Abstract Background: In this study, risk determinants were determined for periodontal disease in the representative population sample ( n =3146) of the Study of Health in Pomerania. Methods: After examining the net random sample (response 69%) and exclusion of edentulous cases and those with missing values, 2595 subjects remained. Using a multivariate, fully adjusted logistic regression, different definitions of “periodontally diseased/healthy” were examined as the dependent variable (extent of attachment loss (AL4 mm, combined AL and tooth loss). The independent variables used were sociodemographic factors (age, gender, income, education), medical factors (systemic diseases, drugs), behavioral factors (regular dental checkup, smoking), and oral factors (presence of supragingival calculus and plaque). Results: The following risk determinants were found for AL: male gender, presence of supragingival plaque and calculus, smoking, low educational level. For the combination of AL and tooth loss, risk determinants were female gender, supragingival plaque, smoking, and low educational level. Consumption of antiallergic medications and regular dental checkups proved to be protective. Smoking was the most influential risk determinant. These parameters explained approximately 43–55% of the variation. Conclusion: These results concur with those of the literature. In order to explain disease status further, host‐response and microbiological factors must also be examined.
The goal of the Study of Health in Pomerania (SHIP) was to estimate the prevalence of diseases, identify potential risk factors in a defined region in northeast Germany, and examine the particular living situation of this population after the reunification of East and West Germany. One of the main concerns of the SHIP design is the analysis of the relationships between dental, medical, social, and environmentally and behaviorally determined health factors. SHIP is a cross-sectional study (clinical findings and sociologic interviews). The sample was drawn in two steps: Thirty-two communities in the region were selected, and within these communities, a simple random sample was drawn from residence registries, stratified by gender and age. The final sample included 4,310 males and females, aged 20 to 79 years. This is equivalent to a participation rate of 68.8%. Data collection was completed in May 2001. The data collection and items comprised four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination included the teeth, periodontium, oral mucosa, morphology and function of the craniomandibular system, and prosthodontics. The medical examination included blood pressure measurements; electrocardiography; echocardiography; carotid, thyroid, and liver ultrasound examinations; neurologic screening; and blood and urine sampling. The computer-assisted interview consisted of questions on symptoms of disease, utilization of medical and dental services, self-assessment of general and oral health, health behavior and knowledge, and socioeconomic variables. The self-administered questionnaire comprised housing conditions, social network, work conditions, subjective well-being, and individual consequences of the German reunification.
AbstractObjectives:For various clinical applications, polyhexamethylene biguanide (PHMB) has been used for many years as an antiseptic in medicine. Little is known, however, of its antibacterial activity in the oral cavity and its ability to inhibit plaque formation. In this study, a 0.04% PHMB mout
Aim: The splint therapy is the most common and recommendable standard therapy for craniofacial pain.This type of therapy can obtain muscle relaxation and improvement of neuromuscular coordination.The aim of the article is to exemplify the clinical course of the dental diagnostics and splint therapy of patients with craniofacial pain.Summary: A patient with craniofacial pain was treated using splint therapy.The therapeutic approach consisted in eliminating centric and eccentric occlusal disturbances, rebuilding lost support zones, and changing the mandibular motion pattern in order to improve muscle tone and neuromuscular coordination.Successful implementation required that, in centric relation and therefore in the splint position, the condyle-disc unit should be still largely intact and the interarticular space not constricted.As a result of the splint treatment, the patient was free of headaches, TMJ problems, and tinnitus, despite continuing work in a very intensive and responsible occupation.Recently, the patient reported not needing the splint at all during a sailing holiday in the Mediterranean.Key learning points: This special type of splint therapy should be conducted in association with muscle massages and physiotherapy exercises, because the jaw relations must adapt to the premature contacts which arise on the splint at first.
The aim of this study was to assess the prevalence and distribution of root caries in the adult population of Pomerania, Germany. The study sample comprised 6,267 randomly selected subjects who were scheduled for examination from 1997 to 2001 (population-based cross-sectional study, response rate: 69%, age range 20–79 years). 499 edentulous persons were excluded from the dental examination (12%) performed according to WHO guidelines (1997). In the statistical analysis, frequency distributions, means and median values were calculated and subdivided for different age groups. The percentage of exposed and affected root surfaces increased with age (root caries index 4.6–10.6%). The mean number of carious/filled root surfaces (RDFS) rose from 0.4 per person (25–34 years) to 2.3 (55–64 years) and dropped for seniors due to the low number of retained teeth. Fillings comprised the largest proportion of the RDFS (69.5%). Most caries/fillings were found on buccal surfaces, the highest rate in mandibular premolars. With about half of over-45-year-olds having at least one carious/filled root surface and increasing number of retained teeth in seniors, root caries is a relevant and probably growing disease in Pomerania and East Germany.
The aim of this study was to evaluate associations among the dental status, socioeconomic factors, and general health of 1,877 subjects between the ages of 55 and 79.Socioeconomic information (age, sex, education level) and questions on smoking and alcohol abuse were taken from an interview; income and medical information (number of diseases) were taken from a self-administered questionnaire; and HbA1C and CDT (diabetes and alcoholism markers) were taken from blood analyses.Of the subjects, 73% had a low education level, and 27% of the subjects had a monthly income of < 1,000 Euro and 13% of > 2,000 Euro. Twenty-six percent of the subjects were edentulous, and 29% had 20 or more teeth. The odds ratio of edentulism increased to 9.0 (95% confidence interval = 7.0-11.5) at the ages of 75 to 79 years compared to ages 55 to 79. Logistic regression analyses showed that edentulism was significantly associated with age, low education level, low income, smoking, and alcohol abuse. However, the retention of more than 20 teeth was associated with age.Age, low income, low education level, smoking, and alcohol abuse seemed to be risk markers for edentulism; whereas, the number of diseases, diabetes, and gender were not.
SUMMARY Objectives: To examine the relationship between condylar position and disk displacement in the temporomandibular joint (TMJ). Methods: 564 joints with no disk displacement (NDD), 114 joints with reducible displaced disk (RDD) and 36 joints with permanently displaced disk (PDD) were diagnosed. The assessment of the condyle and TMJ disk positions was based on the sagittal plane magnetic resonance (MR) images (the position of the disk was controlled by coronal images). Results: There were significant differences in condyle position between the joints with NDD and RDD (χ²-test, P<0,000), while there was no difference between those with NDD and PDD (χ²-test, right: P=0,112; left: P=0,225). There was also a significant correlation between bilateral condylar position and disk displacement in the TMJ (χ²-test, P<0,000). Conclusions: We suggest that if the disk displacement is reducible, the condyle is displaced posteriorly: in joints with PDD the condyle returns to the concentric position. These data also suggest that any change in condylar position induced by a change on the opposite side was essential.
Aim of the study was to determine whether associations exist in men as well as in women between occlusal factors like malocclusions or factors of functional occlusion and subjective temporomandibular joint (TMJ) symptoms, based on the population-based Study of Health in Pomerania (SHIP-0). A representative sample of 4310 men and women (response rate 68.8%) aged 20 to 81 years was examined for subjective temporomandibular joint symptoms, malocclusions (incl. normal occlusion), factors of functional occlusion and for sociodemographic parameters. Men and women were analyzed separately with multiple logistic regression analyses, adjusted for age. The results were compared to other population-based studies from an own systematic review on this subject. In men and women, none of the 48 occlusal factors under survey (malocclusions or functional occlusion) was significantly more frequently associated with the dependent variable "subjective temporomandibular joint symptoms". In contrast, the parafunction "frequent clenching" was associated more frequently and clinically relevant with TMJ symptoms in both sexes (for men, odds ratio = 4.2, prevalence 4.9%; for women OR = 2.9, prevalence 5.6%). Malocclusions and functional occlusion factors only explained a smaller part of the differences between the male and female population with and without subjective TMJ symptoms. Compared to other population-based studies only few and inconsistent associations between occlusal factors and subjective temporomandibular symptoms were ascertainable in both sexes.
Objective: The aim of this study was to describe the oral health status of older adults living in north‐eastern Germany. Materials and Methods: Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross‐sectional, population‐based study. Data on 1446 subjects aged 60–79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss. Results: The prevalence of edentulousness varied from 16% in the 60–65‐year‐old group to 30% in the 75–79‐year‐old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60–65 years) to one in the oldest (75–79 years). Among subjects aged 60–69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70–79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70–79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60–69 years: 85% vs. 71% in 70–79‐year‐old men; women aged 60–69 years: 71% vs. 62% in 70–79‐year‐olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern. Conclusions: It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.
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