Prevalence of Temporomandibular Disorders in subjects affected by Parkinson Disease: a systematic review and metanalysis

Oral health implications in Parkinson's disease

To assist patients in maintaining oral health in patients with Parkinson's disease (PD), this review aims to search the literature on aspects related to oral health in PD patients. In contrast to other research, we included the involvement of microbes in PD patients' poor oral health. Finally, we conclude that, in comparison to healthy individuals, PD patients have poorer oral health and a higher incidence of oral ailments.

Prevalence of Endodontically Treated Teeth in Patients Undergoing Treatment for Painful Temporomandibular Disorders: An Observational Study

INTRODUCTION

Temporomandibular disorders (TMDs) and endodontic pain often present overlapping symptoms, complicating the diagnosis and treatment of patients experiencing orofacial pain.

METHODS

This observational retrospective cohort study aims to determine the prevalence of endodontically treated teeth on the side of pain complaint in patients with TMD, and to explore the association between TMD diagnoses and the presence of endodontically treated teeth. Dental records of patients treated at the TMD and Pain clinic at the Federal University of Uberlândia was reviewed. The study included 85 patients, and demographic data, TMD diagnosis, and the side of referred pain were extracted from the records. Diagnostic imaging exams, including panoramic and periapical radiographs, and cone-beam computed tomography, were analyzed to count the number of endodontically treated teeth on each side of the mouth.

RESULTS

The study population consisted of 88% (n = 70) women, with a mean age of 40.5 ± 16.3 years. A significant association was found between the side of TMD pain and the number of endodontically treated teeth, with more treated teeth on the side of pain complaint (median = 1) compared to the pain-free side (median = 0), with P < .001. When analyzing specific TMD diagnoses, the association was significant in muscle-related and mixed TMD diagnoses but not in joint-related TMD pain. Additionally, a binary analysis confirmed this association, showing that patients were significantly more likely to have at least 1 endodontically treated tooth on the side of TMD pain compared to the nonpain side (χ2 = 13.06, P = .0003).

CONCLUSION

This study underscores the importance of comprehensive diagnostic evaluations in patients with orofacial pain to avoid unnecessary endodontic treatments and ensure appropriate care. Further research is needed to explore the underlying mechanisms linking endodontic and TMD pain and to validate these findings in diverse populations.

Correlation of Occlusion Asymmetry and Temporomandibular Disorders: A Cross-Sectional Study

BACKGROUND

The association between occlusion and temporomandibular disorders (TMD) remains obscure. The present purpose was to explore the asymmetrical occlusion feature(s) potentially linked to TMDs.

METHODS

This study enrolled 148 patients with a chief complaint of malocclusion. Of those, 84 had no signs of TMD (Group-ORD1), and 64 had signs of TMD (Group-ORD2). An additional 84 patients with a chief complaint of TMD symptoms and a history of orthodontic therapy were included (Group-TMD). All patients in the study were female. Asymmetry of six occlusion variables was measured on plaster study casts and recorded as 1 for asymmetry and 0 for symmetry. The variables contain the sagittal asymmetry: the first molar mesial-distal relationship (F1), canine mesial-distal relationship (F2); the horizontal asymmetry: anterior overjet and overbite relationship (F3), posterior overjet and overbite relationship (F4); missing teeth (F5), and the weight of the asymmetrical occluding pair (F6). And logistic regression model was used for data analyses.

RESULTS

In the analyses for Group-ORD2 versus Group-ORD1, the F6 variable and the interactions of F1*F2 and F1*F2*F6 were entered into the model (all OR > 2.68). For Group-TMD versus Group-ORD1, the variables were F1, F5, and F6 (all OR > 2.39) and F4 (OR = 0.28), and the interactions were F5*F6, F1*F2*F6, F1*F5*F6, and F1*F2*F5*F6 (all OR > 2.78) and F2*F4, F3*F5, and F2*F4*F6 (all OR < 0.13). For Group-TMD versus Group-ORD2 the variables and interactions were F5, F5*F6, and F1*F5*F6 (all OR > 4.03) and F4, F4*F6 and F2*F4*F6 (all OR < 0.21) (all P < .05).

CONCLUSIONS

Patients with sagittal asymmetry, asymmetrical missing teeth, or asymmetrical weight of contact have a higher prevalence of TMD.

Paediatric dental trauma: insights from epidemiological studies and management recommendations

Dental trauma is common in all age groups, although, epidemiologically, it is more common in children with studies that indicate that 15% of preschoolers and 20-25% of school-age children experience it. These injuries, which frequently call for immediate attention, can affect the hard tissues and supporting components of the teeth, and, because dental damage in deciduous teeth occurs frequently and affects speech, nutrition, and oral development, it is particularly worrying. After searching three databases, Scopus, Web of Science (WoS), and PubMed, and removing duplicates, 3,630 articles were screened, and 12 publications were included in the qualitative analysis. Due to their busy lifestyles, children are particularly susceptible to oral trauma and in certain areas and lower socioeconomic groups, the incidence is higher. From little fractures in the enamel to serious dislocations and avulsions, injuries vary and must be treated promptly in order to avoid consequences and to prevent long-term issues. Furthermore, a conservative treatment strategy is recommended to preserve tooth vitality and prevent extractions. Reducing the occurrence of dental injuries requires the implementation of preventive measures including mouthguard use and educational campaigns. In summary, this review emphasizes the importance of early diagnosis, immediate management, and long-term care, by synthesizing existing knowledge on the prevalence, types, management, complications, and prevention of dental trauma in deciduous teeth. Finally, it's important to underscore the need for continued research to refine treatment approaches.

Comparative Evaluation of Health Status of Syrian Refugee and Tur CCH_70042 kish Children, Alongside the Factors Influencing Sociocultural Adaptation of Syrian Children in Türkiye

BACKGROUND

The objective of this study encompasses two distinct facets. First, it aims to provide a comprehensive analysis of the comparative assessment of psychosocial wellbeing and oral health status among Syrian and Turkish children in Türkiye. Secondly, it aims to elucidate the factors that play a role in shaping the sociocultural adaptation of Syrian children.

METHODS

A cross-sectional survey assessing self-esteem, social anxiety and resilience and clinical examination were conducted on a convenience sample of Syrian refugee and Turkish children. The sample consisted of 396 participants (55.7% male and 44.3% female), including 173 Syrian individuals (43.7%) with a mean age of 14.12 years (SD = 2.24), and 223 Turkish individuals (56.3%) with a mean age of 12.44 years (SD = 2.47). Sociocultural adaptation and perceived discrimination scales were also taken by refugee children.

RESULTS

Overall, psychosocial wellbeing, academic success and oral health outcomes of refugee participants were lower than those of the Turkish general population. Specifically, independent samples t-test revealed that Syrian refugee children exhibited higher levels of social anxiety (t(384) = 3.138, p < 0.005), higher resilience (t(384) = 3.866, p < 0.001), lower self-esteem (t(389) = 4.614, p < 0.001) and poorer academic performance (t(370.981) = -8.441, p < 0.001) compared to Turkish children. In terms of oral health, Syrian children exhibited significantly higher levels of dental health problems, including DMFT (t(394) = 4.203, p < 0.001), DMFS (t(394) = 4.858, p < 0.001) and PPD (t(394) = 15.09, p < 0.001) than their Turkish counterparts. A one-way ANOVA showed that socio-economic status was an important factor in psychosocial and oral health outcomes, except for psychological resilience (F(2,378) = 0.029, p = 0.971). Children from low socioeconomic backgrounds showed higher levels of social anxiety (F (2,376) = 10.704, p = 0.00), lower academic performance (F(2,365) = 33.119, p = 0.00) and poorer oral health outcomes including DMFT (F(2,381) = 7.230, p = 0.001), DMFS (F(2,381) = 4.983, p = 0.007) and PPD (F(2,381) = 22.463, p = 0.00). Pearson correlation analyses indicated that sociocultural adaptation of refugees was positively associated with their resilience (r = 0.45, p < 0.01), and negatively associated with perceived discrimination (r = -0.34, p < 0.01).

CONCLUSION

The findings underscore the need for integrated healthcare interventions that address the multifaceted health needs of vulnerable populations in diverse societies.

An in-vivo study on the effect of head orientation in the measurement of anthropometric points in stereophotogrammetry

BACKGROUND

It is well known that in bidimensional photography the orientation of the head is fundamental to obtain a correct reproduction of the subject. Even minimal errors in yaw, roll and pitch of the head can be cause of unreliability of the photography itself. This is not the case in three-dimensional photography in which head positioning may have no influence on the reliability of the results since on the computer the 3D reconstruction of the face can be oriented as desired, allowing any small errors to be corrected. The authors, in a previous in-vitro study, demonstrated this using a mannequin of the head. In the present study, the Authors repeat the study in vivo to verify any differences.

METHODS

Seventeen anthropometric points were marked on the face of a young adult female (26 years old) with eyeliner. Images of the face were then acquired with a stereo-photogrammetric system (Face Shape 3D MaxiLine) in natural head position and with varying degrees of roll, pitch and yaw. The anthropometric points marked on the skin were then recognized and marked on a digital software (Viewbox, dHAL Software, 6 Menandrou Street, Kifissia 14561, Greece) on each individual image. 14 linear distances between these points were measured using the same software.

RESULTS

The linear distances of these points in the stereophotos taken at centered positions were then compared with those taken with different degrees of roll, pitch and yaw. This study confirms previous results obtained in vitro regarding the presence of areas of non-equivalence (P<0.05) when comparing the frontal and lateral regions of the face at various angles.

CONCLUSIONS

However, it introduces important suggestions on the collection of data from specific anthropometric points. If these points are to be assessed, the medical staff will have to take special precautions to obtain reliable images.

Orthopedic Devices for Skeletal Class III Malocclusion Treatment in Growing Patients: A Comparative Effectiveness Systematic Review

Background/Objectives: Skeletal Class III malocclusion (Cl III) presents a significant orthodontic challenge, particularly in growing patients, requiring interceptive treatment to achieve effective functional and aesthetic correction. This review aims to compare various orthopedic devices and therapeutic protocols used in Cl III correction, identifying the most effective options in an interceptive context. Methods: We searched the PubMed, Scopus, and Web of Science databases for studies published between 1 January 2003, and 19 July 2023. Inclusion criteria included English language, human studies, open access, and studies addressing Cl III correction with interceptive orthopedic devices. Results: Exclusions included in vitro, animal, off-topic studies, reviews, meta-analyses, and articles in languages other than English. After removing duplicates, 30 articles were selected from a total of 1193 results. Conclusions: The application of orthopedic devices in growing patients can lead to rapid improvement of Cl III malocclusion, although each device has specific effects on the surrounding skeletal structure.

Prevalence and Severity of Sleep Bruxism in Edentulous Patients: A Cross-Sectional Study

Aims: Edentulous patients can also suffer from sleep bruxism (SB), just like dentate patients. This study aims to evaluate the prevalence and severity of SB in edentulous patients using the definitive method. Methods: Twenty-three edentulous patients underwent treatment with new conventional complete dentures. Definitive SB was evaluated using the Bruxoff (portable electromyography device) while sleeping at home. The prevalence of SB was assessed by the Bruxmeter software, where SB was evaluated as "absent" (score zero), "light" (<2 episodes), "moderate" (between 2 and 4 episodes), or "severe" (>4 episodes). The prevalence was expressed with descriptive statistics in percentage using the number of detected cases out of the total number of patients. Results: Eighteen patients (78.26%) were diagnosed with SB. The severity of SB was 55.5%, 5.5%, and 39% for the light, moderate, and severe scores, respectively. Conclusions: Almost 8 out of 10 edentulous patients have SB. Approximately half of the SB-detected patients showed moderate to severe severity of bruxism as measured by a commercial, at-home device.

The Association Between Specific Oral Behaviors and the Number of Temporomandibular Disorder Symptoms in the General Population: A Cross-Sectional Study

OBJECTIVE

This study aimed to thoroughly explore the relationship between individual oral behavior and the differing numbers of temporomandibular disorder (TMD) symptom in the general population.

METHODS

A total of 565 participants were recruited and completed a questionnaire containing demographic characteristics, eight specific oral behaviors, and five major TMD symptoms (5Ts) checklist. Multivariate linear regression analysis was performed to assess the relationship between individual oral behavior and the number of TMD symptoms, after controlling for confounders.

RESULTS

The prevalence of TMD symptoms was up to 38.2% in the general population, with 64.6% of the participants engaging in one or more oral behaviors. Female participants showed a stronger positive association with most oral behaviors than males. Moreover, wake oral behaviors exhibited a higher correlation coefficient value with TMD symptom number than sleep oral behaviors. Among the eight oral behaviors, bruxism in sleep exhibited no significant correlation with the of TMD symptom number (P>0.05). Seven other specific oral behaviors were significantly correlated with the number of TMD symptoms by multivariate linear regression analysis (P<0.01). The associations between the seven oral behaviors and TMD symptom number remained significant in sleep posture pressuring jaw (β: 0.165, 95% CI: 0.080-0.250), bruxism in awake (β: 0.341, 95% CI: 0.132-0.550), teeth clenching (β: 0.422, 95% CI: 0.264-0.580), pressing, holding, or touching teeth together (β: 0.282, 95% CI: 0.169-0.395), holding or tightening muscles without clenching (β: 0.447, 95% CI0.304-0.589), holding jaw forward or to the side (β: 0.694, 95% CI0.526-0.861), and holding jaw in rigid or tense position (β: 0.571, 95% CI0.418, 0.724) after adjustment for demographic factors (P<0.01).

CONCLUSION

There was a positive association between seven specific oral behaviors and TMD symptom number. Individuals with higher frequency of specific oral behaviors are more likely to suffer from more TMD symptoms. Sleep bruxism exhibited no association with TMD symptoms and symptom number.

Temporomandibular joint disorders and associated factors in a Turkish pediatric population

OBJECTIVE

To explore the presence and severity of temporomandibular disorders (TMD) signs and symptoms in a Turkish pediatric population, as well as their relationship to parafunctional behaviors, bruxism, malocclusion, anxiety, and sociodemographic traits.

METHODS

A cross-sectional study was conducted with patients between the ages of 5-15. Demographic variables, TMD signs and symptoms, parafunctional habits, bruxism, and malocclusion were evaluated by clinical examination. Fonseca Anamnestic Index (FAI) was used to determine the presence and severity of TMD. State-Trait Anxiety Scale for Children (STAI-C) was used to evaluate the anxiety. Student t, Mann-Whitney U, chi-square tests, and logistic regression were used for statistical analysis.

RESULTS

One hundred sixty-two participants (85 girls, 77 boys) with a mean age of 10.03 ± 1.88 years were included. The frequency of the participants who reported signs/symptoms of TMD was 19.7% according to FAI scores. Logistic regression analysis with the associated factors showed a significant relationship between the presence of the signs/symptoms of TMD and parafunctional habits (OR 4.24, 95% CI 1.64-10.93), and the presence of signs/symptoms of anxiety (OR 1.09, 95% CI 1.02-1.16).

CONCLUSIONS

Children and adolescents who exhibit parafunctional behaviors and anxiety had a higher likelihood of having TMD signs/symptoms of varying degrees of severity.

Evaluation of occlusal force changes in orthognathic surgery using force-sensing sensors in 3 years of follow-up

Purpose

The aim of this study was to test a prototype device called occlusal force diagnostic system in relation to occlusal force adaptation following orthognathic surgery.

Methods

Retrospective study of 10 patients scheduled for a bimaxillary osteotomy involving a combination of maxillary Le Fort I impaction procedure coupled with a sagittal split advancement of the mandible; in a 3 years follow-up period.

Results

The selection of examiner is not a variable that affects the occlusal force (N) measured by FSS sensors in any of the experimental conditions tested. The sensor position and the surgery recovery time affect the occlusal force irrespective of the examiner selection and/or the surgery recovery time.

Conclusion

The piezoelectric sensors used in the present study have shown high reliability and validity of measurement. The surgery recovery time impacts the occlusal force (N), with a 50% increase in occlusal force (N) measured after 6 months post-surgery, with the value keeping stable at 36 months. This suggests that the patient is only fully recovered from the functional point-of-view at 6 months, having from that point on an improved and stable masticatory function.

DENTAL AND SKELETAL CHANGES OF LONG-TERM USE OF MANDIBULAR ADVANCEMENT DEVICES FOR THE TREATMENT OF ADULT OBSTRUCTIVE SLEEP APNEA: A SYSTEMATIC REVIEW AND META-ANALYSIS

BACKGROUND

Mandibular advancement devices (MADs) are indicated for use in patients with mild to moderate obstructive sleep apnea (OSA). Long-term use of MADs has been found to be associated with dental and skeletal changes. This study aims to conduct a systematic review and meta-analysis to improve knowledge about the dental and skeletal changes of long-term (>1 year) use of MADs for the treatment of OSA.

MATERIAL AND METHODS

Electronic databases were systematically searched. Two reviewers conducted screening, quality assessment, and data extraction independently. Thirty-four studies were included in the systematic review and 23 in the meta-analysis.

RESULTS

The mean change of overjet and overbite was -0.77mm (95%CI -1.01 to -0.53, P < .00001) and -0.64mm (95%CI -0.85 to -0.43, P < .00001), with progressive change over the treatment duration. The inclination of the upper incisor (U1/SN) and the lower incisor (L1/MP) showed a mean change of retroclined -2.10° (95%CI -3.93 to -0.28, P = .02) and proclined 1.78° (95%CI 0.63 to 2.92, P = .002), respectively. The mean change of the anteroposterior position of the mandible (SNB) was -0.33° posteriorly (95%CI -0.65 to -0.02, P = .04).

CONCLUSIONS

The meta-analysis showed a gradual decrease in overjet and overbite with treatment duration with long-term use of MADs for the treatment of OSA. Upper and lower incisors retroclined and proclined, respectively. The skeletal changes might include the mandibular position. Patients treated with MADs need to be continuously monitored over time.

Dental caries prevalence and caries-associated risk factors of students aged 12-15 in Xide County of Liangshan Prefecture, China: a cross-sectional study

OBJECTIVE

About 2 billion people have caries in permanent teeth, and 514 million children have caries in primary teeth worldwide. Regional disparities in caries prevalence are evident in various areas of China. A comprehensive understanding of the status of dental caries and its associated risk factors is essential for developing effective dental health policies in economically disadvantaged regions. Thus, this study aims to examine the prevalence of dental caries and its risk factors among students aged 12-15 in Xide County, a remote mountainous area in China.

DESIGN

In this cross-sectional study, dental health surveys were conducted using self-administered questionnaires and the Decayed-Missing-Filled Tooth (DMFT) Index. An oral clinical examination was carried out by the criteria and guidelines set forth by WHO.

SETTING

Xide County, Liangshan prefecture, China in 2022.

PARTICIPANTS

558 students aged 12-15 years completed the survey.

RESULTS

The study conducted in Xide County found a dental caries prevalence of 42.5% among 12-15 year-old students, with a mean DMFT of 1.50 (SD=2.25). Multivariable logistic regression analysis identified several significant risk factors for dental caries (p<0.05), including starting brushing after the age of six (OR 0.34, 95% CI 0.17 to 0.65), brushing teeth less than once a day (OR 9.24, 95% CI 5.53 to 15.33) and consuming carbonated drinks more than once a day (OR 0.28, 95% CI 0.14 to 0.53). Additionally, the use of fluoride (OR 0.61, 95% CI 0.43 to 0.85) and awareness of its protective effect on teeth (OR 0.75, 95% CI 0.59 to 0.98) were found to be associated with a lower risk of dental caries (p<0.05).

CONCLUSION

The prevalence of dental caries among students aged 12-15 in Xide County was identified as a significant public oral health concern. The oral health behaviours of students were found to be influenced by factors at the family and community levels.

Dopamine in the prefrontal cortex plays multiple roles in the executive function of patients with Parkinson's disease

Parkinson's disease can affect not only motor functions but also cognitive abilities, leading to cognitive impairment. One common issue in Parkinson's disease with cognitive dysfunction is the difficulty in executive functioning. Executive functions help us plan, organize, and control our actions based on our goals. The brain area responsible for executive functions is called the prefrontal cortex. It acts as the command center for the brain, especially when it comes to regulating executive functions. The role of the prefrontal cortex in cognitive processes is influenced by a chemical messenger called dopamine. However, little is known about how dopamine affects the cognitive functions of patients with Parkinson's disease. In this article, the authors review the latest research on this topic. They start by looking at how the dopaminergic system, is altered in Parkinson's disease with executive dysfunction. Then, they explore how these changes in dopamine impact the synaptic structure, electrical activity, and connection components of the prefrontal cortex. The authors also summarize the relationship between Parkinson's disease and dopamine-related cognitive issues. This information may offer valuable insights and directions for further research and improvement in the clinical treatment of cognitive impairment in Parkinson's disease.

Mechanisms Underlying Sex Differences in Temporomandibular Disorders and Their Comorbidity with Migraine

Sexual dimorphism in temporomandibular disorders (TMDs) and their comorbidity with migraine are important phenomena observed in clinics. TMDs are the most prevalent orofacial pain conditions with jaw joint and masseter muscle dysfunction. Migraine is the predominant headache commonly associated with TMDs. Women much more often suffer from this orofacial pain than men. However, currently, there is no gender-specific therapy for such pain conditions. Understanding the pathophysiological mechanisms behind sex differences in TMDs as well as their comorbidity with migraines is essential for developing novel approaches for gender-specific treatment of TMDs and related orofacial pain comorbidity. In this review, we summarize recent research progress regarding sex differences in TMDs, focusing on the underlying mechanisms including craniofacial anatomy, hormonal regulation, and roles of opioids, transient receptor potential channels, and endocannabinoid systems. We also discuss the mechanisms of comorbid TMDs and migraine. The information covered in this review will provide mechanistic insights into sex differences in TMDs and their comorbidity with migraine, which could aid in developing effective treatment strategies for the overlapping orofacial pain condition.

Debonding issues in orthodontics: an RCTs systematic review

Background: This systematic review aims to critically assess the literature on the debonding process of orthodontic brackets from enamel surfaces. The review evaluates Randomized Controlled Trials (RCTs) to determine the effectiveness and implications of various debonding techniques and materials. Methods: The study followed PRISMA guidelines, selecting RCTs published from 1999 onwards that compared the outcomes of various orthodontic bracket debonding techniques. Selection criteria included studies utilizing human teeth, with outcomes such as enamel surface roughness and Adhesive Remnant Index (ARI) analyzed. Data sources included PubMed, Scopus, Web of Science, and the Cochrane Library. Results: Out of 1,587 records identified, five studies met the inclusion criteria. These studies provided comparative data on the effectiveness of various debonding techniques, including tungsten carbide and diamond burs, in minimizing enamel damage and optimizing adhesive removal. Findings indicated that tungsten carbide burs produced the least enamel roughness. Discussion: Utilizing tungsten carbide burs for debonding orthodontic brackets significantly minimizes enamel surface roughness and potential damage, thereby enhancing the preservation of enamel integrity post-treatment. The systematic review highlights current debonding techniques are effective in adhesive removal, and the choice of instrument significantly affects enamel integrity and clinical outcomes. The findings support the need for continuous improvement and innovation in removing braces to improve orthodontic treatment results and patient satisfaction.

Comparative cross-sectional study of socio-psychological orthodontic needs and oral habits in Autism Spectrum Disorder

OBJECTIVE

This cross-sectional study analyzed the socio-psychological need for orthodontic treatment in children and adolescents with and without Autism Spectrum Disorder (ASD) and its association with deleterious oral habits.

METHODS

Children/adolescents aged 6-14 years old, with and without ASD, and their respective caregivers were included. Caregivers completed a questionnaire addressing children and adolescents' deleterious oral habits. To assess the socio-psychological need for orthodontic treatment, we utilized the aesthetic component of the Index of Orthodontic Treatment Needs (IOTN). Caregivers and an orthodontist independently used the standardized IOTN aesthetic attractiveness scale containing ten intraoral photographs and compared them with the most similar condition of the child/adolescent. Data collection occurred at two universities in northeastern Brazil and at an ASD referral center. Statistical analyses encompassed descriptive statistics, Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney, and Chi-squared tests with linear trend (α5%).

RESULTS

The study involved 144 participants, evenly divided into two groups (ASD and non-ASN). The ASD group showed higher average IOTN-AC scores as evaluated by both professionals (mean score = 4.78 [± 2.34], p = .182) and caregivers (mean score = 4.31 [± 2.71], p = .992). Caregivers reported notably elevated IOTN-AC scores in cases where onychophagy was absent (p = .049).

CONCLUSIONS

Patients with ASD are indicated as having a relatively higher socio-psychological need for orthodontic treatment.

Silver Diamine Fluoride in Pediatric Dentistry: Effectiveness in Preventing and Arresting Dental Caries-A Systematic Review

BACKGROUND

Tooth decay is considered a global scourge by the World Health Organization (WHO) starting at an early age. In recent years, silver diamine fluoride (SDF) has regained interest, particularly in pediatric dentistry, used to prevent the development of carious lesions or arrest their progression.

OBJECTIVE

The aim of this study was to assess, through a systematic review of the literature, the effectiveness of SDF, used in pedodontics, in temporary teeth, in preventing or arresting dental caries.

MATERIAL AND METHODS

An electronic search was conducted on PubMed, Web of Science and Scopus. The effect of SDF on both temporary and permanent teeth has been considered.

RESULTS

The inclusion criteria identified 16 randomized controlled trials involving patients aged 18 months to 13 years and followed over a period of 12-30 months.

CONCLUSIONS

SDF is a practical, accessible and effective non-invasive way to prevent and arrest caries in temporary and permanent teeth. Its application requires regular monitoring. The resulting black spot is diminished by immediate application of potassium iodide but this may affect its effectiveness.

Use of botulinum toxin in the management of dystonia in Parkinson's disease

Botulinum toxin is one of the most potent neurotoxins, but when injected into an overactive muscle, it can transiently alleviate an involuntary movement, such as dystonia. The primary aim of this article is to provide a comprehensive review of the various forms of dystonia observed in patients with Parkinson's disease who can benefit from a therapeutic trial of botulinum toxin. Although most of these indications are not supported by randomized controlled clinical trials and, therefore, not approved by the Food and Drug Administration, there are many open-label trials supporting a large body of empirical experience testifying to the benefits of botulinum toxin treatment in these conditions.

Arthroscopy for the Treatment of Temporomandibular Disorders

How to cite this article: Mosaddad SA. Arthroscopy for the Treatment of Temporomandibular Disorders. J Contemp Dent Pract 2024;25(3):197-198. Keywords: Arthroscopy, Facial pain, Temporomandibular joint, Temporomandibular joint disorders.

Prevalence of temporomandibular disorders in juvenile idiopathic arthritis evaluated with diagnostic criteria for temporomandibular disorders: A systematic review with meta-analysis

BACKGROUND

Juvenile idiopathic arthritis (JIA) is a very common systemic inflammatory rheumatic disorder affecting the musculoskeletal system in children below 16 years of age. Joint inflammation and tissue destruction is the prime characteristic of the disease. Along with the systemic involvement in the long joints, several studies are mentioning the increased association of temporomandibular disorders (TMDs) in JIA. This current systematic review intends to find the prevalence rate of TMD in JIA-affected individuals as compared to healthy controls.

METHODS

We have searched in PubMed, Scopus and Ovid SP for articles published between the timeframe 1 January 1990 and 1 June 2023. All the searched articles were subjected to the Population, Exposure, Comparison, and Outcome model (PECO) based on which inclusion or exclusion is carried out. Participants (P) are children below 18 years of age, Exposure (E) is children or adolescents with a diagnosis of JIA, Comparator is age and gender-matched healthy controls who has no JIA or any systemic disorder, Outcome (O) is the prevalence of TMD. Only the studies that evaluated TMD using diagnostic criteria for evaluation of TMD (DC/TMD) were included in the analysis. We have set the exclusion to the following reasons- diagnostic sensitivity studies, case reports, and systematic reviews. The software Review Manager Version 5.4 (Cochrane Collaboration) was used to perform the pooled analysis. We measured the risk ratio (RR) between the two groups (JIA and no JIA) for the outcome TMD.

RESULTS

The pooled total included subjects were 366 in this review with an established diagnosis of JIA as evaluated by DC/TMD. The overall effect of the pooled data suggests that there is a significant difference in the TMD prevalence in the JIA group when compared to the control, results suggest that TMD is more prevalent in the JIA group RR 3.86; 95% CI [2.59, 5.76].

CONCLUSION

Overall, based on the data we can suggest a positive relationship between JIA and TMD, hence presence of JIA can be a risk factor for the development of TMD. The sensitivity of DC/TMD is low when compared to magnetic resonance imaging.

Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study

BACKGROUND

The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms.

METHODS

This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests.

RESULTS

The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05).

CONCLUSIONS

Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.

The role of physiotherapy interventions in the management of temporomandibular joint ankylosis: a systematic review and meta-analysis : Running title: Physiotherapy in TMJ ankylosis

BACKGROUND

The main aim of this systematic review and meta-analysis was to identify peer-reviewed scholarly journal articles reporting the significance of physiotherapy interventions in managing TMJ ankylosis. In addition, this study aimed to critically appraise the existing evidence on the prevalence and clinical presentation, physiotherapy intervention approaches, efficacy of physiotherapy interventions, adverse effects, and safety of physiotherapy interventions in TMJ ankylosis management.

METHODS

An all-inclusive literature search was conducted using the PubMed, Google Scholar, and Scopus electronic databases. The researchers screened the potential articles and assessed for eligibility based on the reported inclusion and exclusion criteria. The quality evaluation tool for observational cohort and cross-sectional studies developed by the National Institutes of Health (NIH) and the Cochrane Collaboration's Risk of Bias Tool were used to assess the quality of the included studies. Researchers also comprehensively analyzed the data, reported the results, and discussed them according to the predominant themes.

RESULTS

The primary electronic database search yielded 409 articles, of which 25 were included in this review. A secondary search was conducted from citations of the included studies, yielding 74 articles, of which six were included in the study. A significantly higher prevalence of bony ankylosis than fibrous ankylosis, with an overall effect size of p < 0.00001. In addition, there were significantly more unilateral than bilateral presentations with an overall effect size of p < 0.00001. Moreover, there were 78 reported complications out of 245 subjects according to five included studies demonstrating a significant effect size with p = 0.001 following the treatment protocols.

CONCLUSION

This study highlighted the prevalence of bony ankylosis in temporomandibular joint ankylosis, emphasizing its impact on patients' well-being. On the other hand, the results show that physiotherapy is essential to optimize postoperative outcomes and minimize adverse events such as re-ankylosis. Practitioners and healthcare professionals must monitor postoperative recovery and ensure strict adherence to physiotherapy protocols for optimal outcomes.

Dentistry: A Multidisciplinary Approach

In this special issue of Medicina, we delve into the dynamic and ever-evolving world of dentistry, highlighting the remarkable innovations that are shaping the future of oral health and clinical dentistry practice [...].

Temporomandibular joint disorders in skeletal class II patients referred to orthognathic surgery: A cross-sectional study

OBJECTIVES

The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD) in subjects with skeletal class II dentofacial deformity referred for orthognathic surgery, as well as to elucidate its association with sociodemographic and psychosocial features.

METHODS

This was a cross-sectional study using the Research Diagnostic Criteria for Temporomandibular Disorders. The sample comprised class II skeletal patients referred to an Oral and Maxillofacial Surgery center in the Brazilian Northeast.

RESULTS

Seventy-three subjects were enrolled and completed the data collection, which consisted of a physical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders and facial analysis. Women represented 82.2% of the sample. Among the assessed subjects, 68.5% were already undergoing orthodontic treatment, and the mean overjet of patients was 6.97 mm. The prevalence of TMD in this sample was 46.6%, with muscular disorders being the most common. Patients with an anteroposterior discrepancy greater than 7 mm showed a higher occurrence of TMD (p = 0.017).

CONCLUSION

This study demonstrated a high prevalence of TMD in skeletal class II patients referred for orthognathic surgery, especially in those with a pronounced overjet, being Group I (muscular disorders) and Group III (degenerative disorders) the most prevalent.

Exploring the therapeutic potential of curcumin in oral squamous cell carcinoma (HSC-3 cells): Molecular insights into hypoxia-mediated angiogenesis

BACKGROUND

Oral cancer represents a substantial global health burden, often associate with hypoxia-induced angiogenesis as a critical factor in its progression. Curcumin, a naturally occurring bioactive compounds, has gained increasing attention for its potential anticancer properties.

OBJECTIVE

To assess the impact of curcumin on oral cancer, particularly its role in modulating HIF-1α-mediated angiogenesis in HSC-3 cells.

METHODS

Our investigation involved multiple experimental approaches, including MTT assay, aerobic glycolysis by metabolic kit, cell cycle, and apoptosis assessment via flow cytometry. Furthermore, we employed molecular docking techniques to examine the interactions between curcumin and key angiogenesis related proteins, including HIF-1α, VEGF-B, MMP-3, and STAT3.

RESULTS

Our results demonstrate that curcumin exerts significant effects on the cell survivability, cell cycle regulation, and apoptosis induction in oral cancer cells. These effects were particularly pronounced under the conditions of HIF-1α mediated angiogenesis. Computational binding analysis revealed strong binding interactions with curcumin and the selected proteins, implying a plausible mechanism through which curcumin may modulate the angiogenic pathways in oral cancer.

CONCLUSION

Our research sheds light on the diverse effects of curcumin on oral cancer cells, emphasizing its potential as a promising therapeutic tool for addressing hypoxia-induced angiogenesis. However, further investigation is essential to comprehensively understand the molecular mechanisms underlying these effects in in vitro models. This deeper comprehension is crucial for translating these findings into clinical applications aimed at improving oral cancer treatment.

Impact of various aligner auxiliaries on orthodontic activity: A systematic review and network meta-analysis

Background

It is imperative to analyze the forces and moments produced by various auxiliaries in order to select the optimal attachments and, eventually, to maximize the efficacy and efficiency of orthodontic therapy. Through this investigation, we aimed to highlight the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment on a pre/post treatment protocol basis.

Methods

After a thorough search of the online journals, a total of 482 documents were found using keywords such as "Orthodontic Treatment", "Aligner Auxiliaries", "Elastic Ligatures" and "Tooth Movement." The database research, elimination of duplicate studies, data extraction and risk of bias were performed by the authors independently. This systematic review and network meta-analysis included prospective studies and clinical trials to evaluate research that had looked at the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment.

Results

Eight investigations of varying designs were selected for this review. The majority of investigations revealed that aligner auxiliaries significantly improve anterior root torque, rotation, and mesio-distal (M-D) movement, as well as posterior anchoring. They also significantly improved anterior root rotation. However, few studies have presented inconsistent or non-statistically significant findings.

Conclusion

Auxiliaries for aligners also appear to improve extrusion and other orthodontic movements, but there is insufficient evidence to support these claims. No research has examined posterior bucco-lingual expansion or tilting. Clarification of the effect of attachments and their related variables requires additional clinical investigations.

Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions

BACKGROUND

The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent.

METHODS

Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias.

RESULTS

Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.

Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population

BACKGROUND

Studies have reported correlations between various oral behaviors and painful temporomandibular disorders (TMD), yet comprehensive research on the independent effects of each oral behavior within the general population remains sparse.

OBJECTIVE

This cross-sectional study aimed to investigate the association between painful TMD (PT) and various oral behaviors in general population.

METHODS

A questionnaire survey was conducted with participants to collect data encompassing demographic characteristics, eight specific oral behaviors, and the 5 major TMD symptoms(5Ts) checklist. Participants were categorized into PT and non-PT (NPT) groups based on their responses to the 5Ts checklist. Those reporting TMJ/facial pain or headaches were assigned to the PT group, while all other participants constituted the NPT group. Both univariate and multivariate logistic regression analyses were employed to evaluate the association between individual oral behavior and the presence of PT, controlling for demographic confounders including age, sex, systemic diseases, and dental treatments history.

RESULTS

A total of 441 valid questionnaires were received, including 156 males and 285 females. The prevalence of PT was identified to be 33.33%, with 61.00% of participants engaging in one or more types of oral behaviors. Each oral behavior was more frequently reported in the PT group compared to the NPT group. The univariate logistic regression analysis identified positive correlations between all eight oral behaviors and PT. In the multivariate logistic regression analysis, these associations persisted after adjustment for demographic confounders including age, sex, history of systemic diseases and dental treatments (P<0.01). The behaviors most strongly associated with PT were "Hold or jut jaw forward/to the side" (OR:4.478), "Hold, tighten or tense muscles without clench" (OR:3.343) and "Hold jaw in rigid or tense position" (OR:3.209).

CONCLUSION

The presence of oral behaviors has significant association with PT. Individuals exhibiting multiple oral behaviors are more likely to experience PT. Additional studies are needed to clarify the effects of reducing oral behaviors on pain-related symptoms.

Prevalence of temporomandibular disorders diagnosis in patients treated with Herbst appliance: a systematic review and meta-analysis

BACKGROUND

The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two pistons the patient cannot remove. The so-called bite-jumping keeps the mandible in a more anterior position for a variable period, usually at least 6 months. This appliance does not inhibit joint functions and movements, although there are scientific papers in the literature investigating whether this appliance can lead to temporomandibular disorders. This systematic review aims to evaluate whether Herbst's device can cause temporomandibular diseases by assessing the presence of TMD in patients before and after treatment.

METHODS

A literature search up to 3 May 2023 was carried out on three online databases: PubMed, Scopus and Web of Science. Only studies that evaluated patients with Helkimo scores and Manual functional analysis were considered, as studies that assessed the difference in TMD before and after Herbst therapy. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (pre and post-Herbst).

RESULTS

The included papers in this review were 60. Fifty-seven were excluded. In addition, a manual search was performed. After the search phase, four articles were considered in the study, one of which was found through a manual search. The overall effect showed that there was no difference in TMD prevalence between pre-Herbst and post-Herbst therapy (OR 0.74; 95% CI: 0.33-1.68).

CONCLUSION

Herbst appliance seems not to lead to an increase in the incidence of TMD in treated patients; on the contrary, it appears to decrease it. Further studies are needed to assess the possible influence of Herbst on TMDs.

Applications of artificial intelligence in the field of oral and maxillofacial pathology: a systematic review and meta-analysis

BACKGROUND

Since AI algorithms can analyze patient data, medical records, and imaging results to suggest treatment plans and predict outcomes, they have the potential to support pathologists and clinicians in the diagnosis and treatment of oral and maxillofacial pathologies, just like every other area of life in which it is being used. The goal of the current study was to examine all of the trends being investigated in the area of oral and maxillofacial pathology where AI has been possibly involved in helping practitioners.

METHODS

We started by defining the important terms in our investigation's subject matter. Following that, relevant databases like PubMed, Scopus, and Web of Science were searched using keywords and synonyms for each concept, such as "machine learning," "diagnosis," "treatment planning," "image analysis," "predictive modelling," and "patient monitoring." For more papers and sources, Google Scholar was also used.

RESULTS

The majority of the 9 studies that were chosen were on how AI can be utilized to diagnose malignant tumors of the oral cavity. AI was especially helpful in creating prediction models that aided pathologists and clinicians in foreseeing the development of oral and maxillofacial pathology in specific patients. Additionally, predictive models accurately identified patients who have a high risk of developing oral cancer as well as the likelihood of the disease returning after treatment.

CONCLUSIONS

In the field of oral and maxillofacial pathology, AI has the potential to enhance diagnostic precision, personalize care, and ultimately improve patient outcomes. The development and application of AI in healthcare, however, necessitates careful consideration of ethical, legal, and regulatory challenges. Additionally, because AI is still a relatively new technology, caution must be taken when applying it to this industry.

Prevalence of Bruxism in alcohol abusers: a systematic review conducted according to PRISMA guidelines and the cochrane handbook for systematic reviews of interventions

BACKGROUND

Bruxism, a common oral parafunctional behavior characterized by the grinding or clenching of teeth, is a multifactorial condition with potentially detrimental effects on oral health and overall well-being. In recent years, there has been growing interest in understanding the relationship between bruxism and alcohol abuse, as both are prevalent issues that may share underlying factors and exacerbate each other. This systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, aims to evaluate the frequency of bruxism among individuals with alcohol abuse.

METHODS

A comprehensive search of electronic databases, including PubMed, Lilacs, Scopus and Web of Science, will be conducted to identify relevant studies published up to the knowledge cutoff date in January 2023. The search strategy will include keywords related to bruxism, alcohol abuse, and their synonyms. Inclusion criteria will encompass original research studies, such as observational, cross-sectional, cohort, and case-control studies, as well as clinical trials, that examine the relationship between bruxism and alcohol abuse. Two independent reviewers will perform the study selection, data extraction, and quality assessment, with discrepancies resolved by consensus.

RESULTS

The systematic review will present a summary of the identified studies, including the study design, characteristics of the study populations, and key findings related to the association between bruxism and alcohol abuse. The potential mechanisms underlying this relationship will also be explored. Subgroup analyses and the quality of evidence will be assessed. Finally, the implications of this association for clinical practice and further research will be discussed.

CONCLUSIONS

This systematic review will contribute to a better understanding of the interplay between bruxism and alcohol abuse, shedding light on potential risk factors, mechanisms, and clinical implications. The findings may have significant implications for the prevention, management, and treatment of bruxism, particularly in individuals with a history of alcohol abuse.

Effect of non-surgical periodontal therapy on CD14 + CD16+ monocyte counts in peripheral blood samples: a clinical interventional study

Monocytes and their macrophage progeny are thought to be involved in tissue and alveolar bone destruction in periodontal disease. It has been documented that the proportion of (CD14 + CD16+) non-classical monocytes in the blood are elevated in chronic periodontitis;A total of 20 chronic generalized periodontitis patients who were otherwise healthy, were recruited for this study. At baseline and 3 weeks after non-surgical periodontal treatment, peripheral blood was obtained to assess the levels of C-reactive protein (CRP) and the proportion of monocyte subsets. Monocyte subsets were assessed using flow cytometry;The mean percentage of CD14 + CD16+ non-classical monocytes in the peripheral blood sample at baseline was 13.95 + 2.09, that reduced to 8.94 + 1.23 3 weeks after non-surgical treatment. A distinct significant reduction in the percentage of non-classical monocytes and a concomitant increase in classical monocytes were observed following periodontal treatment compared to baseline. There was a significant reduction in the all the periodontal parameters and CRP levels 3 weeks post non-surgical periodontal treatment. A positive correlation between CRP and percentage of non-classical monocytes was also observed; Periodontal treatment potentially modulates the host response effectively.

Gene sequencing applications to combat oral-cavity related disorders: a systematic review with meta-analysis

Gene sequencing (GS) has numerous applications in combatting oral-cavity related disorders, including identifying genetic risk factors for diseases, developing targeted therapies, and improving diagnostic methods. It can help identify specific genetic mutations or variations that increase the risk of developing oral-cavity related disorders, such as oral cancer, periodontal disease, and cleft lip and palate. By the means of the following investigation, our primary objective was to assess the impact of GS technique in diagnosing and potentially treating diseases of the oral cavity by the means of a systematic review and meta-analysis. We commenced by defining the terms "gene sequencing," "oral cavity," and "disorders" as the important elements in our investigation's subject. Next, relevant databases like PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched using keywords and synonyms for each concept, such as "genomic sequencing," "DNA sequencing," "oral health," "oral diseases," "dental caries," "periodontal disease," "oral cancer," and "salivary gland disorders." We combined several search terms, such as "gene sequencing AND oral disorders AND periodontal disease" or "oral cancer OR genomic sequencing," to further hone your search results using Boolean operators like "AND" and "OR." The oral cavity analysis obtained by CS in the selected articles revealed that most of the disorders were, in fact, a direct causal event influenced by the oral microbiome. Moreover, each sampled oral cavity evidenced a different microbial community, which predicted the precipitation of benign as well as malignant conditions, though not on a definitive basis. In the last ten years, genomic sequencing had advanced remarkably as majority of our selected studies observed, making it possible to diagnose and treat a variety of oral and maxillofacial disorders, including cancer. It was also used to ascertain a person's genetic make-up as well as to spot numerous genetic abnormalities that can predispose individuals to diseases. Understanding the different sequencing techniques and the resulting genetic anomalies may help with their clinical application and lead to an improvement in illness diagnosis and prognosis as a whole in the field of dentistry.

Correlating estrogen replacement therapy and temporomandibular disorders: a comprehensive review following PRISMA principles and cochrane handbook for systematic reviews of interventions

BACKGROUND

Estrogen replacement therapy (ERT) is a common hormonal treatment for postmenopausal women, aimed at alleviating menopausal symptoms and reducing the health risks associated with estrogen deficiency. However, the impact of ERT on temporomandibular disorders (TMDs) remains unclear. This systematic review aims to evaluate the relationship between ERT and TMDs, including TMD occurence, pain, and associated symptoms.

METHODS

A comprehensive search of seven electronic databases was conducted using predefined search terms and Boolean operators. Inclusion criteria encompassed studies examining the association between ERT and TMDs. Two independent reviewers screened the identified articles, extracted data, and assessed the risk of bias using the RoB -2 tool.

RESULTS

Search strategy identified a total of 3 articles which met the inclusion criteria. The included studies investigated the impact of ERT on TMD occurrence and its related symptoms. The analysis revealed no significant association between ERT and TMD occurrence. A significant dose relationship was noted in one of the studies while another mentioned the possible relationship of TMD with educational status. Risk of bias among the studies was low, and the overall quality of evidence was deemed to be high.

CONCLUSION

This systematic review suggests that there is no conclusive evidence supporting an increased risk of TMDs among women receiving ERT. The findings indicate that ERT is unlikely to have a noticeable impact on TMDs. However, due to the limited number of studies available, further research is warranted to strengthen these conclusions and explore potential factors that may influence the relationship between ERT and TMDs.

The Impact of Cesarean Section Delivery on Intestinal Microbiota: Mechanisms, Consequences, and Perspectives-A Systematic Review

The relationship between cesarean section (CS) delivery and intestinal microbiota is increasingly studied. CS-born infants display distinct gut microbial compositions due to the absence of maternal birth canal microorganisms. These alterations potentially link to long-term health implications like immune-related disorders and allergies. This correlation underscores the intricate connection between birth mode and the establishment of diverse intestinal microbiota. A systematic literature review was conducted on the PubMed, Scopus, and Web of Science databases by analyzing the articles and examining the intricate interactions between CS delivery and the infant's intestinal microbiota. The analysis, based on a wide-ranging selection of studies, elucidates the multifaceted dynamics involved in CS-associated shifts in the establishment of fetal microbiota. We also explore the potential ramifications of these microbial changes on neonatal health and development, providing a comprehensive overview for clinicians and researchers. By synthesizing current findings, this review contributes to a deeper understanding of the interplay between delivery mode and early microbial colonization, paving the way for informed clinical decisions and future investigations in the field of perinatal medicine.

Pharmacological therapy in the management of temporomandibular disorders and orofacial pain: a systematic review and meta-analysis

BACKGROUND

Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or speaks. Several classes of drugs are used to treat symptoms. This review aims to assess which drug suits the different signs.

METHODS

Pubmed, Web of Science and Lilacs were systematically searched until 01/02/2023. Clinical trials were selected that dealt with drugs used in temporomandibular dysfunction RESULTS: Out of 830 papers, eight studies were included. The Meta-Analysis with Continuous Outcomes with Pre-Calculated Effect Sizes resulted in the rejection that there is intergroup variability (p.0.74).

CONCLUSIONS

Treatment of orofacial pain is still a significant challenge for dentistry. We can conclude that there is no drug of first choice in the treatment of temporomandibular pain. However, the clinician must distinguish the type of pain and the aetioloic cause of the pain so that the patient can be treated and managed pharmacologically.

The effectiveness of chitosan as a hemostatic in dentistry in patients with antiplatelet/anticoagulant therapy: systematic review with meta-analysis

Hemorrhage control is a crucial aspect of dental procedures, and achieving efficient hemostasis remains a key challenge. The advent of hemostatic dressings has revolutionized the field of dentistry by providing effective and convenient solutions for managing bleeding in vari-ous dental scenarios. This article aims to provide an overview of hemostatic dressings, their mechanisms of action, and their diverse applications in dentistry. We applied the following Pop-ulation, Exposure, Comparator, and Outcomes (PICO) model to assess the document eligibility. A literature search was performed on major search engines, using keywords. At the end of the search, 3 articles were selected that matched the PICO. Three items were selected after the screen-ing process, and bleeding times were analyzed between the control group and the study group. The overall effect showed a substantial and statistically significant difference with bleeding time in favour of HDD-treated patients, showing that this garrison is very useful in controlling bleed-ing for patients taking anticoagulants and antiplatelets (Mean difference - 5.61; C.I. -5.70, - 5.52); Overall, hemostatic dressings have revolutionized the management of bleeding in dentistry, offering a promising solution to achieve optimal hemostasis, improve treatment outcomes, and enhance patient care, particularly Hemcon.

A comparative evaluation of physical properties of CAD/CAM complete denture resins- an in vitro study

BACKGROUND

In dentistry, there is a growing preference for computer-aided design and computer-aided manufacturing (CAD/CAM) systems over traditional laboratory procedures. However, there is not much literature comparing various CAD/CAM materials. Thus, this study aimed to assess and compare the color stability and hardness of gingival and tooth colored milled and 3D-printed acrylic resins.

MATERIALS AND METHODS

Four types of CAD/CAM materials were prepared: 3D-printed pink shade (PP), milled polymenthymethacrylate (PMMA) pink shade (MP), 3D-printed tooth shade (PT) and milled PMMA tooth shade (MT) (n = 6). For hardness, disc shaped samples of 15 mm × 2 mm and for color stability, bar shaped samples of 65mmx10mmx2.5 mm were prepared and polished. Vickers hardness test was performed in a microhardness tester. Color stability test was done by immersing in coffee solution and coca cola for 7 days. Day 0 and day 7 measurements were recorded using a digital spectrophotometer and the change in color was calculated. For statistical analysis, one-way ANOVA and Tukey's post hoc tests were done.

RESULTS

For color stability, milled PMMA was superior to 3D-printed resin samples. Milled pink and tooth shade samples had similar color stability, whereas 3D-printed tooth shade samples were more color stable as compared to pink shade 3D-printed samples. For hardness, milled tooth shade PMMA was the most superior one, followed by 3D-printed tooth shade, whereas pink shade milled PMMA and 3D-printed resin samples had similar hardness values and were inferior to the tooth shade CAD/CAM materials.

CONCLUSION

Color stability of milled PMMA is superior to that of 3D-printed resins. Hardness of tooth shade milled and 3D-printed resins is more than that of pink shade milled and 3D-printed resins.

Attenuation of orthodontically induced inflammatory root resorption by using low-intensity pulsed ultrasound as a therapeutic modality- a systematic review

Ultrasound is an effective tool for both diagnostic and therapeutic applications. As an imaging tool, ultrasound has mostly been used for real-time noninvasive diagnostic imaging. As ultrasound propagates through a material, a reflected radio-frequency (RF) signal is generated when encountering a mismatch in acoustic impedance. While traditionally recognized for its diagnostic imaging capabilities, the application of ultrasound has broadened to encompass therapeutic interventions, most notably in the form of Low-Intensity Pulsed Ultrasound (LIPUS). Low-Intensity Pulsed Ultrasound (LIPUS) is a form of mechanical energy transmitted transcutaneously by high-frequency acoustic pressure waves. The intensity of LIPUS (30 mW/cm2) is within the range of ultrasound intensities used for diagnostic purposes (1-50 mW/cm2) and is regarded as non-thermal, non-destructive, permeating living tissues and triggering a cascade of biochemical responses at the cellular level. The LIPUS device produces a 200 µs burst of 1.5 MHz acoustic sine waves, that repeats at a modulation frequency of 1 kHz and provides a peak pressure of 30 mW/cm2. Low-intensity pulsed ultrasound (LIPUS) forms one of the currently available non-invasive healing-enhancing devices besides electro-stimulation (pulsed electro-magnetic field, PEMF). This modality has been leveraged to enhance drug delivery, expedite injury recovery, improve muscle mobility, alleviate joint stiffness and muscle pain, and enhance bone fracture healing. Although LIPUS has been embraced within various medical disciplines, its integration into standard dental practices is still in its nascent stages, signifying an unexplored frontier with potentially transformative implications. Low-intensity pulsed ultrasound (LIPUS) has emerged as an attractive adjuvant therapy in various dental procedures, such as orthodontic treatment and maxillary sinus augmentation. Its appeal lies in its simplicity and non-invasive nature, positioning LIPUS as a promising avenue for clinical innovation. One particular area of interest is orthodontically induced inflammatory root resorption (OIIRR), an oftenunavoidable outcome of the orthodontic intervention, resulting in the permanent loss of root structure. Notably, OIIRR is the second most common form of root resorption (RR), surpassed only by root resorption related to pulpal infection. Given the high prevalence and potential long-term consequences of OIIRR, this literature review seeks to evaluate the efficacy of LIPUS as a therapeutic approach, with an emphasis on assessing its capacity to reduce the severity of OIIRR to a level of clinical significance. To conduct this systematic review, a comprehensive automated literature search was executed across multiple databases, including MEDLINE, Embase, PsycINFO, Web of Knowledge, Scopus, CINAHL, LILACS, SciELO, Cochrane, PubMed, trials registries, 3ie, and Google Scholar. Both forward and backward citation tracking was employed, encompassing studies published from database inception through January 2009 to April 2023. The review focused on randomized controlled trials (RCTs) that specifically evaluated the effects of low-intensity pulsed ultrasound therapy on orthodontically induced inflammatory root resorption (OIIRR), without restrictions of publication date. A stringent selection criterion was applied, and only studies demonstrating high levels of statistical significance were included. Ultimately, fourteen studies met the inclusion criteria and were subjected to further analysis. The overall quality of the included randomized controlled trials (RCTs) was rigorously assessed utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. This analysis revealed certain methodological limitations that posed challenges in drawing definitive conclusions from the available evidence. Despite these constraints, the review offers invaluable insights that can inform and guide future research. Specifically, it delineates recommendations for targeted populations, necessary interventions, appropriate outcome measures, suitable study designs, and essential infrastructure to facilitate further investigations. The synthesis of these insights aims to enhance the development and application of low-intensity pulsed ultrasound therapy within the field of dentistry, thereby contributing to improved patient outcomes.

Biomimetic approach to strengthen the incisal fracture composite build-up: an in vitro study

OBJECTIVE

Incisal composite build-up shows a high failure susceptibility. The incorporation of fiber-reinforced composite (FRC) during composite restoration could improve its strength. Hence the study was planned to compare the effect of various positions of FRC on the strength of composite resin incisal build-ups.

METHODS

In maxillary incisors (n = 90), 3 mm of the incisal edge was cut and teeth were categorized into three groups based on the location and number of fibers used during incisal composite build-up - Group I: composite resin; Group II: composite resin and a single fiber palatally and Group III: composite resin along with two fibers palatally.

RESULTS

The data showed that group II had the maximum load-bearing values followed by group I and group III.

CONCLUSION

Within the confines of our study, it can be concluded that the addition of FRC to the conventional incisal composite build-up increased the overall strength restoration. Such composite restoration reinforced with a single fiber on the palatal side showed the highest load-bearing capacity compared to two fibers reinforced and unreinforced composites. The common mode of failure in group I was in composite resin, in two fibers reinforced at fibers-composite junction, and in one fiber reinforced composite was in the remaining part of the tooth.

Importance of periodontal phenotype in periodontics and restorative dentistry: a systematic review

BACKGROUND

Periodontal phenotype is regarded to be one of the key factors influencing the efficacy of restorative therapies in dental practice. The objective of the systematic review was to explore the importance of thin and thick periodontal phenotypes and how they affect the outcome of periodontal and restorative therapies by looking at a number of academic publications from various online databases.

METHODS

Following the PRISMA guidelines (Preferred Reporting Items for Systematic Review standards), relevant data will be searched and retrieved from three significant scientific databases, including PubMed, EBSCO, and Scopus. The articles with full texts that matched the keywords and published in English between 2018 and 2023 were taken into consideration.

RESULTS

The majorities of these articles were based on the type of periodontal phenotype and their impact on periodontal and restorative treatment outcomes were selected. The initial search yielded a total of 530 articles. Only 273 were relevant to the review's objectives, and these were considered for determining eligibility. Only 20 publications were eligible for analysis.

CONCLUSION

Understanding these anatomical aspects of periodontal phenotype is crucial to both periodontology and restorative dentistry. The clinical outcome of restorative, prosthetic, orthodontic, surgical, and periodontal therapies is determined in large part by the periodontal phenotype, which also plays a significant role in clinical failure or success in dental treatments.

TRIAL REGISTRATION

This study protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO) dated 16th June 2023 with the registration ID CRD42023432568.

Dickkopf-related protein 1 as a biomarker of local immune status and worse prognosis of Oral squamous cell carcinoma

BACKGROUND

Oral squamous cell carcinoma (OSCC) is an infiltrative malignancy characterized by a significantly elevated recurrence rate. Dickkopf-related protein 1 (DKK1), which plays an oncogene role in many cancers, acts as an inhibitor of the Wingless protein (Wnt) signaling pathway. Currently, there is a lack of consensus regarding the role of DKK1 in OSCC or its clinical significance.

OBJECTIVE

To examine the role and effect of DKK1 in OSCC.

METHODS

The identification of differentially expressed genes (DEGs) in OSCC was conducted by utilizing databases such as The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). A comprehensive analysis of gene expression profile interactions (GEPIA) and Kaplan-Meier curve were conducted to investigate the associations among DEGs, patient survival and prognosis in individuals with OSCC. The biological function of DKK1 in OSCC was investigated by using molecular biology approaches.

RESULTS

The expression of DKK1 was found to be upregulated in OSCC tissues at various stages. High levels of DKK1 expression exhibited a positive correlation with the overall survival (OS) and progression-free survival (PFS) rates among OSCC patients. DKK1 knockdown suppressed the proliferation and induced apoptotic response in OSCC cells. Moreover, DKK1 exerted a positive regulatory effect on HMGA2 expression, thereby modulating cell growth and apoptosis in OSCC. The expression of DKK1 was found to be positively correlated with the infiltration of immune cells in patients with OSCC. Additionally, higher levels of CD4 + T cells were associated with improved 5-year survival rates.

CONCLUSION

DKK1 is a prognostic biomarker for patients with OSCC.

Predicting the employment of teledentistry in clinical practice by the Saudi dental community using a theoretical model

Introduction

There are very few scholastic studies applying a theory-driven methodology to analyse the employment of teledentistry in clinical practice by the Saudi dental community. The objective of this research was to predict the employment of teledentistry in clinical practice by the Saudi dental community using the UTAUT (Unified Theory of Acceptance and Use of Technology) model.

Methods

A countrywide survey was executed from November 2022 to April 2023 among the dental community (pre-graduate students, graduates, post-graduate students, general dentists, and specialist dentists) involved in clinical practice. The survey employed the UTAUT model, which has four fundamental constructs: performance expectancy (PE), effort expectancy (EE), social influence (SI) and facilitating conditions (FC). These constructs are known to impact the user's behavioural intention (BI). The four fundamental constructs were independent, and BI was the dependent variable. A Likert scale with five scores was used to record each variable. Descriptive statistics were used to describe all the constructs. Cronbach's alpha scores were used to measure the inner consistency of the Likert scale. Simple linear regression and multiple linear regression were used to determine the correlation between all the constructs and the overall model's prediction. The Statistical Package for the Social Sciences was applied for analysis. The study had 80% power and an alpha threshold of .05.

Results

The electronic survey was sent to 3000 participants, out of whom 2143 responded (response rate = 71.43%). PE (R2= 26%, p < .01) was the most significant predictor of the Saudi dental community BI to employ teledentistry in clinical practice, followed by SI (R2= 24%, p < .01), EE (R2= 19%, p < .01) and FC (R2= 6%, p < .01). With statistically significant predictive power, the UTAUT model explained 32% of the variance in the BI (R2= 0.32, p < .01).

Conclusions

Each UTAUT construct and the entire model were significantly correlated with the employment of teledentistry in clinical practice by the Saudi dental community. PE had the most salient correlation, followed by SI, EE and FC. The participants have perceived the benefits of teledentistry, increasing the future likelihood of its utilisation. The Saudi government could consider the UTAUT constructs to promote teledentistry in tandem with Vision 2030.

Early Soft Tissue Response to Immediate Monotype Zirconia Implant: A Metal-Free Restoration

Zirconia in dentistry (zirconium oxide) is an excellent substitute for metal in creating bridges or crowns on both natural teeth and implants and for dental implant fabrication instead of titanium alloys. This case report aims to show the features of zirconia dental implants and prosthodontic restorations to oral soft tissues. Three monotype immediate zirconia implants were placed at the time of tooth extraction. The residual socket gap was treated only by establishing a collagen sponge to stabilize the natural blood clot. Three single zirconia crowns were cemented after 2 months of healing. After 3 years of follow-up, clinical and radiographic stability was demonstrated, confirming the zirconia implants' excellent soft tissue and osseointegration. A zirconia cutback was planned to improve the esthetic result of the whole crown. After 3 years of follow-up visits, clinical and radiographic stability confirmed the optima soft tissue and osseointegration outcome of zirconia implants. Zirconia implants are a valid alternative to titanium implants for treating partial edentulism.

Periapical healing outcome following non-surgical endodontic intervention among diabetic patients: A systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions

Background

Periapical diseases are common dental conditions that require non-surgical endodontic intervention (NEI) for successful treatment. However, the impact of diabetes mellitus (DM) on the periapical healing (PH) outcome in diabetic patients remains somewhat unclear. This review aimed to evaluate the PH outcome following endodontic intervention among DM-afflicted individuals.

Methods

A comprehensive search was conducted across multiple electronic databases to identify relevant studies. Specifically, a set of selection criteria was applied to select studies that assessed PH outcomes in individuals with DM who underwent different treatment protocols. Data extraction and quality assessment were performed following predetermined protocols. The risk of bias (RoB) 2 assessment tool evaluated the quality of the included studies.

Results

A total of 11 studies met the inclusion criteria and were included in the investigation. Four studies showed a higher incidence of apical periodontitis in diabetic individuals compared to controls, and five studies reported reduced healing and success rates in this group. Overall, nine studies have shown that DM has a negative impact on periapical outcomes. This suggests that DM is an important factor in the prognosis of endodontic intervention. The assessment tools used were PAI, PR, SC, and FD analysis. RoB-2 assessed the included studies as having a moderate RoB.

Conclusion

This review provides compelling evidence that DM patients experienced a noticeable negative impact on PH outcomes compared to the control population. These findings highlight the importance of considering the diabetic status of patients when assessing the prognosis of periapical diseases and planning interventions for NEI. Further research is needed to validate these results and explore potential mechanisms underlying the observed associations.

Micronuclei as an indicator of genotoxic change in epithelial cells of buccal mucosa after panoramic radiographs

BACKGROUND

The radiation released at the time of dental panoramic radiographs causes genotoxic and cytotoxic effects on epithelial cells.

OBJECTIVE

This research aimed to evaluate the changes in the frequencies of micronucleated cells in patients' buccal epithelial cells following dental panoramic radiography.

METHODS

74 patients were recruited for the study who were advised for panoramic radiographs. Using a wooden spatula, the buccal epithelial cells were scraped from both cheeks before to panoramic radiation exposure and ten days after the panoramic radiation exposure. Giemsa stain was used to stain the cells, and 500 cells were scored on a slide to determine the frequency of micronuclei. To determine the difference between the frequency of micronuclei before and after radiation exposure, a paired t-test was used in the statistical analysis.

RESULTS

The proportion of micronuclei cells was 0.11% before radiation exposure and 0.57% following radiation exposure after 10 days. A statistically significant increase in the frequencies of micronuclei was noted after radiation exposure values.

CONCLUSION

This study revealed the genotoxicity of epithelial cells with dental panoramic radiation exposure. It is advised to reduce the use of such radiographs and to use only when there is no other diagnostic tool that is helpful or when absolutely essential.

Undergraduates' comparative assessment, utilizing a structured rubric, of hands-on versus video-supported presentation in class II cavity preparation

BACKGROUND

Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an important step in many health professions to become a successful professional. During under graduation, class II cavity preparation exercise is of utmost important in dentistry.

OBJECTIVE

To compare class II cavities prepared by students after hands-on live demonstration and pre-recorded video demonstration using well-organised evaluation rubrics.

METHOD

Preclinical dental students (n= 50) were divided into two groups. The students in group I (n= 25) attended a hands-on live demonstration performed by one faculty while students in group II (n= 25) watched a 15-minute pre-recorded procedural video on the projector. Both groups were appealed to prepare class II cavity for amalgam involving disto-occlusal surface of mandibular second molar articulated on jaw model (TRU LON study model, Jayna industries, Ghaziabad U.P., India). Following completion of the preparations, all teeth were collected, and labelled grades of prepared cavities were given according to prespecified rubrics. The data of scores were presented as means and standard deviation. Statistical analysis of data was executed using SPSS software. A paired t-test was used to compare scores between groups.

RESULTS

The study shows that the video-supported demonstration of a cavity preparation was better than the live hands-on demonstration. A higher mean response for the procedural video group was found compared to the live demonstration group (p= 0.000133).

CONCLUSION

Pre-recorded video-supported demonstration along with guidance by a tutor may be a viable alternative to hands-on live demonstration in cavity preparation procedures during undergraduate dental training. Moreover, rubric methods can be implemented in the teaching of various preclinical exercises for conservative dentistry and endodontics.

The commercially available oral rinse vs. curcumin photosensitizers in an artificial mouth model mimicking their use after meals on early colonizers single species biofilm: An in vitro study

BACKGROUND

Commercially available oral rinses contain active ingredients with concentration that is claimed by manufacturers to be effective as antiplaque agent. To date there has been no mention of the effect of oral rinse on the adherence of early plaque colonizers in plaque formation and the concentration to be used before/after meals.

OBJECTIVE

The chief aim of the study was to evaluate microbial retention on the salivary pellicle on treatment with oral rinses (CHX & EO)/PS (mimicking after meals use of mouth wash/PS).

METHODS

Noordini's Artifical Mouth model was used for developing the single species biofilm with early microbial colonizers of oral biofilm (A. viscosus, Strep. mitis and Strep. sanguinis respectively). The microbial retention on use of oral rinses comprising of CHX and EO as an active ingredients respectively was compared with Curcumin PS. For evaluating the microbial retention, the pellicle with microbial inoculation was developed on the glass beads in the mouth model. Subsequently the respective single specie biofilm was exposed to the mouth wash and PS after inoculation. It mimicked as use of mouth wash/PS after meals. The bacterial count in the dental biofilm was evaluated on serial dilution (CFU/ml). Sterile deionized water was used as a negative control. For qualitative analysis, Scanning electron microscope (SEM) was used to evaluate the microbial count.

RESULTS

From the data it was observed that for the treatment of single species experimental biofilm with commercially available mouth rinses (CHX & EO) and PS (curcumin), there was significant retention for S.mitis, S.sanguinis and A.viscosus. There was no significant difference observed between PS and CHX treated single species biofilm. Whereas a significant difference was observed between EO treated biofilms and CHX/PS treated biofilms (p⩽ 0.05).

CONCLUSION

It can be concluded from the results that curcumin PS and CHX should not be used after meals whereas EO containing mouth rinse can be used to maintain the oral mocroflora.

Efficacy of High-Voltage Pulsed Radiofrequency in Zoster-Associated Pain: A Meta-Analysis and Systematic Review

Background

Zoster-associated pain (ZAP) is often refractory to conventional treatments and can seriously affect patients' physical and mental health. High-voltage pulsed radio frequency (H-PRF) is a new method for treating ZAP with pulse voltages above 60 V or even up to 100 V. The purpose of this paper was to conduct a systematic review and meta-analysis to evaluate the efficacy of H-PRF in the management of ZAP.

Methods

PubMed, Embase, and the Cochrane library were searched from their inception to June 2022 to identify controlled trials which evaluated the effectiveness of H-PRF compared with standard PRF and sham operations. The primary outcome was pain scores at different treatment times. The secondary outcomes included SF-36 scores, rescue analgesic dose, and side effects.

Results

We reviewed 6 randomized controlled trials involving 428 patients. There was no significant difference between the H-PRF and standard PRF pain scores at 1 week after surgery and the sham operation group at 1 month. At 1, 3, and 6 months, the H-PRF group had better pain score than the standard PRF group, and at 3 months, the pain score was better than the sham operation group. The H-PRF group showed improvement in the SF-36 score, and there were no significant complications in the H-PRF group.

Conclusions

H-PRF is an effective and safe treatment method that has better effects in relieving pain and improving the quality of life and physical and mental health. Although H-PRF provides pain relief rates comparable to those of the control group in the early stages, it remains the preferred and alternative treatment for relieving herpes zoster-related pain.