Temporomandibular disorders and neck pain in primary headache patients: a retrospective machine learning study.

OBJECTIVES: To evaluate the linkage underpinning different clinical conditions as painful TMD and neck pain in patients affected by primary headaches. MATERIALS AND METHODS: In this machine learning study, data from medical records of patients with headaches as migraine, tension-type headache (TTH) and other primary ones, referring to a University Hospital over a 10-year period were analysed. VAS was used to evaluate the intensity of the TMD and neck pain. Moreover, the magnetic resonance imaging was used to supplement the clinical data. RESULTS: A total of 300 patients (72 male, 228 female), mean aged 37.78 ± 5.11 years, were included. Higher TMD and neck pain VAS in migraine patients were reported. The machine learning analysis focussed on type of primary headache demonstrated that a higher TMD VAS was correlated to migraine, whereas a higher neck pain VAS was correlated to TTH or migraine. Concerning the TMD type, arthrogenous and mixed TMD were correlated to mild-moderate TMD pain (depending on neck pain intensity), whereas myogenic TMD was correlated to moderate-severe TMD pain. CONCLUSIONS: Machine-learning approach highlighted the complexity of diagnosis process and demonstrated that neck pain might be an influential variable on the belonging to different group of headaches in TMD patients.

Functional status and oral health in patients with amyotrophic lateral sclerosis: A cross-sectional study.

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons. The current practice of caring for patients affected by ALS involves a multidisciplinary team without any indication about oral health care. OBJECTIVE: We sought to investigate the functional status and oral health in patients with ALS to define a specific multidisciplinary management. METHODS: In this cross-sectional study, we included patients affected by ALS, evaluating their functional status, using the Revised ALS Functional Rating Scale (ALSFRS-R) and their oral health status through specific parameters, including Brief Oral Health Status Examination (BOHSE), Winkel Tongue Coating Index (WTCI), and Oral Food Debris Index (OFDI). RESULTS: All 37 patients (mean age: 61.19±11.56 years) showed a poor oral status, independent from the functional status and strictly correlated to the severity of sialorrhea (p = 0.01). OFDI index was negatively correlated with the ALSFRS-R upper limb (p = 0.03). Patients with bulbar onset had significantly lower ability to perform adequate tongue movements in terms of protrusion (p = 0.006) and lateralization (p < 0.001). Significant negative correlations between survival rate and BOHSE (p = 0.03) was found. CONCLUSIONS: Taken together, our findings showed that a poor oral health status might be correlated to a worse functional status and survival time. Thus, an adequate oral health care and rehabilitation should be considered as crucial in the multidisciplinary management of patients with ALS.

Periodontal Disease and Vitamin D Deficiency in Pregnant Women: Which Correlation with Preterm and Low-Weight Birth?

Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital "Maggiore della Carità", Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI > 3 (p = 0.033), and between LBW and OHI > 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) < 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p < 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p < 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women.

High prevalence of human cytomegalovirus in a population of periodontally healthy subjects.

BACKGROUND: Human cytomegalovirus (HCMV) appears to be more frequent in periodontally affected patients than in healthy control groups. Based on this assumption, it has been suggested that HCMV may play a role in the pathogenesis of periodontal disease. OBJECTIVE: The objective of this uncontrolled study was to assess the occurrence of HCMV in a large unselected population of periodontally healthy subjects. STUDY DESIGN: Fifty consecutive periodontally healthy patients satisfied the inclusion criteria. Two samples of gingival crevicular fluids were taken from two non-bleeding on probing sites for each patient. Samples were collected from the anterior and the posterior area. Polymerase chain reaction (PCR) was used to identify the presence of HCMV. RESULTS: HCMV was detected in 17 (33%) out of 50 participants. Ten subjects showed presence of HCMV on both anterior and posterior sites, whereas the remaining 7 only had HCMV present in the anterior sites. No differences were noticed between HCMV positive and HCMV negative in terms of smoking (p = 0.33), drinking habits (p=0,94) or the presence of prosthodontic restorations (p= 0,89). CONCLUSIONS: HCMV was detected in a high proportion of periodontally healthy subjects. Its presence was not found to be influenced by smoking or drinking habits.