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Biopsychosocial factors have an important role in the background of temporomandibular disorders (TMD). Diagnostic Criteria for TMD (DC/TMD) have recently been developed based on the previous RDC/TMD (Research Diagnostic Criteria for TMD). Both criteria include Axis I for clinical diagnoses and Axis II for psychosocial assessment. The aim of the study was to compare the Finnish versions of the RDC/TMD and DC/TMD Axis II instruments and to evaluate their internal reliability. The study also compared the applicability of Graded Chronic Pain Scale (GCPS 1.0 in RDC/TMD-FIN vs. 2.0 in DC/TMD-FIN) pain intensity/interference assessments for biopsychosocial subtyping of TMD pain patients. The aim was also to evaluate the association of pain-related intensity/interference with the outcome of conservative treatment of TMD. The first study sample included 197 TMD pain patients from Finnish university hospitals. The patients filled in DC/TMD-FIN and RDC/TMD-FIN Axis II questionnaires and questionnaires with additional pain-related, biopsychosocial and treatment-related variables. The patients were clinically examined based on DC/TMD Axis I protocol. They were categorized into TMD subtypes 1–3 according to GCPS 1.0 and 2.0. In another study sample, 80 TMD pain patients in tertiary care were categorized into TMD subtypes 1–3 based on GCPS 1.0 at baseline. Patients were treated conservatively. At follow-up visits during 1 year they evaluated their pain intensity and described the treatment outcome and TMD symptom severity. The DC/TMD and RDC/TMD Axis II psychosocial instruments showed significant correlation and high internal reliability and internal inter-item consistency. Patients in TMD subtype 3 had biopsychosocial symptoms and reported previous healthcare visits significantly more often than the others. In the follow-up study, patients with TMD subtype 3 described their symptoms as most severe at each follow-up. The Finnish versions of the DC/TMD Axis II psychosocial, Tiivistelmä Biopsykososiaalisilla tekijöillä on tärkeä rooli purentaelimistön kipujen ja toimintahäiriöiden (TMD) taustalla. Diagnostiset kriteerit purentaelimistön kivulle ja toimintahäiriölle (DC/TMD, Diagnostic Criteria for TMD) on hiljattain kehitetty, ja ne pohjautuvat aikaisempaan RDC/TMD (Research Diagnostic Criteria for TMD) -kriteeristöön. Kriteeristöt koostuvat Axis I -osasta, jonka avulla tehdään somaattinen diagnoosi, ja Axis II -osasta, jota käytetään psykososiaaliseen arviointiin. Tutkimuksen tavoitteena oli verrata RDC/TMD- ja DC/TMD Axis II -instrumenttien suomenkielisiä versioita, arvioida niiden sisäistä reliabiliteettia ja verrata kivun haitta-astetta kuvaavien (Graded Chronic Pain Scale, GCPS 1.0 RDC/TMD-FIN vs. GCPS 2.0 DC/TMD-FIN) kyselyjen soveltuvuutta jaotella TMD-kipupotilaita biopsykososiaalisiin alaluokkiin kivun intensiteetin/toimintahaitan perusteella. Tavoitteena oli myös arvioida toimintahaitan yhteyttä konservatiivisen TMD-hoidon vasteeseen. Ensimmäiseen otokseen kuului 197 TMD-kipupotilasta Suomen yliopistollisista sairaaloista. Potilaat täyttivät DC/TMD-FIN- ja RDC/TMD-FIN Axis II -kyselylomakkeet sekä lisäkyselyt koskien kipua, biopsykososiaalisia tekijöitä ja hoitoon liittyviä muuttujia. Potilaat tutkittiin kliinisesti DC/TMD Axis I -protokollan mukaan. Heidät luokiteltiin TMD-alaluokkiin (1–3) GCPS 1.0- ja GCPS 2.0-kyselyjen pohjalta. Toisessa otoksessa 80 erikoissairaanhoidon TMD-kipupotilasta luokiteltiin TMD-alaluokkiin (1–3) GCPS 1.0 -kyselyn pohjalta. Seurantakäynneillä 1 vuoden aikana he arvioivat kipunsa voimakkuutta, saadun hoidon vastetta ja TMD-oireiden vakavuutta. DC/TMD- ja RDC/TMD Axis II -psykososiaaliset instrumentit korreloivat merkitsevästi, ja niiden sisäinen reliabiliteetti ja kysymysten välinen konsistenssi todettiin korkeiksi. TMD-alaluokan 3 potilailla oli biopsykososiaalisia oireita ja aiempia terveydenhoidon käyntejä merkitsevästi useammin kuin muilla. Seuranta-tutkimuksessa TMD-luokan 3 potilaat kuvailiv

Background: Pain related to temporomandibular disorders (TMD) can be linked with multiple site pain (MSP), and may associate with increased pain sensitivity, more frequently among women than men. The aim of the study was to examine the associations of pressure pain threshold (PPT) and tolerance (PPTo) with TMD and associated MSP in the Northern Finland Birth Cohort 1966 (NFBC1966) study. Methods: Altogether 1961 NFBC1966 subjects attended clinical medical and dental examination at the Institute of Dentistry, University of Oulu in 2012–2013. Clinical examinations were carried out using a modified Diagnostic Criteria for TMD protocol (DC/TMD). MSP was defined based on questions regarding body pain sites. Additionally, PPT and PPTo were assessed using algometer measurements. Mann–Whitney U-test and Tobit regression models were used to analyse associations between TMD sub-diagnoses, MSP, PPT and PPTo, stratified by sex. Further models were adjusted with anxiety and depressive symptoms, which were assessed using Hopkins Symptom Checklist-25 (HSCL-25) and two-way interaction terms. Results: Among females, lower PPT and PPTo were associated with myalgia and arthralgia. Among males, lower PPT and PPTo were associated with MSP-linked TMD. Tobit regression analysis showed significantly lower PPT and PPTo values in the myalgia and arthralgia subgroups among female TMD subjects. Among females, disc displacement with reduction had an inverse association with PPT and PPTo. Among males, lower PPTo was associated with degenerative joint disease and MSP-linked TMD. Conclusions: The pain regulatory mechanisms behind TMD act differently between the genders as local TMD among females and MSP-linked TMD among males were associated with pain sensitivity. Significance: The study shows that there are differences in the associations of painful TMD with pressure pain tolerance, pressure pain sensitivity and MSP between male and female subjects.

Aims: To compare the suitability of Graded Chronic Pain Scale (GCPS) pain intensity and interference assessments (GCPS version 1.0 vs 2.0) for the biopsychosocial screening and subtyping of Finnish tertiary care referral patients with TMD pain. Methods: Altogether, 197 TMD pain patients participated in this study. All patients received Axis II specialist-level psychosocial questionnaires from the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD-FIN) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD-FIN), as well as questionnaires for the assessment of additional pain-related, biopsychosocial, and treatment-related variables. Clinical examinations were performed according to the DC/TMD Axis I protocol. The patients were categorized into TMD subtypes 1, 2, and 3 (GCPS I and II-low; II-high; and III and IV, respectively) based on their biopsychosocial profiles according to GCPS versions 1.0 and 2.0. Results: The distribution of TMD pain patients into TMD subtypes was similar according to the GCPS 1.0 compared to the GCPS 2.0. Over 50% of the patients were moderately (TMD subtype 2) or severely (TMD subtype 3) compromised. Patients in subtype 3 experienced biopsychosocial symptoms and reported previous health care visits significantly more often than patients in subtypes 1 and 2. Patients in subtype 2 reported intermediate biopsychosocial burden compared to subtypes 1 and 3. Conclusions: TMD pain patients differ in their biopsychosocial profiles, and, similarly to the GCPS 1.0, the GCPS 2.0 is a suitable instrument for categorizing TMD tertiary care pain patients into three biopsychosocially relevant TMD subtypes. The GCPS 2.0 can be regarded as a suitable initial screening tool for adjunct personalized or comprehensive multidisciplinary assessment.

Temporomandibular disorders (TMD) comprise pain and disorders in the masticatory muscles, temporomandibular joints (TMJs), and adjacent tissues. The reported association varies between TMD and its background factors, such as psychological distress, other body pain, and recently much debated bruxism. Students comprise a special population at high risk for TMD with various individual stressors. Applied relaxation (AR) is a coping strategy developed to manage stressors; thus, it could also be applicable to TMD patients. The aims of the study were to investigate the prevalence of TMD and bruxism, their mutual association, and their association with perceived risk factors in university students. The population sample in the Finnish Student Health Service (FSHS) survey in 2012 and 2016 consisted of a total of 7 646 students. The survey included questions on TMD symptoms, bruxism, distress (General Health Questionnaire-12), and other pains. Another aim was to investigate the effectiveness of the AR method in the treatment of TMD as compared to stabilization splint (SS). The sample in a randomized controlled trial consisted of 96 students, who were randomly assigned into two intervention groups: AR and SS group. Data on clinical examinations according to modified Axis I protocol of the Diagnostic Criteria for Temporomandibular Disorders, and on pain variables and psychosocial symptoms according to Axis II questionnaires of the Research Diagnostic Criteria for Temporomandibular Disorders with supplements were collected at baseline and at 3-, 6-, and 12-month follow-ups. The prevalence of TMD pain, TMD pain on jaw movement, and TMJ locking was higher in 2016 as compared to 2012. Women reported TMD symptoms more than twice as much as men. Only minor differences in the prevalence of self-reported awake, sleep, and both awake and asleep bruxism were seen between 2012 and 2016. The mutual association between TMD and bruxism was significant, as were their associations wit, Tiivistelmä Purentaelimistön toimintahäiriöt (engl. temporomandibular disorders, TMD) koostuvat puremalihasten, leukanivelten ja läheisten kudosten alueilla esiintyvistä kivuista ja toimintahäiriöistä. TMD:n ja sen taustatekijöiden, kuten psykologisen kuormittuneisuuden, muiden kipujen ja viime aikoina paljon keskustellun narskuttelun yhteys vaihtelee aiemmissa tutkimuksissa. Väestöryhmänä opiskelijat ovat alttiita TMD:lle omaleimaisten stressitekijöidensä vuoksi. Sovellettu rentoutus (AR) on stressitekijöiden käsittelyyn kehitetty elämänhallinta-menetelmä, joka voisi soveltua myös TMD-potilaille. Tutkimuksen tavoitteena oli selvittää TMD:n ja narskuttelun esiintyvyyttä, keskinäistä yhteyttä ja yhteyttä koettuihin riskitekijöihin yliopisto- ja ammattikorkeakouluopiskelijoilla. Ylioppilaiden Terveydenhoitosäätiön organisoimaan väestötutkimukseen osallistui vuosina 2012 ja 2016 kaikkiaan 7 646 opiskelijaa. Väestötutkimuksessa kysyttiin TMD-oireista, narskuttelusta, psyykkisestä kuormittuneisuudesta (General Health Questionnaire-12) ja muista kehon kivuista. Lisäksi tavoitteena oli tutkia AR-menetelmän vaikuttavuutta TMD:n hoidossa verrattuna stabilisaatiokiskoon (SS). Satunnaistettuun kliiniseen tutkimukseen osallistui 96 opiskelijaa, jotka jaettiin AR-ryhmään ja SS-ryhmään. Tutkimuksessa käytettiin kansainvälisen diagnostisen kriteeristön (engl. Diagnostic Criteria for TMD) mukaista purentaelimistön tutkimusta (modifioitu Axis I) ja RDC/TMD-kyselykaavaketta (engl. Research Diagnostic Criteria for TMD, RDC/TMD) täydennyksineen. TMD-kipuoireita levossa ja leuan liikkeessä sekä leukanivelen lukkiutuminen esiintyi enemmän vuonna 2016 kuin 2012. TMD-oireiden esiintyvyys oli naisilla yli kaksi kertaa yleisempää kuin miehillä. Narskuttelua valveilla, nukkuessa ja sekä valveilla että nukkuessa esiintyi vuosina 2012 ja 2016 lähes yhtä paljon. TMD:n ja narskuttelun keskinäinen yhteys oli tilastollisesti merkitsevä, samoin yhteys kohonneeseen psyykkiseen kuormittuneisuuteen ja

Objectives: The aim of this study was to evaluate the association of psychosocial distress and widespread pain with self-reported symptoms of temporomandibular disorders (TMD) and bruxism, in two cross-sectional surveys in 2012 and 2016, and whether there are temporal changes in the magnitude of associations. Materials and methods: The data were gathered from Finnish university students in 2012 and 2016. TMD symptoms were assessed with three validated questions and bruxism with one frequently used question. Psychosocial distress was assessed with the General Health Questionnaire-12 (GHQ-12), and widespread pain with questions of pain in the extremities, the neck or upper back, and lower back. The associations of GHQ-12, widespread pain and background variables with TMD symptoms and bruxism were analyzed with chi-square tests, t-test and binary logistic regression models stratified by gender, and adjusted for age-group, self-reported general health/wellbeing and presence of widespread pain. Results: Higher GHQ-12 score and presence of widespread pain were significantly associated with TMD symptoms in both genders at both time points. The association of higher GHQ-12 score with sleep bruxism and awake bruxism were inconsistent. In the adjusted model higher GHQ-12 score and widespread pain were significantly related to TMD pain symptoms in both genders at both time points, and to bruxism in 2012. Between the two time points a greater variability in these associations was seen in men than in women. Conclusions: Psychological distress and widespread pain are significant determinants in perceived TMD pain and bruxism among students. No significant temporal alterations were observed.

Objectives: The aim of this retrospective data collection study was to determine the effect size of dry mouth on the survival of restorations and teeth. Methods: The data were collected from the electronic patient files of City of Oulu Public Dental Services (Finland). Study population consisted of 71 dry mouth patients and 142 control patients. The survival of 3208 restorations were analyzed using Kaplan-Meier survival curves and multivariate Cox regression analysis with shared frailty for patients. Separate analyses were performed for the survival of the teeth. Results: The hazard ratio of restorations in dry mouth patients was 2.08 (95% CI: 1.65–2.63) compared to the control patients. For the dry mouth patients, the fixed prosthetic crowns outlasted composite fillings of all sizes, but the difference increased concomitantly with the filling size. The dry mouth patients had hazard ratio of 1.98 (95% CI: 1.02–3.82) for tooth extractions compared to the control patients. The teeth with fixed prosthetic crowns outlasted the teeth with direct restorative materials. Conclusions: The survival time of restorations and teeth are severely shortened in patients with dry mouth. Especially the survival time of the large composites is short in dry mouth patients whereas fixed prosthetic crowns have acceptable survival time also in dry mouth patients. Clinical significance: When informing a dry mouth patient on the expected survival of a restoration or tooth, one should take into account that dry mouth patients’ restorations and teeth have severely shortened survival time.

Objective: To investigate the prevalence of self-reported bruxism and its association with temporomandibular disorders (TMD). The hypothesis of the study was that self-reported bruxism is associated with TMD. Methods: The data were gathered from 1962 subjects who participated in a field study in 2012–2013, including a questionnaire concerning bruxism and TMD symptoms as well as clinical sub-diagnoses of TMD using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Statistical method was chi-square test. Bonferroni correction was made, and a p-value of <0.003 was considered as significant. Results: The prevalence of self-reported bruxism was 39.6%: 34.0% in men and 44.5% in women. Those who reported sleep bruxism (SB) or awake bruxism (AB) had significantly more pain-related TMD symptoms and signs compared to those not reporting bruxism. Conclusions: The prevalence of self-reported bruxism is high among middle-aged adults and is associated with TMD pain-related symptoms and signs, as well as TMD diagnoses.

Aim: The aims were to describe the development of a modified national online OSCE during COVID-19 and assess related student feedback. Material and methods: The modified online OSCE comprising of eight question entities was organised simultaneously in all four dental institutes of Finland using the Moodle virtual learning environment. All fourth-year students (n = 179) attended the examination online at home. Student feedback was collected via an anonymous questionnaire with multiple-choice questions and open-ended questions concerning attitudes towards the modified online OSCE, as well as content and usability of the question entities in the examination. Means and standard deviations were calculated for multiple-choice questions. Content analysis was used for open-ended questions. Results: Of 179 students, 119 (66%) consented to the study. Students experienced they had received adequate information (mean 3.8; SD 1.2), had a positive attitude before the examination (4.0; 1.0) and found the practice test useful (3.7; 1.1) (range 1–5). Technical implementation (2.7; 0.7) and the difficulty of the questions (2.9; 0.6) (range 1–4) were found to be good. The teaching students received during their studies was sufficient (3.2; 0.5) (range 1–4). Content (mean 3.2; 0.4) and usability (2.9; 0.4) of the question entities were good (range 1–4). The themes arising from open-ended questions were importance and practicality of the topic (in questions) in relation to the work of a dentist and gratitude for the rapid conversion of the OSCE into an online examination despite COVID-19. The themes arising from negative experiences included difficulties in completing the examination within the time allocated, and dissatisfaction with the model answers provided after the examination. Conclusion: The positive student feedback towards the modified online OSCE encourages including an online examination to complement the traditional OSCE.

Introduction: For over the last 20 years, approximately 70% of working dentists in Finland have been women. However, there is internal division of the profession along gender lines. Female dentists work more often in the public sector and male dentists in the private sector. The aim of this study was to investigate the gender differences in young dentists’ early career choices, specialization plans, values and perceptions of professional identity. Materials and methods: The data were taken from a national e‐mail questionnaire study called “Young Dentist,” which was sent to 458 dentists who had received their licence to practise dentistry in 2014‐2016 from all four universities with dental curricula in Finland. A total of 52% young dentists (n = 238) answered the questionnaire. Results and discussion: The results indicated that whereas female dentists were more likely to perceive themselves as comforters, social workers and health promoters, male dentists tended to perceive themselves as technicians. These professional identities were interrelated with early‐stage career choices in which female dentists worked more often in the public than in the private sector when compared to male dentists. There were also clear gender differences in the importance of values and the specialization plans of the young dentists. Conclusion: Young dentists in Finland make career choices and develop professional identity in accordance with the attributes traditionally associated with cultural ideals related to femininity and masculinity.

Tooth loss adversely affects patients’ quality of life and causes inevitable changes in the mandibular morphology. Polymethyl methacrylate (PMMA) is the most frequently used material of removable dentures. Denture stomatitis (DS) is a common clinical finding among denture wearers, particularly patients with debilitating diseases. Several fillers and nanofillers have been used to improve the physical, mechanical, antifungal, and antimicrobial properties of PMMA. The aim of the present retrospective cross-sectional study was to determine the prevalence of tooth loss and the commonly used prosthetic constructions in 479 adult patients at the Department of Substitutive Dental Sciences (SDS), College of Dentistry, University of Dammam, currently Imam Abdulrahman Bin Faisal University, Dammam. The influence of tooth loss on mandibular morphology was studied by using cone-beam computed tomographic (CBCT) scans of 101 patients. The effect of addition of thymoquinone (TQ) and nanodiamonds (NDs) to PMMA on the flexural and surface properties of PPMA and their antifungal influence was tested through in vitro studies. Edentulousness was recorded in 6%, a single edentulous arch in 8%, and partial edentulousness in 74% of the patients. Age and diabetes were significantly associated with edentulousness. Males had a significantly higher number of missing teeth compared to females. Kennedy class III was most common in the upper and lower jaw and was treated more often with fixed partial denture (FPD) than with removable partial denture (RPD). Larger gonial angle (GA) of the mandible was found in edentulous patients, in females and in older compared to dentate patients, males and younger patients. The addition of TQ to PMMA at low concentration did not significantly change the flexural strength, elastic modulus or surface properties of PMMA. The addition of NDs to PMMA significantly reduced surface roughness and the Candida albicans (C. albicans) count. Edentulousness increa, Tiivistelmä Hampaattomuus vaikuttaa potilaiden elämänlaatuun ja aiheuttaa alaleuan muodon muutoksia. Hampaattomuutta ja hammaspuutoksia voidaan hoitaa purennan kuntoutuksella irtoproteeseilla ja kiinteällä protetiikalla. Polymetyylimetakrylaatti (PMMA) on yleisimmin käytetty irtoproteesien materiaali. Suun sieni-infektio, proteesistomatiitti, on yleinen kliininen löydös proteesipotilailla ja erityisesti potilailla, joilla on yleiskuntoa heikentäviä sairauksia. Erilaisia lisämateriaaleja on käytetty parantamaan PMMA:n fysikaalisia, mekaanisia ja antimikrobisia ominaisuuksia. Tämän retrospektiivisen poikittaistutkimuksen tarkoituksena oli kartoittaa hampaattomuuden ja hammaspuutosten esiintyvyys ja toteutetut proteettiset hoidot 479 saudiarabialaisella aikuispotilaalla, jotka oli hoidettu Dammanin yliopiston hammaslääketieteen laitoksella. Hammaspuutosten vaikutusta alaleuan muotoon tutkittiin 101 potilaan kartiokeilatietokonetomografia (KKTT) kuvista. Tymokinonin (thymoquinone, TQ) ja nanotimanttien (ND) lisäyksen vaikutusta PPMA:n taivutuslujuuteen ja pintaominaisuuksiin sekä niiden antimikrobisia ominaisuuksia tutkittiin in vitro kokein. Täydellistä hampaattomuutta oli 6 %:lla, ylä- tai alaleuan hampaattomuutta 8 %:lla ja osittaista hampaattomuutta 74 %:lla potilaista. Hampaattomuutta lisäsivät merkittävästi potilaan ikä sekä yleissairauksista diabetes. Miehillä oli merkittävästi enemmän omia hampaita jäljellä kuin naisilla. Hammaspuutosten sijainnin luokittelussa Kennedyn luokka III oli yleisin sekä ylä- että alaleuassa ja puutos oli useammin hoidettu kiinteällä siltaratkaisulla kuin irrotettavalla osaproteesilla. Alaleuan leukakulma oli hampaattomilla, naisilla ja vanhemmilla potilailla suurempi kuin hampaallisilla, miehillä ja nuoremmilla potilailla. Alhainen TQ-pitoisuus ei merkittävästi muuttanut PMMA:n taivutuslujuutta, kimmomoduulia eikä sen pintaominaisuuksia. Nanotimanttien lisäys vähensi merkittävästi PMMA:n pinnankarheutta ja Candida albicans-kasvustoa.

Temporomandibular disorders (TMD) are described as a variety of dysfunctions and pains related to the masticatory system. Clicking in the temporomandibular joints (TMJs) and pain in the masticatory muscles are the most common symptoms and signs of TMD. Other frequently reported symptoms are headache, facial pain, and symptoms in the ears. The prevalence of TMD signs in the adult population has been shown to vary between 33% and 86%, being more common in women than in men. TMD has been found to be most prevalent at 20–50 years of age. The aim of this cross-sectional study was to investigate the prevalence of TMD and associated risk factors in the Finnish adult population based on the Northern Finland Birth Cohort (NFBC) 1966. Altogether 1 962 cohort subjects at the age of 46 years (1 050 women, 912 men) responded to questionnaires and participated in a clinical medical and dental examination in 2012–2013. The stomatognathic examination was performed according to a modified protocol of diagnostic criteria for TMD (DC/TMD). The prevalence of TMD signs among the examined cohort subjects was 34.2%; women had clinical signs of TMD more often than men. Clinical signs were registered more often than self-reported TMD symptoms. The most common clinical signs were clicking in the TMJs (26.2%) and palpation pain in the masticatory muscles (11.2%). The most common diagnosis was disc displacement with reduction (7.0%). TMD signs were associated with unstable occlusion. Occlusal disturbances were associated with palpation pain in the masticatory muscles, as well as myalgia and arthralgia diagnoses. Pain-related TMD symptoms and clinical signs correlated strongly with a poor self-reported health condition as well as with painful general health problems., Tiivistelmä Purentaelimistön toimintahäiriöt (engl. temporomandibular disorders, TMD) on yhteisnimitys leukanivelten, puremalihasten, hampaiston ja niihin liittyvien kudosten sairaus- ja kiputiloille. Leukanivelen naksuminen ja kipu purentaelimistön alueella ovat tavallisimmat oireet, mutta myös päänsärky, kasvokipu ja korvaoireet ovat yleisiä TMD-potilailla. Väestötutkimuksissa on havaittu suurta vaihtelua TMD:n esiintyvyydessä (33–86 %). TMD:n oireita sekä löydöksiä todetaan tavallisimmin 20–50-vuotiailla ja naisilla enemmän kuin miehillä. Tutkimuksen tarkoituksena oli selvittää TMD:n esiintyvyyttä ja riskitekijöitä suomalaisessa aikuisväestössä Pohjois-Suomen syntymäkohortti 1966:n (Northern Finland Birth Cohort, NFBC) aineistossa. Vuosina 2012–2013 tutkittiin 1 962 kohortin henkilöä 46 vuoden ikäisinä (1 050 naista, 912 miestä). Tutkimus koostui kyselyistä sekä lääketieteellisestä ja suun terveydentilan kliinisestä tutkimuksesta. Purentaelimistön tutkimuksessa käytettiin kansainvälistä TMD:n diagnostista kriteeristöä (engl. diagnostic criteria for TMD, DC/TMD). TMD-löydösten esiintyvyys tutkitussa kohorttiaineistossa oli 34,2 %. Kliiniset löydökset tutkituilla henkilöillä olivat yleisempiä kuin heidän raportoimansa oireet. Yleisimmät löydökset olivat leukanivelen naksuminen (26,2 %) ja palpaatiokipu puremalihaksissa (11,2 %). Yleisin diagnoosi oli leukanivelen välilevyn palautuva virheasento (7,0 %). TMD-löydösten ja epästabiilin purennan välillä havaittiin yhteys. Purennassa olevien häiriöiden ja puremalihasten palpaatiokivun sekä leukanivelkivun välillä todettiin selvä yhteys. TMD-löydöksillä ja niihin liittyvillä kivuilla havaittiin tilastollisesti merkitsevä yhteys koettuun heikentyneeseen terveydentilaan sekä kivuliaisiin yleissairauksiin.

Metal ceramic restorations have been used in fixed prosthodontics since the 1950s, but the lack of aesthetics, the inclination to use metal-free materials, possible allergic reactions to metals, and the high cost of high noble alloys have increased the use of all-ceramic materials. The ongoing development of ceramic materials led to the introduction of zirconia to fixed prosthodontics over a decade ago. The mechanical properties of zirconia have proven to be excellent, but the clinical outcome of conventional fixed zirconia restorations over the long term is unclear. This retrospective clinical study evaluated two- to seven-year outcomes, early complications during prosthetic treatment and short-term failures during the first year of use of zirconia single crowns and fixed dental prostheses (FDPs). The usefulness and durability of zirconia single crowns in abutment teeth of partial removable dental prostheses (RDPs) was also evaluated. The material consisted of 173 patients treated with zirconia single crowns or FDPs by undergraduate dental students between 2007 and 2010. Of these patients 94 were women and 79 men (mean age 55 years, range 18–79 years). Altogether 268 zirconia single crowns (mean 3 crowns, range 1–12 crowns per patient) had been fabricated for 88 patients and 120 zirconia FDPs (range 3–12 units, mean 4.5 units) for 102 patients. Seventeen patients had received both crown(s) and FDP(s). The results show that zirconia single crowns and FDPs are a suitable treatment alternative in fixed prosthodontics. Early complications during prosthetic treatment and short-term failures during the first year of use were few. The survival rate of the zirconia single crowns after 3.9 years (2–6 years) was 89% and the success rate was 80%. The survival rate of zirconia FDPs after 4.9 years (3–7 years) was 100% and the success rate was 89%. Zirconia single crowns perform well as abutment teeth of partial RDPs with a metal framework, but fractures in the veneeri, Tiivistelmä Metallokeraamisia rakenteita on käytetty kiinteässä protetiikassa 1950-luvulta lähtien, mutta puutteet estetiikassa, pyrkimys metallittomiin materiaaleihin, mahdolliset allergiset reaktiot ja jalojen metallien korkea hinta ovat lisänneet kokokeraamisten materiaalien käyttöä. Kokokeraamisten materiaalien kehitystyö on tuonut zirkonian kiinteän protetiikan materiaaliksi. Zirkonian mekaaniset ominaisuudet ovat osoittautuneet erinomaisiksi, mutta hammaskantoisten kiinteiden zirkonia-runkoisten proteesien kliiniset pitkäaikaistulokset puuttuvat. Tämän retrospektiivisen kliinisen tutkimuksen tarkoituksena oli selvittää zirkonia-runkoisten yksittäisten kruunujen ja zirkonia-runkoisten siltojen menestymistä 2–7 vuoden aikavälillä sekä kartoittaa niiden valmistuksen aikaiset ongelmat ja varhaiset epäonnistumiset ensimmäisen vuoden aikana. Lisäksi tutkittiin zirkonia-runkoisten yksittäisten kruunujen käyttökelpoisuutta ja kestävyyttä metallirunkoisten rankaproteesien tukihampaina. Materiaali koostui 173 potilaasta, joille hammaslääketieteen opiskelijat olivat tehneet zirkonia-runkoisia yksittäisiä kruunuja tai zirkonia-runkoisia siltoja vuosina 2007–2010. Potilaista 94 oli naisia ja 79 miehiä (keski-ikä 55 vuotta, jakauma 18–79 vuotta). Kaiken kaikkiaan 268 zirkonia-kruunua (keskimäärin 3 kruunua, jakauma 1–12 kruunua potilasta kohti) oli valmistettu 88 potilaalle ja 120 siltaa (keskimäärin 4,5 yksikköä, jakauma 4,5 yksikköä) 102 potilaalle. Seitsemälletoista potilaalle oli tehty sekä kruunuja että siltoja. Tulokset osoittavat, että zirkonia-runkoiset kruunut ja sillat ovat käyttökelpoisia kiinteässä protetiikassa. Valmistuksenaikaiset ongelmat ja varhaiset epäonnistumiset ovat vähäisiä. Yksittäisten kruunujen selviytymisprosentti 3,9 vuoden jälkeen (2–6 vuotta) oli 89 % ja onnistumis-prosentti 80 %. Siltojen selviytymisprosentti 4,9 vuoden jälkeen (3–7 vuotta) oli 100 % ja onnistumisprosentti 89 %. Zirkonia-runkoiset kruunut toimivat hyvin rankojen tukihampaina