CRANIO® The Journal of Craniomandibular & Sleep Practice
ISSN: 0886-9634 (Print) 2151-0903 (Online) Journal homepage: http://www.tandfonline.com/loi/ycra20
Contribution of Oral Habits to Dental Disorders Jacob Ehrlich, Nira Hochman & Avinoam Yaffe To cite this article: Jacob Ehrlich, Nira Hochman & Avinoam Yaffe (1992) Contribution of Oral Habits to Dental Disorders, CRANIO®, 10:2, 144-147, DOI: 10.1080/08869634.1992.11677903 To link to this article: http://dx.doi.org/10.1080/08869634.1992.11677903
Published online: 18 Feb 2016.
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View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ycra20 Download by: [Cornell University Library]
Date: 29 June 2017, At: 07:46
• OCCLUSION
CONTRIBUTION OF ORAL HABITS TO DENTAL DISORDERS Jacob Ehrlich, D.M.D., Nira Hochman, D.M.D., Avinoam Yaffe, D.M.D.
0886-9634/92/1 002· 0144$03.00/0, THE JOURNAL OF CRANIOMANDIBULAR PRACTICE, Copyright © 1992 by Williams & Wilkins Manuscript received September 5, 1991; manuscript accepted December 3, 1991
ABSTRACT: Oral habits or parafunction may contribute to dental, periodontal, or neuromuscular damage. Such habits, of which the patient is often unaware, may cause considerable damage. Habits may be occlusal or non-occlusal, and may affect the dentition and/or the oral soft tissues. Drawing a patient's attention to the damage caused by some habits of which he or she is unaware often leads to cessation, whereas with certain conscious habits, such as nail or finger biting, success is much more limited.
This investigation was supported by the Dr. Morton Am· sterdam Chair in Perioprosthesis. Address for reprint requests: Jacob Ehrlich, D.M.D. Department of Prosthodontics Hebrew University·Hadassah School of Dental Medicine POB 1127 91010 Jerusalem, Israel
0
ral habits or parafunction, defined as repetitive activity, frequently contribute to dental, periodontal, or neuromuscular damage. 1- 3 Parafunction, also known as occlusal neurosis or habit, refers to masticatory activities outside the normal function range. 4•5 In most cases, patients are unaware of the nature, intensity, and frequency of their habits. Many oral habits described in the literature concern occlusion. Activities involving either tooth-to-tooth contact or tooth contact with either hard or soft tissues, which often play a role in occlusal traumatism, fall into this category.5 However, another class of parafunctional habits, 6 which are caused by tooth contact with foreign bodies, are considered non-occlusal since irrespective of the classification system used, it involves protrusion of the jaw. The suitability and longevity of dental restorations is dependent on patient oral behavior among other factors. Self-destructive oral habits, such as nocturnal bruxism and daily clenching, can destroy even the most meticulous dental work within a few months. Oral habits with deleterious effects on oral soft tissue, which can lead to muscular pain and tenderness, 1•2•7•8 muscular hypertrophy, head and facial pain, periodontal tissue injury, ligament damage, and disk disorders have also been described .4·8- 11 This paper points out the importance of identifying oral habits, their correlations with specific symptoms, and their distinctive effects on the stomatognathic system.
Dr. Jacob Ehrlich is an associate professor, Director of Occlusion, and Director of the Graduate Studies in Oral Rehabilitation at the Hebrew University Hadassah School of Dental Medicine in Jerusalem, Israel. 1\fter graduating from the Hebrew University, he completed the program in periodontal prosthesis at the University of Pennsylvania. Dr. Ehrlich is a member of the European Academy of Craniomandibular Disorders and the Israeli Society of Crania-Mandibular Disorders.
Dr. Nira Hochman is a senior lecturer in Oral Rehabilitation at the Hebrew University Hadassah School of Dental Medicine in Jerusalem, Israel. After graduating from the Hebrew University, she completed the graduate specialty program in oral rehabilitation. Dr. Hochman has served as a visiting scientist at the National Institute for Dental Research (NIDR) at the National Institutes of Health. She is currently Director of the Undergraduate Program in Prosthodontics at the Hebrew University Hadassah School of Dental Medicine.
Clinical Observations The numerous dental habits observed in patients treated in the university dental clinics and by the authors in their private practices were classified according to the following types: tooth-to-tooth, tooth-to-soft-tissue, or tooth-to-foreign-object contact. 5 Since bruxism, the habit most frequently described in the literature, 12- 14 is difficult to define and includes grinding, clamping, or clenching of the teeth, 15 excessive
144
ORAL HABITS AND DENTAL DISORDERS
EHRLICH ET AL.
tooth wear and faceting was considered as grinding in this study. In accordance with other reports, 6•7•9 nail and/ or soft tissue biting was another commonly observed habit over a wide age range. Biting of soft tissues, including the lips, cheeks, and tongue, was also often found. Less frequent were habits involving contact between the teeth and foreign bodies, such as paper clips, sunflower seeds, and soft drink cans. Most of these habits caused local damage, including marking the teeth and/or the soft tissue, while tenderness in the masticatory muscles and even temporomandibular joint sensitivity was sometimes noted. Headache was also occasionally reported. The destructive effects of several unusual habits are described below.
Case 1 A 19-year-old male came to the clinic seeking a solution for an anterior esthetic defect (Figure 1). Clinical examination revealed irregular local wear on one upper and the lower first right incisors. When asked about habits, the patient mentioned that for several years he had been biting paper clips, forcing them into various configurations (Figures 2 and 3). On further questioning, he also claimed to suffer from headaches. The forceful anterior biting with forward positioning of the lower jaw was assumed to have caused muscle tenderness, leading, in turn, to headaches. 11 Once the habit was brought to the patient's attention, he stopped it, and the headaches ceased. An esthetic solution could then also be offered. Biting on paper clips with different types of movements was also seen in other patients.
Figure 2 Patient showing the paper clip held by the anterior teeth.
ities in the upper incisors (Figure 4). The patient's dental history noted that he ate many sunflower seeds, cracking them between the teeth (Figure 5). When questioned, he revealed that he consumed about 800 grams a week, using several teeth to crack them. On following visits, the patient admitted to suffering from headaches and assumed that cracking sunflower seeds gave him some relief. Local damage involving notching of the incisors and cracking of the canine veneer facet was found. The forward positioning of the lower jaw combined with the forceful anterior biting probably caused the headaches. 11 Other patients with the same habit, but who used another method of breaking open the sunflower seeds, suffered from a different form of tooth mutilation (Figure
6).
Cases 2 and 3
Cases 4 and 5
A 47-year-old male sought treatment for esthetic problems involving a lower fixed partial denture and irregular-
These two cases are examples of habits leading to periodontal damage. A 41-year-old male complained of
Figure 1
Figure 3
An unusual notching on the upper and lower right central incisors.
Patient with deformed paper clip as a result of biting.
APRIL 1992, VOL. 10, NO.2
THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
145
EHRLICH ET AL.
ORAL HABITS AND DENTAL DISORDERS
Figure 4
Figure 6
Patient with notching on upper incisors and cracked veneer.
Patient using a different method for cracking sunflower seeds.
sensitivity in the anterior teeth. Examination of the involved teeth revealed various degrees of tooth abrasion, probing depths of 4 to 5 mm accompanied by slight mobility, and suppuration (Figure 7). The habit of biting on soft drink cans was mentioned in the patient's dental history (Figure 8). Drawing the patient's attention to the extensive damage caused by this habit led to its discontinuation. A 22-year-old female was referred to the clinic complaining of spacing and mobility in the lower teeth (Figure 9), which she claimed had increased during the last few months. Dental examination showed that apart from the anterior area, the rest of the dentition was healthy with good periodontal support and stable intercuspal position. After several visits, the patient mentioned playing with the pendant on her necklace between her lower anterior teeth. This caused the formation of a space between the teeth, which was subsequently perpetuated by tongue thrusting. In this case, the damage was irreversible and could only be corrected by a fixed partial denture.
Discussion This paper shows that various oral behavior patterns can lead to localized destruction, which may be accompanied by craniomandibular manifestations. This finding is in accordance with other reports. 2•6•7•9 The patient is often unaware of his or her habits or may be embarrassed to admit them and therefore the use of questionnaires in research directed toward revealing habits is of doubtful value. Some habits can only be detected by the practitioner due to unusual changes in the hard or soft tissues in the oral cavity. Clinicians should therefore be aware of these habits and should attempt to relate the damage to tooth contact involving excursive movements, or to contact of the teeth with various foreign objects. Patients should be asked about their habits, and since they are often unaware of these, the relevant questions should be repeated on subsequent visits. After the existence of a habit has been revealed, the patient should be
Figure 5
Figure 7
Patient with sunflower seed in the notch, showing forward positioning of the mandible.
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THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
Frontal view of patient showing tooth abrasion (inflammation, mobility, and suppuration were present).
APRIL 1992, VOL. 10, NO.2
ORAL HABITS AND DENTAL DISORDERS
EHRLICH ET AL.
Figure 8 Patient shown biting on a soft drink can, which causes the damage shown in Figure 7.
informed about the damage caused and should be given the motivation to break the habit. Some habits are relatively easy to stop, and, in the authors' experience, with habits of which the patient was unaware, this is facilitated by pointing out the damage they cause. However, success is very unlikely with other habits, such as nail and finger biting of which the patient is aware, 7 particularly when they are coupled with other oral habits, including clenching and bruxing. Repeated attempts to motivate the patient to break these habits, or possibly a team approach, may be more effective in these cases.
References 1.
2. 3.
4. 5.
6.
Rugh JD, Robbins WJ: Oral habit disorders. In Ingersoll BO (ed), Behav· ioral Aspects in Dentistry. New York: Appleton-Century-Crofts, 1982; 179-202 Christensen LV: Jaw muscle fatigue and pains induced by experimental tooth clenching: A review. J Oral Rehabil 1981; 8:27 Yemm R: Causes and effects of hyperactivity of jaw muscles. In Bryant P, GaleE, Rugh J (eds), Oral Motor Behavior: Impact On Oral Conditions and Dental Treatment. NIH publication #79-1845, 1979; 138-156 Mohl NO, Zarb GA, Carlsson GE, Rugh JD: A Textbaok of Occlusion. Lombard: Quintessence Publishing Co, 1988 Abrams L: Occlusal adjustment. In Goldman HM, Cohen OW (eds) Periodontal Therapy, 6th Ed. St. Louis: The CV Mosby Co, 1980; 10651111 Kleinrok M, Melnik-Hus J, Zysko-Wozniak 0, et al.: Investigations on prevalence and treatment of fingernail biting. J Craniomandib Pract 1990; 8:47-50
APRIL 1992, VOL 10, NO.2
Figure 9 Frontal view of a young patient showing lower anterior spacing caused by a pendant, exposed roots covered by calculus, and plaque.
7. 8.
9.
10. 11.
12.
13. 14. 15.
Westling L: Fingernail biting: A literature review and case reports. J Craniomandib Pract 1988; 6:182-187 Helkimo E, Westling L: History, clinical findings, and outcome of treatment of patients with anterior disk displacement. J Craniomandib Pract 1987; 5:269-276 Milner M: Functional disturbances and diseases in the stomatognathic system among 7-to-18-year olds. J Craniomandib Practice 1985; 3:358-367 Mongini F: Etiology of craniofacial pain and headache in stomatognathic dysfunction. Proc Vth World Congress on Pain 1988; 56:512 Villarosa GA. Moss RA: Oral behavior patterns as factors contributing to the development of head and facial pain. J Prosthet Dent 1985; 54:427-430 Rugh JO, Lemke RR: Significance of oral habits. In Matarazzo JD, Weiss SM, Herd JA, Miller NE, Weiss SM (eds), Behavioral Health: A Handbook of Health Enhancement and Disease Prevention. New York: John Wiley & Sons, 1984 Nadler SC: Detection and recognition of bruxism. JADA 1960; 61 :472-479 Glaros AG, Rao SM: Effects of bruxism: A review of the literature. J Prosthet Dent 1977; 38:149-157 Glossary of Periodontic Terms. American Academy of Periodontology, 1986
Dr. Avinoam Yaffe is a senior lecturer in Oral Rehabilitation at the Hebrew University Hadassah School of Dental Medicine in Jerusalem, Israel. After graduating from the Hebrew University, he completed the program in periodontal prosthesis at the University of Pennsylvania. Dr. Yaffe is a specialist in periodontology and oral rehabilitation. He is currently teaching in the undergraduate and graduate programs in oral rehabilitation at the Hebrew University Hadassah School of Dental Medicine. He is a member of the Israeli Society of Crania-Mandibular Disorders.
THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
147
ISSN: 0886-9634 (Print) 2151-0903 (Online) Journal homepage: http://www.tandfonline.com/loi/ycra20
Contribution of Oral Habits to Dental Disorders Jacob Ehrlich, Nira Hochman & Avinoam Yaffe To cite this article: Jacob Ehrlich, Nira Hochman & Avinoam Yaffe (1992) Contribution of Oral Habits to Dental Disorders, CRANIO®, 10:2, 144-147, DOI: 10.1080/08869634.1992.11677903 To link to this article: http://dx.doi.org/10.1080/08869634.1992.11677903
Published online: 18 Feb 2016.
Submit your article to this journal
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ycra20 Download by: [Cornell University Library]
Date: 29 June 2017, At: 07:46
• OCCLUSION
CONTRIBUTION OF ORAL HABITS TO DENTAL DISORDERS Jacob Ehrlich, D.M.D., Nira Hochman, D.M.D., Avinoam Yaffe, D.M.D.
0886-9634/92/1 002· 0144$03.00/0, THE JOURNAL OF CRANIOMANDIBULAR PRACTICE, Copyright © 1992 by Williams & Wilkins Manuscript received September 5, 1991; manuscript accepted December 3, 1991
ABSTRACT: Oral habits or parafunction may contribute to dental, periodontal, or neuromuscular damage. Such habits, of which the patient is often unaware, may cause considerable damage. Habits may be occlusal or non-occlusal, and may affect the dentition and/or the oral soft tissues. Drawing a patient's attention to the damage caused by some habits of which he or she is unaware often leads to cessation, whereas with certain conscious habits, such as nail or finger biting, success is much more limited.
This investigation was supported by the Dr. Morton Am· sterdam Chair in Perioprosthesis. Address for reprint requests: Jacob Ehrlich, D.M.D. Department of Prosthodontics Hebrew University·Hadassah School of Dental Medicine POB 1127 91010 Jerusalem, Israel
0
ral habits or parafunction, defined as repetitive activity, frequently contribute to dental, periodontal, or neuromuscular damage. 1- 3 Parafunction, also known as occlusal neurosis or habit, refers to masticatory activities outside the normal function range. 4•5 In most cases, patients are unaware of the nature, intensity, and frequency of their habits. Many oral habits described in the literature concern occlusion. Activities involving either tooth-to-tooth contact or tooth contact with either hard or soft tissues, which often play a role in occlusal traumatism, fall into this category.5 However, another class of parafunctional habits, 6 which are caused by tooth contact with foreign bodies, are considered non-occlusal since irrespective of the classification system used, it involves protrusion of the jaw. The suitability and longevity of dental restorations is dependent on patient oral behavior among other factors. Self-destructive oral habits, such as nocturnal bruxism and daily clenching, can destroy even the most meticulous dental work within a few months. Oral habits with deleterious effects on oral soft tissue, which can lead to muscular pain and tenderness, 1•2•7•8 muscular hypertrophy, head and facial pain, periodontal tissue injury, ligament damage, and disk disorders have also been described .4·8- 11 This paper points out the importance of identifying oral habits, their correlations with specific symptoms, and their distinctive effects on the stomatognathic system.
Dr. Jacob Ehrlich is an associate professor, Director of Occlusion, and Director of the Graduate Studies in Oral Rehabilitation at the Hebrew University Hadassah School of Dental Medicine in Jerusalem, Israel. 1\fter graduating from the Hebrew University, he completed the program in periodontal prosthesis at the University of Pennsylvania. Dr. Ehrlich is a member of the European Academy of Craniomandibular Disorders and the Israeli Society of Crania-Mandibular Disorders.
Dr. Nira Hochman is a senior lecturer in Oral Rehabilitation at the Hebrew University Hadassah School of Dental Medicine in Jerusalem, Israel. After graduating from the Hebrew University, she completed the graduate specialty program in oral rehabilitation. Dr. Hochman has served as a visiting scientist at the National Institute for Dental Research (NIDR) at the National Institutes of Health. She is currently Director of the Undergraduate Program in Prosthodontics at the Hebrew University Hadassah School of Dental Medicine.
Clinical Observations The numerous dental habits observed in patients treated in the university dental clinics and by the authors in their private practices were classified according to the following types: tooth-to-tooth, tooth-to-soft-tissue, or tooth-to-foreign-object contact. 5 Since bruxism, the habit most frequently described in the literature, 12- 14 is difficult to define and includes grinding, clamping, or clenching of the teeth, 15 excessive
144
ORAL HABITS AND DENTAL DISORDERS
EHRLICH ET AL.
tooth wear and faceting was considered as grinding in this study. In accordance with other reports, 6•7•9 nail and/ or soft tissue biting was another commonly observed habit over a wide age range. Biting of soft tissues, including the lips, cheeks, and tongue, was also often found. Less frequent were habits involving contact between the teeth and foreign bodies, such as paper clips, sunflower seeds, and soft drink cans. Most of these habits caused local damage, including marking the teeth and/or the soft tissue, while tenderness in the masticatory muscles and even temporomandibular joint sensitivity was sometimes noted. Headache was also occasionally reported. The destructive effects of several unusual habits are described below.
Case 1 A 19-year-old male came to the clinic seeking a solution for an anterior esthetic defect (Figure 1). Clinical examination revealed irregular local wear on one upper and the lower first right incisors. When asked about habits, the patient mentioned that for several years he had been biting paper clips, forcing them into various configurations (Figures 2 and 3). On further questioning, he also claimed to suffer from headaches. The forceful anterior biting with forward positioning of the lower jaw was assumed to have caused muscle tenderness, leading, in turn, to headaches. 11 Once the habit was brought to the patient's attention, he stopped it, and the headaches ceased. An esthetic solution could then also be offered. Biting on paper clips with different types of movements was also seen in other patients.
Figure 2 Patient showing the paper clip held by the anterior teeth.
ities in the upper incisors (Figure 4). The patient's dental history noted that he ate many sunflower seeds, cracking them between the teeth (Figure 5). When questioned, he revealed that he consumed about 800 grams a week, using several teeth to crack them. On following visits, the patient admitted to suffering from headaches and assumed that cracking sunflower seeds gave him some relief. Local damage involving notching of the incisors and cracking of the canine veneer facet was found. The forward positioning of the lower jaw combined with the forceful anterior biting probably caused the headaches. 11 Other patients with the same habit, but who used another method of breaking open the sunflower seeds, suffered from a different form of tooth mutilation (Figure
6).
Cases 2 and 3
Cases 4 and 5
A 47-year-old male sought treatment for esthetic problems involving a lower fixed partial denture and irregular-
These two cases are examples of habits leading to periodontal damage. A 41-year-old male complained of
Figure 1
Figure 3
An unusual notching on the upper and lower right central incisors.
Patient with deformed paper clip as a result of biting.
APRIL 1992, VOL. 10, NO.2
THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
145
EHRLICH ET AL.
ORAL HABITS AND DENTAL DISORDERS
Figure 4
Figure 6
Patient with notching on upper incisors and cracked veneer.
Patient using a different method for cracking sunflower seeds.
sensitivity in the anterior teeth. Examination of the involved teeth revealed various degrees of tooth abrasion, probing depths of 4 to 5 mm accompanied by slight mobility, and suppuration (Figure 7). The habit of biting on soft drink cans was mentioned in the patient's dental history (Figure 8). Drawing the patient's attention to the extensive damage caused by this habit led to its discontinuation. A 22-year-old female was referred to the clinic complaining of spacing and mobility in the lower teeth (Figure 9), which she claimed had increased during the last few months. Dental examination showed that apart from the anterior area, the rest of the dentition was healthy with good periodontal support and stable intercuspal position. After several visits, the patient mentioned playing with the pendant on her necklace between her lower anterior teeth. This caused the formation of a space between the teeth, which was subsequently perpetuated by tongue thrusting. In this case, the damage was irreversible and could only be corrected by a fixed partial denture.
Discussion This paper shows that various oral behavior patterns can lead to localized destruction, which may be accompanied by craniomandibular manifestations. This finding is in accordance with other reports. 2•6•7•9 The patient is often unaware of his or her habits or may be embarrassed to admit them and therefore the use of questionnaires in research directed toward revealing habits is of doubtful value. Some habits can only be detected by the practitioner due to unusual changes in the hard or soft tissues in the oral cavity. Clinicians should therefore be aware of these habits and should attempt to relate the damage to tooth contact involving excursive movements, or to contact of the teeth with various foreign objects. Patients should be asked about their habits, and since they are often unaware of these, the relevant questions should be repeated on subsequent visits. After the existence of a habit has been revealed, the patient should be
Figure 5
Figure 7
Patient with sunflower seed in the notch, showing forward positioning of the mandible.
146
THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
Frontal view of patient showing tooth abrasion (inflammation, mobility, and suppuration were present).
APRIL 1992, VOL. 10, NO.2
ORAL HABITS AND DENTAL DISORDERS
EHRLICH ET AL.
Figure 8 Patient shown biting on a soft drink can, which causes the damage shown in Figure 7.
informed about the damage caused and should be given the motivation to break the habit. Some habits are relatively easy to stop, and, in the authors' experience, with habits of which the patient was unaware, this is facilitated by pointing out the damage they cause. However, success is very unlikely with other habits, such as nail and finger biting of which the patient is aware, 7 particularly when they are coupled with other oral habits, including clenching and bruxing. Repeated attempts to motivate the patient to break these habits, or possibly a team approach, may be more effective in these cases.
References 1.
2. 3.
4. 5.
6.
Rugh JD, Robbins WJ: Oral habit disorders. In Ingersoll BO (ed), Behav· ioral Aspects in Dentistry. New York: Appleton-Century-Crofts, 1982; 179-202 Christensen LV: Jaw muscle fatigue and pains induced by experimental tooth clenching: A review. J Oral Rehabil 1981; 8:27 Yemm R: Causes and effects of hyperactivity of jaw muscles. In Bryant P, GaleE, Rugh J (eds), Oral Motor Behavior: Impact On Oral Conditions and Dental Treatment. NIH publication #79-1845, 1979; 138-156 Mohl NO, Zarb GA, Carlsson GE, Rugh JD: A Textbaok of Occlusion. Lombard: Quintessence Publishing Co, 1988 Abrams L: Occlusal adjustment. In Goldman HM, Cohen OW (eds) Periodontal Therapy, 6th Ed. St. Louis: The CV Mosby Co, 1980; 10651111 Kleinrok M, Melnik-Hus J, Zysko-Wozniak 0, et al.: Investigations on prevalence and treatment of fingernail biting. J Craniomandib Pract 1990; 8:47-50
APRIL 1992, VOL 10, NO.2
Figure 9 Frontal view of a young patient showing lower anterior spacing caused by a pendant, exposed roots covered by calculus, and plaque.
7. 8.
9.
10. 11.
12.
13. 14. 15.
Westling L: Fingernail biting: A literature review and case reports. J Craniomandib Pract 1988; 6:182-187 Helkimo E, Westling L: History, clinical findings, and outcome of treatment of patients with anterior disk displacement. J Craniomandib Pract 1987; 5:269-276 Milner M: Functional disturbances and diseases in the stomatognathic system among 7-to-18-year olds. J Craniomandib Practice 1985; 3:358-367 Mongini F: Etiology of craniofacial pain and headache in stomatognathic dysfunction. Proc Vth World Congress on Pain 1988; 56:512 Villarosa GA. Moss RA: Oral behavior patterns as factors contributing to the development of head and facial pain. J Prosthet Dent 1985; 54:427-430 Rugh JO, Lemke RR: Significance of oral habits. In Matarazzo JD, Weiss SM, Herd JA, Miller NE, Weiss SM (eds), Behavioral Health: A Handbook of Health Enhancement and Disease Prevention. New York: John Wiley & Sons, 1984 Nadler SC: Detection and recognition of bruxism. JADA 1960; 61 :472-479 Glaros AG, Rao SM: Effects of bruxism: A review of the literature. J Prosthet Dent 1977; 38:149-157 Glossary of Periodontic Terms. American Academy of Periodontology, 1986
Dr. Avinoam Yaffe is a senior lecturer in Oral Rehabilitation at the Hebrew University Hadassah School of Dental Medicine in Jerusalem, Israel. After graduating from the Hebrew University, he completed the program in periodontal prosthesis at the University of Pennsylvania. Dr. Yaffe is a specialist in periodontology and oral rehabilitation. He is currently teaching in the undergraduate and graduate programs in oral rehabilitation at the Hebrew University Hadassah School of Dental Medicine. He is a member of the Israeli Society of Crania-Mandibular Disorders.
THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
147
