Esa Klemetti

Panoramic mandibular index and bone mineral densities in postmenopausal women

The panoramic mandibular index was used in a group of postmenopausal women to determine whether it correlates with bone mineral densities of the femoral neck, lumbar area, and the trabecular and cortical parts of the mandible. The bone mineral density values were measured by dual-energy x-ray absorptiometry of the femoral neck and lumbar area and by quantitative computed tomography of the mandible. Linear correlation of the panoramic mandibular index with all bone mineral density values was weak. However, the low and high index subgroup means were clearly dependent on the bone mineral density variables.

Oral and dental manifestations in gastroesophageal reflux disease.

One hundred seventeen patients with reflux disease were examined with respect to the severity of their disease and oral, dental, and salivary findings. Twenty-eight patients had dental erosion, whereas the remaining 89 patients did not. No mucosal changes could be observed to be linked with the reflux disease. In the mean, the patients with erosion were older (54 versus 49 years), and the mean duration of their reflux disease was longer in comparison to those without erosion (17 versus 11 years, respectively). The severity of the reflux disease was more marked among patients with erosion than in those without as assessed by esophagogastroduodenoscopy, the Maratka classification, histologic examination of gastric and esophageal biopsy specimens, and 24-hour esophageal pH monitoring. No statistically significant differences were observed between the groups in any salivary parameters studied, although the number of patients with low salivary-buffering capacity was higher among those with erosion than among those without. Patients taking beta-blocking agents or tranquilizers had more erosion than those who did not take these medications. The severity of the reflux disease was not associated with any subjective symptoms in the mouth or pharynx. The frequency of consumption of acidic drinks and foodstuffs as determined by a questionnaire did not differ between the patients with and without dental erosion. Thus severe reflux disease of long duration was found to be potentially detrimental to the teeth, whereas milder forms of the disease need not cause dental side effects.

Biometric design of complete dentures related to residual ridge resorption

The aim of this study was to determine whether the location of the incisive papilla, the extent of the alveolar bone remaining on the facial side of the palatal-gingival margin in the canine region, and the height of the palatal vault in the molar region are associated with factors that may affect the volume of the residual ridges in an edentulous maxillae. Results suggest that duration of the edentulousness and skeletal mineral status are important factors in the resorption of the residual ridges in the maxillae. The location of the incisive papilla and the thickness of the ridge on the facial side of the palatal-gingival margin are associated with these two factors.

Signs of temporomandibular dysfunction related to edentulousness and complete dentures: an anamnestic study.

Symptoms of temporomandibular dysfunction (TMD) are prevalent among elderly individuals with complete dentures. In the agrarian areas of middle Finland it was, as recently as a few decades ago, almost a tradition to extract teeth during young adulthood. Women who today are in post-menopausal age are the last sizable age group in Finland where the problems of edentulousness can be investigated. The purposes of this study were twofold. First, postmenopausal women who are edentulous in the maxilla or totally edentulous were studied to determine if they differ from women with natural teeth in both jaws in terms of subjective TMD symptoms. Second, these subjective symptoms were examined to discover any correlation with duration of edentulousness, age of the dentures, or difficulties in wearing them. The results suggest that for postmenopausal women, clicking noises in the temporomandibular joint and tension in the neck are more common complaints among denture wearers than among those who still have natural teeth. Factors that make the wearing of complete dentures more difficult may also predispose the wearer to TMD symptoms. Duration of edentulousness is not, however, related to the prevalence of anamnestic TMD symptoms.

Craniomandibular Disorders and Skeletal Mineral Status

Values for bone mineral density of the femoral neck and lumbar spine were determined by dual-energy x-ray absorptiometry for 355 postmenopausal women 48 to 56 years of age. The bone mineral density in three regions of the mandible was measured by quantitative computed tomography for 77 of the 355 women. Existing symptoms of craniomandibular dysfunction were recorded in both an anamnestic inquiry and a clinical examination. The purpose of this study was to determine whether the bone mineral density of the skeleton and mandible is associated with symptoms of craniomandibular dysfunctions. The results suggest that the habits and conditions that provoke development of general bone loss in the skeleton may disturb the functional harmony of the masticatory system and, thus, increase the possibility for craniomandibular disorders (CMD).