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Pain Research & Management 2018By analogy with the journal's title Pain Research and Management, this review describes TMD Research and Management. More specific are the (1) research aspects of... (Review)
Review
By analogy with the journal's title Pain Research and Management, this review describes TMD Research and Management. More specific are the (1) research aspects of "occlusion," still one of the most controversial topics in TMD, and (2) as much as possible evidence-based management aspects of "TMD" for the dental practitioner. . The disorders temporomandibular dysfunction and the synonymous craniomandibular dysfunction are still being discussed intensely in the literature. Traditionally, attention is mostly devoted to occlusion and its relationship with these disorders. The conclusions reached are often contradictory. Considering the definitions of temporomandibular and craniomandibular dysfunctions/disorders and "occlusion," a possible explanation for this controversy can be found in the subsequent methodological problems of the studies. Based on a Medline search of these terms over the past 40 years related to contemporary terms such as "Evidence Based Dentistry" and "Pyramid of Evidence," these methodological aspects are examined, resulting in recommendations for future research and TMD-occlusal therapy. . To assist the dental practitioner in his/her daily routine to meet the modern standards of best practice, 7 guidelines are formulated that are explained and accompanied with clinical examples for an evidence-based treatment of patients with this disorder in general dental practices.
Topics: Databases, Factual; Dental Occlusion; Humans; Occlusal Adjustment; Temporomandibular Joint Disorders
PubMed: 29861806
DOI: 10.1155/2018/8746858 -
Clinical, Cosmetic and Investigational... 2016Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction... (Review)
Review
Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists' management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative intervention and occlusal adjustment are not indicated as treatment options to prevent further tooth loss or progression of abfraction. The clinical decision to restore abfraction lesions may be based on the need to replace form and function or to relieve hypersensitivity of severely compromised teeth or for esthetic reasons.
PubMed: 27217799
DOI: 10.2147/CCIDE.S63465 -
European Journal of Dentistry Jul 2023This study aimed to evaluate the effectiveness of conventional occlusal analysis in contrast with digital occlusal analysis in natural dentition. Occlusal analysis...
This study aimed to evaluate the effectiveness of conventional occlusal analysis in contrast with digital occlusal analysis in natural dentition. Occlusal analysis allows the identification of normal and abnormal occlusal contact points that alter the craniomandibular cervical system. We searched for articles with keywords [[dental occlusion]], [[natural dentition]], [[occlusal adjustment]], [[Immediate Complete Anterior Guidance Development]] [[mastication]], [[bite force]], [[premature contact]], [[occlusal balance]] [[articulating paper]]], [[spray]], [[Occlusal contacts]], and [[bite strength]]. They were considered observational , odds ratio and case control studies. We found 189 items. After evaluating the abstracts and full texts of the articles, 10 papers met the inclusion criteria. It was found that occlusal analysis allows the identification of the relationship between poor occlusion and the sensitivity of the teeth due to occlusal trauma, which is also related to temporomandibular joint pain in dynamic occlusion. The contacts of greater strength were observed in nonfunctional cusps, 48%, without ruling out the functional cusps, 24%. Despite being the universal method of occlusal control to date, the use of joint paper, remains subjective compared to the digital occlusal control device. Posture is considered directly related to occlusal trauma and temporomandibular disorders; without proper occlusal analysis, a clear diagnosis of the patient's joint condition cannot be obtained. Digital occlusal analysis is more objective than traditional occlusal analysis.
PubMed: 36252609
DOI: 10.1055/s-0042-1755626 -
Frontiers in Bioengineering and... 2021In dental research, bite force has become an important curative effect evaluation index for tooth restoration, periodontal treatment, and orthodontic treatment. Bite... (Review)
Review
In dental research, bite force has become an important curative effect evaluation index for tooth restoration, periodontal treatment, and orthodontic treatment. Bite force is an important parameter to evaluate the efficacy of the masticatory system. Physicians obtain the therapeutic basis for occlusal adjustment by measuring the bite force and the dynamic changes in occlusal contact at different stages of treatment and objectively evaluate the therapeutic effect. At present, many devices are used to record the bite force. Most of these devices use force transducers to detect bite force, such as strain gauge transducers, piezoresistive transducers, piezoelectric transducers, optical fiber transducers, and pressure-sensitive films. This article summarizes the various equipment used to record bite force, related materials and the characteristics of this equipment. It provides a reference for physicians to make choices during the clinical process and at the same time provides a basis for the development of new occlusal force measurement materials.
PubMed: 33898409
DOI: 10.3389/fbioe.2021.665081 -
The Cochrane Database of Systematic... Nov 2016Occlusal interventions may be used in adults with periodontitis. At present there is little consensus regarding the indications and effectiveness of occlusal... (Review)
Review
BACKGROUND
Occlusal interventions may be used in adults with periodontitis. At present there is little consensus regarding the indications and effectiveness of occlusal interventions in periodontal patients.
OBJECTIVES
To identify and analyse the evidence for the effect of occlusal interventions on adults who have periodontitis in relation to tooth loss, probing depths, clinical attachment level, adverse effects and patient-centred outcomes.
SEARCH METHODS
The search was last conducted in April 2008. We searched the Cochrane Oral Health Group's Trials Register (to 30th April 2008); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 1); MEDLINE (1966 to 30th April 2008); and EMBASE (1980 to 30th April 2008). There were no language restrictions.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) assessing occlusal interventions in patients with periodontitis with a follow up of at least 3 months.
DATA COLLECTION AND ANALYSIS
Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Any disagreements between the review authors were resolved by discussion. The main investigator of the included trial was contacted to obtain missing information. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis.
MAIN RESULTS
Abstracts of 54 papers were identified by the search. One paper was eligible for inclusion. This paper studied the effect of occlusal adjustment against no occlusal adjustment in patients who were treated with non-surgical and surgical periodontal therapy. Methodological quality assessment of the included paper revealed that randomisation of the patients into the treatment groups was adequate. Allocation concealment, masking of patients and clinicians were not reported and no response to author contact was received.Mean change in attachment level and mean pocket depth were reported in the included trial. Mean difference in clinical attachment level between occlusal intervention and control in the non-surgical group amounted to 0.38 mm (95% confidence interval (CI) 0.04 to 0.72) favouring the occlusal intervention group and was statistically significant. In the surgical group the mean difference in clinical attachment level between occlusal intervention and control amounted to 0.40 mm (95% CI 0.05 to 0.75) favouring the occlusal intervention group and was also statistically significant. The difference in mean pocket depth reduction between the occlusal intervention and control in both the surgical and non-surgical groups was less than 0.1 mm and was not statistically significant. Tooth loss, patient-centred affects and adverse effects were not reported. Meta-analysis was not possible due to the inclusion of only one study.
AUTHORS' CONCLUSIONS
There is only one randomised trial that has addressed this question. The data from this study are inconclusive. We therefore conclude there is no evidence for or against the use of occlusal interventions in clinical practice. This question can only be addressed by adequately powered bias-protected randomised controlled trials.
Topics: Adult; Humans; Malocclusion; Occlusal Adjustment; Periodontitis
PubMed: 27893154
DOI: 10.1002/14651858.CD004968.pub3 -
The Cochrane Database of Systematic... Jan 2016The Cochrane Oral Health Group withdrew this review as of Issue 1, 2016. The review is out of date and does not meet current Cochrane methodological standards. It will... (Meta-Analysis)
Meta-Analysis Review
The Cochrane Oral Health Group withdrew this review as of Issue 1, 2016. The review is out of date and does not meet current Cochrane methodological standards. It will be superseded by a new Cochrane review on Occlusal interventions for managing temporomandibular disorders. The editorial group responsible for this previously published document have withdrawn it from publication.
Topics: Adult; Humans; Occlusal Adjustment; Randomized Controlled Trials as Topic; Temporomandibular Joint Disorders
PubMed: 26727292
DOI: 10.1002/14651858.CD003812.pub2 -
Dental Materials Journal May 2021The attrition of enamel when opposed by ceramics is of great concern. The purpose of this study was to evaluate enamel wear against high translucent zirconia (Zr),...
The attrition of enamel when opposed by ceramics is of great concern. The purpose of this study was to evaluate enamel wear against high translucent zirconia (Zr), lithium disilicate (LD), gold (Au), and enamel (E) with different surface and contact conditions. The materials were divided into two groups: polished and ground (n=8 each). Two-body wear tests were performed against human enamel with vertical and horizontal, horizontal, and vertical repetitive movements as experiments 1 to 3 respectively. The surface roughness of all materials except Zr changed throughout the experiments. In experiment 1, Zr and Au showed less antagonist wear when polished than when ground. In experiment 2, polished groups showed less antagonist wear than ground groups in all materials. In experiment 3, Zr and LD exerted greater antagonist wear than E, regardless of Ra. These findings confirm the importance of polishing and occlusal adjustment of zirconia.
Topics: Ceramics; Dental Implants; Dental Polishing; Dental Porcelain; Humans; Materials Testing; Occlusal Adjustment; Surface Properties; Zirconium
PubMed: 33456027
DOI: 10.4012/dmj.2020-190 -
Frontiers in Endocrinology 2022Occlusal support was proved to be associated with type 2 diabetes. Our aim was to investigate the association between the Eichner index and the prevalence of type 2...
Occlusal support was proved to be associated with type 2 diabetes. Our aim was to investigate the association between the Eichner index and the prevalence of type 2 diabetes. We included 715 participants with oral health examinations in the Shanghai Aging Study. The occlusal support status was determined by the number of functional occlusal support areas and Eichner index classifications. Those with fasting plasma glucose ≥126 mg/dL and/or hemoglobin A1c ≥6.5% and/or current medications for type 2 diabetes with relevant medical history were diagnosed with type 2 diabetes. Multiple logistic regression models were used to analyze the relationship between occlusal support status and type 2 diabetes. The average age of 715 participants was 73.74 ± 6.49 years old. There were 84 diabetics with 1.71 occlusal supporting areas on average. Seven hundred and fifteen participants were divided into 3 groups according to Eichner classifications: Eichner group A with 4 occlusal functional areas, Eichner group B with 1-3 occlusal functional areas or 0 area with anterior occlusal contact, and Eichner group C with no functional occlusal contact. Blood glucose level was significantly lower in participants of Eichner group A compared to those in group B or C. The ordinal logistic regression showed more occlusal supporting areas were significantly associated with less type 2 diabetes cases with an Odds Ratio(OR) of 0.253(95%CI 0.108-0.594) after adjusting covariates. Participants in Eichner group A had a significantly much lower OR of 0.078 for type 2 diabetes (95%CI 0.009-0.694) compared to those in Eichner group C after adjustment. The number of functional occlusal support areas might be inversely related to the blood glucose level and the prevalence of type 2 diabetes.
Topics: Aged; Aged, 80 and over; Aging; Blood Glucose; China; Diabetes Mellitus, Type 2; Humans
PubMed: 36004339
DOI: 10.3389/fendo.2022.934274 -
The Journal of Advanced Prosthodontics Jun 2019The aim of this study was to evaluate the effect of occlusal adjustments on the surface roughness of yttria-tetragonal zirconia polycrystal (Y-TZP) and wear of opposing...
PURPOSE
The aim of this study was to evaluate the effect of occlusal adjustments on the surface roughness of yttria-tetragonal zirconia polycrystal (Y-TZP) and wear of opposing artificial enamel.
MATERIALS AND METHODS
Twenty-five Y-TZP slabs from each brand (Lava, 3M and Bruxzir, Glidewell Laboratories) with different surface conditions (Control polished - CPZ; Polished/ground - GRZ; Polished/ground/repolished - RPZ; Glazed - GZ; Porcelain-veneered - PVZ; n=5) were abraded (500,000 cycles, 80 N) against artificial enamel (6 mm diameter steatite). Y-TZP roughness (in µm) before and after chewing simulation (CS) and antagonist steatite volume loss (in mm) were evaluated using a contact surface profilometer. Y-TZP roughness was analyzed by three-way analysis of variance (ANOVA) and teatite wear by two-way ANOVA and Tukey Honest Difference (HSD) (=.05).
RESULTS
There was no effect of Y-TZP brand on surface roughness (=.216) and steatite loss (=.064). A significant interaction effect (<.001) between surface condition and CS on Y-TZP roughness was observed. GZ specimens showed higher roughness after CS (before CS - 3.7 ± 1.8 µm; after CS - 13.54 ± 3.11 µm), with partial removal of the glaze layer. Indenters abraded against CPZ (0.09 ± 0.03 mm) were worn more than those abraded against PVZ (0.02 ± 0.01 mm) and GZ (0.02 ± 0.01 mm). Higher wear caused by direct abrasion against zirconia was confirmed by SEM.
CONCLUSION
Polishing with an intraoral polishing system did not reduce the roughness of zirconia. Wear of the opposing artificial enamel was affected by the material on the surface rather than the finishing technique applied, indicating that polished zirconia is more deleterious to artificial enamel than are glazed and porcelain-veneered restorations.
PubMed: 31297175
DOI: 10.4047/jap.2019.11.3.162 -
Journal of Prosthodontic Research Jul 2016Dentists may encounter patients who present with a sense of a malocclusion but in whom no objective findings can be detected. For the patient who insists that there is... (Review)
Review
PURPOSE
Dentists may encounter patients who present with a sense of a malocclusion but in whom no objective findings can be detected. For the patient who insists that there is occlusal discomfort, in the absence of evidence some dentists elect to perform an occlusal adjustment that not only fails to alleviate symptoms, and may, in fact, exacerbate the discomfort. The patient-dentist relationship is then likely compromised because of a lack of trust.
STUDY SELECTION
In 2011, the Clinical Practice Guidelines Committee of the Japan Prosthodontic Society formulated guidelines for the management of occlusal discomfort. When formulating clinical practice guidelines, the committee bases their recommendations on information derived from scientific evidence. For "occlusal dysesthesia," however, there are an insufficient number of high-quality papers related to the subject. Therefore, a consensus meeting was convened by the Japan Prosthodontic Society to examine evidence in the Japanese- and English-language literature and generate a multi-center survey to create an appropriate appellation for this condition.
RESULTS
As a result of the consensus meeting and survey findings, this condition may be justifiably termed "occlusal discomfort syndrome."
CONCLUSIONS
The Japan Prosthodontics Society believes that identification of an umbrella term for occlusal discomfort might serve as a useful guide to formulating clinical practice guidelines in the future. This position paper represents summary findings in the literature combined with the results of a multicenter survey focused on dental occlusal treatment and the condition of patients who present with occlusal discomfort syndrome.
Topics: Adult; Aged; Disease Progression; Female; Humans; Japan; Male; Malocclusion; Middle Aged; Occlusal Adjustment; Practice Guidelines as Topic; Prosthodontics; Sensation; Syndrome
PubMed: 26868189
DOI: 10.1016/j.jpor.2015.11.002