Research of anthropometric measures of temporomandibular joint's articular eminence on historic samples

Istraživanje antropometrijskih mjera TMZ-a provedeno je na 210 lubanja različitih historijskih populacija: iz ranog i kasnog srednjeg vijeka, suvremenog doba s područja Hrvatske, prastanovnika Illinoisa (od 900. – 1500. g.pos.Kr.), Kentuckya (od 500 g. pr. Kr. do 500 g. pos. Kr.) te američkih bijelaca i crnaca 20. stoljeća. Svrha rada bila je odrediti vrijednosti parametara TMZ-a: nagib posteriornog zida zglobne kvržice (NZK) dvjema metodama, visina zglobne kvržice (VZK) i duljina zakrivljene linije (DZL) od najkranijalnije točke zglobne jamice do najkaudalnije točke zglobne kvržice te dobivene rezultate analizirati s obzirom na historijsku populaciju, stranu tijela, spol, dob, ozubljenost (klasifikacija zubnih lukova prema Kennedy-ju i Eichner-u) i stupanj abrazije zuba. Mjerenje je provedeno na rezovima kroz silikonske otiske zglobne kvržice i jamice (klasična metoda), na lateralnim fotografijama te radiografskim snimkama (ortopantomogrami i kefalogrami) lubanja (samo s područja Hrvatske) te na trodimenzionalno optički i laserski skeniranim otiscima zglobne kvržice i jamice, a potom su međusobno uspoređeni i rezultati mjerenja dobiveni različitim tehnikama. Razlike istraživanih parametara TMZ-a obzirom na historijsku populaciju, stranu tijela, spol, dob, stupanj abrazije zuba te klasifikaciju zubnih lukova prema Kennedy-ju i Eichner-u u većini slučajeva nisu bile statistički značajne (p>0,05) što vodi zaključku kako navedene varijable ne utječu na morfologiju TMZ-a. Najveće vrijednosti istraživanih parametara TMZ-a izmjerene su na rezovima kroz središnji dio silikonskih otisaka zglobne kvržice i jamice (p<0,05). Veće vrijednosti NZK-a karakteristika su više zglobne kvržice, a viša zglobna kvržica rezultira pak većom DZL vrijednošću (p<0,05). Uspoređujući rezultate mjerenja parametara TMZ-a na različitim materijalima dobivene su statistički značajno veće vrijednosti na radiografskim snimkama u odnosu na vrijednosti izmjerene na lateralnim fotografijama (p<0,05). Usporedbom rezultata istraživanja na optički i laserski skeniranim uzorcima s rezultatima klasičnog mjerenja, najveća odstupanja vrijednosti dobivena su na optički skeniranim uzorcima (p<0,05) dok se klasična metoda mjerenja na rezovima kroz silikonske otiske zglobne kvržice i jamice može primijeniti kao kontrolna metoda mjerenja zbog svoje velike točnosti.Objectives: Skeletal components of the temporomandibular joint (TMJ) are important elements in the biomechanics of the entire masticatory system. The aim of this research was to determine the values of TMJ parameters (AEI - articular eminence inclination, AEH - articular eminence height and AEL - length of curved line from the most superior point of the glenoid fossa to the most inferior point of the articular eminence) among historical populations, and to analyze results with regard to the body side, gender, age, Kennedy and Eichner classification of dental arches and degree of tooth abrasion. Measurements were performed on digitalized sections of silicone impressions of the articular eminence and fossa glenoidalis, lateral photographs, and radiographic images of skulls (panoramic radiograps and cephalograms) in order to compare obtained results and methods. Finally, the aim of this study was also to compare obtained results of TMJ parameters measured on sections through silicone impressions of articular eminence and fossa glenoidalis with values measured on three dimensional - laser and optical scanned silicone impressions. Materials and methods: The study included 210 skulls grouped according to historical populations: early medieval Croatian population (EMP; 10th-11th century, 30 skulls), late medieval Croatian population (LMP; 12th-15th century, 30 skulls), contemporary Croatian population (CCP; 20th century, 30 skulls), Illinois population (IP; from 900 AD to 1500 AD years, 30 skulls); Kentucky population (KP; from 500 BC to 500 AD years, 30 skulls) and a group of African Americans (AAP; 30 skulls) and American Caucasian (ACP; 30 skulls) of the 20th century. Investigated TMJ parameters were: articular eminence inclination (AEI) measured by two methods and expressed in degrees (method 1 - M1 - the angle between the line connecting the most superior point of the glenoid fossa and the most inferior point of the articular eminence with the Frankfurt horizontal plane; method 2 - M2 - the angle between the best fitting line to the posterior wall of the articular eminence and the Frankfurt horizontal plane), articular eminence height (AEH) - vertical distance (mm) from the most superior to the most inferior point of the articular eminence, and the length (mm) of curved line (AEL) between the most superior point of the glenoid fossa and the most inferior point of the articular eminence. All skulls were without any damage in the measured area (articular eminence, fossa articularis, meatus acusticus externus, and orbitae). AEI, AEH and AEL were measured on the lateral digital photographs of skulls and radiographs (only for Croatian skulls) - panoramic radiographs and cephalograms using appropriate computer software, as well as on the sections through the right/left silicone impressions of the articular eminence and fossa glenoidalis made for each skull ("classic" method). The base of silicone impressions was parallel to the Frankfurt horizontal plane. Silicone impressions were sliced from lateral to medial side into 5 sections (between each section was a distance of 4 mm). The sections were digitalized and AEI, AEH and AEL were measured using appropriate computer software. Thirty right and thirty left silicone impressions were randomly selected from the total number of silicone impressions. Selected silicone impressions were three-dimensionally digitalized by laser and optical scanner. Applied methods of three-dimensional digitalization of silicone impressions also allow simulation of sections (from lateral to medial side) through the virtual impressions of the articular eminence and fossa glenoidalis with distance of 4 mm between each section. TMJ parameters were measured using appropriate computer software. AEI, AEH and AEL values measured on three-dimensionally digitalized impressions were compared with the results of "classic" measurements. AEI, AEH and AEL were analyzed according to the certain historical population, body side, gender, age (three age groups: skulls under 30 years of age at the time of death; skulls from 31 to 45 years of age at the time of death, and skulls with 46 years of age or older at the time of death), Kennedy and Eichner classification of dental arches, and degree of tooth abrasion (abrasion 1 – occlusal surfaces covered by enamel; abrasion 2 – occlusal surfaces with denuded dentin surrounded by enamel; abrasion 3 - no enamel on the occlusal surfaces). AEI, AEH and AEL values measured by different methods (sections through silicone impressions of articular eminence and fossa glenoidalis, lateral photographs, radiographs, laser and optically scanned silicone impressions) were also compared. Statistical analysis was performed using the computer software IBM SPSS Statistics 19 (SPSS Inc., Chicago, Illinois, USA). Obtained data were analyzed by method of descriptive statistics and by following statistical tests: independent students T test, one-way analysis of variance ANOVA and Scheffe post hoc test, univariate statistical analysis, Pearson's correlation coefficient and non parametric Friedman test. The results were analyzed at the significance level of p<0.05. Results: Mean values of TMJ parameters measured on EMP silicone impressions: right AEI M1 was 35.43°, and left AEI M1 was 36.58°; right AEI M2 was 53.35°, and left AEI M2 was 54.35°; right AEH value was 6.47 mm, and left AEH value was 6.69 mm; right AEL value was 12.10 mm, and left AEL value was 12.30 mm. Mean values of TMJ parameters measured on LMP silicone impressions: right AEI M1 was 37.91°, and left AEI M1 was 38.26°; right AEI M2 was 60.13°, and left AEI M2 was 61.42°; right AEH value was 6.74 mm, and left AEH value was 6.93 mm; right AEL value was 12.15 mm, and left AEL value was 12.40 mm. Mean values of TMJ parameters measured on CCP silicone impressions: right AEI M1 was 34.72°, and left AEI M1 was 34.59°; right AEI M2 was 53.49°, and left AEI M2 was 54.34°; right AEH value was 6.20 mm, and left AEH value was 6.43 mm; right AEL value was 11.76 mm, and left AEL value was 12.30 mm. Mean values of TMJ parameters measured on IP silicone impressions : right AEI M1 was 31.56°, and left AEI M1 was 36.62°; right AEI M2 was 44.14°, and left AEI M2 was 52.67°; right AEH value was 5.82 mm, and left AEH value was 6.32 mm; right AEL value was 11.99 mm, and left AEL value was 11.55 mm. Mean values of TMJ parameters measured on KP silicone impressions: right AEI M1 was 34.36°, and left AEI M1 was 34.54°; right AEI M2 was 46.44°, and left AEI M2 was 50.25°; right AEH value was 5.98 mm, and left AEH value was 5.85 mm; right AEL value was 12.09 mm, and left AEL value was 11.57 mm. Mean values of TMJ parameters measured on AAP silicone impressions: right AEI M1 was 36.48°, and left AEI M1 was 36.42°; right AEI M2 was 50.24°, and left AEI M2 was 52.50°; right AEH value was 6.72 mm, and left AEH value was 6.60 mm; right AEL value was 12.66 mm, and left AEL value was 12.48 mm. Mean values of TMJ parameters measured on ACP silicone impressions: right AEI M1 was 36.26°, and left AEI M1 was 38.72°; right AEI M2 was 52.85°, and left AEI M2 was 58.37°; right AEH value was 6.60 mm, and left AEH value was 6.86 mm; right AEL value was 12.73 mm, and left AEL value was 12.52 mm. Mean AEI values measured by method M1 on lateral skull photographs ranged from 29.59° to 37.65°, and mean AEI values measured by method M2 ranged from 45.25° to 58.60°. Mean AEH values measured on lateral skull photographs ranged from 5.88 mm to 9.78 mm, and mean AEL values ranged from 11.12 mm to 13.33 mm. Mean AEI values measured by method M1 on cephalograms ranged from 36.54° to 39.84°, while mean AEI values measured by method M2 ranged from 56.53° to 59.98°. Mean AEH values measured on cephalograms ranged from 6.69 mm to 9.63 mm, while mean AEL values measured on cephalograms ranged from 12.78 mm to 13.56 mm. Mean AEI values measured by method M1 on panoramic radiographs ranged from 32.21° to 40.58°, while mean AEI values measured by method M2 on panoramic radiographs ranged from 53.86° to 60.81°. AEI, AEH, AEL values didn't differ significantly between historical populations (p>0.05) regardless of the performed measurement technique. AEI, AEH, AEL values didn't differ significantly according to the body side, gender, age and tooth abrasion (p>0.05). Also, the combination of certain historical population and some other variable (age, gender, tooth abrasion, Kennedy and Eichner classification of dental arches) didn’t significantly affect measured TMJ parameters (p>0.05). AEI, AEH and AEL values increased from lateral to medial sections through the silicone impressions of the articular eminence and fossa glenoidalis. The highest AEI, AEH and AEL right side value was measured on the second or third section, and the lowest value was measured on the fifth, most medial section (p<0.05). On the left side, the highest AEI, AEH and AEL values were measured on the third section through the silicone impressions of the articular eminence and fossa glenoidalis while lower values were measured on the fifth section (p<0.05) except AEI M1 with highest value on the fifth section (p<0.05). In most cases, positive, medium or strong correlation existed between AEI M1 and AEH; AEI M2 and AEH, as well as between AEH and AEL values (p<0.05). Between AEI and AEL values was found positive but weak correlation (p<0.05). AEI M1 and AEI M2 values measured on panoramic radiographs and cephalograms were statistically significantly higher than values measured on lateral photographs (p<0.05). If we compare results obtained by “classic method” with values measured on three-dimensionally scanned silicone impressions (laser and optical), from a total of 16 (100%) statistically significant differences, the smallest difference between values measured by „classic method“ and values measured on laser scans existed in 13 cases (81.3%) whereas the results measured on optical scans showed the highest variation (p<0.05). For the remaining 3 (18.7%) cases, the smallest difference was obtained between values measured on the laser and optical scans with highest variation of results measured by classic method (p<0.05). Conclusion: AEI, AEH and AEL values didn't differ among historical populations and according to the body side, gender, age, Kennedy and Eichner classification of dental arches and tooth abrasion. The lowest TMJ values on sections through the silicone impressions of the articular eminence were medial and lateral, and higher values on the central sections. Higher AEI value follows higher AEH, and higher AEH results in greater AEL value. Different measurement techniques give consequently different values of TMJ parameters (higher values measured on radiographic images), therefore, it is of great importance to state which technique was used when expressing AEI, AEH, and AEL data. Among values measured on optical and laser scanned impressions and by „classic“ method, the greatest variations were mostly obtained for values measured on optical scans, while the „classic method“ can still be used as a method with very high accuracy

Research of anthropometric measures of temporomandibular joint's articular eminence on historic samples

Istraživanje antropometrijskih mjera TMZ-a provedeno je na 210 lubanja različitih historijskih populacija: iz ranog i kasnog srednjeg vijeka, suvremenog doba s područja Hrvatske, prastanovnika Illinoisa (od 900. – 1500. g.pos.Kr.), Kentuckya (od 500 g. pr. Kr. do 500 g. pos. Kr.) te američkih bijelaca i crnaca 20. stoljeća. Svrha rada bila je odrediti vrijednosti parametara TMZ-a: nagib posteriornog zida zglobne kvržice (NZK) dvjema metodama, visina zglobne kvržice (VZK) i duljina zakrivljene linije (DZL) od najkranijalnije točke zglobne jamice do najkaudalnije točke zglobne kvržice te dobivene rezultate analizirati s obzirom na historijsku populaciju, stranu tijela, spol, dob, ozubljenost (klasifikacija zubnih lukova prema Kennedy-ju i Eichner-u) i stupanj abrazije zuba. Mjerenje je provedeno na rezovima kroz silikonske otiske zglobne kvržice i jamice (klasična metoda), na lateralnim fotografijama te radiografskim snimkama (ortopantomogrami i kefalogrami) lubanja (samo s područja Hrvatske) te na trodimenzionalno optički i laserski skeniranim otiscima zglobne kvržice i jamice, a potom su međusobno uspoređeni i rezultati mjerenja dobiveni različitim tehnikama. Razlike istraživanih parametara TMZ-a obzirom na historijsku populaciju, stranu tijela, spol, dob, stupanj abrazije zuba te klasifikaciju zubnih lukova prema Kennedy-ju i Eichner-u u većini slučajeva nisu bile statistički značajne (p>0,05) što vodi zaključku kako navedene varijable ne utječu na morfologiju TMZ-a. Najveće vrijednosti istraživanih parametara TMZ-a izmjerene su na rezovima kroz središnji dio silikonskih otisaka zglobne kvržice i jamice (p<0,05). Veće vrijednosti NZK-a karakteristika su više zglobne kvržice, a viša zglobna kvržica rezultira pak većom DZL vrijednošću (p<0,05). Uspoređujući rezultate mjerenja parametara TMZ-a na različitim materijalima dobivene su statistički značajno veće vrijednosti na radiografskim snimkama u odnosu na vrijednosti izmjerene na lateralnim fotografijama (p<0,05). Usporedbom rezultata istraživanja na optički i laserski skeniranim uzorcima s rezultatima klasičnog mjerenja, najveća odstupanja vrijednosti dobivena su na optički skeniranim uzorcima (p<0,05) dok se klasična metoda mjerenja na rezovima kroz silikonske otiske zglobne kvržice i jamice može primijeniti kao kontrolna metoda mjerenja zbog svoje velike točnosti.Objectives: Skeletal components of the temporomandibular joint (TMJ) are important elements in the biomechanics of the entire masticatory system. The aim of this research was to determine the values of TMJ parameters (AEI - articular eminence inclination, AEH - articular eminence height and AEL - length of curved line from the most superior point of the glenoid fossa to the most inferior point of the articular eminence) among historical populations, and to analyze results with regard to the body side, gender, age, Kennedy and Eichner classification of dental arches and degree of tooth abrasion. Measurements were performed on digitalized sections of silicone impressions of the articular eminence and fossa glenoidalis, lateral photographs, and radiographic images of skulls (panoramic radiograps and cephalograms) in order to compare obtained results and methods. Finally, the aim of this study was also to compare obtained results of TMJ parameters measured on sections through silicone impressions of articular eminence and fossa glenoidalis with values measured on three dimensional - laser and optical scanned silicone impressions. Materials and methods: The study included 210 skulls grouped according to historical populations: early medieval Croatian population (EMP; 10th-11th century, 30 skulls), late medieval Croatian population (LMP; 12th-15th century, 30 skulls), contemporary Croatian population (CCP; 20th century, 30 skulls), Illinois population (IP; from 900 AD to 1500 AD years, 30 skulls); Kentucky population (KP; from 500 BC to 500 AD years, 30 skulls) and a group of African Americans (AAP; 30 skulls) and American Caucasian (ACP; 30 skulls) of the 20th century. Investigated TMJ parameters were: articular eminence inclination (AEI) measured by two methods and expressed in degrees (method 1 - M1 - the angle between the line connecting the most superior point of the glenoid fossa and the most inferior point of the articular eminence with the Frankfurt horizontal plane; method 2 - M2 - the angle between the best fitting line to the posterior wall of the articular eminence and the Frankfurt horizontal plane), articular eminence height (AEH) - vertical distance (mm) from the most superior to the most inferior point of the articular eminence, and the length (mm) of curved line (AEL) between the most superior point of the glenoid fossa and the most inferior point of the articular eminence. All skulls were without any damage in the measured area (articular eminence, fossa articularis, meatus acusticus externus, and orbitae). AEI, AEH and AEL were measured on the lateral digital photographs of skulls and radiographs (only for Croatian skulls) - panoramic radiographs and cephalograms using appropriate computer software, as well as on the sections through the right/left silicone impressions of the articular eminence and fossa glenoidalis made for each skull ("classic" method). The base of silicone impressions was parallel to the Frankfurt horizontal plane. Silicone impressions were sliced from lateral to medial side into 5 sections (between each section was a distance of 4 mm). The sections were digitalized and AEI, AEH and AEL were measured using appropriate computer software. Thirty right and thirty left silicone impressions were randomly selected from the total number of silicone impressions. Selected silicone impressions were three-dimensionally digitalized by laser and optical scanner. Applied methods of three-dimensional digitalization of silicone impressions also allow simulation of sections (from lateral to medial side) through the virtual impressions of the articular eminence and fossa glenoidalis with distance of 4 mm between each section. TMJ parameters were measured using appropriate computer software. AEI, AEH and AEL values measured on three-dimensionally digitalized impressions were compared with the results of "classic" measurements. AEI, AEH and AEL were analyzed according to the certain historical population, body side, gender, age (three age groups: skulls under 30 years of age at the time of death; skulls from 31 to 45 years of age at the time of death, and skulls with 46 years of age or older at the time of death), Kennedy and Eichner classification of dental arches, and degree of tooth abrasion (abrasion 1 – occlusal surfaces covered by enamel; abrasion 2 – occlusal surfaces with denuded dentin surrounded by enamel; abrasion 3 - no enamel on the occlusal surfaces). AEI, AEH and AEL values measured by different methods (sections through silicone impressions of articular eminence and fossa glenoidalis, lateral photographs, radiographs, laser and optically scanned silicone impressions) were also compared. Statistical analysis was performed using the computer software IBM SPSS Statistics 19 (SPSS Inc., Chicago, Illinois, USA). Obtained data were analyzed by method of descriptive statistics and by following statistical tests: independent students T test, one-way analysis of variance ANOVA and Scheffe post hoc test, univariate statistical analysis, Pearson's correlation coefficient and non parametric Friedman test. The results were analyzed at the significance level of p<0.05. Results: Mean values of TMJ parameters measured on EMP silicone impressions: right AEI M1 was 35.43°, and left AEI M1 was 36.58°; right AEI M2 was 53.35°, and left AEI M2 was 54.35°; right AEH value was 6.47 mm, and left AEH value was 6.69 mm; right AEL value was 12.10 mm, and left AEL value was 12.30 mm. Mean values of TMJ parameters measured on LMP silicone impressions: right AEI M1 was 37.91°, and left AEI M1 was 38.26°; right AEI M2 was 60.13°, and left AEI M2 was 61.42°; right AEH value was 6.74 mm, and left AEH value was 6.93 mm; right AEL value was 12.15 mm, and left AEL value was 12.40 mm. Mean values of TMJ parameters measured on CCP silicone impressions: right AEI M1 was 34.72°, and left AEI M1 was 34.59°; right AEI M2 was 53.49°, and left AEI M2 was 54.34°; right AEH value was 6.20 mm, and left AEH value was 6.43 mm; right AEL value was 11.76 mm, and left AEL value was 12.30 mm. Mean values of TMJ parameters measured on IP silicone impressions : right AEI M1 was 31.56°, and left AEI M1 was 36.62°; right AEI M2 was 44.14°, and left AEI M2 was 52.67°; right AEH value was 5.82 mm, and left AEH value was 6.32 mm; right AEL value was 11.99 mm, and left AEL value was 11.55 mm. Mean values of TMJ parameters measured on KP silicone impressions: right AEI M1 was 34.36°, and left AEI M1 was 34.54°; right AEI M2 was 46.44°, and left AEI M2 was 50.25°; right AEH value was 5.98 mm, and left AEH value was 5.85 mm; right AEL value was 12.09 mm, and left AEL value was 11.57 mm. Mean values of TMJ parameters measured on AAP silicone impressions: right AEI M1 was 36.48°, and left AEI M1 was 36.42°; right AEI M2 was 50.24°, and left AEI M2 was 52.50°; right AEH value was 6.72 mm, and left AEH value was 6.60 mm; right AEL value was 12.66 mm, and left AEL value was 12.48 mm. Mean values of TMJ parameters measured on ACP silicone impressions: right AEI M1 was 36.26°, and left AEI M1 was 38.72°; right AEI M2 was 52.85°, and left AEI M2 was 58.37°; right AEH value was 6.60 mm, and left AEH value was 6.86 mm; right AEL value was 12.73 mm, and left AEL value was 12.52 mm. Mean AEI values measured by method M1 on lateral skull photographs ranged from 29.59° to 37.65°, and mean AEI values measured by method M2 ranged from 45.25° to 58.60°. Mean AEH values measured on lateral skull photographs ranged from 5.88 mm to 9.78 mm, and mean AEL values ranged from 11.12 mm to 13.33 mm. Mean AEI values measured by method M1 on cephalograms ranged from 36.54° to 39.84°, while mean AEI values measured by method M2 ranged from 56.53° to 59.98°. Mean AEH values measured on cephalograms ranged from 6.69 mm to 9.63 mm, while mean AEL values measured on cephalograms ranged from 12.78 mm to 13.56 mm. Mean AEI values measured by method M1 on panoramic radiographs ranged from 32.21° to 40.58°, while mean AEI values measured by method M2 on panoramic radiographs ranged from 53.86° to 60.81°. AEI, AEH, AEL values didn't differ significantly between historical populations (p>0.05) regardless of the performed measurement technique. AEI, AEH, AEL values didn't differ significantly according to the body side, gender, age and tooth abrasion (p>0.05). Also, the combination of certain historical population and some other variable (age, gender, tooth abrasion, Kennedy and Eichner classification of dental arches) didn’t significantly affect measured TMJ parameters (p>0.05). AEI, AEH and AEL values increased from lateral to medial sections through the silicone impressions of the articular eminence and fossa glenoidalis. The highest AEI, AEH and AEL right side value was measured on the second or third section, and the lowest value was measured on the fifth, most medial section (p<0.05). On the left side, the highest AEI, AEH and AEL values were measured on the third section through the silicone impressions of the articular eminence and fossa glenoidalis while lower values were measured on the fifth section (p<0.05) except AEI M1 with highest value on the fifth section (p<0.05). In most cases, positive, medium or strong correlation existed between AEI M1 and AEH; AEI M2 and AEH, as well as between AEH and AEL values (p<0.05). Between AEI and AEL values was found positive but weak correlation (p<0.05). AEI M1 and AEI M2 values measured on panoramic radiographs and cephalograms were statistically significantly higher than values measured on lateral photographs (p<0.05). If we compare results obtained by “classic method” with values measured on three-dimensionally scanned silicone impressions (laser and optical), from a total of 16 (100%) statistically significant differences, the smallest difference between values measured by „classic method“ and values measured on laser scans existed in 13 cases (81.3%) whereas the results measured on optical scans showed the highest variation (p<0.05). For the remaining 3 (18.7%) cases, the smallest difference was obtained between values measured on the laser and optical scans with highest variation of results measured by classic method (p<0.05). Conclusion: AEI, AEH and AEL values didn't differ among historical populations and according to the body side, gender, age, Kennedy and Eichner classification of dental arches and tooth abrasion. The lowest TMJ values on sections through the silicone impressions of the articular eminence were medial and lateral, and higher values on the central sections. Higher AEI value follows higher AEH, and higher AEH results in greater AEL value. Different measurement techniques give consequently different values of TMJ parameters (higher values measured on radiographic images), therefore, it is of great importance to state which technique was used when expressing AEI, AEH, and AEL data. Among values measured on optical and laser scanned impressions and by „classic“ method, the greatest variations were mostly obtained for values measured on optical scans, while the „classic method“ can still be used as a method with very high accuracy

Škljocanje u temporomandibularnome zglobu – znak za uzbunu!?

Temporomandibularni zglob (TMZ) jedan je od najsloženijih zglobova u ljudskom tijelu i sastavni je dio žvačnog sustava. Pojam temporomandibularnih poremećaja često se spominje kao skupni naziv za niz simptoma i znakova u žvačnom sustavu. Škljocaj u TMZ-u povezuje se s tzv. poremećajima disk-kondil kompleksa. Često pacijenti osjete ili čuju samo škljocaj. Stoga im treba objasniti mehaniku poremećaja te ih uputiti kako eventualno smanjiti opterećenje na zglob. Ovakvo stanje se često može smatrati stabilnim, bezbolnim i dugotrajnim stanjem

Nagib stražnjeg zida zglobne kvržice srednjovjekovne i suvremene hrvatske populacije

Articular eminence inclination (AEI) of the temporomandibular joint leads the mandible in its movements. Therefore, the aim of the present study was to determine AEI values in medieval (MP) and recent (RP) Croatian population. The study was carried out on two groups of specimens: first group with 30 MP human dry skulls, while the other, serving as control group consisted of 137 dry skulls. The AEI was measured on lateral digital skull images as the angle between the best fit line drawn along the posterior wall of the articular eminence and the Frankfurt horizontal plane. No statistically significant (p>0.05) differences between the left and right side AEI were found between MP skulls and RP skulls. The mean value of MP AEI was 45.5˚, with a range of 20.9˚-64˚. The mean RP AEI value was steeper (61.99˚), with a range of 30˚-94˚. Difference between the mean MP and RP AEI values was statistically significant (p0,05) između vrijednosti AEI lijeve i desne strane u uzorku MP i RP. Srednja izmjerena MP vrijednost AEI bila je 45,5˚ u rasponu vrijednosti od 20,9˚ do 64˚. Srednja izmjerena RP vrijednost AEI bila je viša, 61,99˚, s rasponom vrijednosti od 30˚ do 94˚. Razlika srednjih vrijednosti AEI između skupina MP i RP bila je statistički značajna (p<0,05). Vrijednosti AEI su vrlo varijabilne. Razlika (statistički neznačajna) između vrijednosti AEI lijeve i desne strane upućuje na prirodnu asimetriju. Razlike u vrijednostima AEI između skupina RP i MP postoje vjerojatno zbog različite prehrane u srednjem vijeku te posljedično tome različitim žvačnim silama i opterećenju

Human Papillomavirus in the Lesions of the Oral Mucosa According to Topography

Background. The association between human papillomavirus (HPV) types and oral lesions has been shown in many studies. In light of the possibility of early detection of HPV genotypes in oral epithelium, and considering the significance which HPV has in the development of malignant and potentially malignant disorders of oral mucosa, the purpose of this study was to investigate the prevalence of HPV DNA in different oral lesions in the Croatian population. In addition, we wanted to elucidate whether HPV infection is associated predominantly with either the lesion or particular anatomic site of the oral cavity. Methodology/Principal Findings. The study included 246 subjects with different oral lesions, and 73 subjects with apparently healthy oral mucosa (controls). Oral lesions were classified according to their surface morphology and clinical diagnosis. Epithelial cells were collected with the cytobrush from different topographic sites in the oral cavity of oral lesions and controls. The presence of HPV DNA was evaluated by consensus and type-specific primer-directed polymerase chain reaction. The HPV positivity was detected in 17.7% of oral lesions, significantly more than in apparently healthy mucosa (6.8%), with a higher presence in benign proliferative mucosal lesions (18.6%). High-risk HPV types were predominantly found in potentially malignant oral disorders (HPV16 in 4.3% and HPV31 in 3.4%), while benign proliferative lesions as well as healthy oral mucosa contained mainly undetermined HPV type (13.6 and 6.8%, respectively). Conclusions/Significance. Distribution of positive HPV findings on oral mucosa seems to be more associated to particular anatomical site than diagnosis itself. Samples taken from vermilion border, labial commissures, and hard palate were most often HPV positive. Thus, topography plays a role in HPV prevalence findings in oral lesions. Because of the higher prevalence of the high-risk HPV types in potentially malignant oral disorders, these lesions need to be continuously controlled and treated

Prosthetic Modalities Used to Treat Cleft Palate Patients in a University Clinic: A 10-Year Review

Cleft palate patients are not usually seen in general dental clinics, but this congenital anomaly is one of the most frequent of cases. General dental practitioners are usually unwilling or/and not sufficiently trained to treat such patients for whom rehabilitation and interdisciplinary cooperation is often needed. The aim of this study was to determine the incidence of prosthetic modalities most frequently used by licensed prosthodontists for prosthetic rehabilitation of cleft palate patients. Participants in this study were 56 cleft palate patients (aged 23–66 years) who received prosthetic treatment between 2000 and 2010. Patients’ dental status and prosthetic modalities used were noted from patient records archived at Department of Prosthodontics, School of Dental Medicine, University of Zagreb. Data analyses revealed that combined prosthetic constructions (fixed + removable, p<0.05) were the most frequently used. In a group of molar teeth, the most frequent fixed prosthetic modalities were crowns with rests; in a group of premolar teeth, telescopic crowns; on canines, metal ceramic crowns and telescopic crowns; and in a group of incisors, metal ceramic pontics (p<0.05). Understanding the distribution of prosthetic modalities for cleft palate patients could serve to guide dental practitioners towards planning adequate prosthetic treatment for their patients since only a well-planned prosthetic therapy will result in satisfactory function and alleviation of the deformities

Flexible Removable Partial Denture Prosthesis: A Survey of Dentists’ Attitudes and Knowledge in Greece and Croatia

Svrha: U ovom su se istraživanju s pomoću upitnika željeli istražiti znanje, stajališta i moguće razlike u korištenju savitljivih pomičnih djelomičnih proteza (PDP) među doktorima dentalne medicine (DDM) u Grčkoj i Hrvatskoj. Materijali i metode: Upitnik od 16 pitanja sastavljen je izvorno na engleskome jeziku te je preveden na grčki i hrvatski dvosmjernim prevođenjem. Nakon toga testirani su smisao, točnost, jasnoća i homogenost prijevoda upitnika, a u tome je sudjelovalo nekoliko grčkih i hrvatskih doktora dentalne medicine koji govore engleski gotovo kao materinski jezik. Nakon potrebnih ispravaka upitnici su korišteni u dvjema online anketama koje su, zajedno s informacijom o anketi i upitom o pristanku ispitanika na anketu, poslane na e-adrese gotovo četiri tisuće doktora dentalne medicine u svakoj državi. Prikupljeni podatci analizirani su Hi-kvadrat testom uz razinu značajnosti od a = 0,05. Rezultati: U istraživanju je sudjelovalo 378 DDM-a iz Grčke i 304 iz Hrvatske. Njih 137 (36,2 %) iz Grčke i 56 (18,4 %) iz Hrvatske opskrbljivali su svoje pacijente savitljivim PDP-ima. Statistička analiza provedena među svim DDM-ima koji izrađuju savitljive proteze nije otkrila značajnu razliku među spolovima (P > 0,05), ali jest značajnu razliku među dobnim skupinama (P 0,05). Zaključak: Istraživanje je upozorilo na razlike među zemljama u postotcima DDM-a koji upotrebljavaju, odabiru i svojim pacijentima omogućuju izradu savitljivih PDP-a. Dob DDM-a, godine rada i instruiranost bili su povezani s opskrbom pacijenata savitljivim protezama, a udobnost, estetika i cijena bili su razlozi za odluku o uporabi savitljivih PDP-a. Kliničke implikacije: Premda DDM-i tijekom školovanja nisu educirani o savitljivim PDP-ima, njih gotovo trećina svojim pacijentima predlaže takvu vrstu terapije. Kako bi ovi protetski radovi bili dugoročno uspješni, potrebno je kliničko obrazovanje, više iskustva i svakako više istraživanja u ovom području.Purpose: The aim of this study was to investigate through a questionnaire the knowledge, attitudes and possible differences in the use of flexible RPDPs among dentists in Greece and Croatia. Material and Methods: A questionnaire of 16 questions was originally created in English, translated into Greek and Croatian language following a two way translation and tested for apprehension, precision, clarity and homogeneity by a number of native English speaking Greek and Croatian dentists. Following the necessary corrections, the questionnaires replicated in two online surveys and their addresses with an informed consent were sent by emails to nearly 4000 dentists in each country to participate. Collected data were analyzed by chi-square tests at a= .05 level of significance. Results: 378 dentists from Greece and 304 from Croatia participated in the study. 137(36.2%) dentists from Greece and 56(18.4%) from Croatia provided flexible RPDPs to their patients. Statistical analysis for all providers indicated no significant difference between genders (P>.05), significant differences between age groups (P.05). Conclusion: The survey indicated differences between the two countries in the percentages of dentists using, selecting and providing RPDPs for their patients. Practitioners’ age, years in practice and instruction were associated with the provision of the prostheses, while comfort, esthetics and cost were the reasons for deciding to use the flexible RPDPs. Conclusion: Although dentists are not educated in their schools about flexible RPDPs, almost a third of them offer this treatment to their patients. Long term success of these devices depends on clinical education, more experience and definitely more research

Morfologija zglobne kvržice američkih povijesnih i suvremenih populacija

Objectives: This study was performed to determine the values of the articular eminence inclination (AEI), the articular eminence height (AEH), and the length of the articular eminence curved line (AEL) among American prehistoric and contemporary populations. Materials and methods: The study was carried out on 120 human dry skulls divided into 4 groups: Illinois group (IP), Kentucky group (KP), African Americans group (AAP) and American Caucasians group (ACP). Each group comprised 30 human dry skulls. Measurements of AEI (by two methods), AEH and AEL were performed using computer software on 5 sagittal sections through silicone molds of the articular eminence. The obtained results were statistically analyzed at significance level of p 0.05). The mean AEI M1 values ranged from 31.56° to 38.72°, the mean AEI M2 values ranged from 44.14° to 58.37°, the mean AEH ranged from 5.82 to 6.86 mm, and the mean AEL values ranged from 11.57 to 12.73 mm. Conclusions: AEI, AEH, AEL values are variables, but they did not differ significantly among American populations. Left-right differences as the result of natural body asymmetry were not statistically significant. Sex and age did not significantly affect the articular eminence morphology.Svrha rada: Istraživanje je provedeno kako bi se dobile vrijednosti nagiba stražnjega zida zglobne kvržice (AEI), visine zglobne kvržice (AEH) i duljine zakrivljene linije od najviše do najniže točke na zglobnoj kvržici (AEL) između američkih povijesnih i suvremenih populacija. Materijal i metode: Istraživanje je obavljeno na 120 ljudskih lubanja podijeljenih u četiri skupine: Illinois (IP), Kentucky (KP), američki crnci (AAP) i američki bijelci (ACP). U svakoj je bilo po 30 lubanja. Mjerenje AEI (dvije metode), AEH i AEL vrijednosti provedeno je s pomoću računalnog programa na pet rezova kroz si-likonske otiske zglobne kvržice. Rezultati su statistički obrađeni i analizirani na razini značajnosti od p 0,05). Srednje AEI M1 vrijed-nosti bile su od 31,56° do 38,72°, srednje AEI M2 vrijednosti od 44,14° do 58,37°, srednje AEH vrijed-nosti od 5,82 do 6,86 mm, a srednje AEL vrijednosti od 11,57 do 12,73 mm. Zaključak: AEI, AEH, AEL vrijednosti su varijabilne, ali bez statistički značajnih razlika između američkih populacija. Razlike s obzirom na stranu tijela, kao rezultat prirodne asimetrije tijela, nisu bile statistički značajne. Spol i dob nisu značajno utjecali na morfologiju zglobne kvržice

Factors Affecting Oral Health–Related Quality of Life Among Elderly Croatian Patients

Svrha: Na kvalitetu života povezanu s oralnim zdravljem (OHRQoL) i njezinu više-dimenzijsku vrijednost utječe mnogo čimbenika. Stoga se istraživanjem željelo ustanoviti koji demografski i subjektivni čimbenici znatno utječu na OHRQoL među pacijentima starije životne dobi s potpunim pomičnim protezama (CRDP). Materijali i metode: U istraživanju, provedenom ispunjavanjem upitnika, sudjelovao je 301 ispitanik. Svi su bili štićenici domova za starije osobe u Zagrebu i Slavonskom Brodu u Hrvatskoj te su nosili gornji i/ili donji CRDP. Upitnik se sastojao od dva dijela: u prvom su opća pitanja o ispitanicima, a u drugom hrvatska verzija Oral Health Impact Profila (OHIP - 49), upitnika s 49 pitanja podijeljenih u sedam domena. Rezultati: Prosječna dob ispitanika bila je 74 ± 12,1 godinu u rasponu od 60 do 99 godina. Zbroj bodova dobiven OHIP-om bio je 26,5. Najviše prosječne vrijednosti pronađene su u domeni funkcijskog ograničenja – 6,7, fizičke boli – 5,1, i fizičke nesposobnosti – 5,9. Dob ispitanika, obrazovanje, zanimanje, veličina mjesta stanovanja, vrsta CRDP-a i koliko dugo ispitanik nosi protezu, statistički su značajno utjecali na oralno zdravlje – OHRQoL (p < 0,05). Zaključak: Opći i sociodemografski čimbenici značajno utječu na subjektivni doživljaj oralnoga zdravlja. Mlađi ispitanici, ispitanici iz ruralnih mjesta, oni nižeg stupnja obrazovanja i ispitanici koji kraće nose proteze pokazuju veći utjecaj na OHRQoL.Objective of work: Oral health–related quality of life (OHRQoL) as a multidimensional concept is affected by many factors. Therefore, the aim of this study was to determine which demographic and subjective factors are significantly affecting the OHRQoL among the elderly people wearing complete removable dental prostheses (CRDP). Materials and Methods: This questionnairebased study included 301 participants, residents of elderly care homes (in Zagreb and Slavonski Brod, Croatia) wearing maxillary and/or mandibular CRDP. The questionnaire used in this study consisted of two sections; the first section included questions giving general information and in the second section the Croatian version of Oral Health Impact Profile (OHIP)-49 questionnaire with 49 items representing seven OHIP domains was used. Results: Participants were aged between 60–99 years, with average age of 74 ± 12.1 years. OHIP summary score was 26.5. The highest average OHIP mean values in the domain of functional limitation amounted to 6.7, physical pain 5.1, and physical disability 5.9. The participants’ age, education, profession, residence place size, type of CRDP, and the time of denture wearing period all statistically significantly affected OHRQoL (p < 0.05). Conclusions: General and sociodemographic factors had a significant influence on the participant’s subjective perception of oral health and OHRQoL. Younger participants, participants from rural places, those with lower levels of education, and shorter period of denture wearing demonstrated a higher impact on OHRQoL

Prosthetic Modalities Used to Treat Cleft Palate Patients in a University Clinic: A 10-Year Review

Cleft palate patients are not usually seen in general dental clinics, but this congenital anomaly is one of the most frequent of cases. General dental practitioners are usually unwilling or/and not sufficiently trained to treat such patients for whom rehabilitation and interdisciplinary cooperation is often needed. The aim of this study was to determine the incidence of prosthetic modalities most frequently used by licensed prosthodontists for prosthetic rehabilitation of cleft palate patients. Participants in this study were 56 cleft palate patients (aged 23–66 years) who received prosthetic treatment between 2000 and 2010. Patients’ dental status and prosthetic modalities used were noted from patient records archived at Department of Prosthodontics, School of Dental Medicine, University of Zagreb. Data analyses revealed that combined prosthetic constructions (fixed + removable, p<0.05) were the most frequently used. In a group of molar teeth, the most frequent fixed prosthetic modalities were crowns with rests; in a group of premolar teeth, telescopic crowns; on canines, metal ceramic crowns and telescopic crowns; and in a group of incisors, metal ceramic pontics (p<0.05). Understanding the distribution of prosthetic modalities for cleft palate patients could serve to guide dental practitioners towards planning adequate prosthetic treatment for their patients since only a well-planned prosthetic therapy will result in satisfactory function and alleviation of the deformities