Camila Maria Bastos Machado de Resende

Association between prosthetic factors and temporomandibular disorders in complete denture wearers

OBJECTIVE The purpose of this study was to investigate the prevalence of temporomandibular disorders (TMD) in denture wearers and the association between prosthetic factors and this condition. BACKGROUND There is no consensus about the relationship between prosthetic factors and TMD among denture wearers. MATERIALS AND METHODS The sample was composed of 92 patients wearing both maxillary and mandibular complete dentures. The Research Diagnostic Criteria for TMD (RDC/TMD) were adopted for patient examination. Objective evaluation of denture quality was determined by analysis of retention and stability of mandibular denture, interocclusal distance, articulation and occlusion. Association between denture quality and TMD diagnosis was analysed using chi-square and Fishers exact tests. RESULTS 37.4% of the patients presented TMD. Denture quality was not significantly associated with the presence of TMD: mandibular retention (p = 0.466); mandibular stability (p = 0.466); interocclusal distance (p = 0.328); centric relation (p = 0.175); and balanced occlusion (p = 0.56). CONCLUSION Within the scope of this case-controlled cross-sectional study, no robust association between prosthetic factors and TMD was found.

The influence of mandibular ridge anatomy on treatment outcome with conventional complete dentures

Since prognostic indicators are likely to take on increasing importance as a diagnostic tool for selection of patients for implant provision, this study investigated the influence of the shape and resiliency of the mandibular alveolar ridge on the retention and stability of conventional complete dentures. Ninety- three edentulous patients wearing both maxillary and mandibular conventional complete dentures composed the sample. Data were collected regarding shape and resiliencyof the mandibular residual ridge. Dentures were assessed for retention and stability using an objective and reproducible tool.The associations between the clinical characteristics of the mandibular alveolar ridge and denture retention and stability were analyzed using chi-square and Fisher exact tests (a = 0.05). A significant association between ridge shape and denture stability (p < 0.05) was found, while ridge resiliency was significantly associated to denture retention (p < 0.001). Based on the results, mandibular ridge shape and resiliency influenced the retention and stability of conventional complete dentures.

Periodontal Conditions of Abutments and Non-Abutments in Removable Partial Dentures over 7 Years of Use

PURPOSE To evaluate the periodontal conditions and integrity of abutment and non-abutment teeth of patients evaluated 7 years after insertion of the removable partial denture (RPD). MATERIALS AND METHODS Twenty-two patients (17 women, 5 men) were assessed at the moment of denture insertion and 7 years later. The following items were verified in each assessment: bleeding on probing (BP), probing depth (PD), gingival recession (GR), and mobility (M), comparing direct and indirect abutment teeth, and the teeth not involved in the denture design. Tooth integrity was also evaluated and classified as intact when no caries or fractures were observed. The Kruskal-Wallis test was used to reveal statistical significance between the groups (p = 0.05) as well as the Bonferrroni-corrected Mann-Whitney test for post hoc comparison. The Wilcoxon test was used for evaluation within the group over time. Fishers exact test was applied to cross data about abutment integrity. RESULTS Statistically significant differences were found for GR (baseline, p < 0.001; 7 years, p < 0.001) and PD (baseline, p = 0.001; 7 years = 0.004) between the three groups at baseline and after 7 years of follow-up. Mean BP and M values increased from initial assessment to after 7 years of RPD use in every group, but no statistically significant difference was found between the groups. For abutment integrity, a statistically significant difference (p = 0.028) was observed, and the direct abutment exhibited more (33.3%) caries and fractures. CONCLUSION RPDs generated more periodontal damage to direct abutments, since higher gingival recession probing depth indexes, and presence of caries and fractures were observed in comparison to indirect abutments and non-abutments.

Effect of Watsu therapy on psychological aspects and quality of life of patients with temporomandibular disorder: case report

Watsu therapy is a water relaxation intervention technique performed individually in a warm pool with music and peaceful settings involving harmonious rotational movements, stretching, tractions on the joints and pressures at the points of muscle tension. This study evaluated the effect of Watsu therapy on psychological aspects (anxiety and minor psychiatric disorders) and on the quality of life of a patient with temporomandibular disorders. The patient answered three questionnaires: STAI (State-Trait Anxiety Inventory) and GHQ (Goldberg Health Questionnaire) to assess anxiety and psychiatric disorders respectively, and WHOQOL- Brief (World Health Organization Quality of Life) to assess quality of life. Watsu therapy has been used in patients with temporomandibular disorders (TMD) such as myofascial pain diagnosed by RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders). Psychological aspects and quality of life were assessed before and after Watsu therapy. The results after treatment showed relevant and significant improvement on all indices evaluated. Therefore, it was shown that Watsu therapy was effective in reducing anxiety and minor psychiatric disorders, as well as improved quality of life of patients with temporomandibular disorder.

Relationship between anxiety and temporomandibular disorders in dental students

Abstract Objective: To evaluate the prevalence of temporomandibular disorder (TMD) in dental students and its correlation with anxiety. Methods: After probability sampling, 105 students were selected. The diagnosis of TMD was carried out using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) – Axis I; the anxiety level was obtained by the State-Trait Anxiety Inventory (STAI). Data from TMD and anxiety were calculated through frequency and Chi-square test to assess the association between TMD and anxiety, considering a significance level of 5%. Results: TMD was present in 36.2% of the students; disc displacement (42.1%), and arthralgia (42.1%) were the most prevalent subtypes. The majority of students presented both traits (57.1%) and state (65.7%) anxiety in mild levels, followed by moderate levels. No statistical association between TMD and anxiety was found (p > 0.05). Conclusion: Joint TMD was the most prevalent subtype of TMD in dental students and was not associated with anxiety levels.

Satisfaction and Fibromucosa Integrity in Patients Wearing Mandibular Kennedy Class I RPDs

Introduction: The association between the patient’s satisfaction and the occurrence of ulcers is important for treatment predictability. The aim of this study was to evaluate the satisfaction level, fibromucosa integrity and relation between these two factors in patients wearing mandibular Kennedy Class I removable partial dentures (RPD) and maxillary complete dentures at the Dental Department of Federal University of Rio Grande do Norte (UFRN). Materials and Methods: The satisfaction of 52 patients was evaluated based on a questionnaire about current prostheses, reasons for dissatisfaction, personal opinions about the prostheses, function and period 6 months to 1 year after insertion of denture wearing. The fibromucosa integrity was based on the occurrence of ulcers after 24 hours; 7, 15, 30 and 60 days, and 6 months. Results: A total of 90.4% of the patients (n=47) wore RPDs. Most of the patients (75%, n=39) reported satisfaction with RPDs; functional problems were the main reason for dissatisfaction (21.2%, n=11). The occurrence of ulcers decreased over time. The ulcers were usually located in the region of fornix. Patients were classified into Class III and IV according to the PDI classification. Fisher’s exact test was used to assess any association between satisfaction and fibromucosa integrity and no significant difference was found (p=0.275). Conclusions: The patients reported appropriate satisfaction with the Kennedy Class I RPDs after 6 months and 1 year. There was no association between patients’ satisfaction and fibromucosa integrity.

Signs of Combination Syndrome and removable partial denture wearing

Introduction:Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers.Purpose:The aim of this study was to observe and measure the prevalence of CS signs in treatment-seeking wearers of maxillary CD associated or not with RPD (mandibular Kennedy Class I). The association between RPD wearing and the number of CS clinical signs was also evaluated.Material and method:The sample included 62 patients seen at the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). A clinical oral examination was conducted to assess the presence of specific clinical signs of CS as described by Kelly (1972): bone resorption in the maxillary anterior region, tuberosity overgrowth, palatal papillary hyperplasia, extrusion of mandibular anterior teeth and bone resorption in the mandibular posterior region. The chi-square test at the 95% level of significance was used to test the association between dependent and independent variables.Result:Mandibular resorption was the most frequent complication (93.5%). There was a statistically significant difference between RPD wearers and non-wearers with regard to extrusion of mandibular anterior teeth (p = 0.045).Conclusion:Within the limitations of the present study, a high prevalence of CS clinical signs was observed, but no association between RPD wearing and syndrome characteristics was found.