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The destabilizing effect of endodontic treatment upon teeth is still controversial. The purpose of this study was to investigate the effects of different steps of endodontic treatments upon the rigidity of teeth. Extracted untreated central maxillary anterior teeth were loaded (3.75 N), and deformations of the root were assessed by Speckle pattern interferometry. The following treatments (with subsequent determination of deformability) were conducted sequentially: access preparation, manual instrumentation (Kerr files ISO-40, ISO-60, ISO-80, ISO-110), and tapered and parallel-sided post preparation. It was found that the teeth were increasingly destabilized by any treatment. While the increased deformability was not significant with the manual enlargement (p > 0.05), we found a significant destabilization after access preparation and post preparation (p < 0.05). A corresponding difference was found after conversion of the post preparation from tapered to parallel-sided (p < 0.05). Both substance loss and modifications of the natural root canal geometry play an important role in tooth rigidity.

The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects.

BackgroundProgressive scoliosis, pelvic obliquity and increasing reduction of pulmonary function are among the most significant problems for patients with SMA type II and SMA type III once they have lost the ability to walk. The aim of this study was to examine and document the development and natural course of scoliosis in patients with spinal muscular atrophy type II and IIIa.MethodsFor the purposes of a descriptive clinical study, we observed 126 patients, 99 with SMA II and 27 with SMA IIIa and the data of scoliosis, pelvic obliquity and relative age-dependent inspiratory vital capacity were evaluated.ResultsScoliosis and pelvic obliquity were regularly observed already in children under 4 years old in the group with SMA II. The severity and progression of both conditions were much more pronounced in the SMA II group than in the IIIa group. There was already a distinct reduction in relative vital capacity in the group of 4- to 6-year-olds with SMA II.ConclusionsThe differences between the two SMA types II and IIIa described in this study should be taken into consideration when developing new treatments and in management of scoliosis in the childhood years of these patients.

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BackgroundStress is discussed as a potential factor in the development of sleep bruxism (SB). The aim of this study was to investigate whether specific stress-factors correlate with SB-activity.MethodsSixty-nine subjects, of which 48 were SB-patients, completed three German questionnaires assessing different stress-parameters and stress-coping-strategies: Short questionnaire for recognition of stress-factors (Kurzer Fragebogen zur Erfassung von Belastungen, KFB), Questionnaire for recuperation and strain (Erholungs-Belastungs-Fragebogen, EBF-24 A/3) and the stress-coping questionnaire (Stressverarbeitungsfragebogen-78, SVF-78). The diagnosis of SB was based on the clinical criteria of the American Academy of Sleep Medicine (AASM). The degree of SB-activity was measured by the Bruxcore-Bruxism-Monitoring-Device (BBMD, Bruxcore, Boston, USA), worn for five consecutive nights and analyzed using a computer-based method. Non-parametric Spearman correlation coefficients, rho, were calculated between the psychometric data and the amount of SB-activity measured by a pixel score of the BBMD.ResultsSignificant correlations were found for 'daily problems' (r = 0.461, p < 0.01), 'trouble at work' (r = 0.293), 'fatigue' (r = 0.288), 'physical problems' (r = 0.288) and the coping-strategy 'escape' (r = 0.295) (all p < 0.05).ConclusionsWithin the limitations of this study it could be shown that subjects with high SB-activity tend to feel more stressed at work and in their daily life, which in turn might influence their physical state. These subjects also seem to deal with stress in a negative way. However, due to the rather low to almost moderate correlation coefficients and the descriptive character of the study, further investigations are necessary to examine a possible causal relationship.

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