Common therapeutic approaches in sleep and awake bruxism - an overview.

Bruxism, a common medical condition characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible, can occur during sleep, when it is known as sleep bruxism (SB), or during wakefulness, when it is known as awake bruxism (AB). Although bruxism often causes headaches, temporomandibular joint pain, masticatory muscle pain, mechanical tooth wear, prosthodontic complications and cracked teeth, there is still not enough data to define and support a standardised approach to its treatment. The aim of this review was to present the pathophysiology, consequences, types and treatment methods of bruxism in order to increase readers' knowledge of this topic. Differences between awake and nocturnal bruxism are included, as well as risk factors and indicators visible during the clinical examination of affected patients. Among the causes we consider are genetics, stress, oral parafunctions and changes in the Central Nervous System (CNS). Potential and common methods of treatment are presented, along with suggested guidelines that should be followed when determining an appropriate treatment method. We draw attention to the notably dynamic development of bruxism in today's society and the importance of informational and preventive projects, especially those targeted at high-risk patients as well as those targeted at specialists, in order to better tackle the bruxism 'epidemic'.

Assessment of the Socioeconomic Status and Analysis of the Factors Motivating Patients to Apply for Prosthetic Treatment by Students of Dentistry at the Poznan University of Medical Sciences.

This study aimed to determine the motives for undertaking prosthetic treatment at the Prosthetics Clinic of the Poznan University of Medical Sciences (PUMS), pursued by fifth- and sixth-year medicine and dentistry students. The survey consisted of 18 questions, of which 1 to 11 concerned general patient data, while questions 12 to 18 concerned prosthetic treatment. The only open question in the questionnaire was one regarding the motives for the decision to receive treatment. The study group consisted of 153 patients (102 women-66.67% and 51 men-33.33%) of the Prosthetic Clinic. After collecting a total of 200 questionnaires, rejecting 47 (23.50%) due to the lack of answers to all questions (other than question 18), a total of 153 completed (76.50%) questionnaires were obtained. The main motivating factors for patients to undertake prosthetic treatment are functional and aesthetic considerations. In addition, it turned out, that the authority of the university unit is of greater importance than financial issues. Additionally, some patients undergo treatment by students because they can see positive aspects in it, both for them and for students. Hence, the evaluation of the treatment provided by students, as well as their communication skills and their attitude, are rated very highly, although, again, the evaluation was influenced by the education level.

Analysis of human dentition from Early Bronze Age: 4000-year-old puzzle.

This paper presents the first ever paleodontological investigation of human remains from an archeological site in Central Europe dating from the Early Bronze Age and attributed to the Strzyzow Culture. It corroborates the knowledge gained from archeological, anthropological and genetical investigations. Our study aimed to assess dental status, dental morphology and dental pathologies as well as tooth wear and enamel hypoplasia based on visual inspection and stereomicroscopic investigation. The research was supported by CBCT imaging to obtain digital images and 3D reconstructions as well as 2D radiographs essential for dental age estimation. All of the 191 teeth discovered showed morphological similarity, with adult teeth showing similar color, shape and size. A maxillary molar presenting with a unique root morphology and a mandibular molar with a rare occlusal surface were found. Both permanent and deciduous dentition presented significant tooth wear. A few specimens displayed signs of dental caries, periapical pathology and antemortem tooth loss. Three individuals exhibited linear enamel hypoplasia. CBCT provided high-quality 2D images useful for dental age estimation by non-destructive methods. Estimated dental age correlated with the age estimated by other anthropological methods. In one case, this was crucial because of insufficient material for anthropological analysis. The presented studies have proved that besides the skeleton, teeth can be used as a fundamental tool in assessing the overall health and living conditions of paleopopulations. It would seem that there is potential for considerable development to be made in the research and investigation of paleodontological material using CBCT.

Hypothyroidism Affects Olfactory Evoked Potentials.

Background. Objective electrophysiological methods for investigations of the organ of smell consist in recordings of olfactory cortex responses to specific, time restricted odor stimuli. In hypothyroidism have impaired sense of smell. Material and Methods. Two groups: control of 31 healthy subjects and study group of 21 with hypothyroidism. The inclusion criterion for the study group was the TSH range from 3.54 to 110 µIU/mL. Aim. Assessment of the latency time of evoked responses from the olfactory nerve N1 and the trigeminal nerve N5 using two smells of mint and anise in hypothyroidism. Results. The smell perception in subjective olfactory tests was normal in 85% of the hypothyroid group. Differences were noticed in the objective tests. The detailed intergroup analysis of latency times of recorded cortical responses PN5 and PN1 performed by means between the groups of patients with overt clinical hypothyroidism versus subclinical hypothyroidism demonstrated a significant difference (p < 0.05) whereas no such differences were found between the control group versus subclinical hypothyroidism group (p > 0.05). Conclusion. We can conclude that registration of cortex potentials at irritation of olfactory and trigeminal nerves offers possibilities for using this method as an objective indicator of hypothyroidism severity and prognostic process factor.

Difficulties in personal identification caused by unreliable dental records.

This paper demonstrates a case of personal identification that initially seemed straightforward, mainly because complete and comprehensive antemortem dental records of a missing person were made available for analysis. Skeletal remains were found and the skull (most crucial for human identification) was delivered for analysis. Comparative analysis of antemortem and postmortem dental records excluded identification, while the results of superimposition (simultaneously performed by another team member) revealed sufficient concordant points to establish identity. The results caused confusion and additional information was required. The need for more evidence resulted in delivery of elements of the postcranial skeleton. Identification was finally achieved when concordant points were established in a comparison of antemortem X-rays and the humerus. Team members concluded that the dental records were in fact not adequate and that mistakes in numbering the teeth (superior canine instead inferior canine and right and left premolars) were considered to be the initial reason a positive identification had not been made. The authors conclude that a multidisciplinary approach is crucial to making a positive identification and that caution should be exercised when carrying out personal identification from dental records alone. The need to adequately train police officers to collect and preserve dental evidence is also emphasized.

Causes of problems in multidisciplinary bitemark analysis / Przyczyny trudnosci interdyscyplinarnej analizy sladów ugryzien.

Since a successful bitemark analysis depends on many factors, it is important that the phases preceding the analysis be carried out as thoroughly as possible. Interpretive errors in the analysis arise primarily from the complex nature of bitemarks, but also as a result of faulty research methodology, false assumptions or technical errors made during the identification and documentation process. The key role is played by qualifications, knowledge and experience of experts involved in the investigations. In case bitemarks are detected, it is recommended to seek consultations by forensic odontologists or members of an interdisciplinary team experienced in bitemark analysis. The thus obtained information allows for gathering evidence guaranteeing a reliable expert opinion.

[Comparison of bite marks and teeth features using 2D and 3D methods]. / Analiza porównawcza sladów zebów i cech zebów z wykorzystaniem metod 2D i 3D.

UNLABELLED: The nature of bite marks is complex. They are found at the scene of crime on different materials and surfaces - not only on human body and corpse, but also on food products and material objects. Human bites on skin are sometimes difficult to interpret and to analyze because of the specific character of skin--elastic and distortable--and because different areas of human body have different surfaces and curvatures. A bite mark left at the scene of crime can be a highly helpful way to lead investigators to criminals. The study was performed to establish: 1) whether bite marks exhibit variations in the accuracy of impressions on different materials, 2) whether it is possible to use the 3D method in the process of identifying an individual based on the comparison of bite marks revealed at the scene, and 3D scans of dental casts, 3) whether application of the 3D method allows for elimination of secondary photographic distortion of bite marks. The authors carried out experiments on simulated cases. Five volunteers bit various materials with different surfaces. Experimental bite marks were collected with emphasis on differentiations of materials. Subsequently, dental impressions were taken from five volunteers in order to prepare five sets of dental casts (the maxilla and mandible. The biting edges of teeth were impressed in wax to create an imprint. The samples of dental casts, corresponding wax bite impressions and bite marks from different materials were scanned with 2D and 3D scanners and photographs were taken. All of these were examined in detail and then compared using different methods (2D and 3D). RESULT: 1) Bite marks exhibit variations in accuracy of impression on different materials. The most legible reproduction of bite marks was seen on cheese. 2) In comparison of bite marks, the 3D method and 3D scans of dental casts are highly accurate. 3) The 3D method helps to eliminate secondary photographic distortion of bite marks.

[Identification of a murderer on the basis of a biting pattern on body of the victim]. / Identyfikacja sprawcy zabójstwa na podstawie sladów zebów na ciele ofiary.

The authors present a case of identification of a a murderer on the basis of his dentition pattern, reflected by a biting wound on the breast of the victim. The case is exceptional not only from the viewpoint of the authors, but also in view of very sporadic reports on this subject in forensic literature. Cases of biting by humans are not frequent in the forensic/ medical practice, and instances of identification of the perpetrator by his dental pattern reflected in the biting wound are very rare. In Poland, such problems have been the domain of mainly criminologists and only occasionally of forensic medics in collaboration with dentists and anthropologists. Due to the very low number of such cases in Poland, no experts in the matter are available. For this reason, we deemed it purposeful to present respective investigative principles and techniques for identification of a human perpetrator on the basis of the dental pattern reflected in a biting wound on the victim's body.