Nederlands tijdschrift voor tandheelkunde最新文献

Chronic diffuse sclerosing osteomyelitis of the mandible is a relatively rare disease of unknown aetiology. Hyperactivity of the masticatory muscles has been suggested to be a contributing and/or causative factor for the syndrome, also known as chronic tendoperiostitis. A systematic review of the literature shows many treatment options with promising outcomes for conservative treatment and bisphosphonate treatment, and a low success rate for surgical treatment. Conservative treatment (occlusal splint therapy, physiotherapy and/or disease counselling) resulted in a reduction of complaints in 67% of patients; all patients showed improvement of their symptoms after bisphosphonate treatment. The only indication for surgery in chronic diffuse sclerosing osteomyelitis/tendoperiostitis of the mandible is remodelling surgery to treat complaints about facial asymmetry, caused by mandibular deformity. It is recommended to treat patients conservatively at first for at least 6-12 months. If symptoms do not improve sufficiently, supplementary bisphonate treatment can be initiated.

The use of fluoride-free toothpaste seems to be on the increase in recent years, despite the proven effectiveness of fluorides in preventing dental caries. Adults often choose fluoride-free toothpaste because they consider fluoride harmful or unnecessary, prefer organic or natural products, and avoid artificial additives. Oral healthcare providers generally recommend fluoride toothpaste due to its proven effectiveness but consider it important to approach patients with doubts or objections respectfully. By regularly asking about toothpaste use in a non-judgmental way, they are better able to address individual preferences. Exploring alternatives such as hydroxyapatite or adjusting fluoride levels can contribute to shared decision-making. Educational materials and a practical guide can support oral healthcare providers in their communication and advice regarding toothpaste.

Can adhesives still be safely used two years past their expiration date? In an experimental laboratory study, the bond strength of the etch-and-rinse adhesive OptiBond FL was measured two years after its expiration date. Microtensile bond strength testing was performed on 1 1 mm specimens of human enamel and dentin. Statistical analyses were conducted using an independent t-test or a Mann-Whitney U-test. Three specimens were excluded due to air bubbles and testing errors, while 20 dentin specimens in the expired adhesive group failed pretest (0 MPa). The enamel groups were analyzed and showed no significant difference in bond strength between the in-date and expired adhesives (p = 0.77). For dentin, a Mann-Whitney U-test revealed a significantly lower bond strength with the expired adhesive (p = less than 0,001). The conclusion of this study is that an expired etch-and-rinse adhesive may still be effective for enamel bonding, whereas bonding to dentin is significantly weakened.

At the full-term birth of a healthy girl, a swelling was observed in her mouth. Clinical examination revealed a firm, elastic swelling, pedunculated to the superior alveolar process. The swelling, larger than 2 centimeters, hindered mouth closure and prevented normal feeding. It did not interfere with breathing. An MRI scan ruled out vascular malformations, after which the pedicle was surgically removed under general anaesthesia. Histopathological examination showed a subepithelial mass consisting of cells with abundant granular cytoplasm, consistent with the diagnosis of congenital epulis. Congenital epulis is a rare benign tumour, occurring on the upper jaw of newborns. The condition has an incidence of 6 in 1,000,000 and predominantly occurs in girls. Its aetiology is unknown. If there are no feeding or breathing issues, one can await spontaneous regression.

The skin innervation of the head and neck area is largely provided by the trigeminal nerve and the cervical plexus. The separation between the two areas is approximately on the line crown-jaw-chin. The face is provided by the trigeminal nerve (nervus V), while the area below it up to the shoulders is provided by the cervical plexus. The innervation from the oral mucosa to the esophagus is provided by the trigeminal nerve, glossopharyngeus and vagus. This segmental distribution allows for a clear organization of the sensory input, which is clinically important in diagnosing disorders.

One in two people in the Netherlands will be diagnosed with cancer in their lifetime and this number is increasing. At the same time, cancer survival has increased. Oral care professionals are therefore seeing more and more people who are being or have been treated for cancer. Cancer treatment increases the risk of temporary and permanent adverse effects in the perioral area, such as hyposalivation, xerostomia, mucositis, infections, pain, medication-related osteonecrosis of the jaw, osteoradionecrosis and caries. In addition, myelosuppression can occur, causing patients (often temporarily) to experience neutropenia and thrombocytopenia and therefore to run an increased risk of infection and bleeding. Preventive oral care is very important to limit damage and can be provided in any situation. In the case of interventions creating a large wound and/or bone manipulation, the risk of infection, bleeding, osteoradionecrosis and medication-related osteonecrosis of the jaw must be assessed and an adjustment of the oral treatment plan may be necessary (possibly in consultation with the cancer treatment team).

The consumption of sports drinks has increased significantly in recent decades. These drinks are promoted for their ability to improve hydration, replenish electrolytes and provide energy during intense physical exertion. Sports drinks often have low pH and high buffering capacity in addition to high concentrations of sugars, which can be potentially detrimental to the dentition. A number of scientific studies have examined the relationship between sports drinks consumption and tooth wear. Given that erosive dental wear has multifactorial causes, sports drinks appear to be only one of the possible contributing factors.

Elite sportsmen and women often have a poorer oral health than their peers. This is probably due to changes in saliva composition. During periods of high intensity training saliva production is not decreased, but the resting concentrations of immunoglobulin A and several antimicrobial proteins are lower than in non-athletes. This might contribute to an increased risk for oral and airway infections. During exercise, the salivary protein concentration increases, among them mucins. This gives thick, sticky saliva and might contribute to a dry mouth feeling during exercise. Similar to blood, the lactate concentration in saliva increases during intensive exercise. Therefore, salivary lactate might be used as a non-invasive parameter to monitor training intensity, together with changes in saliva composition. These changes may also cause a higher frequency of oral health problems. Therefore, the oral health of elite athletes deserves special attention.

Although mouth guards are traditionally used to prevent oral injury in contact sports, recent studies suggest that they can also contribute to improved performance in terms of strength, aerobic and anaerobic performance, agility, balance and flexibility. This improved performance is thought to be achieved by changes in the position of the temporomandibular joint, increasing the vertical dimension of the occlusion and the occurrence of the concurrent activation potentiation phenomenon as a result of jaw clenching. Based on the available literature, it can be concluded that custom-made mouth guards result in better performance in sports than boil-and-bite or standard mouth guards. In general, they will not negatively affect sports performance. Although it is not readily possible to predict whether and to what extent wearing a mouthguard will have a positive effect on individual athletes, athletes and coaches should be encouraged to consider the use of mouthguards not only from the perspective of safety, but also from the perspective of their potential performance-enhancing value.

Field hockey is associated with an increased risk of orofacial and/or dental injury. One in five hockey players reports having suffered from such an injury. Despite the requirement to wear a mouthguard while playing field hockey, introduced in the Netherlands in 2015, the effect of this measure appears to be limited. Field hockey coaches ability to provide dental first aid in case of injury also wants improvement and additional training in the future. Lab studies show that mouthguards can break when subjected to forces lower than those occurring during field hockey. Saliva proteins are adsorbed by mouthguards, which may affect bacterial adhesion and can contribute to the development of oral health problems. Research on improving mouthguards and on the proper way to clean them therefore also seems necessary.