The Role of the Lateral Pterygoid Muscle in Articular Disc Displacement: A Cross-sectional Magnetic Resonance Imaging Study.

OBJECTIVE: The objective of the study is to determine the role of Lateral Pterygoid Muscle LPM in the articular disc displacement ADD, which is considered controversial due to the variations in the pattern of insertion of the Superior Lateral Pterygoid Muscle SPLM. BACKGROUND: It is well understood that the superior head of the lateral pterygoid muscle has only a single insertion pattern among individuals, in which the muscle is attached to the articular disc and capsule. However, recent findings in many studies have shown a noticeable variation in the insertion pattern of the upper LPM. METHODS: MRI examinations were collected at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. Scans of 61 patients (41 females, 20 males; mean age 33 years old) with symptoms of temporomandibular dysfunction were reviewed retrospectively. The direction of their articular disc displacement was evaluated through sagittal and coronal views in both open and closed mouth positions. RESULTS: There was no statistical significance found between the LPM attachment types and TMJ disc position. The chi-square test also showed no significant difference between the type of LPM attachment and the condylar location. Forty-five percent of the articular discs were located between the articular eminence and the glenoid fossa. The majority of the disc displacement was in the anterior direction. CONCLUSION: There was no statistically significant association found between the type of LPM attachments and the direction of disc displacement.

Survival of Titanium-Zirconium and Titanium Dental Implants in Cigarette-smokers and Never-smokers: A 5-Year Follow-up.

OBJECTIVE: To compare the peri-implant clinical and radiographic status around bone-level narrow-diameter titanium-zirconium (TiZr) implants and titanium (Ti) implants placed in cigarette-smokers (CS) and never-smokers (NS). METHODS: Partially edentulous CS and NS rehabilitated with TiZr and Ti implants were included. Demographic data and information regarding smoking habits were collected. Participants were divided into four groups: group-1, CS with TiZr implants; group-2, NS with TiZr implants; group-3, CS with Ti implants; and group-4, NS with Ti implants. 36, 30, 31 and 33 implants were placed in 24, 23, 24 and 25 male individuals in groups 1, 2, 3 and 4, respectively. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and mesial and distal crestal bone loss (CBL) were measured. All patients were enrolled in biannual routine oral prophylaxis care at least until the fifth year of follow-up and oral hygiene instructions were reinforced at each recall appointment. P < 0.05 was considered statistically significant. RESULTS: At the 3- and 5-year follow-ups, there was no statistically significant difference in the peri-implant PI, BOP, PD and CBL between individuals in all groups. In all groups, the implant success and survival rates were 100% and 100%, respectively, at the 5-year follow-up. CONCLUSION: The TiZr and Ti dental implants can remain clinically and radiographically stable in CS in a manner similar to NS. Routine oral hygiene maintenance plays an essential role in this regard.

Comparison of yeast species in the subgingival oral biofilm of individuals with type 2 diabetes and peri-implantitis and individuals with peri-implantitis without diabetes.

BACKGROUND: There are no studies that have investigated the presence of yeasts in the subgingival oral biofilm (OB) of type-2 diabetic and non-diabetic patients with peri-implantitis. The aim was to assess the presence of yeasts in the subgingival OB of patients with type 2 diabetes and peri-implantitis and patients with peri-implantitis without diabetes. METHODS: Patients with type 2 diabetes with peri-implantitis (group A), non-diabetic individuals with peri-implantitis and without diabetes (group B), and individuals with and without peri-implantitis (group C) were included. Lifestyle-related and demographic data were collected using a questionnaire and hemoglobin A1c levels were measured. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were evaluated and crestal bone loss (CBL) were measured. Subgingival OB samples were collected and oral yeasts species were identified using ChromAgar medium. Level of significance was set at P <0.05. RESULTS: The mean age of individuals in groups A (n = 43), B (n = 41), and C (n = 42) were 55.6 ± 6.4, 54.6 ± 4.5, and 57.1 ± 3.3 years, respectively. The mean HbA1c levels were higher in group A (P <0.01) than groups B and C. Peri-implant PI (P <0.01), BOP (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher in group A compared with patients in groups B and C. Peri-implant PI (P <0.05), BOP (P <0.05), PD (P <0.05), and CBL (P <0.05) were significantly higher among patients in group B compared with group C. Subgingival yeasts were more often isolated from the OB of patients in groups A (74.4%) and B (46.3%) than group C (7.1%). The most common yeast species identified in all groups was Candida albicans. The CFU/mL for subgingival yeasts were higher in group A than groups B (P <0.01) and C (P <0.01). The CFU/mL for subgingival yeasts were higher in group B than group C (P <0.01). CONCLUSION: Candida species (predominantly C. albicans) were more often present in the subgingival OB of patients with and without type 2 diabetes with peri-implantitis than systemically healthy individuals without peri-implant diseases.

Clinical and radiographic indices around narrow diameter implants placed in different glycemic-level patients.

BACKGROUND: Studies assessing peri-implant clinical and marginal bone resorption (MBR) around narrow diameter implants (NDIs) placed in different glycemic levels are uninvestigated. OBJECTIVE: The present 3-year retrospective follow-up investigation was designed to explore clinical and radiographic status of NDIs placed in individuals with different glycemic control levels. MATERIALS AND METHODS: Patients with serum hemoglobin A1c (HbA1c) levels ≥6.5% (Group-1), 5.7%-6.4% (Group-2), and 4.0%-5.0% (Group-3) were included. Clinical indices evaluating bleeding on probing (BOP), plaque scores (PI), peri-implant probing depth (PD), and MBR were recorded around NDIs at 1-, 2-, and 3-year follow-up. Serum HbA1c test was carried out for all patients to assess the profile of glycosylated hemoglobin at 1 and 3 years of follow-up. RESULTS: A significant reduction in mean HbA1c levels from year 1 to year 3 follow-up period was seen in Group-1 only. PI varied from 0.40 in Group 1 at 2 year and 0.42 at 3-year follow-up to 0.18 at 2-year (P = 0.032) and 0.17 at 3-year (P = 0.018) follow-up, respectively. Greater BOP was noted in Group 1 (0.53) as compared with Group 2 (0.42) and Group 3 (0.21) (P = 0.048) at 3-year follow-up. PD after 3 year ranged from 2.04 mm in Group 3 to 2.32 mm in Group 1 that showed statistically significant difference (P = 0.037). No statistical significant differences were observed in MBR at any time point between the groups. CONCLUSION: The results of this short-term follow-up study indicate that NDIs show clinical and radiographic stability, provided oral cleanliness and glycemic levels are relatively maintained. Further long-term clinical studies are needed to evaluate implant stability over the period along with controlled glycemic status.