[Spontaneous pneumomediastinum (Hamman's syndrome) with pneumorrhachis as a rare cause of acute chest pain in a young patient with acute asthma exacerbation]. / Spontanes Pneumomediastinum (Hamman-Syndrom) mit Pneumorrhachis als seltene Ursache für akuten Thoraxschmerz bei einem jungen Patienten mit akut exazerbiertem Asthma bronchiale.

Pneumomediastinum, defined as abnormal presence of air in the mediastinum, is a rare cause of acute chest pain. The condition may occur spontaneously as well as a secondary consequence of trauma or medical interventions. The spontaneous pneumomediastinum (Hamman's syndrome) is associated with a good prognosis, even without intervention. However, undelying severe conditions such as gastrointestinal perforations should be excluded. Diagnosis might be made using conventionell chest x-ray; a CT scan may give additional useful information. A subcutanous emphysema is a common finding in patients with pneumomediastinum. The presence of air in the epidural space of the spinal canal (pneumorrhachis) is a rarely seen but likewise mostly benign complication. We report a case of a young man with Hamman's syndrome and pneumorrhachis, provoked by acute asthma exacerbation; despite pronounced symptoms, his condition could be treated conservatively.

Propolis and Diet Rich in Polyphenols as Cariostatic Agents Reducing Accumulation of Dental Plaque.

Conducted studies indicate the relationship between oral health and systemic diseases. Moreover, the latest research indicated that cariogenic bacteria may severely influence the course of SARS-CoV-2 infection and increase risk of COVID-19 complications. This article aims to review various applications of propolis and pay attention to a healthy diet rich in polyphenols, which may allow the reduction of dental plaque accumulation. A literature review has been conducted from June until November 2021. It showed that propolis could be a useful agent in decreasing the accumulation of dental plaque. Moreover, a diet rich in polyphenols prevents cariogenic bacteria and reduces the accumulation of dental plaque. A reduction of a dental plaque may influence the risk of a severe course of COVID-19. Therefore, propolis and a diet rich in polyphenols may play an important role in prophylaxis of systemic diseases. Recently, it has been proven that oral infection may affect cardiovascular system, musculoskeletal system, respiratory system, nervous system, as well as may be a risk factor for diabetes mellitus. These aspects should stimulate clinicians to further research about polyphenols.

New Method for Analysis of the Temporomandibular Joint Using Cone Beam Computed Tomography.

Modern dentistry commonly uses a variety of imaging methods to support diagnosis and treatment. Among them, cone beam computed tomography (CBCT) is particularly useful in presenting head structures, such as the temporomandibular joint (TMJ). The determination of the morphology of the joint is an important part of the diagnosis as well as the monitoring of the treatment results. It can be accomplished by measurement of the TMJ gap width at three selected places, taken at a specific cross-section. This study presents a new approach to these measurements. First, the CBCT images are denoised using curvilinear methods, and the volume of interest is determined. Then, the orientation of the vertical cross-section plane is computed based on segmented axial sections of the TMJ head. Finally, the cross-section plane is used to determine the standardized locations, at which the width of the gap between condyle and fossa is measured. The elaborated method was tested on selected TMJ CBCT scans with satisfactory results. The proposed solution lays the basis for the development of an autonomous method of TMJ index identification.

The Influence of Propolis on Dental Plaque Reduction and the Correlation between Dental Plaque and Severity of COVID-19 Complications-A Literature Review.

Current studies suggest that cariogenic bacteria in dental plaque influence the severity of COVID-19 complications since the oral cavity is a reservoir for respiratory pathogens potentially responsible for the development of hospital-acquired pneumonia. This article focuses on the association between dental plaque and COVID-19 concerning the influence of altered oral biofilm on the risk of increased severity of SARS-CoV-2 infection. Moreover, it concentrates on the usefulness of propolis, with its apitherapeutic antibacterial properties, for treating oral bacterial infections co-occurring with SARS-CoV-2 infection. A review of the literature on PubMed, Cochrane Library and Medline between 2000 and 2021 revealed 56 published articles indicating that a link between dental plaque and COVID-19 complications was probable. Furthermore, they indicated that propolis may minimize COVID-19 severity by reducing dental plaque accumulation. The possibility that improved oral health could reduce the risk of COVID-19 complications should be of interest to scientists.

Functional impact of pulmonary hypertension due to hypoventilation and changes under noninvasive ventilation.

We aimed to characterise the association of pulmonary hypertension due to hypoventilation and exercise capacity, and the haemodynamic and functional changes under noninvasive ventilation. A retrospective analysis was carried out to assess haemodynamics and functional capacity in 18 patients with daytime pulmonary hypertension, due to hypoventilation, at baseline and after 3 months of noninvasive ventilation. Patients presented with a mean±SD pulmonary artery pressure of 49±13 mmHg, preserved cardiac index (3.2±0.66 L·min(-1)·m(-2)), 6-min walking distance of 303±134 m and severely elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Mean pulmonary artery pressure correlated negatively with maximum work rate (R= -0.72; p=0.03) and 6-min walking distance (R= -0.62; p=0.01). Following noninvasive ventilation we found a significant reduction of mean pulmonary artery pressure (-18 mmHg; p<0.001) and NT-proBNP levels (-2110 pg·mL(-1); p=0.001), and improvement in the 6-min walking distance (+66 m; p=0.008) and maximum work rate (+18 W; p=0.028). Changes in work rate correlated inversely with pulmonary artery pressure (R= -0.75; p=0.031). In this specific cohort with hypoventilation and severe pulmonary hypertension, pulmonary hypertension was associated with reduced exercise capacity. Following noninvasive ventilation, haemodynamics and exercise capacity improved significantly.

Influence of Method of Treatment of Mandibular Condylar Fractures on Range of Articular Path Measured by Cadiax Device.

Background/Objectives: The aim of this study was to evaluate the function of the treated temporomandibular joint based on the analysis of the image of the articular path using the Cadiax device depending on the choice of treatment method for unilateral condylar fracture of the mandible. Methods: Sixty patients who were treated for condylar fractures of the mandible at the Maxil-lofacial Surgery Department in Katowice were qualified for the analysis of the range of movements of the mandibular heads using the Cadiax device. From the group of patients who suffered fractures of the mandible, including condylar processes, patients were finally qualified for the measurement of the articular path of the injured and healthy joint according to strict criteria. Results: The condylar examination was performed in 20 patients who had conservative condylar fracture treatment and 40 patients who underwent various surgeries in the course of a single condylar fracture. The control group consisted of 20 patients whose mean values for the articular pathway measured for both sides were 12.73 and 12.69 and fell within the standard developed for healthy joints tested with the Cadiax device. Conclusions: We have achieved an almost ideal treatment for condylar fractures. We are also beginning to notice the need for rehabilitation of patients after this type of surgery.

Cannabidiol Intervention for Muscular Tension, Pain, and Sleep Bruxism Intensity-A Randomized, Double-Blind Clinical Trial.

Background: Temporomandibular disorders (TMDs) are the most prevalent non-dental pain issues in the maxillofacial region. Despite advancements, diagnosing and managing TMDs continues to pose challenges. This study aimed to assess the efficacy of cannabidiol (CBD) formulations, with different concentrations, in patients experiencing sleep bruxism and muscle-related TMDs, with a particular emphasis on their myorelaxant, pain-relieving, and bruxism-reducing properties. Methods: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs) was utilized as the diagnostic framework. Sixty patients completed the study, which followed a parallel-group, three-arm, randomized, double-blind clinical trial design, with a 1:1:1 allocation ratio across three groups: 1a, 1b, and 2. Groups 1a and 1b received CBD formulations at concentrations of 10% and 5%, respectively, while Group 2 received a placebo formulation. The trial consisted of four main visits, namely screening, baseline, first follow-up after 14 days, and second follow-up after 30 days, during which surface electromyography (sEMG), the visual analogue scale (VAS) for pain assessment, and Bruxoff examinations were conducted. Results: The reduction in pain, as measured by the visual analogue scale (VAS), among patients using the 10% CBD formulation was 57.4% (p < 0.05), accompanied by a decrease in sEMG activity by 42.1% (p < 0.05). Conversely, individuals using the 5% CBD formulation experienced a 40.8% (p < 0.05) decrease in pain. Regarding the decrease in the sleep bruxism index, users of the 10% CBD formulation saw the highest reduction of 51% (p < 0.05). These findings underscore the efficacy of the proposed treatment in both experimental groups, with a notable advantage observed in Group 1a. Conversely, the outcomes of the selected variables for the control group did not exhibit significant differences throughout the study. Conclusions: The intraoral use of CBD formulations in patients with TMDs have proven to be a successful treatment for reducing pain, muscle tension, and bruxing activity in individuals with sleep bruxism and muscle-related TMDs. Specifically, a concentration of 10% CBD has demonstrated superior results compared to 5% CBD.

Molecular detection of Campylobacter jejuni as a cause of culture-negative spondylodiscitis.

Spondylodiscitis caused by Campylobacter species is a rare disease which is most often caused by Campylobacter fetus. We report a case of culture-negative spondylodiscitis and a psoas abscess due to Campylobacter jejuni in a 68-year-old woman, as revealed by 16S rRNA gene and Campylobacter-specific PCRs from biopsied tissue.

Sleep Bruxism in Children: Etiology, Diagnosis, and Treatment-A Literature Review.

(1) Background: Bruxism, a condition characterized by grinding and involuntary clenching of the teeth, is a risk factor for the development of masticatory dysfunction. It can occur together with sleep disturbances and may be associated with abnormal body movements, breathing difficulties, increased muscle activity, and heart rate disturbances. This disorder is becoming an important dental concern in children. (2) Methods: A literature review was carried out based on a search in PubMed and Google Scholar databases for articles on bruxism in children, published between 2014 and 2021. The etiology, diagnosis, and treatment of bruxism in children were of particular interest in the study. (3) Results: A total of 40 articles were included in the review. The analyzed studies indicated that the prevalence rates of bruxism in children vary widely from 13% to 49%. The etiology of bruxism is complex and incomprehensible, and the main diagnostic criteria for this condition in children are subjective observation, clinical history, and clinical examination. The recommended therapy for sleep bruxism in children is physiotherapy and psychotherapy. (4) Conclusions: Dentists and primary care physicians should correctly diagnose bruxism in children, educate parents, prevent potential consequences for oral health, and identify possible comorbidities. Appropriate clinical guidelines for the treatment and prophylaxis of bruxism in children should also be developed.

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials.

BACKGROUND: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction. METHODS: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis. RESULTS: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle. CONCLUSIONS: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.

Platelet-Rich Plasma Intramuscular Injections - Antinociceptive Therapy in Myofascial Pain Within Masseter Muscles in Temporomandibular Disorders Patients: A Pilot Study.

Background and Objective: The objective of this study was to explore the nociceptive effect of platelet-rich plasma (PRP) intramuscular injections in myofascial pain of masseter muscles in patients with TMD. Methods: Patients diagnosed with myofascial pain were assessed for eligibility for the study. Masticatory muscle disorder was diagnosed based on the Research Diagnostic Criteria for Temporomandibular Disorders (Ia and Ib). A total of 80 patients were enrolled in the study; 58 of them (21 male and 37 female, 29.4 ± 6.53 years old) met the inclusion criteria and were randomized to one of the two groups: Group I (n = 29) and Group II (n = 29). The first group received injections with PRP and the second group received injections with isotonic saline as the control group (0.9% NaCl). The Visual Analog Scale (VAS) was used to determine the pain intensity changes during follow-up visits in each group. Results: A significant improvement in pain intensity in VAS scale was observed, with 58% reduction in the experimental group and 10.38% in the control placebo group, 5 days after the injections (Day 5). The pain intensity reduction (VAS) 14 days after the injections (Day 14) in experimental group was 47.16 and 4.62% in control group, according to the baseline values (Day 0). Conclusions: Intramuscular injection of PRP was a successful method for reducing myofascial pain within masseter muscles in temporomandibular disorders patients. However, the use of PRP for the treatment of myofascial pain within masticatory muscles requires further, clinical trials evaluation. Clinical Trial Registration: Bioethical Commission at the Silesian Medical Chamber in Katowice, Poland 44/2017 as well as at ClinicalTrials.gov NCT03323567 (December 13, 2017).

Myorelaxant Effect of Transdermal Cannabidiol Application in Patients with TMD: A Randomized, Double-Blind Trial.

(1) Background: The healing properties of cannabidiol (CBD) have been known for centuries. In this study, we aimed to evaluate the efficiency of the myorelaxant effect of CBD after the transdermal application in patients with myofascial pain. (2) Methods: The Polish version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Ia and Ib) was used. A total of 60 patients were enrolled in the study and were randomly divided into two groups: Group1 and Group2. The average age in Group1 was 23.2 years (SD) = 1.6 years) and in Group2, it was 22.6 years (SD = 1.86). This was a parallel and double-blind trial. Group1 received CBD formulation, whereas Group2 received placebo formulation for topical use. The masseter muscle activity was measured on days 0 and 14, with surface electromyography (sEMG) (Neurobit Optima 4, Neurobit System, Gdynia, Poland). Pain intensity in VAS (Visual Analogue Scale) was measured on days 0 and 14. (3) Results: in Group1, the sEMG masseter activity significantly decreased (11% in the right and 12.6% in the left masseter muscles). In Group2, the sEMG masseter activity was recorded as 0.23% in the right and 3.3% in the left masseter muscles. Pain intensity in VAS scale was significantly decreased in Group1: 70.2% compared to Group2: 9.81% reduction. Patients were asked to apply formulation twice a day for a period of 14 days. (4) Conclusion: The application of CBD formulation over masseter muscle reduced the activity of masseter muscles and improved the condition of masticatory muscles in patients with myofascial pain.

Functional Assessment of the Stomatognathic System, after the Treatment of Edentulous Patients, with Different Methods of Establishing the Centric Relation.

The study compares subjective experiences of patients, wearing complete dentures. Two different methods of determining a centric relation were performed: the traditional method using wax occlusal rims and the Gerber method, based on gothic arch tracings. The success rate of establishing a centric relation in both methods was evaluated (rentgenodiagnostics). The influence of the method used to obtain the centric relation on patients' stomatognathic system (condyle centralization, pain) was also evaluated. Better results were achieved in gothic arch tracing method. Before every prosthetic treatment of edentulous patients, a functional analysis of the TMJ is necessary. The lack of centric relation, in a long term adaptation patients, does not lead to TMD symptoms. This trial is registered with NCT03343015.

[Venopunction of the cubital vein as an alternative approach for CGRP plasma level evaluation in tmd patients]. / Venopunkcja zyly odlokciowej jako alternatywne podejscie dla oceny stezenia CGRP w osoczu krwi u pacjentów z dysfunkcja ukladu ruchowego narzadu zucia.

INTRODUCTION: Calcitonin gene-related peptide is an important vasodilator. It plays an important role in the metabolism of chewing muscles. The aim of the study was to evaluate the plasma level of CGRP in patients with myofascial pain (RDC/TMD Ia) and myofascial pain with limited opening (RDC/TMD Ib) before and after occlusal splint therapy (Michigan splint). MATERIAL AND METHODS: A randomised trial was performed including 39 patients (males = 3, females = 36). Blood samples were taken from the external jugular vein (JUG) and cubital vein (CUB) before and after 30 days of occlusal splint therapy. Plasma levels of CGRP were measured with ELISA KIT for Human Calcitonin Gene Related Peptide (CGRP) 96T (USCNK Business Co. Ltd.). RESULTS: The results of the study show that the plasma CGRP level was higher in the external jugular vein (JUG1 = 5.07pg/mL [SD = 1.99]) than in cubital vein (CUB1 = 4.3 pg/mL [SD = 1.6]). After 30 days of the occlusal splint therapy the levels in both veins increased: JUG2 = 6.07 pg/mL (SD = 2.19), and CUB2 = 4.9 pg/mL (SD = 1.4). The CGRP plasma level increase was statistically significant only in the external jugular vein (JUG) (p < 0.05). Statistically significant pain intensity reduction was observed: VAS1 = 5.4 (SD = 2.08) decreased to VAS2 = 1.7 (SD = 2.07) after splint therapy (p < 0.05). CONCLUSIONS: Venepuncture of an external jugular vein is more precise, than venepuncture of a cubital vein in evaluating CGRP plasma level changes in patients with TMD.

Oral Health of Patients Treated with Acrylic Partial Dentures Using a Toothpaste Containing Bee Product.

This study was carried out to investigate the influence of a propolis and tee tree oil-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Thirty-seven patients who underwent oral rehabilitation with a removable acrylic denture were selected and randomly assigned into two groups: study group (A) which received a newly formulated propolis and tee tree oil-containing toothpaste or a control group (C) without an active ingredient. API, S-OHI, and mSBI were assessed in three subsequent stages. During each examination swabs were employed for microbiological inoculation: in the study group after 4 weeks use of the active toothpaste showed a decrease in the number of isolated microorganisms. In the control group, after 4 weeks use of the toothpaste without active ingredients resulted in increase in the number of the isolated microorganisms. Improvements in hygiene and the condition of periodontium were observed in patients using active toothpastes. In the study group the oral flora diversity was reduced by the decrease in the number of cultured microorganism species, while in the control group an increase in the number of cultured microorganisms and their species was observed.

Effects of Brazilian Propolis on Dental Plaque and Gingiva in Patients with Oral Cleft Malformation Treated with Multibracket and Removable Appliances: A Comparative Study.

Orthodontic appliances modify the local environment of the oral cavity, increase the accumulation of dental plaque, and affect the condition of the gingiva. The aim of this study is assessment of Brazilian propolis toothpaste's effect on plaque index (PLI) and gingival index (GI) in patients with CL/CLP treated using orthodontic appliances in the 35-day study period. The study population included 96 patients of an Orthodontic Outpatient Clinic, ACSiMS in Bytom. All the patients participated in the active phase of orthodontic treatment using buccal multibracket appliances or removable appliances. During the first examination, each patient was randomly qualified to the propolis group or control group. A statistically significant decrease in GI and PLI in the entire propolis group (P < 0.01) was shown during repeated examination. Insignificant change in GI was in the entire control group during the repeated examination compared to the baseline. Similar result was obtained in patients treated with multibracket and removable appliances. The orthodontic appliance type did not affect the final dental plaque amount and gingival condition in patients using the propolis toothpaste. These results may be clinically useful to improve prevention and control oral infectious diseases during orthodontic treatment patients with oral cleft.

The Influence of Ethanolic Extract of Brazilian Green Propolis Gel on Hygiene and Oral Microbiota in Patients after Mandible Fractures.

Maintenance of proper oral hygiene by dental plaque elimination is one of the most important factors affecting the healing process in postoperative oral wounds. Propolis is a substance produced by bees. Ethanolic extract of propolis has bactericidal, fungicidal, anti-inflammatory, and antioxidative properties. Moreover, it can scavenge free radicals. The purpose of this paper is to demonstrate the efficacy of a gel containing 3% of ethanolic extract of Brazilian green propolis (EEP-B) when used for maintaining oral hygiene in patients with postoperative oral mucosal wounds. The hygiene was assessed using API, OHI, and SBI followed by microbiological examinations. The patients were divided into two groups. Group 1 consisted of those who used a gel containing EEP-B for oral hygiene, and group 2 consisted of those who used a gel without EEP-B. Although improved oral hygiene was noted in both groups, the improvement was markedly greater in the group using gel containing EEP-B. Summing up the results of microbiological examinations, EEP-B has beneficial effect on mouth microflora in postoperative period. Propolis preparations used for oral hygiene allow eliminating microorganisms of pathogenic character and physiological flora microorganisms considered as being opportunistic, with no harmful influence on physiological microflora in oral ecosystem.

CGRP plasma level changes in patients with temporomandibular disorders treated with occlusal splints - a randomised clinical trial.

INTRODUCTION: Occlusal splint therapy is a well-known method for the treatment of TMD. Muscle stretching and pain relief are effects of occlusal appliance. The aim of this study was to evaluate the plasma level of CGRP in patients with myofascial pain (RDC/TMD Ia) and myofascial pain with limited opening (RDC/TMD Ib) before and after muscle stretching with occlusal splint therapy. MATERIAL AND METHODS: A randomised trial was performed including 35 subjects (males = 10, females = 25) in the experimental group and 30 subjects (males = 9, females = 21) in the control group. Blood samples were taken from the external jugular vein before and after 30 days of occlusal splint therapy. Plasma levels of CGRP were measured with a Radio Immunoassay Kit (Phoenix Pharmaceuticals Inc.) and Cobra Series Auto-Gamma Counting System. RESULTS: The results of the study demonstrated that CGRP concentrations were significantly higher after occlusal splint than before splint therapy: CGRP2 = 17.02 pg/mL (SD = 5.85), CGRP1 = 13.78 pg/mL (SD = 5.12), in the experimental group (p < 0.05). In the control group, there were no statistically significant changes in CGRP levels: CGRP1 = 14.5 pg/mL (SD = 4.87) to CGRP2 = 13.5 pg/mL (SD = 4.63). In the experimental group, there was a statistically significant reduction in pain intensity, VAS1 = 5 (SD = 2.5) to VAS2 = 1 (SD = 1.04) after splint therapy (p < 0.05). In the control group, there were no statistically significant changes in pain intensity: VAS1 = 5 (SD = 2.3) to VAS2 = 4 (SD = 2.6), (p < 0.05). CONCLUSIONS: CGRP plays an important role in muscle blood flow, which is altered by changes in muscle length. Further investigation is needed to clarify the mechanism of muscle blood flow and the muscle healing process in patients with TMD.

Correlation between TMD and cervical spine pain and mobility: is the whole body balance TMJ related?

Temporomandibular dysfunction (TMD) is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM) and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD) and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P > 0.05), cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility.