Libros

Aims: To investigate the effectiveness of a novel jaw-opening–force measuring device as a screening tool to aid in the diagnosis of temporomandibular disorders (TMD). Methods: Symptomatic TMD patients (n = 58) and control TMD-free participants (n = 56) were screened by an oral medicine specialist according to the Diagnostic Criteria for TMD (DC/TMD). TMD patients were divided into three subcategories based on TMD symptoms (myofascial pain, disc displacement, and both combined). Jaw-opening forces were measured in both groups with an adjustable head device connected to a 1,000-N–load cell. Seven attempts were recorded at 10-second intervals by a data-capturing system. The geometric mean force values were obtained after discarding the first and last attempts. Results: TMD-free participants had greater jaw-opening forces than TMD patients both without and with adjustments for age, sex, height, and weight (both P .001). The geometric mean ± standard deviation values for TMD patients were 18.5 ± 1.62 N and 47.7 ± 1.53 N for TMD-free participants. Differences in jaw-opening forces among the three TMD subcategories were not statistically significant; however, patients with disc displacement (23.7 ± 1.46 N) had greater jaw forces than patients with myofascial pain (17.0 ± 1.74 N) and both myofascial pain and disc displacement (17.0 ± 1.56 N). Conclusion: This study demonstrated that differences in jaw-opening forces could be used as a diagnostic tool for TMD. Future studies should explore the potential of this device to measure improvement in jaw-opening forces following Palabras clave: diagnostic tool, jaw-opening forces, myofascial pain, temporomandibular disorders, temporomandibular joint

Purpose: This two-centre study evaluated the clinical performance of Class I and Class II restorations of the giomer material Beautifil, placed using Fluorobond, a self-etching adhesive system, to determine the suitability of the test system as an alternative for the restoration of posterior teeth. Materials and Methods: A total of 108 restorations, comprising 72 Class II and 36 Class I restorations, was placed predominantly in molars (82%). Evaulations using modified USPHS/Ryge criteria were conducted at baseline and thereafter at 6 months and 1, 2, and 3 years. Die stone replicas of the restored teeth were examined retrospectively. Results: A total of 5 restorations was found to fail during the study - 3 in the first year and 2 during the third year of the study. Occlusal marginal adaptation was less than ideal at baseline in 11% of cases, primarily as a consequence of overcontouring, as observed in the die stone replicas. The combined percentage Alpha ratings at 3 years were: colour match, 98%; marginal adaptation (occlusal), 78%; marginal adaptation (proximal), 97%; anatomic form (occlusal), 99%; anatomic form (proximal), 95%; surface roughness (occlusal), 100%; surface roughness (proximal), 100%; marginal staining (occlusal), 90%; marginal staining (proximal) 81%; interfacial staining (occlusal), 99%; interfacial staining (proximal), 100%; contacts (occlusal), 95%; contacts (proximal), 93%; sensitivity, 100%; secondary caries, 100%; lustre of restoration, 100%. Conclusion: It is concluded that the 3-year performance of Fluorobond-bonded Beautifil for Class I and II restorations demonstrated some marginal changes, but most of the direct evaluation ratings were > 90% Alpha, with the performance observed being similar in the two centres. Palabras clave: giomer, self etching adhesive, clinical trial, posterior restoration

Restaurationen mit marginalen Überhängen stehen häufig in direktem Zusammenhang mit lokalisierten parodontalen Defekten. Der Zugang zu überkonturierten approximalen Rändern ist jedoch oft schwer zu erreichen. Ein System, das sich durch ein vielseitiges Handstück auszeichnet, stellt ein effektives und effizientes Mittel zum Konturieren, Ausarbeiten und Polieren von Restaurationsoberflächen und -rändern dar. Insbesondere vereinfacht es den Zugang zu approximalen und subgingivalen Bereichen zur Entfernung von marginalen Überschüssen und Überhängen. Das System könnte eine wertvolle Bereicherung für die Ausrüstung des konservierend arbeitenden Zahnarztes sein. Palabras clave: Restauration, marginale Überhänge, Präparationsränder, Konturierung, Ausarbeitung, Politur, Approximalbereich

Restorations with marginal overhangs are frequently associated with localized periodontal defects. Access to overcontoured approximal margins of restorations can be difficult to obtain, however. A system featuring a multidirectional handpiece is an effective and efficient means of contouring, finishing, and polishing restoration surfaces and margins. In particular, the system facilitates access to approximal and subgingival areas for the removal of marginal excess and overhangs. This system may be a valuable addition to the practitioner's armamentarium for operative procedures.