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AIMS: To evaluate the relationships between gender, diagnosis, and severity of temporomandibular disorders (TMD) with self-reports of the impact of TMD on the quality of life. METHODS: Eighty-three individuals seeking TMD treatment at the Dental School of Pontifical Catholic University Minas from May to August 2005 were evaluated by a single examiner who was trained and calibrated for diagnosis according to criteria of Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). The severity of TMD was established by the Temporomandibular Index and the impact on quality of life by the Oral Health Impact Profile (OHIP 14). Complete data were available for 78 of the 83 initial patients and evaluated by the Mann-Whitney test and Spearman correlation analysis. RESULTS: Except for one patient, all individuals showed some impact related to physical pain. Of the seven aspects evaluated on the OHIP 14, women presented a greater impact than men only for functional limitations (Mann-Whitney, P < .05). Patients presenting with diagnoses of muscular disorders (group I) or osteoarthritis (group III) reported a greater impact than those without (P < .05). The Spearman test demonstrated a significant correlation between impact on quality of life and severity of TMD (P < .05). CONCLUSION: Orofacial pain had a great impact on the quality of life of individuals with TMD, without group difference between genders. The presence of muscular disorders (group I) and osteoarthritis (group III) was related to greater impact on quality of life, which was not observed for diagnoses of disc displacement (group II). A correlation between severity of TMD and impact on quality of life was clearly observed. [ABSTRACT FROM AUTHOR]

Background: Sleep-related bruxism (SB) is the habit of grinding or clenching the teeth during sleep, mediated by the non-peripheral central nervous system., Purpose: The objectives of this cross-sectional study were to evaluate associations between SB, microarousals and oxyhaemoglobin desaturations and to compare the frequency of SB and microarousals in sleep stages, in an apnoeic population., Methods: Two hundred and forty individuals composed the sample, who underwent a single full-night polysomnography. Self-reports and clinical inspections were not considered for assessing SB. The polysomnographic assessment of SB was performed using electrodes placed on masseter muscles and chin. SB was defined as more than two events of rhythmic masticatory muscle activity per hour of sleep. Microarousals were considered when there were abrupt changes in electroencephalogram frequencies, without complete awakening, lasting from 3 to 15 s. Oxyhaemoglobin desaturations were defined as significant drops (≥3%) in basal oxygen saturations. With these data, SB, microarousals and oxyhaemoglobin desaturations were evaluated and submitted to statistical analysis., Results: Statistically significant differences were observed between bruxers and non-bruxers when comparing the rates of microarousals (p < .001) and oxyhaemoglobin desaturations (p = .038). There was a higher number of SB and microarousals in NREM (non-rapid eye movement) two sleep stage (p < 0.001). Bruxers had a greater risk of higher numbers of microarousals (OR = 1.023; p = .003), which did not occur for oxyhaemoglobin desaturations (OR = 0.998; p = .741)., Conclusions: A higher number of microarousals presents relationship with SB; associations between SB and oxyhaemoglobin desaturations remained inconclusive; higher frequency of SB and microarousals was observed in NREM 2 sleep stage., (© 2024 John Wiley & Sons Ltd.)

Objective: This systematic review aimed to analyze the clinical (survival rate, failure risk, or fracture) and laboratory performance (fracture mode or failure) of rehabilitations of endodontically treated teeth, with and without posts., Materials and Methods: A systematic search was conducted in the Pubmed, Scopus, Web of Science, Embase, Cochrane Library, and OpenGrey databases up to March 2023, according to PRISMA guidelines. In vitro and clinical studies that compared the clinical and laboratory performance of endodontically treated teeth with and without intraradicular posts were included. Studies selection, data extraction, and risk of bias analysis were performed., Results: Thirty-one in vitro and 7 clinical studies were included. For in vitro studies, fiberglass post (n = 24) was the most mentioned. The follow-up time of the clinical studies ranged from 1 to 17 years, with the fiber-reinforced composite post (n = 3) being the most evaluated, and only failure risk proved to be more favorable for using intraradicular posts., Conclusion: Rehabilitations of endodontically treated teeth with and without intraradicular retainers showed no difference in fracture resistance and failure mode, evaluated by in vitro studies. Clinical studies showed no difference in survival rate, but failure risk proved to be more favorable for the use of posts., Clinical Significance: This analysis revealed significant variability between results, however, most laboratory and clinical studies revealed no difference with using the post. Furthermore, it is important to emphasize the need to evaluate the coronary remnant and the general characteristics of the tooth in each situation., (© 2024 Wiley Periodicals LLC.)

Background: Sleep bruxism (SB) is a condition regulated centrally, with a multifactorial etiology, which can occur secondary to systemic disorders and the use of certain medications., Objective: The aim of this study was to identify associations between SB, obstructive sleep apnea, and hypopnea syndrome (OSAHS) and the use of antidepressants., Material and Methods: In this cross-sectional study, 240 individuals underwent full-night polysomnography for medical reasons. Anamnesis was performed to collect data about the use of antidepressants and general health conditions. Polysomnography was performed to analyse sleep data and assess respiratory-related events and apnea and hypopnea index (AHI). The polysomnographic assessment of SB was performed, from electrodes placed on masseter muscles and chin. SB was defined by the presence of more than two events of rhythmic masticatory muscles activity per hour of sleep. Statistical analyses were performed to compare the presence of SB and AHI, the severity of OSAHS, and the use of antidepressants., Results: There were statistically significant differences between bruxers and non-bruxers when comparing AHI (48.28 ± 25.84; p = .001) and severity of OSAHS (p = .015). Regarding the use of antidepressants, comparative analyses did not show correlations with bruxism (p = .072). However, logistic regression suggests that the use of these medications may represent increased odds for SB development (OR =2.387; p = .005)., Conclusion: The relationship between the use of antidepressants and SB remains inconclusive. SB is associated with OSAHS, mainly in its severe form. Therefore, identifying SB can raise the suspicion of the occurrence of other systemic disturbances., (© 2022 John Wiley & Sons Ltd.)

Aim and Objective: This study aims to evaluate the effect of different resin cements on the bond strength (BS) of custom-made glass fiber posts (GFPs) using the push-out test., Materials and Methods: Twenty-four uniradicular bovine teeth were selected. The crowns were sectioned at the cementoenamel junction, and the root canals were treated. The post spaces of the teeth were prepared to a length of 12 mm to receive a GFP. The specimens were randomly assigned to three experimental groups ( n = 8), according to the resin cement used to fix the GFPs: RelyX U200 (U200), Allcem Core (ACC), and Allcem Dual (ACD). Each specimen was sectioned into six slices per root third (cervical, middle, and apical), which were subjected to the push-out test. BS values were calculated and compared using the Kruskal-Wallis and Friedman tests., Results: There were significant differences in the middle third, according to the resin cement type used ( p < 0.05). ACD showed lower BS values ( p < 0.05). Significant differences were observed for ACD among the thirds of the slices, with the lowest values also observed for the middle third ( p < 0.05)., Conclusion: The present study shows that ACC and U200 showed higher BS values compared with ACD, and were also less influenced by the depth of the root dentin., Clinical Significance: The restoration of endodontically treated teeth is a challenge in dentistry, and, in most cases, will require installation of fiberglass pins. In this respect, several types of resin cements are indicated for cementation of these pins; for this reason, their adhesiveness must be adequately investigated. Conventional cements and self-adhesive cements have shown satisfactory performance in cementing the custom-made GFPs, thereby making these cements satisfactory clinical choices. The present study suggests that ACD had lower performance than the other two cements evaluated.

Purpose: Short implants are increasingly being used in posterior regions to avoid grafting procedures and their related risks, costs, and morbidity. However, studies focusing on implants measuring less than 6 mm long remain scarce, and the literature does not yet have a definition of the limits inherent with their use. This study attempts to investigate whether extra-short 4-mm implants are capable of receiving a maxillary single crown., Materials and Methods: This study evaluates, through the finite element method, the stress distribution generated at implant lengths of 4 mm and 10 mm caused by different crown heights (10, 12.5, and 15 mm) in the posterior maxilla region when submitted to axial (200 N) and oblique (100 N) loads., Results: The 4-mm implant showed a similar level of performance as that of the 10-mm implant when submitted to the axial load. However, the oblique load proved to be highly detrimental to both implants, inducing stresses of up to three times higher than those achieved in conjunction with the axial load, especially in the surrounding bone and the abutment., Conclusion: The use of 4-mm short implants to support single crowns in the posterior maxilla region may be feasible in habitual conditions; however, the risk associated with significant oblique loads should be mitigated by adopting a mutually protected occlusion approach and using acrylic occlusal devices if necessary.

Purpose: To apply finite element analysis (FEA) to investigate the stress distribution in a 4-mm-high ultrashort implant when supporting crowns of different heights in order to test the possibility of using this implant unitarily in the posterior edentulous mandible., Materials and Methods: Three models of atrophic mandibles were created (M1, M2, and M3). Each model contained a 4-mm-length implant of a titanium-zirconium alloy, screw-type with internal connection, supporting nonsplinted screwed-in crowns of 10, 12.5, and 15 mm in height. Axial and oblique loads were simulated in the three model crowns., Results: In an oblique load, the stress tended to be concentrated in the lingual region. In the qualitative results of the axial load, peaks of tension occurred in the lower angle between the inner groove and the inner conical portion of the implant. Regarding the differences in crown height, the 15-mm height produced a higher stress peak due to the lever effect of the crown under an oblique load., Conclusion: Within the limits of this study, the results suggest the possibility of using single crowns of proposed heights with unitary ultrashort implants installed in the posterior edentulous mandible, so long as there is no oblique load on the crown.

The purpose of this paper is to present and discuss a simple and low-cost clinical approach to correct an asymmetric skeletal Class III combined to an extensive dental open bite that significantly compromised the occlusal function and smile aesthetics of an adult male patient. The patient did not accept the idealistic surgical-orthodontic treatment option, neither the use of temporary anchorage devices to facilitate the camouflage of the asymmetrical skeletal Class III/open bite. Therefore, a very simple and inexpensive biomechanical approach using sliding jigs in the mandibular arch was implemented as the compensatory treatment of the malocclusion. Although minor enhancements in facial aesthetics were obtained, the occlusal function and dental aesthetics were significantly improved. Furthermore, the patient was very satisfied with his new smile appearance. Some advantages of this treatment option included the small invasiveness and the remarkably low financial costs involved. Moreover, the final results fulfilled all realistic treatment objectives and the patient's expectations. Results remained stable 5 years post-treatment demonstrating that excellent results can be obtained when simple and low cost, but well-controlled mechanics are conducted.

This controlled randomized clinical trial evaluated the effect of associating at-home and in-office bleaching procedures on tooth sensitivity (TS) and bleaching effectiveness. Forty patients subjected to on session of in-office bleaching with 38% peroxide hydrogen. Subsequently, the patients were randomly allocated to receive a second session of in-office bleaching or to use a tray containing 10% carbamide peroxide delivered during 7 consecutive days. The worst TS score reported during or after each bleaching procedure was recorded using a verbal rating scale and TS risk (score different from 0) was calculated. Color changes were measured 7 days after each in-office session (for patients receiving in-office procedures only) or after the end of at-home bleaching (for the combined protocol), and 6 months after the last procedure for both bleaching protocols. Color was assessed by a spectrophotometer and by color match with the Vita Classical and Bleach guide scales. Statistical analyses were carried out to assess possible differences between the protocols regarding the outcomes and to analyze the effect of time of assessment on color changes. The bleaching protocol did not affect the risk for and the maximum level of TS reported, irrespective of the time of assessment. In the color evaluation, the bleaching protocol also did not affect the ultimate tooth color. In conclusion, after one in-office bleaching session, there was no difference in bleaching effectiveness and TS between performing a second in-office session and associating it with 1-week at-home bleaching.

This article reports the camouflage retreatment of an adult patient presenting an asymmetric Class III malocclusion and posterior open bite. Sliding jigs (SJs) associated with intermaxillary elastics were used. The long-term stability of the excellent results suggests that the use of SJs to correct asymmetric posterior occlusions may be effective.

This study evaluated the effects of the remaining coronal tissue and post type on the fracture strength of incisors. Sixty human maxillary central incisors were sectioned at the cemento-enamel junction or at 2 mm above this junction. The roots received cast cores and posts, fibre posts, or relined fibre posts (n = 10 each). A compressive load was applied over the cores untilfracture. In the absence of coronal structure, the fracture strength did not differ among the post types evaluated. In the presence of remaining coronal structure, the fracture strength was higher in specimens with cast cores and posts.

Statement of Problem: Some patients may opt for a prosthetic rehabilitation without replacing all missing teeth, finishing treatment with a reduced dental arch. This choice may be due to biologic reasons or financial restrictions. It is unclear if a reduced dental arch functions as well as a complete dental arch., Purpose: The purpose of this study was to analyze whether shortened dental arches could result in tooth displacement., Material and Methods: Four different 3-dimensional maxillary and mandibular arches with different levels of arch length reduction were created. In all models, anatomic structures that represent the temporomandibular joint, cortical and cancellous bone, enamel, dentin, and periodontal ligament were modeled. Mechanical properties were attributed to each anatomic component, and a total occlusal load of 100 N on masseter, temporal, and medial pterygoid muscles was simulated for each model. The MSC. Patran software was used for the preprocessing and postprocessing of the biomechanical analysis of the models. One complete dental arch was used as the control., Results: The simulations showed that shortened dental arches presented greater tooth displacements than those found in a complete dental arch. The changes in mandibular tooth position were greater than those observed in the maxillary arches. In finite element models 1 and 2, the largest maxillary displacements were found for posterior teeth., Conclusions: Decreasing numbers of occlusal units resulted in increasing amounts of displacements of the remaining teeth, which may compromise dental stability in patients with shortened dental arches., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Unlabelled: The purpose of this paper is to present a case report of an adult Class III patient presenting bilateral congenitally missing maxillary lateral incisors that compromised occlusal function as well as smile and facial esthetics. After the interdisciplinary diagnosis, spaces for prosthetic substitution were opened with the help of miniscrews. The orthodontic therapy achieved a better dental relationship, and the final interdisciplinary treatment results represented a significant improvement in function and both dental and facial esthetics., Clinical Significance: The interdisciplinary treatment of orthodontics and restorative dentistry is very important because the two complement each other in search of the best for the patient. This case demonstrates very well that where orthodontics provided the best tooth position prior to implant placement and restorations., (© 2013 Wiley Periodicals, Inc.)

Objectives: The concept of vertical dimension of occlusion (VDO) refers to a measure in the vertical plane that establishes the relation between the maxilla and the mandible when the posterior teeth, both from the maxillary and from the mandibular arches, are occluded, regardless of whether they are natural or prosthetic, healthy or restored. This measure is subject to change, and when this occurs, it can compromise both the function and the facial aesthetics. This study proposed to develop a methodology based on cephalometric analysis by studying the 31 lateral teleradiographs of adult, dentate individuals to determine the VDO, based on bone structures that are not dependent on the presence or absence of posterior teeth. The final goal was to make this application accessible to individuals who have undergone alterations of the lower portion of the face., Materials and Methods: The cephalometric analysis of this study, called Seraidarian-Tavano, was verified through facial angles (upper and middle angles) that, when correlated, determine the lower position of the face., Results: The analysis of results showed that no statistically significant difference between the angles studied could be observed (superior angle 50.29 ± 3.35 e median angle 49.95 ± 3.37). In the same manner, no variation in the results regarding gender in the measure of these angles could be observed., Conclusion: This cephalometric analysis can be applied to determine the VDO, regardless of the presence or absence of posterior teeth., (© 2011 The Gerodontology Society and John Wiley & Sons A/S.)

The aim of this article is to describe the care of a patient with fibrodysplasia ossificans progressiva (FOP) and to provide dentists with a guide for how to safely care for patients with FOP. Treatment improved the patient's limited mouth opening. FOP is a rare autosomal dominant disorder characterized by congenital malformation of the fingers and toes by heterotopic ossification progressiva of the connective tissue. This ossification causes a limitation in osteoradicular mobility, mainly affecting the spine, shoulders, hips, and peripheral joints. The disease can manifest from pregnancy until adulthood, with no greater prevalence associated with race or gender. Although rare, the disease can be easily identified by its clinical features, and diagnosis can be confirmed by a radiographic examination. There is no known effective treatment for this disease. All therapeutic treatment must be conservative to avoid any condition that may cause heterotopic ossification. Guidelines to prevent new ossifications are important for patients with FOP. Dental professionals should be cautious in planning treatment, avoiding anesthesia, especially in the mandible, to prevent ankylosis of the temporo-mandibular joints. The prevention of dental caries is essential to avoid the need for more invasive treatment., (© 2011 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Objectives: In some clinical situations, dentists come across partially edentulous patients, and it might be necessary to connect teeth to implants. The aim of this study was to evaluate a metal-ceramic fixed tooth/implant-supported denture with a straight segment, located in the posterior region of the maxilla, when varying the number of teeth used as abutments., Material and Methods: A three-element fixed denture composed of one tooth and one implant (Model 1), and a four-element fixed denture composed of two teeth and one implant (Model 2) were modeled. A 100 N load was applied, distributed uniformly on the entire set, simulating functional mastication, for further analysis of the SEQV (Von Mises) principal stresses, which were compared with the flow limit of the materials., Results: In a quantitative analysis, it may be observed that in the denture with one tooth, the maximum SEQV stress was 47.84 MPa, whereas for the denture with two teeth the maximum SEQV stress was 35.82 MPa, both located in the region between the pontic and the tooth., Conclusion: Lower stresses were observed in the denture with an additional tooth. Based on the flow limit of the materials, porcelain showed values below the limit of functional mastication.

Studies investigating the relationship between personality traits and quality of life related to the types of dental prostheses are scarce. The aim of the present study was to assess personality traits and their impact on quality of life for individuals treated with either conventional mandibular dentures (CMD) or implant-supported overdentures. Fifty patients with CMD and 50 patients with implant-supported mandibular overdentures (IMOD) were recruited. Individuals were examined; clinical and demographic data of interest were collected. All participants agreed to answer two questionnaires: the Oral Health Impact Profile (OHIP-14), which assessed quality of life related to oral health, and the Neuroticism Extraversion Openness Five-Factors Inventory (NEO FFI-R), which evaluated five personality domains. The influence of variables of interest on oral health-related quality of life was tested by univariate analysis and multiple linear regression. Patients with CMD reported higher levels of impact on quality of life (OHIP-14=10·30 ± 5·88) when compared to patients with IMOD (OHIP-14=6·52 ± 5·91; P=0·002). Multivariate predictive regression model for quality of life included neuroticism, conscientiousness and gender for the conventional mandibular denture group (P<0·05; R(2)=36·59%), whereas neuroticism, openness and schooling (P<0·05; R(2)=21·09%) were included in the implant-supported mandibular denture group model. Patients with IMOD had less impact on quality of life than patients with CMD. Personality traits, mainly neuroticism, had a significant influence on oral health-related quality of life linked to a chosen modality of prosthetic therapy., (© 2010 Blackwell Publishing Ltd.)

Objectives: This study evaluated by three-dimensional finite element analysis the tensions generated by different disocclusion patterns (canine guide and bilateral balanced occlusion) in an implant-supported mandibular complete denture., Material and Methods: A three-dimensional model of implant-supported mandibular complete denture was fabricated according to the Brånemark protocol. A 5-element 3.75 x 13-mm screw-shape dental implant system was modeled for this study. The implants were located in the inter-mental foramen region with 3-mm-high prosthetic components joined by a nickel-chromium framework with 12-mm bilateral cantilever covered by acrylic resin and 12 acrylic denture teeth. SolidWorks software was used before and after processing the simulations. The mechanical properties of the components were inserted in the model and a 15 N load was established in fixed points, in each one of the simulations. Data were collected in the entire nickel-chromium framework. The results were displayed three-dimensionally as color graphic scales., Results: The canine guide generated greater tensions in the region of the first implant, while the bilateral balanced occlusion generated great tensions in the entire metallic framework. The maximum tension found in the simulation of the bilateral balanced occlusion was 3.22 fold higher than the one found in the simulation of the disocclusion in canine guide., Conclusion: The pattern of disocclusion in canine guide is the ideal for implant-supported mandibular complete denture.

A comparative and qualitative analysis of the tensions generated in the cantilever region of an implant-supported mandibular complete denture was conducted using the three-dimensional finite element method. The mechanical properties of the components were input in the model and a load of 15 N was applied in pre-determined points. In the first simulation, the load was applied on the occlusal surface of the first premolar. In the second simulation, it was applied on the first and second premolars. In the third simulation, it was applied on the first and second premolars and on the first molar. The different occlusion patterns produced similar tension distributions in the cantilever region, which followed a similar pattern in the three simulations. In all of the cases, the highest levels of tension were located in the region of the first implant. However, as the loads were dislocated distally, the tensions increased considerably. The more extensive the cantilever, the more compromised will be the infrastructure, the prosthetic components and the implants. Regardless of the length of the cantilever, the highest tensions will always be located in the region of the implant next to the load application point.

Introduction: Sleep bruxism (SB) is characterized by repetitive and coordinated mandible movements and non-functional teeth contacts during sleep time. Although the etiology of SB is controversial, the literature converges on its multifactorial origin. Occlusal factors, smoking, alcoholism, drug usage, stress, and anxiety have been described as SB trigger factors. Recent studies on this topic discussed the role of neurotransmitters on the development of SB., Objective: Thus, the purpose of this study was to detect and quantify the urinary levels of catecholamines, specifically of adrenaline, noradrenaline and dopamine, in subjects with SB and in control individuals., Materials and Methods: Urine from individuals with SB (n = 20) and without SB (n = 20) was subjected to liquid chromatography. The catecholamine data were compared by Mann-Whitney's test (p

The use of the Finite Element Method (FE) is an appropriate way to study occlusal forces and tooth movement. The purpose of this study was to evaluate the effects of different occlusal contact patterns on tooth displacement in an adult dentition using a three-dimensional FE model of a human maxilla and mandible. Initially, images of a computerized tomography scan were redrawn in a computer program (CATIA) followed by the FE mesh construction. The MSC/Patran software was used to develop the FE mesh comprising 520,445 elements and 106,633 nodes. The MSC/Nastran program was utilized as pre and post-processor for all mathematical calculations necessary to evaluate dental and mandibular biomechanics. Four occlusal patterns were tested: FEM 1 - standard occlusal contacts; FEM 2 - removal of mesial marginal and mesial tripoidism contacts; FEM 3 - removal of distal marginal and distal tripoidism contacts; FEM 4 - similar to FEM 3 with added contacts between upper and lower incisors. Small changes in the standard distribution of occlusal contacts resulted in an imbalance of occlusal forces and changes in dental positioning. All simulations tested showed mesial displacement of posterior teeth. The most significant changes were registered in the model presenting unstable occlusal contacts when the anterior teeth were in occlusion (FEM 4). These findings may explain mandibular incisors crowding and maxillary incisors flaring as a result of small variations in dental contacts.

Aim: The aim of this study is to assess and locate the Foramen of Huschke., Study Design: Anatomical., Material and Method: Using contrast material like gutta-percha and barium sulfate, through extraoral radiographs, such as panoramic, submental vertex and corrected sagittal linear Temporal Mandibular Joint tomograms in four skulls where we clinically checked the existence of foramen of Huschke., Results: The results proved that the foramen of Huschke can be observed in skulls submitted to contrast using radiographic techniques.

A case of peripheral ameloblastoma in a 57-years-old woman is presented, along with a discussion of the clinical and histological characteristics of the lesion. After clinical and radiographic examinations, and with a differential diagnosis of pyogenic granuloma, an excisional biopsy was performed and the material collected was sent for histological examination. On the basis of the histopathological diagnosis, a second operation was performed with a wide safety margin, including bone tissue, which did not show any involvement with the odontogenic neoplasm.

A syndrome--incontinentia pigmenti--of probable genetic etiology, is discussed and a new case report presented. The syndrome presents systemic and dental manifestations, which are separate although similar to those found in other disease entities, i.e., congenital syphilis, hereditary ectodermal dysplasia.