Dental and Medical Problems最新文献

Background: Temporomandibular disorders (TMDs) are challenging to manage due to their multifactorial nature. As with other joints, the function of temporomandibular joint (TMJ) is influenced by proprioception, making it an essential factor in TMD management. However, previous studies on the joint position error (JPE) in TMD patients lacked a proper diagnosis and reliability assessment.

Objectives: The aim of the present study was to develop a reliable JPE test in healthy adults as a foundation for future evaluation in TMD patients.

Material and methods: Two examiners conducted the JPE assessment, utilizing a methodology encompassing between-days intra-rater and within-day inter-rater reliability assessments. A total of 22 healthy participants (7 men and 15 women) with a mean unassisted mouth opening of 46 ±5 mm were recruited. The evaluation targeted specific distances (10 mm, 20 mm and 30 mm) within the participants' mouth opening range, with proprioceptive accuracy evaluated through the measurement of the absolute error (AE) and the constant error (CE).

Results: The CE was consistently lower than AE across all the targeted distances, although with higher standard deviations. Intra-rater reliability varied across the distances, with poor reliability observed for AE at 10 mm, moderate reliability for CE at 10 mm, good reliability for both AE and CE at 20 mm, and moderate reliability for both AE and CE at 30 mm. Inter-rater reliability was moderate at 10 mm and good at 20 mm for both AE and CE, with equally moderate reliability levels at 30 mm.

Conclusions: The 20 mm target distance demonstrated good intraand inter-rater reliability, warranting its evaluation in patients with TMDs in the subsequent investigation phase.

Background: Rapid maxillary expansion (RME) is a common treatment for maxillofacial skeletal abnormalities. Numerous studies have explored the impact of RME on skeletal, dental and nasal structures.

Objectives: The aim of the study was to evaluate the effects of RME on the three-dimensional (3D) Eustachian tube (ET) and auditory tube morphologies of adolescents using cone-beam computed tomography (CBCT).

Material and methods: A total of 97 patients (59 females and 38 males; age: 13.27 ±2.10 years) with maxillary transversal deficiencies who had undergone orthodontic RME were enrolled in the study. The treatment concluded when a cusp-to-cusp relationship was achieved between the palatal cusp of the maxillary first molar and the buccal cusp of the mandibular first molar. Cone-beam computed tomography was performed before maxillary expansion (T0) and after expansion (T1). The measurement of 2 linear and 4 angular, 3D, right and left ET parameters, as well as the ET and auditory tube angles, was conducted. The paired t-test was used to compare the data.

Results: There was no significant difference between T0 and T1 in any angular or linear ET parameters or the left auditory tube angle (p > 0.05). The T0 right auditory tube angle was significantly greater than the T1 angle (p < 0.05). Rapid maxillary expansion did not modify the 3D ET parameters; only the right auditory tube angulation improved after expansion.

Conclusions: Compared to conventional radiography, CBCT provides better morphological, angular and linear data regarding the ET and auditory structures. No significant differences were observed in linear or angular ET parameters based on the status of maxillary expansion treatment. The right auditory tube angle differed significantly between T0 and T1.

Background: Periodontal diseases are chronic inflammatory diseases related to many hereditary, environmental, physical, and psychological factors.

Objectives: The aim of the present study was to determine the demographic data, periodontal status and systemic conditions of patients who reported to the Department of Oral and Maxillofacial Radiology, and to evaluate the relationship between the periodontal status and the associated risk factors.

Material and methods: The study included a total of 2,000 patients (974 males and 1,026 females). The anamnesis data on the patients' systemic diseases/conditions and periodontal diagnoses were analyzed statistically.

Results: Upon evaluating the clinical and radiological examination data, the findings were as follows: 9.20% of patients had clinically healthy gingiva; 15.20% had gingivitis on an intact periodontium; 22.75% had gingivitis on a reduced periodontium (in total, 37.95% had gingivitis); 47.20% had mild to moderate periodontitis (stages I and II, grades A and B); and 3.45% had severe periodontitis (stages III and IV, grades B and C) (in total, 50.65% had periodontitis). Additionally, 2.20% of patients were diagnosed with necrotizing periodontal diseases (NPD). Gingival health was significantly poorer in patients with hypertension, diabetes, gastrointestinal system diseases (GID), cardiovascular system diseases (CVD), gynecological disorders, psychiatric disorders, hypothyroidism, rheumatological diseases, osteoporosis, chronic respiratory diseases/asthma, anemia, a history of cancer, and dermatological problems (p < 0.001).

Conclusions: Periodontitis is a significant public health concern among the Turkish population, with high incidence rates of mild to moderate periodontitis attributed to risk factors such as age, smoking and various systemic diseases.

Background: Obstructive sleep apnea (OSA) is associated with an increased likelihood of health issues, such as hypertension, cardiovascular disease and stroke. Screening is typically performed through selfreport questionnaires related to OSA symptoms.

Objectives: The present study aimed to evaluate sex differences in the commonly used questionnaires for the evaluation of OSA symptoms in order to determine whether different OSA screening tools should be considered in males and females.

Material and methods: The data was collected from the general population (N = 622, 66% female) through an online cross-sectional survey. The survey incorporated the STOP-Bang Questionnaire, the Epworth Sleepiness Scale (ESS), the Patient Health Questionnaire-4 (PHQ-4), the Fatigue Assessment Scale (FAS), and sleep bruxism (SB) questionnaires.

Results: Female subjects exhibited elevated levels of anxiety and fatigue (p < 0.001 for both) and the potential presence of SB (p < 0.005). The logistic regression analysis revealed that the odds of moderate to severe OSA increased by 5-8% for age and sleepiness, were higher for subjects exhibiting SB (an increase of 82%), and were particularly high for males (male sex increased the odds of moderate to severe OSA by over 5 times). Despite higher fatigue scores among females, the effect of fatigue on the probability of moderate to severe OSA in females was non-significant. While male subjects demonstrated lower fatigue scores, these levels were significantly associated with the risk of moderate to severe OSA. Daytime sleepiness did not influence the OSA risk for either sex.

Conclusions: The impact of reported fatigue on the prevalence of OSA is substantial among males but non-significant among females. The efficacy of daytime sleepiness scales in evaluating OSA is poor. The fatigue scale may be more effective in the screening of OSA, at least in males. Limitations of the study include potential response bias due to participant anonymity and the use of the STOP-Bang Questionnaire instead of polysomnography, the gold standard for OSA diagnosis.

Background: Periodontitis and peri-implantitis are chronic inflammatory diseases that lead to progressive connective tissue degradation and alveolar bone resorption. The presence of characteristic periodontitisassociated fibroblasts (PAFs) that display a remarkably high capacity for extracellular matrix (ECM) degradation was previously reported in periodontitis lesions.

Objectives: The aim of the study was to analyze collagen gel degradation in an experimental cell culture model using fibroblasts isolated from peri-implantitis lesions.

Material and methods: A patient-derived experimental cell culture model of periodontitis was developed. Gingival tissues were obtained during peri-implant, periodontal, and tooth extraction surgeries. Fibroblasts isolated from tissues affected by peri-implantitis, mixed in a three-dimensional (3D) collagen gel, were co-cultured with gingival epithelial cells. The degree of collagen gel degradation was analyzed using gel contraction, and a histologic examination was performed.

Results: In 5 examined cases, gel contraction was observed in the 3D co-culture model to considerably different degrees, which may demonstrate the presence of peri-implantitis-associated fibroblasts (PIAFs) that display a high capacity for collagen degradation. Histologically, the collagen gels with PIAFs showed numerous vacuoles adjacent to the cells when compared to gels with normal fibroblasts. The PIAFs from one case showed a rapid and significantly elevated level of collagen gel degradation in comparison to the PIAFs from the other cases.

Conclusions: The study revealed the presence of PIAFs among the fibroblasts isolated from peri-implantitis lesions, displaying a capacity for collagen degradation. Further detailed studies are required to clarify the characteristics of PIAFs as well as their role in the occurrence and progression of peri-implantitis.

Background: Children with Down syndrome (DS) frequently experience nutritional issues. Some of them are attributed to gastrointestinal tract abnormalities, while others are due to feeding behaviors. Previous studies have reported inconclusive results regarding the prevalence of dental caries among individuals with DS.

Objectives: The study aimed to assess the nutritional status, prevalence of dental caries and oral hygiene level among children and adolescents with DS aged 8-15 years in comparison to healthy peers.

Material and methods: A case-control observational study was carried out in Damascus, Syria, and its surrounding countryside. The study included 135 participants between the ages of 8 and 15 years who were divided into 2 groups based on the presence of DS. The data was processed using the IBM SPSS Statistics for Windows software, v. 26. The Kruskal-Wallis H test, Mann-Whitney U test and χ2 test, as well as Spearman's correlation were implemented.

Results: Almost half of the participants in the DS group were classified as overweight or obese (33.9% and 19.1%, respectively), while the percentages of overweight and obese children in the control group were 14.9% and 10.4%, respectively. No statistically significant results were noted between oral hygiene levels and the prevalence of dental caries among the study groups (p > 0.05). Only 50% of parents thought that their children needed help during daily oral hygiene practices; however, only 39.4% of parents actually provided such assistance.

Conclusions: Children and adolescents with DS exhibited a tendency toward shorter stature in comparison to their peers. In the DS group, the economic status and paternal education level exhibited an inverse correlation with body mass index (BMI)-for-age. Oral hygiene practices and dietary habits are the most influential factors in the development of dental caries. The DS group followed an unhealthy dietary pattern, characterized by elevated levels of sugar consumption. There is an urgent need for effective promotion programs within the educational plans of schools and centers of special needs. These programs must educate parents and caregivers about effective oral hygiene practices and make them aware of their children's need for help during the oral hygiene process.

Background: The mechanical reliability of occlusal splints and their long-term behavior are significant factors determining the clinical outcome of temporomandibular disorder (TMD) therapy. However, improvements are still needed in this area.

Objectives: This in vitro study aimed to (1) compare the hardness and flexural properties of materials manufactured using 3 techniques for occlusal splint fabrication (conventional heat curing, thermoforming followed by light curing, and three-dimensional (3D) printing) and (2) analyze the effect of artificial aging on the properties of the materials.

Material and methods: A total of 120 disc-shaped specimens were manufactured for the Shore D hardness evaluation, and 120 bar-shaped specimens were fabricated for the flexural properties evaluation (n = 15 for each group). Each material was tested in 2 groups of specimens, non-aged and artificially aged (stored for 90 days in water at 37°C). Statistical differences were assessed using one-way or two-way parametric analysis of variance (ANOVA) with Tukey's or Šídák's post-hoc test, or the non-parametric KruskalWallis test with Dunn's post-hoc test. A p-value of less than 0.05 was considered statistically significant.

Results: The mechanical properties of the materials varied significantly. Among the non-aged materials, the 3D-printed resin exhibited the highest Shore D hardness (85.3D), but it decreased significantly after 90 days of water storage (80.4D, p < 0.0001). The unpolished heat curing acrylic showed the highest resistance to artificial aging (p = 0.0436). However, its hardness decreased significantly after polishing (81.0D vs. 83.4D, p = 0.0015). The conventional heat curing material also exhibited superior flexural properties (σ = 89.63 MPa, E = 2616 MPa). All tested materials were susceptible to deterioration due to aging.

Conclusions: The conventional method of occlusal splint fabrication remains the optimal choice, particularly for long-term use. However, it is still necessary to develop materials that are resistant to aging in order to ensure successful clinical performance.

Botulinum toxin (BTX) demonstrates potential as a complementary therapy in managing chronic orofacial pain (OFP), but challenges in the standardization of protocols and indications remain.

Background: Most dental implants are made of titanium (Ti) or, more recently, ceramic. Both of these materials are safe and biocompatible. Maintaining healthy bone around the dental implant platform is a key component of any modern implant therapy. Understanding the impact of various external factors on marginal bone preservation is essential for accurate diagnosis before any planned procedure.

Objectives: The aim of the present study was to assess the preservation of the alveolar bone near the implant platform with regard to varying parameters of gingival thickness over the implant site and different serum vitamin D3 levels.

Material and methods: The study analyzed the records of 72 patients who had a total of 115 dental implants inserted with the simultaneous preoperative determination of vitamin D3 levels and the soft tissue thickness between January 2022 and February 2023 at a private medical facility.

Results: Patients with vitamin D deficiency showed significantly higher levels of bone loss around implants as compared to those with normal vitamin D levels. Moreover, the thickness of the gingival tissue over the implant site had a significant effect on the preservation of the alveolar bone around the implant platform, regardless of the vitamin D3 status.

Conclusions: Monitoring the concentration of 25-hydroxycholecalciferol (25(OH)D), along with the radiological assessment of the gingival tissue thickness, may be a simple and reliable method to achieve predictable outcomes in dental implantology.

Background: Sleep-disordered breathing (SDB) is a group of disorders that can affect the upper airway by increasing the chances of collapsibility during sleep.

Objectives: The primary objective of the present study was to estimate the prevalence of pediatric SDB in the orthodontic population using the Pediatric Sleep Questionnaire (PSQ). The secondary objective was to assess the factors associated with pediatric SDB in the orthodontic population.

Material and methods: A cross-sectional study was conducted on a sample of 60 children aged 7-12 years who attended the orthodontic clinics at Aga Khan University Hospital, Karachi, Pakistan. The parents/guardians of the patients were asked to complete a validated PSQ and an additional health history questionnaire regarding the factors associated with SDB. The risk of SDB was reported for the pediatric orthodontic population. Logistic regression analysis was applied to assess the factors associated with SDB in the pediatric orthodontic population.

Results: A score suggestive of a high risk for SDB (≥33%) was found in 12 (20%) out of 60 patients. Patients with a history of allergies were 3.96 times more likely to have SDB (p = 0.049). In comparison with female patients, male patients had a higher susceptibility to SDB.

Conclusions: The prevalence of SDB was found to be 20% in the pediatric orthodontic population. The frequency of allergies was higher among the patients in the high-risk SDB group. Orthodontic practitioners are advised to incorporate routine SDB screening into their clinical practice, as there could be a specific subgroup of SDB patients that may go undetected in general pediatric clinics.