Temporomandibular joint involvement in individuals with ankylosing spondylitis: A scoping review.

OBJECTIVE: This scoping review aimed to identify the signs and symptoms of temporomandibular joint (TMJ) involvement in individuals with ankylosing spondylitis (AS). DESIGN: Systematic literature searches were performed on PubMed, Embase, and Web of Science databases (up to April 2022). Studies with signs and symptoms of temporomandibular joint disorder (TMD) in adults with AS were included. TMJ outcomes were extracted and analyzed qualitatively. RESULTS: From 527 potentially eligible studies, 22 were included. A total of 4309 individuals with AS were evaluated, aged between 18 and 80 years, being males approximately 65% of the sample. Signs and symptoms of pain, tenderness to palpation on TMJ and masticatory muscles, joint noises (i.e., clicking or crepitus), limited mouth opening, disc displacement, and radiographic changes were often observed. CONCLUSION: The available evidence shows that different signs and symptoms of TMD co-occur with AS disease, with a higher prevalence of TMD observed in individuals with AS than in individuals without AS. Indeed, it seems that individuals suffering from AS disease have an increased risk of developing TMD.

Sleep Bruxism in Puerperal Women: Data from a Population-Based Survey.

OBJECTIVE: To evaluate the self-reported SB prevalence and explore associated risk factors in puerperal women who had given birth in Rio Grande, Southern Brazil. METHODS: A single, standardized questionnaire was given within the 48 h postpartum period. Self-reported SB was the main outcome investigated. Chi-square test was used to compare proportions, and Poisson regression with robust variance adjustment was used in the multivariate analysis. RESULTS: A total of 2225 women were included. Only 79 (3.6%) of these reported clenching or grinding their teeth during sleep. Adjusted analysis showed that the higher education level of the mothers (PR = 3.07; 95% CI 1.49-6.28; P = 0.006); living with three or more persons in the household (PR = 0.54; 95% CI 0.34-0.84; P = 0.007); medication intake during pregnancy (PR = 1.68; 95% CI 1.09-2.58; P = 0.017); smoking (PR = 1.93; 1.16-3.23; P = 0.024), or ever smoked (PR = 1.82; 95% CI 0.85-3.90; P = 0.024); severe anxiety (PR = 1.36; 95% CI 0.61-3.02; P = 0.005); and headache upon waking (PR = 4.19; 95% CI 1.95-9.00; P < 0.001) were significantly associated with self-reported SB. CONCLUSION FOR PRACTICE: Our data pointed towards new factors in a specific group of women that may be relevant for preventing sleep-related behaviors in the pregnancy-puerperal cycle. The higher levels of education, medication intake, smoking or even smoked, severe anxiety, the higher the probability of puerperal woman to self-report SB. The nighttime tooth clenching strongly increased headache upon waking.

Invasive surgical procedures for the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis regarding the effects on pain and jaw mobility.

OBJECTIVES: This systematic review compared minimally and invasive surgical procedures to manage arthrogenous temporomandibular joint (TMJ). MATERIALS AND METHODS: The review included clinical trials assessing surgical procedures of arthrogenous temporomandibular disorder (TMD) management by carrying out comparisons within the same surgical procedure (pre- and post-treatment) as well as between different surgical procedures. Meta-analyses were conducted only for similar comparison reporting the same outcome measures, visual analog scale (VAS) values to evaluate pain and maximum incisal opening (MIO) values. RESULTS: Of the 1,015 studies identified by the search strategy, 26 were selected for full-text reading, and 19 were included in the review. Of these, 16 studies were included in the meta-analysis and 3 in the qualitative analysis. The VAS scores showed significantly lower values after discectomies (p < 0.001) and discoplasties (p < 0.001) in the within-group comparison. Moreover, significantly lower VAS scores and higher MIO values were observed after discectomy compared to arthroscopy, eminectomy, and discoplasty (p < 0.05). CONCLUSION: The findings of this systematic review suggest that although significantly lower VAS scores and higher MIO values were observed after discectomy, the currently available scientific evidence is unclear, and the use of invasive surgical procedures should not be implemented as an efficient first-line treatment option for arthrogenous TMD management. CLINICAL SIGNIFICANCE: VAS and MIO outcomes could be insufficient to describe the success or failure of open surgical procedures like discectomy and discoplasty.

Influence of feldspar ceramic thickness on the properties of resin cements and restorative set.

This in vitro study evaluated the influence of feldspathic ceramic thickness on the properties of light- and dual-cured resin cements. For each cement (RelyX Veneer, Allcem Veneer, RelyX Ultimate, and Allcem Dual), three ceramic specimens were prepared, with seven thicknesses for each (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, and 3.5 mm). The degree of conversion, Vickers microhardness, irradiance power, color variation (ΔE00 ), and translucency parameters were assessed. Microhardness and irradiance power were analyzed using analysis of variance (ANOVA) with post hoc Tukey's test, while ΔE00 , translucency parameters, and degree of conversion were analyzed using ANOVA of ranks with post hoc Duncan's Multiple Range Test. The relationship between each of the dependent variables (degree of conversion, ΔE00 , and translucency parameter tests) and the specimen thickness was described using linear regression for each of the four resin cements. The significance level for all analyses was set at 5%. RelyX Ultimate yielded the lowest degree of conversion values among all resin cements. Allcem Veneer produced the lowest microhardness values, without statistical differences between thicknesses, of up to 1 mm. Allcem Dual produced the highest ΔE00 and translucency parameter values. Feldspathic ceramic thickness influenced the mechanical properties of resin cements and optical aspects of the restorative set.

Sleep architecture and factors associated with sleep bruxism diagnosis scored by polysomnography recordings: A case-control study.

OBJECTIVE: This study evaluated the association between the diagnosis of sleep bruxism (SB), scored by way of polysomnographic (PSG) recordings, clinical conditions and sleep architecture. DESIGN: A case-control study was conducted. All records from adults who had undergone polysomnography (PSG) recordings at a private medical outpatient clinic between January 2015 and December 2017 were reviewed. The sample included 58 bruxers (case group) and 58 non-bruxers (control group), identified based on the PSG recording and matched by sex and age. RESULTS: Obese individuals had significantly lower chance (OR 0.18; 95 % CI: 0.05-0.62; P = 0.005) of an SB diagnosis than individuals with normal BMI. Alcohol consumption significantly increased (OR 2.74; 95 % CI: 1.11-6.78; P = 0.029) and OSA decreased the chances (OR 0.55; 95 % CI: 0.23-1.30; P = 0.173) of an SB diagnosis. Bruxers had a significantly shorter wake time after sleep onset (WASO) (p = 0.002). As far as non-rapid eye movement (NREM) is concerned, the duration of stage N1 was statistically shorter (p = 0.034) and the duration of stage N3 was statistically longer (p = 0.001) in bruxers. Arousals (p = 0.013), arousals per hour (p = 0.009), respiratory disturbance index (RDI) values (p < 0.0005) and the apnoea-hypopnea index (AHI) (p = 0.002) were all lower in bruxers than in non-bruxers. CONCLUSION: The results of this study support a significant association between SB diagnosis, BMI and alcohol consumption. SB modified the sleep architecture as statistically significant differences were found between bruxers and non-bruxers for WASO, NREM stage N1 and N3, arousals, arousals per hour, RDI and AHI.

Variações anatômicas do canal mandibular e forame mentual avaliadas através de tomografia computadorizada de feixes cônicos / Anatomical variations of the mandibular canal and mental foramen measured by cone beam computed tomography

Este estudo investigou as variações anatômicas do canal mandibular (CM) e do forame mentual (FM) em uma população do sul do Brasil utilizando exames de tomografia computadorizada de feixes cônicos (TCFC). Exames de 99 pacientes (198 hemimandíbulas) foram avaliados quanto à presença e localização de canais mandibulares duplos (CMD), presença e extensão de alça anterior do CM, presença de forame mentual acessório (FMA), e a relação entre FMA e CM. Em adição às estatísticas descritivas, o teste de Qui-quadrado e o teste Exato de Fisher compararam a ocorrência de variações anatômicas para cada lado da mandíbula e para o gênero dos pacientes. CMD foram encontrados em 63 hemimandíbulas (32,48%) e a maioria foi classificada como canal vestíbulo-lingual. Alça anterior do CM foi detectada em 14 hemimandíbulas (7%) com comprimento médio de 1,87±0,56 mm. FMA foi encontrado em apenas duas hemimandíbulas (1,1%) e um FMA estava em relação com o CM. O teste de Qui-quadrado não mostrou relação entre variações anatômicas e lado da mandíbula. Entretanto, a presença de CMD foi relacionada de forma estatisticamente significativa com o gênero masculino. CMD foi observado em um percentual significativo da população estudada e ocorreu mais em homens. Entretanto, outras variações anatômicas avaliadas através de TCFC não foram associadas de forma significativa com nenhuma outra variável abordada, sugerindo que essas variações não são prevalentes na população estudada (AU).

This study investigated the anatomical variations of the mandibular canal (MC) and mental foramen (MF) in a southern Brazilian population using cone beam computed tomography (CBCT). Exams of 99 patients (198 hemimandibles) were evaluated for the presence and location of double mandibular canals (DMC), the presence and extent of MC anterior loops, the presence of an accessory mental foramen (AMF), and the relationship between the AMF and the MC. In addition to descriptive statistics, Chi-squared and Fisher's exact tests compared the occurrence of anatomical variations to each side of the mandible and the gender of patients. DMC was found in 63 hemimandibles (32.48%) and most was classified as buccolingual canals. Anterior loops were detected in 14 hemimandibles (7%) and they averaged 1.87±0.56 mm in length. AMFs were found in only 2 hemimandibles (1.1%) and one AMF was related to the MC. Chi-square tests showed no relationship between the anatomical variations and the side of the mandible. However, DMC was significantly more common in men. DMC was observed in a significant percentage of the population and they occurred more frequently in men. However, others anatomical variations evaluated by CBCT were not significantly associated with any characteristic of the study population, suggesting that these are not prevalent variations in southern Brazilians (AU).

Prevalence of Abnormal Morphology of the Temporomandibular Joint in Asymptomatic Subjects: A Retrospective Cohort Study Utilizing Cone Beam Computed Tomography.

PURPOSE: This retrospective cohort study in an asymptomatic nonpatient population evaluated the prevalence of specific morphologic changes usually associated with the presence of degenerative joint diseases (DJD) using cone beam computed tomography (CBCT) and examined the associations between DJD and age, sex, and number of teeth present. MATERIALS AND METHODS: CBCT images (268 TMJs) of 134 asymptomatic patients were studied. Patient data were obtained from clinical records, and calibrated examiners interpreted the CBCT images. The presence or absence of traditional radiographic signs of DJD (erosion, generalized sclerosis, osteophytes, and subchondral cysts) in the condyle and articular eminence of each TMJ were evaluated. The data were submitted to bivariate (chi-square and Fisher exact tests) and multivariate (Poisson regression) analyses (α = .05). RESULTS: The sample was primarily composed of men (52.24%) and individuals aged ≥ 61 years (55.64%); 61.94% were partially edentulous with ≤ 12 teeth in the oral cavity. The most common DJD diagnoses were mandibular condyle osteophytes (30.22%) and erosion (12.69%), followed by articular eminence erosion (8.58%) and mandibular condyle subchondral cysts (7.09%). The bivariate analysis showed a statistically significant association between women and subchondral cysts (P = .007), between edentulous individuals and subchondral cysts (P = .008), and between individuals with ≤ 12 teeth and mandibular condyle erosion (P = .005). In the adjusted Poisson regression analysis, a significant association was found between DJD and gender (P = .015). CONCLUSION: Despite the limitations of this study, the results show a high prevalence of morphologic changes usually associated with the presence of DJD in asymptomatic subjects. Osseous TMJ abnormalities were most present in women, individuals with a lower number of teeth, and older individuals.