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Journal of Conservative Dentistry and... Feb 2024The COVID-19 infection has become a pandemic after breaking out in China in the past months of 2019 and spreading rapidly worldwide. To counter this pandemic, several...
BACKGROUND
The COVID-19 infection has become a pandemic after breaking out in China in the past months of 2019 and spreading rapidly worldwide. To counter this pandemic, several governments worldwide have taken several drastic measures to try to stop the spread of the virus, including a very strict lockdown that has caused a sudden and, in many cases, negative change in people's daily lives. In the literature, several studies have shown how the pandemic has significantly impaired many people's mental health, causing short- and long-term stress, anxiety, and sleep disturbances.
INTRODUCTION
This study aims to analyze the correlation between the stress caused by the COVID-19 pandemic and the parafunctions of the temporomandibular joint and masticatory muscles, which in turn, have led to an increase in the incidence of fractures and dental injuries. The ultimate goal is to understand the best choice the dentist must make in the preventive and therapeutic fields.
MATERIALS AND METHODS
A questionnaire called "Incidence of tooth fractures during the COVID-19 pandemic" was prepared using the Google Forms platform. This questionnaire consists of 13 questions. This electronic questionnaire was addressed to all dentists in the Campania Region (ITA) and disseminated through social networks such as WhatsApp or Facebook or E-mail.
RESULTS
A total of 730 dentists completed the survey. Of these, 450 (61.7%) stated that the number of patients reporting muscle and joint pain in the morning had increased during the COVID-19 pandemic. 414 (56.7%) dentists noted an increase in parafunction and 392 (53.6%) an increase in dental fractures during the pandemic period.
DISCUSSION AND CONCLUSIONS
As can be seen from the study results, an important correlation was found between the stress resulting from the COVID-19 pandemic and dental fractures. The dental elements treated endodontically, depending on the extent of the damage, require restoration, which is also the best preventive strategy in the case of dental fractures.
PubMed: 38463480
DOI: 10.4103/JCDE.JCDE_241_23 -
Dental and Medical Problems 2024Temporomandibular disorders (TMD) are a group of conditions that affect the function of the masticatory muscles, temporomandibular joints and surrounding structures.
BACKGROUND
Temporomandibular disorders (TMD) are a group of conditions that affect the function of the masticatory muscles, temporomandibular joints and surrounding structures.
OBJECTIVES
The objective of the preliminary investigation was to develop an initial questionnaire for emotional assessment, pre-designed for TMD patients, and provide guidance for further management through referral to psychological and/or psychiatric counseling. Additionally, we aimed to compare the results of tests carried out in TMD patients with those of healthy subjects.
MATERIAL AND METHODS
The study involved 260 patients who reported for dental treatment. The TMD study group (Group 1, n = 130) consisted of patients diagnosed with TMD, and the control group (Group 2, n = 130) had TMD diagnostically excluded. The questionnaire included 30 questions about the emotional state of the patients in the past 4 weeks.
RESULTS
The mean scores were 37.715 points for Group 1 (median (Me) = 35.5, standard deviation (SD) = 12.58 and 24.938 points for Group 2 (Me = 24, SD = 7.95) (p < 0.001).
CONCLUSIONS
The research suggests that the developed questionnaire is useful for an initial assessment of the psycho-emotional state of TMD patients. Furthermore, the results emphasize a greater need for psychological counseling in TMD patients compared to their healthy counterparts.
Topics: Humans; Pilot Projects; Temporomandibular Joint Disorders; Temporomandibular Joint; Referral and Consultation
PubMed: 38441313
DOI: 10.17219/dmp/178325 -
BioMed Research International 2024Temporal muscles of 14 adult cadavers were studied. The muscle bellies were divided into six areas, three superior (1.2 and 3) and three inferior areas (4, 5, and 6)...
METHOD
Temporal muscles of 14 adult cadavers were studied. The muscle bellies were divided into six areas, three superior (1.2 and 3) and three inferior areas (4, 5, and 6) lower, according to a Cartesian plane to analyze and describe the entry points of the branches of the deep temporal nerves into the muscle. The branching distribution was analyzed using Poisson log-linear tests with Bonferroni post hoc tests for comparison between groups (sextants) ( < 0.05).
RESULTS
Deep temporal nerve entry points were found in the temporal muscle in all areas. Most of the branches were observed in areas 2 and 5, which coincide with the muscle fibers responsible for mandible elevation and related to the previously described MTPs. Fewer branches were found in areas 1 and 6, where contraction produces mandible retraction.
CONCLUSION
There is an anatomical correlation between the branching pattern of the deep temporal nerve and temporal muscle trigger points. Adequate knowledge of the innervation of the temporal muscle may help elucidate the pathophysiology of myofascial syndromes and provide a rational basis for interventional or conservative approaches and help surgeons avoid iatrogenic lesions to the deep temporal nerve lesion.
Topics: Adult; Humans; Temporal Muscle; Trigger Points; Cadaver; Mandible; Muscle Fibers, Skeletal
PubMed: 38435541
DOI: 10.1155/2024/6641346 -
BMC Oral Health Mar 2024Overerupted maxillary molars is common in adults, which can lead to insufficient intermaxillary vertical space ,great difficulty in prosthetic reconstruction ,and cause...
BACKGROUND
Overerupted maxillary molars is common in adults, which can lead to insufficient intermaxillary vertical space ,great difficulty in prosthetic reconstruction ,and cause occlusal interference in movements.To reconstruct occlusal function, it is necessary to prepare enough space for prostheses. The aim of the present study was to evaluate the effect of space-adjustment occlusal splint on overerupted maxillary molars by clinical and electromyographic signals analysis.
METHODS
Eighteen patients with overerupted maxillary molars were selected to wear space-adjustment occlusal splint suppressing overerupted maxillary molars for three months. Satisfaction was assessed by 5-point Likert; intermaxillary vertical space and the teeth transportation distance were measured in models; clinical periodontal status were evaluated by periodontal probing depth (PPT) and bleeding index (BI); electromyographic recordings of the masseter and anterior temporal muscles were monitored by Cranio-Mandibular K7 Evaluation System.
RESULTS
All the patients were satisfied with the treatment effect (Likert scale ≧ 4). The intermaxillary space in edentulous areas after treatment showed statistically significant increasing when compared with those before treatment. PPT and BI showed no significant difference. No statistically significant differences were found in electromyographic activity of anterior temporal muscles, while a reduction of muscle activity in masseter in the contralateral side were detected in post-treatment evaluations compared with pre-treatment at mandibular rest position.
CONCLUSIONS
Space-adjustment occlusal splint is an efficient treatment option on overerupted maxillary molars by intruding the maxillary molar to obtain adequate intermaxillary space for prostheses.
Topics: Adult; Humans; Splints; Molar; Masseter Muscle; Temporal Muscle; Occlusal Splints; Electromyography
PubMed: 38431564
DOI: 10.1186/s12903-024-04039-6 -
Alternative Therapies in Health and... Feb 2024Trigeminal neuralgia (TN) is very common in the middle-aged and elderly population and seriously affects the normal life of patients. This study aims to analyze the...
OBJECTIVE
Trigeminal neuralgia (TN) is very common in the middle-aged and elderly population and seriously affects the normal life of patients. This study aims to analyze the therapeutic effect of percutaneous balloon compression (PBC) on TN and to explore the clinical significance of NOD-like receptor thermal protein domain associated protein 3 (NLRP3), which not only can provide a reference for the clinical treatment of TN in the future, but also can help the clinic to find a reliable indicator for the assessment of TN condition.
METHODS
The length of stay, total cost of hospitalization, and adverse reactions during treatment were compared between the two groups. Patients were subjected to assessments or investigations of the Barrow Neurological Institute (BNI) scale, Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) before and after treatment. In addition, NLRP3 in the peripheral blood of patients in the research group was measured, and the correlation of NLRP3 with BNI score and prognosis for recurrence was analyzed.
RESULTS
The length of stay and the total cost of hospitalization were respectively (12.10±2.20) d and (26445.96±5553.78) yuan in the research group, significantly reduced than those in the control group (P < .05). And the BNI score, PSQI and SAS/SDS were lower in the research group after treatment (P < .05), but the incidence of facial numbness, herpes orofacialis and masticatory muscle weakness were higher in the research group than in the control group (P < .05). After treatment, NLRP3 decreased in the research group, which was positively correlated with BNI score (P < .05). In addition, NLRP3 showed an excellent effect in predicting recurrence.
CONCLUSION
PBC effectively improved the pain and negative psychological status of patients with TN, and NLRP3 was closely related to the pain of patients with TN. In the future, PBC is used in the clinic to treat TN and improve the prognosis of patients.
PubMed: 38401065
DOI: No ID Found -
PloS One 2024The effects of jaw clenching on balance has been shown under static steady-state conditions but the effects on dynamic steady-state balance have not yet been...
The effects of jaw clenching on balance has been shown under static steady-state conditions but the effects on dynamic steady-state balance have not yet been investigated. On this basis, the research questions were: 1) if jaw clenching improves dynamic steady-state balance; 2) if the effects persist when the jaw clenching task loses its novelty and the increased attention associated with it; 3) if the improved dynamic steady-state balance performance is associated with decreased muscle activity. A total of 48 physically active healthy adults were assigned to three groups differing in intervention (Jaw clenching and balance training (JBT), only balance training (OBT) or the no-training control group (CON)) and attending two measurement points separated by two weeks. A stabilometer was used to assess the dynamic steady-state balance performance in a jaw clenching and non-clenching condition. Dynamic steady-state balance performance was measured by the time at equilibrium (TAE). The activities of tibialis anterior (TA), gastrocnemius medialis (GM), rectus femoris (RF), biceps femoris (BF) and masseter (MA) muscles were recorded by a wireless EMG system. Integrated EMG (iEMG) was calculated to quantify the muscle activities. All groups had better dynamic steady-state balance performance in the jaw clenching condition than non-clenching at T1, and the positive effects persisted at T2 even though the jaw clenching task lost its novelty and attention associated with it after balance training with simultaneous jaw clenching. Independent of the intervention, all groups had better dynamic steady-state balance performances at T2. Moreover, reductions in muscle activities were observed at T2 parallel to the dynamic steady-state balance performance improvement. Previous studies showed that jaw clenching alters balance during upright standing, predictable perturbations when standing on the ground and unpredictable perturbations when standing on an oscillating platform. This study complemented the previous findings by showing positive effects of jaw clenching on dynamic steady-state balance performance.
Topics: Adult; Humans; Electromyography; Masseter Muscle; Muscle, Skeletal; Muscle Contraction; Standing Position
PubMed: 38386649
DOI: 10.1371/journal.pone.0299050 -
Scientific Reports Feb 2024The antinociceptive effect of BoNT-A have been well documented in animal studies; however, results of few but well-designed randomized placebo-controlled clinical trials... (Randomized Controlled Trial)
Randomized Controlled Trial
Botulinum toxin-A effects on pain, somatosensory and psychosocial features of patients with refractory masticatory myofascial pain: a randomized double-blind clinical trial.
The antinociceptive effect of BoNT-A have been well documented in animal studies; however, results of few but well-designed randomized placebo-controlled clinical trials about BoNT-A efficacy in masticatory myofascial pain (MFP) are inconsistent. Therefore, the present randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy of BoNT-A in patients with refractory MFP. Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of > 50 mm on the visual analogue scale (VAS) participated. Patients were randomly assigned to receive a total of 80 U of BoNT-A or saline solution (SS) injected into the masseter and anterior temporalis muscles. Pain intensity (VAS), quantitative sensory testing (QST), conditioned pain modulation (CPM), and psychosocial status were examined. Follow-up was performed at 1 and 6 months. For repeated-measure comparisons between evaluation times, Friedman test with Bonferroni correction was used for pain and somatosensory variables and the Wilcoxon test for the psychosocial variables. The Mann-Whitney test was used for all comparisons between groups. The BoNT-A group had a significant decrease in pain intensity at follow-ups compared with the SS group (p < 0.001). QST assessment revealed higher pressure pain threshold values in the masseter muscle for BoNT-A group compared to SS (p < 0.03) at all follow-ups. No differences were found for mechanical pain threshold and wind-up ratio values (p > 0.05) in the entire study. The BoNT-A group presented the most efficient CPM effect (p < 0.03) only at the 1 month follow-up in the masseter muscle. There was a significant time effect for BoNT-A in all psychosocial variables (p < 0.05) and a drug effect in the Central Sensitization Inventory (p < 0.01), Pittsburgh Sleep Quality Index (p < 0.004), and Healthy Survey 36 (p < 0.05) at 6 months follow-up. The study demonstrates that a single injection-session of BoNT-A has positive effects on the hall pain spectrum of patients with refractory masticatory myofascial pain.
Topics: Humans; Treatment Outcome; Botulinum Toxins, Type A; Pain; Injections; Myofascial Pain Syndromes; Pain Threshold; Double-Blind Method
PubMed: 38378855
DOI: 10.1038/s41598-024-54906-z -
Medical & Biological Engineering &... Jun 2024Challenges arise in accessing archived signal outputs due to proprietary software limitations. There is a notable lack of exploration in open-source mandibular EMG...
Challenges arise in accessing archived signal outputs due to proprietary software limitations. There is a notable lack of exploration in open-source mandibular EMG signal conversion for continuous access and analysis, hindering tasks such as pattern recognition and predictive modelling for temporomandibular joint complex function. To Develop a workflow to extract normalised signal parameters from images of mandibular muscle EMG and identify optimal clustering methods for quantifying signal intensity and activity durations. A workflow utilising OpenCV, variational encoders and Neurokit2 generated and augmented 866 unique EMG signals from jaw movement exercises. k-means, GMM and DBSCAN were employed for normalisation and cluster-centric signal processing. The workflow was validated with data collected from 66 participants, measuring temporalis, masseter and digastric muscles. DBSCAN (0.35 to 0.54) and GMM (0.09 to 0.24) exhibited lower silhouette scores for mouth opening, anterior protrusion and lateral excursions, while K-means performed best (0.10 to 0.11) for temporalis and masseter muscles during chewing activities. The current study successfully developed a deep learning workflow capable of extracting normalised signal data from EMG images and generating quantifiable parameters for muscle activity duration and general functional intensity.
Topics: Humans; Electromyography; Deep Learning; Mandible; Adult; Male; Female; Signal Processing, Computer-Assisted; Young Adult; Masseter Muscle; Mastication; Temporomandibular Joint
PubMed: 38376739
DOI: 10.1007/s11517-024-03047-6 -
Journal of Cranio-maxillo-facial... May 2024The primary aim of this study was to investigate whether patients with end-stage temporomandibular joint (TMJ) disease treated with gap arthroplasty with temporalis...
Did temporomandibular gap arthroplasty with temporalis interpositional flap improve function and pain in patients with end-stage joint disease? A 5-year retrospective follow-up.
The primary aim of this study was to investigate whether patients with end-stage temporomandibular joint (TMJ) disease treated with gap arthroplasty with temporalis interpositional flap (GAT) had improved maximal interincisal opening (MIO) and TMJ pain in a long-term perspective. All patients with severe osteoarthritis, or fibrous or bony ankyloses, and subjected to GAT between 2008 and 2015 were included. The criteria of treatment success were TMJ pain VAS score ≤4 and MIO ≥30 mm. Reoperation was considered as a failure. Forty-four patients (mean age 47 years) were included in this retrospective descriptive case series and followed up for up to 7 years (mean 4.5). Comorbidities were frequent (n = 34) and most commonly rheumatic disease (n = 17). The indications for surgery were ankylosis (n = 32) or severe osteoarthritis (n = 12). Of the 44 included patients, 84% (n = 37) had a history of earlier TMJ surgery. The preoperative mean values for TMJ pain and MIO (VAS 7 and 23 mm, respectively) changed significantly (p < 0.001) to postoperative means of VAS 3 and 34 mm, respecitvely. The success rate was 59% (n = 26). When compared with a previous 2-year follow-up, the success rate was found to have decreased over time (p = 0.0097). The rate of successful treatment outcome in terms of MIO alone was 82% (n = 36). The most common reason for treatment failure was residual pain. In conclusion, the success-rate after GAT did not show long-term stability and continued to drop over time in this patient cohort. TMJ pain seems to be the main reason for failure.
Topics: Humans; Middle Aged; Temporomandibular Joint Disorders; Retrospective Studies; Male; Female; Follow-Up Studies; Surgical Flaps; Adult; Arthroplasty; Aged; Ankylosis; Osteoarthritis; Treatment Outcome; Pain Measurement; Temporal Muscle
PubMed: 38368213
DOI: 10.1016/j.jcms.2024.02.013