A proposal for a database of sounds generated by temporomandibular joints and a tool for automateddiagnosisbasedonanRDC/TMDquestionnaire.

The prevalence of TMD indicates a need to develop new tools that are useful in the case of screening examinations. These methods can support diagnosis at the early stage of the disorder. The purpose of this research was to develop a comprehensive tool that would function as both a database of sounds generated by TMJ and as software which facilitates automated diagnosis. The software would also use the data from the RDC/TMD questionnaire. Such a tool may significantly reduce the time spent by dentists on making manual RDC/TMD diagnoses. Moreover, this solution would enable dentists who do not specialise in TMD to make effective diagnoses. 95 patient took part in the clinical examination: 30 man and 65 females. The mean age of the participants was 33 years. Patients participating in the clinical process were examined according to the Polish version of the RDC/TMD questionnaire (Axis I and Axis II). Subsequently, all subjects were auscultated with an electronic stethoscope. An application has been implemented based on the RDC/TMD diagnostic flow chart. This tool was used for the automated generation of RDC/TMD diagnoses for all patients. As a result of the kind permission and participation of the patients under examination, it was possible to store records of ninety-five people. Each record contains RDC/TMD questionnaire data, auscultation signals and RDC/TMD diagnoses. For the first time, a database was created that has the potential to facilitate further examination. However, the developed system is universal and can therefore be adapted to new DC/TMD criteria.

The effect of root canal rinsing protocol on the push-out bond strength to the dentin cementation of the fiber post.

B a c k g r o u n d: Studies on the effect of root canal rinsing protocols on fiber post bonding to dentin are inconclusive. This study reports investigation of this topic. O b j e c t i v e s: to determine effects of irrigation protocol by means of a push-out test on the strength of adhesion between the post and dentin in an in vitro study. Materials and Method: Thirty human single-rooted teeth were prepared using hand instruments and the step-back technique, filled with gutta-percha, sealed with AH Plus (Dentsply), and divided into three groups: A: rinsed with NaCl; B: rinsed with 2% chlorhexidine (CHX); C: not rinsed before cementation of posts. The fiber posts were set using RelyX and Built-it. The tooth roots were sliced and the push-out test was performed. The area of contact between the post and dentin was calculated and the destroying force was established. The results were statistically analyzed. R e s u l t s: The mean adhesive strength was 10.69 MPa in group A, 16.33 MPa in group B, and 16.72 MPa in C. The adhesive strength in group B and C was statistically significantly higher than in group A (p = 0.0016, ANOVA). Conclusion: Rinsing root canals with CHX seems to be the most effective method prior to setting a fiber post.

Candida prevalence and oral hygiene due to orthodontic therapy with conventional brackets.

BACKGROUND: Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene, which predisposes to increased carriage of microbiota. Orthodontic brackets could act as reservoir of yeast and predispose to oral candidosis. The aim of this study was to assess Candida prevalence and the role of oral hygiene during fixed appliance therapy. A further aim was to characterize the isolated yeasts according to their ability to form biofilms. METHODS: Seventeen participants (average age 17 ± 7 years) were monitored by taking oral rinses and elastomeric ligature samples, and by evaluating the approximal plaque index (API) and gingival bleeding index (GBI) before and after placement of the orthodontic conventional brackets for 12 weeks. Isolated yeasts were counted and biofilm formation was evaluated. RESULTS: One hundred and sixteen samples (67 oral rinses and 49 orthodontic elastomers) were collected. Ten patients (58.8% subjects) were Candida-carriers (two were colonized after bracket placement) and C. albicans was the most common species. The average number of yeasts in the oral cavity showed some fluctuation during the study, but in general had an upward trend (adj. R2 = 0.7967, p = 0.07025). A correlation was found between median number of yeasts and the periodontal indices (API, GBI). The average API values decreased in the Candida-carriers (adj. R2 = 0.95; p = 0.01709), while average GBI values increased in the noncarriers (adj. R2 = 0.92; p = 0.0256). CONCLUSIONS: Treatment with orthodontic appliances promotes Candida yeast colonization, which is variable over time in terms of strain and species, with dominance of C. albicans, and without increased biofilm-forming activity. The API value decreases over time in carriers, and the GBI value increases in uncolonized patients, which may have predictive significance for the development of oral candidiasis during orthodontic treatment.

[Interdisciplinary surgical and prosthetic treatment of adenocarcinoma of the palate].

INTRODUCTION: The palatal mucosa requires careful testing prior to prosthetic treatment. Pathological changes may occur during the period of use of a dental prosthetic, especially when worn constantly. Aim of the report: We describe the case of a patient who experienced extensive changes in the mucosa of the hard palate over 12 years of dentures used. CASE PRESENTATION: The 78-year-old female patient was referred to the Department of Otolaryngology of the Jagiellonian University Hospital in Krakow with a diagnosis of adenocarcinoma of the palate. In connection with the planned extensive surgery, there was indication for the use of a palatal plate with an obturator in order to close the expected gap in the palate structure. No recurrence of the tumor was seen in the period examined. Summation: Despite the extensive tumor, two small defects in the palate remained after surgery. These were effectively sealed and the patient reached the five-year survival point.

Activity of the masticatory muscles and occlusal contacts in young adults with and without orthodontic treatment.

BACKGROUND: Symmetry evaluation of the craniofacial complex generally involves models of mandibular movement and masticatory muscle activity, especially during the development of the craniofacial complex. The aim of this screening study was to detect differences in the asymmetry and activity indices and in the occlusal contact distribution in groups with and without orthodontic treatment, and between the sexes in the healthy population. MATERIAL AND METHOD: This screening study involved the participation of 149 Caucasian (F = 101, M = 48) 18-year-old volunteers, of whom 77 had received orthodontic treatment (Group I) and 72 had not (Group II). All participants underwent sEMG recording with an eight-channel electromyograph (Bio EMG III). A T-Scan III device was used to analyze the occlusal contact points. We measured the voltage of the right and left temporalis anterior (RTA, LTA) and of the right and left masseter muscles (RMM, LMM). On the basis of the Naeije study, we calculated the Asymmetry and Activity indices (AsI, AcI). RESULTS: No significant differences were found in the asymmetry or activity indices, or in the occlusal contact distribution of young adult subjects with or without orthodontic treatment. There were two findings in the females. First (p = 0.04), a higher voltage (131.12 µV) was recorded in the right temporalis anterior muscle in female group, compared to 119.65 µV in the male group. Secondly (p = 0.002), the activity index showed a predominance of the temporalis anterior (AcI = 10.52). In the males, the activity index showed a predominance of the masseter muscles (AcI =-1.22). CONCLUSIONS: The null hypothesis was supported, as we found that no significant differences were observed in occlusal contact, asymmetry, or activity indices between healthy young adults with or without orthodontic treatment. However, there do exist significant differences in the activity index between genders.

Assessment of stress burden among dental students: A systematic literature review and meta-analysis of data.

BACKGROUND: The education of dentists is associated with high levels of stress among students. This phenomenon is observed in many countries. OBJECTIVES: The aim of the study was to sum up the knowledge about stress burden among dental students and to determine the causal factors on the basis of a quantitative systematic review of the literature. MATERIAL AND METHODS: The PubMed/MEDLINE and Cochrane Library databases were reviewed, and the literature was manually searched for the following keywords: 'stress'; 'dental student'; 'dental education'; and 'DES questionnaire'. The inclusion criteria for the systematic literature review were original papers and literature reviews, published after 1990, written in English, containing the analysis of the DES questionnaires, and on the topic of stress among students of dentistry. The inclusion criteria for the meta-analysis were publications with the same thematic structure of the DES questionnaire and with the number of survey participants provided. RESULTS: A total of 36 original papers were found, out of which 29 met the inclusion criteria, and thus were included into the systematic literature review analysis. Taking all the papers into consideration, the highest level of stress was caused by grades and examinations, and the atmosphere created by clinical professors. Nearly half of the studies demonstrated higher levels of stress in women. Also, students of higher years were characterized by higher stress indicators. The statistical analysis comprised data from 11 European universities that met the inclusion criteria. The highest mean scores were obtained for 'performance pressure', while the lowest mean scores for 'relationship with sex/race'. CONCLUSION: There was a great heterogeneity among the pooled estimates, which could be attributed to the varying levels of stress among dental students. The students' ethnicity and cultural indicators have a decisive influence on the stress levels of dental students, not the characteristics of the field of study.

Foundations of fluoride prophylaxis in Poland and the prosthetic rehabilitation of the masticatory organ in arthropathies and malocclusion: Scientific achievements of Professor Noemi Wigdorowicz-Makowerowa.

Professor Noemi Wigdorowicz-Makowerowa was born in Warsaw to a Polish Jewish family on November 24, 1912. She graduated from the Medical University of Warsaw in 1937 and from the Academy of Dentistry in 1939. In early 1940, she was forcibly relocated to the Warsaw Ghetto, from which she escaped in January 1943. Shortly after the Second World War, in 1946, she started working at Wroclaw University. She conducted multiple studies there on the fluoride prophylaxis of caries, and on temporomandibular joint arthropathy and its etiology. She proved the efficiency of tap water fluoridation in caries prevention through a comparative study on children from schools in Wroclaw and Malbork, where the fluoride concentrations were 0.1 mg/L and 3.2 mg/L, respectively. The incidence of deep caries and the rate of tooth mortality were significantly lower in Malbork. Her long-term studies on the fluoride prophylaxis of caries prompted Professor Wigdorowicz-Makowerowa to found the Scientific and Technical Team for Fluoride Prophylaxis, based at the Department of Dental Prosthetics in the Institute of Dentistry of Wroclaw Medical University, which led to the creation of 35 fluoride water treatment plants in Poland by 1980. Moreover, she emphasized that malocclusion caused by dental caries and tooth loss, bruxism, higher susceptibility to stress, and increased muscle tone may constitute reasons for masticatory organ disorders. In her long career of over 30 years, she published 68 articles about fluorine and its use in dentistry, and 50 articles about temporomandibular joint arthropathy and other masticatory organ disorders.

Relationship between oral hygiene and fungal growth in patients: users of an acrylic denture without signs of inflammatory process.

OBJECTIVES: To answer to the following questions: is there any relationship between oral hygiene and the growth of yeast in patients without mucosal inflammation; and is there a need for mycological examination patients without mucosal inflammation? BACKGROUND: Patients with candidiasis may report varied symptoms, but such infections are most often asymptomatic. In addition to its high incidence in denture users (60%-100%), there is a concern that Candida species from the oral cavity may colonize the upper gastrointestinal tract and lead to septicemia, which has a 40%-79% mortality rate and can require a prolonged hospital stay. It is thus important for all physicians to be aware of the risk factors, diagnosis, and treatment of oral candidiasis in older patients. METHODS: A retrospective study was carried out on a group of patients who had undergone mycological examination and assessment of the intensity of yeast growth, and oral hygiene. RESULTS: Ninety-one denture wearers who lacked signs of clinical inflammation were included in the study. The growth of Candida albicans was as follows: 14 patients had up to 20 colonies; 19 patients had over 20 colonies. Ten percent of patients with good oral hygiene proved to have more than 20 yeast colonies. 5% of patients with bad oral hygiene had more than 20 colonies. CONCLUSIONS: There was no relationship found between hygiene and the growth rate of fungal microorganisms. In patients without clinical symptoms of stomatitis, mycological examination should be considered.

Relation between Headache and Mastication Muscle Tone in Adolescents.

Headache is a common problem in the population, which decreases the quality of life and makes everyday functioning difficult. It often coexists with typical symptoms of temporomandibular disorders. The objective of the study was to clarify whether there is a relationship between the presence of headache in young volunteers and the mastication muscle tone. Material and Method. Volunteers aged 18 years who underwent general dental examination, clinical evaluation, and examination using the dual-axis diagnostic system Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) form in the Polish language version participated in the study. On the basis of the examination results, these individuals were divided into three groups according to RDC results. A group of healthy individuals (axis I value 0), a group of sick individuals (axis I diagnosis Ia, IIa, or IIIa), and a group of individuals suffering from depression (axis II values 1-3) were singled out. Then, volunteers were divided into two groups: group I reporting headache and group II without any pain. In each of these individuals, the contractile activity of the masseter muscles and anterior temporal muscles was recorded bilaterally as the surface electromyographic activity (sEMG) at rest, during swallowing, and maximum clenching. The activity index ranging between +100 (activity of the masseter muscles only) and -100 (activity of the anterior temporal muscles only) was used to indicate the predominance of activity of the study muscles. Results. The statistical analysis of data showed that there was a significant relationship between the presence of headache and a change in the mastication muscle tone, expressed as the predominant activity of the temporal muscles, only in the group of sick individuals during maximum clenching. Summary. The diversity of sEMG results implies that a change in the mastication muscle tone is not a direct consequence of headache, but it has to be modified by other factors.

The evaluation of the effect of carbon dioxide laser radiation on dentine tissue.

of this study was to analyze the effects of carbon dioxide (CO2) laser light on the structure and elemental composition of dentine. METHODS: The evaluation was conducted on samples from extracted teeth. The surface of the dentine was exposed to the radiation from a CTL 1401 CO2 laser (Centre of Laser Technology, Poland). The radiation and frequency parameters were as follows: group I with 5 W and 1 Hz, group II with 10 W and 1 Hz, group III with 5 W and 5 Hz, and group IV with 10 W and 5 Hz. The altered dentine structure was macroscopically and microscopically evaluated using a Nova NanoSEM 200 Scanning Electron Microscope (FEI Europe) with integrated microanalysis X-ray system for elemental analysis in points. RESULTS: There were significant differences between groups in the macro- and microstructure of laser defects. CONCLUSIONS: CO2 laser radiation causes irreversible, destructive changes in dentine. The structural dentine lesions developed under the influence of the CO2 laser radiation may hinder proper adhesion of bonding systems with the damaged tissue. Laser defects in the structure should be treated like defects of noncarious origin requiring preparation and filling with composite materials in accordance with the procedures.

Treatment of denture-related stomatitis improves endothelial function assessed by flow-mediated vascular dilation.

INTRODUCTION: The presence of oral inflammation has recently been linked with the pathogenesis of cardiovascular diseases. While numerous studies have described links between periodontitis and endothelial dysfunction, little is known about the influence of denture-related stomatitis (DRS) on cardiovascular risk. Therefore, the aim of this study was to determine whether the treatment of DRS can lead to improvement of the clinical measures of vascular dysfunction. MATERIAL AND METHODS: The DRS patients were treated with a local oral antifungal agent for 3 weeks. Blood pressure, flow-mediated dilatation (FMD) and nitroglycerine-mediated vascular dilatation (NMD) were measured during three study visits: before treatment, one day and two months after conclusion of antifungal therapy. RESULTS: Flow-mediated dilatation measurements showed significant improvement of endothelial function 2 months after treatment (FMD median 5%, 95 CI: 3-8.3 vs. 11%, 95% CI: 8.8-14.4; p < 0.01), while there was no difference in control, endothelium-independent vasorelaxations (NMD; median = 15.3%, 95% CI: 10.8-19.3 vs. 12.7%, 95% CI: 10.6-15; p = 0.3). Other cardiovascular parameters such as systolic (median = 125 mm Hg; 95% CI: 116-129 vs. 120 mm Hg, 95% CI: 116-126; p = 0.1) as well as diastolic blood pressure and heart rate (median = 65.5 bpm, 95% CI: 56.7-77.7 vs. 71 bpm, 95% CI: 66.7-75; p = 0.5) did not change during or after the treatment. CONCLUSIONS: Treatment of DRS is associated with improvement of endothelial function. Since endothelial dysfunction is known to precede the development of severe cardiovascular disorders such as atherosclerosis and hypertension, patients should be more carefully screened for DRS in general dental practice, and immediate DRS treatment should be advised.

Correlation between age and gender in Candida species infections of complete denture wearers: a retrospective analysis.

AIM: Denture-related stomatitis is a disorder that often affects denture wearers. The purpose of this study was to evaluate the intensity, genera, and frequency of yeasts in the oral cavity of complete denture wearers in terms of subject gender and age. MATERIALS AND METHODS: Nine hundred twenty patients (307 males and 613 females) with complete upper dentures were selected for the study and divided into four age groups: ≤50 years, 51-60, 61-70, and >70 years. Yeast samples were taken as a smear from the palate. The data were collected from January 15, 2007 to January 15, 2012. RESULTS: The distribution of the number of yeast colonies by gender was statistically significant (P=0.02). Across all subjects, there was a statistically significant relationship between the intensity of yeast growth and the gender (P=0.01). In every age group, the number of infection-free individuals was greater among males than females. Intermediate, intense, and abundant growth of yeast occurred most frequently in the youngest group of females. CONCLUSION: The genera of Candida species and the frequency of yeast infection in denture wearers appear to be influenced by both age and gender. The complete denture wearers ≤50 years of age appeared to have the greatest proclivity to oral Candida infections.

The Polish face in profile: a cephalometric baseline study.

BACKGROUND: This study reports the cephalometric evaluation of a group of adolescent Polish individuals describing dento-facial structure as well as details of incisor position and soft tissue characteristics. The results should reveal morphological features specific to Polish persons and serve as a comparative material for future diagnostic procedures. METHODS: The study was based on an analysis of cephalgrams of 122 Polish adolescents average age 18 years 6 months analysed in a computer system using the Kracovia composite system analysis describing dento-facial morphology ad modum Björk as well as soft tissue factors. The control material was based on published reports by Björk (Dento-facial characteristics) Riketts and Holdaway (soft tissue profile). RESULTS: The comparative study revealed a slight reduction in the sagittal jaw relationship with a significant reduction in the vertical jaw relationship and a distinctive mandibular morphology with a reduced jaw angle and an increase in the "Beta angle". These findings were reflected in the soft tissue pattern. The soft tissue profile reflected the skeletal cephalometrics observation. CONCLUSION: The dento-facial profile of Polish adolescents demonstrates specific characteristics which should be taken into account when diagnosing facial form in connection with orthodontic treatment planning in particular Polish patients.

Denture-related stomatitis is associated with endothelial dysfunction.

UNLABELLED: Oral inflammation, such as periodontitis, can lead to endothelial dysfunction, accelerated atherosclerosis, and vascular dysfunction. The relationship between vascular dysfunction and other common forms of oral infections such as denture-related stomatitis (DRS) is unknown. Similar risk factors predispose to both conditions including smoking, diabetes, age, and obesity. Accordingly, we aimed to investigate endothelial function and major vascular disease risk factors in 44 consecutive patients with dentures with clinical and microbiological features of DRS (n = 20) and without DRS (n = 24). While there was a tendency for higher occurrence of diabetes and smoking, groups did not differ significantly in respect to major vascular disease risk factors. Groups did not differ in main ambulatory blood pressure, total cholesterol, or even CRP. Importantly, flow mediated dilatation (FMD) was significantly lower in DRS than in non-DRS subjects, while nitroglycerin induced vasorelaxation (NMD) or intima-media thickness (IMT) was similar. Interestingly, while triglyceride levels were normal in both groups, they were higher in DRS subjects, although they did not correlate with either FMD or NMD. CONCLUSIONS: Denture related stomatitis is associated with endothelial dysfunction in elderly patients with dentures. This is in part related to the fact that diabetes and smoking increase risk of both DRS and cardiovascular disease.

Dentinogenesis imperfecta type II: ultrastructure of teeth in sagittal sections.

The morphological abnormalities of the teeth of patients affected by dentinogenesis imperfecta type 2 (DI-II) may underlie the difficulties with the clinical restoration of such teeth. We therefore performed a scanning electron microscopy (SEM) study of four permanent first mandibular molars of four DI-II patients with periapical pathosis. The teeth were prepared for SEM evaluation by standard methods. In the crown, the enamel presented a highly irregular surface with a number of cracks and crevices. In some places, only granular remains of the enamel were found, while in other parts of the crown, the enamel was absent. SEM examination revealed the structural changes responsible for the lower enamel's hardness and resistance to attrition, and for tooth wear, while the structural changes in the dentin may explain the failure of some adhesive restorative materials. This SEM study thus revealed structural defects which underlie the problems of attrition and restoration loss found in patients with this genetic dental condition.

Relationship between occlusal force distribution and the activity of masseter and anterior temporalis muscles in asymptomatic young adults.

UNLABELLED: Healthy subjects have a prevalent side on which they display higher-muscle activity during clenching. The relationship between symmetry of masseter muscle (MM) and anterior temporalis (TA) muscle activities and occlusion has been evaluated on the basis of physiological parameters. The aim of the present study was to investigate whether the symmetry of surface EMG (sEMG) activity in asymptomatic young adults is related to symmetry of occlusal contacts. MATERIAL: The study population consisted of seventy-two 18-year-old subjects with no temporomandibular disorder (TMD) symptoms. METHOD: All the participants underwent an sEMG recording with an 8-channel electromyograph (BioEMG III). A T-Scan III evolution 7.01 device was used to analyze the occlusal contact points. RESULTS: The correlation between the activity of right (R) and left (L) TA and the percentage of occlusal contacts was assessed, but no significant differences were found between the RMM and LMM muscles. The differences in the medium values of sEMG between males and females were not statistically significant. Equilibrated muscular activity between RTA and LTA occurred when occlusal contacts reached the percentage of 65% on the left side. CONCLUSION: The symmetry of sEMG activity in asymptomatic young adults is not related to symmetry of occlusal contacts.

Dentinogenesis imperfecta - hardness and Young's modulus of teeth.

Dentinogenesis imperfecta type II (DI-II) is the most common dental genetic disease with reported incidence 1 in 8000. Elasticity and hardness of the enamel of teeth are important values which are connected with their resistance to attrition. It is hypothesized that values of physical properties for healthy teeth and teeth with DI-II are different. The aim of the study was to investigate some physical properties of teeth extracted from patients with DI-II in comparison with normal teeth. The material of the study was six teeth: three lower molars, with clinical signs of DI-II, which were extracted due to complications of pulp inflammation and three other lower molars which were extracted for orthodontic reasons - well formed, without any signs of pathology. The surfaces of DI-II and normal teeth were tested on the CSM Instruments Scratch Tester machine (producer CSEM Switzerland) by Oliver and Pharr method. The indenter used was Vicker's VG-73 diamond indenter. Additionally, the Scanning Electron Microscopy (SEM) analysis of the surface of the teeth with DI-II was made. Vickers hardness of the teeth with dental pathology (DI-II) was seven times smaller, and Young's modulus six times smaller than those of healthy teeth. The parameters of hardness and elasticity of enamel of teeth with clinical diagnosis of DI-II were very much smaller than in normal teeth and because of that can be responsible for attrition.

Mycological analysis of the oral cavity of patients using acrylic removable dentures.

Background. The problems of fungal infections in edentulous have been discussed in literature. Findings show that oral mycosis has an influence on the mycosis of oesophageal mucosa. Based on this we started to follow from 2007 in patients who wear dentures mycological examination, to evaluate changes of yeasts numbers, the sensitivity to antibiotics and determine the impact of types of prosthesis, time of using, gender and age of patients. 1230 patients who were wearing dentures participated in the retrospective study. The material for mycological examination was sampled as a smear from the palate. After the mycological identification of Candida species and assessment of growth, the susceptibility testing with Fluconazole and Nystatin was made. The number of 23 Candida species was diagnosed microbiologically in five years. C. albicans and C. glabrata were increasing in number-from 33,7% to 46,9% and 6,7% to 14,0%, respectively. There was a significant statistical difference between yeasts growth and gender (P = 0, 017 < 0.05). The conclusion is that a large percentage of persons wearing removable denture has been affected by Candida species and that could lead to the mycosis of farther gastrointestinal tract sections. The mycological examination before treatment, especially in patients using acrylic denture, appears to be necessary.