No abstract

Acidic fluoride solutions may reduce dental erosion. The aim of this study was to compare the effect of different acidic fluoride solutions on enamel dissolution using an established in vivo model. When possible 4 anterior teeth (255 teeth in a total of 67 subjects) were isolated and exposed to 0.01 M citric acid. The acid was collected in test tubes before (etch I) and 5 min after (etch II) application of test fluoride preparations. Acidic fluoride solutions (pH range 1.5–2.9), i.e. SnF₂, TiF₄ and hydrogen fluoride (HF) (all approx. 0.1 M F), HF (0.027, 0.055, 0.082 M F) and neutral NaF solution (0.1 M F) as control were applied to the labial surfaces of the teeth for 1 min (6 ml/min). Enamel dissolution was examined by chemical analysis of calcium content in the citric acid etch solutions using atom absorption spectrometry. The change in calcium concentration (ΔCa) and the percentage of mean calcium reduction were calculated from the difference in calcium loss between etch I and etch II. Statistical analysis was carried out using the Wilcoxon signed rank test and Kruskal-Wallis tests with Dunn’s multiple comparison. Results showed a mean ΔCa of 0.671 mg/l (SD 0.625) for SnF₂, and ranged from 0.233 mg/l (SD 0.248) for the weakest HF solution to 0.373 mg/l (SD 0.310) for the strongest HF solution. This represented a 67% reduction in enamel dissolution for SnF₂ and a 40–76% reduction for the HF solutions. No reduction was observed for TiF₄ or NaF. The types of metal, pH and fluoride concentration are all important for the in vivo effect.

The aim of this study was to compare conventional and digital additive manufacturing of hard occlusal stabilization splints (SS) using technical and clinical parameters. 14 subjects were subjected to DC/TMD Axis I clinical examination protocol and Axis II questionnaire. The subjects underwent treatment with splints over a period of 12 weeks. All subjects underwent both conventional alginate impression and intraoral digital scanning. Seven subjects received conventional manufactured stabilization splints (CM-SS), and seven subjects received CAD-CAM additive manufactured stabilization splints (AM-SS). 12 subjects completed the 12 weeks follow-up period. The subjects significantly preferred digital intraoral scanning compared to conventional alginate impression. There was a significant difference in VAS between CM-SS and AM-SS. The mean VAS result was 15 for AM-SS and 42 for CM-SS, 0 represented excellent comfort and 100 very uncomfortable. This was significant. Splint manufacturing method had no influence on treatment outcome. There was no significant difference in mean delta change for unassisted jaw opening from baseline to 12 weeks between the two groups, for CM-SS it was 2 mm difference and for AM-SS the difference was 3 mm. All subjects in both treatment groups showed improved oral function. In this study, the scanning procedure is more accepted by the subjects than alginate impressions, however the first procedure was more time consuming.

No abstract

Myalgia is a subdivision of temporomandibular dysfunction (TMD), which in turn comprises disorders of the temporomandibular joint and surrounding musculature. Schiffman et al 1 defined myalgia as pain of muscle origin that is affected by jaw movement, function or parafunction, and replication of this pain occurs with provocation testing of the masticatory muscles. The low-cost, and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, 2 stretching exercises, 2 manual therapy, 3 acrylic splints 4 and cognitive behavioural therapy. 5 In addition, Norwegian national recommendations include, acupuncture, sleep, posture correction, diaphragmatic breathing and NSAIDs. 30 The National Board of Health and Welfare in Sweden also ranks the different treatments from 1 to 10, based on level of evidence, cost vs effect and probability for success. Many of the treatments prescribed by general practitioners today are labelled as self-care, implicating that the patients themselves are responsible for performing the prescribed treatment. 2,4,6-13 These reversible and low-cost treatments entail little risk for patient injury, but one would still expect the treatments to be supported by scientific evidence.While, the prevalence of TMD in Scandinavia is reported to be as This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Abstract Background: The low-cost and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, stretching exercises, manual therapy, acrylic splints and cognitive behavioural therapy.Objective: The aim of this study was to evaluate the evidence behind the use of self-exercising programmes and occlusal splints in the treatment of myofascial pain. Methods:We conducted a thorough search of five databases, using four cardinal search terms in combination with twelve supporting terms. We also assessed the evidence quality, using GRADEpro software. Results:The search resulted in 4967 individual studies. 18 studies met the inclusion criteria and were re-evaluated. Conclusion:The selected studies were in favour of a self-care or an occlusal splint treatment of myalgia. However, a GRADE assessment showed that 14 of the 18 selected studies had low or very low evidence quality. Studies also showed weaknesses with regard to nomenclature and reproducibility. Hence, it is our professional opinion that the evidence level for prescribing self-exercises and occlusal splints in the treatment of myalgia is low. K E Y W O R D Sevidence-based medicine, myalgia, myofascial pain, self-care, temporomandibular dysfunction How to cite this article: Eliassen M, Hjortsjö C, Olsen-Bergem H, Bjørnland T. Self-exercise programmes and occlusal ...

Objective The aim of this retrospective study was to evaluate clinical success and satisfaction of patients with amelogenesis imperfecta treated with three different types of bonded restorations at a university clinic. Materials and Methods One hundred fifty‐four restorations in 15 subjects with mean age of 17.3 years (SD 8.2) were evaluated after treatment with three different types of bonded restorations: all ceramic enamel‐dentin bonded restorations, prefabricated composite veneers, and direct composite resin restorations. A modified version of the Californian Dental Association system for quality evaluation of dental care and a questionnaire assessing patient satisfaction were used for classification. The restorations were evaluated with respect to patient satisfaction, esthetics, technical, and biological complications. Results Mean observation period for the restorations was 42.5 months (SD 35.6). All restorations were in place at the time of the examination. Surface and color calibration showed a success of 95% for the ceramic enamel‐dentin bonded restorations, 44% for the direct composite resin restorations, and 0% for the prefabricated composite veneers. The same pattern was evident for anatomy and marginal integrity. The subjects reported a high degree of satisfaction with both the esthetics and function of their restorations. Conclusion The results indicated that all ceramic restorations demonstrated the best results for patients with amelogenesis imperfecta.

This study aimed to investigate the surface zones of acidic fluoride-treated enamel. Human teeth were each divided into three or four enamel specimens that were treated for 10 min with solutions of 0.2 and 0.4% HF (pH 3.09 and 2.94), 1.74% SnF₂ (pH 2.9), 0.68% TiF₄ (pH 1.6) and 0.84% NaF (pH 4.5). Untreated specimens functioned as negative controls. The microstructure and elemental composition of the surface zones were studied by scanning electron microscopy/energy-dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM) and nanospot-EDX following cross-sectional preparation using focused ion beam technology. TEM/EDX analyses of NaF-treated specimens showed a 500-nm-thick closed surface film containing 20-40 at% (atomic percent) F. HF-treated specimens had a distinct surface film 200-600 nm thick (dense, not globular) containing 45-47 at% F. TiF₄-treated specimens had a surface film of 200-300 nm in thickness containing 8-11 at% Ti but no detectable fluoride. SnF₂-treated specimens had a modified surface enamel layer varying in thickness from 200 to 800 nm with an inhomogeneous distribution of Sn. Local spots were detected with as high as 8 at% Sn (30 wt%, weight percent). The results suggest that the reaction mechanisms of SnF₂ and TiF₄ solutions with dental enamel differ from those occurring after enamel exposure to acidulated NaF and HF solutions. While the HF and NaF treatments resulted in the formation of CaF₂-like material as shown by EDX, no significant surface fluoridation was found for SnF₂ and TiF₄ solutions within the TEM/EDX detection limits. These results suggest that the erosion-protective mechanisms of these latter compounds probably relate more to the formation of hardly soluble and acid-resistant reaction surface films and less to surface fluoride incorporation.

The results in this clinical study are positive and promising. Admittedly, the study design is purely retrospective and observational with a small participant cohort, so the technical solution of placing three implants in the edentulous maxilla to retain a removable prosthesis should be appraised further in more controlled studies.