J.A. De Boever

Otalgia in patients with temporomandibular joint disorders

Otalgia without organic causes is a common symptom in temporomandibular dysfunction (TMD) patients even though the etiology is controversial. Investigations of the influence of TMD treatment on otalgia are scarce. This follow-up study analyzed the clinical profile of TMD patients with otalgia and evaluated the treatment outcome. A total of 400 consecutive TMD patients (75% women) were divided in two groups: group 1 consisted of 233 patients (58%) with no complaint of ear symptoms and group 2 consisted of 167 patients (42%) with complaint of otalgia. The patients were examined with a standardized protocol and treated similarly with conservative methods. Group 2 was referred and examined by otolaryngologists. Otalgia patients (group 2) had statistically significantly higher pain scores (p 0.02). They belonged to the greater dysfunction scores (Di III) according to the Helkimo Pain and Dysfunction index (41%) vs. 24%; p < 0.001). There was a statistically significant association with pain on condyle palpation and otalgia (p < 0.01). One year after the first examination, the patients exhibited no pain or occasionally mild pain in 66% (group 1) and 74% (group 2) (p 0.35). Of the otalgia patients, 48% no longer had otalgia and 32% of the patients experienced mild or occasional otalgia. The changes in dysfunction scores after 1 year revealed significant improvement. No difference was found between group 1 and 2 in pain and dysfunction score. For the dysfunction index readings 0 and I, 77% and 73% had no or only mild symptoms (Di 0 and I). The conclusions of this study are that TMD patients with otalgia are not a separate TMD group and they responded well to conservative treatment.

Comparison of clinical profiles and treatment outcomes of an elderly and a younger temporomandibular patient group

STATEMENT OF PROBLEM Older temporomandibular disorder patients with more general complications and health problems may have a different clinical profile and be likely to react less favorably to conservative treatment. PURPOSE This retrospective study compared the clinical profiles of a young (20 to 30 years) and an older (50 to 70 years) group of patients with pain and dysfunction in the temporomandibular region and to analyze treatment outcomes. METHODS Clinical profiles and treatment outcomes were studied with a standardized protocol and the Helkimo Pain and Dysfunction Index up to 1 year after initial examination. RESULTS Younger and older patients with temporomandibular disorder differed only in pain intensity at initial examination, but the outcome of conservation treatment was equally successful. CONCLUSION Conservative treatment resulted in a significant alleviation of pain and dysfunction in almost 85% of patients. Both the younger and the older patient groups benefitted from this treatment protocol and therefore can be treated in the same fashion.

13 Tandtrauma en hypermobiliteit

Ter hoogte van het parodontium kunnen zich mechanische traumata voordoen die invloed hebben op de mobiliteit van de tanden en de overleving van de gebitselementen in het gedrang brengen. Traumata kunnen worden veroorzaakt door externe factoren (slag, val) of interne factoren (voortijdige occlusale contacten, parafuncties). Het trauma kan acuut of chronisch van aard zijn.

35 Behandeling van furcatieletsels

De succesvolle behandeling van furcatieletsels blijft een moeilijk probleem De introductie van de regeneratieve technieken deed hoopvolle verwachtingen ontstaan, die niet helemaal werden ingelost. Het gebrek aan reproduceerbaarheid van de gebruikte methoden blijft een obstakel dat een veralgemeende toepassing in de weg staat.

43 Brugreconstructies bij patiënten met gereduceerd parodontium

In talrijke klinische studies is aangetoond dat bij de meerderheid van de patienten met parodontitis, mits zij grondig parodontaal zijn behandeld, een nauwkeurige onderhoudstherapie volgen en een grote therapietrouw vertonen, verdere parodontale afbraak kan worden vermeden. Slechts een beperkt aantal patienten neigt tot recidief en is parodontaal niet volledig onder controle te krijgen op lange termijn.Bij parodontaal gesaneerde patienten zijn vaak gebitselementen geextraheerd vanwege uitgesproken parodontaal aanhechtingsverlies.