Determination of pain intensity, pain-related disability, anxiety, depression, and perceived stress in Polish adults with temporomandibular disorders: A prospective cohort study.

Background: There is a need to assess a relationship between the psychoemotional state of patients and the occurrence and the intensity of pain and temporomandibular disorders (TMD) in relation to a Polish population. There are no such precision data in the literature relating to the population of big Eastern European country. The study conducted by the authors refer to a large group of male and female adult patients of the Polish population in a different age profile. As a result, this study provides a picture of the situation that also takes into account population characteristics that may affect the clinical situation of patients. Objective: The aim of the study was to assess the pain intensity, pain-related disability, anxiety, depression, and perceived stress among Polish adults with TMD as well as the association between psychosocial impairment and TMD. Materials and methods: This prospective cohort study included 219 adult patients from the Outpatient Clinic for Temporomandibular Disorders at the Academic Dental Polyclinic in Wroclaw. The patients completed validated questionnaires, and received a TMD diagnosis based on a standardized examination (Diagnostic Criteria for Temporomandibular Disorders) performed by a qualified dentist. A statistical analysis was carried out on the collected data. Results: Myalgia was the most commonly diagnosed condition among the TMD patients. Furthermore, the prevalence of perceived stress, anxiety, and depression was high in the studied sample. Females showed more depression symptoms than males, while the level of anxiety and stress was similar in both groups. The most statistically significant correlation was observed between the group of masticatory muscle disorders and the level of depression, stress, pain intensity, and pain-related disability. Conclusion: Due to the high prevalence of increased levels of anxiety, depression, and perceived stress, it is essential to screen the psychosocial status of Polish TMD adult patients. Psychosocial status may have an impact on a studied patient's response to treatment and pain intensity, and pain-related disability. Therefore, Polish TMD adult patients should be provided with management based on an interdisciplinary approach. Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT05183503].

Patterns of synthetic cathinones use and their impact on depressive symptoms and parafunctional oral behaviors. / Wzory stosowania syntetycznych katynonów a objawy depresyjne i parafunkcyjne zachowania ustne.

OBJECTIVES: The objective of the study wasto determine the impact of synthetic cathinonesusage on depressive symptoms and oral behaviors among recreational users. METHODS: Users of online drugs-related forums were asked to fill in a questionnaire via Google Forms Platform. The questionnaire contained questions about patterns of drugs use, the Beck Depression Inventory II, the Oral Behaviors Checklist (OBC), and questions about basic demographic data (age, gender). RESULTS: 150 participants (75 in the study group, 75 in the control group) took part in the study. In the study group (aged 15-28), all participants used cathinones and other psychoactive substances. 42 participants used cathinones during last month. Statistical analysis showed a correlation between amount of drugs types used and level of depressive symptoms for both groups (study group and control group), as well as a statistically significantly higher mean value of the OBC scores in a group of cathinones users than in controls. Correlation between the BDI-II and OBC results was statistically significant for both the study and control groups. CONCLUSIONS: Considering easy access to synthetic cathinones, widely spread intoxications and young age of participants of this survey the subject needs to be widely researched. Psychoactive substances can predispose to development of depression and various forms of parafunctional oral behaviors.

Temporomandibular Disorders and Bruxism Outbreak as a Possible Factor of Orofacial Pain Worsening during the COVID-19 Pandemic-Concomitant Research in Two Countries.

BACKGROUND: In late December 2019, a new pandemic caused by the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection began to spread around the world. The new situation gave rise to severe health threats, economic uncertainty, and social isolation, causing potential deleterious effects on people's physical and mental health. These effects are capable of influencing oral and maxillofacial conditions, such as temporomandibular disorders (TMD) and bruxism, which could further aggravate the orofacial pain. Two concomitant studies aimed to evaluate the effect of the current pandemic on the possible prevalence and worsening of TMD and bruxism symptoms among subjects selected from two culturally different countries: Israel and Poland. MATERIALS AND METHODS: Studies were conducted as cross-sectional online surveys using similar anonymous questionnaires during the lockdown practiced in both countries. The authors obtained 700 complete responses from Israel and 1092 from Poland. In the first step, data concerning TMDs and bruxism were compared between the two countries. In the second step, univariate analyses (Chi2) were performed to investigate the effects of anxiety, depression, and personal concerns of the Coronavirus pandemic, on the symptoms of TMD, and bruxism symptoms and their possible aggravation. Finally, multivariate analyses (logistic regression models) were carried out to identify the study variables that had a predictive value on TMD, bruxism, and symptom aggravation in the two countries. RESULTS: The results showed that the Coronavirus pandemic has caused significant adverse effects on the psychoemotional status of both Israeli and Polish populations, resulting in the intensification of their bruxism and TMD symptoms. CONCLUSIONS: The aggravation of the psychoemotional status caused by the Coronavirus pandemic can result in bruxism and TMD symptoms intensification and thus lead to increased orofacial pain.

Prevalence and Overlaps of Headaches and Pain-Related Temporomandibular Disorders Among the Polish Urban Population.

AIMS: To investigate the prevalence and overlaps of headaches and pain-related temporomandibular disorders (TMD) among the Polish urban population. METHODS: The study was conducted in four Polish cities (Wroclaw, Lublin, Katowice, and Lodz) between February and November 2017. Participation in the study was voluntary. The examination consisted of two parts: a clinical examination of TMD using the Diagnostic Criteria for TMD Examination Form and the Head-HUNT Study questionnaire filled in by the participants to determine the occurrence and type of headaches. An experienced and qualified clinician trained all the examiners in the clinical examination protocol. Statistical analyses were based on descriptive and nonparametric statistics. In addition, univariate logistic regression was used. The significance level was set at α = .05. RESULTS: Overall, 213 individuals were examined (149 women and 64 men). The mean age of the participants was 37 ± 15.82 years. The diagnosis for 55.9% of the participants was pain-related TMD, including myalgia (47.4%), myofascial pain (14.1%), arthralgia (21.1%), or headache attributed to TMD (10.3%). In the study population, 48.8% were diagnosed with temporomandibular joint disorders, most frequently disc displacement with reduction (47.9%). A total of 73% of the individuals had experienced headaches in the previous 12 months. The majority of the participants described the headache episodes as occurring less than 7 days/month and lasting less than 4 hours. Among people with painful TMD, the frequency of headaches was almost twice as high as that in nondisordered individuals (48.35% and 25.35%, respectively; P < .0001). The logistic regression model confirmed a significant overlap between headache and painful TMD (OR = 4.77, 95% CI 2.44-9.32, P = .0000). For the entire studied population, no statistically significant connections were established between the occurrence of identified TMJ disorders and headache reports or diagnoses (P > .05). CONCLUSION: Headaches and pain-related TMD are major problems among the Polish urban population. Headache was a much more frequent problem for participants with painful TMD. This issue requires further research and identification of cause-and-effect relationships. Considering the entire studied population, the relationship between identified TMJ disorders and headache is negligible.

Modifications of Polymeric Membranes Used in Guided Tissue and Bone Regeneration.

Guided tissue/bone regeneration (GTR/GBR) is a widely used procedure in contemporary dentistry. To achieve the required results of tissue regeneration, soft tissues that reproduce quickly are separated from the slow-growing bone tissue by membranes. Many types of membranes are currently in use, but none of them fulfil all of the desired features. To address this issue, further research on developing new membranes with better separation characteristics, such as membrane modification, is needed. Many of the current innovative modified materials are still in the phase of in vitro and experimental studies. A collective review on new trends in membrane modification to GTR/GBR is needed due to the widespread use of polymeric membranes and the constant development in the field of dentistry. Therefore, the aim of this review was to present an overview of polymeric membrane modifications to the GTR/GBR reported in the literature. The authors searched databases, including PubMed, SCOPUS, Web of Science, and OVID, for relevant studies that were published during 1999-2019. The following keywords were used: guided tissue regeneration, membranes, coating, and modification. A total of 17 papers were included in this review. Furthermore, the articles were divided into three groups that were based on the type of membrane modification: antibiotic coating, ion-use modifications, and others modifications, thus providing an overview of current existing knowledge in the field and encouraging further research. The results of included studies on modified barrier membranes seem to be promising, both in terms of safety and benefits for patients. However, modifications result in a large spectrum of effects. Further clinical studies are needed on a large group of patients to clearly confirm the effects that were observed in animal and in vitro studies.

Selected Applications for Current Polymers in Prosthetic Dentistry - State of the Art.

BACKGROUND: Polymers have wide applications in medicine, including dentistry, i.e. in prosthetic dentistry. AIM: The following paper is aimed at demonstrating the applications of selected modern polymers in prosthetic dentistry based on the reported literature. MATERIAL AND METHODS: The study was conducted using the PubMed, SCOPUS and CINAHL databases in relation to documents published during 1999-2017. The following keywords were used: polymers with prosthetic dentistry, impression materials, denture base materials, bite registration materials, denture soft liners, occlusal splint materials and 3D printing. Original papers and reviews which were significant from the modern clinical viewpoint and practical validity in relation to the possibility of using polymeric materials in prosthetic dentistry were presented. RESULTS: Denture base materials were the most commonly modified polymers. Modifications mainly concerned antimicrobial properties and reinforcement of the material structure by introducing additional fibers. Antimicrobial modifications were also common in case of relining materials. CONCLUSION: Polymeric materials have widely been used in prosthetic dentistry. Modifications of their composition allow achieving new, beneficial properties that affect the quality of patients' life. Progress in science allows for a more methodologically-advanced research on the synthesis of new polymeric materials and incorporation of new substances into already known polymeric materials, that will require systematization and appropriate classification.

The bond shear strength of methacrylate materials used to reduce dental and alveolar undercuts.

BACKGROUND: The reduction of dental and alveolar undercuts on plaster models is an important issue in the process of planning partial and complete prostheses. In recent years, new materials such as methacrylate resins that can be used to reduce undercuts have emerged. Their great advantage is high temperature insensitivity and relatively high ease of use. OBJECTIVES: The study aimed at determining the factors that affect the shear bond strength, and which material can be better used at the laboratory stage of preparing the plaster model to facilitate the denture bearing area and reduce the traumatizing impact of the prosthesis. MATERIAL AND METHODS: In the study, 2 composite materials Block-Out Gel LC (VOCO GmbH, Cuxhaven, Germany) and LC Block-Out Resin (Ultradent Products Inc., South Jordan, USA) were used for tests on the Tewerock and Stodent plaster. Specimens consisted of 20 mm × 10 mm × 10 mm plaster blocks as a base, and composite cylinders of 3 mm diameter and 5 mm height, attached to the blocks. The base of the sample was combined with a composite cylinder in the Individo Light Box halogen lamp (VOCO GmbH, Cuxhaven, Germany). A total of 120 samples were studied. The shear bond strength (SBS) test was performed using the Hounsfield H5KS model HTE S/N D83281 fitted with a 5.000-N head using a cutting knife speed of 5 mm/ min. RESULTS: LC Block-Out Resin and Block-Out Gel LC materials deposited on class III plaster and polymerized at temperatures of up to 100°C had the best SBS (5.59 MPa and 4.0 MPa, respectively). Samples made of LC Block-Out Resin and class IV plaster showed no statistically significant differences between all the groups. Additional polymerization under 2.4 bar was the most effective in improving SBS among Block-Out Gel LC and class IV plaster samples. CONCLUSIONS: The results of the studies show that both the plaster type and the polymerization process have a significant effect on the SBS of light-cured methacrylate material to plaster.

Evidence to Use Botulinum Toxin Injections in Tension-Type Headache Management: A Systematic Review.

Tension-type headache (TTH) is the most common type of chronic recurring head pain. It can occur twice as often in women as in men. It is the most common type of headache. Its lifetime prevalence is 30% to 78% in the general population. TTH treatment should be multilevel. It often consists of taking pain medication, muscle relaxants, antidepressants, using biofeedback therapy, acupuncture, and attending behavioral therapy. Several clinical trials also suggest that botulinum toxin (BTX) may be an effective treatment option for such patients. The aim of this study was to evaluate if BTX can be used as a treatment method in TTH in the light of current medical literature. The authors searched the PubMed, EBSCOhost, OVID, Web of Knowledge, Cochrane Library and CINAHL databases to identify relevant publications. The authors finally included 11 papers-prospective and retrospective cohort studies. Among most of the selected studies, there was a significant correlation between using BTX and reduction of TTH pain intensity and severity. By analyzing qualified studies, it can be concluded that botulinum toxin seems to be effective in TTH management.

Mental Status as a Common Factor for Masticatory Muscle Pain: A Systematic Review.

Masticatory muscle pain (MMP) is the primary reason for chronic non-odontogenic orofacial pain in the human population. MMP has become a considerable social problem, which affects about 12-14% of the adult population and is 1.5-2 times more frequent in women than in men. This term defines a pain which has its origins in the masticatory muscles. Although MMP is typically felt in the face, jaws, and preauricular area, MMP can radiate to the ear, teeth, head, and neck. This systematic review explains the relationship between MMP and common mental states, such as anxiety, depression, mood and stress-related disorders, and is reported in accordance with PRISMA guidelines. We performed a search in the PubMed database for peer-reviewed articles published after November 1st 2006 in the context of MMP and mental states. According to the defined criteria, 38 studies were finally included into the systematic review, of which prospective cohort studies were found to be the most common. We investigated four primary outcomes (anxiety, depression, mood disorders, and stress-related disorders) and several secondary outcomes of search. Seventy-nine percent of studies concerned depression, 42% anxiety, 29% mood disorders, and 21% stress-related disorders. Most of the studies showed a relationship between MMP and alterations in mental status. Nonetheless, the researchers usually evidenced only the co-occurrence of psychiatric disorders and dysfunctions of the masticatory muscles among the group of patients, in large part in women. Moreover, some studies were marked with limited generalizability of the reported results, quality flaws and heterogeneity. In the light of the analyzed literature, the causal relationship between mental states and MMP is still not clearly established.

Clinical Application of Chitosan in Dental Specialities.

Chitosan is a linear amino-polysaccharide and a natural polymer with a structure based on repetitive deacetylated and acetylated units randomly distributed. It is produced from chitin, one of the most common naturally occurring polysaccharides. Its numerous biomedical applications have been extensively described in the literature. It becomes more and more popular as a therapeutic agent and its use is constantly extended. Given its commonness, regenerative properties, easy chemical treatment, and biocompatibility, it might be used in the treatment of damaged oral cavity tissues. Due to its antimicrobial and regenerative-inducting properties as well as high biocompetency, chitosan is more and more frequently used in medicine and dentistry. It can be applied in all fields of dentistry including preventive dentistry, conservative dentistry, endodontics, surgery, periodontology, prosthodontics and orthodontics. Several data discussing the effectiveness of chitosan use on new bone formation are still inconclusive. The aim of the paper was to evaluate the applicability and biochemical impact of chitosan on oral health maintenance. Even though chitosan might find its adhibition in all dental specialities, it should still be considered as a potential allergen and thus further studies on this topic should be carried out.

Evaluation of the Elastic Properties of Thirteen Silicone Interocclusal Recording Materials.

Background. Addition silicones are popular as dental impression materials and are used in bite registration procedures. Objective. This study aimed to compare the postsetting elasticities and other mechanical properties of thirteen addition silicone interocclusal recording materials. Materials and Methods. The following materials were investigated: Colorbite D, Futar D, Genie Bite, Jet Blue Bite fast, Memoreg 2, O-Bite, Occlufast Rock, Omni-Bite Plus, Regidur i, Registrado X-tra, Regofix transparent, StoneBite, and Variotime Bite. Thirty specimens of each material were tested. The elasticities and strengths of the materials were measured with a universal testing machine, and computer software was used to determine the E-moduli, ultimate tensile strengths, and ultimate elongations of the specimens. Results. The results were subjected to statistical analysis using the Kruskal-Wallis test (p ≤ 0.05). The statistics revealed that the mean E-modulus values varied significantly across the materials (p = 0.000) and were highest for the StoneBite and Registrado X-tra and lowest for the Regofix transparent. The ultimate tensile strengths were highest for the Regofix transparent and Registrado X-tra (p = 0.000) and lowest for the Jet Blue Bite fast and Memoreg 2 (p = 0.000). The elongation percentages at the point of breaking varied significantly across the materials (p = 0.000); the lowest value was observed for the StoneBite, whereas the Regofix transparent nearly doubled original length. Conclusions. The authors concluded that materials with the high E-moduli and great ultimate tensile strengths may be most useful clinically. Registrado X-tra and StoneBite best met these criteria.

Prevalence and correlation between TMD based on RDC/TMD diagnoses, oral parafunctions and psychoemotional stress in Polish university students.

The aim of the study was to assess the prevalence of temporomandibular disorders (TMD) and oral parafunctions, as well as their correlation with psychoemotional factors in Polish university students. The research was conducted in a group of 456 students (N = 456). The examination form comprised of two parts: survey and clinical examination. The research diagnostic criteria for temporomandibular disorders (RDC/TMD) was used in order to assess TMD. Symptoms of TMD were observed in 246 (54%) students after clinical examination. The largest group involved students with disc displacement (women: 132, 29%; men: 70, 15%). Women (164; 36%) suffered more frequently than men (82; 18%) from problems related to the stomatognathic system (P < 0.05), described themselves as easily excitable and emotionally burdened, and reported symptoms as tightness of the facial and neck muscles (P < 0.05). In 289 (64%) students intraoral symptoms concerning occlusal parafunctions were observed. In 404 (89%) examined students, nonocclusal parafunctions were recorded. A significant correlation between TMD and psychoemotional problems could be detected. TMD symptoms more often concern women. Emotional burden and excitability are factors predisposing muscular disorders.