bluuebunny/crossref_metadata_2025 huggingface dataset:
Hereditary sensory and autonomic neuropathy: review and a case report with dental implications
Authors: Erdem T. L. , Özcan İ. , İlgüy D. , Şirin Ş
Published: March 2003

Hereditary sensory and autonomic neuropathy (HSAN) is a rare syndrome which is seen in early childhood. Five different types are described. Absence of pain and self‐mutilation are characteristic findings of this syndrome. Teeth in the oral cavity can cause damage to the oral tissues and tongue. When it is diagnosed, there should be co‐operation between dentist and neurologist. Using an oral shield prevents the biting and, thus, traumatization of the tissues can be prevented. A case report which is diagnosed as HSAN type 4 is presented and information submitted about its treatment.
The effect of polishing systems on microleakage of tooth coloured restoratives: Part 1. Conventional and resin‐modified glass–ionomer cements
Authors: Yap A. U. J. , Tan S. , Teh T. Y.
Published: March 2003

The purpose of this in vitro study was to investigate the effect of polishing systems on the microleakage of conventional and resin‐modified glass–ionomer cements. Class V cavities were prepared at the cemento–enamel junction of 80 freshly extracted posterior teeth. The prepared teeth were randomly divided into two groups and restored with conventional or resin‐modified glass–ionomer cements. The restored teeth were stored in distilled water at 37 °C for 1 week after removal of excess restorative with diamond finishing burs. The restored teeth were then divided into four groups of 10 and finished and polished using the following systems: Two Striper MFS; Sof‐Lex XT; Enhance Composite Finishing and Polishing System; Shofu Composite Finishing Kit. The finished restorations were subjected to dye penetration testing. Results showed that the microleakage at dentin margins of conventional glass–ionomer cements and enamel margins of resin‐modified glass–ionomer cements are significantly affected by the different polishing systems.
The relationship between dentofacial morphology and the isometric jaw‐opening and closing muscle function as evaluated by electromyography
Authors: Watanabe K.
Published: March 2003

The purpose of this study was to clarify the relationship between the dentofacial morphology and masticatory muscle function in both isometric jaw‐opening and closing. The subjects consisted of 26 male adults without masticatory dysfunction. Electromyograms were obtained from the digastric and masseter muscles to evaluate their muscle activities. The sum energy, median frequency, and equilibrium index were calculated as parameters of the muscle activity. A correlation analysis was performed between the parameters for the muscle activity and the dentofacial morphology on lateral roentgenographic cephalograms. The sum energy in the jaw‐closing muscle showed a significant relationship with the gonial angle, mandibular length, and facial height, but not in the jaw‐opening muscle. A median frequency in the jaw‐opening muscle showed a significant relationship with size and position of the mandible, and also that in the jaw‐closing muscle with the mandibular plane angle, facial height, and mandibular body length. Furthermore, the equilibrium index of the median frequency was related to the facial height, mandibular length, and inclination of the mandibular incisor. In conclusion, the dentofacial morphology was found to be closely related to the muscle activity not only of the jaw‐closing muscle but also of the jaw‐opening muscle during isometric muscle contraction.
The effect of oestrogen deficiency on the alveolar bone resorption caused by traumatic occlusion
Authors: Kawamoto S. , Nagaoka E.
Published: March 2003

This study, using 132 female rats, was designed to investigate whether oestrogen loss facilitates alveolar bone alterations induced by traumatic occlusion. Rats were ovariectomized (OVX) or underwent sham‐operation (Sham). Seven days after surgery, half of the rats in each group were subjected to experimental traumatic occlusion (trauma), and the other half were left untreated. Thus, there were four groups: OVX+trauma, Sham+trauma, OVX, and Sham. Rats in each group were killed 1, 3, 5, 7, or 10 days after the introduction of occlusal trauma. The resected mandibles were processed without decalcification, and histomorphometric measurements were performed in the alveolar bone adjacent to the periodontal ligament of the first molar. The statistical assessment of the time‐ and group‐specific differences by analysis of variance revealed significant differences between the OVX+trauma and Sham+trauma groups in the resorption parameters, but not in the formation parameters. The results show that the alveolar bone dynamics induced by traumatic occlusion are enhanced by oestrogen deficiency.
Functional‐rhythmical coupling of head and mandibular movements
Authors: Kohno S. , Matsuyama T. , Medina R. U. , Arai Y.
Published: March 2003

It is known that small head movements accompany the movements of the jaw during mastication; however, it is unknown whether these movements occur rhythmically and synchronously. The objective of this study was to determine whether there exists a functional coupling between the head and mandibular movements. Four healthy male adults (mean age 25·5) with normal occlusion and without TMD history were selected as subjects. Using the Trimet system, we measured tridimensionally both the movement of the head and the mandible by tracking upper and lower incisal points, respectively, during tapping movements with different opening range and frequency, then analysed the vertical component of these movements. The upper incisal point moved in opposite direction to the mandible in all tapping strokes in all subjects, during opening the head moved in a cranial direction and during closing in a caudal direction; the incidence rate for this concomitant movement was 98%, implying that the head moves periodically and rhythmically, as the mandible does. The cycle time of these coincident movements showed a correlation coefficient of 0·94. Moreover, the vertical range of head movement was within 10% of the jaw's movement. From these results we concluded that, at least during teeth tapping, the head moves in rhythmical coordination with mandibular movement.
An appraisal of the literature on centric relation. Part III
Authors: Keshvad A. , Winstanley R. B.
Published: March 2003

The literature directly and indirectly related to centric relation (CR) has been reviewed chronologically. More than 300 papers and quoted sections of books have been divided into three sections. The first two parts are related to CR. Studies in this group mainly compared, either the position of the mandibular condyle or the mandible itself in different CR recordings. Various tools were discussed for this purpose. The third part of the paper is about CR–centric occlusion (CO) discrepancy. CR still remains one of the controversial issues in prosthodontics and orthodontics. Debates such as mounting casts on the articulator by reproducible records for orthodontic treatment planning and end results, and whether or not orthodontic treatment based on CO causes TMJ dysfunction, remain unsolved. The references are listed at the end of Part III.
An evaluation of elastomeric impression materials based on surface compressive strength
Authors: Omori K. , Arikawa H. , Inoue K.
Published: March 2003

The setting times of seven commercially available elastomeric impression materials were determined using Wilson’s reciprocating rheometer at temperatures 23 ± 0·5 or 32 ± 0·5 °C. The surface compressive strength and depression of these materials after setting time were measured using a rheometer (Fudoh). Each material was mixed according to the mixing proportion (base/accelerator or catalyst ratio) recommended by the manufacturer. The surface compressive strength and the depression of each material were measured by using a method which pressed the material to the edge of a sensitive rod (2·0 mm in diameter) connected to a load cell. In the case of silicone impression materials (additional type) at a temperature of 23 ± 0·5 °C, the surface compressive strength and the depression of these materials were extremely stable after the setting time. However, the surface compressive strength of other materials except additional type materials increased markedly after setting time and the depression corresponding to the surface compressive strength decreased. These increased largely with the increase, in pressing speed to the sensitive rod. At 450 s from the setting time of all materials, there was an adequate correlation (r = 0·84) between measured values and theoretical values derived using the theory of elasticity.
Influence on force curve exerted by jaw tapping force
Authors: Suenaga H. , Torisu T. , Yoshimatsu T. , Fujii H.
Published: March 2003

The purpose of this study, which made use of visual biofeedback, was to determine how methods of regulating jaw tapping force differed depending on the strength of the tapping, using the force curve as an index. Nine healthy examinees were asked to make 30–35 jaw tapping movements, reproducing the defined target tapping force as accurately as possible. We measured the duration of the tooth contact phase, the time to peak force, the first time derivative of force (peak dF/dt), and the time to peak dF/dt. The results indicated that the duration of the tooth contact phase and the time to peak force increased with the target value (P < 0·01). As the target rose, the peak dF/dt increased significantly (P < 0·01), but the time to peak dF/dt was not significant (P=0·134). We found that the higher the target value, the greater the degree of dependency on feedback information. We also found that both the peak dF/dt and the time to peak dF/dt were determined for each examinee prior to movement.
Coffee beans as a natural test food for the evaluation of the masticatory efficiency
Authors: Schneider G. , Senger B.
Published: March 2003

A lot of test foods have been used during this century to evaluate the masticatory ability of human subjects. Nevertheless, none has been universally admitted. If the test food by itself is of importance, attention should also be paid to its behaviour during the chewing test procedure. Therefore, we analysed step by step coffee beans through the processing of the chewing test and a dry sieving method. The development of a compression test and a computer simulation have shown that groups of 11 coffee beans give satisfactory results and deserve to be used in mastication studies.
‘The first bite of the cherry’ Intra‐oral manipulation prior to the first bite in humans
Authors: Prinz J. F. , Lucas P. W.
Published: March 2003

The breakdown of food in the mouth during mastication can be described in terms of two parameters: a breakage function, which describes the fragmentation of food after a bite, and a selection function which defines the probability of particle fracture. The non‐zero value of the selection function depends on the manipulation of food particles by the tongue. Little, however, is known about this. As a first step, this study investigated the manipulation of wax sheets of differing sizes and shapes by the tongue after ingestion. It was found that subjects tended to orientate rectangular and square wax wafers so that the long axis of the particle was parallel to the tooth row, independent of the initial orientation given when they were introduced into the mouth. Circular wafers were randomly oriented relative to initial orientation. If this could be extrapolated to the start of mastication, then it suggests that the tongue tends to align food particles so that the post‐canines produce close to the greatest surface area possible by fragmenting them along their longest axis.
Flexural behaviour of post‐cured composites at oral‐simulating temperatures
Authors: Ho C.‐T. , Vijayaraghavan T.V. , Lee S.‐Y. , Tsai A. , Huang H.‐M. , Pan L.‐C.
Published: March 2003

Post‐curing treatments have been known to improve the mechanical stability of visible light‐cured composites. After individual post‐curing treatment, the flexural strength (FS) of four commercial direct/indirect placement composite materials which differ greatly in composition [oligocarbonate dimethacrylate (OCDMA)‐based Conquest C & B (CQT), Bisphenol‐A glycidyl dimethacrylate (BisGMA)‐based Charisma, urethane dimethacrylate (UDMA)‐based Concept (CCT), and BisGMA/UDMA‐based Dentacolor] was evaluated under water in the temperature range of 12–50 °C. A control series was tested in air at room temperature (25 ± 1 °C). Data were analysed using ANOVA and Duncan’s test. Flexural strengths overall decreased (20–40%, P < 0·01) with increasing temperatures except with Conquest C & B. Surprisingly, higher FS values were found in wet conditions than in dry conditions at 25 °C. UDMA‐based materials much more easily undergo softening in water and by temperature change than do BisGMA‐ or OCDMA‐based materials. Post‐cured composites can be significantly affected by exposure to oral environments. Different composition determines the degree of influence.
The short‐term effect of stabilization‐type splints on the local asymmetry of masseter muscle sites
Authors: Bertram S. , Rudisch A. , Bodner G. , Emshoff R.
Published: March 2003

Patients with temporomandibular disorders (TMD) may present with a cluster of joint and muscle disorders characterized primarily by pain, joint sounds and irregular or deviating jaw function. Maxillary stabilization‐type splints represent the best standard therapy, so the purpose of this study was to evaluate changes in local cross‐sectional dimensions (LCSD) of masseter muscle sites associated with short‐term application of ‘splint therapy’ using the diagnostic approach of high‐resolution gray‐scale ultrasonography. The study included 29 patients who had signs and symptoms of temporomandibular disorders. Ultrasonographic investigation was performed with a linear (B‐scan) 7·5 MHz small‐part transducer to visualize the antero‐superior, antero‐inferior, medio‐superior, medio‐inferior, postero‐superior and postero‐inferior sites of the masseter muscle. To assess local muscle asymmetry patterns and to evaluate the respective effect of occluding splints, the ‘absolute asymmetry index (AAI)’ was used, with the mean maximum muscle diameter of the respective right and left sides calculated from three consecutive measurements before and after splint therapy. Comparing the pre‐treatment with the 2‐month follow‐up values revealed a significant decrease in the overall mean asymmetry indices at the anterior (P < 0·01), medial (P < 0·05) and posterior (P < 0·05) muscle sites. There was no significant change in LCSDs at the various muscle sites (P > 0·05). The results of this study suggest stabilization‐type splints to be effective in reducing local muscle asymmetries. Further studies are warranted to evaluate muscle‐site specific effects in patient and non‐patient groups and to relate these effects to pre‐treatment variables like bite force, preferred chewing side, facial morphology and occlusion.
Immunolocalization of vimentin and α‐smooth muscle actin in dysfunctional human temporomandibular joint disc samples
Authors: Leonardi R. , Villari L. , Piacentini C. , Bernasconi G. , Travali S. , Caltabiano C.
Published: March 2003

The expression of vimentin and α‐smooth muscle (α‐SM) actin was examined in 10 human temporomandibular joint (TMJ) disc samples, with internal derangement and in two control specimens, in order to evaluate the phenotypic characteristics of TMJ disc cells in relationship to histological findings. This was accomplished by means of monoclonal antibodies specific for vimentin and α‐SM actin and immunocytochemical technique. The study, revealed that every disc cell constantly expressed vimentin. Scattered α‐SM actin positive cells could be appreciated in normal TMJ discs and tissues with minor pathological findings. In TMJ discs with severe alterations, i.e. tears and clefts, almost fibroblast‐like cells, fibrochondrocytes and chondrocyte‐like cells were strongly immunolabelled by anti‐α‐SM actin antibody. According to these findings it can be assumed that vimentin is expressed by all disc cell populations and it appears not to be influenced by any disease condition of the disc; on the other hand the up‐regulation α‐SM actin immunolabelling seems to be correlated to histopathological findings of tears and clefts. Cells, with a contractile phenotype, close to such defects, could be involved in disc tissue contraction and repair. The plasticity of disc cell populations which evolve towards a different phenotype when subjected to action of macro‐ and micro‐environmental factors is also supported.
Bond strengths of five tapered root posts regarding the post surface
Authors: Nergiz I. , Schmage P. , Platzer U. , Özcan M.
Published: March 2003

The advantage of tapered passive root posts is their homogenous force transmission without creating stress peaks on the root surface because of their anatomical root form. However, their expected retentive strengths are low compared with the other post systems. The objective of this in vitro study was to determine the retentive strengths of five tapered post systems from different manufacturers using tensile tests. For this purpose, all posts were cemented with zinc phosphate cement (Tenet®) into the roots of 50 intact anterior teeth according to the manufacturer's instructions for each system. The contact surface area between the root canal wall and the post was taken into account in the calculations in order to obtain comparable results for different post configurations. The highest bond strength values were achieved for the Erlangen post system® (10·8 N mm–2) and MP Pirec post system® (10 N mm–2). These values were more than three times those of the Velva‐Post® (3·2 N mm–2) and the Cylindro‐Conical system® (3·5 N mm–2) and five times more than those of the Dr Mooser post system® (1·7 N mm–2). The bond strength values of the Erlangen post system®, Cylindro‐Conical system® and Dr Mooser post system® showed statistically significant differences compared with the other groups. The results of this study indicated that the bond strengths of tapered posts were not only affected by the contact surface but also by the taper angle, shape of the post system, the width of the cement joint, surface roughness of the posts as well as the form of the canal wall. In clinical practice, in case of choosing tapered posts with similar shapes, retention may still vary because of other factors.
Consequences of oral rehabilitation on dyskinesia in adults with Down's syndrome: a clinical report
Authors: Faulks D. , Veyrune J‐L. , Hennequin M.
Published: March 2003

The aim of this article is to demonstrate that the presence of orofacial dyskinesia is often owing to underlying facial dysmorphology in persons with Down's syndrome. A series of cases is presented where orofacial dyskinesia was successfully treated by therapy establishing occlusal stability. The diagnosis of dyskinesia owing to dysmorphology should be precluded before any link with the degree of intellectual disability or neurological deficit is presumed. A multidisciplinary approach may be necessary to diagnose and treat these patients.
Evaluation of design parameters of osseointegrated dental implants using finite element analysis
Authors: Chun H.‐J. , Cheong S.‐Y. , Han J.‐H. , Heo S.‐J. , Chung J.‐P. , Rhyu I.‐C. , Choi Y.‐C. , Baik H.‐K. , Ku Y. , Kim M.‐H.
Published: March 2003

Finite element analyses were performed for various shapes of dental implant to study effects on stress distribution generated in the surrounding jaw bone and to determine an optimal thread shape for even stress distribution. It was found that the square thread shape filleted with a small radius was more effective on stress distribution than other dental implants used in the analyses. Additional analyses were performed on the implant with the thread shape obtained from previous analyses for varying other design parameters, such as the width of thread end and height of thread for various load directions, to determine the optimal dimensions of the implant. Stress distribution was more effective in the case when the width of thread end and the height of thread were 0·5p and 0·46p, respectively, where p is the screw pitch. Then, using the optimal implant thread dimensions determined previously, stress analyses were performed with various screw pitches and implant lengths, to investigate effects on stress distribution and to find the way to reduce the maximum effective stress generated in the jaw bone. Results show that the maximum effective stress decreased not only as screw pitch decreased gradually but also as implant length increased.
Changes of the elastic fibre network of the rabbit temporomandibular joint following discectomy
Authors: SATO S. , GOTO S. , KOEDA S. , MOTEGI K.
Published: March 2003

Summary Elastic fibres are thought to be very important for the function of various organs including the temporomandibular joint (TMJ). The current study was designed to examine changes in the elastic fibres of the TMJ following discectomy. The TMJs of six rabbits were surgically exposed, and the disc removed with a scalpel. Three untreated and three sham‐operated rabbits were used as controls. Complete TMJs were removed in three rabbits 1 month and in three rabbits 3 months after discectomy and processed for histochemical demonstration of elastic fibres. In the TMJ 1 month after discectomy, osteoarthritic changes and a significant increase in the numbers of elastic fibres were observed in the condyle and articular eminence. In the TMJs 3 months after discectomy, they tended to revert to the levels in the condyle and articular eminence of the control TMJs. Our results show that after experimental discectomy, elastic fibres very often appear initially in the condyle and articular eminence, but they are destined to disappear later. This information may improve our understanding of the consequences of removal of the disc in clinical practice.
Anticipatory and reflexive neck muscle activities during voluntary rapid jaw opening and passive jaw depression in humans
Authors: Torisu T. , Suenaga H. , Yoshimatsu T. , Kanaoka R. , Yamabe Y. , Fujii H.
Published: March 2003

summary  The characteristics of head movement during voluntary rapid jaw opening movement and passive jaw depression were investigated using accelerometers and electromyographs (EMG) on eight healthy examinees. Passive depressions were executed by means of load on the lower jaw, initiated either by examinees themselves or an experimenter. In the depression initiated by examinees, a head‐extension movement that preceded the load to the lower jaw and anticipatory activities in the nuchal region of the trapezius muscle were observed. In the depression initiated by the experimenter, the anticipatory activities were not observed. In both of these cases, stretch reflexes were induced in the trapezius muscle. During voluntary rapid jaw opening, a head‐extension movement nearly synchronized with the opening movement in the lower jaw acceleration, and dorsal‐neck muscle activities accompanying the synchronized movement were observed. The peak timing of these neck‐muscle activities preceded the latencies of the stretch–reflex activities observed in the jaw‐depressed tasks, but no anticipatory activities were observed in the dorsal‐neck muscles. We conclude that neither the anticipatory activities nor the reflex activities observed in the passive depressions have effects on the initial part of the dorsal‐neck muscle activities, which are related to the head‐extension synchronized with the voluntary lower‐jaw opening movement.
Effect of HEMA on bonding of Er:YAG laser‐irradiated bovine dentine and 4‐META/MMA‐TBB resin
Authors: Kameyama A. , Kawada E. , Amagai T. , Takizawa M. , Oda Y. , Hirai Y.
Published: March 2003

Summary The purpose of this study was to evaluate the priming effect of 2‐hydroxyethylmetaclirate (HEMA) following acid treatment on resin bonding to prototype Er:YAG laser‐irradiated dentine. Extracted bovine dentine following laser irradiation was acid treated by aqueous solution of 10% citric acid (10‐0) or 10% citric acid/3% ferric chloride (10‐3), and additionally treated with 35% HEMA. Pre‐treated dentines were bonded to the polymethyl‐methacrylate (PMMA) rod with 4‐META/MMA‐TBB resin (Super Bond C & B) and miniaturized dumbbell‐shaped bonded specimens were prepared. These specimens profiled for tensile bond testing and fractured surfaces were observed by scanning electron microscopy (SEM). Cross‐sections of resin–dentine interface were also examined. The HEMA treatment following acid conditioned by 10‐3 or 10‐0 for both laser‐irradiated and non‐irradiated dentines was significantly higher than that without HEMA treatment. SEM view of a fractured specimen showed some cohesive failure in cured resin, but almost all of the fractured surface shows boundary failure between the penetrated resin and underlying dentine. A cross‐sectional view of the interface showed a very thick hybrid layer between the hybridized dentine and underlying dentine. It was concluded that HEMA treatment following acid conditioning provided a slightly higher bond strength for both the Er:YAG laser‐irradiated and non‐irradiated dentines. However, the bond strength of Er:YAG laser irradiated dentine was significantly lower than that of the non‐irradiated dentine.
Effects of colour measuring mode and light source on the colour of shade guides
Authors: Lee Y.‐K. , Yoon T.‐H. , Lim B.‐S. , Kim C.‐W. , Powers J. M.
Published: March 2003

SUMMARY  The objectives of this paper were to evaluate the effects of colour measuring modes [specular component excluded (SCE) versus specular component included (SCI)] and the standard light source (C, A or D65) on the colour of shade guides. After the labial part of shade tabs of two shade guides (Vita and Chromascop) was polished flat up to no. 2400 silicone carbide paper, the colour was measured according to the International Commission on Illumination (CIE)L*a*b* colour scale on a spectrophotometer. In both shade guides, all the average CIE L* values of each shade series, and most of CIE b* values were different depending on the measuring mode (P < 0·01). However, there was no difference in CIE a* values depending on the measuring mode. Colour difference (ΔE*) between the values measured with SCE mode and with SCI mode was 3·21–6·50 in Vita shade guide, 3·22–5·47 in Chromascop shade guide. ΔE* caused by the difference in light source was very small in Vita shade guide regardless of the measuring mode. In the Vita shade guide, the shade series (A–D) was negatively correlated with CIE L* and CIE a* values measured with SCE mode. In the Chromascop shade guide, the shade series (100–500) was negatively correlated with CIE L* value measured with SCI mode.
Clinical relevance of a simple fragmentation model to evaluate human masticatory performance
Authors: Schneider G. , Senger B.
Published: March 2003

Summary To explain the breakage process of food particles in human mastication, we propose a simple fragmentation model. To verify its clinical accuracy, a mechanical test with a sieving method and a natural test food (coffee) was performed on three groups of subjects. The values obtained permitted to demonstrate that the model could predict, at least qualitatively, the general trend of the experimental data, even for a very small group (two subjects). It also shows that the choice of the yielding factors used to calculate the masticatory index (MI) is relevant.
Scanning electron microscopic and energy dispersive spectrometric investigations on the effect of XeCl excimer laser on human dentin with smear layer
Authors: Kumar A. R. Pradeep , Rao C. V. Subba , Parameswaran A. , Kishen A. , Lim C. S.
Published: March 2003

summary  The purpose of this study was to study the effect of XeCl excimer laser on smear layer covered dentine of extracted human teeth. Twenty‐four freshly extracted human molar teeth were collected and randomly divided into one control group and three experimental groups of six teeth each (groups A–D). The teeth in the experimental groups were irradiated with XeCl 308‐nm excimer laser at a fluence of 0·4 J cm−2 and a constant pulse repetition rate of 25 Hz. Group A was used as the control, while groups B, C and D were irradiated at different exposure times of 3, 5 and 7 s, respectively. Subsequently these teeth specimens were subjected to scanning electron microscopic (SEM) examination and energy dispersive X‐ray (EDX) spectrometric analysis. The SEM examination revealed melting of the smear layer covered dentin to conceal the underlying dentinal tubules. At a longer exposure time (7 s), dentin melted to form large grains and this resulted in non‐uniform closure of underlying dentinal tubules. Under the conditions of this study, it is concluded that the pulsed XeCl 308‐nm excimer laser at a fluence of 0·4 J cm−2, with an exposure time of 5 s uniformly occluded exposed smear layer covered dentine with no conspicuous variation in chemical structure.
Analysis of post‐treatment electromyographs in patients with non‐reducing disc displacement of the temporomandibular joint
Authors: Sato S. , Nasu F. , Motegi K.
Published: March 2003

SUMMARY  The purpose of this study was to clarify the electromyographic property of chewing movement before and after treatment in patients with non‐reducing disc displacement of the temporomandibular joint (TMJ). Twenty patients who were diagnosed with unilateral non‐reducing disc displacement of the TMJ were treated by pumping and injection of sodium hyaluronate into the joint. Chewing movement in these patients was evaluated by electromyography (EMG) at the initial visit and at mean 19‐month follow‐up and the results were compared. Chewing movement in 23 normal controls were also examined. Duration of contraction, cycle time and integrated value at the initial visit which were different from those in the controls without TMJ dysfunction tended to be at the control level mean 19 months after treatment of pumping and injection of sodium hyaluronate into the joint in patients with non‐reducing disc displacement of the TMJ. Electromyography appeared to be a method of documenting the chewing movement which was impaired at initial visit improved after treatment in patients with non‐reducing disc displacement of the TMJ.
The McGill pain questionnaire in patients with myogenic facial pain and TMJ disorders
Authors: MONGINI F. , RAVIOLA F. , ITALIANO M.
Published: March 2003

The assessment of pathologies characterized by pain situated at the temporomandibular joint (TMJ) or cheek, consequent on disorders of the TMJ itself and/or of the craniofacial or masticatory muscles is still controversial. As verbal pain assessment techniques are of help in discriminating between different pain sensations, our purpose was to assess the discriminative capacity of the McGill Pain Questionnaire (MPQ) in patients with TMJ disorders or with myogenous facial pain (MP).

The MPQ was administered to 57 TMJ and 28 MP patients. Weighted MPQ item scores, subscale Pain Rating Indexes (PRI), total PRI and the number of words chosen were calculated. Mean scores were tested for significant differences (Student's t) and the frequency with which each descriptor was chosen by the patients of both groups was also analysed. Furthermore, the data were processed through two systems based on a counter‐propagation neural network: the Self Organising Map (SOM) system, and a cluster‐like analysis.

In the MP group 16 of 20 mean MPQ item scores and all mean PRI were significantly higher than those of the TMJ group. The SOM analysis was able to distribute the two groups in the two different halves of the map; only two of 28 MP cases (7%) and 12 of 57 TMJ cases (21%) were misplaced. The cluster‐like analysis based on the 20 MPQ item scores was able to correctly recognize 94·73% TMJ patients and 89·28% MP patients.

In conclusion, the MPQ showed a consistent discriminative capacity between TMJ and MP patients.
Permeability of the petrotympanic fissure
Authors: CHIARINI M. , GAJISIN S.
Published: March 2003

The communicating canal through the petrotympanic fissure of the glenoid fossa is about 2 mm long in the new‐born, but may measure up to 15 mm in the adult. It connects the middle ear with the fossa. Little is known about its permeability.

After defreezing, 20 temporomandibular joints were extracted from 10 freeze preserved cadavers (seven females and three males, mean age >65 years at death), with a circular cutter from lateral following a transversal axis. The cylindrical tissue sample contained the external auditory meatus, parts of the petrous bone with the middle and inner ear, the styloid process and the complete temporomandibular joint with condyle, disc and part of the attached lateral pterygoid muscle.

The soft tissue except the disc was removed manually and thereafter India ink was percolated into the middle ear directly by introducing a needle through the tympanic membrane, without pressure. The perfusion was stopped once the India ink started to flow out from the tuba auditiva. In the following the samples were cooled again and the tympanic chamber was opened from above to gain a free view on the ossicles. Thereafter, the petrotympanic canal was carefully opened under magnification (magnifier, operating microscope) and checked for percolated India ink.

It resulted that in three of the 20 joints, the ink had percolated from the middle ear to the glenoid fossa through the petrotympanic fissure.

The question arises whether infectious diseases of the middle ear could possibly reach the retrodiscal pad and therefore the temporomandibular joint, although such a situation has never been described up to nowadays.
Alteration in mandibular posture by vibration of posterior fibres of the temporalis muscle
Authors: DICKSON M. , LYONS M. F. , MURRAY C. A.
Published: March 2003

Introduction: Vibration causes reflex muscle shortening because of excitation of muscle spindle primary afferents. Although this is subordinate to voluntary control, responses have been demonstrated in jaw elevator and (unexpectedly) in jaw depressor muscles. Forward posturing of the mandible is a common habit. The only part of the perioral musculoskeletal system that actively retrudes the mandible is the posterior part of the temporalis muscle. This study set out to investigate the effect of vibration of this area on the horizontal position of the mandible during a jaw registration procedure.

Method: In a randomized cross‐over study, the posterior fibres of both left and right temporales of 17 subjects were vibrated synchronously at 180 Hz. Interocclusal wax jaw registrations were recorded for each subject with and without vibration applied. Position of the mandible was assessed by mounting pairs of casts using these registrations and measuring their position relative to intercuspal position.

Results: In 17 subjects, the effects of vibration on mandibular posture were: no change in one; protrusion in two; and retrusion in 14. A sign test returned a value of P < 0·01.

Discussion: Reasons for the protrusion seen in two subjects are discussed. These may be anatomical or methodological. However, vibration of the posterior part of the temporalis muscle retruded the mandible in a significant majority of cases.
Psychological distress in chronic craniomandibular and cervical spinal pain patients
Authors: VISSCHER C. M. , LOBBEZOO F. , BOER W. De , VAN DER MEULEN M. J. , NAEIJE M.
Published: March 2003

In chronic craniomandibular disorders, a relationship with psychological distress has often been investigated, with contradictory results. Recent studies on chronic pain patients have shown that the level of psychological distress is related to the number of painful body areas. Therefore, the aim of this study was to analyse differences in psychological distress between craniomandibular pain patients with or without cervical spinal pain, taking the number of painful body areas below the cervical spine also into account. Based on an oral history and, independently performed, dynamic/static tests, the presence or absence of a painful CMD or CSD was recognized. To assess the level of psychological distress, the Dutch version of the Symptom Checklist 90 (SCL‐90) was used. The number of painful body areas was indicated on the body drawing of the McGill Pain Questionnaire (MPQ‐DLV).

From the initial 250 participants, 103 persons could unequivocally be classified as having or not having a painful CMD and/or CSD and fully completed both questionnaires. Patients with both craniomandibular and cervical spinal pain showed higher levels of psychological distress than patients with only local craniomandibular pain and persons without pain (ancova and t‐tests, P=0·026–0·000). Further, persons with more painful body areas below the cervical spine showed higher SCL‐90 scores (ancova and t‐tests, P=0·045–0·000). In conclusion, chronic craniomandibular pain patients with a coexistent cervical spinal pain show more psychological distress than patients with only local craniomandibular pain and asymptomatic persons. (Supported by the IOT)
The effect of disinfectant agents in eliminating the contamination of dental unit water
Authors: Özcan M. , Kulak Y. , Kazazoglu E.
Published: March 2003

summary  High concentrations of water‐borne organisms cause multiple public health problems. Contamination of water exiting the dental unit water lines could be inhibited with the use of some disinfectants. The purpose of this investigation was to establish the effect of two disinfectants and to test their capacity to eliminate colony forming units (CFU) per mL. Vacuum lines of four chairs were treated for a total of 2 weeks. Two disinfectants (Bio® 2000 and Alpron®) were used as per manufacturer's instructions. Water samples for hetereothrophic counts from each unit's air/water syringe line were collected before treating the first patient of the day. Baseline, daily, first and second week samples of 10 mL were plated on blood agar plates and eosin ethylene blue agar. For meosifilic bacterial counts, Mueller Hinton agar plates with 1 mL direct and 1/10 were used in sterile serum and CFU were counted. The suspected colonies were further evaluated using API 20E and API 20NE. No Gram(–) opportunistic pathogens were found during the entire observation. Baseline contamination level (>102 CFU mL−1) without use of disinfectants was significantly higher (P < 0·0001) than at both first and second weeks when disinfectants were used. No colony was formed when Bio 2000 was used after both first and second weeks, whereas small number of CFU mL−1 was found at the end of the first week when Alpron (<10) was used. In conclusion, when used daily, both disinfectants prevent the development of bacterial contamination after first and second weeks with no significant differences (P=0·35).
Periodontitis, caries and salivary factors in Sjögren's syndrome patients compared to sex‐ and age‐matched controls
Authors: Jorkjend L. , Johansson A. , Johansson A.‐K. , Bergenholtz A.
Published: March 2003

summary  The aims of this investigation were: (i) to study a group of dry mouth Sjögren's syndrome (SS) patients comprising individuals with pathological and non‐pathological amounts of rest saliva and (ii) to compare these two categories of SS patients with a sex‐ and age‐matched control group with respect to their periodontal and dental status. Thirty‐three dry mouth patients and 33 sex‐ and age‐matched patients, referred to the same private dental clinic in southern Norway, were examined for rest and stimulated saliva, as well as their dental and periodontal status. All patients were referred to the local hospital for blood and urine examinations. The dry mouth SS patients were all of the secondary type. Volumes of rest and stimulated saliva were significantly lower in the low saliva SS group compared with the high saliva SS group; the values for immunoglobulin G (IgG) and IgA were similarly lower for the low saliva group, but not for IgM which was significantly higher. The two SS subgroups and their controls were compared for the volume of rest and stimulated saliva, which showed a statistically significant lower volumes for the low saliva SS group compared with the control group. None of the subgroups and their controls differed concerning filled or missing teeth, but the total SS group revealed significantly higher number of missing teeth. The periodontal and dental status did not show any statistically significant differences except for a few scattered higher periodontal level losses of attachment in the SS subgroups. The blood and urine analyses showed statistically significant higher values for sedimentation rate, white blood cell count and haemoglobin in the SS low saliva group compared with the control group while anti‐streptolysin was lower. In the high saliva SS group only sedimentation rate and white cell count were higher compared with the control. The conclusions is SS patients do not have an increased risk for developing periodontitis.
Protection and advocacy: an ethics practice in mental health
Authors: Olsen D. P.
Published: March 2003

This paper reports the findings of investigations into allegations of patient abuse and the implications for policy and practice. These investigations were carried out by a nurse with a background in ethics for the office of Protection and Advocacy for Individuals with Mental Illness (PAIMI), a state agency operating under a United States federal law entitling it to investigate complaints by psychiatric patients. PAIMI uses investigations both to help individuals and to provide an avenue for broader change. There are four steps in the investigation process: (1) definition of the problem; (2) gathering information; (3) synthesis; and (4) addressing the problem. Cases are presented to illustrate the investigation process and identify ethical issues arising in mental health treatment. Among the issues raised are autonomy and forced treatment, deinstitutionalization, bias against the mentally ill, privacy, and surrogate treatment decisions. Resolutions range from providing individual advice to clients or clinicians, to changes in institutional policy and the publication of guidelines for specific situations. The following lessons were learnt from the investigations: (1) tell patients what to expect; (2) pay attention to the process of giving care; (3) allow patients to feel ambivalent about treatment; and (4) work to develop good relationships; underlying every investigation has been a poor relationship.
The use of special observations: an audit within a psychiatric unit
Authors: Neilson P. , Brennan W.
Published: March 2003

Observation is a fundamental skilled nursing intervention. Special observation is an intensified and often prolonged form of this intervention. Depending upon their nature, and the circumstances under which they are carried out, special observations may invoke varying degrees of stress in both the observer and the observed. They may also raise important ethical and significant financial questions. In psychiatry, special observations are usually imposed where a patient is assessed as representing some degree of risk to themselves or others because of their behaviours or potential behaviours. Special observations vary in their degree of intrusiveness and restrictiveness, and may arouse strong emotions in the patient and staff. Patients may be denied privacy for their most intimate needs, and staff may become a focus for patients' acting‐out behaviours. Special observations may be medically imposed with minimal consultation with nursing staff, and where there is no nursing and medical staff agreement on their need, nursing staff may at times feel frustrated and powerless to reduce the patients' discomfort with their situation. This paper presents a study into the use of special observations on psychiatric inpatients across a range of clinical settings. The literature on special observations is reviewed, and the findings of an audit into the documentation of special observations is presented and discussed. The study sites comprised two open acute wards, one elderly functionally mentally ill assessment unit which also treats patients with eating disorders, and a secure high dependency unit, which provides rehabilitation within a secure environment for patients with severe and enduring mental illness.
Integration of theory and practice in learning mental health nursing
Authors: MUNNUKKA T. , PUKURI T. , LINNAINMAA P. , KILKKU N.
Published: March 2003

This article describes an action research project that aimed at a better integration of theory and practice in the education of mental health nursing students. Two partners, an institute of nursing and health care and a university hospital, collaborated to develop a new educational programme for mental health nursing. The blocks of theoretical studies were implemented simultaneously with practical training, and the theory content was taught by nursing teachers as well as by nurse practitioners who worked on the teaching wards. In addition, the students had their own personal nurse‐preceptors on the wards. The nurse managers were responsible for the educational level of the teaching wards and the director of nursing planned the teaching arrangements together with the nursing teachers. In all, the project involved over 50 different actors and several researchers. The results are encouraging: all the participants – students, preceptors, nurse managers and nursing teachers – found the project rewarding and they want to continue to develop and improve the level of teaching and learning in mental health nursing education. All the participants grew and developed professionally during the project.
Patient initiatives in psychiatric care concerning shame in the discussion in co‐operative team meetings
Authors: VUOKILA‐OIKKONEN P. , JANHONEN S. , NIKKONEN M.
Published: March 2003

The aim of this paper is to describe patients’ experiences of shame and the way in which this experience is discussed in co‐operative team meetings in acute psychiatric care. As an experience, shame is described as a painful and ugly feeling, which results in personal devaluation, isolation and a feeling of inferiority compared to others. This paper is based on 11 videotaped episodes of co‐operative team meetings in two psychiatric units. The study approach was narrative. Shame was found to be the core narrative. The narrative of shame was laid out as an experience, and shame caused difficulties in the patients’ daily lives and finally led to feelings of difference and loneliness. When the psychiatric patients and significant others tried to speak about the experience of shame with the professionals, the professionals either did not respond or changed the topic of discussion by asking questions about the patient’s daily life and rationalizing the experience of shame. The participants did not share a common objective in the co‐operative team meetings. Further research is needed to find new ways of co‐operative team discussion and to develop the co‐operative team meetings towards a patient‐orientated model.
The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: an exploratory study. Part 2
Authors: Van Meijel B. , Van Der Gaag M. , Kahn R. S. , Grypdonck M.
Published: March 2003

In this article we describe the findings of an exploratory study into the application of early recognition and early intervention methods aimed at prevention of psychotic relapses in patients with schizophrenia. Following the results we described in part 1, we now focus specifically on factors which favourably or adversely affect the use of early recognition and early intervention methods. The following issues will be addressed: (i) information and education; (ii) attitude of health care professionals; (iii) the patient’s insight; (iv) acceptance of illness; (v) motivation; (vi) other relevant patient characteristics; and (vii) continuity of care. Finally, the implications of the findings for the development of a nursing intervention protocol will be discussed.