Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

BACKGROUND: The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent. METHODS: Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias. RESULTS: Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.

Awareness and practice of dentists in gulf cooperation council countries regarding medication-related osteonecrosis of the jaw - A web-based survey.

Background/purpose: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication among dental patients undergoing treatment with antiresorptive medications such as bisphosphonate and denosumab. The present survey investigated the awareness and practice of dentists in the Gulf Cooperation Council (GCC) countries regarding MRONJ. Materials and methods: This questionnaire-based study was conducted among dental practitioners in all six GCC countries. A questionnaire was designed and distributed among all potential participants via different social media platforms. SPSS version 22 was used for data analysis, and P-value <0.05 was considered statistically significant. Results: Overall, 1685 dentists from the six GCC countries participated in the present study. The surveyed dentists revealed relatively fair practices and awareness regarding MRONJ and its prevention, with the majority reported asking their patients about history of anti-osteoporotic medications (67.8%), recording name of the medication (73.1%) and duration of treatment (75.5%). However, the majority of the participants were unconfident about the duration of drug holiday prior to dental surgical interventions (70.6%) and the overall good level of knowledge/practice related to MRONJ was just 50.6%. The regression analysis revealed that previous exposure to MRONJ cases and attending a seminar, course, meeting, or conference about osteonecrosis of the jaw were independent predictors for positive awareness/good practice regarding MRONJ (P < 0.05). Conclusion: The results show inadequate awareness and practices of dentists practicing in GCC countries regarding MRONJ, with significant variations among the countries. Therefore, appropriate interventions such as periodic continuous education courses are required to improve dentists' knowledge and practices regarding MRONJ.

Clinical and radiographic outcomes of adjunctive photodynamic therapy for treating peri-implantitis among diabetics and cigarette smokers: a systematic review of randomized controlled trials.

Photodynamic therapy (PDT) has been suggested as an adjunctive therapeutic approach for peri-implantitis. This systematic review aimed to assess the clinical and radiographic outcomes of adjunctive PDT (aPDT) for the treatment of peri-implantitis among diabetics and cigarette smokers. Randomized controlled trials (RCTs), which assessed the clinical and radiographic outcomes of aPDT versus other intervention(s) and/or MD alone among diabetics and smokers with peri-implantitis, were considered eligible for the review. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval (CI). The methodological quality of the included studies was evaluated using the modified Jadad quality scale. The meta-analysis revealed no significant differences between the influence of aPDT and other intervention/MD alone on the peri-implant PI among diabetics at the final follow-up. However, statistically significant improvements in the peri-implant PD, BOP, and CBL were observed after the application of aPDT among diabetics. Similarly, no significant differences were found between the influence of aPDT and other interventions/MD alone on the peri-implant PD among smokers with peri-implant diseases at the final follow-up. However, statistically significant improvements in the peri-implant PI, BOP, and CBL were observed after the application of aPDT among smokers. Significant improvements in the peri-implant PD, BOP, and CBL among diabetics and the peri-implant PI, BOP, and CBL among smokers after the application of aPDT at the final follow-up. However, large-scale, well-designed, and long-term RCTs are recommended in this domain.

Investigation on Enamel and Dentine of Tooth through 1D Photonic Structure to Identify the Caries in Human Teeth.

In this research, a one-dimensional (1D) photonic structure was employed to study the nature of both enamel and dentine teeth at the signal of 1.8 THz. A simple three layer one-dimensional crystal is chosen to avoid fabrication intricacy. The materials and methods for sample preparations are discussed. The principle of investigation of caries in the teeth relies on the amount of reflected signal from the structure. Similarly, reflectance is a function of refractive indices and thickness of each layer, the nature of both substrate and infiltrated materials, and the configuration of the structure. Apart from this, the fabrication process of one-dimensional structure and experimental set-up was proposed in this article. The numerical treatment is explained here to obtain reflectance, and subsequently, the output potential. Comparison studies on output potential between enamel and dentine are also shown through graphical representation. The output result in terms of milli-Volt (mV) were obtained at the output end and collected at the photodiode. Interesting results were also observed at the photodetector. For example; the output potential of the reflected signal is around 0.18 mV for both enamel and dentine teeth whereas the potential is more than 0.26 mV and 0.31 mV for caries in dentine and enamel, respectively. Finally, it was inferred that the nature of teeth pertaining to the caries in the enamel and dentine teeth can be investigated by identifying the amount of potential at the output end.

Comparative Analysis of Electric Field Strength, Magnetic Field Strength and Power Density around the Cell Phone Towers of Varying Characteristics with a Proposed Classification Facilitating Research on Human Population.

The continuous exposure of electromagnetic field (EMF) radiation from cell phone towers may possibly have an influence on public health. Each cell phone tower is unique in terms of number of antennas and its associated attributes; thus, the radiation exposure varies from one tower to another. Hence, a standardized method for quantifying the exposure is beneficial while studying the effects of radiation on the human population residing around the cell phone towers. A mere collection of data or human samples without understanding the cell phone tower differences may show study results such as an increase or decrease in biological parameters. Those changes may not be due to the effects of EMF radiation from cell phone towers but could be due to any other cause. Therefore, a comparative study was designed with the aim of quantifying and comparing the electric field strength (EF), magnetic field strength (MF) and power density (PD) on four sides of cell phone towers with varying numbers of antennas at 50 m and 100 m. Further, an attempt was made to develop a PD-based classification for facilitating research involving human biological samples. Through convenience sampling, sixteen cell phone towers were selected. With the use of coordinates, the geographic mapping of selected towers was performed to measure the distance between the towers. Based on the number of antennas, the cell phone towers were categorized into four groups which are described as group I with 1-5 antennas, group II comprising of 6-10 antennas, group III consisting of 11-15 antennas and group IV comprised of towers clustered with more than 15 antennas. The study parameters, namely the EF, MF and PD, were recorded on all four sides of the cell phone towers at 50 m and 100 m. One-way ANOVA was performed to compare the study parameters among study groups and different sides using the Statistical Package for the Social Sciences (SPSS) version 25.0. The mean MF in Group IV was 2221.288 ± 884.885 µA/m and 1616.913 ± 745.039 µA/m at 50 m and 100 m respectively. The mean PD in Group IV at 50 m was 0.129 ± 0.094 µW/cm2 and 0.072 ± 0.061 µW/cm2 at 100 m. There was a statistically significant (p < 0.05) increase in the MF and PD at 50 m compared to 100 m among cell phone tower clusters with more than 15 antennas (Group IV). On the other hand, a non-significant increase in EF was observed at 50 m compared to 100 m in Group II and IV. The EF, MF and PD on all four sides around cell phone towers are not consistent with distance at 50 m and 100 m due to variation in the number of antennas. Accordingly, a PD-based classification was developed as low, medium and high for conducting research involving any biological sample based on quantile. The low PD corresponds to 0.001-0.029, medium to 0.03-0.099 and high to 0.1-0.355 (µW/cm2). The PD-based classification is a preferred method over the sole criteria of distance for conducting human research as it measures the true effects of EMF radiation from the cell phone towers.

Temporomandibular Joint Space Dimensions among Saudi Patients with Temporomandibular Disorders: MRI-Based Retrospective Study.

Introduction: The temporomandibular joint is a complex synovial joint in the body. It is the area in which the mandible articulates with the cranium. The temporomandibular joint space is located between the articular eminence and the glenoid fossa of the temporal bone at the base of the skull and the condylar process of the mandible. This interarticular space is divided into superior joint space (1.2 ml) and inferior joint space (0.9 ml) by the articular disc. The purpose of this study is to detect and evaluate the variations in the temporomandibular joint space among patients having temporomandibular joint disorders. Materials and Methods: In this retrospective study, 60 magnetic resonance imaging scans were evaluated at King Faisal Specialist Hospital in Riyadh, Saudi Arabia, between the years 2006 and 2016. Measurements were done in sagittal view in three areas: anterior, central, and posterior areas. However, coronal view readings were recorded in two different areas: medial and lateral joint spaces. All measurements were recorded at the highest point of the condyle that is perpendicular to the opposing bone. The SPSS program was used for statistical analysis. Results: The central joint space values were higher than the anterior and posterior joint spaces in both coronal and sagittal views. We also found that joint spaces among male patients were higher than female patients (right side P=0.015 and left side P=0.006). It is worth mentioning that the number of temporomandibular joint disorder female patients was more than the number of male temporomandibular joint disorder patients (52 females versus 24 males). Additionally, patients who were older than 55 years old had wider joint spaces than patients who were younger than 25 years old. Conclusion: The central joint space value was the highest among the other joint spaces on both views of magnetic resonance imaging, and the values of joint spaces among males were larger than those of females on sagittal magnetic resonance imaging. Patients with elderly temporomandibular joint disorders showed larger joint spaces than young patients. This study spotlights the importance of magnetic resonance imaging evaluation in temporomandibular joint disorder patients for a better understanding of the clinical evolution of temporomandibular disorders.

Comparison of Dental Anxiety While Visiting Dental Clinics before and after Getting Vaccinated in Midst of COVID-19 Pandemic.

Vaccination is critical to control the rate of coronavirus transmission and infectivity. Dental practices are a high-risk area for contracting coronavirus; this fact generates psychological disturbances amongst patients. In this study, we aimed to assess the levels of anxiety of patients while visiting dental practices before and after getting vaccinated. This cross-sectional study was carried out between March and December 2021. An electronic survey was distributed among the vaccinated individuals who visited dental clinics before and after getting vaccinated. The survey consisted of the following four parts: demographic characteristics, questions related to coronavirus, and anxiety scores before and after getting vaccinated. SPSS-25 was used to perform the statistical analysis, where paired t-test was used to compare the anxiety scores, and Mann-Whitney U test to assess the association of gender with anxiety scores. A p-value of ≤0.05 was considered to be statistically significant. A total of 400 vaccinated individuals participated in this study, with a response rate of 88.23%. The majority of the respondents (71.0%) did not test positive for coronavirus. More than half of the participants (54.0%) reported to not be suffering from any coronavirus-related symptoms. About 100 (25.0%) of the individuals stated that dental clinics are an environment in which there is a high risk of contracting coronavirus. In regards to the comparison of the mean MDAS scores of the participants before and after getting vaccinated, a significant difference (p = 0.001) was found. Vaccination has been recommended for all eligible individuals to control the transmission and infectivity of coronavirus. Vaccinations have decreased the dental anxiety of patients while visiting dental clinics. However, the protective measures are still valid and should be followed, regardless of the vaccination status.

Pattern of Mandibular Third Molar Impaction in Nonsyndromic 17760 Patients: A Retrospective Study among Saudi Population in Central Region, Saudi Arabia.

The objective of this study was to study the incidence of type of impaction of mandibular third molars based on the classifications of Pell and Gregory and Winter, which included angulation of the tooth and level of the occlusal surface of the third molar with respect to the second molar, respectively, in a sample of Saudi population in central region. In this retrospective study, orthopantomograms (OPGs) of 17760 patients were examined, who were reported by the Dental University Hospital (DUH) at King Saud University, Riyadh, Saudi Arabia, between the years 2016 and 2020. Out of 17760 radiographs, 2187 (12.31%) patients presented with at least one impacted third molar. Out of which, 1337 (7.52%) patients had bilateral impaction and 850 (4.78%) patients had unilateral impaction (p < 0.001). No gender predominance was noted in the impaction status (p > 0.05). In bilateral impaction, 671 were male (50.2%) and 666 were female (49.8%). Among unilateral impaction, 394 (46.4%) were male and 456 (53.6%) were female. Mesioangular angulation was the most common pattern of impaction (65%) followed by vertical angulation in both bilateral and unilateral impactions. Level A impaction was found to be highest in both bilateral and unilateral impactions which are 48.02% and 54.0%, respectively (p < 0.05). Our study highlights mesioangular impaction and level "A" as the most frequently encountered angulation and level of impaction in impacted teeth. This study result provides us useful data regarding the radiographic status of mandibular third molars in the population of Saudi Arabia.