TEMPOROMANDIBULAR JOINT DISORDERS AND THE WAY OF THEIR OPTIMIZATION: A LITERATURE REVIEW.

The literature review aims to investigate temporomandibular joint disorders and modern approaches to their treatment. An extensive literature search was performed using Scopus, ScienceDirect, and PubMed databases to identify the most relevant published articles. The year of publication was limited to over the past 5 years. The language was limited to English. More than 200 articles were found and analyzed. At first, abstracts were reviewed. After that 40 of the most relevant articles were selected and included. Systematical literature revision revealed that temporomandibular joint dysfunction is an essential public health issue worldwide due to its high prevalence and associated incapacity. Approximately one-third of the adult population worldwide suffers from at least one symptom of temporomandibular joint dysfunction. The etiology of this disease is considered to be multifactorial. Main risk factors include postural and parafunctional habits, several types of traumas, psychological distress, and occlusal factors. Temporomandibular disorder encompasses several pathological conditions. Based on the currently available evidence, chronic pain is frequently observed and results in lower quality of life. Proper diagnosis is crucial for successful treatment planning and outcomes of temporomandibular joint disorders. multidisciplinary treatment for the complete remission of all symptoms should be focused on the pain experience, jaw, and psychosocial functioning of the patients.

MORPHOLOGICAL CHANGES IN PERIODONTAL TISSUE DURING PERIODONTITIS.

Periodontitis is the most common oral disease worldwide and is the leading cause of tooth loss. It is considered to be a major burden in terms of costs of treatment and preventive measures. According to the systematic reviews, there is a link between periodontitis and cancer. In particular, patients diagnosed with periodontitis have a higher risk of developing oral cancer. In this regard, the histomorphological examination of patients with periodontitis, which has not yet been sufficiently introduced in dental practice, is acquiring more and more importance. The aim of the work is a morphological study of periodontal tissues in patients with severe generalized periodontitis in Georgia - to identify signs of possible precancerous lesions. The data obtained show that the morphological characteristic of severe periodontitis is purulent destructive inflammation. In addition, a third of severe periodontitis is accompanied by mild to moderate epithelial dysplasia, which should be taken into account when choosing a treatment method in terms of oncological alertness.

PREVALENCE AND RISK-FACTORS OF BRUXISM IN CHILDREN AND ADOLESCENT POPULATION AND ITS IMPACT ON QUЕALITY OF LIFE (REVIEW).

Bruxism has become more and more debatable and pressing issue all over the world last years. the etiology of bruxism has been changing diverse definitions, over the years, however recently it is defined as a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and by bracing or thrusting of the mandible. This literature review discusses the possible risk factors of bruxism in children and adolescence, among which behavioral abnormalities and sleep disturbances predominates. Moreover, it reviews pathological impact of bruxism on general health and quality of life. The literature review has been carried out using the "ScienceDirect", "Scopus" and "PubMed" databases in order to define relevant scientific works - published in English, during the last 5 years. 31 most relevant articles were chosen. Bruxism is a psychophysiological disorder that can take place during the day and/ or night, in a form of clenching and grinding. It can cause health problems such as tooth sensitivities, headaches, facial myalgia, ear ache, tightness/stiffness of the shoulders, limitation of mouth opening, sleep disruption, sleep disruption of bed partner due to noise, excess tooth mobility, inflamed & receding gums, Temporomandibular Joint Disorder, tooth wear and breakage and tongue's deformation. Considering the potential negative consequences of bruxism on dental and oral health, various clinical methods have been devised to assess it over the years. As the etiology is multifactorial, there is no exact treatment to prevent bruxism. Counselling and behavioral strategies, splint therapy, medications, and contingent electrical stimulation can be used as different ways reducing the effects of bruxism.

INFLUENCE OF PERIODONTITIS ON SOMATIC DISEASES AND THE ROLE OF ORTHODONTICS IN COMBINED TREATMENT OF PERIODONTITIS (REVIEW).

The literature review was conducted in order to assess correlations between periodontics and orthodontics, effectiveness of the orthodontic treatment in patients with periodontitis. Also, causative agents of periodontitis, risk factors and its influence on systemic diseases are discussed and analyzed. The literature review was carried out several databases such as PubMed, Google Scholar, Scopus, Web of Science and Medline. The language of publication was limited to English and the year of publication was limited to over the past 5 years. For that healthy oral cavity is the guarantee of the state of the person's general health. There is a correlation between the oral health and systemic diseases. Timely diagnosis and combined treatment is crucial for the successful treatment of the periodontal diseases and stabilization of the condition to achieve the satisfactory results. Orthodontic treatment is a basic component of the combined treatment of periodontitis as the correction of teeth, dental arches and occlusion occurs, gingival architecture improves, the periodontal recovery occurs and accordingly it impacts on the patient's quality of life and self-esteem. Prevention and treatment of periodontitis reduces the increase of several systemic diseases that accordingly reduces the treatment resources and expenses.

CORRELATION OF ORAL HEALTH STATUS WITH GENERAL HEALTH IN ELDERLY LIVING AT RESIDENTIAL HOMES IN GEORGIA.

The aim of the study was to assess oral health status and its correlations with the general health in older adults living in residential houses in Georgia. The study was conducted in 2017-2018 years based on WHO recommendations. The study got approval from bioethical council of National Center for Disease Control and Public Health, protocol #2017-039, 28.06.2017y. 300 voluntary residents from various residential houses for older people (aged 65 years and more) were observed in regions of Georgia: "Basiliada" (Tbilisi), residential home of municipality of Samtredia, (Imereti), residential home "Carefree old age" (Kakheti). Age groups were divided as following: 65-74; 75-84; 85<. Statistical Package for Social Sciences (SPSS) version 22.0 was used for statistical analysis. DMFT was assessed to be 28.74. Significantly high prevalence of needs of prosthetic treatment 91.1% (p=0.0005), full edentulism 36.2% (p=0.0049), participants with the extraction of more than 20 teeth 81.3% (p=0.0000) and unsatisfactory oral hygiene 39.3% (p=0.0003) were observed. Prevalence of systemic diseases was assessed as the following: cardiovascular disease - 56%, gastroenterologycal diseases - 6%, diabetes - 2.9%, respiratory disease - 8.4%, oncological disease - 6.7%, dementia - 24.2 %.( p<0.005). Cardiovascular system diseases appeared to be one of the most commonly encountered diseases in dental practice. Based on the study results new program was created "Improve of oral hygiene of older adults living in residential homes in Georgia" in order to increase their access to the dental care, including preventive dental care and improve oral health related quality of life.

RELATIONSHIP BETWEEN GENERAL HEALTH, ORAL HEALTH AND HEALTHY LIFESTYLE IN ELDERLY POPULATION (REVIEW).

This literature review aims to investigate how a poor oral health impacts on general health and healthy lifestyle of elderly people. The literature review was performed using ScienceDirect, Scopus and PubMed databases to identify relevant published studies. The year of publication was limited to over the past 5 years and the language was limited to English. Having considered the relevant articles' abstracts the 36 articles were selected. Systematical literature revision shows that recently, the older population has increased worldwide and it is being predicted to keep growing in near future. As age-related changes are observed in oral cavity, geriatric dentistry becomes more relevant to investigate oral disorders and to take relevant measures in elderly population. There is an urgent need to clarify the correlations between oral and general health. Unsatisfactory oral conditions lead to serious systemic diseases. Based on the currently available evidence, better collaboration between medical and dental fields is required in order to create and maintain healthy elderly population. A special association with professional group is important for implementation of new programs, in order to enhance and maintain satisfactory oral hygiene, oral health and oral health related quality of life.