Biomedical subjects

Eva Piehslinger

Publications and source records attributed to Eva Piehslinger.

9 recordsLinked to original sources

PubMed2006

Oral acupuncture in the therapy of craniomandibular dysfunction syndrome -- a randomized controlled trial.

CONTEXT: Patients with disorders of the stomatognathic system describe pain and clicking phenomena as primary symptoms. Rapid improvement of the pain is required to ensure and maintain adequate patient compliance. OBJECTIVE: The study was intended to assess the effects of acupuncture in patients with temporomandibular disorders as compared to placebo therapy (sham laser); the primary target parameter was the subjective pain sensation. DESIGN: Randomized, placebo-controlled trial. PATIENTS AND METHODS: 23 patients were enrolled and randomly assigned to one of the two groups. One group received acupuncture treatment according to the very-point technique, the other group received sham laser treatment. The following observer-blinded findings were evaluated before and after treatment: subjective pain, mouth opening, and muscular tenderness and pain on pressure. In addition, mandibular joint movement pathways were recorded using electronic axiography. OUTCOMES: Improvements in pain scores (scale, 0-100) in the acupuncture group (19.1 +/- 11.9) were significant (p = 0.03) versus those in the placebo group (6.2 +/- 14.8). Mouth opening showed an insignificant trend towards improvement (p > 0.1) in the acupuncture (5.0 +/- 6.2 mm) versus the placebo group (1.0 +/- 4.7 mm), differences in tenderness and pain on pressure in neck and masticatory muscles were significant (p < 0,05) for most of the muscles having shown pretreatment tenderness or pain. The axiographic tracings were assessed for quality, symmetry and curve characteristics. Recordings of the opening and closing movement in the acupuncture group showed an increased frequency of improvements of curve characteristics as compared to the placebo group. The acupuncture group also showed an increased frequency of improvement in protrusion and retrusion movements, though no statistical significance could be obtained. CONCLUSION: On the basis of the results of the present study, acupuncture may be recommended as acute treatment of craniomandibular disorders, but studies with larger numbers of patients as well as about long-term treatment outcomes should be conducted.

Acupuncture Therapy↗

PubMed2005

Correlation between disk morphology on MRI and time curves using electronic axiography.

This retrospective series was intended to determine whether morphological disk findings in open and closed mouth magnetic resonance imaging (MRI) may be correlated with the time curves in axiography. In this series, 45 temporomandibular joints of 33 patients were subjected to a retrospective evaluation. Magnetic resonance images obtained with closed and open mouth and joint movements assessed by electronic axiography were analyzed. Disk morphology in MRI was classified as normal, partly flattened, partly thickened, or completely thickened. For the axiographic tracings, time curves of the free movements of the respective joint were developed and evaluated. Data obtained were analyzed for any potential correlation using scatter plots and discriminance analysis. No correlation between these data was found suggesting that the axiographic time curves do not provide for any conclusions with regard to disk morphology. Apart from patient history and a thorough clinical evaluation, recording of jaw movements, but also using MRI continues to be of particular value in the diagnostic assessment of anterior disk displacement.

Adolescent↗

PubMed2003

A comparative analysis of optical and conventional axiography for the analysis of temporomandibular joint movements.

STATEMENT OF PROBLEM: Currently available systems for pantographic tracing are heavy, bulky, and can interfere with jaw movements. PURPOSE: This study describes the development and clinical application of optoelectronic axiography designed to overcome system inherent problems of conventional bulky frame-based registration axiography. The purpose of this study is the comparison of the newly developed system and conventional axiography. MATERIAL AND METHODS: Three-dimensional recordings of condylar pathways were acquired by means of infrared digitizers interfaced to newly developed software. Ten distinct curves in each of 10 subjects were recorded by synchronous optoelectronic axiography (100 tracings) and by conventional axiography (100 tracings). Usually, two 3-dimensional (3D) light weight sensors are provisionally fixed to the facial surface of a maxillary and mandibular incisor by means of a single orthodontic bracket. To allow for direct comparison of all 100 pairs of curves in this study, the 3D sensors of the optoelectronic system were attached to the bulky double face-bow system of the axiograph. The conformity of tracings (protrusion, opening/closing, mediotrusion, and laterotrusion) was evaluated by means of correlation analysis. Resulting axiographic recordings from both systems were evaluated by 3 experts (dentists, experienced in axiographic investigations, who were blind to the source of the data), focusing on standardized qualitative criteria of the recordings (homogeneity/smoothness, pathway-characteristics, excursion, and left/right-symmetry). After testing for normal distribution of the ratio scaled data (length of pathway, horizontal condylar inclination [HCI], Bennett angle) with the Kolmogoroff-Smirnov test (alpha=.01), axiographic curves were quantitatively compared by means of an intraclass correlation coefficient ([ICC] alpha =.01). The Wilcoxon test (alpha=.01) was used to evaluate equivalence of ordinally scaled values (homogeneity of tracings) and Cohen's Kappa was used to compare excursion and left/right symmetry. RESULTS: High correspondence between curves recorded by conventional and optoelectronic axiography was observed. The mean differences of lengths between the protrusive, opening/closing, and mediotrusive pathways were 0.0 mm, 0.6 mm, and 0.1 mm, respectively. Pathways and values for HCI were found highly correlated (pathways: 95% CI of ICC 0.9776-0.9908; HCI: 95% CI of ICC 0.8641-0.9597). The 95% CIs for differences of pathways, HCI-value, and Bennett angle were -0.1mm/0.3mm, -3.4 degrees/1.9 degrees, and -2.8 degrees/4.8 degrees, respectively. Pathway characteristics also corresponded well (Cohen's Kappa: 0.73 for symmetric and 0.72 for asymmetric movements), 0.77 for left/right symmetry, whereas other characteristics showed less significant correlation (Cohen's Kappa of excursion: 0.21 for symmetric and 0.09 for asymmetric movements, homogeneity: 0.08 for symmetric and 0.15 for asymmetric movements). CONCLUSION: Within the limitations of this study, optoelectronic axiography proved to be an applicable, promising technique, leading to diagnostic interpretations equivalent (with respect to the CIs) to conventional axiography.

Dental Occlusion↗

PubMed2003

Variants of ossification in the stylohyoid chain.

The purpose of this study was to evaluate the age-related differences in the incidence, length and topographic location of ossification in the stylohyoid chain. Panoramic radiographs of 420 patients (795 reviewed stylohyoid-chains), subdivided into 4 age groups (20 years and under, 21 to 40 years, 41 to 60 years, older than 60 years) were reviewed and examined for the incidence, length and topographic location of stylohyoidal ossification. 245 (30.8%) out of 795 reviewed stylohyoidal chains showed radiological variabilities (elongation of the styloid process and/or ossification of the stylohyoid ligament). With increasing age, there was an increase in the incidence and length of stylohyoidal ossifications (p<0.01). A significant linear correlation between the length of the stylohyoidal ossifications and age was only found in the young age group (under 20 yrs.; p<0.01). In the young age group (under 20 yrs), there was also a higher prevalence of isolated locations in the superior stylohyoidal segment. With increasing age, there was a pronounced presence of ossifications in the middle and inferior stylohyoid segments and combinations of ossified variabilities. Stylohyoidal ossifications show age-related differences in incidence, length and topographical location. Stylohyoid ossifications gain a different importance in adult patients than in juvenile patients.

Adolescent↗

PubMedDate not supplied

Status of teeth adjacent to single-tooth implants.

PURPOSE: This study evaluated the status of teeth adjacent to single-tooth implants in the anterior and posterior jaw during a follow-up of more than 3 years. MATERIALS AND METHODS: Seventy-eight single-tooth implants and 148 adjacent teeth were followed for a mean of 58 months. Implant survival rate, peri-implant structures, and prosthetic complication rates were evaluated. Crowns and periodontal status of adjacent teeth were compared at crown placement and at the last examination. Horizontal distance from the implant edge to adjacent teeth was calculated and compared for anterior and posterior regions. The influence of approximal crestal bone resorption of the adjacent teeth was calculated using multivariate regression analysis. RESULTS: The clinical findings for implants (one loss), peri-implant structures, and prosthetic complication rates (three crown fractures) were excellent. There was a high proportion of intact adjacent teeth in both anterior and posterior regions at crown placement and at the follow-up examination. No adjacent teeth required extraction or endodontic treatment, and only four required restoration. Comparison of the periodontal status at crown placement and at follow-up revealed no differences for plaque and bleeding indices or for pocket depth of adjacent teeth. There was a significant influence of the horizontal distance on approximal bone loss in the closer distance of the anterior region, but not in the posterior region. CONCLUSION: The crown and periodontal status of teeth adjacent to single-implant restorations was excellent. The approximal bone crest reduction of the adjacent teeth was significantly influenced by the horizontal distance between the implant edge and neighboring tooth.

Adult↗

PubMedDate not supplied

Maxillary interim overdentures retained by splinted or unsplinted provisional implants.

PURPOSE: The survival rate of splinted and unsplinted provisional implants for anchoring removable interim overdentures, as well as handling and maintenance of the interim dentures, was evaluated. MATERIALS AND METHODS: Eighteen edentulous maxillae were provided with 72 provisional implants for anchoring interim overdentures. For 10 patients, 40 unsplinted implants were used with conical copings to retain the provisional prostheses, while for 8 patients 32 implants had a splinted bar architecture for supporting the interim prostheses. Failure rate of provisional implants, as well as handling and behavior of the anchored interim overdentures, was followed until definitive prosthetic restoration and compared between groups. RESULTS: Eighteen (25.0%) of the 72 provisional implants were prematurely lost. The loss rate of unsplinted implants (37.5%) was significantly higher than that of splinted implants (9.3%). Patient handling and maintenance of maxillary interim overdentures during the follow-up period was found to be easier with the splinted bar-retained method than with the unsplinted prosthodontic method. CONCLUSION: Placement of provisional implants fulfilled the requirements for initiating immediate prosthetic rehabilitation and showed that removable interim overdentures can be adequately stabilized and provide added patient comfort and satisfaction. The results suggest benefits of the splinted retention modality over the unsplinted method because of advantages regarding failure rate, patient handling, and interim denture maintenance.

Aged↗

PubMedDate not supplied

Clinical outcome and prosthodontic compensation of tilted interforaminal implants for mandibular overdentures.

PURPOSE: The aim of this study was to evaluate the sagittal inclination of interforaminal implants, the clinical implant outcome, and the necessary extent of prosthodontic compensation modalities for implant overdentures (IODs). MATERIALS AND METHODS: Lateral cephalometric radiographs of 62 patients, each with a mandibular IOD retained by 2 to 4 implants, were analyzed. The sagittal inclination of the longitudinal implant axis of the most anterior implant was analyzed relative to the mandibular and occlusal planes. The angle needed to compensate for the inclination of the mandibular implant to obtain Angle's class I for the prosthesis (the compensation angle) was measured and compared with respect to skeletal class. Peri-implant structures were measured using the Plaque Index and the Gingival Index. The compensation angle was correlated with the mandibular implant inclination, the degree of mandibular atrophy, and the anterior facial height. RESULTS: The most anterior mandibular implants showed a mean retroinclination of 74.3 +/- 9.3 degrees in relation to the mandibular plane; retroinclination was significantly more pronounced in skeletal class II than skeletal classes I and III (P < .05). The compensation angle (26.9 +/- 10.5 degrees) was more significant for skeletal class II than for skeletal classes I and III (P < .01). Sagittal mandibular implant inclination correlated significantly to the compensation angle (r = -0.46; P < .05), mandibular atrophy (r = 0.32; P < .05) and mandibular facial height (r = -0.45; P < .05). Implant survival rate and peri-implant parameters (bone loss, pocket-depth, Plaque and Gingival Indices) of the interforaminal implants were not shown to be influenced by implant retroinclination. Nine patients (2 skeletal class 1, 7 skeletal class II) reported phonetic problems with the IOD because of narrowing of the lingual space but described significant improvement after a median 4.7 months (range, 3 to 12 months). DISCUSSION AND CONCLUSION: Depending on skeletal class, prosthetic compensatory mechanisms will be operative in the presence of mandibular implant retroinclination for IOD. Knowledge of mandibular inclinations and the compensatory mechanisms may be an essential factor in successful prosthetic rehabilitation and may provide for a homogenous design of the bar construction and easier handling and may also reduce stress on the attachment mechanism.

Cephalometry↗

PubMedDate not supplied

Implant-supported mandibular overdentures retained with ball or telescopic crown attachments: a 3-year prospective study.

PURPOSE: The aim of the present study was to evaluate implant survival, peri-implant conditions, and prosthodontic maintenance requirements for implant-supported mandibular overdentures in atrophic mandibles retained with ball or resilient telescopic crown attachments during a 3-year period. MATERIALS AND METHODS: Twenty-five patients with edentulous mandibles each received 2 Camlog root-form dental implants in the mandibular interforaminal (canine) region. The denture attachment system was chosen randomly; 13 patients received ball attachments and 12 patients received resilient telescopic crowns. Implant survival, implant mobility (Periotest values), and peri-implant conditions such as bone resorption, pocket depth, Plaque Index, Gingiva Index, Bleeding Index, and Calculus Index values were assessed for each implant. In addition, detailed prosthodontic maintenance was evaluated during the follow-up period and the 2 retention modalities were compared. RESULTS: There were no differences in implant survival, implant mobility (Periotest values), and peri-implant conditions between the 2 retention modalities. During the 3-year period significantly more complications/interventions for maintenance purposes were registered in the ball group (62 interventions) than in the telescopic crown group (26 interventions; P < .01). CONCLUSION: The results indicate that both ball attachments and resilient telescopic crowns used on isolated implants in the edentulous mandible are viable treatment options. Implant success and peri-implant conditions did not differ between ball attachments and telescopic crowns used as retention modalities for implant overdentures, but the frequency of technical complications was significantly higher with ball attachments than with resilient telescopic crowns.

Crowns↗

PubMedDate not supplied

Computerized tomography-assisted calculation of sinus augmentation volume.

PURPOSE: This study was intended to calculate the augmentation volume for a sinus lift procedure based on cross-sectional computerized tomography (CT) scans for 2 different augmentation heights. MATERIALS AND METHODS: Based on area calculations of cross-sectional CT scans, the volume of additional bone needed was calculated for 44 sinus lift procedures. The amount of bone volume needed to raise the sinus floor to heights of both 12 and 17 mm was calculated. RESULTS: To achieve a sinus floor height of 12 mm, it was necessary to increase the height by a mean of 7.2+/-2.1 mm (range, 3.0 to 10.5 mm), depending on the residual ridge height; to achieve a height of 17 mm, a mean of 12.4+/-2.0 mm (range, 8.5 to 15.5 mm) was required (P < .01). The calculated augmentation volume for an augmentation height of 12 mm was 1.7+/-.9 cm3; for an augmentation height of 17 mm, the volume required was 3.6+/-1.5 cm3. Increasing the height of the sinus lift by 5 mm, ie, from 12 mm to 17 mm augmentation height, increased the augmentation volume by 100%. A significant correlation was found between augmentation height and the calculated sinus lift augmentation volume (r = 0. 78, P < .01). DISCUSSION AND CONCLUSION: Detailed preoperative knowledge of sinus lift augmentation volume is helpful as a predictive value in deciding on a donor site for harvesting autogenous bone and on the ratio of bone to bone substitute to use. Calculation of the augmentation size can help determine the surgical approach and thus perioperative treatment and the costs of the surgery for both patients and clinicians.

Adult↗