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Summary : Periodontal disease and increased missing teeth were associated with incident vertebral fractures. In contrast, professional dental cleaning and frequent tooth brushing, was associated with a lower risk of vertebral fracture. Better oral hygiene care attenuated the risk associated with dental diseases. Purpose: To investigate the association between oral health and the risk of vertebral fractures. Methods: We included 2,532,253 individuals aged ≥40 years who underwent the Korean National Health Insurance Service health examinations in 2008 and followed up until December 31, 2017. We performed multivariable Cox proportional hazard regression analyses to evaluate the association between dental diseases and oral hygiene care and the risk of vertebral fractures. Results: Over the 9.3-year median follow-up, 1.46% (n = 36,857) experienced vertebral fractures. Individuals with dental diseases had a higher risk of vertebral fracture than those without (hazard ratio [HR] 1.04, 95% confidence interval [CI]: 1.02–1.07 for periodontal diseases; 1.02, 1.00–1.05 for dental caries; 1.12, 1.05–1.20 for ≥15 missing teeth). Good oral hygiene care was associated with a lower vertebral fracture risk (HR 0.89, 95% CI: 0.86–0.91 for ≥1 time/year [vs. <1 time/year] of professional dental cleaning; 0.90, 0.87–0.93 for ≥2 times/day [vs. 0–1 time/day] of toothbrushing). The combined dental diseases was significantly associated with an increased vertebral fracture risk, whereas combined oral hygiene care was associated with further risk reduction. Better oral hygiene care reduced vertebral fracture risk associated with dental diseases (all P <0.001). Conclusion: Periodontal disease, dental caries, and an increased number of missing teeth were independently associated with higher risks for vertebral fractures. Conversely, improved oral hygiene care, such as personal dental cleaning and frequent tooth brushing, may modify vertebral fracture risks associated with dental disease. [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) is a versatile imaging modality utilized in various medical fields. Specifically used for evaluation of soft tissues, with non-ionizing radiation and multiplanar sections that has provided great guidance to diagnosis. Nowadays, use of MRI in dental practice is becoming more pervasive, especially for the evaluation of head-and-neck cancer, detection of salivary gland lesions, lymphadenopathy, and temporomandibular joint disorders. Understanding the basic principles, its recent advances, and multiple applications in dentomaxillofacial region helps significantly in the diagnostic decision making. In this article, the principle of MRI and its recent advances are reviewed, with further discussion on the appearance of various maxillofacial pathosis. [ABSTRACT FROM AUTHOR]

Objectives: Cone-beam computed tomography (CBCT) scans enable quantification of interproximal bone loss after implant procedures in dental patients. In order for this quantification to be accurate, software is typically used to manipulate image sets captured before and after implantation to obtain their exact registration (i.e., alignment). However, no affordable CBCT image registration software is currently available for dental applications. Thus, the aim of the present study was to develop a freely available graphical user interface, called DentIR, that automates 2-dimensional (2-D) or 3-D image registration for use in planning dental treatment. Methods: The DentIR app was designed using the MATLAB environment, downloaded to a desktop personal computer (PC and Mac), and tested for its ease of use and alignment accuracy in the absence of the MATLAB environment. Results: The DentIR app enabled previewing of the CBCT images in 3-D to allow for filtering of each frame to reduce noise and blurring before registration. The 2-D or 3-D registration was tested with four transformation methods. The accuracy of each method was assessed by comparing the mean squared error and the peak signal-to-noise ratio values that were provided by the DentIR app. The registered images could be saved as Portable Network Graphics (PNG) images. Conclusions: The free, user-friendly DentIR app was easily downloadable to Mac or PC platforms. It provided accurate image registration to aid in the planning of dental treatment. Future updates of the DentIR app include adding the ability to register more than two images at once, enhancing image editing options and enabling registration of a cropped portion of the image for more in-depth analyses. [ABSTRACT FROM AUTHOR]

Purpose: More attention has been focused on the long-term side effects of treatment protocols since impressive advances in childhood cancer treatment have resulted in a growing population of patients. The purpose of this study was to investigate the disturbances of dento-facial development in children who were long-term survivors of childhood malignancies.Methods: Fifty-three children (mean age, 10 years + 4 months) in long-term remission underwent oral/dental and radiographic examinations after completion of therapy. Crown and root malformations, gingival/periodontal status, enamel defects, discolorations, decayed and unerupted teeth, premature apexifications, agenesis, maximal interincisal opening and lateral movement of jaws, and soft tissue abnormalities were noted. Caries were evaluated by the decayed-missing-filled teeth (DMFT) index. Forty healthy children (mean age, 12 years + 4 months) belonging to the same age group and socioeconomic community were served as controls. All participants in the study were evaluated in terms of craniofacial development.Results: The data of the study showed that higher prevalence of root malformation, unerupted teeth, and enamel hypoplasia were detected as a consequence of childhood cancer and/or antineoplastic therapy. Although no differences of craniofacial growth and development were observed between groups (P > 0.05), plaque and gingival index scores were statistically higher in the study group (P < 0.05).Conclusion: A range of variations in dental structures is recognized as a side effect of childhood cancer therapy in long-term survivors of pediatric malignancies that may affect their quality of life. [ABSTRACT FROM AUTHOR]

Background: The number of older people with dementia and a natural dentition is growing. Recently, a systematic review concerning the oral health of older people with dementia with the focus on diseases of oral hard tissues was published. Objective: To provide a comprehensive literature overview following a systematic approach of the level of oral hygiene and oral health status in older people with dementia with focus on oral soft tissues. Methods: A literature search was conducted in the databases PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. A critical appraisal of the included studies was performed with the Newcastle-Ottawa scale (NOS) and Delphi list. Results: The searches yielded 549 unique articles, of which 36 were included for critical appraisal and data extraction. The included studies suggest that older people with dementia had high scores for gingival bleeding, periodontitis, plaque, and assistance for oral care. In addition, candidiasis, stomatitis, and reduced salivary flow were frequently present in older people with dementia. Conclusions: The studies included in the current systematic review suggest that older people with dementia have high levels of plaque and many oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, stomatitis, mucosal lesions, and reduced salivary flow. Scientific rationale for study: With the aging of the population, a higher prevalence of dementia and an increase in oral health problems can be expected. It is of interest to have an overview of the prevalence of oral problems in people with dementia. Principal findings: Older people with dementia have multiple oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, mucosal lesions, and reduced salivary flow. Practical implications: The oral health and hygiene of older people with dementia is not sufficient and could be improved with oral care education of formal and informal caregivers and regular professional dental care to people with dementia. [ABSTRACT FROM AUTHOR]

Objective: The aim of this review was to provide a systematic overview including a quality assessment of studies about oral health and orofacial pain in older people with dementia, compared to older people without dementia. Methods: A systematic literature search was performed in PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. The quality assessment of the included articles was performed using the Newcastle-Ottawa Scale (NOS). Results: The search yielded 527 articles, of which 37 were included for the quality assessment and quantitative overview. The median NOS score of the included studies was 5, and the mean was 4.9 (SD 2.2). The heterogeneity between the studies was considered too large to perform a meta-analysis. An equivalent prevalence of orofacial pain, number of teeth present, decayed missing filled teeth index, edentulousness percentage, and denture use was found for both groups. However, the presence of caries and retained roots was higher in older people with dementia than in those without. Conclusions: Older people with dementia have worse oral health, with more retained roots and coronal and root caries, when compared to older people without dementia. Little research focused on orofacial pain in older people with dementia. Clinical relevance: The current state of oral health in older people with dementia could be improved with oral care education of caretakers and regular professional dental care. [ABSTRACT FROM AUTHOR]

Numerous factors can be considered for the etiology of temporomandibular disorders (TMD). The aim of the present study was to investigate whether the presence of both nasal septal deviation (NSD) and habitual prone sleeping posture (HPSP) predisposes TMD. We evaluated 200 subjects in 4 groups. Group I (NSD−, HPSP−/control group), Group II (NSD+, HPSP−), Group III (NSD−, HPSP+), Group IV (NSD+, HPSP+). All patients were examined according to the research diagnostic criteria to determine the presence of TMD. Group IV had the highest value for TMD incidence (44 %). Thus, we found that the presence of both NSD and HPSP parameters increased TMD incidence in Group IV compared to the control group ( p = 0.000). Additionally, Group IV showed significantly higher values than Group II ( p = 0.012) and Group III ( p = 0.039). For Group III (NSD−, HPSP+), TMD was determined higher compared to the control group ( p = 0.009). A statistically higher value of presence of TMD was determined in Group II (NSD+, HPSP−) than control group ( p = 0.029). The incidence of TMD was significantly higher in women than men ( p = 0.020). We concluded that one having an unilateral obstructive nasal septal deviation in addition to a habit of sleeping in prone position must be alert for potential TMD. [ABSTRACT FROM AUTHOR]

This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus. [ABSTRACT FROM AUTHOR]

Purpose: Although the incidence of zygomatic air cell defects (ZACDs) is significantly low in general population, still they pose as a risk factor during surgical procedures like eminectomies and eminoplasties because there is a risk of spread of infection intracranially. Furthermore, such procedures are more common in TMD patients. With this fact in mind, this study was designed to find out the prevalence, radiographic appearance, and characteristics of zygomatic air cell defects in diagnosed symptomatic temporomandibular joint disorder patients. Method: The study comprised of evaluation of panoramic radiographs of 70 temporomandibular joint disorder (TMD) patients in the age range of 18-30 years selected on the basis of Research Diagnostic Criteria (RDC/TMD). The radiographs were evaluated regarding the presence, variations, and characteristics of ZACDs. Groups were compared by χ analysis. Results: ZACDs were identified in 21 TMD subjects out of 70, giving an overall prevalence of 30 %. Out of 21 ZACDs, nine were in males (42.8 %) and 12 were in females (52.38 %). ZACDs were unilateral in ten TMD patients (47.61 %) and were bilateral in 11 patients (52.38 %). Conclusion: It can be concluded that the number of ZACDs is surprisingly more in diagnosed TMD patients. This strengthens the need for thorough preoperative imaging evaluation of ZACDs in such patients. Further longitudinal studies are required to find out the long-term effect of ZACDs on symptomatic as well as non-symptomatic TMD subjects. This may prove helpful to appreciate that whether ZACDs have any role in the development TMDs and vice versa. As with many TMD studies, caution should be exercised in interpreting these results until further studies have been carried out on this topic. Ideally, some prospective randomised evaluations with 'hard' evidence of the diagnosis with MRI support. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint (TMJ) ankylosis is an extremely disabling affliction that causes problems in mastication, digestion, speech, appearance, and hygiene. The disease also has an impact on the psychological development of the patients. Case report: A 49-year-old male patient came to our unit with complaint of restriction in his alimentation and of mouth opening. In the anamnesis, the patient reported that this limitation began 11 years ago, soon after a serious car accident that caused trauma on the face. In the clinical examination, the patient's mouth opening was 1 mm, and there was satisfactory occlusion. He was diagnosed with bilateral temporomandibular joint (TMJ) ankylosis after an imaging examination. Discussion: In order to confirm the post-traumatic etiology of the anquilose, we got the medical records from the hospital where the patient received the first treatment. The records, at that time, reported facial trauma with bilateral condylar fracture and comminuted symphyseal fracture which was reduced and fixed followed by maxillomandibular fixation that remained for 45 days. After collecting all the information needed for diagnosis, surgical treatment was proposed through arthroplasty. The patient was placed on immediate post-operative jaw physiotherapy, and 12 months after surgery, his mouth opening improved to 35 mm. Thus, in our case, ankylosis may have been developed as a sequel of the mandibular fractures. [ABSTRACT FROM AUTHOR]

Low-level laser therapy (LLLT) has been widely used in the treatment of the stomatognathic system dysfunction; however, its biological effect remains poorly understood. This study evaluated the effect of LLLT (GaAlAs, 780 nm, 20 J/cm², 40 mW) on masseter muscle of HRS/J mice after different numbers of laser irradiations (three, six, and ten) for 20 s in alternate days. Three experimental groups were defined according to the number of laser irradiations and three control groups ( n = 5) were used. On the third day after the last irradiation, all animals were killed and the masseter muscle was removed and processed for the following analysis: (a) transmission electron microscopy, (b) zymography, (c) immunohistochemistry for vascular endothelial growth factor (VEGF) and VEGFR-2. The results showed: (a) with six laser applications, a dilation of T tubules, and sarcoplasmic reticulum cistern, increased pinocytosed vesicles in the endothelium; with ten laser applications, few pinocytic vesicles in the endothelium and condensed mitochondria. (b) Under the conditions of this study, the synthesis of other matrix metalloproteinases was not observed, only the MMP-2 and -9. (c) After ten laser irradiations, immunostaining was observed only for VEGFR-2. We conclude that after six laser applications, ultrastructural changes may facilitate the Ca transfer to cytosol and increase the fluid transport from one surface to another. The ultrastructural changes and no immunostaining for VEGF with ten applications may decrease the metabolic activity as well as damage the angiogenic process, suggesting that an effective number of laser applications may be less than ten, associating to this therapy a better cost-benefit. [ABSTRACT FROM AUTHOR]

We performed cluster analysis of stabilometry data of 129 men and 122 women at the age of 20-60 years using the following 4 methods: European stabilometry variant, Romberg test (European variant), Romberg test (American variant), and Romberg test (American Universal variant). Results of factor analysis of primary data matrix obtained during the test 'eye open-teeth clenched' attest to higher clinical significance of absolute stabilometry parameters in comparison with relative ones. The results of factor analysis revealed peculiarities of functional status of the stomatognathic system as the postural sensor and its effect on postural balance. The contribution of the functional status of the stomatognathic system into the postural balance is about 2%. [ABSTRACT FROM AUTHOR]

This study compared the depression status of adolescents with temporomandibular (TM) pain to those without, considering the influence of age, sex, and other pain conditions. From a general population sample of 455 adolescents, 29 cases (mean age, 15.3 years) with current TM pain were compared with 44 age-matched controls without such pain. Study participants were examined for general health status, additional pain sites (back, abdomen, and head) in the previous month, and depression, using a 15-item German-language depression questionnaire. Cases had a statistically significant higher average depression score than controls (14.2 ± 7.1 vs. 9.7 ± 6.3; t test, p < 0.01), and they reported more often additional pain. The more pain sites were mentioned, the higher was the depression score [no pain, 4.0 ± 2.8; four pains, 17.3 ± 8.0; analysis of variance (ANOVA), p < 0.001]. We conclude that TM pain assessment among adolescents should include a whole-body pain drawing as well as a screening questionnaire to identify pain-related depressive symptoms. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to conduct an exploration of differences in oral health behaviour and outcome between dentally phobic and non-phobic participants in the UK Adult Dental Health Survey (ADHS, 2009). The null hypotheses for this study were that there are no differences in oral health status of non-phobic and dental phobic individuals.Methods: The ADHS survey covered the adult population in England, Wales and Northern Ireland and was commissioned by the NHS Information Centre for Health and Social Care (NHS IC). Dental anxiety was defined using the Modified Dental Anxiety (MDAS) with the cut-off point set at 19 and above as indicating dental phobia. Descriptive statistics were calculated and the chi-square test was used to compare both groups in terms of their demographics, oral health, oral health-related behaviour and attitudes, and treatment.Results: More women (16.8% [1,023]) than men (7% [344]) reported dental phobia. Generally, people with dental phobia were in routine occupations (648 [47.7%]), single (402 [29.4%]) and with lower educational attainment (858 [80.9%]). They were irregular attendees (798 [58.5%]), had a less restored dentition, increased numbers of one or more teeth with caries (292 [39.9%]), and were more likely to have PUFA (puss, ulceration, fistulae, abscess) scores of one or more (89 [12.2%]) in comparison to the non-phobic group (314 [5.6%]). However, people with and without dental phobia had similar numbers of sound and missing teeth (34.5% of the phobic group had 20 or more sound teeth in comparison to 31.7% of the non-phobic group). There were significant differences (p<0.001) between the phobic group's and non-phobic group's Oral Health Impact Profile-14 (OHIP) and Oral Impacts on Daily Performance (OIDP) scores with phobic participants having generally higher scores. Additionally, the phobic group responded negatively more commonly about their most recent dental treatment in terms of dentists' ability to listen to their concerns, explaining the reasons for their dental care while paying full attention to their needs by treating them with respect and dignity. The difference between the two groups was statistically significant (p<0.001).Conclusions: Participants reporting dental phobia are mostly females, irregular attendees and have a greater treatment need with increased caries levels. [ABSTRACT FROM AUTHOR]