Self-Massage and Low-Level Laser in Treatment of Masseter Myalgia: Short-Term Effect.

INTRODUCTION: The aim of this study was to explore the efficiency of massage in the treatment of masseter myalgia compared with biostimulatory laser. MATERIALS AND METHODS: The instrument Diagnostic Criteria for Temporomandibular Disorders was used to select subjects and monitor treatment outcome. 54 subjects with masseter myalgia of more than 3 months in duration were invited to participated and 42 cases were available at the end and analyzed. Age range was 16-67 years (median 33, interquartile range 25-53), 36% subjects was ≥40 years and there were 62% females in both groups. Both treatment groups (self-massage and laser) had 21 participants and were monitored one months after the start of treatment. Age, gender, distress, somatization, catastrophizing, hypervigilance, health competence and oral parafunctions were also assessed as factors that could influence effectiveness of treatment. RESULTS: Laser and massage are effective in reducing symptoms of chronic myalgia of the masseter in self-reported limitation of jaw function and reducing pain intensities (p<0.001). Increase of mouth opening was present in both groups, but mainly significant in laser group. The differences in the amount of change between groups were not significant. Psychological characteristics and parafunctions, present before the treatment, age and gender did not have major affect the effectiveness of treatment. CONCLUSION: Both treatment modalities are effective in treatment of chronic myalgia in short-term.

Effects of Visual Stimuli from Media on the Perception of Dentofacial Esthetics.

OBJECTIVES: The study explored whether television commercials change the perception of one's own dentofacial attractiveness and to identify if it is influenced by personality traits. MATERIALS AND METHODS: The sample included 83 participants, aged 19-27 years. The experimental group (N=42) watched commercials portraying famous young individuals with high smile esthetics, bright teeth and no visible malocclusions, while the control group (N=41) watched neutral commercials (without people or visible teeth). The perception of subjects` own orofacial esthetics and its psychosocial effects were assessed a month before the exposure and immediately after it. The subjects` malocclusion severity and personality characteristics (extraversion, conscientiousness, agreeableness, neuroticism, intellect, self-esteem and perfectionism) were assessed. RESULTS: In their second report, respondents were inclined to report less psychosocial impacts with small differences (ranging from 0-3 scalar points on average) and less significant in the active group compared to neutral group (2 out of 7 vs. 5 out of 7 aspects). Types of visual stimuli were a significant predictor only of changes pertaining to psychological impact of dental esthetics (p=0.045; r=0.221). The intellect moderated perception of smile esthetics, after having been exposed to commercials, accentuated beautiful smiles as a suppressor (ΔR2=0.076; p=0.005; total model R2=0.347; p=0.033). In subjects with higher cognitive abilities, an increase in the self-perceived malocclusion level induced a smaller decrease in psychological impact of dental esthetics as compared to those with lower intellect. CONCLUSION: Psychosocial influences of malocclusion are not stable and tend to decrease during time. However, the exposure to a high smile esthetic of other individuals can inhibit that process in persons with more severe malocclusion and higher cognitive abilities.

Association between Vitamin D and Candida-Associated Denture Stomatitis.

Candida-associated denture stomatitis (CADS) is a fungal infection affecting 60-65% of denture wearers. Its etiology is complex and multifactorial and often associated with host immunodeficiency. Evidence exists that vitamin D has potential immunomodulatory and anti-inflammatory effects. The aim of this case-control study was to assess the association between vitamin D levels and CADS. The study included 32 complete denture wearers with CADS and 32 sex- and age-matched complete denture wearers without CADS. The patients were clinically examined, and the severity of denture stomatitis was assessed according to Newton's classification scale. The serum vitamin D level was determined via the use of an electrochemiluminescence assay. The vitamin D level in the CADS group and control group was 54.68 ± 17.07 and 56.82 ± 17.75 nmol/L, respectively. There was no significant difference between the groups (p = 0.622). Univariate logistic regression analysis showed that the presence of CADS was not associated with hypovitaminosis D (odds ratio (OR) = 1.44; 95% confidence interval (CI) = 0.37-5.54). It can be concluded that vitamin D is not associated with CADS and does not play a significant role in host susceptibility to CADS. This finding suggests that vitamin D screening is not indicated routinely in patients with Candida-associated denture stomatitis.

P2Y2 Receptors Mediate Masseter Muscle Mechanical Hypersensitivity in Rats.

PURPOSE: P2Y2 receptors (P2Y2Rs) are among the various receptors that play an important role in nociception. The goal of this research was to investigate possible P2Y2R expression changes in the trigeminal ganglion (TRG) in bilateral masseter muscle (MM) hypersensitivity following unilateral MM inflammation. The impact of unilateral intramasseteric administration of P2Y2R antagonist on bilateral MM hypersensitivity was also explored. MATERIALS AND METHODS: Bilateral MM hypersensitivity was provoked by unilateral intramasseteric injection of complete Freund's adjuvant (CFA). The head withdrawal threshold (HWT) was assessed bilaterally 4 days later. Bilateral TRG and MM isolation were followed, and quantitative real-time polymerase chain reaction (qRT-PCR) and histopathological analysis were carried out on these tissues, respectively. The involvement of P2Y2Rs in nocifensive behavior was evaluated by administering two doses of P2Y2R antagonist AR-C118925 (0.2 or 1 mg/100 µL) in inflamed MM 4 days post-CFA administration. Bilateral HWT was assessed at different time points following antagonist injection. RESULTS: qRT-PCR analysis demonstrated P2Y2R up-regulation in TRG ipsilateral to the site of CFA administration. Compared to the controls, both doses of AR-C118925 injected ipsilateral to the TRG increased the bilateral HWT at 30, 60, 90, and 120 minutes after antagonist administration. CONCLUSION: The findings suggest that P2Y2Rs may affect MM inflammatory hypersensitivity owing to its up-regulation in the TRG in MM inflammatory pain states.

Changes in quality of life induced by tooth whitening are not influenced by global self-esteem: a randomized double-blind placebo-controlled trial.

The purpose of this paper is to investigate which elements of tooth colour are most influenced by whitening and to identify the short-term changes in satisfaction with smile aesthetics and quality of life induced by tooth whitening and the role of global self-esteem. Sixty participants were randomly assigned to a treated or a placebo group (each group N = 30). Their anterior teeth were bleached with a photo-activated whitening gel, or subjected to a placebo. Lightness, chroma and the translucency of teeth were assessed before and 1 week after the procedure using a spectrophotometer. The Self-Esteem Scale, Psychosocial Impact of Dental Aesthetics Questionnaire, the Orofacial Aesthetic Scale and the Oral Health Impact Profile were administered to subjects. Changes in colour and chroma were greater in the treated than the placebo group (3.8 ± 1.5 vs. 1.7 ± 1.5 and - 3.2 ± 1.5 vs. 0.0 ± 1.1; p < 0.001). The treated group reported increased satisfaction with appearance and a decrease in psychological and social impacts (p < 0.05). In the placebo group there was no objective change in colour but the subjects reported an increase in satisfaction and dental self-confidence, as well as a decrease in psychological impact (p < 0.05). Self-esteem did not have a moderation nor a mediation effect. In conclusion, patients are not able to accurately detect the colour change induced by tooth whitening after 1 week, but they are also largely suggestible when evaluating the changes in quality of life. Changes in quality of life induced by tooth whitening are not influenced by global self-esteem.ClinicalTrials.gov Identifier NCT03380702.

Tooth Color as a Predictor of Oral Health-Related Quality of Life in Young Adults.

PURPOSE: Smiling plays an important role in social interaction. The purpose of this research was to explore the extent to which objective parameters of color of one's own teeth affected the social and emotional dimensions of young adults' lives. MATERIALS AND METHODS: The sample included 134 subjects-students of the University of Rijeka, Croatia (65% female) aged 19 to 28 years (median 21). All subjects had six intact maxillary anterior teeth without restorations or severe malocclusions and healthy gingiva with no signs of inflammation. Tooth color was assessed intraorally using a spectrophotometer. Lightness, chroma, and translucency of the right maxillary central incisors (the reference teeth) were calculated and used for analysis. Subjects reported dimensions of their oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP), Orofacial Esthetic Scale (OES), and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Linear relationships between elements of tooth color and OHRQoL were explored using Pearson correlations. Multiple linear regression, while controlling for the influence of age and gender, was also calculated. ANOVA with a Tukey post hoc test was employed to test whether nonlinear relationships existed between OHRQoL and categories of color elements. RESULTS: Dental self-confidence, esthetic concerns, orofacial appearance, social impact and psychological impact were not related to lightness, chroma, or translucency of the subjects' teeth. Neither linear nor nonlinear relationships were detected between those aspects. Satisfaction with smile esthetics was only related to translucency where subjects with moderate translucency were least likely to be satisfied (p = 0.033). Women tended to report greater psychosocial impacts than men (p < 0.05), regardless of their tooth color. CONCLUSION: According to the results of this study objective, measurable, quantitative parameters of tooth color did not accurately predict psychosocial dimensions of OHRQoL in dentate young adults.

Smile Aesthetics Satisfaction Scale: development and validation of a new brief five-item measure of satisfaction with smile aesthetics in adults and the elderly.

OBJECTIVE: To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry. MATERIALS AND METHODS: A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86 years of age, were included in the investigation. The internal consistency, validity and stability of the questionnaire, along with the responsiveness induced by the tooth-whitening procedure, were evaluated. The relationship between self-perceived satisfaction with the smile aesthetics and the clinical status of the dentition was assessed. RESULTS: The questionnaire had one dimension accounting for 64.3% of variance and showed a high level of reliability (Cronbach α = 0.859). It measured a construct similar to concern with tooth appearance and the desire to improve this appearance (r = -0.403 and r = -0.353, respectively; P < 0.001). High test-retest reliability was demonstrated (intraclass correlation coefficient = 0.985). The questionnaire was able to detect an increase in satisfaction with smile aesthetics as a result of the tooth-whitening procedure (P = 0.016). Clinical predictors of greater satisfaction with smile aesthetics were greater tooth display when smiling, decreased chroma and the absence of gingivitis, as well as absence of crowded, fractured and restored teeth in the anterior segment. CONCLUSIONS: A new questionnaire, titled the Smile Aesthetics Satisfaction Scale (SASS), showed good psychometric properties and its use can be recommended.

Development and validation of a new condition-specific instrument for evaluation of smile esthetics-related quality of life.

OBJECTIVE: Orofacial esthetics raises psychosocial issues. The purpose was to create and validate new short instrument for psychosocial impacts of altered smile esthetics. MATERIALS AND METHODS: A team of an orthodontist, two prosthodontists, psychologist, and a dental student generated items that could draw up specific hypothetical psychosocial dimensions (69 items initially, 39 in final analysis). The sample consisted of 261 Caucasian subjects attending local high schools and university (26% male) aged 14 to 28 years that have self-administrated the designed questionnaire. Factorial analysis, Cronbach's alpha, Pearson correlation, paired samples t-test and analysis of variance were used for analyses of internal consistency, construct validity, responsiveness, and test-retest. RESULTS: Three dimensions of psychosocial impacts of altered smile esthetics were identified: dental self-consciousness, dental self-confidence and social contacts that can be best fitted by 12 items, 4 items in each dimension. Internal consistency was good (α in range 0.85-0.89). Good stability in test-retest was confirmed. In responsiveness testing, tooth whitening induced increase in dental self-confidence (P = 0.002), but no significant changes in other dimensions. CONCLUSION: The new instrument, Smile Esthetics-Related Quality of Life (SERQoL), is short and has proven to be a good indicator of psychosocial dimensions related to perception of smile esthetics. CLINICAL SIGNIFICANCE: Smile Esthetics-Related Quality of Life questionnaire might have practical validity when applied in esthetic dental clinical procedures.

Salivary Flow Rate, Oral Yeast Colonization and Dental Status in Institutionalized and Non-Institutionalized Elderly

Elderly people, especially those institutionalized in long-term care facilities, are at risk of various oral diseases. The aim of the study was to determine the incidence of hyposalivation and colonization/oral fungal infection of oral cavity with yeasts, as well as dental status in institutionalized and non-institutionalized elderly. The study included 280 institutionalized and 61 non-institutionalized elderly people. Salivary flow rate, oral colonization with yeasts/oral infection and dental status were assessed and compared between the groups. The institutionalized elderly had a significantly lower salivary flow rate (p=0.035). Oral colonization with yeasts was more frequently found in institutionalized elderly (p<0.001) as compared with non-institutionalized elderly. A negative correlation was found between decreased salivary flow rate and oral yeast colonization and oral fungal infection in both the institutionalized (rs=-0.58; p<0.05) and non-institutionalized (rs=-0.52; p<0.05) groups. A significant difference in DMFT index was observed between the two groups (p<0.001). A negative correlation between decreased salivary flow rate and dental status was found in both the institutionalized (rs=-0.22; p<0.05) and non-institutionalized (rs=-0.56; p<0.05) groups. The results revealed a significantly higher level of hyposalivation and oral yeast colonization and poorer dental status in the institutionalized group as compared with the non-institutionalized group of elderly people.

Gender, age, and psychosocial context of the perception of facial esthetics.

OBJECTIVE: To explore the effects of gender, age, and psychosocial context on the perception of facial esthetics. METHODS: The study included 1,444 Caucasian subjects aged 16 to 85 years. Two sets of color photographs illustrating 13 male and 13 female Caucasian facial type alterations, representing different skeletal and dentoalveolar components of sagittal maxillary-mandibular relationships, were used to estimate the facial profile attractiveness. The examinees graded the profiles based on a 0 to 10 numerical rating scale. The examinees graded the profiles of their own sex only from a social perspective, whereas opposite sex profiles were graded both from the social and emotional perspective separately. RESULTS: The perception of facial esthetics was found to be related to the gender, age, and psychosocial context of evaluation (p < 0.05). The most attractive profiles to men are the orthognathic female profile from the social perspective and the moderate bialveolar protrusion from the emotional perspective. The most attractive profile to women is the orthognathic male profile, when graded from the social aspect, and the mild bialveolar retrusion when graded from the emotional aspect. The age increase of the assessor results in a higher attractiveness grade. CONCLUSIONS: When planning treatment that modifies the facial profile, the clinician should bear in mind that the perception of facial profile esthetics is a complex phenomenon influenced by biopsychosocial factors. CLINICAL SIGNIFICANCE: This study allows a better understanding of the concept of perception of facial esthetics that includes gender, age, and psychosocial context.

The effect of frequent removable partial denture wearing on alveolar bone resorption.

AIM: To determine the influence of frequent removable partial denture (RPD) wearing on the alveolar bone density changes around the abutment teeth. METHODS: Fifty examinees of both genders, wearing partial dentures, were included in the study. Thirty one of the examinees (62%) were wearing the dentures 24 hours a day, while nineteen (34%) of them were wearing them only during the day. The changes in the bone density around the abutment teeth were determined by the intraoral microdensitometry method. Standard retroalveolar radiographs were performed twice. The first one before the removable partial denture delivery and the second one after a period of three-month denture wearing. A copper step wedge consisting of five steps (0.1-0.5 mm) was attached to the radiograph in order to calibrate it. Seven points, regions of interest (ROI) close to the root of the abutment tooth, all ten pixels in size, were selected on each radiograph. Grey areas in the regions of interest were measured and converted into the copper step wedge thickness equivalents in order to estimate the change in the alveolar bone density and measure the difference in alveolar bone density between two radiographs. RESULTS: The results indicated that there is not any statistically relevant change (t-value less than 2,011; t(49,0.05) / F less than 4,0426; F0.05(1,48)) in the alveolar bone density depending on the frequency of removable partial denture wearing. CONCLUSION: The frequency of removable partial denture wearing does not cause any changes in the alveolar bone density around the abutment teeth in the period of three-month denture wearing.

Depression, somatization and anxiety in female patients with temporomandibular disorders (TMD).

The aim of this research was to determine the possible differences in degrees of depression, somatization and anxiety between the acute and chronic female patients with temporomandibular disorders (TMD), and whether these differences exist in healthy female patients. Ninety female patients were involved in this research; 60 of them were TMD patients of the Dental Polyclinic, while other 30 females came for a routine recall visit and had no problem related to TMD. Patients were aged 22 to 67 years, the average age being 38.5 +/- 12 years. All patients were asked to fill in the RDC/TMD protocol and three psychological tests (Emotions Profile Index, Somatization Scale and life Events Scale). Following the analysis of the RDC/TMD protocol and psychological tests, it was determined that the chronic female patients had higher depression and somatization scores in comparison with the acute patients (p < 0.01); the acute patients self-perceive higher levels of anxiety in relation to the control group; furthermore, the patients reporting higher levels of depression were more inclined to somatization and had experienced a greater number of stress events in the past six months. It is beyond doubt that patients suffering from the TMD's exhibit higher levels of depression, somatization and anxiety compared to the healthy ones, which proves that physiological factors may play a predisposing role in combination with reduced level of body tolerance to pain, and a decreased tolerance to stress.