u realnom vremenu možemo snimati i analizirati kretnje donje čeljusti. Bitna stavka kod elektronskih uređaja za registraciju i analizu kinematike je fiksacija paraokluzijske žlice na donji zubni niz. Paraokluzijska žlica se izrađuje na modelu donje čeljusti iz svjetlosnopolimerizirajućeg akrilata. Ima osnovu iz savitljivog metala koji se lako prilagodi na modelu. U ustima pacijenta se pričvršćuje pomoću materijala za izradu provizornih nadomjestaka. Kod izrade i pričvršćivanja paraokluzijske žlice bitno je da akrilat nije u dodiru sa gornjim zubnim nizom jer bi to moglo dovesti do distorzije kretnji donje čeljusti prilikom njihove registracije. Zaključak: Od izuzetnog značaja kod složenih protetskih rekonstrukcija je potpuna individualizacija artikulatora koja je omogućena pomoću takvih elektronskih uređaja (kut nagiba kondilne staze, Bennettov kut, imedijatni pomak u stranu, kut incizalnog vođenja, kut lateralnog prednjeg vođenja).

Cilj: Svrha ovog istraživanja bila je odrediti uspješnost stabilizacijskih udlaga u smanjivanju simptoma bruksizma i različitih tipova temporomandibularnih poremećaja iz pacijentove perspektive. Materijali i metode: Studija je uključivala 98 pacijenata (Zavod za mobilnu protetiku, Stomatološki fakultet, Sveučilište u Zagrebu, Hrvatska) koji su nosili stabilizacijsku udlagu zbog bruksizma ili temporomandibularnih poremećaja. Ispitanici su bili podijeljeni u tri grupe (prema najučestalijim dijagnozama, koje su bile zabilježene u pacijentovom kartonu): bruksizam, poremećaj disk-kondil kompleksa i bol u temporomandubularnom zglobu. Pacijenti su kontaktirani putem telefona i pitani da (subjektivno) procijene rezultate tretmana stabilizacijskom udlagom. Upitani su da iskreno ocijene rezultate tretmana stabilizacijskom udlagom, koji su kategorizirani u tri skupine: udlaga je pomogla, udlaga nije pomogla, nisam siguran. Rezultati su statistički analizirani. Rezultati: Prikazana studija zabilježila je 50 dijagnoza bruksizma, 23 dijagnoze pomaka diska, 21 dijagnozu boli u temporomandibularnom zglobu i 4 ostale dijagnoze (podatci iz pacijentova kartona). Hi- kvadrat test nije pokazao razlike ishoda pacijentova tretmana između bruksizma, poremećaja disk-kondil kompleksa i boli u temporomandibularnom zglobu ( vrijednost=1, 50 ; p=0, 83). Od svih pacijenata, 67, 35% odgovorilo je da je udlaga pomogla, 9, 18% da udlaga nije pomogla i 23, 47% da nisu sigurni. Zaključci: Većina pacijenata smatra terapiju stabilizacijskom udlagom korisnom pri smanjivanju simptoma zbog kojih su i došli u kliniku. Terapija stabilizacijskom udlagom je djelotvoran način da se pomogne pacijentu u smanjivanju simptoma bruksizma i temporomandibularnih poremećaja.

Cilj: U poremećaje u jedenju ubrajamo anoreksiju nervozu, bulimiju nervozu, nespecifični poremećaj u jedenju i kompulzivno prejedanje. Poremećen odnos prema jelu rezultira brojnim metaboličkim komplikacijama te promjenama u usnoj šupljini kao što su dentalne erozije, suha usta, karijes, parodontna bolest, lezije mekog tkiva i povećanje žlijezda slinovnica. Cilj istraživanja je bio utvrditi prisutnost promjena u usnoj šupljini u pedijatrijskih bolesnika s poremećajima u jedenju. Materijali i metode: U razdoblju od šest mjeseci, učinjen je pregled usne šupljine 26 pacijentica Zavoda za gastroenterologiju Klinike za pedijatriju, dobi 10-18 godina, koje boluju od poremećaja u jedenju. Rezultati: Zabilježeno je 13 različitih promjena u usnoj šupljini u 24 od 26 pacijentica. Najčešće promjene su marginalni gingivitis (16/26) i zubni plak (16/26), dok se ostale promjene bilježe u manjeg broja pacijentica: morsikacija (8/26), karijes (8/26), kamenac (7/26), eritem farinksa (7/26), angularni heilitis (6/26), zadah (5/26), frikcijska hiperkeratoza jezika (3/26), afte (2/26), impresije zuba na jeziku (2/26), geografski jezik (2/26) i linea alba (1/26). Otekline žlijezda slinovnica i erozije palatinalne strane zuba nisu zamijećene niti u jedne pacijentice. Zaključak: Ovim istraživanjem utvrdili smo prisutnost niza promjena u usnoj šupljini u pacijentica oboljelih od poremećaja u jedenju sukladno podacima iz recentne literature. Otekline žlijezda slinovnica i erozije palatinalne strane zuba koje se u literaturi opisuju, posebice u oboljelih od bulimičnog oblika poremećaja, nismo utvrdili. Takvi rezultati mogu se objasniti malim brojem ispitanika s bulimičnim oblikom poremećaja te mlađom životnom dobi i kraćim trajanjem bolesti.

Svrha istraživanja bila je procjeniti upotrebu štitnika za zube tijekom bavljenja borilač- kim sportovima. Materijali i postupci: Istraživanje je provedeno putem anonimnog on-line upitnika koji je poslan različitim borilačkim klubovima u Hrvatskoj, a koji su proslijedili link za upitnik svojim članovima. Istraživanje je uključilo 59 ispitanika. Dvadeset četvero ispitanika bavilo se boksom, 13 mješovitim borilačkim sportom (Mixed Martial Arts – MMA), 11 kikboksom dok se 11 ispitanika bavilo drugim vrstama borilačkih sportova. Rezultati: Svih 59 ispitanika bilo je upoznato sa štitnicima za zube. Dvadeset sedam ispitanika je bilo profesionalno upoznato sa štitnicima za zube tijekom bavljenja borilačkim sportom, dok 32 nije. Pedeset i pet ispitanika odgovorilo je da nosi štitnik tijekom bavljenja sportom, dok 4 ispitanika nosi povremeno. Kao razlog povremenog nošenja naveden je problem u komunikaciji (1 ispitanik), ometanje disanja (2 ispitanika), teška dostupnost štitnika, dok jedan ispitanik smatra da štitnik nije potreban. 55 ispitanika koristi štitnik iz trgovine, dok 4 ispitanika koristi individualni izrađen kod stomatologa. Na pitanje „Ako ste ikad tijekom borbe primili udarac bez štitnika, kako bi procijenili razliku naspram primljenog udarca sa štitnikom?“, 70, 9 % ispitanika je procijenilo razliku kao veliku, 25, 5 % kao srednju dok je 3, 6 % ispitanika odgovorilo da je mala razlika. Zaključak: Potrebno je poboljšati edukaciju boraca o vrstama i koristima štitnika za zube. Iako su poznate koristi štitnika za zube, određenom postotku boraca (u ovom istraživanju 5, 1 %) mogu stvarati poteškoće prilikom bavljenja borilačkim sportom.

Objectives Temporomandibular disorders have high prevalence in general population. Data about temporomandibular disorders among different types of contact sports athletes are scarce. The objective of this study was to analyze association between self-reported temporomandibular dysfunctions and combat sports training. Methods This study included 57 participants who were trained/training combat sports. Twenty four participants were practicing boxing, 12 mixed martial arts, 11 kickboxing, and 10 participants were practicing other types of combat sports. All participants filled out the online questionnaire which was sent to different combat sports clubs in Croatia, which forwarded the questionnaire to its club members. Results Eighteen participants responded that they had previous temporomandibular joint trauma, 29 had not, while 10 was not sure about past temporomandibular joint trauma during sports practicing. Thirty-three participants experienced pain in temporomandibular joint during or after sports practicing. Forty-two participants reported previous pain at opening/closing of the mouth during or after sports practicing. Twenty-nine participants experienced muscle tenderness associated with opening and closing of the mouth during or after sports practicing. Sixteen participants had limited mouth opening during or after sports practicing. Sixteen participants associated disc dislocation and/or crepitus in temporomandibular joint with previous trauma during combat sports training. Conclusions Almost every participant experienced some symptom or sign of the temporomandibular dysfunctions. Combat sports training could have its influence on the temporomandibular joint health. More frequent visits to the dentists of the combat sports athletes could be recommended.

Background: Bruxism and muscular temporomandibular dysfunctions (TMD) are common in patients and are considered as a contraindication for implant prosthetic treatment. The reason for this is a high percentage of implant failure, as well as biological and technical failures on implant-retained prosthetic restorations. The standard treatment in patients diagnosed with bruxism and muscular TMD includes fabrication of an occlusal splint, which should be made of a suitable material with a precise fit and allow precise occlusal contacts. Aim of the study: The purpose of this paper is to present two clinical cases indicating benefits of CAD/CAM occlusal splint fabrication immediately after implant prosthetic treatment, as an everyday procedure for the purpose of extending implant life and reducing the possibility of biological and mechanical failures of implant-retained prosthetic restorations. Materials and methods: Bruxism and muscular TMD were diagnosed in the two patients by means of clinical functional analysis before the implant treatment. Implant-retained prosthetic restorations were made and fabrication of an occlusal splint was initiated. Impressions of the upper and lower jaw were taken for fabrication of dental stone casts. Interarch relationships were registered using the face bow and centric registration, and eccentric registrations were taken for articulator individualization. The occlusal splint was fabricated by means of the Ceramill CAD/CAM system (AG, Germany). The casts were first scanned in the Map scanner in the real interarch relationships, and they were transferred in the Mind software to the individualized virtual articulator. The occlusal splint was designed in the M-Splint software, first its shape, and then its occlusal surfaces, by creating static and dynamic occlusal contacts. The final design of the splint was milled from the Splintec PMMA material in the Motion 2 milling machine. The fabricated CAD/CAM splint was checked in the articulator and handed in to the patient, together with its fit and occlusal contacts checking. Results: In relation to the fabrication of occlusal splints by means of standard procedures of flasking and polymerization, occlusal splints from transparent PMMA material can be fabricated without contractions using the CAD/CAM system. This enables their excellent retention and stabilization, as well as precise planning and occlusal contacts fabrication. One to two occlusal contacts per a pair of antagonists were established in static occlusion, while contacts according to the concept of canine guided occlusion were established in dynamic occlusion. Four years after the fabrication of implant-retained prosthetic restorations, the two patients had no radioopaque bone loss around the implant, nor biological and technical deficiencies on implant-retained prosthetic restorations. Conclusions and clinical implications: Beside planning of the position of dental implant placement and correct surgical and prosthetic methods in fabrication of implant-retained prosthetic restorations, it is important for patients diagnosed with bruxism or muscular TMD to receive a precise occlusal splint immediately after the implant- prosthetic treatment is finished, in order to prolong the life expectancy of the implant and reduce the possibility of occurrence of biological and technical failures.

Uvod: Stabilizacijske udlage su najčešći oblik terapije temporomandibularnih poreme- ćaja. Mehanizam djelovanja udlaga tijekom njihovog nošenja još uvijek je kontroverzan. Svrha ovog rada je utvrditi položaj mandibularnog kondila prilikom nošenja stabilizacijske udlage različite debljine. Materijali i postupci: Istraživanje je uključilo 10 potpuno ozubljenih ispitanika (prosjek godina 23, 8, 70 % žena, 30 % muških ispitanika), bez temporomandibularnih poremećaja. Svakom ispitaniku su napravljene po dvije akrilatne stabilizacijske udlage („Michigan splint“). Prva udlaga je napravljena na visini od 1 mm u prostoru molara, dok je druga udlaga napravljena na položaju 3 mm višem od prve udlage (gledano na razini incizalnog kolčića artikulatora). Mjerenja položaja lijevog i desnog kondila kod udlaga izvedena su pomoću ultrazvučnog uređaja za snimanje kretnji donje čeljusti na temelju šest stupnjeva slobode. Nakon što se pričvrstila paraokluzijska žlica i namjestio obrazni luk uređaja, udlage su vraćene u usta. Izmjerena su odstupanja lijevog i desnog kondila u položaju okluzije udlaga naspram referentnog položaja habitualne okluzije: na razini antero – posteriorne (x), vertikalne (y) i lateralne (z) osi. Iz vrijednosti Kartezijevog koordinatnog sustava, izračunate su linearne vrijednosti odstupanja udlaga od položaja habitualne okluzije te su podatci statistički analizirani. Rezultati: Linearna udaljenost između položaja habitualne okluzije i okluzije stabilizacijske udlage visine 1 mm na području molara iznosila je prosječno 2, 04 ± 1, 18 mm, dok je kod druge udlage (+ 3 mm na razini incizalnog kolčića artikulatora) iznosila prosječ- no 2, 32 ± 1, 24 mm. T testom nezavisnih uzoraka nije utvrđena statistički značajna razlika u vrijednostima odstupanja x, y, z osi niti u linearnim vrijednostima odstupanja izme- đu udlaga različite debljine. Zaključak: Podizanjem visine udlage ne mjenja se značajno položaj kondila unutar temporomandibularnog zgloba, te se kod „deblje“ stabilizacijske udlage ne može očekivati ve- ća distrakcija unutar zgloba kod zdravih ispitanika.

Svrha ovog istraživanja bila je istražiti povezanost odstupanja između retrudiranog kontaktnog položaja (RKP) i okluzije centrične relacije (OCR) na razini kondila donje čeljusti. Materijali i postupci: Istraživanje je uključilo dvadeset potpuno ozubljenih ispitanika (prosjek godina 24, 4 ± 1, 2). Sva mjerenja kondilarnih položaja su rađena ultrazvučnim uređajem za snimanje kretnji donje čeljusti na temelju šest stupnjeva slobode. OCR određena je aktivnom metodom određivanja centrične relacije (ispitanici su uvježbani šarnirsku kretnju uz zadržavanje položaja donje čeljusti na prvom zubnom dodiru/dodirima). RKP određen je pasivnom metodom određivanja centrične relacije (metodom vođenja brade). Pomoću uređaja za snimanje kretnji donje čeljusti, registrirana su odstupanja RKP i OCR prema referentnom položaju habitualne okluzije za lijevi i desni kondil na razini x (antero – posteriorne), y (vertikalne) i z (lateralne) osi. Iz vrijednosti Kartezijevog koordinatnog sustava utvrđena su linearna odstupanja RKP i OCR prema referentnom položaju (habitualna okluzija). Izračunata je deskriptivna statistika te su vrijednosti odstupanja RKP i OCR uspoređene T testom zavisnih uzoraka. Rezultati: Prosječna linearna vrijednost odstupanja kondila kod položaja OCR iznosila je 1, 30 ± 1, 14 mm dok je kod RKP iznosila 2, 13 ± 1, 89 mm. T testom za zavisne uzorke je utvrđena statistički značajna razlika između linearnih vrijednosti odstupanja položaja OCR i RKP. Zaključak: Postoji razlika u položaju kondila unutar temporomandibularnog zgloba kod određivanja centrične relacije aktivnim i pasivnim metodama. OCR i RKP se mogu promatrati kao zasebni okluzijski položaji.

Objectives The objective was to describe the knowledge, opinions and practices of Croatian dental practitioners with respect to caries risk assessment (CRA) through the use of a national questionnaire survey. Methods An online questionnaire survey was administrated to a random sample of 1, 500 dentists in Croatia via email. Descriptive and logistic regression analyses were performed. Results The response rate was 17.13%. Of the respondents, 47% reported that CRA was part of their routine practice, but only 4.5% did so using a specific evaluation form. There was a great variation among respondents with respect to the importance given to different factors to be considered for the development of a treatment plan. Moreover 77% of the respondents plan individual caries prevention (ICP) based on the CRA. There was statistically significant association between CRA and ICP, and between CRA and treatment plan (p0.05). Conclusions A substantial percentage of Croatian dentists do not perform CRA, and there is a strong relationship between its use and ICP and therapy plans. There is a need to encourage the use of CRA in daily dental practice in Croatia.

Selective laser melting technique is form of 3D printing, and has been increasingly used in dentistry. Literature data about clinical procedure and performance of this kind of 3D printing technique are scarce. The purpose of this article was to show clinical case of production of removable partial denture with metal framework made with selective laser melting technique

The objective of this in vitro study was to compare microtensile bond strength of fiber reinforced composite and particulate filler composite to coronal and pulp chamber floor dentin using self- etching adhesive system. Forty human molar teeth, were divided into two experimental groups (n = 20 per group). In the first group, coronal dentin was exposed by cutting of occlusal enamel with the Isomet saw. In the second group, pulp chamber floor dentin was exposed by trepanation, after which chemo- mechanical instrumentation and root canal filling were performed. These two groups were further subdivided into two groups (n=10) according to the type of composite: fiber reinforced composite (everX Posterior, GC, Tokyo, Japan, ) and particulate filler composite (G- aenial Posterior, GC, Tokyo, Japan). A self-etching adhesive system (G-aenial Bond, GC, Tokyo, Japan) was used for all specimens. In the group with exposed coronal dentin, 5 mm high composite blocks were built up with each of the tested composites. In the group with exposed pulp chamber floor dentin, composite resin blocks were built to the level of occlusal surface. Each specimen was serially sectioned to obtain sticks with a cross- sectional area of 1 mm2, and microtensile bond strength test was performed (Figure 1). Statistical analysis was performed using one-way ANOVA test at level of significance set at 5%. Microtensile bond strength values were significantly higher for coronal dentin in comparison to pulp chamber floor dentin (p0.05), (Figure 2). Only the adhesive type of failure was observed in all four experimental groups. Higher microtensile bond strength values were observed for coronal dentin than for pulp chamber floor dentin. Fiber reinforeced and particulate filler composite performed similarly regarding the microtensile bond strength.

Svrha ovog istraživanja bila je procijeniti utjecaj umjetne okluzijske interference na položaj kondila. Materijali i postupci: U istraživanje je bilo uključeno deset ispitanika. Sva mjerenja položaja kondila obavljena su ultrazvučnim mjernim uređajem za snimanje kretnji donje čeljusti na temelju šest stupnjeva slobode. Paraokluzijska žlica bila je pričvršćena na donji zubni niz, a od kompozita napravljena je umjetna okluzijska interferenca na drugom donjem lijevom pretkutnjaku debljine 1 mm. Mjernim uređajem izmjerena su kondilarna odstupanja položaja okluzije s umjetnom okluzijskom interferencom. Kondilarni položaji utvrđeni su prema Kartezijevu koordinatnom sustavu. Sva odstupanja mjerena su prema referentnom položaju maksimalne interkuspidacije. Iz vrijednosti Kartezijeva koordinatnog sustava dobivene su vrijednosti linearnog odstupanja kondila između referentnog položaja i položaja okluzije s umjetnom okluzijskom interferencom. Rezultati: Prosječni superiorni pomak kondila iznosio je 0, 17 mm (SD 0, 39). Prosječno linearno odstupanje između položaja maksimalne interkuspidacije i položaja okluzije s umjetnom okluzijskom interferencom iznosilo je 0, 48 mm (SD 0, 29, min. 0, 17 mm, maks. 1, 19 mm). Zaključak: Okluzijske interference rezultiraju neposrednim promjenama u položaju kondila u temporomandibularnom zglobu. Utvrđeni prosječni superiorni položaj kondila govori u prilog stvaranju poluge unutar stomatognatog sustava. Rezultati se moraju interpretirati u sklopu ograničenja ove studije (neposredno mjerenje položaja kondila). Za spoznaje o progresiji položaja kondila pri okluzijskoj interferenci preporučuju se nove studije.

TMJ disorder is an umbrella term for several TMJ diagnoses, the most common being osteoarthritis (OA) and disc displacement (DD). Apart from the musculoskeletal pain of the orofacial region, headaches are the most common neurological pain. Also, musculoskeletal diseases can develop in other anatomically-topographically approximate areas, particularly in the form of cervicogenic and cervicocephalic syndromes. Clinical diagnostics of TMJ disorders are related to the existence of another type of headache, particularly since a special diagnosis of TMJ- related headache according to research criteria for temporomandibular disorders (RC/TMD) was introduced.

There have been studies that investigated mandibular movements during swallowing, but the results were inconsistent, and still the exact position of the condyles during swallowing is unknown. The purpose of this investigation was to determine the actual position of the mandible and the condyles during the process of swallowing.The results of the study suggest that retrusion during swallowing is not the rule, although on average there is a slight tendency of condylar movement toward posterior.

Purpose: The Bennett angle is an important parameter during prosthodontic rehabilitation. Existing data about impact of different occlusion types on the values of the Bennett angle are scarce. The purpose of this study was to investigate effect of different occlusion types on the Bennett angle values. Materials and Methods: Study included 98 participants (26.0 ± 5.2 years) divided into four study groups: Angle’s class I, Angle’s class II, subdivision 1, Angle’s class II, subdivision 2 and Angle’s class III. All recordings were obtained using ultrasound jaw tracking device with six degrees of freedom. After paraocclusal tray was fixed on the lower jaw, every subject had to make three protrusive, three left and right laterotrusive movements. From the laterotrusive movements, device’s software automatically calculated Bennett angle values for left and right joints, and data were statistically analyzed. Results: One-way ANOVA did not show differences between different Angle’s classes of occlusion for the Bennett angle values. Average Bennett angle value for all participants was 7.7°. Conclusions: Our results suggest that different Angle’s classes of occlusion do not have impact on the Bennett angle values. Average value of the Bennett angle is 8°, and should be used for average articulator settings.

Aim. Aim of this study was to compare the clinical characteristics of patients from the subgroup with osteoarthritis (G-1) and patients with disc displacement (DD) (G-2) of TMJ related types of headaches and with one-year-follow-up after treatment. Methods. G-1 included 70 patients who were treated for signs and symptoms of OA of TMJ. Pain intensity (at first examination T0) in TMJ was shown on the visual-analogue scale (0, no pain ; 10, the worst pain) as well as headaches. They were treated by an occlusal splint and/or physical therapy with a six- month (T1) and one-year (T2) follow-up. G-2 included 35 patients from a subgroup with DD. Definitive TMJ- diagnoses were confirmed by magnetic resonance imaging. Results. There was a significant age difference (p

Partial articular disc displacement in patients with TMJ disorder

Kinematika donje čeljusti posebno je zanimljivo područje u znanstvenom i kliničkom smislu. Temeljem novih spoznaja i primjenom suvremene metodologije može se utjecati na unapređenje uvriježenog načina rada. Istraživanje je podijeljeno u tri dijela u kojima su sva mjerenja učinjena korištenjem ultrazvučnog uređaja za snimanje i analizu kinematike donje čeljusti, sa šest stupnjeva slobode. Cilj prvog dijela (N=104) bilo je utvrđivanje vrijednosti kuta nagiba kondilne staze, imedijatnog pomaka u stranu, Bennettovog kuta, kuta incizijskog vođenja, kuta lateralnog prednjeg vođenja i pomaka iz okluzije centrične relacije u maksimalnu interkuspidaciju, te utvrđivanje razlika između različitih skupina ispitanika (prema British Standard Instituteu i klasifikaciji po Angleu). Kod klase I, II/1 i II/2 po Angleu nisu utvrđene razlike prosječnih vrijednosti postavki artikulatora putem KTS sustava. Kod klase III po Angleu su utvrđene u prosjeku niže vrijednosti kuta incizijskog vođenja, kuta lateralnog prednjeg vođenja i kuta nagiba kondilne staze, te su za pacijente s Angle klasom III sugerirane niže vrijednosti prosječnih postavki tih parametara artikulatora. U svih ispitanika imedijatni pomak u stranu je iznosio 0 mm. Ako je imedijatni pomak u stranu definiran kao trenutni pomak ne treba ga očekivati kod ljudi sa zdravim TMZ. Prosječna vrijednost Bennettovog kuta iznosila je 8°, bez razlika prema klasama okluzije. Utvrđena je prosječna vrijednost pomaka iz okluzije centrične relacije u maksimalnu interkuspidaciju od 0,68 mm, uz najčešći anteroinferiorni smjer. Podudaranje okluzije centrične relacije i maksimalne interkuspidacije utvrđeno je u manje od 10% ispitanika. Svrha drugog dijela istraživanja bila je analiza ponovljivosti određivanja centrične relacije kod ispitanika s dislokacijom diska s redukcijom, i ispitanika sa zdravim TMZ. Svim ispitanicima su određena tri registrata centrične relacije metodom vođenja brade, te su mjerene razlike položaja kondila. Statistička obrada nije utvrdila razliku između dvije promatrane skupine. Drukčiji pristup pacijentima s dislokacijom diska s redukcijom prilikom određivanja centrične relacije ne može se preporučiti. U treći dio istraživanja uključeno je 15 ispitanika kojima su napravljene po dvije stabilizacijske udlage; jedna korištenjem KTS sustava individualizacije artikulatora, a druga prijenosom obraznim lukom uz prosječne postavke artikulatora. Statističkom obradom nije utvrđena značajna razlika u preciznosti između dvije metode. Ipak, granični rezultati sugeriraju prijenos obraznim lukom uz individualizaciju vrijednosti artikulatora kao precizniju metodu. Objective: Lower jaw kinematics is an interesting area, both in scientific and clinical applications. Improvements of the common methods can result from application of modern technology and new achievements. The present study consisted of three different parts. The objective of the first part of the study (N=104) was to determine values of the sagittal condylar inclination, immediate side shift, Bennett angle, incisal guide angle, lateral anterior guidance angle, slide from centric occlusion to intercuspal position, and to determine variations between different groups of participants (British Standards Institution's incisal classification and Angle's classification). The purpose of the second part of the investigation was to study the reproducibility of the centric relation records between participants with disc displacement with reduction, and participants with healthy temporomandibular joints. The purpose of the third part of the study was to determine precision between two methods of bite splint fabrication: KTS system and average facebow transfer with average values of the articulator settings. Methods: All measuremets were performed using an ultrasonic device for jaw kinematics measurements and analysis with six degrees of freedom. In the second part of the study three centric relation records using the chin point guidance technique were determined for each subject, and variations between condylar positions were measured. The third part of the study involved 15 participants, who received two stabilization splints; one was made with the KTS system of the articulator settings, and the second one with an average facebow transfer and average values of the articulator settings. Precision of these two methods was tested. Results: Angle class I, II/1 and II/2 showed no difference in average values of the articulator settings with the KTS system. Angle class III group showed lower values for the sagittal condylar inclination, incisal guidance angle and lateral anterior guidance angle. The average value for the Bennett angle was 8°, consistent for all occlusion types. All the participants showed 0 mm for the immediate side shift. The obtained average value for centric occlusion to intercuspal position slide was 0.68 mm, with anteroinferior direction being the most frequent. An identical position for centric occlusion and intercuspal position was determined in less than 10% of the subjects. In the second part of the study, no statistically significant differences were determined between the two groups. The third part of the study showed no statistically significant difference in precision between the two studied methods. Conclusion: Results suggest lower values for the sagittal condylar inclination, incisal guidance angle and lateral anterior guidance angle for average articulator settings in patients with Angle class III. Differences in Bennett angle values in different occlusion types are not expected. If the immediate side shift is defined as an „immediate“ movement, it should not be expected in subjects with healthy temporomandibular joint. Results of the present study suggest that during centric relation recording in patients with disc displacement with reduction a different approach than usual cannot be recommended. Although there was no difference in precision between the two studied methods, the results suggested facebow transfer with individual articulator settings as the most precise method for the bite splint fabrication.

Objective: To determine the effect of different prosthodontic treatment options on patient's chewing function (CF) and oral health related quality of life (OHRQoL). Method: Patients treated with 138 complete dentures (CD), 114 removable partial dentures (RPD), 52 fixed partial dentures (FPD), 34 implant-supported complete dentures (CDi), 8 removable partial implant-supported dentures (RPDi) and 58 implant-supported fixed partial dentures (FPDi) took a part in this study (a total of 404 patients). The survey was conducted using two questionnaires: the OHIP-CRO14 for the assessment of OHRQoL and the Chewing function questionnaire (CFQ) for the assessment of a chewing function. The questionnaires have been administrated twice: the first time prior the therapy had begun and the second time three months after the prosthodontic treatment had been finished. Statistical analysis included descriptive statistics, paired t test and effect size calculation. Result: The CFQ and the OHIP summary scores significantly decreased after all types of prosthodontic treatment, revealing significantly better OHRQoL and better CF after treatment (p

Kinematika donje čeljusti posebno je zanimljivo područje u znanstvenom i kliničkom smislu. Temeljem novih spoznaja i primjenom suvremene metodologije može se utjecati na unapređenje uvriježenog načina rada. Istraživanje je podijeljeno u tri dijela u kojima su sva mjerenja učinjena korištenjem ultrazvučnog uređaja za snimanje i analizu kinematike donje čeljusti, sa šest stupnjeva slobode. Cilj prvog dijela (N=104) bilo je utvrđivanje vrijednosti kuta nagiba kondilne staze, imedijatnog pomaka u stranu, Bennettovog kuta, kuta incizijskog vođenja, kuta lateralnog prednjeg vođenja i pomaka iz okluzije centrične relacije u maksimalnu interkuspidaciju, te utvrđivanje razlika između različitih skupina ispitanika (prema British Standard Instituteu i klasifikaciji po Angleu). Kod klase I, II/1 i II/2 po Angleu nisu utvrđene razlike prosječnih vrijednosti postavki artikulatora putem KTS sustava. Kod klase III po Angleu su utvrđene u prosjeku niže vrijednosti kuta incizijskog vođenja, kuta lateralnog prednjeg vođenja i kuta nagiba kondilne staze, te su za pacijente s Angle klasom III sugerirane niže vrijednosti prosječnih postavki tih parametara artikulatora. U svih ispitanika imedijatni pomak u stranu je iznosio 0 mm. Ako je imedijatni pomak u stranu definiran kao trenutni pomak ne treba ga očekivati kod ljudi sa zdravim TMZ. Prosječna vrijednost Bennettovog kuta iznosila je 8°, bez razlika prema klasama okluzije. Utvrđena je prosječna vrijednost pomaka iz okluzije centrične relacije u maksimalnu interkuspidaciju od 0, 68 mm, uz najčešći anteroinferiorni smjer. Podudaranje okluzije centrične relacije i maksimalne interkuspidacije utvrđeno je u manje od 10% ispitanika. Svrha drugog dijela istraživanja bila je analiza ponovljivosti određivanja centrične relacije kod ispitanika s dislokacijom diska s redukcijom, i ispitanika sa zdravim TMZ. Svim ispitanicima su određena tri registrata centrične relacije metodom vođenja brade, te su mjerene razlike položaja kondila. Statistička obrada nije utvrdila razliku između dvije promatrane skupine. Drukčiji pristup pacijentima s dislokacijom diska s redukcijom prilikom određivanja centrične relacije ne može se preporučiti. U treći dio istraživanja uključeno je 15 ispitanika kojima su napravljene po dvije stabilizacijske udlage ; jedna korištenjem KTS sustava individualizacije artikulatora, a druga prijenosom obraznim lukom uz prosječne postavke artikulatora. Statističkom obradom nije utvrđena značajna razlika u preciznosti između dvije metode. Ipak, granični rezultati sugeriraju prijenos obraznim lukom uz individualizaciju vrijednosti artikulatora kao precizniju metodu.

Most of the literature states that slide from centric relation occlusion (OCR) to intercuspal position (ICP) occur at approximately 90% of people, and on average is 1 mm long. The purpose of this study was to test the possible differences in OCR-ICP slide between different Angle classes of occlusion. Study included 98 participants (58 class I, 10 class II/1, 14 class II/2, 16 class III). Each participant gave written informed consent, which was approved by the Ethical Committee of the School of Dentistry, University of Zagreb. Recordings were obtained by the electronic ultrasound measuring device (Arcus Digma II, Kavo, Germany), using module “EPA- Electronic Position Analysis”. Reference position was ICP, while OCR was achieved with training participants to move mandible posteriorly (no guidance). Data were transferred to the computer, and processed and analyzed with device's software. For every participant, distance between ICP and OCR was measured (x-anteroposterior, y-vertical, z-transversal values). Analysis of variance, followed by Newman-Keuls test was applied. Analysis of variance showed significant differences in vertical values of OCR-ICP slide (p=0.045). Newman-Keuls test for vertical distances between tested groups showed significant difference between II/2 and II/1 (p=0.049), and between II/2 and I (p=0.043). Out of 98 participants, none showed coincidence of OCR and ICP position. Unlike other studies, Angle class II/2 showed smaller movements in vertical direction, in comparison with Angle class I and II/1. Since function and morphology of the TMJ are closely related, it is possible that smaller OCR- ICP slide in vertical direction, as expression of anatomy/function, happens at Angle class II/2. This could be explained by „locked occlusion“, and posterior condylar position in Angle class II/2 advocated by some authors. In concordance with novel studies, coincidence of OCR and ICP position is less than 10 %.