New Bone Growth into Surgical Bone Defects Grafted with a Novel Cultivated Coral Graft: A Histomorphometric Study in Rabbit Calvarias.

Natural Coral Particles (NCPs) are a suitable scaffold material for Guided Bone Regeneration (GBR) procedures; it combines the placement of a bone substitute supporting a barrier membrane. Due to increasing sea pollution and the declarations of endangered coral species (KYOTO 1997), they are no longer suitable for the medical industry. Novel domestic corals have been grown under controlled conditions to produce cultivated coral graft (CCG) material. This study aimed to evaluate a new CCG in an in vivo experimental GBR procedure. The calvarias of 8 rabbits were surgically exposed, and circular defects 8 mm in diameter were prepared. One defect was filled with CCG particles (experimental group); the contralateral defect (control group) was spontaneously filled by blood clot. The defects were covered with a collagen membrane. Animals were euthanized after 8 weeks. Histological observations of the defects showed similar bone growth patterns in both experimental and control osteotomies. In the experimental defects, no traces of coral particles were observed. Histometric analysis showed denser bone in the pristine zone (65-66%) than in the peripheral zone for both the control (50%) and experimental defects (31%) (P= NS). The new bone percentage was reduced from the peripheral zone toward the middle and the center of the defect (31%, 32% and 27%, respectively) as the distance from the peripheral pristine bone borders increased. The existing data support the complete degradation of CCG as space-maintaining scaffold for GBR procedures.

The effect of burning on dental tissue: A macroscopic and microscopic investigation.

Teeth are considered unique as fingerprints for identification purposes. Their structure and resilience mean they can remain for thousands and millions of years withstanding extreme conditions, including burning. During burning, bones undergo carbonization at approximately 400°C and calcination at approximately 700°C. This study aimed to investigate the effects of carbonization and calcination on dental tissue. It involved nondestructive analyses of 58 extracted human teeth before and after burning, using x-ray diffraction, micro-CT, and high-resolution confocal microscopy. The results revealed that during carbonization, dentin volume decreased in two thirds of the sample, accompanied by crack formation and significant reduction in hydroxyapatite crystal size (p<0.001). During calcination, dentin volume decreased in all teeth, along with a significant deepening of the cracks (p<0.001), while enamel crystal size increased slightly. Initial changes in teeth occurred at lower temperatures than had once been assumed, as indicated by the cracks during carbonization, and there was up to a 36% decrease in dentin volume during calcination, which should be considered when measuring burnt teeth. The results of this research provide new insight into understanding dental tissue response to burning. Thus, dental remains may contribute to the knowledge needed to reconstruct anthropological and forensic scenarios involving burning.

Finite element analysis of Neanderthal and early Homo sapiens maxillary central incisor.

Neanderthal anterior teeth are very large and have a distinctive morphology characterized by robust 'shovel-shaped' crowns. These features are frequently seen as adaptive responses in dissipating heavy mechanical loads resulting from masticatory and non-masticatory activities. Although the long-standing debate surrounding this hypothesis has played a central role in paleoanthropology, is still unclear if Neanderthal anterior teeth can resist high mechanical loads or not. A novel way to answer this question is to use a multidisciplinary approach that considers together tooth architecture, dental wear and jaw movements. The aim of this study is to functionally reposition the teeth of Le Moustier 1 (a Neanderthal adolescent) and Qafzeh 9 (an early Homo sapiens adolescent) derived from wear facet mapping, occlusal fingerprint analysis and physical dental restoration methods. The restored dental arches are then used to perform finite element analysis on the left central maxillary incisor during edge-to-edge occlusion. The results show stress distribution differences between Le Moustier 1 and Qafzeh 9, with the former displaying higher tensile stress in enamel around the lingual fossa but lower concentration of stress in the lingual aspect of the root surface. These results seem to suggest that the presence of labial convexity, lingual tubercle and of a large root surface in Le Moustier 1 incisor helps in dissipating mechanical stress. The absence of these dental features in Qafzeh 9 is compensated by the presence of a thicker enamel, which helps in reducing the stress in the tooth crown.

Masticatory habits of the adult Neanderthal individual BD 1 from La Chaise-de-Vouthon (France).

OBJECTIVES: The analysis of dental wear provides a useful approach for dietary and cultural habit reconstructions of past human populations. The analysis of macrowear patterns can also be used to better understand the individual chewing behavior and to investigate the biomechanical responses during different biting scenarios. The aim of this study is to evaluate the diet and chewing performance of the adult Neanderthal Bourgeois-Delaunay 1 (BD 1) and to investigate the relationship between wear and cementum deposition under mechanical demands. MATERIALS AND METHODS: The macrowear pattern of BD 1 was analyzed using the occlusal fingerprint analysis method. We propose a new method for the bilateral measurement of the cementum volume along both buccal and lingual sides of the molar root. RESULTS: BD 1's anterior dentition is more affected by wear compared to the posterior one. The macrowear pattern suggest a normal chewing behavior and a mixed-diet coming from temperate environments. The teeth on the left side of the mandible display greater levels of wear, as well as the buccal side of the molar crowns. The cementum analysis shows higher buccal volume along the molar roots. DISCUSSION: BD1 could have been preferably chewing on the left side of the mandible. The exploitation of various food resources suggested by the macrowear analysis is compatible with the environmental reconstructions. Finally, the greater wear on the buccal side of the molar occlusal surface and the greater volume of cementum in that side of the molar roots offers a preliminary understanding about the potential correlation between dental wear and cementum deposition.

A novel micro-CT analysis for evaluating the regenerative potential of bone augmentation xenografts in rabbit calvarias.

Guided Bone Regeneration is a common procedure, yet, as new grafting materials are being introduced into the market, a reliable evaluation method is required. Critical size defect in animal models provides an accurate simulation, followed by histological sections to evaluate the new bone formation. However, histology is destructive, two-dimensional and technique-sensitive. In this study we developed a novel volumetric Micro-CT analysis to quantify new bone formation characteristics. Eight adult female New Zealand white rabbits were subjected to calvarial critical-size defects. Four 8 mm in diameter circular defects were preformed in each animal, to allow random allocation of four treatment modalities. All calvarias were scanned using Micro-CT. Each defect was segmented into four equal parts: pristine bone, outer, middle, and inner. Amira software (v. 6.3, www.fei.com ) was used to calculate the new bone volume in each region and compare it to that of the pristine bone. All grafting materials demonstrated that new bone formation decreased as it moved inward. Only the inner region differed across grafting materials (p = 0.001). The new Micro-CT analysis allowed us to divide each defect into 3D regions providing better understanding of the bone formation process. Amongst the various advantages of the Micro-CT, it enables us to quantify the graft materials and the newly formed bone independently, and to describe the defect morphology in 3D (bi- vs. uni-cortical defects). Providing an insight into the inner region of the defect can better predict the regenerative potential of the bone augmentation graft material. Therefore, the suggested Micro-CT analysis is beneficial for further developing of clinical approaches.

New Bone Growth into Surgical Bone Defects Grafted with a Novel Cultivated Coral Graft: A Histomorphometric Study in Rabbit Calvarias.

Natural Coral Particles (NCPs) are a suitable scaffold material for Guided Bone Regeneration (GBR) procedures; it combines the placement of a bone substitute supporting a barrier membrane. Due to increasing sea pollution and the declarations of endangered coral species (KYOTO 1997), they are no longer suitable for the medical industry. Novel domestic corals have been grown under controlled conditions to produce cultivated coral graft (CCG) material. This study aimed to evaluate a new CCG in an in vivo experimental GBR procedure. The calvarias of 8 rabbits were surgically exposed, and circular defects 8 mm in diameter were prepared. One defect was filled with CCG particles (experimental group); the contralateral defect (control group) was spontaneously filled by blood clot. The defects were covered with a collagen membrane. Animals were euthanized after 8 weeks. Histological observations of the defects showed similar bone growth patterns in both experimental and control osteotomies. In the experimental defects, no traces of coral particles were observed. Histometric analysis showed denser bone in the pristine zone (65-66%) than in the peripheral zone for both the control (50%) and experimental defects (31%) (P= NS). The new bone percentage was reduced from the peripheral zone toward the middle and the center of the defect (31%, 32% and 27%, respectively) as the distance from the peripheral pristine bone borders increased. The existing data support the complete degradation of CCG as space-maintaining scaffold for GBR procedures.

Redifferentiated cardiomyocytes retain residual dedifferentiation signatures and are protected against ischemic injury.

Cardiomyocyte proliferation and dedifferentiation have fueled the field of regenerative cardiology in recent years, whereas the reverse process of redifferentiation remains largely unexplored. Redifferentiation is characterized by the restoration of function lost during dedifferentiation. Previously, we showed that ERBB2-mediated heart regeneration has these two distinct phases: transient dedifferentiation and redifferentiation. Here we survey the temporal transcriptomic and proteomic landscape of dedifferentiation-redifferentiation in adult mouse hearts and reveal that well-characterized dedifferentiation features largely return to normal, although elements of residual dedifferentiation remain, even after the contractile function is restored. These hearts appear rejuvenated and show robust resistance to ischemic injury, even 5 months after redifferentiation initiation. Cardiomyocyte redifferentiation is driven by negative feedback signaling and requires LATS1/2 Hippo pathway activity. Our data reveal the importance of cardiomyocyte redifferentiation in functional restoration during regeneration but also protection against future insult, in what could lead to a potential prophylactic treatment against ischemic heart disease for at-risk patients.

Color change in teeth due to burning: Spectrophotometric analysis.

Teeth are one of the most common skeletal elements for forensic identification purposes and also the strongest human tissue, making them resistant to high temperatures. Over the course of burning as temperature increases, teeth go through a process of structural change characterized by a carbonization phase (at approx. 400 °C) and calcination phase (at approx. 700 °C) that might result in complete enamel loss. The aim of the study was to quantify color change of enamel and dentin and to determine whether both tissues can be used for estimating burn temperature as well as to evaluate the whether these changes are visually perceptible. 58 human, permanent maxillary molars without restorations were burned for 60 min at either 400 °C or 700 °C in a Cole-Parmer StableTemp Box Furnace. The change in color was measured for the crown and root using a SpectroShade Micro II spectrophotometer to determine lightness (L*), green-red color (a*), and blue-yellow color (b*). Statistical analysis was performed using SPSS version 22. There is a significant difference between the L*, a*, and b* values of pre-burned enamel and dentin at 400 °C (p < 0.001). In addition, differences in dentin measures between 400 °C and 700 °C (p < 0.001), as well as pre-burned teeth and 700 °C (p < 0.001). The mean L*a*b* values were used to calculate a measure of the perceptible difference between colors (ΔE) revealing a highly perceptible color difference between the pre- and post-burn teeth for both enamel and dentin. There is a low perceptible difference between burned enamel and dentin was found. During the carbonization phase the tooth gets darker and redder and as temperature increases, teeth become bluer. Overall, as calcination occurs the tooth root color gets closer to a neutral gray palette. The results showed a highly perceptible difference indicating that for forensic purposes simple visual color evaluation can provide reliable information, and dentin color evaluation can be used in cases when enamel is missing. However, the spectrophotometer allows an accurate replicable measure of tooth color across various stages of the burning process. This has practical applications in forensic anthropology as a portable and nondestructive technique that can be used in the field regardless of the practitioner's level of experience.

Immunomodulatory fibrous hyaluronic acid-Fmoc-diphenylalanine-based hydrogel induces bone regeneration.

AIM: To investigate the potential of an ultrashort aromatic peptide hydrogelator integrated with hyaluronic acid (HA) to serve as a scaffold for bone regeneration. MATERIALS AND METHODS: Fluorenylmethyloxycarbonyl-diphenylalanine (FmocFF)/HA hydrogel was prepared and characterized using microscopy and rheology. Osteogenic differentiation of MC3T3-E1 preosteoblasts was investigated using Alizarin red, alkaline phosphatase and calcium deposition assays. In vivo, 5-mm-diameter calvarial critical-sized defects were prepared in 20 Sprague-Dawley rats and filled with either FmocFF/HA hydrogel, deproteinized bovine bone mineral, FmocFF/Alginate hydrogel or left unfilled. Eight weeks after implantation, histology and micro-computed tomography analyses were performed. Immunohistochemistry was performed in six rats to assess the hydrogel's immunomodulatory effect. RESULTS: A nanofibrous FmocFF/HA hydrogel with a high storage modulus of 46 KPa was prepared. It supported osteogenic differentiation of MC3T3-E1 preosteoblasts and facilitated calcium deposition. In vivo, the hydrogel implantation resulted in approximately 93% bone restoration. It induced bone deposition not only around the margins, but also generated bony islets along the defect. Elongated M2 macrophages lining at the periosteum-hydrogel interface were observed 1 week after implantation. After 3 weeks, these macrophages were dispersed through the regenerating tissue surrounding the newly formed bone. CONCLUSIONS: FmocFF/HA hydrogel can serve as a cell-free, biomimetic, immunomodulatory scaffold for bone regeneration.

The Hidden Secrets of the Dental Calculus: Calibration of a Mass Spectrometry Protocol for Dental Calculus Protein Analysis.

Dental calculus is a solid deposit that forms and accumulates on the tooth surface, entrapping oral microorganisms, biomolecules, and other micro-debris found in the oral cavity. A mass spectrometry analysis of its protein content opens a vista into the subject's diet, oral flora, and even some aspects of health, thus providing new insight and expanding our knowledge of archaic cultures. Multiple experimental protocols have been proposed for the optimal extraction of proteins from dental calculus. Herein, we compared various experimental conditions in order to calibrate and validate a protocol for protein extraction. Our results show that a high concentration of acetic acid followed by mechanical crushing and sonication provided the highest protein yield, while acetone precipitation enabled the identification of more distinct proteins. We validated this protocol using archeological samples, identifying human and microbial proteins in specimens from the eighth and seventeenth centuries (approximately 250-1300 years ago). These findings demonstrate that the developed protocol is useful for studying excavated archaeological samples and that it might be utilized to explore the biohistory, dietary habits, and microbiome of archaic populations.

Response to Comment on "A Middle Pleistocene Homo from Nesher Ramla, Israel".

Marom and Rak claim, on the basis of a few mandibular features, that the Nesher Ramla (NR) Homo is a Neanderthal. Their comments lack substance and contribute little to the debate surrounding the evolution of Middle Pleistocene Homo. Limitations and preconceptions in their study prevented them from achieving resolution beyond a dichotomous interpretation of the NR as either a Neanderthal or a modern human.

Secondary Dentin Formation Mechanism: The Effect of Attrition.

Human dentin consists of a primary layer produced during tooth formation in early childhood and a second layer which first forms upon tooth eruption and continues throughout life, termed secondary dentin (SD). The effect of attrition on SD formation was considered to be confined to the area subjacent to attrition facets. However, due to a lack of three-dimensional methodologies to demonstrate the structure of the SD, this association could not be determined. Therefore, in the current study, we aimed to explore the thickening pattern of the SD in relation to the amount of occlusal and interproximal attrition. A total of 30 premolars (50-60 years of age) with varying attrition rates were evaluated using micro-computerized tomography. The results revealed thickening of the SD below the cementoenamel junction (CEJ), mostly in the mesial and distal aspects of the root (p < 0.05). The pattern of thickening under the tooth cervix, rather than in proximity to attrition facets, was consistent regardless of the attrition level. The amount of SD thickening mildly correlated with occlusal attrition (r = 0.577, p < 0.05) and not with interproximal attrition. The thickening of the SD below the CEJ coincided with previous finite element models, suggesting that this area is mostly subjected to stress due to occlusal loadings. Therefore, we suggest that the SD formation might serve as a compensatory mechanism aimed to strengthen tooth structure against deflection caused by mechanical loading. Our study suggests that occlusal forces may play a significant role in SD formation.

Three-Dimensional Surface Texture Analysis of Fluoride's Effect on Enamel Erosion.

Enamel erosion has become a common clinical finding that often impairs dental esthetics and function. In the current study, we aimed to implement the three-dimensional surface texture analysis (3DST) method to explore the protective effect of fluoride on surface texture prior to erosive conditions. For each of the 50 teeth used in this study, the polished buccal enamel surface was divided into three separate areas: the first area was untouched polished enamel, the two other surfaces were immersed in 0.3% citric acid for 30 s. One was treated with high-concentration (19,000 ppm) sodium fluoride (NaF) solution prior to acid attack, and the other had no treatment prior to acid exposure. Enamel surface texture and step height measurements were obtained using a high-resolution disk scanning confocal microscope, and SEM images were also acquired. Surfaces treated with fluoride showed fewer variations in 3-D surface texture parameters than the eroded surface compared to the control group (p = 0.001). This was in accordance with the SEM descriptive images. The findings indicate that pre-fluoridated enamel areas were less affected by the acid and showed similar features to the untouched enamel. Moreover, a protective effect of the fluoride treatment against irreversible enamel damage was noted as the surface loss (step-height) was significantly reduced (p = 0.03). The study showed that 3DST analysis is a valuable methodology for detecting and quantifying subtle differences between the surfaces. When exploring the combination of all surface texture parameters, it was revealed that the pre-fluoridated eroded enamel surfaces showed considerable similarity to the untouched enamel.

Exploring directional and fluctuating asymmetry in the human palate during growth.

OBJECTIVES: Palate morphology is constantly changing throughout an individual's lifespan, yet its asymmetry during growth is still little understood. In this research, we focus on the study of palate morphology by using 3D geometric morphometric approaches to observe changes at different stages of life, and to quantify the impact of directional and fluctuating asymmetry on different areas at different growth stages. MATERIALS AND METHODS: The sample consists of 183 individuals (1-72 years) from two identified human skeletal collections of 19th and early 20th Century Italian contexts. A 3D-template of 41 (semi)landmarks was applied on digital palate models to observe morphological variation during growth. RESULTS: Asymmetrical components of the morphological structure appears multidirectional on the entire palate surface in individuals <2 years old and become oriented (opposite bilateral direction) between 2 and 6 years of age. Specifically, directional asymmetry differentially impacts palate morphology at different stages of growth. Both the anterior and posterior palate are affected by mild alterations in the first year of life, while between 2 and 6 years asymmetry is segregated in the anterior area, and moderate asymmetry affects the entire palatal surface up to 12 years of age. Our results show that stability of the masticatory system seems to be reached around 13-35 years first by females and then males. From 36 years on both sexes show similar asymmetry on the anterior area. Regarding fluctuating asymmetry, inter-individual variability is mostly visible up to 12 years of age, after which only directional trends can be clearly observed at a group level. DISCUSSION: Morphological structure appears instable during the first year of life and acquires an opposite asymmetric bilateral direction between 2 and 6 years of age. This condition has been also documented in adults; when paired with vertical alteration, anterior/posterior asymmetry seems to characterize palate morphology, which is probably due to mechanical factors during the lifespan. Fluctuating asymmetry is predominant in the first period of life due to a plausible relationship with the strength of morphological instability of the masticatory system. Directional asymmetry, on the other hand, shows that the patterning of group-level morphological change might be explained as a functional response to differential inputs (physiological forces, nutritive and non-nutritive habits, para-masticatory activity as well as the development of speech) in different growth stages. This research has implications with respect to medical and evolutionary fields. In medicine, palate morphology should be considered when planning orthodontic and surgical procedures as it could affect the outcome. As far as an evolutionary perspective is concerned the dominance of directional asymmetries in the masticatory system could provide information on dietary and cultural habits as well as pathological conditions in our ancestors.

Are chin and symphysis morphology facial type-dependent? A computed tomography-based study.

INTRODUCTION: The chin is a major determinant of the facial profile; hence, it plays a major role in orthodontics and orthognathic surgery. It is thus essential to follow and better understand its expression in different facial types. The major objectives of the current study were to characterize morphometrically the chin and symphysis and reveal their association with different facial types. METHODS: Computed tomography scans of the head and neck of 311 adults (163 males, 148 females; age range, 18-95 years) were classified into 3 facial types: short, average, and long. Height, width, projection, inclination, thickness, and area were measured on the chin and symphysis. RESULTS: The majority of the population (70%) manifested an average facial type; the other 30% were almost equally distributed between short and long facial types. The long facial type was more common among females and the short facial type among males. Chin projection, area, and size were significantly greater in short-faced patients. Chin width in males was similar for all facial types, whereas, in females, chin width was the widest in the short facial type and the narrowest in the long facial type. Symphysis height was significantly greater in long-faced patients in both sexes. The mandibular incisors' inclination relative to the mandibular plane was not significantly associated with the chin or symphysis morphology. CONCLUSIONS: Chin and symphysis morphology is facial type-dependent. Orthodontists and maxillofacial surgeons should be aware of the complex relationship between facial types and chin/symphysis size and shape when planning treatment.

The dental remains from the Early Upper Paleolithic of Manot Cave, Israel.

This study presents the dental remains discovered at Manot Cave (MC), Western Galilee, Israel. The cave contains evidence for human occupation during the Early Upper Paleolithic period (46-33 ka) mainly of Early Ahmarian (∼46-42 ka) and Levantine Aurignacian (∼38-34 ka) cultural levels. Six teeth (three deciduous and three permanent) were found at the site, of which four could be thoroughly analyzed. The morphology of the teeth was qualitatively described and analyzed using traditional and geometric morphometric methods. A large comparative sample was used in order to assess the morphological affiliation of the Manot specimens with other Homo groups. The results provided equivocal signals: the upper first premolar (MC-9 P3) is probably modern human; the upper deciduous second molar (MC-10 dm2) and the upper second permanent molar (MC-8 M2) might be modern humans; the lower second deciduous molar (MC-7 dm2) might be Neanderthal. Owing to the small sample size and the almost total lack of distinctive characteristics, our outcome could not supply conclusive evidence to address the question of whether Manot Aurignacian population came from Europe or descended from the local Ahmarian population.

Early Upper Paleolithic human foot bones from Manot Cave, Israel.

The transition from the Middle Paleolithic to the Upper Paleolithic in the Levant represents a major event in human prehistory with regards to the dispersal of modern human populations. Unfortunately, the scarcity of human remains from this period has hampered our ability to study the anatomy of Upper Paleolithic populations. This study describes and examines pedal bones recovered from the Early Upper Paleolithic period at Manot Cave, Israel, from 2014 to 2017. The Manot Cave foot bones include a partial, left foot skeleton comprising a talus, a calcaneus, a cuboid, a first metatarsal, a second metatarsal, a fifth metatarsal, and a hallucal sesamoid. All these remains were found in the same archaeological unit of the cave and belong to a young adult. Shape and size comparisons with Neanderthals, Anatomically Modern Human and modern human foot bones indicate a modern human morphology. In some characteristics, however, the Manot Cave foot bones display a Neanderthal-like pattern. Notably, the Manot Cave foot is remarkable in its overall gracility. A healed traumatic injury in the second metatarsal (Lisfranc's fracture) is most likely due to a remote impact to the dorsum of the foot. This injury, its subsequent debility, and the individual's apparent recovery suggest that the members of the Manot Cave community had a supportive environment, one with mutual responsibilities among the members.

The endocast of the late Middle Paleolithic Manot 1 specimen, Western Galilee, Israel.

Studying endocasts has long allowed anthropologists to examine changes in the external topography and the overall size of the brain throughout the evolutionary history of hominins. The nearly complete calvaria of Manot 1 presents an opportunity to gain insights into the external brain morphology, vascular system, and dimensions of the brain of this late Middle Paleolithic hominin. Detailed size and shape analyses of the Manot 1 endocast indicate a modern Homo sapiens anatomy, despite the presence of some primitive features of the calvaria. Traits considered to be derived endocranial features for H. sapiens are present in Manot 1, including an elongated parietal sagittal chord with an elevated superior part of the hemisphere, a widened posterior part of the frontal lobes, a considerable development of the parietal reliefs such as the supramarginal lobules, and a slight posterior projection of the occipital lobes. These findings, together with data presented in previous studies, rule out the possibility of a direct Neanderthal ancestry for the Manot 1 hominin and instead confirm its affiliation with H. sapiens. The Manot 1 calvaria is more similar to that of later Upper Paleolithic H. sapiens than it is to the earlier Levantine populations of Skhul and Qafzeh. The late Middle Paleolithic date of Manot 1 provides an opportunity to analyze the recent developments in human cerebral morphology and organization.

The Association between Emotional Stress, Sleep, and Awake Bruxism among Dental Students: A Sex Comparison.

Psychosocial factors may play an important role in the etiology of sleep and awake bruxism. The purpose of this study was to assess the relationship between emotional stress and bruxism in male and female dental students at various stages of their education. Dental education in Israel is based on a six-year curriculum, divided into three stages: pre-medical studies (yr. 1-2), manual skills (yr. 3-4), and clinical experience (yr. 5-6). Each stage requires different capabilities and skills. Questionnaires regarding psychological state (SCL-90) measuring depression, anxiety, and somatization as well as stress evaluation questioners (Perceived Stress Scale questionnaire 14) were completed by 387 dental students in the 1st to 6th years. Sleep and awake bruxism were evaluated based on the respondent's awareness. During the manual stage of studies, a significant increase was identified, albeit with weak correlations, between stress scales, depression, anxiety, somatization, and the prevalence of awake bruxism, particularly among males. Only in females was sleep bruxism correlated with emotional parameters, whereas no significant difference in sleep bruxism was observed in males throughout the stages of the study. The manual years of dental education were found to be linked to higher levels of emotional distress and awake bruxism, particularly in men. Sleep bruxism, on the other hand, was not directly linked to emotional factors, implying a distinct etiology.