Platelet-rich plasma injections for the treatment of temporomandibular joint disorders: A systematic review.

OBJECTIVE: This systematic review aimed to investigate and examine whether intra-articular injections of platelet-rich plasma (PRP) after arthrocentesis are beneficial for the treatment of temporomandibular disorders, when compared to other treatments, such as injections of hyaluronic acid (HA) or saline after arthrocentesis. METHODS: An electronic search on PubMed was performed using combinations of the terms 'temporomandibular' and 'platelet rich plasma', to identify studies reported in English and published up until 2017. The initial screening identified 222 records, of which only seven fulfilled the inclusion criteria and were included in this review. Of these studies, three compared injection of PRP after arthrocentesis with the injection of HA after arthrocentesis, while two compared injection of PRP after arthrocentesis with Ringer's lactate after arthrocentesis and one compared injection of PRP after arthrocentesis to sodium chloride. RESULTS: Five of the studies found that PRP injections have led to significant improvements in mandibular range of motion and pain intensity up to 12 months after treatment, while the remaining two studies found similar results for the different treatments. CONCLUSION: However, a standardized protocol for PRP preparation and application needs to be established.

Effect of Different Application Modalities on the Bonding Performance of Adhesive Systems to Dentin: A Systematic Review and Meta-Analysis.

Diverse types of dental adhesives exhibit different cytotoxic outcomes on cells in vitro. Currently, no standard adhesive application technique has so far been decisive for clinicians for better durability of resin-dentin bonds of adhesive systems. The purpose of this study was to systematically review the literature to evaluate the bonding performance of adhesive systems to dentin by using different application modalities. The systematic research strategy was conducted by two reviewers among multiple databases: PubMed, Scopus, Web of Science, Embase, and Scielo. In vitro studies reporting the effects of additional steps for the application of adhesive systems on the bond strength to dentin were selected. Meta-analysis was performed using Review Manager Software version 5.3.5 using the random effects model. The methodological quality of each in vitro study was assessed according to the parameters of a previous systematic review. The electronic research through different databases generated a total of 8318 references. After the examination of titles and abstracts, a total of 106 potentially relevant studies accessed the full-text evaluation phase. After full-text examination, 78 publications were included for the qualitative analysis, and 68 studies were included in the meta-analysis. Regarding the etch-and-rinse adhesive systems, the application modalities that improved the overall bond strength were the application of a hydrophobic resin layer (p = 0.005), an extended application time (p < 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p = 0.05), the agitation technique (p = 0.02), and the active application of the adhesive (p < 0.001). For self-etch adhesive systems, the techniques that improved the overall bond strength were the application of a hydrophobic resin layer (p < 0.001), an extended application time (p = 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p < 0.001), the agitation technique (p = 0.01), and the active application of the adhesive (p < 0.001). The in vitro evidence suggests that the application of adhesive systems using alternative techniques or additional strategies may be beneficial for improving their bond strength to dentin. The application modalities that favored the overall bond strength to dentin were an extended application time, a double-layer application, an application assisted by an electric current, the active application of the adhesive, and the application of a hydrophobic resin layer. Worth mentioning is that some techniques are intended to increase the degree of the conversion of the materials, and therefore, improvements in the biocompatibility of the materials can be expected.

The Prevalence and Predicting Factors of Temporomandibular Disorders in COVID-19 Infection: A Cross-Sectional Study.

Introduction During the pandemic of coronavirus disease 2019 (COVID-19), an increase in temporomandibular disorders (TMDs) was noticed in infected patients. In the present study, we aimed to assess the prevalence of TMDs during COVID-19 infection and to evaluate associated factors. Methods An observational cross-sectional online survey was conducted in April and May 2021 in order to estimate the prevalence of TMDs in participants who were previously infected with COVID-19. A multivariable logistic regression model was carried out to explore predicting factors of TMDs during COVID-19 infection. Results In total, the prevalence of TMDs during the COVID-19 infection period among participants was 41.9%. High fever episodes (adjusted odds ratio {aOR}: 3.25), gastro-esophageal reflux (aOR: 2.56), and toothache (aOR: 3.83) during COVID-19 illness were found to be positive predictors of TMDs, while vitamin D deficiency was found to be a negative predictor (aOR: 0.28). Conclusion Our study has highlighted a relatively high prevalence of TMDs in COVID-19-infected patients that may conclude TMDs as a possible COVID-19 symptom. Further studies are warranted to confirm the association between TMDs and COVID-19 infection and thereupon include TMDs among the known symptoms of COVID-19.

Effect of Occlusal Splints on Posture Balance in Patients with Temporomandibular Joint Disorder: A Prospective Study.

AIM AND OBJECTIVE: Force platforms are widely used to evaluate the relationship between bodily posture and jaw positions. The aim and objective of this clinical prospective study was to evaluate the effect of occlusal splints on bodily posture using force platforms. MATERIALS AND METHODS: Forty-seven female patients with temporomandibular disorders (TMD) underwent a clinical and postural examination before and during an occlusal treatment with an upper splint. Six postural stabilometric examinations were performed under different visual conditions. Postural stability was assessed using a force platform (SATEL). Subjects were evaluated in static and dynamic conditions, with open and closed eyes, at baseline, at 1 week, and at 3 months. Changes in stabilometric parameters (sway area and sway length) were assessed and compared. RESULTS: In static and dynamic positions, the sway surface area decreased significantly after the occlusal guard placement with closed eyes (p-value, 0.012). Likewise, the sway surface area decreased significantly in the dynamic lateral position with closed eyes (p-value, 0.018) and in anteroposterior dynamic position with open eyes (p-value, 0.031). The mean sway length decreased significantly after the placement of the occlusal guard when participants were in the lateral position with open eyes (p-value, 0.025) and in the anteroposterior position with open eyes (p-value, 0.014). On a 3-month assessment, the mean surface and mean length decreased significantly after the placement of the occlusal guard for practically all the static and dynamic positions. CONCLUSION: The sway surface area and sway length decreased significantly with the use of occlusal splints Clinical significance: In female patients with TMD, the use of an occlusal splint is associated with a postural improvement evaluated by posturo-stabilometric tests.