Air-abrasive debridement with glycine powder versus manual debridement and chlorhexidine administration for the maintenance of peri-implant health status: a six-month randomized clinical trial.

STUDY DESIGN: This single-masked, randomized and six-month clinical intervention trial including two study groups was planned to evaluate the efficacy of maintenance treatment with glycine powder on the periodontal health of peri-implant tissues. METHODS: A total of 46 patients with partial or total edentulism, carrying a total of 88 implants, were assigned either to an air abrasive with the glycine powder treatment group (AAD) or to a manual debridement and clorexidine administration treatment group (MDA). Clinical data were collected before treatment and at 3 and 6 months after the treatment. Plaque index (PI), bleeding index (BOP), probing depth (PD), clinical attachment level (CAL) and bleeding score (BS) were analysed. RESULTS: After 3 months, AAD treatment statistically significantly improved BS (P < 0.05); at 6 months, AAD treatment statistically significantly improved indexes PD, PI, BOP and BS (P < 0.05). In addition, the AAD treatment proved to be more effective than MDA in maintaining the peri-implant health of PD at three and 6 months, and of PI at 6 months (P < 0.05). There were no significant changes of CAL in both groups, and all the indexes remained within the physiological levels. CONCLUSIONS: Within the limits of the study, treatment with glycine seems appropriate in the maintenance of peri-implant health and more effective than the traditional treatment with plastic curette and chlorhexidine.

Histological and functional changes in retrodiscal tissue following anterior articular disc displacement in the rabbit: review of the literature.

AIM: Numerous studies have shown how the disc displacement, which usually occurs in an antero-medial direction, can be a factor contributing to temporomandibular joint (TMJ) pain and dysfunction. The aim of this study was to ascertain, through a critical review of the literature, current knowledge relating to anterior articular disc (ADD) in the rabbit that constitutes an extremely suitable animal model for studying the human TMJ. METHODS: An electronic search of the MEDLINE database was performed without applying time or language restrictions and using the following key words: TMD, anterior disc displacement, rabbit, bilaminar zone. This was followed by a manual search. The articles identified were assessed to verify their pertinence, or otherwise, to the topic of investigation. RESULTS: The articles examined were divided into the following groups according to the topic (histological and/or functional) they dealt with: experimental animal models, joint changes, elastic fibers, collagen, chondrocytes and nervous tissue. CONCLUSION: The papers reviewed covered many aspects, both microscopic and histochemical, of the dysfunctional picture o anterior ADD, furnishing a vast body of useful information, not only from the point of view of the results recorded, but also as regards the various surgical and analytical methods used.

Role of psychosocial factors in the etiology of temporomandibular disorders: relevance of a biaxial diagnosis.

AIM: The prevalence of temporomandibular disorders (TMD) is higher among women than men, indicating a multifactorial role for gender-related differences in the etiology of TMD: physiological hormonal differences, inflammatory response to stress, and sociocultural differences in response to pain. The aim of this study was to draw a biobehavioral picture of the TMD patient based on Research Diagnostic Criteria for TMD (RDC/TM) Axis II diagnosis and analysis of gender-related differences. METHODS: Between January 2006 and January 2008, 362 subjects were consecutively enrolled from patients who presented at the Clinic for Temporomandibular Disorders, School of Dental Medicine, University of Pavia, because of orofacial pain, limitation or joint sounds on mandibular movement. Of the 362 subjects evaluated, 308 met the inclusion criteria. RESULTS: The average age of the study population was 41 years; the female: male ratio was 4:1. When stratified according to chronic pain intensity grade and gender, 26% of the women had grade I, 36.4% grade II, 17% grade III, and 9.7% grade IV; 34.4% of the men had grade I, 32.8% grade II, 6.5% grade III, and 3.3% grade IV. Depression was moderate in 35 women and in 6 men and severe in 138 women and in 24 men; somatization was moderate in 59 women and in 20 men and severe in 143 women and in 19 men. CONCLUSIONS: Gender-related differences may be considered risk factors for TMD; psychological characteristics, including somatization, depression, and anxiety related to gender, appear to have a significant impact on the prevalence of TMD.

Temporomandibular disorders and sleep disorders: which relationship?

AIM: The aim of this case-control study was to establish statistically significant associations between temporomandibular disorders (TMD) and obstructive sleep apnea (OSA) or excessive daytime sleepiness (EDS) using, respectively, the Douglass Sleep Disorders Questionnaire and the Epworth Sleepiness Scale. METHODS: A total of 100 patients affected by TMD and 100 age- and sex-matched controls randomly chosen from the general population, answered the 2 questionnaires, which investigated their sleep habits, sleep hygiene and sleep disorders. OSA was considered as present if the total Douglass questionnaire score reached or exceeded the cut-off point of 32 for women and 36 for men. The total score on the Epworth Sleepiness Scale was calculated for each subject, a total >10 considered to indicate the presence of EDS. The data were analysed by using the chi squared test. RESULTS: EDS was found in 19% of the patients and in 10% of the control subjects, and OSA in 6 patients and in 4 control subjects. No statistically significant association emerged between TMD and OSA. EDS was more frequent in patients with myofascial pain. On the basis of the results of the first questionnaire, we were able to develop a profile of OSA patients: they are predominantly smokers, middle-aged (40-60 years old), overweight men. CONCLUSIONS: Although most TMD patients complain of poor sleep quality, the age and sex prevalence of OSA was lower than that of TMD, and EDS was found to be present in only a few cases.

[Quality of life in patients with temporomandibular disorders]. / Qualità della vita nei pazienti affetti da disordini temporomandibolari.

AIM: Oral disorders have a psycho-social impact on the quality of life, that can be measured with instruments as the Oral Health Impact Profile questionnaire (OHIP). Using the OHIP, we evaluated if and how the orofacial pain can affect the quality of life in temporomandibular disorders (TMD) patients. METHODS: A transversal case-control study was carried out. Study subjects were patients referred to the Section of Prosthetic Dentistry and Temporomandibular Disorders of the University of Pavia (Italy). Subjects were recruited sequentially until the target of 124. The controls were 61 "pain free" subjects, who were recruited from the same clinic. In analyzing the data, the chi squared test was used for categorical data, and t test and one-way analysis of variance were used for numerical scores. RESULTS: The subjects in this study were predominantly females (83.9%). The mean age of subjects was 35.1 years (standard deviation= 14.0). The most frequently reported symptoms were pain in the temporomandibular joint (TMJ) (87.1%). The data showed that orofacial pain had an important impact on daily life (p<0.05) and that its most common outcomes were psychological. CONCLUSIONS: Comparison with a "pain free" population clearly indicated that orofacial pain and associated symptoms negatively affect the quality of life of TMD patients.

[Pathogenesis of tension headache: role of temporomandibular disorders. A research protocol]. / La patogenesi delle cefalee di tipo tensivo: ruolo dei disordini cranio-cervico-mandibolari. Protocollo di ricerca.

BACKGROUND: The purpose of this research is to verify through a blind, controlled study if there is a positive correlation between tension-type headache and the most likely causative factors. In accordance with the headache classification of the international headache society, they are: oro-mandibular dysfunction; psychosocial stress; anxiety; depression; headache as a delusion or an idea; muscular stress; drug overuse for tension-type headaches. METHODS: The subjects who participated in the study were selected from patients diagnosed as having tension-type headache. The patients were of both sexes and aged between 18 and 60 years. A control subject was joined to every case. 102 subjects entered the study. The protocol includes the following examinations: questionnaire about the headache's characteristics; questionnaire about muscular stress; questionnaire about sleep; physiologic and pathologic history; structured Clinical Interview for DSMIII-R (Diagnostic and Statistical Manual of Mental Disorders) for diagnosis of anxiety, depression and somatoform disorder; DSMIII-R questionnaire about psychosocial stressors; EMG; algometry; evaluation of the TMJ; evaluation of the muscles of mastication; evaluation of the denture. RESULTS AND CONCLUSIONS: A positive correlations between oro-mandibular dysfunction, anxiety, muscular stress and tension-type headache was found.

[T-Scan. Applied potential. Experimental verification]. / T-Scan. Potenzialità applicative. Verifica sperimentale.

The Authors have tried to underline the characteristics and limits of T-Scan so as to provide an aid for the reliable usage of the instrument and avoid possible erroneous interpretations of the given data.

[T-Scan tracing of the arches. Computerized analysis]. / T-Scan disegno delle arcate. Analisi al computer.

This work deals with a quality control of the dental arch reconstructing software developed for T-Scan. We have developed an original system that employs computer controlled optical acquisition of data. This system behaves satisfactorily following our metodology.

[A new computerized method for quantitative occlusal analysis]. / Nuova metodica computerizzata per un'analisi occlusale quantitativa.

In this work the authors wanted to stress the importance of the occlusal analysis in the sphere of the dental clinic test considering the different methods. Moreover the characteristics of a new system computed for the remark of the occlusal contacts have been analysed with greater detail, debating advantages, limits and clinics applications.