Effectiveness of bruxism treatment in young adults.

OBJECTIVE: Aim: This study aimed to assess the effectiveness of the developed algorithm for treatment and prevention measures aimed at eliminating clinical manifestations of bruxism in young people. PATIENTS AND METHODS: Materials and Methods: A cohort of 377 individuals aged 25 to 44 years underwent examination. Based on identified etiological factors, three distinct groups were delineated. Treatment and preventive strategies were then implemented and evaluated. Tailored treatment algorithms were devised for each group: Group one received selective grinding of supracontacts (up to 0.5-0.75 mm) and treatment for orthodontic issues utilizing removable and fixed orthodontic structures. Group two underwent finger self-massage of masticatory muscles, fabrication of biting dental splints, and anti-inflammatory drug therapy. Group three received sedative drug therapy in conjunction with psychiatric consultation, based on indications. Treatment efficacy was assessed 12 months post-initiation. Statistical analyses were conducted using Statistica 10.0 (StatSoft, Inc., USA) and Microsoft Office Excel 2010. RESULTS: Results: In cases where orthodontic pathology and supracontacts predominated (r=0.99, p<0.05), employing selective grinding and orthodontic treatment according to specific indications yielded significant efficacy. This approach resulted in a notable reduction in bruxism severity, corroborated by occludogram results 12 months post-treatment initiation. Notably, 90.0% of occludogram indicators fell within the 90-100% range, accompanied by a decrease in the BruxChecker abrasion facets area (p<0.05). Further, there was a substantial enhancement in occlusal contacts (Ck=0.68, Ck =0.71, Ck =0.93). In instances where TMJ pathology predominated with high reliability (r=0.98, p<0.05), effective normalization of masticatory muscle tone and alleviation of temporomandibular joint issues were observed. After 12 months, palpation revealed minimal tenderness in specific muscle areas and normalization of electromyography readings from initial indicators (p<0.05). Moreover, when the psycho-emotional factor primarily contributed to bruxism etiology (r=0.97, p<0.05), medical intervention proved effective. This approach led to bruxism disappearance and normalization of the psycho-emotional state within 12 months (p<0.05). CONCLUSION: Conclusions: The conducted studies provide high-confidence evidence of the effectiveness of bruxism treatment when diagnosing the prevailing etiological factor and targeting its specific impact, leading to the normalization of all other factors, a reduction in bruxism intensity, and its complete disappearance.

Correlación entre la presencia de apnea del sueño y las fracturas protésicas e implantológicas. Serie de casos clínicos con identificación del proceso y tratamiento con dispositivo de avance mandibular / Correlation between the presence of sleep apnea and prosthetic and implant fractures. Series of clinical cases with identification of the process and treatment with mandibular advancement device

Introducción: La presencia de signos y síntomas dentales en pacientes con apnea obstructiva del sueño (AOS) reconocibles para el odontólogo, nos sitúa en la primera línea de diagnóstico y tratamiento posterior para los pacientes que sufren esta patología. Métodos: Han sido reclutados de forma retrospectiva pacientes con problemas en distintas rehabilitaciones sobre implantes de tipo eminentemente mecánico (fractura de cerámica, de prótesis o de componentes, así como de implantes) a los que se ha realizado una poligrafía respiratoria para poner de manifiesto la posible presencia de un AOS. En aquellos casos donde se ha constatado la presencia de este trastorno, hemos seleccionado los pacientes con un AOS moderado-severo (índice de apnea-hipopnea (IAH) ≥ 20), para analizar los distintos eventos adversos acontecidos en función de la severidad del cuadro. Resultados: Fueron reclutados 22 pacientes que cumplieron los criterios de inclusión. En todos los pacientes se identificaron eventos adversos, siendo estas complicaciones: fractura de la cerámica de la prótesis (63,6%), fractura estructural de la prótesis en un 18,2% de los casos (estructura en sí misma o recubrimiento de resina en las híbridas) y fracturas o fisuras en los implantes en un 18,2% de los casos. Se realizó un abordaje terapéutico con CPAP (dispositivo de presión continua de oxígeno en vía aérea) unido a un dispositivo de avance mandibular (DIA) en dos pacientes, en el resto solamente DIA. Con el tratamiento finalizado, los pacientes pasaron de una media de IAH de 33,29 (+/- 18,90) a una media de 17,38 (+-10,37), siendo estas diferencias estadísticamente significativas (p<0,001). Conclusiones: El bruxismo y la AOS están íntimamente relacionados, así como los signos dentales de ambos procesos, como son el desgaste y la fractura de dientes, implantes o rehabilitaciones. (AU)

Introduction: The presence of dental signs and symptoms in patients with sleep apnea (OSA) that are recognizable to the dentist places us in the first line of diagnosis and subsequent treatment for patients suffering from this pathology. From problems such as wear and tear and fractures, we can reach a diagnosis of a pathology with great repercussions for the patient and address crucial part of the treatment, such as recovering the vertical dimension and the use of mandibular advancement devices. Material and method: We retrospectively recruited patients who attended our dental clinic with problems in different implant rehabilitations of an eminently mechanical nature (fracture of ceramics, prostheses, or components as well as implants) who underwent respiratory polygraphy to reveal the possible presence of OSA. In those cases where this disorder was found to be present, we selected patients with moderate-severe OSA (apneahypopnea index (AHI) ≥ 20) to analyze the different adverse events that occurred according to the severity of the sleep disorder recorded. Results: Twenty-two patients who met the previously established inclusion criteria were recruited. Adverse events were identified in all patients in their implant restorations, these complications being: fracture of the prosthesis ceramic (63.6%), structural fracture of the prosthesis in 18.2% of the cases (structure itself or resin coating in hybrids) and fractures or cracks in the implants in 18.2% of the cases. The mean AHI (apnea-hypopnea index) of all patients was 33.29 (+/- 18.90; range 20-110). If we analyze the presence of adverse events in the prostheses according to the AHI, we find that most adverse events are concentrated in the higher AHI ranges... (AU)

Del COVID leve al síndrome persistente: evaluación integral de la salud oral / From mild COVID to long COVID: comprehensive oral health assessment

Introducción: El COVID-19 ha causado una amplia sintomatología, incluyendo la presente en la cavidad oral. Cada día cobra más importancia un nuevo síndrome relacionado: el COVID persistente. El objetivo de este trabajo es analizar el efecto de la infección por SARS-CoV-2 a nivel oral en sujetos diagnosticados de COVID persistente, en comparación con la infección aguda. Métodos: Se llevó a cabo un estudio de casos y controles con 102 sujetos reclutados entre 2021 y 2022, de los que se obtuvieron 34 variables de salud oral y posibles factores de riesgo. Resultados: El análisis estadístico reveló que los sujetos COVID persistente presentaban significativamente mayor prevalencia de: adenopatías, dolor de ATM, irritación faríngea, xerostomía, obturaciones, ausencias y coronas dentales, mayor valor en índices CAOM y CAOD y mayor número de síntomas odontológicos en total. Además, el estrés apareció como factor de riesgo; aquellos pacientes con COVID persistente que presentaron mayor nivel de estrés (7,73 ± 2,02) también eran los que sufrían, en mayor medida, xerostomía o bruxismo, responsable del dolor de ATM, también más prevalente en este grupo. Conclusiones: El COVID persistente provoca manifestaciones orales relacionadas, algunas de ellas, con el hecho de que la cavidad oral sea vía de entrada del virus, como la irritación mucosa; otras, relacionadas con su posible naturaleza autoinmune, como la xerostomía y, de la misma manera, otras relacionadas con el estrés, reflejado en la presencia de bruxismo. Resulta imprescindible desarrollar protocolos que mejoren tanto el diagnóstico precoz como el manejo de estos pacientes en nuestras clínicas. (AU)

Introduction: COVID-19 has caused a wide range of symptomatology, including that present in the oral cavity. A new related syndrome is gaining importance: Long COVID. The aim of this work is to analyse the effect of SARS-CoV-2 infection at the oral level in subjects diagnosed with Long COVID, compared to acute infection. Methods: A case-control study was conducted with 102 subjects recruited between 2021 and 2022, from whom 34 oral health variables and possible risk factors were obtained. Results: Statistical analysis revealed that Long COVID subjects had significantly higher prevalence of: adenopathies, TMJ pain, pharyngeal irritation, xerostomia, fillings, dental absences and dental crowns, higher CAOM and CAOD index values and higher total dental symptoms. In addition, stress appeared as a risk factor; those patients with Long COVID who presented a higher level of stress (7.73 ± 2.02) were also those who suffered, to a greater extent, from xerostomia or bruxism, responsible for TMJ pain, also more prevalent in this group. Conclusions: Long COVID causes oral manifestations related, some of them, to the fact that the oral cavity is a route of entry of the virus, such as mucosal irritation; others, related to its possible autoimmune nature, such as xerostomia and, in the same way, others related to stress, reflected in the presence of bruxism. It is essential to develop protocols that improve both the early diagnosis and management of these patients in our clinics. (AU)

Physical manifestations of stress in women. Correlations between temporomandibular and pelvic floor disorders.

INTRODUCTION: Stress is characterized as a challenging occurrence that triggers a physiological and/or behavioral allostatic response, alongside the demands typically encountered throughout the natural course of life. A sustained state of stress gives rise to secondary effects, including insomnia and neck pain. Also, the risk of musculoskeletal problems in the cervical and lumbar spine can be increased due to a sustained state of stress. The present study main objective is to study the association between orofacial and pelvic floor muscles in women in Spain. METHODOLOGY: An observational, cross-sectional, retrospective analytical study was designed and carried out in the laboratories of the European University of Madrid. Sixty-five participants were recruited with a mean age of 29.9 ± 7.69. Measurements were taken by myotonometry on natural oscillation frequency (Hz), dynamic stiffness (N/m), elasticity (N/m2), mechanical stress relaxation time (ms) and creep, for the following muscles: right and left masseter, right and left temporalis and central fibrous nucleus of the perineum (CFPF). On the other hand, the subjects completed the following questionnaires: perceived stress scale (PSS-14), anxiety scale (STAI), self-reported bruxism questionnaire (CBA), Fonseca Anamnestic Index and the Pittsburgh Sleep Quality Scale (PSQI). RESULTS: Significant correlations were found in several parameters between the right temporalis and CFPF (p<0.05). Highlighting the correlation between TMDs and lubrication r = -0.254 (p = 0.041) and bruxism with pain in sexual intercourse r = 0.261 (p = 0.036). CONCLUSION: The results support the proposed hypothesis. To the author's knowledge, this is the first study which relates both locations, and it is suggested to continue with the research and expand the knowledge of it.

[Temporomandibular dysfunction and bruxism in patients with early rheumatoid arthritis and at-risk patients: a cross-sectional study]. / Temporomandibulaire disfunctie en bruxisme bij patiënten met vroege reumatoïde artritis en risicopatiënten: een cross-sectioneel onderzoek.

What is the prevalence of temporomandibular dysfunction in patients with early rheumatoid arthritis and individuals at risk of rheumatoid arthritis? 3 groups (of 50 participants each) were examined for a possible TMD diagnosis: 1. patients with early rheumatoid arthritis, 2. at-risk individuals, and 3. healthy controls. A possible association with bruxism, determined on the basis of self-reporting and clinical features, was also examined. At-risk patients had a higher prevalence of TMD pain diagnoses compared to healthy controls (p = 0.046). Within the early rheumatoid arthritis group, seronegative patients had a higher prevalence of TMD pain diagnoses than seropositive patients (p = 0.048). No further differences in the prevalence of TMD diagnoses were found between the groups. Participants with a TMD pain diagnosis were more often diagnosed with probable sleep bruxism than those without a TMD pain diagnosis. The prevalence of TMD pain is increased in individuals at risk of rheumatoid arthritis and seronegative early rheumatoid arthritis patients, and is associated with signs of bruxism.

Temporomandibular Disorders, Bruxism and Headaches.

Temporomandibular disorders (TMDs) and headache disorders are highly prevalent in the population. TMDs can present headache symptoms as a secondary headache and, in addition, be comorbid with primary headache disorders. This overlap has significant clinical implications for which it is essential for the physician to be aware, and they should screen for the potential presence of TMDs in a headache patient. Bruxism is a parafunctional behavior also prevalent in the population which has a role in TMDs and may influence headache symptomatology, but it is still necessary to clarify this relationship.

Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals.

OBJECTIVE: To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial. MATERIALS AND METHODS: Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05). RESULTS: After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months. CONCLUSION: GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism. CLINICAL SIGNIFICANCE: After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

Comparison of ultrasonography-based masticatory muscle thickness between temporomandibular disorders bruxers and temporomandibular disorders non-bruxers.

To compare masticatory muscle thickness in patients with temporomandibular disorders (TMDs) during rest and clenching, and by body position, using ultrasonography. This prospective study included 96 patients with TMD (67 females, 29 males; mean age: 40.41 ± 17.88 years): group 1, comprising 66 patients with TMD without bruxism (TMD_nonbruxer), and group 2, comprising 30 patients with concurrent TMD and bruxism (TMD_bruxer). In patients with TMD, bruxism was correlated with the presence of tinnitus, muscle stiffness, sleep problems, psychological stress, and restricted mouth opening. The masseter muscle significantly thickened during clenching (11.16 ± 3.03 mm vs 14.04 ± 3.47 mm, p < 0.001), whereas the temporalis muscle showed no significant increase in thickness from resting to clenching in an upright position (7.91 ± 1.98 vs 8.39 ± 2.08, p = 0.103). Similarly, during clenching in the supine position, the masseter muscle was significantly thicker compared with rest (11.24 ± 2.42 vs 13.49 ± 3.09, p < 0.001), but no significant difference was observed in temporal muscle thickness (8.21 ± 2.16 vs 8.43 ± 1.94, p = 0.464). In comparison between two groups, the average thickness of the masseter muscle was greater among TMD_bruxers than among TMD_nonbruxers in both the upright and supine positions (all p < 0.05). In the generalized lineal model, female sex (B = - 1.018, 95% confidence interval [CI] - 1.855 to - 0.181, p = 0.017) and bruxism (B = 0.868, 95% CI 0.567 to 1.169, p = 0.048) significantly predicted changes in masseter muscle thickness. Female sex (B = - 0.201, 95% CI - 0.299 to - 0.103, p = 0.011), increased age (B = - 0.003, 95% CI - 0.005 to 0.000, p = 0.038), and muscle stiffness (B = - 1.373, 95% CI - 2.369 to - 0.376, p = 0.007) were linked to decreased temporal muscle thickness. Comparing TMD nonbruxer and bruxer muscle thicknesses in upright and supine positions revealed significant increased thickness in the masseter muscle during clenching but not in the temporalis muscle. Masseter muscle thickness varied significantly by sex, body position, and resting/clenching, notably influenced by bruxism. These findings emphasize the relevance of these factors in clinical examinations of patients with TMD.

The effectiveness of botulinum toxin for temporomandibular disorders: A systematic review and meta-analysis.

OBJECTIVE: The current body of research on utilizing botulinum toxin (BTX) to manage temporomandibular disorders (TMDs) has not yet yielded definitive conclusions. The primary objective of this study was to determine the effectiveness of BTX in pain reduction for TMDs compared to placebo and other treatments. The secondary outcomes evaluated were adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. MATERIALS AND METHODS: A literature search was performed on PubMed, Dimension Publication, Scopus, and Google Scholar. The RoB 2 tool was used for quality assessment. The mean differences in pain scores were estimated to measure the effect of BTX on pain reduction. For adverse events, the risk ratio for the incidence of side effects was calculated. RESULTS: Two hundred and sixty non-duplicate articles were identified; however, only 14 RCTS were included in this review. The total study population included 395 patients. The overall risk of bias showed a low to moderate quality of evidence. Results from 6 studies were reported only narratively; four studies were used for meta-analysis on pain reduction, and five were used for meta-analysis on adverse events. The control used in the meta-analysis was placebo injections. Results of the meta-analysis for pain reduction were statistically insignificant for the BTX group with mean differences at MD = -1.71 (95% CI, -2.87 to -0.5) at one month, -1.53 (95% CI, -2.80 to -0.27) at three months, and -1.33 (95% CI, -2.74 to 0.77) at six months. This showed that BTX treatment was not significantly better than placebo for a reduction in pain scores at 1, 3, and 6 months. Regarding safety, the placebo group showed a relative risk of 1.34 (95%CI, 0.48-6.78) and 1.17 (95%CI, 0.54-3.88) at 1 and 3 months respectively. However, the risks were not statistically significant. There was also no difference in the effectiveness of BTX compared to placebo and other treatments for maximum mouth opening, bruxism events, and maximum occlusal force. CONCLUSION: BTX was not associated with better outcomes in terms of pain reduction, adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. More high-quality RCTs are needed to better understand this topic.

Temporomandibular disorders and bruxism - up-to-date assessment and screening tools the general dentist should be aware of.

The recently proposed shortened screening tools for temporomandibular disorders (TMD) and bruxism should enable a better assessment of these conditions by the general dentist.

An epidemiological qualitative/quantitative SWOT-AHP analysis in order to highlight the positive or critical aspects of dental implants: A pilot study.

OBJECTIVES: In recent years, dental implants are increasing in popularity due to their high success rate, demonstrated functionality, and aesthetic treatment results. Scientific research is very active in proposing improvements in the quality and survival of implants, taking into consideration various aspects. The objective of this study was to provide a holistic epidemiologic view of the state of dental implants, using a systematic approach based on a multimethod SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and AHP (analytical hierarchical process) qualitative-quantitative analysis to identify the characteristics that can determine their success or failure. MATERIALS AND METHODS: The study used the hybrid method of SWOT-AHP. RESULTS: Analysis of the results showed that among strengths, the skill of the dentist was considered the most important factor, followed by the success of dental implants in the old people; among weaknesses, bruxism and chronic diseases were highlighted; for opportunities, biomechanical behavior, in terms of good mechanical strength and good tribological resistance to chemical and physical agents in the oral cavity, were considered the most important factors; finally, among threats, medical liability and biomechanical problems had equal weight. CONCLUSIONS: This study applied a multimethod SWOT-AHP approach to bring out favorable or critical evidence on the topic of dental implants. In accordance with the result of the strategic vector identified in the Twisting zone Adjustment type section, showed that implant surgery is a widespread technique but always needs improvement to increase the likelihood of success and reduce the complications that can lead to implant failure.

Recurrence of exostosis as a result of medication-induced bruxism: case study.

Introduction: Alveolar oral exostosis is a common, benign condition routinely found in dentistry. Clinical problems associated with exostoses are the maintenance of oral hygiene as well as the fabrication of prosthodontic appliances. Over time, exostoses may contribute to irritation and periodontal disease. Case description: The patient in this case study had a recurrence of exostoses and was bothered by consistent and prominent pain. She reported being a bruxer; her bruxism was exacerbated due to attention-deficit hyperactivity disorder and antidepressant medications. Discussion: The etiology behind the recurrence of exostosis is discussed. The most evident etiology seems to be persistence of medication-induced bruxism, specifically awake bruxism. Conclusion: It is necessary to take a proper history to identify the cause of the recurrence of exostosis. Dental hygienists can contribute to a better understanding of and provide better treatment options for patients who have medication-induced bruxism.

Introduction: L'exostose buccale alvéolaire est une affection bénigne courante couramment observée en dentisterie. Les problèmes cliniques associés aux exostoses sont le maintien de l'hygiène buccale ainsi que la fabrication d'appareils prosthodontiques. Avec le temps, les exostoses peuvent causer de l'irritation et des maladies parodontales. Description de cas: Dans cette étude de cas, la patiente présente des exostoses récurrentes et est dérangée par une douleur constante et proéminente. Elle a déclaré souffrir de bruxisme exacerbé par la prise de médicaments antidépresseurs et contre le trouble déficitaire de l'attention avec hyperactivité. Discussion: L'étiologie derrière la récurrence de l'exostose est abordée. L'étiologie la plus évidente semble être la persistance du bruxisme induit par les médicaments, en particulier le bruxisme diurne. Conclusion: Il est nécessaire d'obtenir les antécédents médicaux appropriés pour identifier la cause de la récurrence de l'exostose. Les hygiénistes dentaires peuvent contribuer à une meilleure compréhension et offrir de meilleures options de traitement aux patients atteints de bruxisme induit par les médicaments.

Botulinum Toxin-Induced Parotitis: A Postoperative Complication Following Masseter Muscle Injection.

Botulinum toxin (BTX) injection is a common treatment for bruxism, but there is no literature on potential salivary gland complications. This paper presents a case of acute parotitis in a 60-year-old female following BTX injections to the masseter muscle. This case highlights the possible salivary gland complications after injection of BTX into the masticatory muscles. An electronic search of PubMed and Embase databases was conducted to create a literature review in order to delve into the etiology behind the presented case and suggest potential preventive measures to avoid salivary gland complications. Thirty-one articles are reviewed and discussed. Currently, there is no consensus on the causes of the mentioned complication. However, various factors have been proposed, encompassing anatomical, physiological, biological, and physical aspects. Several methods have been recommended for the safe injection of BTX, which, along with better medical training and knowledge, are warranted to achieve predictable results.

MR sialographic assessment of the masseter muscle and the ductal kinking in patients with recurrent parotitis.

Dysfunction of the masseter muscle may cause pathological kinking of the parotid duct leading to parotitis; MR sialography is a non-invasive radiological examination that allows to evaluate dynamically the ductal system of the parotid glands. In the present study we aimed to assess the relationships between Stensen's duct and masseter muscle and their implications in the aetiopathogenesis of recurrent parotitis secondary to masseter muscle dysfunction. Forty-one patients with recurrent unilateral parotitis and nine with bilateral recurrent parotitis, all with a clinical suspicious of masseter muscle hypertrophy due to bruxism were enrolled. They underwent ultrasonography as a first line examination and then MR sialography and sialendoscopy. Different anatomical features were studied. Involved parotid glands had a wider duct compared to contralateral unaffected parotid glands of patients with recurrent parotitis (p = 0.00134); male subjects with parotitis had a longer duct compared to the salivary glands of healthy patients (p = 0.00943 for affected glands and p = 0.00629 for the contralateral). A concordance between the evidence of an acute duct angle during sialendoscopy and a wider duct in patients with parotitis was observed although not statistically significant. These initial findings suggest that the masticatory muscle dysfunction related to bruxism seems to condition alteration of parotid duct course and anatomy thus favouring the occurrence of recurrent parotitis. A specific diagnostic iter based on clinical evaluation, dynamic ultrasonography and MR sialography, is therefore, mandatory to confirm the relationship between masseter muscle anatomy and parotid duct anomalies; this is the premise for an adequate therapeutic approach to underlying masticatory muscle disorder.

Investigation of masticatory muscle thickness and mechanosensitivity of cervical and masticatory muscles in myofascial temporomandibular disorder patients with bruxism: A cross-sectional study.

OBJECTIVE: Bruxism is a common problem associated with temporomandibular disorders (TMD). The aim of this study was to compare a patient group with Myofascial TMD and bruxism and a healthy control group in terms of masseter and temporal muscle thickness (clenching and resting), mechanosensitivity of neck and jaw muscles, craniofacial pain, and disability and emotional stress status. METHODS: The study included 31 patients with myofascial TMD and bruxism (19 females, 12 males) with a mean age of 29.96 ± 8.12 years (range, 18-45 years), and a control group of 31 healthy subjects (19 females, 12 males) with a mean age of 27.58 ± 9.39 years years (range, 18-45 years). Masseter and temporal muscle thicknesses were evaluated with a mobile ultrasound device both at rest and when clenching the jaw. The mechanosensitivity values between the upper trapezius, obliquus capitis inferior, masseter and temporal muscles were measured with a digital algometer device. Craniofacial pain and disability level were evaluated with the Craniofacial Pain and Disability Index (CFPDI), and emotional stress levels with the Perceived Stress Scale-14 (PSS-14). RESULTS: No difference was determined between the two groups in respect of the clenching and resting ratios of muscle thickness in any muscle (p > 0.05). The mechanosensitivity values in all muscles were lower in the myofascial TMD group than in the healthy group (p < 0.05). The CFPDI and PSS-14 scores were higher in the myofascial TMD group (p < 0.05). There was a moderate positive correlation between CFPDI, PSS-14 and Bruxism Frequency Score (p < 0.05). CONCLUSION: The difference in mechanosensitivity and CFPDI values between the myofascial TMD patients with bruxism and the healthy control group indicates that the problem in this patient group has effects in the craniocervical and cervical regions. In addition, the correlation between CFPDI, PSS-14 and Bruxism Frequency Score in myofascial TMD patients suggests that this problem may be affected by the interaction of different parameters.

The survival of periodontally treated molars in long-term maintenance: A systematic review and meta-analysis.

AIM: This systematic review and meta-analysis aimed to determine the survival of periodontally treated molars during maintenance care and identify the risk factors associated with molar loss among patients with periodontitis who received professional periodontal therapy and maintenance. MATERIALS AND METHODS: Longitudinal studies with a minimum follow-up duration of 5 years published until 28 August 2023 were retrieved from the following databases: the Cochrane Library, Embase, MEDLINE and Web of Science. All included studies reported data on molar retention. Meta-analysis was performed using Review Manager 5.4. A modified version of the Newcastle-Ottawa Scale was used to evaluate the study quality. Statistical results of analyses of the overall survival rate and molar loss are presented as estimated standardized mean differences, whereas the results of the analyses of risk factors are presented as risk ratios with 95% confidence intervals (95% CIs). RESULTS: From among the 1323 potentially eligible reports, 41 studies (5584 patients, 29,908 molars retained at the beginning of maintenance therapy, mean follow-up duration of 14.7 years) were included. The pooled survival rate of the molars during maintenance therapy was 82% (95% CI: 80%-84%). The average loss of molars was 0.05 per patient per year (95% CI: 0.04-0.06) among the patients receiving long-term periodontal maintenance (PM) therapy. Fifteen factors were examined in this meta-analysis. Six patient-related factors (older age, lack of compliance, smoking, bruxism, diabetes and lack of private insurance) and five tooth-related factors (maxillary location, high probing pocket depth, furcation involvement, higher mobility and lack of pulpal vitality) were identified as risk factors for molar loss during maintenance therapy. CONCLUSIONS: The findings of the present study suggest that the long-term retention of periodontally compromised molars can be achieved. The average number of molars lost per decade was <1 among the patients receiving long-term PM therapy. Older age, noncompliance, smoking, bruxism, diabetes, lack of private insurance coverage, maxillary location, furcation involvement, higher mobility, increase in the probing pocket depth and loss of pulpal vitality are strong risk factors for the long-term prognosis of molars.

Autistic individuals have worse oral status than neurotypical controls: a systematic review and meta-analysis of observational studies.

OBJECTIVE: To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing individuals. MATERIAL AND METHODS: Observational studies presenting clinical measures of oral outcomes between autism spectrum disorder (ASD) individuals and controls. EMBASE, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 26, 2023. Pairs of reviewers independently conducted study selection, data extraction, and assessments of methodological quality and certainty of evidence. Meta-analyses of standardized mean differences (SMD) and risk ratio (RR) were performed. RESULTS: A total of 47 studies comprising 6885 autistic individuals were included in the review. Autistic individuals had significantly higher severity of dental-caries experience in primary teeth (SMD 0.29, 95%CI 0.02, 0.56), of dental plaque presence (SMD 0.59, 95%CI 0.24, 0.94), and of gingivitis (SMD 0.45, 95%CI 0.02, 0.88). Autistic individuals showed higher probability of occurrence of gingivitis (RR 1.34, 95%CI 1.08, 1.66,), bruxism (RR 4.23, 95%CI 2.32, 7.74), overjet (RR 2.16, 95%CI 1.28, 3.64), overbite (RR 1.62, 95%CI 1.02, 2.59), crossbite (RR 1.48, 95%CI 1.02, 2.13), and openbite (RR 2.37, 95%CI 1.46, 3.85), when compared to neurotypical individuals. Most estimates showed a small effect size with very low certainty of evidence. CONCLUSION: Autistic individuals show worse oral health status than controls. CLINICAL RELEVANCE: The findings reported herein can help to build health policies to better serve autistic individuals including prevention actions and access to specialized dental care.

Influence of malocclusion on sleep bruxism and orofacial pain: data from a study in school children.

OBJECTIVES: This cross-sectional school-based study explored the influence of malocclusion on temporomandibular disorders (TMD) pain complaints, and whether this association would be mediated by sleep bruxism in a representative sample of 7- to 8-year-old children. METHODS: Path analysis estimated direct, indirect, and total effects of occlusal features on sleep bruxism and TMD pain in 7- to 8-year-old children. Occlusal features were assessed with Dental Aesthetic Index (DAI), orofacial pain complaints using the TMD pain screener, possible sleep bruxism based on self-reports, and probable sleep bruxism based on self-reports combined with clinical findings. Structural equation modeling analyzed data with confounding factors. RESULTS: From 580 participants, possible sleep bruxism was observed in 136 children (31.5%), probable sleep bruxism in 30 children (6.7%), and TMD pain complaints in 78 children (13.8%). Malocclusion had no direct effect on either possible sleep bruxism [standardized coefficient (SC) 0.000; p = 0.992], or TMD pain complaints (SC - 0.01; p = 0.740). When probable sleep bruxism was set as the mediator of interest, malocclusion did not directly affect probable sleep bruxism (SC 0.01; p = 0.766), nor TMD pain complaints (SC - 0.02; p = 0.515). A direct effect of probable sleep bruxism on TMD pain complaints was observed with an SC of 0.60 (p < 0.001). However, in neither case, malocclusion indirectly affected TMD pain complaints via bruxism. CONCLUSION: Malocclusion in 7- to 8-year-old children did not directly influence possible or probable sleep bruxism or TMD pain complaints. Instead, probable sleep bruxism was strongly associated with TMD pain complaints. CLINICAL SIGNIFICANCE: The impact of occlusal features on TMD pain complaints and bruxism has been a long-standing controversy in dentistry. However, the scientific literature linking this association may be inconsistent, mainly due to biased sample selection methods with inadequate consideration of confounders. Further research should try to identify additional risk factors for TMD pain in addition to probable sleep bruxism in children.

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.