Peri-implantitis Diagnosis and Prognosis Using Biomarkers: A Systematic Literature Review.

PURPOSE: To summarize the latest scientific literature regarding the concentrations of biomarkers in saliva and peri-implant crevicular fluid (PICF) of healthy implant (HI) patients and patients with peri-implant mucositis (PIM) and peri-implantitis (PI). MATERIALS AND METHODS: The literature review was performed according to PRISMA guidelines. The databases used were PubMed MEDLINE, ScienceDirect, and Cochrane Library. A combination of keywords was used, and selection criteria were applied. Selected articles were published between February 1, 2017, and February 1, 2022, written in English, conducted in humans, and examined the levels of saliva and PICF biomarkers in PI patients and compared them to HI/PIM patients. RESULTS: A total of 16 publications were selected, involving a total of 1,117 patients with 1,346 implants. Qualitative analysis revealed 49 different biomarkers, the levels of which were compared between groups. After evaluating the most frequently studied biomarkers, significantly higher values of IL-1ß, RANKL, sRANKL, IL-6, TNF-α, TNFSF12, MMP2, and MMP8 levels were observed in the PI group than in the HI group. CONCLUSIONS: Of all 49 biomarkers evaluated, IL-1ß and RANKL have potentially the highest diagnostic significance in the assessment of peri-implant inflammatory conditions, as differences were observed between all three groups (HI < PIM < PI), but data from current publications were not fully sufficient to provide strong evidence.

Odontogenic sinusitis: causes, symptoms and treatment. A review of current literature and concepts.

OBJECTIVE: Diagnosis of odontogenic maxillary sinusitis (OMS) often is misdiagnosed as rhinosinusitis, the main symptoms of these diseases are the same: facial pain, postnasal discharge, and congestion. However, OMS and rhinogenic sinusitis require different treatments. Without addressing dental factors in odontogenic sinusitis, conventional rhinitis treatment will often fail, and symptoms will persist. This review aims to assess the most recent literature about OMS causes, symptoms, and treatment. MATERIAL AND METHODS: Literature analysis was carried out on the basis of PRISMA guidelines. Eligible articles no older than 5 years were included, with a few exeptions. An electronic search was performed using MEDLINE (PubMed), The Cochrane Library, and ScienceDirect databases. RESULTS: More than one possible cause for the development of OMS has been identified. The literature indicates that anaerobic microorganisms are found in the case of sinusitis, but there is no consensus regarding the initial exact causative bacteria of this disease. Symptoms of OMS can be one-sided facial pain, purulent anterior rhinorrhoea, headache, cacosmia, pressure or nasal congestion, post-nasal drip. For better diagnostic of OMS imaging modalities are used. Management of OMS requires dual treatment. The treatment of the disease should begin with the need to remove the causative factor. Antibiotic therapy alone is not used for the treatment of odontogenic sinusitis, but can be used to relieve symptoms. It should be prescribed in accordance with the antibiogram after causative factor is removed. When the dental and medical treatment is not enough for sufficient management of OMS surgery is required. CONCLUSION: It is evident that the etiology of OMS includes more than one etiological factor, just as the causative agents of this pathology are various bacteria. Therefore, one of the key elements in choosing the treatment of OMS should be a proper diagnosis.

Different intra-articular injection substances following temporomandibular joint arthroscopy and their effect on early postoperative period: A randomized clinical trial.

OBJECTIVE: To compare the effect of plasma rich in growth factors (PRGF), hyaluronic acid (HA), and saline intra-articular injections following temporomandibular joint arthroscopy on decreasing pain and increasing maximal mouth opening. METHODS: Included patients were randomized into three groups: PRGF group, hyaluronic acid group, and control group. Intra-articular injections were done at the end of the arthroscopy. Pain was measured using the VAS scale preoperatively, 7 days, 1 month, and 6 months postoperatively. Maximal mouth opening was measured preoperatively and 7 days postoperatively. RESULTS: There was a statistically significant decrease in pain in all groups, although, the decrease was significantly greater in the HA group following surgery. CONCLUSION: A hyaluronic acid injection following temporomandibular joint arthroscopy can decrease pain better than saline and platelet-rich plasma during the first postoperative week. However, the results do not differ in later postoperative periods.

The Efficiency of Different Arthroscopic Discopexy Techniques Based on Clinical and Radiographic Findings: A Systematic Review.

The aim of this systematic review was to evaluate the effectiveness of different temporomandibular joint arthroscopic discopexy techniques. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and an electronic search was performed using MEDLINE (PubMed), The Cochrane Library, ScienceDirect databases using a combination of the terms ''discopexy,'' ''disc recapture,'' ''disc fixation,'' and ''temporomandibular joint'' to identify clinical trials published from 2010. In total, 493 records were screened, of which only 9 fulfilled the inclusion criteria and were included in qualitative data synthesis. The results of clinical findings evaluation showed that arthroscopic discopexy statistically significantly improved levels of pain (VAS) and maximum interincisal opening whereas magnetic resonance imaging evaluation showed disc position improvement of up to 90% to 100%. In conclusion, this review provides the evidence of the potential benefits of arthroscopic disc fixation in the treatment of patients with internal derangements : reduced pain, increased maximum interincisal opening, and improved disc position evaluated by magnetic resonance imaging, whereas disc fixation using suturing techniques seems to be the most appropriate method.

Management of bisphosphonate-related osteonecrosis of the jaw using teriparatide treatment: A systematic review.

OBJECTIVE: To systematically review the current literature and determine whether the additional TPTD administration for patients with BRONJ is an effective treatment modality. MATERIAL AND METHODS: The systematic review was registered in the PROSPERO (CRD42021242796) and conducted according to the PRISMA statement. An electronic search was performed using MEDLINE (PubMed), ScienceDirect, The Cochrane Library and LILACS databases using a combination of the keywords "Bisphosphonate-Associated Osteonecrosis of the Jaw"[Mesh], "treatment" to identify studies published from 2010. RESULTS: The authors found 8 articles that met the inclusion criteria of this systematic review. According to two studies, TPTD was statistically significantly associated with a greater BRONJ lesion resolution, compared to control group (p<0.05). However, one article showed no significant difference in proportion of resolved lesions (p=0.478). Regarding the effectiveness of TPTD treatment according to administration frequency, daily injection group showed no significant changes in the clinical stage of BRONJ, no difference in the percentage of bone formation on patients osteolysis, compared to weekly injections. Concerning bone resorption/regeneration markers, all the included studies showed that bone resorption markers significantly increased after 3-month TPTD administration. In a study which used multivariate analysis between TPTD and non-TPTD groups using age, BMI, duration of BP usage, the difference in s-OC values after 3 months of the treatment was significant (p<0.05). CONCLUSION: This review provides evidence for the potential benefits of additional TPTD administration for patients with BRONJ being an effective treatment modality.

Chronic Odontogenic Rhinosinusitis: Optimization of Surgical Treatment Indications.

BACKGROUND: The treatment of chronic odontogenic and nonodontogenic rhinosinusitis is different. It requires the elimination of odontogenic cause and optimal sinus surgical treatment. To date, there are no clear indications when sinus surgical treatment is necessary. OBJECTIVE: Our aim was to define clear indication(s) for sinus surgical treatment in patients with chronic odontogenic rhinosinusitis after elimination of odontogenic cause. METHODS: A group of 96 patients with chronic odontogenic rhinosinusitis caused by apical periodontitis completed a Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire with incorporated additional symptom "malodor" before treatment. Moreover, they were distributed according to computed tomography (CT) radiological criteria such as degree of periapical pathology, anatomical ratio between maxillary lateral teeth and sinus floor, sinus mucosal thickening, and ostiomeatal complex condition. The elimination of odontogenic cause was performed by extracting causative tooth. Questionnaire was filled again 2 weeks, 3 months, and 6 months after treatment. All data were analyzed to search the clear indications for sinus surgical treatment. RESULTS: Of 96 patients, 74 (77.1%) patients had full resolution of symptoms after dental cause was eliminated. For other 22 (22.9%) patients, symptoms persisted and sinus surgical treatment was indicated. In recovered group, mean SNOT-22 score was different between all periods of measuring, while within nonrecovered group, small differences were seen only when compared to before treatment. No statistically significant correlation between radiological criteria and rhinosinusitis healing after tooth extraction was found (P > .05). Statistically significant correlation was found between the disappearance of malodor/SNOT-22 score reduction after elimination of dental cause and healing success (P < .005). CONCLUSIONS: Our study revealed that extraction of causative tooth is an effective treatment of chronic odontogenic rhinosinusitis caused by apical periodontitis. CT criteria are not valuable indicator for sinus surgery, but persistence of malodor after 2 weeks is the strongest indication for this type of treatment.

Comparison of Different Intraarticular Injection Substances Followed by Temporomandibular Joint Arthroscopy.

Nowadays, temporomandibular joint (TMJ) arthroscopies are often finished with intraarticular injections. There are a couple of different substances that can be injected into the articular cavity following arthroscopy; however, it is still unclear which one can help to reach the best clinical results.The aim of this systematic review was to compare different substances that can be injected intraarticularly following TMJ arthroscopy to enhance clinical success.A review protocol was registered in PROSPERO (Registration number: CRD42018114833). An electronic search was performed using PubMed, Cochrane Library, PlosOne, and Science Direct databases using a combination of the terms "temporomandibular" and "arthroscopy" to identify clinical trials published from 2009 until 2019. Mean differences of pain levels were evaluated in random-effect meta-analysis.In total, 951 records were screened, of which only 3 fulfilled the inclusion criteria and were included into qualitative data synthesis, and only 2 articles were included into quantitative data analysis.The results showed that subjects who received plasma rich in growth factors intraarticular injections had statistically significantly lower pain levels 18 months postoperatively than patients who received hyaluronic acid injections.The results of the meta-analysis revealed that intraarticular injections followed by TMJ arthroscopy were more effective than arthroscopy alone in pain management (mean difference = -1.00, 95% confidence interval: -4.76 to 2.77, I = 97% with significant heterogeneity).The authors conclude that, although the sample is not extensive (only 3 studies), a tendency towards the superiority of plasma rich in growth factors over other treatments is seen in pain management of TMD.

Comparison of Sino-Nasal Outcome Test 22 Symptom Scores in Rhinogenic and Odontogenic Sinusitis.

BACKGROUND: Odontogenic maxillary sinusitis (OMS) and rhinogenic sinusitis (RS) are the main types of chronic rhinosinusitis (CRS) and have a significant impact on health-related quality of life (HRQL), but the difference in HRQL and symptom presentation between them has not been specifically evaluated to date. Obejctive: Our aim was to compare patterns of symptoms and HRQL disease-specific domains in patients affected with these 2 types of CRS. METHODS: A group of 201 patients with CRS (99 with rhinogenic and 102 with odontogenic origin) completed the Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire before treatment. Data sets were analyzed by using principal component analysis (PCA) to identify a set of symptom components together with the items excluded from PCA, which were then analyzed for differences between patients with OMS and RS. RESULTS: PCA of SNOT-22 items identified 5 components: "rhinologic," "extranasal rhinologic," "ear/facial," "sleep and functional disturbance," and "emotional disturbance." Sneezing was excluded from PCA and treated as separate outcome variable and was significantly worse in RS patients. Patients with OMS scored significantly higher scores with regard to emotional disturbance, while RS patients scored significantly worse in sleep and functional disturbance. The extra symptom "malodor" was the most different symptom and was significantly worse in OMS patients. The total SNOT-22 score was not significantly different between the groups. CONCLUSION: With controlling of covariates that may influence the severity of the disease, this study showed some significant differences in symptom patterns and HRQL impairment between patients with OMS and RS. Malodor is the most characteristic feature of OMS. Therefore, OMS should always be suspected in patients complaining of bad breath.

Quality of life in patients with temporomandibular disorders. A systematic review.

OBJECTIVE: The purpose of this study was to systematically review the literature concerning the quality of life of patients with temporomandibular joint disorder. MATERIAL AND METHODS: Systematic review was performed with the information contained in international databases: PubMed and Google Scholar. Keywords and their combinations were used to find relevant articles and publications concerning the subject. RESULTS: A total of 320 publications were initially retrieved. After further examination 12 articles were selected due to their relevance to inclusion criteria and were included in the systematic review. The selected 12 articles published between year 2006 and 2016. CONCLUSION: In this systematic review it was found that there is a direct correlation between temporomandibular disorders and lower quality of life. Out of questionnaires used for identification of patient satisfaction SF-36 and OHIP-14 were most popular in these studies. Statistical analysis of studies mentioned lead us to believe that psychological and physical ailments caused by TMD result in lower quality of life in patients.

Oral Behaviors and Parafunctions: Comparison of Temporomandibular Dysfunction Patients and Controls.

The aim of this study is to evaluate the frequency of oral behaviors in patients with temporomandibular disorders (TMD) and a control group without TMD.In this baseline case-control study, 260 controls and 260 subjects with TMD completed the oral behaviors checklist defined as a "self-report scale for identifying and quantifying the frequency of jaw overuse behavior" and underwent clinical examinations using the DC/TMJ international examination form (version May 12, 2013). Relationships of oral parafunctions' frequencies between groups were examined. The statistical analysis was performed with IBM SPSS Statistics 23 software.Age and gender distribution in the study groups did not reveal statistical differences (P > 0.05). Multivariate logistic regression analysis was conducted to establish system of independent oral behaviors for prognosis TMD. The stepwise regression analysis demonstrated that very frequent expression of holding, tightening, or tense muscles is associated with 10.83 times (P < 0.05) higher risk of TMD, grinding teeth together during waking hours with 4.94 times (P < 0.05) higher risk, and sustained talking with 2.64 times (P < 0.05) higher risk of TMD. By contrast, it was determined that 3 oral behaviors were less common in the TMD patients compared with the control group: clenching teeth together during waking hours, facing grimaces, and yawning (P < 0.05). The individuals with TMD reported a significantly higher frequency of 10 behaviors (P < 0.05), 3 of which may be regarded as independent risk factors for TMD. In addition, 3 oral behaviors were more frequently observed in the healthy subjects than in the TMD patients.

Management of maxillofacial fractures within three years of empirical findings.

OBJECTIVES: To investigate which treatment of maxillofacial fractures is more effective and what type of complications is the most common after observed treatment. The second aim is to explore relationship between treated facial bone fractures and temporomandibular joint (TMJ) pathology. MATERIAL AND METHODS: Cases with TMJ pathology in Lithuanian University of Health Sciences (LUHS) in the Department of Maxillofacial Surgery (MS) during 2012-2014 were analysed to research the occurrence of TMJ disorders after facial bone fracture treatment. Moreover, the clinical data of patients that were treated in LUHS in the Department of MS during 2012-2014 was collected and analysed. RESULTS: Male patients had higher fracture ratio (zygomatic and maxillary - 84%, mandibular - 89.72%). Complications occurred in 6% of the patients in a zygomatic and maxillary fractures group, mainly as an infraorbital nerve injury. Closed reduction and indirect fixation were performed for mandibular patients 49.7%. The ratio of complications for mandibular fractures was 6.1%. There were complications in group with the open reduction and direct fixation (24.2%, mostly osteomyelitis), when in the closed reduction and indirect fixation group (42.4%, mostly bone healing complications). There were no patients with TMJ pathology as a complication after facial bone fracture treatment. CONCLUSIONS: Fractures treatment technique differs in all cases because of individual characteristics and treatment variations. In the open reduction and direct fixation group complications occurred in fewer cases than in the closed reduction and indirect fixation group. Well-timed facial bone fracture treatment leads to non-occurrence of TMJ complications.