The role of tryptophan and its derivatives in musculoskeletal pains: A systematic review and meta-analysis.

BACKGROUND: Studies present ambiguous findings regarding the role of tryptophan and its metabolites, kynurenine and serotonin in chronic musculoskeletal pain. This systematic review aimed to investigate the expression of tryptophan and its metabolites, serotonin and kynurenine in patients with local and generalized chronic musculoskeletal pain in comparison with pain-free controls. METHODS: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL) and Web of Science for clinical and observational trials from the beginning of each database to 21 April 2023. Out of 6734 articles, a total of 17 studies were included; 12 studies were used in the meta-analysis of serotonin, 3 regarding tryptophan and 2 studies for a narrative synthesis regarding kynurenine. Risk of bias was assessed using the quality assessment tool for observational cohort and cross-sectional studies of the National Heart, Lung, and Blood Institute, while the certainty of evidence was by GRADE. RESULTS: All included studies showed a low risk of bias. The meta-analysis showed lower blood levels of tryptophan (p < .001; very low quality of evidence) and higher blood levels of serotonin (p < .001; very low-quality evidence) in patients with generalized musculoskeletal pain, when compared to pain-free individuals. In local chronic musculoskeletal pain, there were higher blood levels of serotonin (p=.251; very low quality of evidence) compared to pain-free individuals. Regarding kynurenine, the studies reported both higher and lower blood levels in generalized chronic musculoskeletal pain compared to pain-free individuals. CONCLUSIONS: The blood levels of tryptophan and its metabolites serotonin and kynurenine seem to influence chronic musculoskeletal pain.

Psychological treatments for temporomandibular disorder pain-A systematic review.

OBJECTIVE: Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard treatment, psychological treatments have been suggested. The aim was to investigate the effects of psychological treatments on patients with painful TMD in a short- and long-term perspective. MATERIALS AND METHODS: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) reporting psychological interventions for TMD. Registered beforehand in PROSPERO (CRD42022320106). In total, 18 RCTs were included; six RCTs that could be used in the meta-analysis, and all 18 RCTs were used in the narrative synthesis. Risk of bias was assessed by the Cochrane's tool for assessing risk of bias and certainty of evidence by GRADE. RESULTS: The narrative synthesis indicates that psychological treatment options seem equivalent to standard treatment for painful TMD. The meta-analysis showed that a combination of psychological treatment and standard treatment and manual treatment (very low-quality evidence) are significantly better in pain reduction than just counselling and standard treatments of TMD. CONCLUSION: This study indicates that psychological treatments seem to reduce pain intensity in individuals with painful TMD, and that the effect seems to be equally good as standard treatment. However, a combination of psychological treatments and standard treatments seems to have an even better effect. This indicates that psychological treatments are promising as an additional treatment approach for painful TMDs.

Temporomandibular involvement in children and adolescents with juvenile idiopathic arthritis: a 2-year prospective cohort study.

This study aimed to clinically evaluate temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) and the ability to identify and/or predict development of TMJ-deformities over time using cone beam computed tomography (CBCT). The predictive value of self-reported TMJ pain was also assessed. A prospective longitudinal cohort study comprising 54 children with JIA, 39 girls and 15 boys, was performed. All children had active disease at baseline, 50% with the subtype oligoarthritis. Repeated clinical orofacial and CBCT examinations were performed over a two-year period. At baseline, 39% had radiographic TMJ deformities (24% unilateral, 15% bilateral), at 2-year follow-up, 42% (p > 0.05). Both progressing and improving TMJ deformities were observed. An association was found between TMJ-deformities and self-reported TMJ pain at baseline (p = 0.01). Maximum unassisted mouth opening (MUO) was smaller for children with TMJ-deformities (p < 0.05). The prevalence of palpatory muscle pain was high (48-59%) but not predictive of development of TMJ-deformities. TMJ noises increased over time and crepitations were associated with TMJ-deformities (p < 0.05). In conclusion, in children with JIA, self-reported TMJ pain and dysfunction were common and predictive of TMJ deformities. TMJ deformities were associated with smaller MUO and palpatory TMJ pain as well as crepitations. Trial registration. ClinicalTrials.gov Protocol id: 2010/2089-31/2.

Sociodemographic Profile: A Forgotten Factor in Temporomandibular Disorders? A Scoping Review.

The literature on Temporomandibular Disorders (TMD) incidence commonly reports sociodemographic factors such as gender and age. However, the role and prevalence of other sociodemographic factors in TMD are not well defined. Therefore, this scoping review aimed to report the prevalence of sociodemographic factors in TMD patients. A systematic search was conducted in the PubMed and Web of Science databases to identify clinical trials in adult populations, using the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD) and reporting sociodemographic data in TMD patients. Twenty-seven studies meeting the criteria were included in this review. The most commonly reported sociodemographic factors assessed in the included studies were age, race, education, job, income, and marital status. TMD prevalence was observed to be higher among younger and divorced individuals among the included studies. However, conflicting results were found for education level, and employment was not considered a risk factor for TMD. Although this review has methodological limitations, it suggests an association between TMD incidence and certain sociodemographic factors; nevertheless, further studies are needed to establish this relationship more conclusively.

Pharmacological Treatments of Temporomandibular Disorders: A Systematic Review Including a Network Meta-Analysis.

OBJECTIVE: Temporomandibular disorders (TMD) comprise a cluster of conditions with a wide range of etiological factors that causes pain and discomfort in the masticatory muscles (TMD-M) and temporomandibular joints (TMD-J). More than 50% of the patients with TMD report regular usage of drugs. However, there is still no consensus, nor is there any evidence-based support for clinicians when choosing between different drugs. Therefore, this systematic review, including a network meta-analysis (NMA), aimed to evaluate the scientific evidence and discuss the pharmacological treatment options available to treat painful TMD. METHOD: An electronic search was undertaken to identify randomized controlled trials (RCTs) investigating pharmacological treatments for TMD-M and/or TMD-J, published until 6 April 2023. Since only 11 articles could be used for an NMA regarding TMD-M, a narrative synthesis was also performed for all 40 included RCTs. The quality of evidence was rated according to Cochrane's tool for assessing risk of bias, while the certainty of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: When it comes to TMD-M, evidence arises for wet needling therapies with BTX-A, granisetron, and PRP as well as muscle relaxants. For TMD-J, evidence points toward pharmacological treatment approaches including non-steroidal antiinflammatory drugs (NSAIDs) and glucocorticosteriods (for inflammatory conditions) as well as hyaluronic acid and dextrose. CONCLUSIONS: The evidence clearly indicates that the pharmacological treatment approaches differ between TMD-M and TMD-J. Therefore, it is of great importance to first try to uncover each patient's individual and multifactorial etiology and then employ a multifaceted treatment strategy, including pharmacological treatment approaches.

Pain after emergency treatments of symptomatic irreversible pulpitis and symptomatic apical periodontitis in the permanent dentition: a systematic review of randomized clinical trials.

Background: Symptomatic irreversible pulpitis (SIP) or symptomatic apical periodontitis (SAP) are two painful conditions often warranting emergency treatment. The most common emergency treatments supported by evidence are pulpotomy and pulpectomy and are normally performed under time-constrained circumstances. However, there is no strong evidence of which treatment suggested in literature a clinician can use to reduce endodontic pain effectively. Therefore, the aim of this systematic review is to investigate the present knowledge on postoperative pain related to the two types of emergency treatments available for treating SIP and SAP. Methods: Randomized controlled trials investigating postoperative pain after emergency treatments (pulpotomy and/or pulpectomy) on permanent dentition with signs and symptoms of SIP and/or SAP were searched in three major databases from 1978 until 2022. Risk of bias was assessed with Cochrane's tool. Results: Only five studies fulfilled the inclusion criteria. The included studies indicated that pulpotomy and pulpectomy are both suitable treatment options for SAP and SIP, as they provide sufficient alleviation of pain in permanent dentition. However, inconsistent results were found between the included trials on which emergency treatment is more effective in reducing pain. Cochrane's tool revealed that the studies had a low risk of bias. Limitations found in the design of the included randomized control trials decreased the level of evidence. None of the included studies accounted for essential confounding variables, such as factors affecting pain (including the psychological aspects). Moreover, possible non-odontogenic pain was not assessed, and therefore, it was not excluded; hence, affecting the internal validity of the studies. Conclusion: There are controversies within the available randomized control trials on which treatment is most effective in reducing emergency pain. This could be due to some weaknesses in the design of the clinical trials. Thus, further well-designed studies are warranted to draw conclusions on which emergency treatment is more effective in reducing pain. Systematic Review Registration: PROSPERO (CRD42023422282).

Publication performance and trends in bruxism research: A bibliometric analysis.

BACKGROUND: Bruxism is an umbrella term that encompass a multidimensional spectrum of masticatory muscle activities. OBJECTIVE: The purpose of this study was to do a bibliometric analysis including citation performance in the research topic of bruxism, by using an innovative method including details of article title, author keyword, KeyWords Plus and abstracts. METHODS: The data were retrieved 2022-12-19 from the Clarivate Analytics Web of Science Core Collection, and the online version of the Science Citation Index Expanded (SCI-EXPANDED) for studies published 1992 to 2021. To evaluate research trends, the distribution of keywords in the article title and author-selected keywords were used. RESULTS: The search yielded 3233 documents in SCI-EXPANDED, of which 2598 were of the document-type 'articles' published in 676 journals. The analysis of the articles revealed that "bruxism/sleep bruxism," "electromyography," "temporomandibular disorders" and "masticatory muscles" are the most used keywords by the authors. Further, the most frequently cited study was published 9 years ago and handles the present definition of bruxism. CONCLUSION: The most productive authors and those with the highest performance have some common features; they have several national and international collaborations; and they have published articles about the definition, aetiology/pathophysiology and prevalence of bruxism, all senior researchers in the field of TMD. Hopefully, based on this study, researchers and clinicians will have information to be stimulated to outline future research projects on bruxism-related aspects, and to initiate new international or multinational collaborations.

Chocolate intake and muscle pain sensation: A randomized experimental study.

BACKGROUND: Chocolate, as a cocoa-derived product rich in flavanols, has been used for medical and anti-inflammatory purposes. Therefore, the aim of this study was to investigate if the ingestion of different percentages of cocoa products affects the experimentally induced pain caused by intramuscular hypertonic saline injections in the masseter muscle of healthy men and women. METHODS: This experimental randomized, double-blind, and controlled study included 15 young, healthy, and pain-free men and 15 age-matched women and involved three visits with at least a 1-week washout. Pain was induced twice at each visit with intramuscular injections of 0.2 mL hypertonic saline (5%), before and after intake of one of the different chocolate types: white (30% cocoa content), milk (34% cocoa content), and dark (70% cocoa content). Pain duration, pain area, peak pain, and pressure pain threshold (PPT) were assessed every fifth minute after each injection, up until 30 min after the initial injection. Descriptive and inferential statistics were performed using IBM® SPSS (Version 27); significance level was set to p<0.05. RESULTS: This study showed that intake of chocolate, no matter the type, reduced the induced pain intensity significantly more than no intake of chocolate (p<0.05, Tukey test). There were no differences between the chocolate types. Further, men showed a significantly greater pain reduction than women after intake of white chocolate (p<0.05, Tukey test). No other differences between pain characteristics or sexes were revealed. CONCLUSION: Intake of chocolate before a painful stimulus had a pain-reducing effect no matter the cocoa concentration. The results indicate that perhaps it is not the cocoa concentration (e.g., flavanols) alone that explains the positive effect on pain, but likely a combination of preference and taste-experience. Another possible explanation could be the composition of the chocolate, i.e. the concentration of the other ingredients such as sugar, soy, and vanilla. ClinicalTrials.gov Identifier: NCT05378984.

Dental Students' Positive and Negative Views on Aging at an Undergraduate Course at the University of British Columbia, Canada.

Background: Different views of aging exist, including ageism as the stereotyped idea about older adults in general. The objective of this study was to perform an initial exploration on how third-year undergraduate dental students at the University of British Columbia (UBC), Vancouver, Canada self-perceived themselves at ages 65, 75, or 85 years old. Methods: For a period of 10 years, and using a cross-sectional design, third-year undergraduate dental students were asked to envision themselves at 65, 75, or 85 years old in a brief 150-word written essay. We employed a thematic analysis of the textual data via a coding process as suggested. The main themes were identified and displayed in a table with their respective categories of information. NVivo® 12 (QSR International) software was used for data analysis. Results: Between 2010 and 2020, a total of 519 students enrolled in the UBC undergraduate dental program; 425 essays were collected. Initial coding and thematic analysis led to the identification of four main themes and eight categories; themes included "Ups and Downs," "Financial Sustainability," while categories focused on "Trade-offs," and "Camaraderie," for example. Different levels of ageism were also apparent when students saw themselves experiencing isolation and forgetfulness regardless of the selected age and the academic year. For other students, they anticipate aging would be healthy, joyful, and productive. Conclusion: Ageism was present when students imagined themselves at three different older ages, but so were more realistic views of an aging. Further studies are warranted to unravel the impact of geriatric education in tackling stereotypes and ageism.

The Vastus Lateralis Muscle Interstitium Proteome Changes after an Acute Nociception in Patients with Fibromyalgia Compared to Healthy Subjects-A Microdialysis Study.

Fibromyalgia (FM) is a complex disorder and a clinical challenge to diagnose and treat. Microdialysis is a valuable tool that has been used to investigate the interstitial proteins and metabolites of muscle in patients with fibromyalgia. The implantation of the catheter in the muscle causes acute tissue trauma and nociception. The aim of this study was to investigate acute proteome changes in the vastus lateralis muscle in women fibromyalgia patients (FM) and healthy subjects (CON). A further aim was to study if a 15-week resistance exercise program in FM had any influence on how chronic painful muscle responds to acute nociception. Twenty-six women patients with FM and twenty-eight CON were included in this study. A microdialysis catheter (100 kilo Dalton cut off, membrane 30 mm) was inserted in the vastus lateralis muscle, and samples were collected every 20 min. Subjects rated pain before catheter insertion, directly after, and every 20 min of sample collection. Dialysate samples from time points 0-120 were pooled and considered trauma samples due to the catheter insertion. The samples were analyzed with nano-liquid chromatography-tandem mass spectrometry (nLC-MS/MS). Advanced multivariate data analysis was used to investigate protein profile changes between the groups. Multivariate data analysis showed significant (CV-ANOVA p = 0.036) discrimination between FM and CON based on changes in 26 proteins. After the 15-week exercise intervention, the expression levels of the 15 proteins involved in muscle contraction, response to stimulus, stress, and immune system were increased to the same expression levels as in CON. In conclusion, this study shows that microdialysis, in combination with proteomics, can provide new insights into the interstitial proteome in the muscle of FM. In response to acute nociception, exercise may alter the innate reactivity in FM. Exercise may also modulate peripheral muscle proteins related to muscle contraction, stress, and immune response in patients with FM.

Publication performance and trends in temporomandibular disorders research: A bibliometric analysis.

BACKGROUND: Temporomandibular disorders (TMD) are common, can be both painful and non-painful, and encompass various conditions affecting the temporomandibular joint, the masticatory muscles or both TMD. Therefore, the purpose of this bibliometric analysis was to synthetically analyze citation performance in TMD, to address a more innovative method including details of article title, author keyword, KeyWords Plus, and abstracts. MATERIAL AND METHODS: Data used in this study were retrieved from the Clarivate Analytics Web of Science Core Collection, the online version of the Science Citation Index Expanded (SCI-EXPANDED) between 1992 and 2021. The distribution of key words in the article title and author­selected keywords were used to evaluate research trends. RESULTS: Of the 7,228 documents in SCI-EXPANDED, 6,138 documents met all inclusion criteria and were included in the final analysis, of which 4,945 were articles. The present bibliometric analysis of the articles published in the research filed of TMD revealed that orofacial pain, bruxism, chronic pain, and myofascial pain are the most commonly used keywords by the authors. Further, over the last 30 years 4,945 articles are published in the field of TMD, and the far most frequently cited study was published 8 years ago and handles the diagnostic criteria of TMD. The USA and Brazil were top two ranking productive countries of publication on TMD. The most productive journal was Journal of Oral Rehabilitation, followed by Cranio-The Journal of Craniomandibular & Sleep Practice and Journal of Oral & Facial Pain and Headache. The most productive authors were P. Svensson, R. Ohrbach, and F. Lobbezooas. The most productive institutes were Sao Paulo University (Brazil), Malmo University (Sweden), and Washington university (USA) CONCLUSION: Based on the outcome of this bibliometric study, the authors hope that both clinicians and researchers will have information to shape their future research focus, finding prominent institutions in their nearby area, or even to be stimulated to initiate new international or even multinational collaborations.

Are we passing the acceptable? Standard setting of theoretical proficiency tests for foreign-trained dentists.

INTRODUCTION: Dentists educated outside the EU, EEA and Switzerland have the option to undergo proficiency testing to practice dentistry in Sweden. A standardised evidence-based procedure for proficiency tests is crucial. This paper explores if the standard setting of the theoretical examination in the Swedish proficiency test for foreign dentists is fit to differentiate candidates who meet the acceptable standard for licensure from those who do not, by analysis of inter-rater reliability and credibility of Angoff panels and the test's ability to differentiate candidates regarding learning outcomes and dental disciplines. MATERIALS AND METHODS: In a cohort study design, test results were collected from seven examinations during 2018-2019 (n = 316), combined with Angoff judgements and demographic data from The National Board of Health and Welfare. Intraclass correlation, Pearson correlation and linear regression were calculated. RESULTS: All exams demonstrated substantial judge inter-rater reliability using the Angoff procedure (0.65-0.82). Item difficulty predicted by the expert panels showed significant positive correlations with the item difficulty by candidate results (0.69-0.77). Candidates who did not meet the requirements for pass mark in the theoretical test revealed a significantly reduced performance overall in professional qualifications (i.e., learning outcomes) and reduced performance within dental disciplines. CONCLUSIONS: The results indicate that a modified Angoff method is a feasible, simple, and defensible method for setting the pass mark for the theoretical examinations. The standard setting appears to differentiate candidates who do not meet the requirements of the professional qualifications of the dental degree. Adjustments could be undertaken to further discriminate for competence within single dental disciplines.

Are acupuncture and dry needling effective in the management of masticatory muscle pain: A network meta-analysis of randomised clinical trials.

BACKGROUND: Several studies have shown that both acupuncture and dry needling are effective in the treatment of musculoskeletal pains. Therefore, the aim of this network meta-analysis (NMA) was to investigate the treatment outcome of acupuncture and dry-needling for masticatory muscle pain (TMD-M) and to compare with active and inactive placebo. MATERIAL AND METHOD: An electronic search was performed to identify randomised controlled trials (RCTs) published until September 2019, comparing dry-needling, acupuncture, and inactive as well as active placebo in patients with TMD-M. Outcome variables were post-treatment pain intensity, pressure pain threshold (PPT), and maximum mouth opening (MMO). The quality of evidence was rated according to Cochrane's tool for assessing the risk of bias. Mean difference was used to analyse via frequentist NMA using STATA-software. RESULTS: Both NMA and direct pairwise meta-analysis have shown that there was no difference between active treatment with either acupuncture or dry-needling when compared to active and inactive placebo in patients with TMD-M with respect to pain intensity, and PPT (p > .05). However, there was a significant increase in MMO following dry-needling when compared to the placebo (very low-quality evidence). CONCLUSION: Despite the short-term positive effect of MMO by dry-needling, this NMA could not show any pain-reducing effect in patients with TMD-M by acupuncture or dry-needling when compared to an active or inactive placebo. Taken together, this NMA indicates that it is the placebo effect that accounts for the majority of the treatment effect of TMD-M, rather than a real therapeutic effect of acupuncture/dry-needling.

Clinical aspects of mastication myalgia-an overview.

Mastication myalgia is the most common cause of non-odontogenic pain in the orofacial region and is often associated with a reduced quality of life. The purpose of this review is to provide an overview of the clinical aspects of myalgia based on available research. The review includes epidemiological, diagnostic, and etiological aspects. In addition, the potential risk factors related to the transition from acute to chronic myalgia are explored and treatment strategies are presented for its management. As a result, this review may increase clinical knowledge about mastication myalgia and clarify strategies regarding prevention, diagnostics, and management to improve prognosis and reduce patient suffering.

Early steps towards professional clinical note-taking in a Swedish study programme in dentistry.

BACKGROUND: Higher education tends to focus on academic writing only, instead of emphasizing that professional texts are also used as a basis for communication in contexts with a variety of participators. When it comes to clinical notes, research is scarce and focused on technology and informatics. Therefore, the aim was to explore dental students' clinical notes, and specifically which aspects of the clinical notes characterizes clinical notes that are not sufficient enough for professional purposes. METHODS: The object of analysis was the student's written completion of a teacher constructed protocol regarding oral mucosa, the dental apparatus including pathology on tooth level, oral hygiene, and a validated international clinical examination protocol of the temporomandibular region. The study was framed within the New Literacy Studies approach, and the clinical notes were analyzed using thematic analysis. RESULTS: Within the clinical notes three themes were identified; a) familiar content; b) familiar content in new context; and c) new content. The forms of notes could refer to either categorizational clinical notes or descriptive clinical notes. Most students were able to write acceptable clinical notes when the content was familiar, but as soon as the familiar content was in a new context the students had difficulties to write acceptable notes. When it comes to descriptive notes students suffered difficulties to write acceptable notes both when it came to familiar content, or familiar content in a new context. CONCLUSIONS: Taken together, the results indicate that students have difficulties writing acceptable notes when they are novices to the content or context, making their notes either insufficient, too short or even wrong for professional purposes. With this in mind, this study suggests that there is a need to strengthen the demands on sufficient professional quality in clinical notes and focus on clinical notes already in the early stages of the different medical educations.

Can aerosols-generating dental, oral and maxillofacial, and orthopedic surgical procedures lead to disease transmission? An implication on the current COVID-19 pandemic.

Various dental, maxillofacial, and orthopedic surgical procedures (DMOSP) have been known to produce bioaerosols, that can lead to the transmission of various infectious diseases. Hence, a systematic review (SR) aimed at generating evidence of aerosols generating DMOSP that can result in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), further investigating their infectivity and assessing the role of enhanced personal protective equipment (PPE) an essential to preventing the spreading of SARS-CoV-2 during aerosol-generating procedures (AGPs). This SR was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidelines based on a well-designed Population, Intervention, Comparison, Outcomes and Study (PICOS) framework, and various databases were searched to retrieve the studies which assessed potential aerosolization during DMOSP. This SR included 80 studies (59 dental and 21 orthopedic) with 7 SR, 47 humans, 5 cadaveric, 16 experimental, and 5 animal studies that confirmed the generation of small-sized < 5 µm particles in DMOSP. One study confirmed that HIV could be transmitted by aerosolized blood generated by an electric saw and bur. There is sufficient evidence that DMOSP generates an ample amount of bioaerosols, but the infectivity of these bioaerosols to transmit diseases like SARS-CoV-2 generates very weak evidence but still, this should be considered. Confirmation through isolation and culture of viable virus in the clinical environment should be pursued. An evidence provided by the current review was gathered by extrapolation from available experimental and empirical evidence not based on SARS-CoV-2. The results of the present review, therefore, should be interpreted with great caution.

Bone Graft Osseous Changes After Maxillary Sinus Floor Augmentation: A Systematic Review.

This systematic review aimed to evaluate computed tomographic scans for volumetric bone gain following lateral sinus floor augmentation of the atrophic posterior maxilla after the use of various bone-grafting materials. The databases MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL), and SCOPUS were used for a comprehensive search for all potentially eligible randomized controlled trials (RCTs), without language restrictions, from the beginning of each database until June 2021. The predictor variables for this review were autogenous bone (AB), allografts (AG), xenografts (XG), and alloplastic bone (AP), which were assessed individually and in combination with the inclusion of growth factors with XGs. The outcome variable was the graft volume on cone beam computerized tomographic (CBCT) scans. Seven RCTs with a short-term observation period were included. Topographical analyses of all graft materials identified a volumetric reduction at 6 months postgrafting, compared with values immediately after graft placement. The volumetric reduction occurred regardless of the type of bone-grafting material. The largest volumetric gain over baseline, pregraft values, was found in the AG+XG group. Autografts, the present gold standard bone graft, showed a high resorption rate and inferior volumetric increase when compared with alternative grafting combinations. AG and XG also showed a significant difference with less volumetric gain than AP and their combinations. No difference was detected between AP and AG+AP. However, there was significantly less volumetric gain for AP alone compared with AG+XG and XG-growth factor combinations. As a result, these findings suggest significant advantages to new bone formation using grafting materials in combination. To achieve a better understanding of topographical variables related to various grafting materials, more clinically focused RCTs, with sufficient statistical power to control for confounding factors, are needed.

Top 100 Cited Publications in the Field of Temporomandibular Disorders: A Bibliometric Analysis.

Background: The aim of this bibliometric research was to identify and analyze the top 100 cited publications in the field of temporomandibular disorders (TMD) in order to guide any professional level with interest in this topic by mapping the current trends in the field of TMD. Materials and Methods: The Clarivate Analytics' Web of Science database was used to find the top 100 most cited papers in the field of TMD, published from the year 2000 to November 18, 2021, with MeSH terms in the search strategy. Data extracted were ranking, title, main author, institution, publication year, a total of citations, citation average per year, the journal the study was published, journal impact factor, and the number of studies that each journal published. Further, also the percentage of the different study designs, the number of studies regarding a specific area within the field of TMD, and the number of studies per country were also calculated. A ranking of authors was also performed. Results: The top cited paper was a study on diagnostic criteria for TMD, with 1,287 citations published in 2014 in the Journal of Oral and Facial Pain and Headache which also had most of the top 100 cited publications. Eighty-one percent of the most cited studies were from the USA and Europe and 33% of the included studies were review articles. Conclusion: Taken together, since all papers were considered classic, one can draw the conclusion that researchers in 2000 onward in the field of TMD are interested in (a) diagnostic criteria, (b) TMD symptoms and mainly pain-related symptoms, (c) etiology and risk factors of TMD and mainly bruxism, and (d) treatment of TMD. However, topics such as imaging, occlusion, tissue engineering, and disk displacements are presently not as popular.

Salivary biomarkers in children with juvenile idiopathic arthritis and healthy age-matched controls: a prospective observational study.

Monitoring the immune system's regulation and signaling using saliva could be of interest for clinicians and researchers. Saliva, a biofluid with close exchange with serum, is influenced by circadian variance and oral factors such as masticatory function. This study investigated the detectability and concentration of cytokines and chemokines in saliva in children with juvenile idiopathic arthritis (JIA) as well as saliva flow and the influence of orofacial pain on saliva flow. Of the 60 participants (7-14 years old) enrolled, 30 had a diagnosis of JIA and active disease, and 30 were sex- and age-matched healthy controls. Demographic data and three validated questions regarding presence of orofacial pain and dysfunction were recorded. Stimulated whole saliva was collected and analyzed using a customized R&D bead-based immunoassay with 21 targeted biomarkers. Fourteen of these were detectable and showed similar levels in both children with JIA and controls: TNF-alpha, TNFRSF1B, MMP-2, MMP-3, IL-1alpha, IL-1beta, IL-6R alpha, IL-8, S100A8, CCL2, CCL3, IL-10, CCL11, and CXCL9. In addition, there was no difference in salivary flow rate between groups, but there was an association between orofacial pain and reduced saliva flow rate for both groups.Trial registration: ClinicalTrials.gov Protocol id: 2010/2089-31/2.