Comparison of occlusal bite force distribution in subjects with different occlusal characteristics.

OBJECTIVE: To analyze bite force distribution in subjects with different occlusal characteristics. METHODS: This prospective study included 132 candidates (50 males, 82 females) seeking orthodontic treatment, who were divided into four groups based on Angle's classification of malocclusion. T-Scan® III Version 7.0 was used to record their relative distribution of bite forces, which were compared using gender, Angle's occlusal classification, overjet, overbite, space analysis, sagittal, and transverse skeletal relations variables. RESULTS: ANOVA revealed significant differences in posterior/anterior bite force ratios between sagittal dental and skeletal relationships, overjet, and overbite groups (p < 0.05). No significant difference was found between different space analysis and transverse relationship groups (p > 0.05) or between genders (p > 0.05). CONCLUSION: Subjects with Class III, decreased overjet and decreased overbite displayed higher bite force in posterior teeth compared to other groups. This feature must be considered when evaluating patients with dental and periodontal pathologies that might be affected by excessive tooth stress, especially in subjects with oral parafunctions and bruxism.

Oral myofunctional therapy for the treatment of temporomandibular disorders: A systematic review.

Objective: To investigate the role of oral myofunctional therapy for the treatment of temporomandibular disorders.Methods: A search of the literature was carried out looking for randomized controlled trials performed on humans and written in English, Italian, French, and Arabic.Results: Four randomized controlled trials were found and evaluated by using the Study Quality Assessment Tool of the National Institute for Health and Clinical Excellence.Oral myofunctional therapy was shown to be effective for the treatment of temporomandibular disorders, alone or associated with other treatments, in three out of four studies, with significant reduction of pain intensity when compared to other conservative treatments and no treatment.Discussion: Even though scientific evidence is weak, oral myofunctional therapy appears to be effective for the treatment of temporomandibular disorders with favorable cost-benefit and risk-benefit ratios.

Applied kinesiology and dentistry - A narrative review.

OBJECTIVE: To investigate the use of applied kinesiology in the field of dentistry. METHODS: A review of the literature was carried out looking for all articles written on the topic. PubMed, Ovid Medline, and The Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched. RESULTS: Only one study was retrieved on the use of applied kinesiology in temporomandibular disorder patients, and only one study was published on dental material testing. A change in muscle strength associated with changes in dental occlusion has been observed in many of the articles selected. DISCUSSION: The use of applied kinesiology for the diagnosis and treatment of pathologies in the field of dentistry is not supported by scientific evidence. However, a relationship between dental occlusion or maxillo-mandibular relationship and isometric muscle strength has been noted.

Depression is related to edentulism and lack of functional dentition: An analysis of NHANES data, 2005-2016.

OBJECTIVE: Depression and tooth loss are significant health problems that affect individuals' functionality and quality of life. Comorbidity between depression and oral diseases has been reported. The aim of this study was to investigate the association between depression and tooth loss in a US representative adult sample. METHODS: This study included data from 22,532 adults ≥18 years by combining six 2-year cross-sectional cycles of the National Health and Nutrition Examination Survey (NHANES) administered between 2005 and 2016. Data were analyzed using descriptive statistics and multinomial logistic regression adjusted for gender, age, race/ethnicity, smoking, education, socioeconomic status, body mass index, diabetes, and alcohol intake. RESULTS: Of the total sample, 4.5 percent were edentulous, 10.3 percent were lacking functional dentition (1-19 remaining teeth) and 85.2 percent had functional dentition (≥20 remaining teeth); among whom, the prevalence of depression was 12.4, 11.7, and 5.9 percent, respectively. Compared to individuals without depression, those with depression were more likely to be edentulous or lacking functional dentition versus having functional dentition (adjusted odds ratios (95% CI): 1.48 (1.16-1.89) and 1.43 (1.18-1.75), respectively). CONCLUSIONS: Depression was associated with edentulism and a lack of functional dentition. Further longitudinal and interventional studies are needed to elucidate the nature and direction of the relationship between depression and tooth loss.

Occlusion time, occlusal balance and lateral occlusal scheme in subjects with various dental and skeletal characteristics: A prospective clinical study.

OBJECTIVES: To analyse occlusion time, occlusal balance and lateral occlusal scheme in subjects with various dental and skeletal characteristics. METHODS: A total of 132 subjects (50 males and 82 females) seeking orthodontic treatment were included in this prospective study. Using the T-Scan III version 7.0 (Tekscan Inc, South Boston, MA, USA), the occlusion time, occlusal balance and lateral occlusal schemes were recorded and compared with gender, Angle's occlusal classification, overjet, overbite, space analysis, skeletal and transverse relations. ANOVA, t test and contingency tables analyses were performed. Statistical significance was set at P < .05. RESULTS: Occlusion time was significantly shorter in subjects with balanced occlusion (0.18 seconds, P < .001), Class I normal occlusion (0.35 seconds, P = .028) and Class I skeletal profile (0.37 seconds, P = .002). Occlusion time was significantly longer in subjects with decreased overjet (0.60 seconds, P = .003). There were significant associations between the distribution of occlusal balance and Angles' classes of occlusion, skeletal relationship, overjet, overbite and space analysis (P < .05). Lateral occlusal schemes were only associated with Angle's classes of occlusion and skeletal relationship (P < .05). CONCLUSIONS: Patients with Class I occlusion showed the least occlusion time, the most balanced occlusion and a higher frequency of canine guidance. Nonetheless, potentially balanced occlusion and group function were highly prevalent in all groups; therefore, ideal occlusion must be considered an ideal to inspire and aim for, but cannot be considered an essential requirement of every dental treatment.

Efficacy and safety of acetaminophen and caffeine for the management of acute dental pain: A systematic review.

AIM: Because the use of non-steroidal anti-inflammatory drugs and opioids has several restrictions, this review evaluates the efficacy and safety of acetaminophen and caffeine for the management of dental pain. METHODS: A search of the literature was carried out looking for randomized controlled trials on the use of acetaminophen and caffeine for the management of dental pain, performed on humans and written in English, Italian, French or Arabic languages. The following databases were searched: PubMed, The Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline and Scopus. RESULTS: Three controlled clinical trials were retrieved and evaluated by using the Study Quality Assessment Tool of the National Institute for Health and Clinical Excellence. CONCLUSION: The use of acetaminophen and caffeine appears to be effective in achieving good control of acute dental pain compared to placebo and other analgesic medications, but clinical recommendations cannot be made for the limited number of studies assessed.

Ancillary factors in the treatment of orofacial pain: A topical narrative review.

Ancillary factors, not directly related to treatment, often play a significant role by affecting therapeutic outcome. A search of the literature was conducted including words related to the placebo phenomenon and orofacial diseases. Therefore, critical factors have been grouped into three major categories: (a) the natural course of the diseases; (b) the regression of the symptoms to their mean intensity; and (c) placebo response. This topical narrative review describes the elements mentioned above, provides an up-to-date overview of the hot topics and gaps in the field and indicates developing and future research direction of the orofacial pain field. Such a knowledge might be positively used during daily clinical practice to optimise the management of orofacial pain diseases, as well as in conducting future clinical trials for validating new interventions.

Global mapping of stratigraphy of an old-master painting using sparsity-based terahertz reflectometry.

The process by which art paintings are produced typically involves the successive applications of preparatory and paint layers to a canvas or other support; however, there is an absence of nondestructive modalities to provide a global mapping of the stratigraphy, information that is crucial for evaluation of its authenticity and attribution, for insights into historical or artist-specific techniques, as well as for conservation. We demonstrate sparsity-based terahertz reflectometry can be applied to extract a detailed 3D mapping of the layer structure of the 17th century easel painting Madonna in Preghiera by the workshop of Giovanni Battista Salvi da Sassoferrato, in which the structure of the canvas support, the ground, imprimatura, underpainting, pictorial, and varnish layers are identified quantitatively. In addition, a hitherto unidentified restoration of the varnish has been found. Our approach unlocks the full promise of terahertz reflectometry to provide a global and detailed account of an easel painting's stratigraphy by exploiting the sparse deconvolution, without which terahertz reflectometry in the past has only provided a meager tool for the characterization of paintings with paint-layer thicknesses smaller than 50 µm. The proposed modality can also be employed across a broad range of applications in nondestructive testing and biomedical imaging.

Terahertz frequency-wavelet domain deconvolution for stratigraphic and subsurface investigation of art painting.

Terahertz frequency-wavelet deconvolution is utilized specifically for the stratigraphic and subsurface investigation of art paintings with terahertz reflective imaging. In order to resolve the optically thin paint layers, a deconvolution technique is enhanced by the combination of frequency-domain filtering and stationary wavelet shrinkage, and applied to investigate a mid-20th century Italian oil painting on paperboard, After Fishing, by Ausonio Tanda. Based on the deconvolved terahertz data, the stratigraphy of the painting including the paint layers is reconstructed and subsurface features are clearly revealed, demonstrating that terahertz frequency-wavelet deconvolution can be an effective tool to characterize stratified systems with optically thin layers.

Actinic Keratosis Pathogenesis Update and New Patents.

BACKGROUND: Actinic keratosis is a common premalignant skin lesion. Because of its increasing incidence, several efforts have been made to earlier detectection and to improve knowledge on photocarcinogenic pathways of keratinocytes. As a consequence, recently new discoveries have been done in this field. OBJECTIVE: Starting from our previous review on actinic keratosis, we reviewed the literature focusing on pathogenesis and new patents in order to highlight the most recent progresses in diagnosis and therapeutic approach. CONCLUSION: Although several efforts have been done in the field of photodamaged skin, new upgrades in diagnosis and therapy are needed to detect superficial actinic keratosis earlier, to improve the disease free survival of patient and to better treat the field cancerization.

The role of genetic factors in the etiology of temporomandibular disorders: a review.

OBJECTIVES: To perform a review of the literature of published articles assessing the role of genetic factors in the etiology of temporomandibular disorders (TMDs). METHODS: A PubMed search was carried out by looking for all controlled clinical trials related to the topic and limiting the search to English language and humans. The references from the studies included and those from review articles were also examined for further relevant papers. RESULTS: A total of 1999 articles were first identified, 24 of which were considered relevant to the topic. Two other papers were found while searching the references. While TMD signs and symptoms' co-occurrence was not found in subjects within the same family, many gene polymorphisms were shown to be associated with a higher or lower risk of TMD. Such genes were mainly related to serotonin activity and metabolism, Tcellreceptor pathway, catecholamine activity and metabolism, estrogen activity, folate metabolism, glutathione activity, ANKH gene, major histocompatibility complex, extracellular matrix metabolism, genes studied in the orofacial pain prospective evaluation risk and assessment (OPPERA) study, and related to cytokines activity and metabolism. DISCUSSION: This new understanding of the pathophysiology of TMD can lead to a different treatment approach by identifying the subjects at higher risk for this pathology, and possibly by creating new drugs targeted at interfering with the expression of the genes that enhance such risk.

The role of mandibular third molars on lower anterior teeth crowding and relapse after orthodontic treatment: a systematic review.

AIMS: To evaluate the role of third molars in the development of crowding or relapse after orthodontic treatment in the anterior segment of the dental arch. METHODS: PubMed search of the literature was performed selecting all the articles relevant to the topic and limiting the studies to controlled trials on humans and written in English language. Systematic review was conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement. RESULTS: A total of 12 clinical studies were included in the review. A high risk of bias was found in most of the articles, either because the relative items assessed were inadequate or because they were unclearly described. The third molars were not correlated with more severe anterior tooth crowding in most of the studies. However, four of them described a different outcome. CONCLUSION: Definitive conclusions on the role of the third molars in the development of anterior tooth crowding cannot be drawn. A high risk of bias was found in most of the trials, and the outcomes were not consistent. However, most of the studies do not support a cause-and-effect relationship; therefore, third molar extraction to prevent anterior tooth crowding or postorthodontic relapse is not justified.

Low level laser therapy for the treatment of temporomandibular disorders: a systematic review of the literature.

The authors performed a review of the literature to evaluate the efficacy of low level laser therapy (LLLT) for the treatment of temporomandibular disorders (TMD). Selection criteria included: 1) human subjects, 2) articles written in English, and 3) randomized placebo-controlled trials. Evaluation was performed according to the CONSORT 2010 criteria. A total of 14 articles were included in the review. Studies varied considerably in terms of methodological design, particularly regarding the site of application of the laser beam, the number of applications performed, their duration, the laser beam features (wavelength, frequency, output, dosage), and outcome measures. The outcome of the trials was controversial and not particularly related to any features of the laser beam, to the number of laser applications, and their duration. Based on the results of this review no definitive conclusions can be drawn on the efficacy of LLLT for the treatment of TMD. Many methodological differences among the studies, especially regarding the number and duration of laser applications and characteristics of the laser beam (wavelength, frequency, output), do not allow for standardized guidelines for effective treatment with LLLT. The only indication seems to be that LLLT is probably more effective for the treatment of TMJ disorders, and less effective for the treatment of masticatory muscle disorders.

Bruxism elicited by inferior alveolar nerve injury: a case report.

The aim of this case report is to describe the history of a patient who received an injury to the right inferior alveolar nerve after placement of a dental implant, with bruxism noted afterward. The symptoms were managed by the use of an occlusal appliance worn at night and occasionally during the day, associated with increased awareness of parafunction during the day to reduce muscle pain and fatigue. Paresthesia of the teeth, gingiva, and lower lip persisted but were reduced during appliance use.

Temporomandibular joint disk fracture: a case report.

A case of a patient with a fracture of the temporomandibular joint (TMJ) disk is reported. The patient presented with posterior bilateral open-bite and difficulty to chew due to lack of contact between the posterior teeth. Diagnosis of disk fracture of the right TMJ was made based on magnetic resonance imaging (MRI), with posterior displacement of the posterior fragment of the disk, causing the posterior open-bite, and anterior displacement of the anterior fragment of the disk. TMJ manipulation failed to reposition the posterior fragment of the disk, and the patient refused to undergo TMJ arthroscopy to try to remove it. After four months, the posterior open-bite was reduced, probably because of remodeling of the posterior TMJ capsule and extrusion of the molars and premolars. Contact with the patient was lost after that time.

Effect of cigarette smoking on pain intensity of TMD patients: a pilot study.

To evaluate the effect of cigarette smoking (CS) on pain intensity in a sample of temporomandibular disorder (TMD) patients, 352 clinical charts were reviewed. Subjects were first divided into two groups: smokers (YS) and nonsmokers (NS); then, YS were further divided into three subgroups: light smokers (LS), moderate smokers (MS), and heavy smokers (HS). Overall TMD pain intensity was higher in YS, compared to NS, and a correlation was found between pain intensity and the number of cigarettes smoked in a day by each subject. A significant difference was evident between NS and HS. The results were not evident in males; age was not correlated either with smoking or pain intensity, and the effect of CS on pain intensity was not correlated with any particular TMD diagnosis. CS seems to be a relevant factor affecting the intensity of TMD pain, thus, control of smoking habits should be considered when treating TMD patients.