Stress Experience, Depression and Neck Disability in Patients with Temporomandibular Disorder-Myofascial Pain with Referral

The etiology of temporomandibular disorders (TMDs) is firmly anchored in the biopsychosocial model in which a special role is attributed to the stress, depression, somatic symptoms, and anxiety. The aim of the study was to assess the level of stress, depression and neck disability in patients with temporomandibular disorder-myofascial pain with referral. The study group enrolled 50 people (37 women and 13 men) with complete natural dentition. All the patients underwent a clinical examination according to the Diagnostic Criteria for Temporomandibular Disorders and were diagnosed as individuals with myofascial pain with referral. The questionnaires were associated with stress, depression, and neck disability; Perceived Stress Scale (PSS-10), Beck Depression Inventory(BDI), and Neck Disability Index (NDI) were evaluated. Of the individuals evaluated, 78% showed elevated levels of stress, and the average value of the PSS-10 in the study group was 18 points (Me = 17). Furthermore, 30% of the subjects presented depressive symptoms, with the average value of BDI was 8.94 points (Me = 8), and 82% of the subjects showed neck disability. The multiple linear regression model revealed that BDI and NDI allowed explanations for the 53% differentiation of PSS-10. In conclusion, stress, depression, and neck disability coexist with temporomandibular disorder-myofascial pain with referral.

The Prevalence and Overlaps of Temporomandibular Disorders in Patients with Myofascial Pain with Referral-A Pilot Study

The aim of the study was to evaluate the temporomandibular joint, the prevalence of single and multiple diagnosis and potential sided domination of temporomandibular dysfunction in patients with temporomandibular disorder-myofascial pain with referral. The study group enrolled 50 people-37 females and 13 males between 18 and 25 years old with an average age of 23.36 ± 2.14. The patients underwent joint vibration analysis. Sixty seven percent of all examined tem-poromandibular joints were classified as group I according to Mark Piper's classification. Class IIIA appeared in 17% of joints. Eight percent of temporomandibular joints were classified as class IVA. There were no statistically significant differences in the prevalence of temporomandibular disorder with respect to gender (p = 0.838639). The relatively high prevalence of multiple diagnoses proved the overlapping nature of muscle and intraarticular disorders. Twenty eight percent of the subjects suffered from a combination of myofascial pain with referral and bilateral temporoman-dibular dysfunction. In 62% of the patients a lack of intraarticular disorders was reported. The suggestion that there exists sided domination in the occurrence of temporomandibular disorders has not been confirmed. Due to the small sample size, such differences cannot be excluded. Fur-ther research is needed.

Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral

The aim of the study was functional evaluation of soft tissue mobilization in patients with temporomandibular disorder-myofascial pain with referral. The study group consisted of 50 individuals-37 females and 13 males. The average age was 23.36 ± 2.14 years. All subjects were diagnosed with myofascial pain with referral (diagnostic criteria for temporomandibular disorders). Soft tissue mobilization was applied three times. Electromyography of selected masticatory muscles was performed six times-before and after the treatment. After each mobilization, a decreasing tendency of muscular activity was observed in the entire study group. The Friedman test indicated that mobilization altered the activity of the right temporal muscle (p = 0.00010), both masseters (p = 0.0000), right sternocleidomastoid (p = 0.00251), left sternocleidomastoid (p = 0.00033), and right and left digastric muscles (p = 0.00045 and p = 0.00000, respectively). With respect to symmetry a statistically significant difference was noted in the case of the sternocleidomastoid muscles (p = 0.00729). In conclusion, soft tissue mobilization seems to be effective in the relaxation of masticatory muscles in patients with temporomandibular disorders. Our findings proved that soft tissue mobilization does not improve the symmetry and synergy of the masticatory muscles limited by dental occlusion.

Alveolar ridge atrophy related to facial morphology in edentulous patients

OBJECTIVES

The morphology of the alveolar process determines the retention and stability of prosthetic restorations, thereby determining the result of the therapy. Considering that the edentulous jaws may be affected by the atrophy process, it was hypothesized that the morphology of the alveolar process of the maxilla may be dependent on the anterior facial height and anatomy of the mandible.

SUBJECTS AND METHODS

Twenty-five healthy edentulous Caucasian individuals were randomly chosen. Each subject underwent a lateral cephalogram before and after prosthetic rehabilitation. During exposition, newly made prostheses were placed in the patient's mouth. Teeth remained in maximal intercuspidation. Morphological parameters were evaluated according to the Ricketts, McNamara, and Tallgren's method.

RESULTS

An inversely proportional association was observed between patient age and the distal part of the maxilla. A statistically significant connection was noted between the vertical dimension of alveolar ridge and anterior total and lower facial height conditioned by prosthetic rehabilitation.

CONCLUSION

The height of the lateral part of the alveolar ridge of the maxilla remains in connection with the anterior total and lower facial height obtained in the course of prosthetic rehabilitation. The vertical dimension of the alveolar ridge of the maxilla seems to be in close relationship with the morphology of the lower jaw.

Pathologies of the oral cavity in patients with non-controlled diabetes type 1 and type 2--analysis of periodontal status and periodontal treatment needs

INTRODUCTION

Decompensated diabetes is a major risk factor in the development of periodontal diseases. This leads to disturbances of carbohydrates, protein, and fat and morphological changes in many organs. These changes also apply to the masticatory system, especially periodontal tissues. The aim of the study was to assess the periodontal status and periodontal treatment needs in patients with non-controlled diabetes type 1 and type 2 (HbA1c > 7%), and to compare the results with the data obtained in a group of generally healthy patients.

MATERIAL AND METHODS

The study included 275 patients, 155 of them were patients with non-controlled diabetes during hospitalisation (study group), while 120 subjects constituted the control group of healthy people. The study excluded edentulous people. CPITN index (according to Ainamo et al.) was used to assess the periodontal state and periodontal treatment needs.

RESULTS

The average level of glycated haemoglobin HbA1C among patients in the study group was 9.43% in women and slightly more at 9.57% in men. The periodontal status in healthy people was satisfactory, dominated by the maximum values of CPITN = 0, CPITN = 1, and CPITN = 2. The study group more frequently revealed the maximum values of CPITN = 3 and CPITN = 4. This shows the more advanced periodontal changes in this group. Due to the bad condition of the periodontium, the periodontal treatment needs proved to be far greater in the study group and related primarily to comprehensive specialist treatment (TN3).

CONCLUSIONS

Decompensated diabetes may be an important cause of changes in periodontal tissues and may cause a significant loss of masticatory function in patients.

The influence of occlusal morphology on occlusion time

OBJECTIVES

The aim of the study was to assess how the morphology of the occlusal surfaces of premolars and molars influenced the occlusion time in a mixed gender group of young adults with full natural dentition.

METHODS

Fifty healthy volunteers with Angle's Class I occlusion were included in the study. After clinical examination, the alginate impressions of both arches were taken, and plaster casts were prepared. To assess the morphology of lateral teeth, the digital models were measured. Occlusal analysis was performed with the T-Scan^® III to assess occlusion time.

RESULTS

A direct correlation was found between the cusp distance for the first upper premolar and occlusion time (r = -0.29, p<0.05) and the distance between distal buccal and distal lingual cusps of the first lower premolar and occlusion time (r = 0.33, p<0.05). The parameters that had their impact on occlusion time were the opening angle of lingual cusps for the lower molars and the furrow angle of aperture between cusps for first upper premolar.

DISCUSSION

Occlusal surface morphologies of premolars may have direct impact on occlusion time. However, anterior guidance parameters and morphologies of molars could also influence the time teeth are in contact coming to maximal intercuspation.

The relationship between facial morphology and the structure of the alveolar part of the mandible in edentulous complete denture wearers. A preliminary study

OBJECTIVE

Although the effect of involutional processes that occurs in the maxilla and mandible of edentulous subjects is obvious, the problem of factors definitely determining the direction of changes still remains unsolved. This study was aimed at determining the relationship between facial morphology and the structure of the alveolar part and the body of the mandible in edentulous complete denture wearers.

MATERIALS AND METHODS

Twenty-five healthy edentulous Caucasian patients in the 70.5 ± 9 years of age group were examined. All patients underwent tele-X-ray examination with the presence of currently used dentures in the oral cavity. To assess morphological parameters of the facial skeleton, cephalograms were analyzed according to Ricketts and Mc Namara method. To assess the mandible morphology, the films were measured using the method of Tallgren.

RESULTS

The period of edentulism was found to be negatively correlated with the anterior segment of the body of the mandible within its symphysis. The parameter corresponding to the location of the first lower molar showed a directly proportional correlation with G'-Sn', G'-Me', Sn'-Me', N-Ans, N-Me, Ans-Me, Co-Gn and Co-Go. Positive correlations were found between the parameters describing contour of the alveolar part of the body of the mandible and mandibular symphysis and G'-Me', Sn'-Me', N-Me, Ans-Me describing the height of the occlusal vertical dimension.

CONCLUSION

The study showed a directly proportional correlation between the vertical occlusal dimension of the lower face conditioned by prosthetic rehabilitation and the height of the alveolar part in the lateral regions of the mandible.

Evaluation of estrogen receptor-β expression in the epithelium of the oral mucosa in menopausal women under hormone replacement therapy

PURPOSE

We aimed to evaluate the ERβ expression in the epithelium of the oral mucosa in menopausal women treated with oral, transdermal or local (vaginal) menopausal hormone therapy.

MATERIAL/METHODS

In this study, we included 60 women treated with oral, transdermal or vaginal menopausal hormone therapy. The study material was obtained from swabs taken from the buccal mucosa before administering HRT, and after 6 weeks, 3 months, 6 months and 12 months of therapy. We assessed estrogen receptor-β (ERβ) expression levels in subsequent swabs by immunohistochemical analysis.

RESULTS

The highest increase in the ERβ expression was observed after 3 months of oral and transdermal hormone therapy.

CONCLUSIONS

Oral and transdermal HRT may be an effective method of treatment of oral discomfort in menopausal women.