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At least 433 records · Page 24Linked to original sources
PubMed2000

Treating severe bruxism with botulinum toxin.

BACKGROUND: Locally administered botulinum toxin, or BTX, is an effective treatment for various movement disorders. Its usefulness in treating bruxism, however, has not been systematically evaluated. SUBJECTS AND METHODS: The authors studied 18 subjects with severe bruxism and whose mean duration of symptoms was 14.8 +/- 10.0 years (range three-40 years). These subjects audibly ground their teeth and experienced tooth wear and difficulty speaking, swallowing or chewing. Medical or dental procedures had failed to alleviate their symptoms. The authors administered a total of 241 injections of BTX type A, or BTX A, in the subjects' masseter muscles during 123 treatment visits. The mean dose of the BTX A was 61.7 +/- 11.1 mouse units, or MU (range 25-100 MU), per side for the masseter muscles. RESULTS: The mean total duration of response was 19.1 +/- 17.0 weeks (range six-78 weeks), and the mean peak effect on a scale of 0 to 4, in which 4 is equal to total abolishment of grinding, was 3.4 +/- 0.9. Only one subject (5.6 percent) reported having experienced dysphagia with BTX A. CONCLUSION: The results of this study suggest that BTX administered by skilled practitioners is a safe and effective treatment for people with severe bruxism, particularly those with associated movement disorders. It should be considered only for those patients refractory to conventional therapy. Future placebo-controlled studies may be useful in further evaluating the potential of BTX in the treatment of bruxism.

Adolescent↗
PubMed2003

Oral health of Bangladeshi women tobacco-with-paan users and self-reported oral pain following tobacco cessation.

OBJECTIVES: The study objectives were to assess the oral health status of a sample of UK resident Bangladeshi women tobacco-in-paan users and its relationship to participant age and number of daily paan, to determine the prevalence of oral pain at baseline and at the one-week postcessation follow-up, and to explore the relationship between oral health status and changes in self-reported oral pain at baseline and at the one-week postcessation follow-up. METHODS: Interviews were conducted in Sylheti using fully structured questionnaires and an oral examination was carried out. A quit date was set and nicotine replacement therapy patches (Nicorette 15 mg, Pfizer) were supplied. Age, number of daily paan, and oral pain characteristics, including intensity, frequency, any provoking factors, and associated symptoms were recorded. Oral mucosal lesions (OMLs) and numbers of teeth decayed, missing, filled, and those with recession, abrasion, loss of attachment (LOA), and tooth wear were charted. RESULTS: Fifty-two women took part. The mean age was 42.8 years and number of daily paan with tobacco was 13. Compared to those aged 18-39 years, those aged 40 years and older had poorer oral health. Older adults were significantly more likely to have higher numbers of teeth with recession, abrasion, and LOA greater than 3.5 mm. They were significantly more likely to have an OML at baseline. The prevalence of self-reported oral pain was 26.9 percent at baseline and 51.9 percent at one-week follow-up. Presence of an OML at baseline was a significant predictor of reports of oral pain at the one-week follow-up. Results of stepwise multiple regression analysis confirmed this finding (OR = 3.66; 95% CI = 1.06, 12.621; P = .04). CONCLUSIONS: Reports of oral pain at follow-up during a tobacco cessation program correlate with the presence of OMLs at baseline. Further investigation of this relationship is needed. Access to appropriate dental care, as an aid to successful tobacco cessation, is indicated.

Adolescent↗
PubMed2000

Clinical evaluation of resin-bonded gold alloy veneers.

STATEMENT OF PROBLEM: Clinical performance of resin-bonded alumina-abraded type III cast gold alloy veneers has not been reported. PURPOSE: This retrospective study evaluated the survival of such restorations for the management of tooth wear and other restorative problems. MATERIAL AND METHOD: This clinical study evaluated 25 patients between 14 and 60 years of age treated with a total of 158 cast gold veneers cemented with Panavia Ex cement. Restorations placed between January 1990 and February 1996 (mean age 48 months) were evaluated. Factors, including age, gender, operator, site, design, the extent of dentin exposure, the presence of previous restorations, dynamic and static occlusion, rubber dam, cause, and methods of interocclusal space creation, were evaluated with Cox regression. Survival probability was evaluated with Kaplan-Meier analyses. Significance was taken as P <.05. RESULTS: Failures occurred for 7.6% of restorations in 28% of patients. Alumina-abraded gold alloys cemented with Panavia Ex cement had an estimated 89% survival probability at 60 months using Kaplan-Meier analyses. The only variable to statistically influence survival was operator (P <.0001). Operator differences were due to a single operator who placed only 2 restorations in the same patient, both of which failed unusually quickly. CONCLUSION: Resin-bonded alumina-abraded type III cast gold alloys can be successfully used to restore both anterior and posterior teeth and were associated with an estimated 89% survival probability at 60 months.

Adolescent↗
PubMed1996

Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study.

The clinical validity of diagnostic criteria for sleep orofacial motor activity--more specifically, bruxism--has never been tested. Polysomnographic recordings from 18 bruxers and 18 asymptomatic subjects, selected according to American Sleep Disorders Association criteria, were analyzed (1) to discriminate sleep bruxism from other orofacial motor activities and (2) to calculate sensitivity, specificity, and predictive values of research criteria. Clinical observations and reports revealed that all 18 bruxers reported frequent tooth-grinding during sleep. Tooth wear was noted in 16 out of 18 bruxers and jaw discomfort reported by six of them. These findings were present in none of the controls. The analysis of polysomnographic data showed that the asymptomatic subjects presented a mean of 1.7 +/- 0.3 bruxism episodes per hour of sleep (sustained or repetitive bursting activity in jaw closer muscles), while bruxers had a significantly higher level of activity: 5.4 +/- 0.6. Controls exhibited 4.6 +/- 0.3 bruxism bursts per episode and 6.2 (from 0 to 23) bruxism bursts per hour of sleep, whereas bruxers showed, respectively, 7.0 +/- 0.7 and 36.1 (5.8 to 108). Bruxism-like episodes with at least two grinding sounds were noted in 14 of the 18 bruxers and in one control. The two groups exhibited no difference in any of the sleep parameters. Based on the present findings, the following polysomnographic diagnostic cut-off criteria are suggested: (1) more than 4 bruxism episodes per hour, (2) more than 6 bruxism bursts per episode and/or 25 bruxism bursts per hour of sleep, and (3) at least 2 episodes with grinding sounds. When the polysomnographic bruxism-related variables were combined under logistic regression, the clinical diagnosis was correctly predicted in 81.3% of the controls and 83.3% of the bruxers. The validity of these clinical research criteria needs now to be challenged in a larger population, over time, and in subjects presenting various levels of severity of sleep bruxism.

Adult↗
PubMed2004

The reproducibility of ultrasonic enamel thickness measurements: an in vitro study.

OBJECTIVES: The diagnosis of tooth wear is mostly based on visual scoring systems. Recently, methods measuring ultrasonic enamel thickness have been proposed. The aim of this study was to evaluate the reproducibility and evaluate factors affecting variation of ultrasonic enamel thickness measurements in an in vitro set up. METHODS: Four observers (1-4) in two institutes (G and S) performed ultrasonic enamel thickness measurements at buccal and palatal surfaces of extracted teeth placed in a phantom jaw. A Panametrics 25DL thickness gauge (Panametrics, Waltham MA, USA), with a 15 MHz transducer, covered by a plexi-glass delay line with a tip diameter of 2 mm was used, coupled to a laptop computer. After one week these measurements were repeated. Subsequently four selected teeth were measured 20 times at a fixed buccal site by one observer. Finally, two observers made ink marks with the instrument probe tip on the buccal and palatal surfaces of all teeth. This was repeated after one week. Digital images were made of the marked teeth and analysed to determine variation in positioning. The underlying enamel thickness variation was subsequently estimated. Results were analysed by calculating the 95% range of measurement variation (RMV, 4 x standard deviation) for each experiment. RESULTS: The main reproducibility experiment showed a 95% RMV of 0.79 mm (observer 1G), 0.64 mm (observer 2G), 0.63 mm (observer 3S), 0.71 mm (observer 4S), 0.51 mm (observer 1S). The repeatability experiment showed a mean 95% RMV of 0.26 mm. The probe position variation in the cervical-incisal direction resulted in an estimated thickness 95% RMV of 0.10 mm (1G) and 0.09 mm (2G). CONCLUSIONS: It was concluded that, due to measurement variation, thickness changes of less than 0.33 mm cannot be detected reliably. Probe positioning and a poor repeatability were responsible for only a small part of the total variation. Hence other factors influencing variation in enamel thickness are still to be identified.

Dental Enamel↗
PubMed1998

Radiographic study of the broadbeach aboriginal dentition.

This study forms part of a larger anthropological investigation of the Ngaraangbal Aboriginal Tribe's ancestral burial ground at Broadbeach, Australia. It examines the dentition, records the associated pathology in a noninvasive manner, and relates this to the likely subsistence diet of the tribe. The Broadbeach osteological collection was returned for reburial in 1985; however, radiographic and photographic records of 36 adult males were available. These form the basis of our study. The pathology noted in the study sample was compared with a representative sample (n = 38) of pre-European Aboriginal remains from throughout Queensland for verification purposes only. Rates of dental pathology and injury were calculated from the radiographic and photographic records. There was a significant rate of tooth-wear related intra-bony pathology (4.0%), moderate to severe alveolar bone loss, and heavy dental attrition, of which the mandibular posterior teeth were the most severely affected. Caries prevalence (0.8%) was low for hunter-gatherer populations. A large number of molar pulp chambers had a distinctive "cruciate" morphology resulting from the formation of secondary dentine and pulp stones. Injuries and abnormalities included upper central incisor avulsion (58.3%) and taurodontism. These results support the proposal that the Ngaraangbal tribe was a hunter-gatherer population subsisting on an abrasive diet that included marine foods.

Adolescent↗
PubMed2005

Linear enamel hypoplasias as indicators of systemic physiological stress: evidence from two known age-at-death and sex populations from postmedieval London.

Enamel hypoplasias are useful indicators of systemic growth disturbances during childhood, and are routinely used to investigate patterns of morbidity and mortality in past populations. This study examined the pattern of linear enamel hypoplasias in two different burial populations from 18th and 19th Century church crypts in London. Linear enamel hypoplasias on the permanent dentitions of individuals from the crypt of Christ Church, Spitalfields, were compared to enamel defects on the teeth of individuals from St. Bride's. The method used involves the identification of enamel defects at a microscopic level, and systemic perturbations are detected by matching hypoplasias among different tooth classes within each individual. The pattern of linear enamel hypoplasias was contrasted between individuals from the burial sites of Spitalfields and St. Bride's, between males and females, and between those aged less than 20 years of age and those aged over 20 years at death. Six different parameters were examined: frequency of linear enamel hypoplasias, interval between defects, duration of hypoplasias, age at first occurrence of hypoplasia, age at last occurrence of hypoplasia, and the percentage of enamel formation time taken up by growth disturbances. All individuals in the study displayed linear enamel hypoplasias, with up to 33% of total visible enamel formation time affected by growth disruptions. Multiple regression analysis indicated a number of significant differences in the pattern of enamel hypoplasias. Individuals from Spitalfields had shorter intervals between defects and greater percentages of enamel formation time affected by growth disturbances than did individuals from St. Bride's. Females had greater numbers of linear enamel hypoplasias, shorter intervals between defects, and greater percentages of enamel formation time affected by growth disturbances than males. There were also differences in the pattern of enamel hypoplasias and age at death in this study. Individuals who died younger in life had an earlier age at first occurrence of enamel hypoplasia than those who survived to an older age. The pattern of enamel hypoplasias detected in this study was influenced by tooth crown geometry and tooth wear such that most defects were found in the midcrown and cervical regions of the teeth, and greater numbers of defects were identified on the anterior teeth. Differences in sensitivity of the parameters used for the detection of enamel hypoplasias were found in this study. The percentage of visible enamel formation time affected by growth disturbances was the parameter that identified the greatest number of significant differences among the subgroups examined.

Adolescent↗
PubMed1983

Aspects of masticatory form and function in common tree shrews, Tupaia glis.

Tree shrews have relatively primitive tribosphenic molars that are apparently similar to those of basal eutherians; thus, these animals have been used as a model to describe mastication in early mammals. In this study the gross morphology of the bony skull, joints, dentition, and muscles of mastication are related to potential jaw movements and cuspal relationships. Potential for complex mandibular movements is indicated by a mobile mandibular symphysis, shallow mandibular fossa that is large compared to its resident condyle, and relatively loose temporomandibular joint ligaments. Abrasive tooth wear is noticeable, and is most marked at the first molars and buccal aspects of the upper cheek teeth distal to P2. Muscle morphology is basically similar to that previously described for Tupaia minor and Ptilocercus lowii. However, in T. glis, an intraorbital part of deep temporalis has the potential for inducing lingual translation of its dentary, and the large medial pterygoid has extended its origin anteriorly to the floor of the orbit, which would enhance protrusion. The importance of the tongue and hyoid muscles during mastication is suggested by broadly expanded anterior bellies of digastrics, which may assist mylohyoids in tensing the floor of the mouth during forceful tongue actions, and by preliminary electromyography, which suggests that masticatory muscles alone cannot fully account for jaw movements in this species.

Animals↗
PubMed1986

Age at death determinations for autopsied remains based on aspartic acid racemization in tooth dentin: importance of postmortem conditions.

The extent of aspartic acid racemization in human dentin can be used to assess chronological age of the individual. This novel chemical method of aging human remains has potential applications in forensic sciences. Six autopsy cases have been analyzed for D/L aspartic acid contents, and their ages at death calculated. Independent age information came from known identity, tooth maturation, or tooth wear estimations. The six cases represented a range of postmortem fates: recent demise, burial, and ground surface exposure. Five samples, four recently deceased and one a burial, showed racemization ages in close agreement with other age data. One specimen, subjected to 51 days of open air exposure, exhibited a vastly inflated racemization age. Postmortem conditions are crucial to the accuracy of racemization age at death measurements.

Adult↗
PubMed2003

Restoration of canine guidance on an occlusal splint using amalgam: a clinical report.

A primary consequence of sleep bruxism is severe tooth wear. Although an occlusal splint is able to protect teeth, grinding may continue on its surface. This clinical report describes an approach to restore canine guidance on an occlusal splint, with amalgam, for a patient with sleep bruxism. This procedure allowed maintenance of the canine guidance for a period of time longer than 3 months, postponing the fabrication of a new splint.

Adolescent↗
PubMedDate not supplied

Vectored upper cervical manipulation for chronic sleep bruxism, headache, and cervical spine pain in a child.

OBJECTIVE: To discuss the management of chronic sleep bruxism in a 6-year old girl. Clinical features The patient had morning headaches and cervical spine pain. Due to abnormal tooth wear, bruxism had been previously diagnosed and was verified by observation during sleep. She also had abnormal postural and palpatory findings, indicating upper cervical joint dysfunction. Intervention and outcome Bilateral rotary cervical stretching/mobilization and a vectored high-velocity, low-amplitude adjustment were performed in the upper cervical spine, using the atlas transverse process as the contact point. There was complete relief of the chronic subjective symptoms concomitant with remission of the objective signs of joint dysfunction. CONCLUSIONS: Cervical, particularly upper cervical, spine muscle-joint dysfunction should be considered as a potential etiology in chronic childhood sleep bruxism.

Bruxism↗
PubMed2005

The clenching-grinding spectrum and fear circuitry disorders: clinical insights from the neuroscience/paleoanthropology interface.

This review discusses the clenching-grinding spectrum from the neuropsychiatric/neuroevolutionary perspective. In neuropsychiatry, signs of jaw clenching may be a useful objective marker for detecting or substantiating a self-report of current subjective emotional distress. Similarly, accelerated tooth wear may be an objective clinical sign for detecting, or substantiating, long-lasting anxiety. Clenching-grinding behaviors affect at least 8 percent of the population. We argue that during the early paleolithic environment of evolutionary adaptedness, jaw clenching was an adaptive trait because it rapidly strengthened the masseter and temporalis muscles, enabling a stronger, deeper and therefore more lethal bite in expectation of conflict (warfare) with conspecifics. Similarly, sharper incisors produced by teeth grinding may have served as weaponry during early human combat. We posit that alleles predisposing to fear-induced clenching-grinding were evolutionarily conserved in the human clade (lineage) since they remained adaptive for anatomically and mitochondrially modern humans (Homo sapiens) well into the mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain, craniomaxillofacial musculoskeletal pain, temporomandibular disorders, oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders are linked. A 2003 Cochrane meta-analysis concluded that dental procedures for the above spectrum disorders are not evidence based. There is a need for early detection of clenching-grinding in anxiety disorder clinics and for research into science-based interventions. Finally, research needs to examine the possible utility of incorporating physical signs into Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition posttraumatic stress disorder diagnostic criteria. One of the diagnostic criterion that may need to undergo a revision in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition is Criterion D (persistent fear-circuitry activation not present before the trauma). Grinding-induced incisor wear, and clenching-induced palpable masseter tenderness may be examples of such objective physical signs of persistent fear-circuitry activation (posttraumatic stress disorder Criterion D).

Anthropology↗
PubMed2005

Forensics: age written in teeth by nuclear tests.

Establishing the age at death of individuals is an important step in their identification and can be done with high precision up to adolescence by analysis of dentition, but it is more difficult in adults. Here we show that the amount of radiocarbon present in tooth enamel as a result of nuclear bomb testing during 1955-63 is a remarkably accurate indicator of when a person was born. Age is determined to within 1.6 years, whereas the commonly used morphological evaluation of skeletal remains and tooth wear is sensitive to within 5-10 years in adults.

Age Determination by Teeth↗
PubMed1999

The craniofacial morphology of bruxers versus nonbruxers.

The purpose of this investigation was to test for an association between the craniofacial morphologies of bruxers and nonbruxers. The sample for this retrospective descriptive comparative study consisted of 28 Caucasian dental school subjects. Sixteen were bruxers and 12 were nonbruxers. The determination of bruxism was based on a six-item questionnaire as well as objective measures of the severity of tooth wear as analyzed from dental casts. Craniofacial morphology was determined directly using anthropometric spreading calipers. Craniofacial measurements included glabella-opiscranion, euryon-euryon, nasion-gnathion, zygoma-zygoma, and gonion-gonion. From these measurements, the following indices were calculated: cephalic (Gla-Op/Eu-Eu), facial (Na-Gla/Zy-Zy), gonial (Zy-Zy/Go-Go), and gonial height (Na-Gla/Go-Go). This study found no differences in the craniofacial morphologies of bruxers and nonbruxers, nor was there a difference in overbite. There was, however, a statistically significant difference in the bizygomatic (Zy-Zy) and cranial (Eu-Eu) widths of bruxers compared with nonbruxers.

Adult↗
PubMed2000

Saliva tannin interactions.

Many plant foods contain tannins, compounds that bind proteins, such as mammalian enzymes. Although described as tasteless, tannins can be detected orally by their astringency. However, the actual mechanism of oral detection and the effect of tannins on mastication and swallowing have been little investigated. Here, we show from in vitro tests that tannic acid, a common standard in tests used to detect tannins, significantly reduces the lubricating qualities of human saliva both by decreasing its viscosity and increasing friction, both factors lending support to the notion that astringency is a tactile phenomenon. From the literature, it is clear that this effect depends on the presence of salivary proline-rich proteins (PRP). In a mammalian context, ingestion of tannin-rich foods in a species with salivary PRP will be signalled by interference with bolus formation during mastication while the increase in friction may also be detectable and lead to increased tooth wear if the signal is ignored. In a human context, cross-cultural preferences for tannin-rich beverages such as tea, coffee and red wine at the end of meals may be explained by reduction in adhesion of food particles to the oral mucosa allowing their rapid oral clearance.

Adult↗
PubMed1999

Bruxism and cranial-cervical dystonia: is there a relationship?

To characterize the relationship between bruxism and dystonia, 79 patients (28 men and 51 women) with cranial-cervical dystonia were studied. Sixty-two patients (78.5%), 22 men and 40 women, had bruxism. The mean age at onset of dystonia in patients with bruxism was 52.4 +/- 12.6 years (range 14-80), similar to patients with cranial-cervical dystonia without bruxism. Involuntary oromandibular movements (46 patients) and blepharospasm (34 patients) were the most common initial symptoms among patients with dystonia. About one-fourth of bruxism patients had associated dental problems including TMD (21%) and tooth wear (5%). A majority (58%) of the bruxism patients had diurnal bruxism and 12% had nocturnal bruxism. The bruxism patients were compared to 100 patients with Parkinson's disease (PD), cervical dystonia, cranial dystonia, and normal controls, respectively. The prevalence of bruxism was much higher in the cranial-cervical dystonia patients when compared to normal controls (P < 0.001); however, this difference was not significant between other diseased groups and controls. Medications and botulinum toxin injections, used in the treatment of focal dystonia also provided effective relief of bruxism.

Adolescent↗
PubMed1998

Functional occlusal relationships in a group of post-orthodontic patients: preliminary findings.

This study investigated features of the functional occlusion in a group of 37 patients immediately following two-arch fixed appliance treatment. Study casts were mounted in the retruded axis position on a semi-adjustable articulator and occlusal contacts were recorded with articulating paper in retruded and lateral mandibular positions. The magnitude of the slide between the retruded axis position and the intercuspal position was measured to the nearest 0.5 mm in the antero-posterior, vertical and lateral directions. The results revealed that the majority of subjects had a unilateral contact on initial closure in the retruded axis position, and a slide between this position and the intercuspal position. Most subjects demonstrated canine guidance on the working side in lateral positions. In addition, however, most subjects had contact between the second molars on the non-working side. Based on current concepts of functional occlusion, this group of post-orthodontic patients did not exhibit ideal occlusal relationships. The long-term implications of this finding are unclear, but may be associated with post-orthodontic instability, tooth wear and temporomandibular disorders. A long-term follow-up is planned to attempt to clarify some of these issues.

Dental Articulators↗