Search Results (21)

Background: Prematurely born newborns with low birth weight constitute a group of patients who require special care from the first days of life. Prematurity and low birth weight affect about 13.4 million infants. Risk factors include placental disorders but also factors related to the mother, such as smoking, alcohol drinking, drug use, malnutrition, or certain diseases. It is imperative to educate women of reproductive age (15–49) about the basic factors influencing embryonic development, such as oral health, diet, medicine intake, and harmful habits. Even though most women are aware of the negative impact of harmful habits on the fetus, still too little attention is paid to oral health in pregnant women. Poor oral health may influence the well-being of the future mother, as well as of the child. Therefore, women of reproductive age and those who are pregnant must have adequate knowledge on this subject. The aim of this study was to assess the knowledge of Polish women of reproductive age (15–49) regarding oral health during pregnancy, including the impact of dental treatment, oral hygiene, and maternal oral conditions on pregnancy outcomes and the health of the newborn. Materials and Methods: This was a cross-sectional study of 508 women, in the reproductive age, whose age ranged from 18 to 49 years old. The surveys were conducted from April 2020 to November 2020. The questionnaire was originally developed based on the available literature and consisted of seven sections: basic information, general health and habits, pregnancy status and dental care, knowledge of treatment options during pregnancy, oral health status and its association with the risk of preterm birth, prematurity and the child’s oral health, and breastfeeding and oral development. Results: After excluding incomplete questionnaires, a total of 499 questionnaires were included in the analysis. Women participating in the study had a fairly good understanding of the impact of oral health on the fetus and the role of breastfeeding in the development of the stomatognathic system (from 50% to 70% correct answers). However, even though most respondents had completed higher education (344/68.94%), their knowledge of oral health, preterm birth, and low birth weight was very limited (including the impact of inflammation on the intrauterine development of the child or bacteria and transfer across the placenta). In these sections, the percentage of correct answers ranged from less than 20% to 50%. When analyzing knowledge by age, education, number of births, and place of residence, the highest levels of knowledge were observed among respondents with higher education, particularly those aged 27–32. Conclusions: Respondents had a fairly good understanding of the general impact of oral health during pregnancy and recognition of the importance of breastfeeding for infants. However, their knowledge about the impact of bacteria and inflammation in the mother’s oral cavity on prematurity and low birth weight was limited. Therefore, educating women of reproductive age and pregnant women on this topic is essential, as it may help reduce the adverse consequences of prematurity. Full article

Backgrounds and objective: Disorders in the stomatognathic system and otorhinolaryngologic manifestations are frequently observed in individuals living with HIV. Ear, neck, and throat (ENT) signs and symptoms often serve as critical markers of treatment failure, particularly in the advanced stages of HIV infection. This article aims to evaluate and consolidate recent developments in the treatment and management of otorhinolaryngological manifestations in HIV-positive patients. Materials and methods: We carried out a retrospective clinical investigation of patients admitted with HIV/AIDS in the northeastern region of Romania, hospitalized in the “St. Parascheva” Clinical Hospital of Infectious Diseases in Iasi. We followed the viro-immunological status correlated with patients’ otolaryngology and dental symptomatology, aiming to emphasize the comorbidities of HIV/AIDS cases. The study period spanned from 1 January 2020 to 30 November 2024. Results: There were a total of 552 recorded cases of oropharyngeal manifestations in patients with HIV. They were more frequent in men (358 cases, 64.85%) than women (194 cases, 35.15%). The majority of cases were young adults, aged 30 to 39 years, comprising 255 patients (46.19%), and most cases (36.85%) had CD4+ T-lymphocyte values between 200 and 499 cells/μL. The most frequent diagnosis was oral candidiasis, recorded in 335 male and 174 female cases (509, 92.21% total). Other notable conditions included gingivitis/periodontitis, sinusitis/rhinosinusitis, mastoiditis, and dental abscesses, albeit at lower frequencies. Notably, antifungal therapy with fluconazole was the most frequently employed treatment, followed by aminopenicillins and fluoroquinolones. With respect to the antiretroviral treatment, 83.69% of cases were prescribed a single-pill regimen. Conclusions: The key to the management of HIV-positive patients is a multidisciplinary approach, including an ENT specialist and access to antiretroviral therapy. Full article

Background/Objectives: New devices such as surface electromyography (sEMG) have been proposed to support traditional gnathological examination and diagnostic protocols. The aim of this study is to investigate whether sEMG can be considered a diagnostic instrument to discriminate between healthy subjects and patients with temporomandibular disorders (TMDs) of an articular or muscular nature. Methods: A systematic review was conducted according to PRISMA guidelines using literature searches of MEDLINE (via PubMed), Scopus, and Web of Science. Inclusion criteria: recent clinical studies (≤10 years) in English or Italian, involving electromyography in TMD diagnosis, with a control group of healthy patients. Data considered to be homogenous were subjected to meta-analysis (95% confidence interval [CI]; α = 0.05). Hedge g was calculated because all variables were continuous. Articles meeting the inclusion criteria were checked for further consideration, and relevant data were collected into two tables. In total, 18 studies were included after full-text reading. Meta-analyses were carried out for the static impact index (IMP), percentage overlapping coefficient (POC), and torque coefficient, and dynamic Symmetrical Mastication Index (SMI). Results: Patients with TMD had lower values in all parameters except IMP. sEMG registered a reduction in masseter activity, lower chewing efficiency, and an increase in fatigue during contractions in TMD patients. Conclusions: sEMG is not reliable to distinguish healthy from TMD patients, but despite the limitations related to the high variability in the studies (type of electromyography, static or dynamic tests, and population characteristics), the sEMG results are reliable considering the POC and SMI parameters, encouraging more in-depth studies for a predictable clinical practice. Patients with TMD had lower values in the dynamic index SMI and in static indexes POC and torque coefficient, except IMP. EMG might performs better if employed in muscle forms. Full article

Background: The temporomandibular joint (TMJ) is a key component of the stomatognathic system, playing a major role in maintaining mandibular stability and function. Temporomandibular disorders (TMDs) are a prevalent disease in the world, with surgical treatment being reserved for complex cases or end-stage TMJ disease. A narrative review was conducted to describe the quantitative and qualitative factors that affect TMJ prosthesis stability. Methods: Studies with a sample size equal to or greater than 10 subjects who underwent surgical procedures for joint replacement using stock or customized ATM prostheses were included. This narrative review examined some variables that may influence in terms of the longevity of the TMJ prosthesis, highlighting issues to be considered in future research. Results: The current development of TMJ prostheses is benefiting from technological advances, offering a suitable adaptation to the patient’s anatomy and superior results in functionality and patient satisfaction. However, the biomechanical complexity of the TMJ shows unique challenges compared to other joints in the body, where anatomical, biomechanical, and functional requirements are high. The stability of the TMJ prosthesis is affected by multiple variables, including the selection of biocompatible materials that resist corrosion and wear, the design of the prosthesis, the diagnosis and indication for its use, and the surgeon’s experience. The success of TMJ replacement can be measured by improving the patient’s quality of life, reducing pain, restoring mandibular functionality, and recovering suitable facial morphology for the patient’s conditions. Conclusion: There is a need for training of maxillofacial surgeons in TMJ surgery and replacement, as well as a greater focus on the research and development of systems to simplify surgical design and procedures and to optimize the results of TMJ replacement. Full article

Prosthodontic treatment of developmental age patients presents a significant challenge to the dentist. The growth and development of the stomatognathic system must be considered in treatment planning. Temporary prosthetic restorations must be regularly inspected and recemented, and final prosthetic restoration should not be delivered until the growth of the body is complete. In addition, due to the complex nature of morphological and functional disorders during the developmental period, simultaneous prosthetic and orthodontic treatment may be required. The case presented in this article is a 16-year-old boy with severe tooth destruction caused by untreated caries disease and poor oral hygiene. The patient required conservative, endodontic, and surgical treatment to restore the occlusion and aesthetics to allow the proper development of the masticatory organ. This article also presents the treatment case of a young patient with damaged crowns in the upper arch, which were restored with standard root–crown posts and cores and temporary 3D-printed composite crowns. Full article

Periodontitis is a complex condition. Left untreated, it leads to tooth loss and the need for prosthetic treatment. The incidence of periodontitis is steadily increasing, so new methods are being sought to aid in the diagnosis of the disease. Among the methods postulated is the determination of concentrations of bioactive compounds which include extracellular matrix metalloproteinases (MMPs). These enzymes are present in various structural elements of the stomatognathic system. The most promising enzyme of this group appears to be metalloproteinase 8 (MMP-8). MMP-8 assays are performed in gingival fluid or saliva, and MMP-8 levels have been shown to be higher in patients with periodontitis compared to healthy subjects and correlated with some clinical parameters of the condition and the severity of the disease. In addition, the preliminary usefulness of this enzyme in evaluating the effectiveness of periodontal treatment and doxycycline therapy has been demonstrated. Determination of the active form of MMP-8 (aMMP-8) in oral rinse fluid using off-the-shelf assays shows the highest potential. Despite reports about aMMP-8 and promising data on the role of MMP-8 in periodontal diagnosis, a clear determination of the usefulness of this enzyme requires further research. Full article

Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients’ swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD. Full article

Introduction: Orofacial pain is a common occurrence in daily dental practice; it is frequently attributed to temporomandibular dysfunction, one of its major causes, followed by pathology of the salivary glands, without avoiding interference at the level of the pain pathways caused by complications of periodontal pathology. The main objective of this study is to identify an important cause of pain in the oral–maxillofacial territory by quantifying the changes at the salivary glandular level using stereological methods. The secondary objective of the present research is to identify the implications of periodontal changes as a consequence of salivary quantitative and qualitative changes, quantified using periodontal indices, on the balance of the temporomandibular joint, dysfunction of it being an important cause of facial pain and having a profound impact on the complex oral rehabilitation algorithm of each clinical case, a condition evaluated with the analysis of the results of the Souleroy questionnaire. Material and methods: In a retrospective study, we evaluated the clinical results obtained after applying complex rehabilitation treatment to 35 subjects, 20 women and 15 men with salivary and TMJ dysfunctions, selected between 2020 and 2021 from the Clinic of Maxillofacial Surgery, Iasi. Results and discussion: The most common symptoms of temporomandibular disorders (TMDs) that were identified through the Souleroy questionnaire were pain and different types of damage to the masticatory muscles. The most significant changes in elders are reported in the case of serous cells, which reduced their percentage volume from 46.7% to 37.4%. Conclusion: As regards stereological analysis in conjunction with histological images, there were significant changes in diameters, perimeters, and longitudinal axes in the adult patients as opposed to the elderly patients, which were also influenced by the type of pathology at this level. The scores recorded on the diagnostic Souleroy scale indicated a large number of patients with low efficiency and maximum stress levels: 20.0% in level 1, 25.7% in level 2, and 25.7% in level 3. Full article

The main objective of this study is to quantify the implications of the complications of periodontal pathology and dental mobility on the pathology of dysfunctional algo syndrome, a clinical entity with profound implications for the patient’s quality of life. Methodology: Clinical and laboratory evaluation was conducted in the 2018–2022 period, on a group of 110 women and 130 men, aged between 20–69, selected from our practice venue, Policlinica Stomatologica nr. 1 Iasi, Clinical Base of Dentistry Education “Mihail Kogalniceanu” Iasi, “Grigore T. Popa” University of Medicine and Pharmacy Iasi and “Apollonia” University Iasi. Overall, 125 subjects were diagnosed with periodontal disease with complications and TMJ disorders and followed periodontal therapy in the context of oral complex rehabilitation treatments (study group); the results of their clinical evaluation were compared with the results of the evaluation of the control group, made from the other 115 patients). Results: Dental mobility and gingival recession were identified as more frequent in the study sample compared with the control sample, the differences being statistically significant in both cases. In total, 26.7% of patients had different types of TMJ disorders and 22.9% of patients had occlusal changes; the percentages are slightly increased in the study sample compared with the control one, but the recorded differences are not statistically significant. Conclusions: Dental mobility, most of the time, is a negative consequence of periodontal disease, leading to the alteration of the mandibular-cranial relations, materializing in an important proportion as an etiopathogenic factor of the dysfunctional syndrome of the stomatognathic system. Full article

Temporomandibular disorder is a musculoskeletal disease with complex, multifactorial etiology regarding improper functioning of the stomatognathic system (masticatory muscles, temporomandibular joints, and surrounding structures). This article presents medical emergencies occurring among patients treated for temporomandibular disorders, which tend to constitute a severe difficulty for practitioners during their clinical practice. Examples of the most common emergencies of this type are disc displacement without reduction and a sudden contraction of the inferior part of the lateral pterygoid muscle. The latter occurs in cases of uncontrolled and incorrect use of the anterior repositioning splints and the hypertrophy of the coronoid process of the mandible. The sudden attacks of pain of secondary trigeminal neuralgia are also discussed in this article, together with their specific nature, which is significantly different from the nature of the pain of primary trigeminal neuralgia, yet the two types of neuralgia can be easily confused when the primary one takes the painful form. Subsequent emergencies discussed are myofascial pain syndrome, traumatic and inflammatory states of the temporomandibular joints, subluxation, and the consequences of intense occlusive parafunctions. Finally, the recommended therapeutic methods, which are used as part of the treatment in the cases of aforementioned emergencies, are described in this mini-review article, emphasizing that the implementation of the incorrect treatment and rehabilitation for emergencies of temporomandibular disorders may lead to permanent damage to the soft tissue structures of the temporomandibular joints. Full article

Background: Personality traits are one of the major factors influencing the behavior and functioning of an individual, and they play a crucial role in the development of psychosomatic disorders and diseases. This paper aimed to evaluate the importance of personality traits in temporomandibular disorder (TMDs) development using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). Moreover, the relationship between personality type and the intensity of dysfunctional changes in the stomatognathic system was assessed using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). Material and Methods: The study included a group of 75 adult participants (aged 19–52) with TMD diagnosed according to DC/TMD criteria and a control group of 75 participants without symptoms of dysfunction. The study consisted of a questionnaire and clinical study; the questionnaire included the NEO-FFI psychological questionnaire and a self-authored one. The clinical part consisted of extra- and intraoral dental examinations. Results: Participants who clenched their teeth showed a greater degree of conscientiousness than those who did not exhibit this symptom (p = 0.048). Presence of headaches was correlated with greater severity of neuroticism (p = 0.001). Moreover, participants with enamel cracks showed a lower intensity of extraversion (p = 0.039), and those with worn hard dental tissues showed a higher intensity of neuroticism (p = 0.03), a lower intensity of conscientiousness (p = 0.01), and a lower intensity of extroversion (p = 0.046). Acoustic symptoms during mandibular movements were found to be linked with a higher level of neuroticism (p = 0.020), a lower level of extraversion (p = 0.035), and a lower level of conscientiousness, whereas pain upon mandibular movements were linked to a lower level of conscientiousness (p = 0.025). Participants with pain upon palpation of the masticatory muscles showed a lower level of conscientiousness (p = 0.01) compared to those without pain symptoms. Episodes of mandibular blockage or problems with its adduction depend on the intensity of conscientiousness (p = 0.007). Moreover, people from the study group with high levels of neuroticism showed lower protrusion values (p = 0.016). Conclusion: The intensity of individual personality traits was found to be associated with some TMDs in comparison to healthy controls. Full article

Temporomandibular disorders (TMDs) are a multifactorial joint disease of the masticatory system. The possible etiological factors involved in the onset and progression of TMDs include oral parafunctional habits (OPFHs) and postural habits (PHs). However, little information is available on the association between OPFHs and PHs and a predisposition to TMDs. Thus, to investigate whether the presence of OPFH and PH predisposes individuals to TMDs, a survey-based cross-sectional cohort study of self-reported TMD was performed. A total of 2292 patients with TMD were recruited for the survey. Through one-to-one propensity score matching, 166 patients with and without sleep bruxism (SB) were selected. The SB group had a significantly higher risk of masticatory muscular pain or fatigue than the non-SB group (p = 0.018). Furthermore, the SB group without other OFPHs and PHs did not show a significantly higher risk of TMD symptoms than the non-SB group. Diurnal clenching and bad posture also affect the stomatognathic system, causing pain or fatigue; however, it did not result in TMDs in patients without any OPFHs and PHs. This implies that OPFHs and PHs may increase the risk of TMD symptoms in coexistence with other habits. Full article

Background: Obesity is a multifactorial chronic disease involving multiple organs, devices, and systems involving important changes in the stomatognathic system, such as in the orofacial muscles, temporomandibular joint, cheeks, nose, jaw, maxilla, oral cavity, lips, teeth, tongue, hard/soft palate, larynx, and pharynx. Patients with obesity indicated for bariatric surgery reportedly presented with abnormalities in the structures and function of the stomatognathic apparatus. This occurs through the accumulation of adipose tissue in the oral cavity and pharyngeal and laryngeal regions. Therefore, this systematic review aimed to elucidate the changes occurring in the stomatognathic system of patients with obesity after undergoing bariatric surgery. Method: Information was searched based on the equations developed with the descriptors obtained in DECS and MESH using the PRISMA methodology. Studies published between 2010 and October 2021 in databases including PubMed, ProQuest, Scielo, Dialnet, EBSCO, and Springer Link were considered. Results: Eighty articles met the inclusion criteria after evaluating the articles, thereby allowing for the determination of the morphophysiological correlation of the stomatognathic system with the population studied. At the morphological or structural level, changes were observed in the face, nose, cheeks, maxilla, jaw, lips, oral cavity, teeth, tongue, palate, temporomandibular joint, neck, muscles, head, shoulders, larynx, and pharynx. At the morphological level, the main changes occurred in, and the most information was obtained from, the labial structures, teeth, muscles, pharynx, and larynx. Physiological changes were in breathing, phonation, chewing, and swallowing, thereby revealing the imbalance in basic and vital functions. Conclusions: Analyzing the changes and structures of obese patients and candidates for bariatric surgery revealed that, in the preoperative period, the evidence is clear owing to the presence of a wide range of information. However, the information is more limited regarding the postoperative period; thus, further research focusing on characterization of the system postoperatively is warranted. Full article

Periodontal diseases generally correspond to a disturbance in the balance between the host’s defense and the micro-organisms colonizing the periodontal environment. The exact mechanisms underlying the destruction of the periodontium remain to be fully elucidated. Our study aims to quantify the main bacteria pool involved in periodontal pathology and associate it with other factors involved in the onset of periodontal disease so that an accurate diagnosis with profound implications for the therapeutic algorithm can be developed. Micro-Ident tests, based on the polymerase chain reaction (PCR) technique, were used for the study group, chosen for their high specificity in identifying periodontopathogenic bacteria and determining their relative numbers. The results of our study indicate an increased concentration of 4.50 (number of strains) for Capnocytophaga, followed by Tannerella forsythia, in a concentration of 3.50; the next highest concentration percentages are for Treponemei denticola, and Prevotela intermedia, low concentrations were found for Fusobacterium nucleatum and Porphyromonas. The concentration of each type of bacteria is reflected in the clinical picture and constitutes the starting point for a targeted antibiotic therapy. Following the effects of antibiotic-targeted therapy obtained from the evaluation of the micro-IDent B test results on the periodontium of the supporting teeth, we observed that the values of the periodontal indices change slightly at 3-month intervals with a predominance of plaque, bleeding, and gingival indices, and less in the indices concerning the depth of the probing pocket and the loss of attachment on the buccal and oral surfaces. In conclusion, our study emphasizes a direct relationship between the subgingival tartar presence and the patients age, gingival recession, presence of periodontal pockets, dental mobility, as well as the periodontal indexes: plaque index, bleeding index, and gingival index. The correlation of negative values of periodontal indices with the nature of the involved bacteria materializes in relevant starting points in the elaboration of the periodontal diagnosis of the therapeutic plan and predictability of the prognosis of oral rehabilitation. Full article