Self-reported bruxism in patients with post-traumatic stress disorder

OBJECTIVE

The present study aimed to investigate the association between self-reported awake/sleep bruxism, and orofacial pain with post-traumatic stress disorder (PTSD).

METHODS

A case-control study with a convenience sample was designed. Participants were recruited from a university-based Trauma Ambulatory. The diagnosis of PTSD was established through a clinical interview and the Structured Clinical Interview (SCID-I/P). Thirty-eight PTSD patients and 38 controls completed the Research Diagnostic Criteria for Temporomandibular Disorders Axis-II to categorize awake/sleep bruxism and orofacial pain. Following this, we performed a short clinical examination of the temporomandibular joint and extraoral muscles.

RESULTS

Adjusted logistic regression analysis showed that awake bruxism was associated with PTSD (OR = 3.38, 95% CI = 1.01-11.27, p = 0.047). Sleep bruxism was not associated with any covariate included in the model. In a Poisson regression model, PTSD (IRR = 3.01, 95% CI = 1.38-6.55, p = 0.005) and the muscle pain/discomfort (IRR = 5.12, 95% CI = 2.80-9.36, p < 0.001) were significant predictors for current orofacial pain.

CONCLUSIONS

PTSD was associated with self-reported awake bruxism and low-intensity orofacial pain. These conditions were frequent outcomes in patients previously exposed to traumatic events.

CLINICAL RELEVANCE

We suggest including a two-question screening for bruxism in psychiatry/psychology interviews to improve under-identification and to prevent harmful consequences at the orofacial level.

Interpersonal psychotherapy for treatment of obesity: A systematic review and meta-analysis

BACKGROUND

Social and interpersonal context are associated with the onset and persistence of psychiatric disorders. We compared the effects of short-term interpersonal psychotherapy (IPT) on weight loss, binge eating behaviors, and depressive symptoms against cognitive-behavioral therapy (CBT), health education (HE), and behavioral weight loss (BWL).

METHODS

We searched until May 28th, 2022 following databases: PubMed, CINAHL, Science Direct, Web of Science, EMBASE, and Scopus. Articles on parallel randomized clinical trials were included. Outcomes were body mass index (BMI), binge days (bulimic episode), and depressive symptoms. These outcomes were self-reported or measured with specific scales (BMI) or instrument (depressive symptoms).

RESULTS

The initial search retrieved 820 articles, a total of 10 studies met the eligibility criteria, and seven were included in the meta-analysis. Participants with overweight/obesity were women (62-100 %), aged between 11 and 50 years. There was a trivial to small effect on BMI favoring IPT over other interventions (standardized mean difference [SMD] = -0.10; 95%CI: -0.27 to 0.07, I² = 0 %), especially when compared to health education (SMD = -0.21; 95%CI: -0.54 to 0.12, I² = 0 %); no effect on number of binge days (SMD = -0.09; 95%CI: -0.30 to 0.11, I² = 0 %); and a small effect on depressive symptoms (SMD = -0.25, 95%CI = -0.50 to 0.00, I² = 0 %).

LIMITATIONS

Small number of studies, the discrepancy in age cohorts, and racial diversity. Psychotherapeutic protocols and assessment tools had to be adapted across studies.

CONCLUSIONS

Patients with overweight/obesity and depression had some benefit from IPT when compared with other interventions. In view of existing evidence, an IPT program adapted to obesity could help to achieve reliable and long-term effects.

The Impact of the COVID-19 Pandemic and Associated Control Measures on the Mental Health of the General Population : A Systematic Review and Dose-Response Meta-analysis

BACKGROUND

To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear.

PURPOSE

To assess the trajectory of mental health symptoms during the first year of the pandemic and examine dose-response relations with characteristics of the pandemic and its containment.

DATA SOURCES

Relevant articles were identified from the living evidence database of the COVID-19 Open Access Project, which indexes COVID-19-related publications from MEDLINE via PubMed, Embase via Ovid, and PsycInfo. Preprint publications were not considered.

STUDY SELECTION

Longitudinal studies that reported data on the general population's mental health using validated scales and that were published before 31 March 2021 were eligible.

DATA EXTRACTION

An international crowd of 109 trained reviewers screened references and extracted study characteristics, participant characteristics, and symptom scores at each timepoint. Data were also included for the following country-specific variables: days since the first case of SARS-CoV-2 infection, the stringency of governmental containment measures, and the cumulative numbers of cases and deaths.

DATA SYNTHESIS

In a total of 43 studies (331 628 participants), changes in symptoms of psychological distress, sleep disturbances, and mental well-being varied substantially across studies. On average, depression and anxiety symptoms worsened in the first 2 months of the pandemic (standardized mean difference at 60 days, -0.39 [95% credible interval, -0.76 to -0.03]); thereafter, the trajectories were heterogeneous. There was a linear association of worsening depression and anxiety with increasing numbers of reported cases of SARS-CoV-2 infection and increasing stringency in governmental measures. Gender, age, country, deprivation, inequalities, risk of bias, and study design did not modify these associations.

LIMITATIONS

The certainty of the evidence was low because of the high risk of bias in included studies and the large amount of heterogeneity. Stringency measures and surges in cases were strongly correlated and changed over time. The observed associations should not be interpreted as causal relationships.

CONCLUSION

Although an initial increase in average symptoms of depression and anxiety and an association between higher numbers of reported cases and more stringent measures were found, changes in mental health symptoms varied substantially across studies after the first 2 months of the pandemic. This suggests that different populations responded differently to the psychological stress generated by the pandemic and its containment measures.

PRIMARY FUNDING SOURCE

Swiss National Science Foundation. (PROSPERO: CRD42020180049).

Evaluation of periodontitis in hospital outpatients with major depressive disorder. A focus on gingival and circulating cytokines

An imbalance in stimulated cytokine production is associated with the etiopathogenesis of numerous diseases such as major depressive disorder (MDD) and periodontal disease. Increased cytokine levels have been reported in the gingival crevicular fluid (GCF) of patients with MDD. Thirty-six outpatients with MDD participated in this study. Each outpatient was age-matched (± 3 years) with a healthy control (n=36). The patients were controlled for race and smoking habits. Unstimulated and stimulated interleukin 6 (IL-6), interleukin 1β (IL-1β), and interferon-γ (INF-γ) production in whole blood culture (WBC) and IL-6 and IL-1β levels in the GCF were evaluated. Circulating levels of IL-6 and IL-1β (unstimulated) as well as GCF IL-1β were modestly lower in MDD patients, compared to the levels in age-matched controls (Mann-Whitney, p=0.002, 0.0075, ANCOVA, p=0.025, respectively). In the unstimulated group, there was no correlation between the levels of circulating IL-6 and GCF IL-6 (r=0.07, p=0.67), and between the levels of circulating IL-1β and the IL-1β level in the CGF (r=-0.08, p=0.63). In the LPS stimulation group, there was no correlation between the levels of circulating levels of IL-6 and GCF IL-6 (r=0. 02, p=0.91) or between the circulating IL-1β and GCF IL-1β (r=0.13, p=0.42). We observed modest immunosuppression in MDD patients (evaluated by no stimulation whole blood culture [WBC]), especially in patients with melancholic depression, chronic depression, and severe depression.

Effect of ultrasonic instrumentation on the bond strength of crowns cemented with zinc phosphate cement to natural teeth. An in vitro study

Several studies have reported the benefits of sonic and/or ultrasonic instrumentation for root debridement, with most of them focusing on changes in periodontal clinical parameters. The present study investigated possible alterations in the tensile bond strength of crowns cemented with zinc phosphate cement to natural teeth after ultrasonic instrumentation. Forty recently extracted intact human third molars were selected, cleaned and stored in physiologic serum at 4 degrees C. They received standard preparations, at a 16 masculine convergence angle, and AgPd alloy crowns. The crowns were cemented with zinc phosphate cement and then divided into four groups of 10 teeth each. Each group was then subdivided into two subgroups, with one of the subgroups being submitted to 5,000 thermal cycles ranging from 55 +/- 2 to 5 +/- 2 degrees C, while the other was not. Each group was submitted to ultrasonic instrumentation for different periods of time: group 1 - 0 min (control), group 2 - 5 min, group 3 - 10 min, and group 4 - 15 min. Tensile bond strength tests were performed with an Instron testing machine (model 4310). Statistical analysis was performed using ANOVA and Tukey's test at the 5% level of significance. A significant reduction in the tensile bond strength of crowns cemented with zinc phosphate and submitted to thermal cycles was observed at 15 min (196.75 N versus 0 min = 452.01 N, 5 min = 444.23 N and 10 min = 470.85 N). Thermal cycling and ultrasonic instrumentation for 15 min caused a significant reduction in tensile bond strength (p < .05).