Effect of physiotherapeutic procedures on the bioelectric activity of the masseter muscle and the range of motion of the temporomandibular joints in the female population with chronic pain: a randomized controlled trial.

INTRODUCTION: Physical therapy (PT) methods applied in dentistry are increasingly discussed nowadays. Taking into account a rapidly growing number of temporomandibular disorders (TMDs) and orofacial pain patients, it is reasonable to determine which of the available physiotherapeutic (PT) methods are more effective than others, especially in terms of their possible analgesic and myorelaxant effects. OBJECTIVE: To assess manual and physical factors influencing pain reduction or elimination and increased muscle tension in patients with TMD; yet the influence of the applied forms of PT on the range of motion (ROM) of temporomandibular joints (TMJ). MATERIAL AND METHODS: A randomized, parallel-group, RCT, single-blind, equi-randomized (1:1) study was conducted in DC/TMD Group Ib patients (20-45 years of age). An experimental group (G1, n = 104) and a control group without TMD (G2, n = 104) were created according to CONSORT guidelines. Diagnostic measurements were performed in both groups (mass sEMG, temporomandibular joint range of motion-ROM, pain intensity - NRS). Group G1 was randomly divided (envelope method) into 4 therapeutic groups, in which therapy was carried out for 10 days: magnetostimulation (MS), magnetoledotherapy (MLE), magnetolaserotherapy (MLA), manual therapy (MT). Each time after the therapy, ROM and NRS measurements were performed, and after the 5th and 10th day sEMG. RESULTS: Statistically significant differences were found in the sEMG values of the masseter muscles, TMJ ROM and the pain intensity in G1 and G2 (p < 0.00). The largest decrease in sEMG (% MVC) of the masseter muscle occurred in the subgroup in which the manual therapy (MT) procedures were applied, p < 0.000. There was no clinically significant difference in and between other subgroups. There was a distinct mandible ROM increase noted in the MT group, with minimal changes in the MLA and MLE groups and no changes in the MS group. There was a clear increase in the lateral mobility of both right and left TMJ in the MT group. There were no differences in the course of the study in the MS group, and slight increases in the MLA and MLE groups. In the case of pain measurements, the greatest decrease in pain intensity was observed in the MT subgroup. CONCLUSIONS: According to our results manual therapy is an effective form of treatment in patients with pain, increased masticatory muscle tension and limitation in mandible ROM. Dental physiotherapy should become an integral part of multimodal TMD patients' treatment.

Does the Protrusion of Corticobasal Implants in the Maxillary Sinuses Affect Sinus Health? A Retrospective Study.

AIM: The aim of this retrospective study is to investigate the effect of corticobasal implant penetration in the nasal and maxillary sinuses on sinus health and implant survival rate in cases of severely atrophid ridges. MATERIALS AND METHODS: This retrospective study was conducted on thirty patients with 172 implants who underwent corticobasal implant treatment between 2014 and 2018. Implants were divided into two groups according to the penetration depths (Group A, <4 mm; Group B, 4 mm). Inclusion criteria for the study included: (A) patients with severe maxillary ridge resorption with an immediately loaded corticobasal implant-supported prosthesis that showed implant protrusion inside the maxillary sinus on cone-beam computed tomography (CBCT); and (B) patients with a preoperative and postoperative follow-up CBCT scan using the same standard technique and machine. (C) Patients without any history of sinusitis before implant insertion patients who fulfilled the inclusion criteria were recalled for follow-up. The presence of sinus complications was clinically assessed according to the clinical practice guidelines for adult sinusitis of the American Academy of Otolaryngology-Head and Neck Surgery and Radiologically using CBCT. Moreover, patient satisfaction was evaluated using yes-or-no questions. The result was statistically analyzed using Fisher's Exact test. RESULTS: Despite the differences in implant penetration depths, no clinical signs of sinusitis were evident in any patient. One patient presented with transient epistaxis after the surgery, and 2 patients with nine implants revealed nonsignificant thickening of the sinus membrane radiologically (p = 0.055). All implants showed optimum bone-implant contact with a 100% survival rate. A significant relationship was reported between the thickness of the membrane and the patient's gender, hypertension, and smoking habits. (p = 0.001*, p = 0.002*, and p = 0.034*, respectively). CONCLUSION: Penetration of corticobasal implants in the maxillary sinus did not compromise the health of the maxillary sinus or implant survival rate. CLINICAL SIGNIFICANCE: Limited posterior maxillary bony support and maxillary sinus pneumatization present challenges in implant dentistry and increase the possibility of implant protrusion inside the maxillary and nasal cavities. Hence, studying the effect of this protrusion on the maxillary sinuses' health and implant survival is highly significant.

An implant-supported prosthetic rehabilitation of a patient with a bilateral subtotal maxillectomy defect secondary to rhino-orbital-cerebral mucormycosis: A clinical report of a graftless approach.

This clinical report presents the rehabilitation of extensive hard and soft tissue defects caused by rhino-orbital-cerebral mucormycosis as a result of untreated diabetes mellitus. The patient underwent subtotal maxillectomy and was rehabilitated with an implant-supported maxillofacial prosthesis with zygomatic and pterygoid implants by following an immediate loading protocol.

Evaluation of biofilm formation on acrylic resins used to fabricate dental temporary restorations with the use of 3D printing technology.

BACKGROUND: Temporary implant-retained restorations are required to support function and esthetics of the masticatory system until the final restoration is completed and delivered. Acrylic resins are commonly used in prosthetic dentistry and lately they have been used in three-dimensional (3D) printing technology. Since this technology it is fairly new, the number of studies on their susceptibility to microbial adhesion is low. Restorations placed even for a short period of time may become the reservoir for microorganisms that may affect the peri-implant tissues and trigger inflammation endangering further procedures. The aim of the study was to test the biofilm formation on acrylamide resins used to fabricate temporary restorations in 3D printing technology and to assess if the post-processing impacts microbial adhesion. METHODS: Disk-shaped samples were manufactured using the 3D printing technique from three commercially available UV-curable resins consisting of acrylate and methacrylate oligomers with various time and inhibitors of polymerization (NextDent MFH bleach, NextDent 3D Plus, MazicD Temp). The tested samples were raw, polished and glazed. The ability to create biofilm by oral streptococci (S. mutans, S. sanguinis, S. oralis, S. mitis) was tested, as well as species with higher pathogenic potential: Staphylococcus aureus, Staphylococcus epidermidis and Candida albicans. The roughness of the materials was measured by an atomic force microscope. Biofilm formation was assessed after 72 h of incubation by crystal violet staining with absorbance measurement, quantification of viable microorganisms, and imaging with a scanning electron microscope (SEM). RESULTS: Each tested species formed the biofilm on the samples of all three resins. Post-production processing resulted in reduced roughness parameters and biofilm abundance. Polishing and glazing reduced roughness parameters significantly in the NextDent resin group, while glazing alone caused significant surface smoothing in Mazic Temp. A thin layer of microbial biofilm covered glazed resin surfaces with a small number of microorganisms for all tested strains except S. oralis and S. epidermidis, while raw and polished surfaces were covered with a dense biofilm, rich in microorganisms. CONCLUSIONS: UV-curing acrylic resins used for fabricating temporary restorations in the 3D technology are the interim solution, but are susceptible to adhesion and biofilm formation by oral streptococci, staphylococci and Candida. Post-processing and particularly glazing process significantly reduce bacterial biofilm formation and the risk of failure of final restoration.

Kinesio Taping as an alternative therapy for limited mandibular mobility with pain in female patients with temporomandibular disorders: A randomized controlled trial.

BACKGROUND: Kinesio Taping (KT) is a non-invasive therapy commonly used in physiotherapy (PT). However, the available data on its effectiveness in patients with symptomatic temporomandibular disorders (TMD) remains scarce and contradictory. OBJECTIVES: The aim of the study was to evaluate the analgesic and myorelaxant effects of KT in TMD patients with limited mandibular mobility. MATERIAL AND METHODS: A single-blind randomized controlled trial was conducted among female patients aged 20-45 years with Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) group Ib, using a parallel group design and equal randomization (1:1). All patients underwent surface electromyography (sEMG) of the masseter muscle (MAS), pain intensity was assessed using a Numeric Rating Scale (NRS), and temporomandibular joint mobility was measured before and after 6 and 12 days of treatment. The Perceived Stress Scale (PSS-10) questionnaire was administered on the first and last days of treatment. Statistical analysis was performed using analysis of variance (ANOVA). Mauchly's sphericity test determined changes over time and between groups for variables with a normal distribution. Bonferroni's correction was used for post hoc multiple comparisons. Variables with a non-normal distribution were analyzed using the nparLD package and multiple comparison post hoc test, while correlations were assessed using Spearman's coefficient. RESULTS: Each treatment had a significant effect on the bioelectrical sEMG parameters (p = 0.05). Kinesio Taping had a superior analgesic effect compared to the controls (p < 0.001). The combination of KT with therapeutic exercise (TE) proved to be a more effective therapy for improving the maximal mouth opening (MMO) and reducing perceived stress than monotherapy (p < 0.001). Minimally significant clinical differences were observed for sEMG, MMO and PSS-10 parameters after both therapies. CONCLUSIONS: Kinesio Taping combined with TE may be considered an effective complementary noninvasive treatment modality for TMD, either as a stand-alone or as part of the therapeutic process in patients experiencing pain and limited mandibular ROM. Additionally, the use of KT and TE was found to have a beneficial effect on perceived stress levels.

Temporomandibular joint and cervical spine disability assessment in people with hypermobility joint syndrome.

BACKGROUND: Temporomandibular disorders (TMDs) and cervical spine problems are a growing public health issue, as they increase the risk of disability in people with hypermobility joint syndrome (HJS). OBJECTIVES: The present study aimed to assess the prevalence of TMD symptoms, and cervical spine and TMJ disability in HJS patients. MATERIAL AND METHODS: A survey was conducted among physical therapy students (mean age: 21 years). The study comprised 2 stages. The 1st one was HJS assessment (the Beighton scale and the Brighton criteria). Based on the assessment, 56 HJS subjects were enrolled for the study. The control group (CG) consisted of 60 HJS-free subjects, according to the aforementioned criteria. The 2nd stage of the study involved conducting a self-administered questionnaire on the prevalence of TMD symptoms. Both the TMD disability questionnaire (TMD-Q) and the neck disability index (NDI) scores were recorded. Pain intensity was assessed using the numeric rating scale (NRS). RESULTS: The HJS group showed higher NRS scores (p < 0.001). Headache, neck and shoulder girdle pain, and temporomandibular joint (TMJ) pain were found to be more severe in almost each patient from the HJS group as compared to CG. Those individuals had a greater degree of disability on the TMD-Q and the NDI scales (p < 0.001). The HJS group showed significant positive correlations between the TMD-Q and NDI scores (p = 0.0035), and between the TMD-Q and TMJ symptom questionnaire scores (p = 0.0047). A significant positive correlation between the NDI and TMJ symptom questionnaire scores was found both in the HJS group (p < 0.001) and CG (p < 0.001). CONCLUSIONS: The HJS bearers tended to obtain higher TMJ and cervical spine disability scores, at the same time reporting increased headache, neck and shoulder girdle pain, and TMJ pain intensity. Therefore TMJs should be carefully examined for possible signs of dysfunction in HJS subjects prior to dental or prosthetic treatment. According to our data, TMJ and cervical spine disability assessment should be included as a routine practice in the case of HJS patients, who should remain under the long-term care of a multidisciplinary team of doctors and therapists.

Surface electromyography evaluation of selected manual and physical therapy interventions in women with temporomandibular joint pain and limited mobility. Randomized controlled trial (RCT).

Non-invasive approach is gaining an increasing recognition in the TMD patients management. It is therefore reasonable to conduct RCTs evaluating the effectiveness of both physical and manual physiotherapy interventions. The aim of this study was to evaluate the short-term efficacy of selected physiotherapeutic interventions and their effect on the bioelectrical function of the masseter muscle in patients with pain and limited TMJ mobility. The study was conducted on a group of 186 women (T) with the Ib disorder diagnosed in DC/TMD. The control group consisted of 104 women without diagnosed TMDs. Diagnostic procedures were performed in both groups. The G1 group was randomly divided into 7 therapeutic groups in which the therapy was carried out for 10 days: magnetostimulation (T1), magnetoledotherapy (T2), magnetolaserotherapy (T3), manual therapy- positional release and therapeutic exercises (T4), manual therapy - massage and therapeutic exercises (T5), manual therapy - PIR and therapeutic exercises (T6), self therapy - therapeutic exercises (T7). In the T4 and T5 groups, the treatments led to complete resolution of pain after the 10th day of therapy and to the largest minimal clinically significant difference in the MMO and LM parameter. GEE model for PC1 values using treatment method and time point showed that T4, T5 and T6 treatments had the strongest effect on the parameters studied. Therefore, it may be concluded that SEMG testing is a helpful indicator to assess the therapeutic effectiveness of physiotherapeutic interventions. BACKGROUND: Non-invasive approach is gaining an increasing recognition in the TMD patients management. It is therefore reasonable to conduct RCTs evaluating the effectiveness of both physical and manual physiotherapy interventions in a qualitative and quantitative manner. However, there were numerous controversies reported regarding the use of surface electromyography (SEMG) in Orofacial Pain patients. Therefore, we wanted to assess the effectiveness of physiotherapy interventions in TMD patients using SEMG. PURPOSE: Evaluation of the short-term efficacy of selected physiotherapeutic interventions and their effect on the bioelectrical function of the masseter muscle in patients with pain and limited TMJ mobility. MATERIAL AND METHODS: The study was conducted on a group of 186 women (T) with the Ib disorder diagnosed in DC/TMD (Ib - myofascial pain with restricted mobility). The control group consisted of 104 women without diagnosed TMDs (normal reference values for TMJ ROM and masseter muscle SEMG bioelectric activity). Diagnostic procedures were performed in both groups (SEMG of the masseter muscles at baseline and during exercise, measurement of TMJ mobility, assessment of pain intensity - NRS scale). The G1 group was randomly divided into 7 therapeutic groups in which the therapy was carried out for 10 days: magnetostimulation (T1), magnetoledotherapy (T2), magnetolaserotherapy (T3), manual therapy- positional release and therapeutic exercises (T4), manual therapy - massage and therapeutic exercises (T5), manual therapy - PIR and therapeutic exercises (T6), self-therapy - therapeutic exercises (T7). Each time after therapy, the intensity of pain and TMJ mobility were assessed. Sealed, opaque envelopes were used for randomization. After 5 and 10 days of therapy, bilateral SEMG signals of the masseter muscles were acquired. PC1 factor analysis was performed. A score of 99% in the PC1 parameter, demonstrates the clinical relevance of electromyography (MVC). RESULTS: Synergism of physical factors will lead to a higher MID on the NRS scale. Evaluating the MID of the therapeutic interventions used showed a better therapeutic effect of manual interventions over physical and self-therapy. In the T4 and T5 groups, the treatments led to complete resolution of pain after the 10th day of therapy and to the largest minimal clinically significant difference in the MMO and LM parameter. GEE model for PC1 values using treatment method and time point showed that T4, T5 and T6 treatments had the strongest effect on the parameters studied. CONCLUSIONS: 1. Exercise SEMG testing is a helpful indicator to assess the therapeutic effectiveness of physiotherapy interventions. 2. Manual therapy treatments are superior to physical treatments in their relaxation and analgesic efficacy and should therefore be prescribed as a first line non-invasive intervention for TMD pain patients.

Evaluation of the efficacy of manual soft tissue therapy and therapeutic exercises in patients with pain and limited mobility TMJ: a randomized control trial (RCT).

The limited number of randomized controlled trials (RCTs) comparing the efficacy of soft tissue manual therapy and self-therapy interventions prompted the authors to focus on the analgesic and myorelaxant use of massage, post-isometric muscle relaxation (PIR) and therapeutic exercise in TMD patients. OBJECTIVES: To evaluate the effectiveness of soft tissue therapy and therapeutic exercises in female patients with pain, increased masseter muscle tension and limited mandibular mobility. MATERIAL AND METHODS: The study was conducted on a group of 82 women (G1) with the Ib disorder diagnosed in DC/TMD (Ib-myofascial pain with restricted mobility). The control group (G2) consisted of 104 women without diagnosed TMDs (normal reference values for TMJ ROM and masseter muscle sEMG bioelectric activity). Diagnostic procedures were performed in both groups (sEMG of the masseter muscles at baseline and during exercise, measurement of TMJ mobility, assessment of pain intensity-NRS scale). The G1 group was randomly divided into 3 therapeutic groups in which the therapy was carried out for 10 days: therapeutic exercises (TE), manual therapy - massage and therapeutic exercises (MTM_TE), manual therapy - PIR and therapeutic exercises (MTPIR_TE). Each time after therapy, the intensity of pain and TMJ mobility were assessed. Sealed, opaque envelopes were used for randomization. After 5 and 10 days of therapy, bilateral sEMG signals of the masseter muscles were acquired. RESULTS: Massage, PIR and self-therapy led to a decrease in sEMG at rest as well as in exercise. After day 6 of therapy, the groups obtained a significant difference (p = 0.0001). Each of the proposed forms of therapy showed a minimal clinically significant difference (MID) in the sEMG parameter at the endpoint, with the most considerable difference in the MTM_TE group. The forms of MT used were effective in reducing the patients' pain intensity; however, a significant difference between therapies occurred after 4 treatments (p = 0.0001). Analyzing the MID between methods, it was observed that self-therapy had an analgesic effect only after 8 treatments, while PIR after 3 and massage after 1 treatment. After day 7, the mean pain score in the MTM_TE group was 0.889 and in the TMPIR_TE group was 3.44 on the NRS scale. In terms of MMO, a significant difference was obtained between monotherapy and each form of TM, i.e. massage (p = 0.0001) and PIR (p = 0.0001). Analyzing mandibular lateral movements, the authors got a significant difference in the proposed MT forms, of which massage treatments exceeded the effectiveness of PIR. CONCLUSIONS: Soft tissue manual therapy and therapeutic exercise are simple and safe interventions that can potentially benefit patients with myogenic TMDs, with massage showing better analgesic effects than PIR.

Is Chlorhexidine in Dentistry an Ally or a Foe? A Narrative Review.

Chlorhexidine has been one of the most effective and popular antiseptic substances used in medicine for decades. In dentistry, it has been used in endodontics, periodontology, surgery, and general dentistry. It is also widely used daily by patients in mouth rinses, gels, or toothpastes. Because of its multiple uses, we should follow all types of research reporting its potential adverse effects. This article aims to review the most up-to-date studies regarding chlorhexidine and its possible side effects, in the period of the SARS-CoV-2 pandemic, as the use of different antiseptic substances has rapidly increased.

Multiple pterygoid approach: A novel technique with single-piece implants.

The intended target site to engage a fixture distal into the tuberosity is the pterygoid apophysis that comprises the maxillary tuberosity, pyramidal process of the palatine bone, and the pterygoid process of the sphenoid bone. Pterygoid implants are incorrectly labeled in literature owing to the fact that they are actually root form conventional implants and should hence be termed as 'tubero-pterygoid implant'. An implant engaging the pterygoid apophysis/pillar taking distal maxillary support and avoiding successfully the cantilever situation is called a pterygoid implant. It essentially does not acquire primary with support of distal maxilla initially from the tuberosity. Instead, it makes its way into the apophysis and sometimes via a transsinus approach. A tubero-pterygoid implant, because of the root form screw shape fixture that is wide at the crestal aspect and converging toward the apex, takes the primary support from the tuberosity and engages the pterygoid pillar apically, thus allowing more bone to implant contact but has its limitation in deficient/atrophied tuberosity.

Zygomatic approach with single-piece implants: A technical note.

Single piece zygomatic implant, or a remote anchorage implant, is an effective tool for the rehabilitation of the atrophic/resected jaws with least postoperative complications such as screw loosening, screw fractures, bone loss, mucositis, and peri implantitis. The aim of this paper was to summarize a technique for the use of a zygomatic approach for single piece implants. We used the key-words 'single piece implants" and the search revealed 700 papers in the PubMed database. After screening through the abstracts, we selected 50 articles that we finally reviewed. Zygomatic fixtures avoid the grafting procedures and cantilever situation, restoration of atrophic or postablative jaws are completed with immediate loading. It is advisable placement of zygomatic implant flapless with surgical guide, but the author believes more on the tactile perception and when the splint is at mucosal or bone level, a small change in orientation will lead the dramatic error in desired angulation leading to unwanted complication.

Clinically Based Classification and Positioning Indication for Single-Piece Compressive Implants Placement in Regard to Extraction Socket.

(1) Background: Dental implantology has been rapidly developing over the last decades. The introduction of new materials, surface modifications and implant designs has brought the need to rethink and systematize our knowledge regarding dental implants. Thus, the aim of this paper is to introduce a new classification and implant positioning indications that can be used to maximize the survival rate and the aesthetic outcome of single-piece compressive screw implants. (2) Materials and methods: This classification was based on a multicenter clinical and radiological observation of 151 patients, in whom 1057 implants were placed with a success rate of 98.5% (1041). The follow-up period was up to 82 months with a mean of 22.34 months. (3) Results: it seems that, in the case of single-piece implants, diameter and length of the implant have influence on their survival rate, whereas smoking and hypertension do not. (4) Conclusions: this paper provides clinicians with comprehensive information about the rationale, criteria and implementation of the new classifications based on a large number of implants and long-term observations.

Chronotype Profile, Stress, Depression Level, and Temporomandibular Symptoms in Students with Type D Personality.

Background: Despite a growing interest in the types of human circadian activity, different chronotypes and personality-related issues have been rarely studied. It has already been emphasized that 'stress personality' is considered a risk factor for certain psychosomatic diseases and may be a temporomandibular disorders (TMDs) predictor. Therefore, an attempt has been made to analyze the chronotypes, stress levels, stress factors, and the occurrence of depression and TMDs in students with type D personalities. People with this personality trait tend to experience negative emotions more­depression, anxiety, anger, or hostility­yet may have a negative image of themselves and report somatic complaints. Aim: The aim of this study was to analyze the importance of the chronotype profile for the level of stress perceived, as well as for the occurrence of depression and TMDs in people with type D personalities. Material and Methods: The study has been conducted on a group of 220 physical therapy students. The study group G1 consisted of 110 participants with type D personalities, the control group G2 consisted of the same number of participants without the stress personality. All participants have been analyzed for the chronotype (MEQ), stress perception (PSS10), the occurrence of depression (Beck scale-BDI), the occurrence of TMDs symptoms and have completed the stress factor assessment questionnaire during the study, followed by DS14 questionnaire­a tool for assessing the prevalence of type D personality. Results: In students with type D personalities (G1), the definitely evening and evening chronotypes have been significantly more predominant than in the control group (G2). A significantly higher number of stressors and TMDs symptoms have been observed in the respondents from the G1 group than in the control group (<0.001). Univariate logistic regression analysis showed that type D personality was strongly associated with a more frequent occurrence of all TMD symptoms. Additionally, a significant influence of the evening chronotype on the occurrence of type D personality was observed. Among the potential confounding variables, female gender and a mild and moderate degree of depression have an impact on the occurrence of type D personality (p < 0.05). In the multivariate model, adjusted with the above-mentioned factors, an increased risk of the type D personality trait was found. Conclusion: The evening chronotype and type D personality may imply greater feelings of stress, greater depression, and more frequent symptoms of TMDs in young adults.

Personalized, 3D- printed fracture fixation plates versus commonly used orthopedic implant materials- biomaterials characteristics and bacterial biofilm formation.

Additive manufacturing enabled the development of personalized, ideally fitting medical devices. The topography of the surface of the 3D-printed implant may not only facilitate its integration but also cause its rejection, as the surface may become a reservoir for different bacterial strains. In this study, the innovative, raw, 3D- printed fracture fixation plates, manufactured by using selective laser melting (SLM) from Ti-6Al-4V were compared with commercially available, surface-modified plates commonly used in orthopedic surgery. The topography surface of the plates was studied by atomic force microscopy. Susceptibility to the development of biofilm was tested for Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus mutans by using crystal violet staining of biomass, confocal, and scanning electron microscopy (SEM). 3D- printed plates showed higher roughness (Sa=131.0 nm) than commercial plates (CP1 and CP2), Sa= 60.67 nm and Sa=55.48 nm, respectively. All strains of bacteria colonized 3D- printed raw plates more densely than commercial plates. The microscopic visualization showed biofilm mostly in irregular cavities of printed plates while on commercial plates it was mainly located along the edges. The research has indicated that there is need for further development of this technology to optimize its effectiveness and safety.

Effect of Personality Type on the Occurrence of Temporomandibular Disorders-A Cross-Sectional Study.

BACKGROUND: Personality traits are one of the major factors influencing the behavior and functioning of an individual, and they play a crucial role in the development of psychosomatic disorders and diseases. This paper aimed to evaluate the importance of personality traits in temporomandibular disorder (TMDs) development using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). Moreover, the relationship between personality type and the intensity of dysfunctional changes in the stomatognathic system was assessed using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). MATERIAL AND METHODS: The study included a group of 75 adult participants (aged 19-52) with TMD diagnosed according to DC/TMD criteria and a control group of 75 participants without symptoms of dysfunction. The study consisted of a questionnaire and clinical study; the questionnaire included the NEO-FFI psychological questionnaire and a self-authored one. The clinical part consisted of extra- and intraoral dental examinations. RESULTS: Participants who clenched their teeth showed a greater degree of conscientiousness than those who did not exhibit this symptom (p = 0.048). Presence of headaches was correlated with greater severity of neuroticism (p = 0.001). Moreover, participants with enamel cracks showed a lower intensity of extraversion (p = 0.039), and those with worn hard dental tissues showed a higher intensity of neuroticism (p = 0.03), a lower intensity of conscientiousness (p = 0.01), and a lower intensity of extroversion (p = 0.046). Acoustic symptoms during mandibular movements were found to be linked with a higher level of neuroticism (p = 0.020), a lower level of extraversion (p = 0.035), and a lower level of conscientiousness, whereas pain upon mandibular movements were linked to a lower level of conscientiousness (p = 0.025). Participants with pain upon palpation of the masticatory muscles showed a lower level of conscientiousness (p = 0.01) compared to those without pain symptoms. Episodes of mandibular blockage or problems with its adduction depend on the intensity of conscientiousness (p = 0.007). Moreover, people from the study group with high levels of neuroticism showed lower protrusion values (p = 0.016). CONCLUSION: The intensity of individual personality traits was found to be associated with some TMDs in comparison to healthy controls.

The Impact of SARS-CoV-2 Outbreak on the Polish Dental Community's Standards of Care-A Six-Month Retrospective Survey-Based Study.

Currently, SARS-CoV-2 is the primary pathogen worldwide, disrupting most of our everyday activities. The study aim was to evaluate its impact on the Polish dental community, standards of care, health, and welfare. METHODS: A Google Forms survey was conducted among 303 dental practitioners. RESULTS: Of respondents, 54.93% curbed the number of patients in the last six months, 34.21% declared no changes, and 10.86% reported an increase; whereas 70.7% of the respondents reported a treatment price increase within the same period (27.96% and 1.32% reported no changes and a decrease, respectively). Of the respondents, 15.5% did not close their businesses during the first wave of the pandemic. Most declared 1 or 2 month break, 30.7% and 34.7%, respectively. Some reported 3, 4, or 5 month breaks (15.84%, 1.32%, and 0.99%, respectively), and only two respondents (0.66%) did not admit patients at all. Headache episodes were more frequent among female dentists before the pandemic; after the pandemic, headache frequency increased among both sexes. Temporomandibular disorders (TMDs) were more frequent among women (p = 0.017). CONCLUSIONS: Most Polish dentists followed SARS-CoV-2 recommendations and restricted their practices to admitting only patients with pain or incomplete treatment. Decreased sleep parameters, head, back, and neck pain, were observed. This situation may affect dental health conditions in Polish society over time.

Type D Personality and Stomatognathic System Disorders in Physiotherapy Students during the COVID-19 Pandemic.

BACKGROUND: A person's response to stressors is largely dependent on their personality traits that affect the way stress is controlled and relieved. This article is a quantitative analysis assessing the importance of the distressed personality in the development of stomatognathic system disorders (SSDs) in physiotherapy students during the COVID-19 pandemic. OBJECTIVE: The goal of the research was to assess the presence of type D personality in students with symptoms of stomatognathic system disorders. MATERIAL AND METHOD: The research was carried out among 300 physiotherapy students. The data were collected using the form of the occurrence of symptoms of SS disorders developed for the purpose of the study and the standardized psychological DS14 questionnaire. RESULTS: In a group of 300 students, the presence of type D personality was found in 160 people (53.3%). People with type D personality had symptoms of SS disorders more often than the group without stressful personality traits. There was a significant difference between the groups regarding all the examined symptoms. In the group of people with type D personality, the most frequently reported symptoms of SS disorders included: headache (51.3%), pain in the neck and shoulder girdle (43.1%), and teeth clenching (35.6%). As many as 70% of the respondents in the group with symptoms of SS disorders (P1) had type D personality, whereas in the asymptomatic group (P2) this result was 23.3%. There was a significant difference between the groups (p = 0.00). Statistically significantly higher values of both D personality dimensions were observed in women than in men with symptoms of SS disorders. In people reporting symptoms of SS disorders, higher average values were observed in both dimensions of type D personality. There were significant differences between the groups. CONCLUSION: type D personality may contribute to the development of symptoms of stomatognathic disorders.

A practical approach to orofacial rehabilitation in a patient after inferior maxillectomy and rhinectomy with mono framework construction supported on a zygomatic implant placed in the glabella: a case report.

BACKGROUND: In the field of craniofacial tumor surgery, an adequately performed excision, despite being a life-saving procedure, is only a first step to successful treatment. During such a procedure, the main goal is to completely remove the lesion, paying less attention to factors contributing to future rehabilitation possibilities. One ty 2of the possibilities for prosthetic rehabilitation of such cases is utilizing one-piece implants with bicortical anchorage. CASE PRESENTATION: This case report presents a case of a 48-year-old patient with oral squamous cell carcinoma (OSCC). The treatment protocol consisted of radical surgery to remove the tumor, and intraoral and extraoral rehabilitation with a single framework prosthesis anchored with one-piece implants. Moreover, the intraoral stomatognathic deformity was corrected with a fixed implant-retained prosthesis, and the extraoral defect was covered with a removable epithesis. CONCLUSIONS: The use of one-piece implants with bicortical anchorage may be an additional tool in reconstructing maxillofacial defects. Properly executed treatment may improve the esthetics, speech, masticatory function, muscle support, and the overall quality of life of patients with extensive defects in the maxillofacial region.

The Importance of Type D Personality in the Development of Temporomandibular Disorders (TMDs) and Depression in Students during the COVID-19 Pandemic.

BACKGROUND: a type D personality is a factor in a person's susceptibility to general mental stress, especially during the COVID-19 pandemic. Although many studies were conducted on the relationships among stressful situations, an individual's personality, depression, and the occurrence of various diseases, e.g., cardiovascular disease or cancer, there are no analogous data on people with temporomandibular disorders (TMDs). AIM: the assessment of TMDs and depression symptoms in students with type D personality. MATERIAL AND METHODS: the research was carried out with the participation of 240 physiotherapy students. The study group (G1) consisted of 120 participants with type D personalities, the control group (G2) consisted of the same number of participants, without "stress" personalities. All subjects were assessed for the occurrence of TMD symptoms, as well as for depression and anxiety symptoms, using the Beck Depression Inventory (BDI), based on the proprietary questionnaire. RESULTS: in students with type D personality symptoms, TMDs occurred significantly more often and in greater number (p = 0.00) than in those without stress personalities. The exception was the symptom of increased muscle tension, which showed no statistical difference (p = 0.22). Among the 240 respondents, depression was found in 128 people (53.3%). In the group of students with type D personalities, depression was significantly more frequent than in the group without type D personalities (p = 0.00). In participants with depression, TMD symptoms were more common, i.e., headaches, neck, and shoulder girdle pain, TMJ acoustic symptoms, increased masticatory muscle tension, teeth clenching, and teeth grinding. There was no significant difference between the incidence of depression and TMJ pain and jaw locking. There was a significant interaction between the occurrence of headaches and acoustic symptoms and the occurrence of depression. For headache and depression interactions, the OR was >1; based on the results, we may assume that a headache depends more on the occurrence of depression rather than it being a symptom of a TMJ disorder in people with type D personalities. CONCLUSION: type D personality and depression may contribute to the development of TMD symptoms.

The Influence of the COVID-19 Pandemic on the Stress Levels and Occurrence of Stomatoghnatic System Disorders (SSDs) among Physiotherapy Students in Poland.

BACKGROUND: This study is a quantitative analysis examining the impact of the COVID-19 pandemic on the occurrence of stress and stomatognathic system disorders (SSDs) among students of physiotherapy. OBJECTIVE: To assess stress severity, strategies of coping with stress and the presence of type D personality among physiotherapy students including those with symptoms of stomatognathic system disorders. MATERIAL AND METHODS: The research was conducted from October to December 2020 on a sample of 188 students of physiotherapy. The data were collected using a survey form related to the occurrence of SS disorders symptoms and standardized psychological questionnaires, such as the Perceived Stress Scale (PSS)-10, Mini-Cope, and the type-D Scale (DS14), developed for the purpose of this study. RESULTS: Women experiencing at least one of the SS disorder-related symptoms were characterized by a significantly higher level of stress and a type D personality (p < 0.05). Among men, these differences were not statistically significant (p > 0.05). On the basis of the strategies of coping with stress, i.e., positive self-reevaluation, discharging and blaming oneself, and taking psychoactive substances, it is possible to predict the intensity of stress during the pandemic in the group of the examined students. Among the reported symptoms of SS, headache was a significant predictor of stress, which was accompanied by an increase in the intensity of stress by nearly 0.2 measurement points. Students with higher levels of stress showed more symptoms of type D personality, and those with more severe symptoms of SS showed higher levels of stress. CONCLUSIONS: People prone to stress and having type D personality traits should be assessed for the presence of SS disorders.