Pages 289-299, Language: English, GermanJüch, Frits
Dieser Artikel beschreibt die Lokalisation, Innervation und Funktion des menschlichen Geschmacksorgans, die zur Geschmackswahrnehmung beitragenden Faktoren im Allgemeinen und wie sich Bedeckungen des harten Gaumens mit Prothesen auf die Genauigkeit der Geschmackswahrnehmung im Besonderen auswirken. Beim Essen wird die Geschmackswahrnehmung überall in der Mundhöhle erlebt; sie ist nicht auf Bereiche eingegrenzt, die mit Geschmacksknospen bestückt sind. Der harte Gaumen, an dem keine Geschmacksrezeptoren liegen, leistet einen wichtigen Beitrag zur gustatorischen Reaktion. Es gilt als gesichert, dass bei Bedeckung des harten Gaumens die veränderte Temperatur- und Texturwahrnehmung von Nahrungsmitteln die Hauptfaktoren sind, die die Geschmacksreaktionen verändern. Der Artikel bietet Hilfestellungen, wie Prothesenträger, bei denen sich eine Veränderung der Geschmackswahrnehmung einstellt, behandelt werden können.
Keywords: Geschmack, Geschmacksempfindlichkeit, Geschmackswahrnehmung, Zahnprothese, Totalprothese
Pages 301-313, Language: English, GermanOlthoff, Lambertus W. / Bilt, Andries van der
Chewing is the first phase in the digestive process. Its purpose is to break up and soften the food to be ingested. The degree of fragmentation depends on a number of factors, such as chewing force generated by the chewing muscles, the number and the morphology of the (pre)molars, the neuromuscular control of the movements of the mandible and the quantity and quality of the saliva. To enable an effective chewing process, form and function have to be well controlled. Disorders of function and maladjustments in form may cause complaints in temporomandibular joints (temporomandibular dysfunction, myofascial pain). These complaints are mostly accompanied by a hampered chewing function. Research on the mechanisms of these functional processes may help to better understand clinical abnormalities.
Keywords: masticatory performance, neuromuscular control, food
Pages 315-327, Language: English, GermanWeber, Daniel / Lotzmann, Ulrich / Künzel, Hermann J.
Aims: The present investigation explores the possibility to characterize causal connections between speech sound articulation and dental irregularities in the form of the loss of lateral teeth. Material and methods: Edentulous patients with full dentures were used as subjects. Precise duplicates of their dentures were modified in a way to create seven varieties of arrangements of the lateral teeth, ranging from a "full set of teeth" to large unilateral or bilateral edentulous areas. A phonetically balanced text was read aloud and recorded digitally. Standard acoustic and auditory analyses were performed, as well as perception tests with groups of listeners with different degrees of professional auditory skills. Thus, it was possible to discern both acoustic and auditory deviations of consonants from their phonetic norms. Results and conclusions: The results show that immediately after insertion of the different varieties of test prostheses, only a small number of acoustic and perceptual deviations occurred. It is concluded that the disturbances caused by the artefacts were not severe enough to impede the course of the normal automatic sequence of articulatory movementsdrastically. This may be regarded as a fine example of what phoneticians call the ability of the vocal apparatus for 'articulatory compensation'.
Keywords: Disturbance of phonation, loss of lateral teeth, shortened dental arch, articulatory compensation, analysis of speech
Open AccessPages 329-348, Language: English, GermanImhoff, Bruno
Objective: The aim of this study was to analyze the significance of various factors in the diagnostics and therapy of temporomandibular disorder (TMD) patients. To this purpose, the study and treatment data of 384 TMD patients who were treated by one practicing clinician from 2008 to 2010 were evaluated retrospectively. Material and methods: Data collection took place using a data sheet developed by the author: biographical data, type and duration of symptoms, diagnosis in accordance with the research diagnostic criteria for temporomandibular disorders (RDC/TMD) - axis I and axis II - diagnoses according to Ahlers and Jakstat, the treatment measures (advice: n = 110, splint therapy: n = 166, occlusal therapy: n = 108) and the success of treatment. The factors gender, duration of symptoms and axis II disability were evaluated with regard to the method and the success of treatment. Results: 71% of the patients were female (n = 274), and were represented 2.6 times more frequently than males (n = 110) in the patient population examined. The duration of symptoms (3.4 years on average) showed no direct negative correlation with the success of treatment. In the case of a high occurrence of axis II disability, the success rate of both therapeutic means dropped clearly from 86% to 21%. By restoring the occlusion (n = 108), a good success rate of treatment was achieved in over 70% of patients in therapy-resistant splint cases.Conclusions: Occlusal factors and axis II disability should always be analyzed and evaluated together before commencing treatment. In the case of mild and moderate axis II disability, occlusal therapy can be successful. Not all chronic pain is chronified pain.
Keywords: TMD, occlusion, axis II, chronic pain, evidencebased medicine, Michigan-type occlusal splint, canine guidance, systematic additive occlusal therapy