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BackgroundPain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management.MethodsA survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ rheumatoid disorders and TMJ surgery. Original articles and review papers which presented the clinical relevance and practical validity regarding the possibility of application in TMD management have been included. Authors have excluded articles without outstanding practical aspect and evidence-based background. A first selection was carried out by reviewing titles and abstracts of all articles found according to the criteria. After that the full texts of potentially suitable articles were assessed. In line with these criteria, among 11467 results the writers have included 66 papers.ResultsThe most commonly reported conservative treatments are massage therapy and individually fabricated occlusal splints. In addition to massage, other popular methods include manual therapy and taping, warming/cooling of aching joints, and light and laser therapy. Drugs are also commonly used. In the most severe cases of the temporomandibular joint degeneration, surgical restoration of the joint is sometimes applied.ConclusionsThe authors concluded that conservative treatment including counselling, exercises, occlusal splint therapy, massage, manual therapy and others should be considered as a first choice therapy for TMD pain because of their low risk of side effects. In the case of severe acute pain or chronic pain resulting from serious disorders, inflammation and/or degeneration pharmacotherapy, minimally invasive and invasive procedures should be considered.

Chitosan is a linear amino-polysaccharide and a natural polymer with a structure based on repetitive deacetylated and acetylated units randomly distributed. It is produced from chitin, one of the most common naturally occurring polysaccharides. Its numerous biomedical applications have been extensively described in the literature. It becomes more and more popular as a therapeutic agent and its use is constantly extended. Given its commonness, regenerative properties, easy chemical treatment, and biocompatibility, it might be used in the treatment of damaged oral cavity tissues. Due to its antimicrobial and regenerative-inducting properties as well as high biocompetency, chitosan is more and more frequently used in medicine and dentistry. It can be applied in all fields of dentistry including preventive dentistry, conservative dentistry, endodontics, surgery, periodontology, prosthodontics and orthodontics. Several data discussing the effectiveness of chitosan use on new bone formation are still inconclusive. The aim of the paper was to evaluate the applicability and biochemical impact of chitosan on oral health maintenance. Even though chitosan might find its adhibition in all dental specialities, it should still be considered as a potential allergen and thus further studies on this topic should be carried out.

Objectives. Polyamide-12 (PA) is a flexible material suited for denture bases and clasping. This study investigated its potential aging effects with a focus on surface roughness, color stability, and elasticity. Methods. PA specimens (Valplast) of 40 × 10 × 2 mm and equally measuring PMMA specimens (Palapress) as control were fabricated. Color changes after storage in air, water, coffee, and red wine (n = 10) were measured using the CIE L*a*b* color specification. Elasticity after thermocycling (1000, 3000, and 7000 cycles,  n = 15) was measured by three-point bending testing. Mean surface roughness (Ra) was determined after storage in the liquids mentioned above and thermocycling (n = 10). Results. Tukey's HSD test (P < 0.05) revealed statistically significant color changes of PA in red wine (ΔE = 4.27 after 12 days, ΔE = 6.90 after 12 days) and coffee (ΔE = 3.93 after 36 days) but no color changes in PMMA. Elastic modulus of PA was 845 MPa and not affected by thermocycling (Tukey's HSD test,  P > 0.81). Dry specimens showed significantly decreased elasticity (P < 0.001). Mean surface roughness (PA 0.20 μm, PMMA 0.28 μm) did not change significantly after thermocycling or storage (Mann-Whitney U-test,  0.16 < P < 0.65). Significance. PA exhibited a higher susceptibility to discoloration than PMMA. Neither surface roughness nor elasticity of PA was altered by artificial aging.

The problems encountered in casting titanium in dentistry have not been completely resolved. The Procera system forms crowns by means of a combination of spark-erosion and milling. The accuracy of fit was examined before and after ceramic veneering both in vitro and in vivo. Before veneering, on conical surfaces space widths were approximately 53 microns in vitro and 69 microns in vivo. At shoulders and occlusal surfaces, spaces of about 430 microns were measured in vitro and of about 500 microns were measured in vivo. After ceramic veneering, slight increases in space widths could be observed. The metal-ceramic compound was tested by the 3-point bending test (DIN) and the bending test (ISO). The DIN test was satisfactory, but not the ISO test. It is concluded that titanium crowns processed by the Procera System are suitable for clinical usage, if the space widths at shoulders and the occlusal surface and the special requirements of tooth preparation are taken into account.

Regarding declining resources epidemiological data on needs for oral rehabilitation are required. Within the framework of an oral health survey a non-stratified two-stage random sample was taken to represent the over 14-year-old population of Saxony/Germany. The participation rate was 55%. Normative need was determined by dental assessment and guidelines developed in a consensus process, subjective prosthetic treatment need by self-complete questionnaire. About 97% of the realized sample could be planned within the guidelines. About 81% had normative prosthetic treatment need. Compared with the rate of normative need the rate of subjective need (13%) was considerably lower (chi(2) P < 0;01). Different predictive parameters of subjective need were identified by logistic regression. Besides other factors subjective need was associated with giving dentist's recommendation as significant reason for prosthetic restorations [odds ratio (OR)=5;43], not believing that the own teeth were all right (OR=0;17), and the existence of prosthetic restorations (OR=3;87 for fixed restorations; OR=4;05 for removable dentures). The guidelines proved their suitability to assess normative prosthetic treatment need in oral health surveys. Further research is necessary to find adequate options for including patients' preferences in an adequate need definition.

Aging reduced the translucency in all specimens tested. Furthermore, translucency differed between the zirconia brands tested. Nevertheless, the differences were below the detectability threshold of the human eye. The aging process can influence the translucency and thus the esthetic outcome of zirconia restorations; however, the changes in translucency were minimal and probably undetectable by the human eye.

Abstract:Chitosan is known for its hemostatic and antimicrobial properties and might be useful for temporary coating of removable dentures or intraoral splints to control bleeding after oral surgery or as a supportive treatment in denture stomatitis. This study investigated a new method to adhere chitosan to polymethyl methacrylate (PMMA) and polyethylene terephthalate (PET). There were 70 cylindrical specimens made from PMMA and 70 from PET (13 mm diameter, 6 mm thickness). The materials with ten specimens each were sandblasted at 2.8 or 4.0 bar with aluminum oxide 110 µm or/and aluminum oxide coated with silica. After sandblasting, all specimens were coated with a 2% or 4% acetic chitosan solution with a thickness of 1 mm. Then the specimens were dried for 120 min at 45˝C. The precipitated chitosan was neutralized with 1 mol NaOH. After neutralization, all specimens underwent abrasion tests using the tooth-brushing simulator with soft brushes (load 2N, 2 cycles/s, 32˝C, 3000 and 30,000 cycles). After each run, the specimen surfaces were analyzed for areas of remaining chitosan by digital planimetry under a light microscope. The best chitosan adhesion was found after sandblasting with aluminum oxide coated with silica (U-Test, p < 0.05) in both the PMMA and the PET groups. Hence, with relatively simple technology, a reliable bond of chitosan to PMMA and PET could be achieved.