Radiological Associations between Posterior Edentulism and Condylar Bony Changes: A Retrospective Study

This retrospective study aimed to investigate the relationship between posterior edentulism and condylar bone changes in patients aged 35-60 years. The CBCT images of 259 patients, including 131 posterior edentulous and 128 posterior dentulous patients, were analyzed to identify the types of condylar bone changes. The frequency of flattening, sclerosis, erosion, and reduced joint space was found to be higher in posterior edentulous patients. Regression analysis revealed that combined premolar and molar loss and being female were significant predictors of condylar erosion (p = 0.006; OR: 3.264; 95% CI: 1.401 - 7.603, p=0.031; OR: 2.652; %95 CI: 1.095 - 6.424). The study provides support for the domino effect phenomenon in temporomandibular joint pathology, indicating that posterior edentulism can have a significant impact on the occurrence of erosive condylar changes. The findings suggest that prosthetic and temporomandibular joint treatment approaches should consider the association between posterior edentulism and condylar bone changes, particularly in female patients with combined premolar and molar loss. Therefore, close attention should be paid to the management of these patients to minimize the risk of temporomandibular joint pathology.

Dental and temporomandibular joint pathology of the red fox (Vulpes vulpes)

Skulls from 305 red foxes (Vulpes vulpes) were examined using predefined criteria to assess for the presence and severity of dental and temporomandibular joint (TMJ) pathology. Of the 305 specimens examined, 131 were male (42.9%), 103 were female (33.4%), 71 were of unknown sex (23.3%), 238 were adults (78.03%) and 67 were young adults (21.97%), with juveniles excluded from the study. Of a maximum of 12,810 possible teeth, 12,355 (96.5%) were present for examination, 72 (0.6%) were absent congenitally, 97 (0.8%) were acquired tooth loss and 280 (2.2%) were absent artefactually. Eight teeth (0.06%) in five specimens (1.6%) had abnormal tooth form and four (0.03%) supernumerary teeth were present across four (1.3%) specimens. Ten persistent deciduous teeth were present in seven (2.3%) specimens and six (0.05%) unerupted teeth were found in four (1.1%) specimens. Root number variation was present in 51 (0.4%) teeth, predominantly premolar teeth. Twenty-one (6.9%) specimens had lesions consistent with enamel hypoplasia and 42 (13.8%) showed root fenestrations in the maxillary alveolar bone. Periodontitis and attrition/abrasion were present in most specimens (56.7% and 96.1%, respectively). Three-hundred and eighty (3.1%) teeth were fractured, with the most common fracture type being root fractures. Eleven periapical lesions were found in nine (0.03%) specimens. Six-hundred and eight TMJs were evaluated and many specimens (11.5%) had evidence of low-grade TMJ osteoarthritis. Overall, these red foxes share similar dental pathology to other foxes, but had a higher prevalence of congenital tooth absence, persistent deciduous teeth, TMJ pathology and enamel hypoplasia.

Dental and temporomandibular joint pathology of the Arctic fox (Vulpeslagopus)

Museum skull specimens from 224 Arctic foxes (Vulpes lagopus) were examined macroscopically using an established protocol for examination of mammalian skull specimens. Foxes were collected from coastal and island regions of Alaska, USA, except for two individuals. Collection years ranged from 1931 to 2016 with most specimens collected during the 1950s and 1960s. The study population comprised more females (n = 134, 59.8%) than males (n = 83, 37.0%) and individuals of unknown sex (n = 7, 3.1%). There were 108 (48.2%) young adults, 115 (51.3%) adults, and one (0.4%) individual of unknown age. A total of 8,891 teeth (94.5%) were available for examination. The most common types of pathology observed were periodontitis (n = 222, 99.1%), dental fractures (n = 175, 78.1%) and attrition/abrasion (n = 198, 88.4%). Periapical lesions (n = 12, 5.3%), temporomandibular joint (TMJ) osteoarthritis (n = 3, 1.3%) and root number variation (n = 5, 2.2%) were less common. Enamel hypoplasia was noted in eight foxes (3.6%), all of which were discovered on St. Matthew Island, Alaska, in 1963. As in other canid species, periodontitis, attrition/abrasion and tooth fractures are common in the Arctic fox, while TMJ pathology is rare. Loss of tooth crown substance probably reflects the influence of diet, interspecific and conspecific aggression and oral trauma due to trapping and hunting methods. The high prevalence of periodontitis is probably also due to the combined effects of diet, genetics and host immune reaction to oral bacteria.

Dental and temporomandibular joint pathology of the island fox (Urocyon littoralis)

Museum skull specimens from 318 island foxes (Urocyon littoralis) were examined macroscopically according to predefined criteria. The study population included males (n = 129, 40.6%), females (n = 93, 29.3%) and animals of unknown sex (n = 96, 30.2%), and comprised 182 (57.2%) adults, 118 (37.1%) young adults and 18 (5.7%) individuals of unknown age, with juveniles and neonates excluded. The number of teeth present for examination was 11,438 (85.6%) with 1918 (14.4%) absent artefactually, 4 (0.03%) absent congenitally and 243 (1.82%) lost ante mortem through acquired tooth loss. There were seven persistent deciduous teeth (0.05%) in three specimens and 11 supernumerary teeth (0.08%) in 10 specimens. Teeth with extra roots were found in 38 skulls (11.9%) with 0.48% of all teeth affected. Two (0.63%) specimens had one tooth with an abnormal form. Fifty-eight (18.2%) specimens had bone fenestrations. Of the alveoli examined, 5361 (46.9%) displayed bony changes suggestive of periodontitis, with 315 (99.1%) of skulls affected. Of the teeth available for examination in 310 specimens (97.5%), most (n = 6,040, 52.8%) had some degree of attrition or abrasion. Fractures affected 1217 (11.0%) of the teeth present in 266 specimens (83.6%). Twenty-three periapical lesions (0.20%) were present in 16 skulls (5.03%). Evidence of temporomandibular joint osteoarthritis was found in seven specimens (0.02%) on either the mandibular head of the condylar process or on the mandibular fossa of the temporal bone.

Dental and Temporomandibular Joint Pathology of the Steller Sea Lion (Eumetopias jubatus)

Skulls from 112 Steller sea lions (Eumetopias jubatus) were examined according to predefined criteria. Of the specimens, 73 (65.2%) were from males, 29 (25.9%) from females and 10 (8.9%) were of unknown sex, with 50 adults (44.6%), 61 young adults (54.5%) and one of unknown age (0.9%). The number of teeth evaluated was 3,521. Adults had more acquired tooth loss than young adults (P <0.0001). A total of 1,660 teeth (47.1%) from 111 specimens (99.1%) had evidence of attrition or abrasion. Adults displayed more attrition or abrasion than young adults (P <0.0001). A total of 241 teeth (6.8%) from 47 specimens (42%) had tooth fractures. Adults had more fractured teeth than young adults (P <0.0001). Bony changes consistent with periodontitis affected 36.7% of teeth. Adults had more teeth affected by periodontitis than young adults (P <0.0001). Temporomandibular joint osteoarthritis lesions were found in 54 specimens (48.2%) with more in adults than in young adults (P <0.0001). Although the significance of our findings is unknown, the occurrence and severity of these lesions may play an important role in the morbidity and mortality of Steller sea lions.

Nasal airway obstruction and orofacial pain: a multicenter retrospective analysis

The aim of this study was to investigate the relationship between nasal airway obstruction (NAO) and symptoms of orofacial pain, including temporomandibular joint pathology and primary headaches. This study was a retrospective analysis of consecutive patients seeking care for chronic orofacial pain at 14 North American treatment centers. The standardized evaluation protocol followed for all patients included cone beam computed tomography (CBCT), a comprehensive clinical examination, and a thorough review of the patient's subjective complaints and health history, including pain and sleep pathology. The primary conditions of interest in this study were the following 5 types of NAO: nasal valve compromise (NVC), deviated septum, septal swell body, concha bullosa, and inferior turbinate soft tissue hypertrophy. Descriptive statistics and regression analysis were performed to determine comorbidities between orofacial pain symptoms and NAO observed on CBCT images. The study population consisted of 1393 patients, 253 men (18.2%) and 1140 women (81.8%). The mean age of the patients was 43.3 (SD 18.1) years. NVC was the most prevalent type of NAO found in the study population (n = 1006; 72.2%). NVC showed a statistically significant comorbidity with capsulitis (odds ratio, 3.73) as well as facial and cervical myositis (odds ratio, 6.97). To the author's knowledge, this is first time that these comorbidities have been identified. NAO had a high comorbidity with orofacial pain. Specifically, NVC was a major contributor to NAO. An understanding of the mechanisms of orofacial pain as well as the effects of improper (mouth) breathing, adaptive forward head posture, muscular fatigue, parafunction, and temporomandibular joint pathology will help the clinician to evaluate the role a patient's nose may be playing in orofacial pain.

[Age features of bioregulatory therapy of dental diseases.]

The article presents data on the use of peptide bioregulators of cell homeostasis and the protective functions of the body in various dental diseases and pathology of organs and tissues of the maxillofacial region. Issues related to the immunopharmacological effect and clinical use of natural and synthetic peptide thymomimetics (thymalin, thymogen, vilon, epithalamin, cortexin) and peptide bioregulators from cartilaginous (sigumir, chondrolux) and other tissues in case of trauma, as well as inflammatory, inflammatory and other pathological processes of tissues of the oral cavity and maxillofacial region. Particular attention is paid to their use in the complex treatment of dental diseases in the elderly.

Dental and Temporomandibular Joint Pathology of the Kit Fox (Vulpes macrotis)

Skull specimens from 836 kit foxes (Vulpes macrotis) were examined macroscopically according to predefined criteria; 559 specimens were included in this study. The study group consisted of 248 (44.4%) females, 267 (47.8%) males and 44 (7.9%) specimens of unknown sex; 128 (22.9%) skulls were from young adults and 431 (77.1%) were from adults. Of the 23,478 possible teeth, 21,883 teeth (93.2%) were present for examination, 45 (1.9%) were absent congenitally, 405 (1.7%) were acquired losses and 1,145 (4.9%) were missing artefactually. No persistent deciduous teeth were observed. Eight (0.04%) supernumerary teeth were found in seven (1.3%) specimens and 13 (0.06%) teeth from 12 (2.1%) specimens were malformed. Root number variation was present in 20.3% (403/1,984) of the present maxillary and mandibular first premolar teeth. Eleven (2.0%) foxes had lesions consistent with enamel hypoplasia and 77 (13.8%) had fenestrations in the maxillary alveolar bone. Periodontitis and attrition/abrasion affected the majority of foxes (71.6% and 90.5%, respectively). Nine-hundred and fifty-eight (4.4%) teeth were fractured, a large proportion (41.8%) of which were characterized as complicated crown fractures. Sixty-six periapical lesions from 52 (9.3%) skulls were found. A considerable portion of foxes (5.9%) showed evidence of low-grade temporomandibular joint osteoarthritis. Overall, kit foxes share dental pathology similar to that of the grey fox (Urocyon cinereoargenteus).

Dental and Temporomandibular Joint Pathology of the Grey Wolf (Canis lupus)

Skulls from 392 grey wolves (Canis lupus) were examined macroscopically according to predefined criteria. Two hundred and seven skulls were included in this study, comprised of 124 young adults (59.9%) and 83 adults (40.1%); of these, 65 (31.4%) specimens were from male wolves and 104 (50.3%) were from females, with 38 (18.4%) of unknown sex. Out of 8,694 possible teeth, 8,339 (95.9%) were present for evaluation. Fifty-five teeth (15.5%) were absent congenitally, 30 (8.5%) were lost during life and 270 (76.1%) were lost artefactually post mortem. Skeletal or dental malocclusion was present in 37 specimens (17.9%), with level bite being the most commonly encountered malocclusion. Enamel hypoplasia was present in five skulls (2.4%), affecting eight teeth (0.1%) in total. An abnormal number of roots was found on 23 teeth (0.3%) on 13 skulls (6.3%). Persistent deciduous teeth occurred in two (1.0%) specimens, affecting one (0.01%) tooth each. Fenestration or dehiscence was found associated with 203 teeth (2.4%) in 72 skulls (34.8%). Periodontitis was noted on 115 skulls (55.6%) and 1,000 teeth (11.5%), affecting significantly more adults (n = 63, 75.0%) than young adults (n = 52, 41.9%; P <0.0001). One hundred and sixty-one skulls (77.8%) showed signs of endodontal disease, including attrition or abrasion on 144 skulls (69.6%) and 2,522 teeth (30.2%) and 424 fractured teeth (5.1%) on 103 skulls (49.8%). Both lesions affected significantly more adults than young adults. Overt periapical disease was associated with six teeth (0.1%) distributed across five skulls (2.4%). A carious lesion was present on one tooth (0.01%) of one specimen (0.5%). Lesions consistent with temporomandibular joint (TMJ) osteoarthritis were found in 24 specimens (11.6%), affecting 38 joints (9.2%). Trauma to the skull, such as bite marks, bullet holes or blunt trauma, was noted in 44 skulls (21.2%). The grey wolf and the domestic dog (Canis lupus familiaris) share common dental diseases; however, the proportion and severity may vary. Although the clinical significance of dental and TMJ pathology in the grey wolf remains unknown, based on the impact of these disorders on the domestic dog, the occurrence and severity of these lesions are likely to play an important role in the morbidity and mortality of this wild canid species.

Dental Pathology of the Grey Fox (Urocyon cinereoargenteus)

Museum specimens from 637 grey foxes (Urocyon cinereoargenteus) were examined macroscopically according to predefined criteria. Of the 637 specimens, 569 were included for further examination. The study population included more males (n = 261, 45.9%) than females (n = 196, 34.4%) and animals of unknown sex (n = 112, 19.7%). Additionally, 481 (84.5%) adults, 67 (11.8%) young adults and 21 (3.7%) individuals of unknown age comprised the study population, with juveniles and neonates excluded. The number of teeth present for examination was 23,066 (96.5%) with 624 (2.6%) absent artefactually, 15 (0.06%) absent congenitally and 193 (0.8%) lost ante mortem through acquired tooth loss. No persistent deciduous teeth or temporomandibular joint osteoarthritis were found in any of the specimens. Ten supernumerary teeth from nine (1.6%) specimens were encountered. Teeth with extra roots were found in 61 individuals (10.7%), with 0.4% of all teeth affected. Of the alveoli examined, 1,529 (6.4%) displayed bony changes suggestive of periodontitis, with 276 (48.7%) of individuals affected. Significantly more adults were affected by bony changes associated with stage 3 periodontitis than young adults. All specimens displaying stage 4 periodontitis were adults. Fractures affected 446 (78.4%) of the specimens examined and 3,554 (15.4%) of teeth present. Almost half (n = 10,856, 47.1%) of the teeth available for examination and most specimens (n = 487, 85.6%) displayed some degree of attrition or abrasion. Two individuals (0.4%) exhibited periapical lesions. Traumatic skull injuries affected 56 (9.8%) specimens. Characterizing the dental pathology in the grey fox provides key insight into the ecology of the species and factors contributing to fitness.

Dental and Temporomandibular Joint Pathology of the North American Brown Bear (Ursus arctos horribilis, Ursus arctos middendorffi and Ursus arctos sitkensis)

Museum specimens (maxillae and mandibles) from 393 North American brown bears (Ursus arctos) from Alaska were examined macroscopically according to predefined criteria and 204 specimens were included in this study. The specimens were acquired between 1905 and 2012. There were 99 specimens (48.5%) from male animals, 87 (42.7%) from female animals and 18 (8.8%) from animals of unknown sex. The ages of the animals ranged from neonate to adult, with 92 adults (45.1%) and 112 young adults (54.9%) included and neonates/juveniles excluded from the study. The number of teeth available for examination was 6,525 (76.2%); 8.6% of teeth were absent artefactually, 0.8% were deemed absent due to acquired tooth loss and 14.5% were absent congenitally. None of the brown bears had supernumerary teeth, persistent deciduous teeth or abnormally formed crowns. Only four of the specimens in the present population were affected by enamel hypoplasia and one specimen contained two mandibular fourth premolar teeth with one root instead of two. All 204 specimens displayed at least some degree of attrition/abrasion, affecting 63% of all teeth, ranging from mild wear of the enamel to deep abrasion associated with pulp exposure. Ten-times more adult than young adult specimens had abrasion causing pulp exposure, while more young adults showed mild attrition/abrasion. Dental fractures were noted in one-third of brown bears and in 3.0% of the total number of present teeth. More adult brown bears had dental fractures than young adults. There were 11 specimens (5.4%) that displayed overt periapical disease, affecting a total of 20 dental alveoli (0.22%), with adults significantly more affected than young adults. Some degree of periodontitis was seen in 145 specimens (71.1%), affecting 13.6% of all dental alveoli. Nearly one-third (29.9%) of skulls displayed skeletal and/or dental malocclusion, most commonly a level bite. Lesions consistent with temporomandibular joint (TMJ) osteoarthritis were found in 27 specimens (13.2%). Caries lesions were discovered in four specimens (2.0%), affecting eight teeth in total. Although the clinical significance of dental and TMJ pathology in the brown bear remains elusive, the occurrence and severity of some of these lesions may play an important role in the morbidity of this species.

Dental and Temporomandibular Joint Pathology of the American Black Bear (Ursus americanus)

Museum specimens (maxillae and/or mandibles) from 371 American black bears (Ursus americanus) acquired between 1889 and 2006 were examined macroscopically according to predefined criteria, and 348 were included in this study. Of the 348 specimens, 126 (36.2%) were from male animals, 106 (30.5%) were from female animals and 116 (33.3%) were from animals of unknown sex. Specimen ages ranged from young adult (n = 63, 18.1%) to adult (n = 285, 81.9%), with juveniles excluded from the study. The number of teeth available for examination was 12,019 (82.2%); 7.0% of teeth were absent artefactually, 0.4% were deemed absent due to acquired tooth loss and 9.7% were absent congenitally. In 43 specimens (12.3%), 82 teeth (0.68%) were small vestigial structures with crowns that were flush with the level of surrounding alveolar bone. The remaining teeth (99.3%) were of normal morphology. Only three supernumerary teeth and three instances of enamel hypoplasia were encountered. Persistent deciduous teeth or teeth with an aberrant number of roots were not encountered in any of the specimens. Approximately one-third of the teeth examined (4,543, 37.8%) displayed attrition/abrasion, affecting nearly all of the specimens (n = 338, 97.1%). Incisor and molar teeth accounted for 52.5% and 34.3% of the affected teeth, respectively, with significantly more adults affected than young adults. Dental fractures were noted in 63 bears, affecting 18.1% of specimens and 1.0% of the total number of present teeth. The canine teeth were most often fractured, with adults having significantly more complicated crown fractures of these teeth than young adults. There were 11 specimens (3.2%) that displayed periapical lesions, affecting 12 (0.1%) dental alveoli. There were 179 specimens (51.4%) displaying bony changes indicative of periodontitis, affecting 816 (6.8%) dental alveoli. The proportion of adult bears affected by periodontitis (57.9%) was significantly greater than that of young adults (22.2%). Exactly half of the specimens (n = 174) possessed lesions consistent with mild temporomandibular joint osteoarthritis. The occurrence and severity of the dental pathology encountered in this study may play an important role in the morbidity and mortality of the American black bear.

Dental and Temporomandibular Joint Pathology of the Walrus (Odobenus rosmarus)

Maxillae and/or mandibles from 76 walruses (Odobenus rosmarus) were examined macroscopically according to predefined criteria. The museum specimens were acquired between 1932 and 2014. Forty-five specimens (59.2%) were from male animals, 29 (38.2%) from female animals and two (2.6%) from animals of unknown sex, with 58 adults (76.3%) and 18 young adults (23.7%) included in this study. The number of teeth available for examination was 830 (33.6%); 18.5% of teeth were absent artefactually, 3.3% were deemed to be absent due to acquired tooth loss and 44.5% were absent congenitally. The theoretical complete dental formula was confirmed to be I 3/3, C 1/1, P 4/3, M 2/2, while the most probable dental formula is I 1/0, C 1/1, P 3/3, M 0/0; none of the specimens in this study possessed a full complement of theoretically possible teeth. The majority of teeth were normal in morphology; only five teeth (0.6% of available teeth) were malformed. Only one tooth had an aberrant number of roots and only one supernumerary tooth was encountered. No persistent deciduous teeth were found in any of the young adult or adult specimens, nor were any specimens affected by enamel hypoplasia. The majority of teeth (85.5%) displayed attrition/abrasion. Of the adult and young adult specimens, 90.8% showed some degree of attrition/abrasion on at least one tooth. Tooth fractures were noted in eight walruses, affecting 10.5% of specimens and 1.3% of the total number of teeth, nearly three-quarters of which were maxillary canine teeth (tusks). Three specimens (3.9%), all adult males, displayed overt periapical disease. The majority (99.2%) of dental alveoli did not have bony changes indicative of periodontitis, with only five specimens (6.6%) affected by periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 46 specimens (60.5%) and TMJ-OA was significantly more common in adults than young adults and males than females. Although the clinical significance of dental and TMJ pathology in the walrus remains unknown, the occurrence and severity of these lesions may play an important role in the morbidity and mortality of this species.