Associations between fluctuation of treatment need for temporomandibular disorders (TMD) and age, gender, stress, and diagnostic subgrouping were analyzed in a 2-year follow-up of 391 subjects. All the studied factors were significantly associated with the treatment need for TMD at all examinations. The diagnostic subgroup (TMD arthro, TMD myo, TMD comb, or non-classified) at base line was significantly associated with the fluctuation of the treatment need for TMD also during the follow-up, but age, gender, and stress score were not. In the subgroup needing active treatment for TMD at least once during the follow-up (n = 65), the stress score did not show statistically significant covariation with the treatment need. The diagnostic subgrouping of these 65 subjects at the second and third examination at 12-month intervals did not show any association with the subgrouping at base line or with any studied variable. Detailed descriptive diagnostics may serve well in treatment planning but do not necessarily help us in understanding the nature of TMD.
We studied the fluctuation of temporomandibular disorders, applying two classifications systems, in a 2-year follow-up study of 411 subjects. In general, the fluctuation was not large. There were no major differences between the two classifications. In our opinion, a decision to treat a patient on the basis of the treatment need grouping would not lead to overtreatment. The study design suffered from the fact that it is not possible to separate the fluctuation of the TMD itself and the fluctuation of its signs and symptoms from each other, owing to the descriptive nature of the diagnosis 'temporomandibular disorder'.
The occlusal fissures of 156 permanent first molars in 63 children, 7--8 years of age, were sealed with a chemically polymerizing material (Delton). Deep and narrow fissures were opened up with a pointed diamond before etching and sealing. The treatment was performed by untrained dental students. The patients were called back for treatment every 6 months. 2/3 of the patients were followed up for a period of 2 1/2 years. After that period the retention of sealants was 93% (74 sealants) in ground deep fissures and 88% (28 sealants) in unground shallow fissures.
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