Self-reported bruxism in patients with post-traumatic stress disorder.

OBJECTIVE: The present study aimed to investigate the association between self-reported awake/sleep bruxism, and orofacial pain with post-traumatic stress disorder (PTSD). METHODS: A case-control study with a convenience sample was designed. Participants were recruited from a university-based Trauma Ambulatory. The diagnosis of PTSD was established through a clinical interview and the Structured Clinical Interview (SCID-I/P). Thirty-eight PTSD patients and 38 controls completed the Research Diagnostic Criteria for Temporomandibular Disorders Axis-II to categorize awake/sleep bruxism and orofacial pain. Following this, we performed a short clinical examination of the temporomandibular joint and extraoral muscles. RESULTS: Adjusted logistic regression analysis showed that awake bruxism was associated with PTSD (OR = 3.38, 95% CI = 1.01-11.27, p = 0.047). Sleep bruxism was not associated with any covariate included in the model. In a Poisson regression model, PTSD (IRR = 3.01, 95% CI = 1.38-6.55, p = 0.005) and the muscle pain/discomfort (IRR = 5.12, 95% CI = 2.80-9.36, p < 0.001) were significant predictors for current orofacial pain. CONCLUSIONS: PTSD was associated with self-reported awake bruxism and low-intensity orofacial pain. These conditions were frequent outcomes in patients previously exposed to traumatic events. CLINICAL RELEVANCE: We suggest including a two-question screening for bruxism in psychiatry/psychology interviews to improve under-identification and to prevent harmful consequences at the orofacial level.

Evaluation of periodontitis in hospital outpatients with major depressive disorder. A focus on gingival and circulating cytokines.

An imbalance in stimulated cytokine production is associated with the etiopathogenesis of numerous diseases such as major depressive disorder (MDD) and periodontal disease. Increased cytokine levels have been reported in the gingival crevicular fluid (GCF) of patients with MDD. Thirty-six outpatients with MDD participated in this study. Each outpatient was age-matched (± 3 years) with a healthy control (n=36). The patients were controlled for race and smoking habits. Unstimulated and stimulated interleukin 6 (IL-6), interleukin 1ß (IL-1ß), and interferon-γ (INF-γ) production in whole blood culture (WBC) and IL-6 and IL-1ß levels in the GCF were evaluated. Circulating levels of IL-6 and IL-1ß (unstimulated) as well as GCF IL-1ß were modestly lower in MDD patients, compared to the levels in age-matched controls (Mann-Whitney, p=0.002, 0.0075, ANCOVA, p=0.025, respectively). In the unstimulated group, there was no correlation between the levels of circulating IL-6 and GCF IL-6 (r=0.07, p=0.67), and between the levels of circulating IL-1ß and the IL-1ß level in the CGF (r=-0.08, p=0.63). In the LPS stimulation group, there was no correlation between the levels of circulating levels of IL-6 and GCF IL-6 (r=0. 02, p=0.91) or between the circulating IL-1ß and GCF IL-1ß (r=0.13, p=0.42). We observed modest immunosuppression in MDD patients (evaluated by no stimulation whole blood culture [WBC]), especially in patients with melancholic depression, chronic depression, and severe depression.

Effect of ultrasonic instrumentation on the bond strength of crowns cemented with zinc phosphate cement to natural teeth. An in vitro study.

Several studies have reported the benefits of sonic and/or ultrasonic instrumentation for root debridement, with most of them focusing on changes in periodontal clinical parameters. The present study investigated possible alterations in the tensile bond strength of crowns cemented with zinc phosphate cement to natural teeth after ultrasonic instrumentation. Forty recently extracted intact human third molars were selected, cleaned and stored in physiologic serum at 4 degrees C. They received standard preparations, at a 16 masculine convergence angle, and AgPd alloy crowns. The crowns were cemented with zinc phosphate cement and then divided into four groups of 10 teeth each. Each group was then subdivided into two subgroups, with one of the subgroups being submitted to 5,000 thermal cycles ranging from 55 +/- 2 to 5 +/- 2 degrees C, while the other was not. Each group was submitted to ultrasonic instrumentation for different periods of time: group 1 - 0 min (control), group 2 - 5 min, group 3 - 10 min, and group 4 - 15 min. Tensile bond strength tests were performed with an Instron testing machine (model 4310). Statistical analysis was performed using ANOVA and Tukey's test at the 5% level of significance. A significant reduction in the tensile bond strength of crowns cemented with zinc phosphate and submitted to thermal cycles was observed at 15 min (196.75 N versus 0 min = 452.01 N, 5 min = 444.23 N and 10 min = 470.85 N). Thermal cycling and ultrasonic instrumentation for 15 min caused a significant reduction in tensile bond strength (p < .05).

Effect of ultrasonic instrumentation on the bond strength of crowns cemented with zinc phosphate cement to natural teeth: an in vitro study

Several studies have reported the benefits of sonic and/or ultrasonic instrumentation for root debridement, with most of them focusing on changes in periodontal clinical parameters. The present study investigated possible alterations in the tensile bond strength of crowns cemented with zinc phosphate cement to natural teeth after ultrasonic instrumentation. Forty recently extracted intact human third molars were selected, cleaned and stored in physiologic serum at 4°C. They received standard preparations, at a 16º convergence angle, and AgPd alloy crowns. The crowns were cemented with zinc phosphate cement and then divided into four groups of 10 teeth each. Each group was then subdivided into two subgroups, with one of the subgroups being submitted to 5,000 thermal cycles ranging from 55 ± 2 to 5 ± 2°C, while the other was not. Each group was submitted to ultrasonic instrumentation for different periods of time: group 1 - 0 min (control), group 2 - 5 min, group 3 - 10 min, and group 4 - 15 min. Tensile bond strength tests were performed with an Instron testing machine (model 4310). Statistical analysis was performed using ANOVA and Tukey's test at the 5 percent level of significance. A significant reduction in the tensile bond strength of crowns cemented with zinc phosphate and submitted to thermal cycles was observed at 15 min (196.75 N versus 0 min = 452.01 N, 5 min = 444.23 N and 10 min = 470.85 N). Thermal cycling and ultrasonic instrumentation for 15 min caused a significant reduction in tensile bond strength (p < .05).

Anticorpos para colágeno tipos I, II, IV e laminina na periodontite crônica / Antibodies for collagen types I, II, IV and laminin in chronic periodontitis

O objetivo deste estudo foi analisar anticorpos IgG para colágenos tipos I, II, IV e laminina, presentes em indivíduos clinicamente saudáveis e em pacientes com periodontite crônica. Detectaram-se os anticorpos por ELISA, em amostras do fluido gengival, coletados com cones de papel absorvente, comumente usados em endodontia. Os resultados mostraram níveis significativamente maiores desses anticorpos em sítios doentes do que em sítios saudáveis (p < 0,01 por cento). As maiores reatividades foram observadas para laminina e colágeno tipo IV, que poderiam ser sugeridos como marcadores de doença periodontal

Influência do estresse sobre as doenças periodontais / Influence of stress on periodontal diseases

Alguns autores têm encontrado um relacionamento importante entre a doença periodontal e fatores estressores. A maioria das pesquisas correlaciona parâmetros clínicos periodontais com instrumentos psicométricos (escalas de auto-avaliaçäo) que medem a existência ou freqüência desses fatores. Esses instrumentos säo questionários e näo säo adequados ao diagnóstico psiquiátrico, mostrando apenas a presença ou ausência de sintomas psíquicos. Apesar da falta de um diagnóstico operacional, os resultados dessas pesquisas podem ser explicados pela associaçäo existente entre estresse e diminuiçäo da funçäo imunológica. Também foi observada uma maior incidência de GUNA (Gengivite Ulcerativa Necrosante Aguda) em grupos influenciados por fatores psicossociais

Estresse, depressao, alteracoes imunologicas e doenca periodontal / Stress, depression, immune system abnormalities and periodontal disease

Fatores estressores psicossociais e depressao tem sido associados com diminuicao da funcao imunologica e aumento da susceptibilidade a infeccoes e neoplasias. Alguns autores tem encontrado uma relacao importante entrea doenca periodontal e os fatores estressores que pode ser explicada pelas alteracoes em ...

Auto-anticorpos naturais em pacientes com e sem doença periodontal / Autoantibodies in healthy and periodontal diseased subjects

Foi analisada a resposta de auto-anticorpo natural do fluido gengival de indivíduos com o periodonto saudável e com periodontite. Pesquisaram-se duas diferentes especificidades: antitransferrina e antifibronectina. Os resultados mostraram que os níveis de auto-anticorpos para as duas proteínas estavam elevados na maioria dos indivíduos com doença periodontal quando comparados aos controles, principalmente com relaçäo à fibronectina

Associação da periodontite crônica ao transtorno depressivo maior / Association of chronic periodontits to Major Depressive Disorder

Foi conduzido um estudo transversal para investigar se pacientes com Transtorno Depressivo Maior tinham maior probabilidade de apresentar periodontite crônica. Além disso, avaliou-se a correlação entre parâmetros clínicos periodontais e variáveis relacionadas à depressão. A profundidade clínica de sondagem (PCS) e o nível clínico de inserção (NCI) foram registrados em 6 sítios por dente. A presença de placa foi registrada pelo índice de placa (Silness; Lõe, 1964) e a condição gengival pelo índice gengival (Lõe; Silness, 1963). A depressão foi avaliada por meio da Entrevista Clínica Estruturada (SCID), um instrumento desenvolvido para gerar diagnósticos segundo as definições e critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais, quarta edição (DSM-IV). A gravidade do quadro depressivo foi avaliada pela Escala de Depressão de Hamilton (HAM-D 31). Informações sobre a história médica, hábitos e dados demográficos também foram coletados. A amostra total foi composta por 79 indivíduos, 19 doentes (2 sítios com NCI ? 6mm em 2 ou mais dentes e um ou mais sítios com PCS ? 5mm) e 60 sadios. As variáveis demográficas foram comparadas entre os grupos e observaram-se diferenças estatisticamente significativas somente para a idade (p=0,004). As variáveis relacionadas à depressão não foram associadas às variáveis periodontais. Todas as variáveis, até aquelas que não mostraram significância estatística, foram utilizadas no modelo de regressão logística. Os resultados desta análise mostraram que pacientes fumantes e ex-fumantes apresentavam maior risco para periodontite estabelecida (OR: 9,36; IC: 2,33-37,61). Neste modelo a depressão não aumentou o risco para a doença periodontal