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Pavlou IA, Spandidos DA, Zoumpourlis V, Papakosta VK. Neurobiology of bruxism: The impact of stress (Review). Biomed Rep 2024; 20:59. [PMID: 38414628 PMCID: PMC10895390 DOI: 10.3892/br.2024.1747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
Bruxism is a non-functional involuntary muscle activity that affects more than one-third of the population at some point in their lives. A number of factors have been found to be related to the etiopathogenesis of bruxism; therefore, the condition is considered multifactorial. The most commonly accepted factor is stress. Stress has long been considered to increase muscle tone and to reduce the pain threshold. Current evidence indicates that exposure to chronic stress, distress and allostatic load ignite neurological degeneration and the attenuation of critical neuronal pathways that are highly implicated in the orofacial involuntary muscle activity. The present review discusses the negative effects that chronic stress exerts on certain parts of the central nervous system and the mechanisms through which these changes are involved in the etiopathogenesis of bruxism. The extent of these morphological and functional changes on nerves and neuronal tracts provides valuable insight into the obstacles that need to be overcome in order to achieve successful treatment. Additionally, particular emphasis is given on the effects of bruxism on the central nervous system, particularly the activation of the hypothalamic-pituitary-adrenal axis, as this subsequently induces an increase in circulating corticosterone levels, also evidenced by increased levels of salivary cortisol, thereby transforming bruxism into a self-reinforcing loop.
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Affiliation(s)
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Vassilis Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
| | - Veronica K Papakosta
- Department of Oral and Maxillofacial Surgery, University Hospital Attikon, 12462 Athens, Greece
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Differences between Maximum Tongue Force in Women Suffering from Chronic and Asymptomatic Temporomandibular Disorders-An Observational Study. Life (Basel) 2023; 13:life13010229. [PMID: 36676178 PMCID: PMC9866298 DOI: 10.3390/life13010229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Temporomandibular disorders are craniofacial disorders characterized by the presence of chronic pain in masticatory muscles, with higher incidence in the women population. There is little research that has studied tongue force related to temporomandibular disorders, but there are a lot of studies that have demonstrated the impact of tongue force in vital functions, such as chewing, swallowing, phonation, or breathing. According to this, the aim of this study was to compare the maximum force of the tongue between females with chronic temporomandibular disorders and asymptomatic females. We also wanted to establish whether any relationship existed between the pain and fatigue versus the maximum force developed in females with chronic temporomandibular disorders. Material and methods: A cross-sectional study of 67 women between the ages of 18 and 65 years old was performed. The included women were assigned to one of two groups, according to whether they had chronic temporomandibular disorders or not. The procedure was the same for both groups. Outcome measures included the maximum tongue force, intensity of perceived orofacial pain, and intensity of perceived orofacial fatigue. Results: The results showed significant statistical differences for the maximum tongue force measurement between the chronic temporomandibular disorders group and the control group (p < 0.05) for all the movements, except the lip pressure measurement. Furthermore, the analysis revealed significant statistical differences between the intensity of perceived orofacial fatigue between the groups (p < 0.05). Moreover, the data showed no significant correlations between variables. Conclusion: The study found significant differences in maximum tongue force when comparing women with chronic temporomandibular disorders and asymptomatic women (being superior in these). Likewise, we found that the intensity of perceived orofacial fatigue after tongue exercises showed significant differences between groups. However, this study reveals no correlations between the intensity of perceived orofacial pain and fatigue and the maximum tongue force.
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Chen Q, Shi Y, Jiang L, Zhou Y, Dan H, Jin X, Sun S, Zeng X. Management of burning mouth Syndrome: A position paper of the Chinese Society of Oral Medicine. J Oral Pathol Med 2020; 49:701-710. [PMID: 32589772 DOI: 10.1111/jop.13082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/07/2020] [Accepted: 06/08/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Burning mouth syndrome is a syndrome with tongue as the main affected site and burning pain as the main complaint. Although a variety of therapies have been reported to treat BMS, there is a lack of widely recognized therapies and it is still a dilemma for clinicians to treat BMS. OBJECTIVE To develop the position paper and provide the references for clinical practice of BMS in China. METHODS Under the guidance of WHO (World Health Organization) Handbook for Guideline Development, we used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach as a tool to develop this position paper in the following steps: setting up the groups, formulating the clinical questions and choosing the outcomes, retrieving and synthesizing of evidence, assessing the evidence, investigating the patients' values and preferences, developing the recommendations, reviewing the recommendations, and writing the position paper. RESULTS The 27 recommendations were formed from the following 7 aspects: pre-treatment examination, removal of stimuli, medication, physical therapy, psychological therapy, and antipsychotics. There are 3 strong recommendations and 12 weak recommendations in pre-treatment examination and removal of stimuli, as well as 12 weak recommendations in therapies. CONCLUSION The Chinese position paper for management of BMS has been developed, which could provide the references for clinical practice of BMS in China. Twenty-seven recommendations were formed based on consensus of experts on the balance of benefits vs side effects, evidence, cost, and patients' values and preferences, although the quality of evidence is relatively low.
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Affiliation(s)
- Qianming Chen
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Yujie Shi
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Xin Jin
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Silu Sun
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, Dept. of Oral Medicine of West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
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4
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Freilich JE, Kuten-Shorrer M, Treister NS, Woo SB, Villa A. Burning mouth syndrome: a diagnostic challenge. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:120-124. [DOI: 10.1016/j.oooo.2019.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 01/03/2023]
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5
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Thoppay J, Desai B. Oral burning: local and systemic connection for a patient-centric approach. EPMA J 2019; 10:1-11. [PMID: 30984309 DOI: 10.1007/s13167-018-0157-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/20/2018] [Indexed: 12/24/2022]
Abstract
Burning symptoms in the oral cavity are caused by a range of systemic and local factors, in addition to the neuropathic pain disorder burning mouth syndrome (BMS). Patients may state oral burning as a standalone symptom or may report as a secondary symptom in association with other factors, most commonly with oral dryness, oral mucosal lesions, or certain systemic conditions. There is a level of uncertainty in the presentation of this condition which creates a diagnostic challenge from both the patient's perspective and the practitioner evaluating these individuals. The diagnoses are complicated due to the lack of a clear definition of BMS and clinical guidelines to distinguish BMS from other conditions that are responsible for oral burning symptoms. A clinician should be able to differentiate oral burning from burning mouth syndrome. This integrative review discusses on local and systemic etiologies of oral burning based on current evidence that needs to be excluded for a diagnosis of BMS. It also provides an algorithm for diagnostic workup and therapeutic management to medical providers for patients experiencing oral burning symptoms. This comprehensive system provides a systematic stepwise workup in diagnosing and managing patients presenting with a complaint of oral burning that optimally meets a predictive, preventive, and personalized medicine (PPPM) approach.
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Affiliation(s)
- Jaisri Thoppay
- 1Oral Medicine, Orofacial Pain and Geriatric Programs, Virginia Commonwealth University, Richmond, VA USA
| | - Bhavik Desai
- 2Oral Health and Diagnostic Sciences, Oral Medicine Section, Dental College of Georgia at Augusta University, Augusta, GA USA
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6
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Neupane S, Jung HG, Sohn WJ, Yamamoto H, Kim JY, Byun JS, Lee Y, Bae YC, Choi JK, Kim JY, Jung JK. Focal localization of inflammatory cytokines and neurotrophins in a tongue chronic injury model. Arch Oral Biol 2018; 99:22-30. [PMID: 30590230 DOI: 10.1016/j.archoralbio.2018.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Chronic injury in tongue causes the variety of reactions in the oral cavity, frequently leading to its functional and structural disintegrity including inflammation and sensory dysfunction, but its detailed profiles were not elucidated yet. One of the chronically injured tongue such as tongue piercing, as a pathological aspect, is currently popular among younger people but may be associated with severe side effects, leading to pathophysiological complications. However, the pathophysiological aspects and related cellular and molecular mechanisms underlying tongue injury are not clearly understood. DESIGN In this study, we designed an experimental model system using C57BL/6 male mice that mimics a chronically injured situation by penetrating the middle part of tongue with silk suture. After 5 and 10 days mice were sacrificed and tongues were collected and processed for histological evaluation and immunohistochemistry. RESULTS We found that the anterior tongue showed localization of neuro-inflammatory signaling molecules such as myeloperoxidase (MPO), matrix metalloproteinase 2 (MMP2), tumor necrosis factor-α (TNF-α), nerve growth factor, and transient receptor potential cation channel subfamily V member 1 (TRPV1) without any apparent inflammation in temporal manner. In addition, the signal for AM1-43, an activity-dependent nerve terminal probe, decreased within the fungiform papillae on the anterior tongue after injury. CONCLUSIONS These results implied that the distinct localizations of inflammatory cytokines and neurotrophin would contribute altered sensory function in anterior tongue following the chronic injury. Our study indicates the possible pathophysiologic mechanism underlying neuro-inflammation following chronically injury of tongue. In addition, it could be cautiously postulated that mechanical injury should be avoided to prevent chronic pain disorders from being triggered.
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Affiliation(s)
- Sanjiv Neupane
- Department of Biochemistry, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Hyun-Guek Jung
- Department of Biochemistry, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Wern-Joo Sohn
- Pre-Major of Cosmetics and Pharmaceutics, Daegu Haany University, Gyeongsan, Republic of Korea
| | - Hitoshi Yamamoto
- Department of Histology and Developmental Biology, Tokyo Dental College, Tokyo, Japan
| | - Ji-Youn Kim
- Department of Dental Hygiene, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Jin-Seok Byun
- Department of Oral Medicine, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Youngkyun Lee
- Department of Biochemistry, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Yong Chul Bae
- Department of Oral Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Kap Choi
- Department of Oral Medicine, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea
| | - Jae-Young Kim
- Department of Biochemistry, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea.
| | - Jae-Kwang Jung
- Department of Oral Medicine, School of Dentistry, IHBR, Kyungpook National University, Daegu, Republic of Korea.
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Endogenous pain modulation in chronic orofacial pain: a systematic review and meta-analysis. Pain 2018; 159:1441-1455. [DOI: 10.1097/j.pain.0000000000001263] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
Primary burning mouth syndrome (BMS) is an oral mucosal disorder that is characterized by a chronic and often debilitating intraoral burning sensation for which no localized or systemic cause can be found. BMS most commonly affects postmenopausal women. The pathophysiology of primary BMS is not well understood. Diagnosing BMS can prove to be challenging. BMS patients can also pose a therapeutic challenge to clinicians who are consulted to evaluate these patients. Most commonly used therapies include tricyclic antidepressants, α-lipoic acid, clonazepam, and cognitive-behavioral therapy. Clinical judgment, patient counseling, and monitoring of pain are important. Further research is required to assess the effectiveness of serotonin and newer serotonin-noradrenalin reuptake inhibitors.
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Affiliation(s)
- Siamak Moghadam-Kia
- Department of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Nasim Fazel
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, CA.
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Meynardi F, Pasqualini ME, Rossi F, Dal Carlo L, Nardone M, Baggi L. Implant Dentistry: Monitoring of Bacteria Along the Transmucosal Passage of the Healing Screw in Absence of Functional Load. ORAL & IMPLANTOLOGY 2017; 9:10-20. [PMID: 28280528 DOI: 10.11138/orl/2016.9.1s.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the changes in bacterial profile along the transmucosal path of healing screws placed immediately after insertion of two-piece endosseus implants during the 4-month osseointegration phase, in absence of functional load. MATERIALS AND METHODS Two site-specific samples were collected at the peri-implant mucosa of the healing screws of 80 two-piece implants, for a total of 640 samples. Implants placement was performed following a single protocol with flapless technique, in order to limit bacterial contamination of the surgical site. Identical healing screws (5 mm diameter/4 mm height) were used for each of the 80 implants. During the 4 months of the study, the patients followed a standard oral care regimen with no special hygiene maneuvers at the collection sites. RESULTS The present research documents that during the 4-month period prior to application of function load the bacterial profile of all sites exhibited a clear prevalence of cocci at the interface between implant neck and osteoalveolar crest margin. CONCLUSIONS A potentially pathogenic bacterial flora developed only along the peri-implant transmucosal path.
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Affiliation(s)
| | | | - F Rossi
- Private practice, Varese, Italy
| | | | - M Nardone
- Ministry of Public Health, Rome, Italy
| | - L Baggi
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy
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10
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Chimenos-Küstner E, de Luca-Monasterios F, Schemel-Suárez M, Rodríguez de Rivera-Campillo ME, Pérez-Pérez AM, López-López J. Burning mouth syndrome and associated factors: A case-control retrospective study. Med Clin (Barc) 2017; 148:153-157. [PMID: 27871766 DOI: 10.1016/j.medcli.2016.09.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/26/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Burning mouth syndrome (BMS) can be defined as burning pain or dysesthesia on the tongue and/or other sites of the oral mucosa without a causative identifiable lesion. The discomfort is usually of daily recurrence, with a higher incidence among people aged 50 to 60 years, affecting mostly the female sex and diminishing their quality of life. The aim of this study was to evaluate the association between several pathogenic factors and burning mouth syndrome. PATIENTS AND METHODS 736 medical records of patients diagnosed of burning mouth syndrome and 132 medical records for the control group were studied retrospectively. The study time span was from January 1990 to December 2014. The protocol included: sex, age, type of oral discomfort and location, among other factors. RESULTS Analysis of the association between pathogenic factors and BMS diagnosis revealed that only 3 factors showed a statistically significant association: triggers (P=.003), parafunctional habits (P=.006), and oral hygiene (P=.012). There were neither statistically significant differences in BMS incidence between sex groups (P=.408) nor association of BMS with the pathogenic factors of substance abuse (P=.915), systemic pathology (P=.685), and dietary habits (P=.904). CONCLUSIONS Parafunctional habits like bruxism and abnormal movements of tongue and lips can explain the BMS main symptomatology. Psychological aspects and systemic factors should be always considered. As a multifactorial disorder, the treatment of BMS should be executed in a holistic way.
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Affiliation(s)
- Eduardo Chimenos-Küstner
- Departamento de Odontoestomatología, Campus Universitario de Bellvitge , L'Hospitalet de Llobregat, Barcelona, España.
| | | | - Mayra Schemel-Suárez
- Escuela de Odontología, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | | | - Alejandro M Pérez-Pérez
- Facultad de Biología, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - José López-López
- Departamento de Odontoestomatología, Campus Universitario de Bellvitge , L'Hospitalet de Llobregat, Barcelona, España
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Corsalini M, Daniela DV, Biagio R, Gianluca S, Alessandra L, Francesco P. Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients. Open Dent J 2017; 11:91-98. [PMID: 28357002 PMCID: PMC5345327 DOI: 10.2174/1874210601711010091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 01/02/2017] [Accepted: 01/16/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The purpose of this study is to highlight the evidence of signs and symptoms of craniomandibular disorders (CMD) in patients suffering from fibromyalgia. MATERIALS AND METHOD The study has been carried out from May 2011 to May 2015, recruiting a sample of fibromyalgia patients at the Department of Neurophysiopathology at the hospital Policlinico in Bari. Among the 150 examined patients, 60 of them have been diagnosed to suffer from fibromyalgia and 27 accepted to be investigated with a gnathologic examination at the Dental School at the University of Bari. RESULTS 24 patients (88.9%) were women and 3 (11.1%) men; from 26 to 66 years old (average age, 39). 14 patients (51.9%) were affected by primary fibromyalgia, the remaining 13 (48.1%) by secondary fibromyalgia, mainly associated with hypothyroidism (29.6%). VAS average score was about 8 ± 1.85. The frequency of pain was daily in 15 patients (55.6%); twice a week in 10 patients (37.03%) and a few times a month in 2 patients (7.4%). 11 patients (40.7%) attributed the onset of fibromyalgia to a specific instigating event. In addition, from the gnathologic anamnesis, 11 patients (40,7%) reported a painful symptom in the head-neck region, especially in the frontal region, in the neck, in the masseter muscle and ATM. VAS average score was 3.4 ± 2.8, significantly lower than the one referring to the fibromyalgia pain. The gnathological examination found CMD signs and symptoms in 18 patients (66.7%). Concerning the prevalence of CMD, in type I fibromyalgia, myofascial pain was more frequent (5 patients), whereas in type II fibromyalgia, what was more frequent was a dislocation with reduction (3 patients). CONCLUSION Based on clinic experience, we can affirm that some patients with CMD report pain in other regions. It is difficult to distinguish the CMD forms directly correlated to fibromyalgia from those engendered by parafunctional activities; hence the need is to resolve the fibromyalgia syndrome adopting a multidisciplinary approach.
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Affiliation(s)
- Massimo Corsalini
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
| | - Di Venere Daniela
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
| | - Rapone Biagio
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
| | | | | | - Pettini Francesco
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
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Sabatini S, Ricci M, Candotto V, Lauritano D, Nardi GM. Effects of the application of high-pressure oxygen on the treatment of periodontal disease in diabetic patients. ACTA ACUST UNITED AC 2017; 10:412-423. [PMID: 29682259 DOI: 10.11138/orl/2017.10.4.412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Purpose In this study we wanted to observe the improvement in the healing of periodontal tissues in a group of diabetic patients treated with traditional methods compared to another group treated with the addition of oxygen.The potential of oxygen has long been known in the field of plastic surgery, where it is used to treat burns and skin lesions. Materials and methods This study consists in a split mouth study which involved 30 patients. We carefully treated them with periodontal therapy using manual and mechanical instrumentation. Then, we applied oxygen in half mouth according to randomization list. Finally we checked up patients after some weeks. Results Our results highlight that all areas treated with oxygen application healed more rapidly and better than no treated areas. Conclusions All in all, we have demonstrated that oxygen can improve the outcome of non-surgical periodontal treatment in diabetic subjects.
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Affiliation(s)
- S Sabatini
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - M Ricci
- Private practice, Sarzana (SP), Italy
| | - V Candotto
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - D Lauritano
- Department of Medicine and Surgery, University of Milano "Bicocca", Monza, Italy
| | - G M Nardi
- Department of Dental and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
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13
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El Haddad E, Giannì AB, Mancini GE, Cura F, Carinci F. Implant-abutment leaking of replace conical connection nobel biocare ® implant system. An in vitro study of the microbiological penetration from external environment to implant-abutment space. ORAL & IMPLANTOLOGY 2017; 9:76-82. [PMID: 28042434 DOI: 10.11138/orl/2016.9.2.076] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE The aim of our study is to value the microbial contamination in the implant-abutment connections (IAC) of a Nobel Replace Conical Connection implant system [Nobel Biocare®, Vimercate (MB), Italy]. MATERIALS AND METHODS To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified bacteria across IAC was evaluated. Four Nobel Replace Conical Connection implants (Nobel Biocare®, Vimercate (MB), Italy) were immerged in a bacterial culture for twenty-four hours and then bacteria amount was measured inside and outside IAC with Real-time PCR. Bacterial quantification was performed by Real-Time Polymerase Chain Reaction using the absolute quantification with the standard curve method. RESULTS In all tested implants, bacteria were found in the inner side, with a median percentage of 10.9%. The analysis revealed that in both cases (internally and externally), bacteria grew for the first 48 hours but subsequently they started to dye, probably as a consequence of nutrient consumption. Moreover, the difference between outer and inner bacteria concentration was statistically significant at each time point. CONCLUSIONS Implant's internal contamination shows that IAC is not sealing. The reported results are similar to those of previous studies carried out on different implant systems. Until now, no IAC has been proven to seal the gap between implant and abutment.
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Affiliation(s)
| | - A B Giannì
- Maxillo-Facial and Dental Unit, "Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico", Milano, Italy
| | - G E Mancini
- Maxillo-Facial and Dental Unit, "Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico", Milano, Italy
| | - F Cura
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - F Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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14
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Andreasi Bassi M, Andrisani C, Lico S, Ormanier Z, Arcuri C. Upper full arch rehabilitation with sinus by-pass with tilted implants via tapered-threaded expanders in low density bone: a clinical trial. ORAL & IMPLANTOLOGY 2017; 9:61-68. [PMID: 28042432 DOI: 10.11138/orl/2016.9.2.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE In the present paper the use of tapered-screw bone expanders (TSBEs) is proposed, in combination with the placement of tilted implants, in close proximity to the anterior sinus wall, solving the problem of the reduced height of the alveolar bone in the sub-antral area. The Authors present a case series of full-arch rehabilitations performed with this procedure named: Tilted Implant Expansion Osteotomy (TIEO). MATERIALS AND METHODS 12 patients (5 males and 7 females, average age 58.5 ± 8.1 years) with totally or partially edentulous maxilla were enrolled in this study. For each patient 4 implants were placed, the anterior implants in the area of lateral incisors or canines while, the posterior implants, immediately in front of the maxillary sinus, with an inclined position. Adopting the aforesaid procedure, 48 cylindrical two-piece implants were placed, 24 of which were placed in tilted position, in order to by-pass the maxillary sinus. After a healing period of 6 months, the second stage surgery was performed. The cases were finalized by means of a hybrid metal-acrylic prosthesis. The post finalization follow-up was at 12 months. RESULTS Survival rate was 100% since none fixtures were lost. At the one-year follow up the clinical and radiological appearance of the soft and hard tissues was optimal and no pathological signs were recorded. CONCLUSION TIEO is a promising surgical procedure for full-arch rehabilitation of maxillary edentulous sites and represents a therapeutic alternative to sinus lift techniques.
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Affiliation(s)
| | | | - S Lico
- Private Practice in Olevano Romano (RM), Italy
| | - Z Ormanier
- Department of Oral Rehabilitation, Tel-Aviv University, Tel-Aviv, Israel
| | - C Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
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15
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Mancini GE, Gianni' AB, Cura F, Ormanier Z, Carinci F. Efficacy of a new implant-abutment connection to minimize microbial contamination: an in vitro study. ORAL & IMPLANTOLOGY 2017; 9:99-105. [PMID: 28042437 DOI: 10.11138/orl/2016.9.3.099] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of the present study is to evaluate the effectiveness of Ditron implants abutment connection (IAC) to sealing the gap between two pieces. MATERIALS AND METHODS To identify the efficacy of a new IAC, the passage of genetically modified bacteria across IAC was evaluated. A total of five Ditron Implants were used. All implants were immerged in a bacterial culture for forty-eight hours and then bacteria amount was measured inside and outside IAC with Real-time PCR. Bacterial quantification was performed by Real-Time Polymerase Chain Reaction using the absolute quantification with the standard curve method. RESULTS In all the tested implants, bacteria were found in the inner side, with a median percentage of 1.35%. The analysis revealed that, in untreated implants, bacteria grew (internally and externally). Moreover, the difference between outer and inner bacteria concentration was statistically significant at each time point. CONCLUSIONS Ditron Implant IAC (MPI, Ditron Dental, Israel) is efficacy in reducing bacterial leakage.
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Affiliation(s)
- G E Mancini
- Maxillo-Facial and Dental Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - A B Gianni'
- Maxillo-Facial and Dental Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - F Cura
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Z Ormanier
- Department of Oral Rehabilitation, Tel-Aviv University, Tel-Aviv, Israel
| | - F Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Lucchese A, Guida A, Capone G, Donnarumma G, Laino L, Petruzzi M, Serpico R, Silvestre F, Gargari M. Proteomic peptide scan of porphyromonas gingivalis fima type ii for searching potential b-cell epitopes. ORAL & IMPLANTOLOGY 2017; 9:83-88. [PMID: 28042435 DOI: 10.11138/orl/2016.9.2.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To identify potential antigenic targets for Porphyromonas gingivalis vaccine development. MATERIALS AND METHODS In the present study, we analyzed the Porphyromonas gingivalis, fimA type II primary amino acid sequence and characterized the similarity to the human proteome at the pentapeptide level. RESULTS We found that exact peptide-peptide profiling of the fimbrial antigen versus the human proteome shows that only 19 out of 344 fimA type II pentapeptides are uniquely owned by the bacterial protein. CONCLUSIONS The concept that protein immunogenicity is allocated in rare peptide sequences and the search the Porphyromonas gingivalis fimA type II sequence for peptides unique to the bacterial protein and absent in the human host, might be used in new therapeutical approaches as a significant adjunct to current periodontal therapies.
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Affiliation(s)
- A Lucchese
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples SUN, Naples, Italy
| | - A Guida
- Postgraduate School in Oral Surgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - G Capone
- Department of Biosciences, Biotechnologies and Pharmacological Sciences, University of Bari, Bari, Italy
| | - G Donnarumma
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, Second University of Naples, Naples, Italy
| | - L Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples SUN, Naples, Italy
| | - M Petruzzi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - R Serpico
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples SUN, Naples, Italy
| | - F Silvestre
- Departimento de Estomatologia, University of Valencia, Valencia, Spain
| | - M Gargari
- Department of Clinical Sciences And Translational Medicine, University of Rome "Tor Vergata", Rome, Italy; Department of dentistry "Fra G.B. Orsenigo - Ospedale San Pietro F.B.F.", Rome, Italy
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17
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TETTAMANTI L, BASSI MANDREASI, TRAPELLA G, CANDOTTO V, TAGLIABUE A. Applications of biomaterials for bone augmentation of jaws: clinical outcomes and in vitro studies. ORAL & IMPLANTOLOGY 2017; 10:37-44. [PMID: 28757934 PMCID: PMC5516426 DOI: 10.11138/orl/2017.10.1.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Partially or totally edentulous jaws frequently undergoes from moderate to severe bone atrophy with problems of prosthetic rehabilitation. The inability to make a prosthetic rehabilitation on implants may led to the use of a partial or total removable denture with difficulties in eating and speech, ulcerations of the oral mucosa and loss of facial vertical dimension. These problems may be solved performing bone augmentation procedures. Bone grafts and distraction osteogenesis brought implant dentistry from an experimental practice to become a consolidate dental procedure. Bone grafts, in particular, are currently a valuable treatment modality for the prosthetic rehabilitation. Numerous biomaterials have been developed for the rehabilitation of partially or totally edentulous jaws with fixed or removable dentures. The aim of this paper is to describe biomaterials for bone augmentation. Biomaterials are gradually resorbed by the osteoclasts and replaced by new bone formed through osteoblastic activity. Many biomaterials have been studied, but the most common are as follows: Allogro®, Algipore®, Osteobiol®, Peptide-15, Engipore®, Medpore®, Osteoplant®, Calcium sulfate, Perioglass®, Bio-Oss®, Calcium phosphate.
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Affiliation(s)
- L. TETTAMANTI
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - G. TRAPELLA
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - V. CANDOTTO
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - A. TAGLIABUE
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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18
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DI Venere D, Gaudio RM, Laforgia A, Stefanachi G, Tafuri S, Pettini F, Silvestre F, Petruzzi M, Corsalini M. Correlation between dento-skeletal characteristics and craniomandibular disorders in growing children and adolescent orthodontic patients: retrospective case-control study. ORAL & IMPLANTOLOGY 2016; 9:175-184. [PMID: 28042446 DOI: 10.11138/orl/2016.9.4.175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this retrospective case-control study was to identify, in a group of growing children and adolescents affected by malocclusion, specific dento-skeletal characteristics which could be correlated to the onset, in the above-mentioned subjects, of craniomandibular disorders (CMD). MATERIALS AND METHODS Among the patients treated at the Paedodontics and Orthodontics department of Bari Dental School, we recruited a group of patients with malocclusion and symptoms of temporomandibular disorders, as an experimental group. We considered as controls those patients who, match-paired to their skeletal class depending on the ANB angle, did not show any CMD sign or symptom. RESULTS Of the 128 examined patients, 15 showed signs and/or symptoms of CMD (11.7%). When compared to 15 patients non-affected by CMD, we could not detect statistically significant differences in both skeletal and occlusal characteristics. It is still interesting to notice how in CMD patients, characteristics of skeletal hyperdivergence are often to be found. CONCLUSIONS The present study seems to confirm that in growing children and adolescents, the presence of signs and/or symptoms of CMD is not associable to a specific vertical skeletal growth pattern or to other specific occlusal characteristics.
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Affiliation(s)
- D DI Venere
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - R M Gaudio
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - A Laforgia
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - G Stefanachi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - S Tafuri
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - F Pettini
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - F Silvestre
- Departimento de Estomatologia, University of Valencia, Valencia, Spain
| | - M Petruzzi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - M Corsalini
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
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Lucchese A, Dolci A, Minervini G, Salerno C, DI Stasio D, Minervini G, Laino L, Silvestre F, Serpico R. Vulvovaginal gingival lichen planus: report of two cases and review of literature. ORAL & IMPLANTOLOGY 2016; 9:54-60. [PMID: 28042431 DOI: 10.11138/orl/2016.9.2.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Oral Lichen Planus (OLP) is a chronic inflammatory disease of skin and mucous membranes. Approximately 20% of women with oral lichen planus develops lesions in the genital mucosa. In 1982, Pelisse described a special form of lichen planus (LP), which consists of a triad of symptoms: vulval, vaginal and gingival (VVG)-LP lesions. Aim of the present report is to report two new cases and review the international literature. MATERIAL AND METHODS Two cases of VVG-LP are reported and a review of recent literature is performed. RESULTS The onset of erosive or ulcerative mouth lesions may precede or follow by months or even years the onset of vulvovaginal lesions. Vaginal agglutination is associated with the postmenopausal state in conjunction with a dermatologic condition. Intra-lesional corticosteroids have a role in localized chronic ulceration, while systemic therapies such as corticosteroids, azathioprine, mycophenolate mofetil, hydroxychloroquine, ciclosporin, methotrexate, retinoids, thalidomide and photo chemotherapy have been used in more severe cases with varying success. CONCLUSIONS VVG-LP is rather a rare condition and has been documented in the literature mainly in the form of case reports. Lack of a precise diagnostic criteria of VVG-LP depends on the specialists.
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Affiliation(s)
- A Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - A Dolci
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - G Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - C Salerno
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - D DI Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - G Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - L Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - F Silvestre
- Departimento de Estomatologia, University of Valencia, Valencia, Spain
| | - R Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
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Co-occurrence of Pain Symptoms and Somatosensory Sensitivity in Burning Mouth Syndrome: A Systematic Review. PLoS One 2016; 11:e0163449. [PMID: 27657531 PMCID: PMC5033415 DOI: 10.1371/journal.pone.0163449] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 08/16/2016] [Indexed: 01/03/2023] Open
Abstract
Background Burning mouth syndrome (BMS) is a chronic and spontaneous oral pain with burning quality in the tongue or other oral mucosa without any identifiable oral lesion or laboratory finding. Pathogenesis and etiology of BMS are still unknown. However, BMS has been associated with other chronic pain syndromes including other idiopathic orofacial pain, the dynias group and the family of central sensitivity syndromes. This would imply that BMS shares common mechanisms with other cephalic and/or extracephalic chronic pains. The primary aim of this systematic review was to determine whether BMS is actually associated with other pain syndromes, and to analyze cephalic and extracephalic somatosensory sensitivity in these patients. Methods This report followed the PRISMA Statement. An electronic search was performed until January 2015 in PubMed, Cochrane library, Wiley and ScienceDirect. Searched terms included “burning mouth syndrome OR stomatodynia OR glossodynia OR burning tongue OR oral burning”. Studies were selected according to predefined inclusion criteria (report of an association between BMS and other pain(s) symptoms or of cutaneous cephalic and/or extracephalic quantitative sensory testing in BMS patients), and a descriptive analysis conducted. Results The search retrieved 1512 reports. Out of these, twelve articles met criteria for co-occurring pain symptoms and nine studies for quantitative sensory testing (QST) in BMS patients. The analysis reveals that in BMS patients co-occurring pain symptoms are rare, assessed by only 0.8% (12 of 1512) of the retrieved studies. BMS was associated with headaches, TMD, atypical facial pain, trigeminal neuralgia, post-herpetic facial pain, back pain, fibromyalgia, joint pain, abdominal pain, rectal pain or vulvodynia. However, the prevalence of pain symptoms in BMS patients is not different from that in the age-matched general population. QST studies reveal no or inconsistent evidence of abnormal cutaneous cephalic and extracephalic somatosensory sensitivity. Conclusions There is no evidence for a high rate of other pain symptoms or somatosensory impairments co-occurring with BMS. These results thus suggest that BMS rather depends on specific mechanisms, likely at the trigeminal level. Nevertheless, more thoroughly conducted research is required to draw definitive conclusion.
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Laforgia A, Corsalini M, Stefanachi G, Pettini F, Di Venere D. Assessment of Psychopatologic Traits in a Group of Patients with Adult Chronic Periodontitis: Study on 108 Cases and Analysis of Compliance during and after Periodontal Treatment. Int J Med Sci 2015; 12:832-9. [PMID: 26516312 PMCID: PMC4615244 DOI: 10.7150/ijms.12317] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 08/17/2015] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Although there is nowadays wide agreement on bacteria being the main etiologic agents of periodontal disease, their sole presence cannot damage periodontal tissues in all subjects. This suggests that an individual response and an adaptation to a certain quantity of bacterial biofilm can occur without the disease progressing and vice versa. Depression, stress and anxiety have not been confirmed yet as risk conditions but, in some observational studies, they have been identified as potential risk factors of periodontal disease. The current study aims at investigating the role which these psychological disorder have in the onset and progression of advanced stage periodontitis. MATERIALS AND METHODS The case selection was carried out by means of clinical and radiological periodontal assessment involving a total of 108 subjects, both male and female, aged between 24 and 67. Patients were then divided in two groups of 54 patients each: the first group included patients with severe periodontal disease, the second group was formed by periodontally healthy subjects. Clinical assessment was performed by a sole examiner who selected and divided periodontopathic patients from non-periodontopathic ones. From the current study were excluded: patients with systemic pathologies; smokers; patients taking antidepressant drugs; pregnant women. RESULTS For what concerns depression, in the group of periodontopathic patients it was found that the 62.5% of them were depressed, against the 38.86% in the group of periodontally healthy subjects. For the other two psychological conditions taken into consideration, anxiety and stress, it emerged a different percentage of subjects with anxiety in the periodontal group (31.48%) against healthy controls (20.37%). CONCLUSIONS For each of the psychological variables considered (depression, anxiety, stress), a significant correlation could be observed with periodontal disease, it can be therefore be suggested that the importance these disturbs have in the onset and progress of the dental disease which supports the existing available data in literature. The innovative aspect of this research was the focus on the assessment of compliance, monitoring the ability of periodontal patients to follow oral hygiene instructions aiming at the improving and keeping their own periodontal condition, even though this takes more time than the control group.
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Affiliation(s)
| | - Massimo Corsalini
- Interdisciplinary Department of Medicine, Dental school, University of Bari, Bari, Italy
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23
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Di Venere D, Corsalini M, Stefanachi G, Tafuri S, De Tommaso M, Cervinara F, Re A, Pettini F. Quality of life in fibromyalgia patients with craniomandibular disorders. Open Dent J 2015; 9:9-14. [PMID: 25674166 PMCID: PMC4319208 DOI: 10.2174/1874210601509010009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 12/30/2022] Open
Abstract
Fibromyalgia (FM) is a rheumatic disease which affects fibrous tissues and muscles; it is characterized by chronic pain and it is often associated with craniomandibular disorders (CMD). 31 patients were assessed from March 2012 to October 2012 through the administration of specific questionnaires and following neurologic and gnatologic assessment. A relevant corre-lation between FM and CMD emerges from the present study, as 80.6% of our patients report CMD symptoms with high prevalence of myofascial pain (84%). Multivariate regression analysis revealed that the patients in the present study did not differ in score of quality of life questionnaires from patients with fibromyalgia. The neuropathic pain diagnostic question-naire (DN4) scores were positively affected by belonging to group II of Research Diagnostic Criteria of Temporomandibular Disorders (RDC/ TDM) classification, suggesting the possibility of a neuropathic component in chronic pain in this CMD group, as already speculated in our study on the correlation between burning mouth syndrome and CMD and by other au-thors in studies on chronic low back pain. However, further clinic and instrumental studies are needed in order to test this as-sumption.
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Affiliation(s)
- D Di Venere
- Dental School, University of Bari, Bari, Italy
| | - M Corsalini
- Dental School, University of Bari, Bari, Italy
| | | | - S Tafuri
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - M De Tommaso
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - F Cervinara
- Dental School, University of Bari, Bari, Italy
| | - A Re
- Dental School, University of Bari, Bari, Italy
| | - F Pettini
- Dental School, University of Bari, Bari, Italy
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