Parafunctional Habits Research Articles

Enhancing Localized, Occlusal Space by Relative Axial Tooth Movement in Patient with Dentinogenesis Imperfecta—A Case Report

ABSTRACT Dentinogenesis imperfecta (DI) is a hereditary disorder that affects dentin formation, leading to discolored, fragile teeth with increased susceptibility to wear and fracture. A 41-year-old woman presented with a family history of DI and significant tooth wear primarily affecting her maxillary anterior teeth due to parafunctional habits. She reported dissatisfaction with her smile, indicating that her front teeth were short and did not show when smiling. Examination revealed blue-gray teeth with craze lines characteristic of DI, receded pulp chambers, and evidence of significant tooth surface loss due to attrition. The patient had no significant medical history or allergies, with a regular history of dental attendance. The management plan involved restorative treatment using a staged approach. Initially, non-surgical debridement, management of caries, and the placement of provisional restorations using a fixed Dahl appliance were performed to create occlusal space. This was followed by definitive ceramic restorations to restore esthetics and function. The treatment successfully improved the patient’s smile and functional outcomes. This case highlights the importance of a comprehensive, phased treatment approach for managing DI, emphasizing the need for occlusal space creation, caries management, and esthetic restoration to improve patient satisfaction and dental health outcomes.

Potential predisposing features of external cervical resorption: An observational study.

To assess the occurrence of external cervical resorption (ECR) in relation to patient characteristics and potential predisposing factors. In total, 215 ECR lesions (194 patients) referred to the Endodontic postgraduate Unit at King's College London or Specialist Endodontic practice (London, UK) between September 2017 and January 2022. The clinical records were readily accessible for evaluation. At the time of initial presentation, patients diagnosed with ECR were interviewed regarding potential predisposing factors using a checklist based on existing literature of reported predisposing factors. Absolute and relative frequencies for all variables were computed. Inferential analysis was carried out to determine if there was any potential association between the type and location of tooth in the jaw as well as sex, age of the patient and potential predisposing factors. No identifiable predisposing factor were detected in 22.3% (48/215 teeth) of the cases, 57.7% (124/215 teeth) had a sole, identifiable predisposing factor and 20% (43/215 teeth) had combined (several) factors. The most common (sole or combined) potential predisposing factors were previous/existing history of orthodontic treatment (25.6%, 55/215 teeth), dental trauma injury (DTI) (20.9%, 45/215 teeth), domestic cat ownership (15.8%, 34/215 teeth) and parafunctional habits (10.2%, 22/215 teeth). The highest occurrence of sole predisposing factors was recorded for males (62%, 75/121 teeth), all other ethnic groups combined (non-white) patients (58.5%, 24/41 teeth), incisor teeth (64.4%, 56/87 teeth) and maxillary teeth (62.4%, 68/109 teeth). While the highest occurrence of combined predisposing factors was found in females (22.3%, 21/94 teeth), white patients (20.1%, 35/174 teeth), premolars (29%, 9/31 teeth) and mandibular teeth (21.7%, 23/106 teeth). There were significant associations between tooth type and trauma (p < .001), cat ownership (p = .003) and parafunctional habits (p = .017). The association between trauma (p < .001), cat ownership (p = .002) and jaw location were found to be significant. Concerning parafunctional habits, female patients had significantly (p = .015) more ECR occurrence than male patients. Most cases had 1 (sole) identified predisposing factor; orthodontic treatment, dental trauma history and (previous) cat ownership were the most identified factors. The information may be helpful in diagnosing early stage ECR.

Clinical and Radiographic Features of Peri-Implant Medication-Related Osteonecrosis of the Jaw: ARetrospective Study.

This study aimed to analyze the factors affecting the occurrence of peri-implant medication-related osteonecrosis of the jaw (PI-MRONJ) in patients using anti-resorptive drugs (ARDs) on different implant position, inclinations, and types of prosthesis. The data of 75 patients with bone necrosis that progressed around the implant between 2018 and 2022 were retrospectively examined to identify the factors influencing PI-MRONJ. Data, including patient demographics (age, sex, smoking status, concomitant disease, time of ARD therapy, dose of ARDs, and parafunctional habits) and implant-specific information (type of prosthesis, angle of insertion), were extracted from medical and dental records. Tilted implants with an angle ≥ 5.1° relative to the occlusal plane of the prosthesis had a stronger association with PI-MRONJ in comparison to non-tilted implants (inclination was < 5°). Additionally, the boundary of the area of osteonecrosis around the fixture was larger for the splinted implant-supported crowns than for the single implant supported crowns). In patients taking anti-resorptive medications the inclination of the implant was associated with the occurrence of PI-MRONJ. Further studies are required to confirm the clinical findings.

Etiology, Diagnosis And Therapy Of Burning Mouth Syndrome In Denture Wearers - Review

Background: The Burning Month Syndrome (BMS) is an oral mucosa pain - with or without inflammatory signs - without any specific lesion. Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity. The cause of BMS is not known, therefore a complex association of biological, psychological and neurophatic factors has been identified. BMS is classified as an idiopathic (nociplastic) orofacial pain with or without somatosensory changes by International Classification of Orofacial Pain (ICOP 2020). The aim of this study was to understand the etiological factors (local, systemic, and psychosocial) which may be responsible for oral burning associated with BMS, and to offer the prosthodontic practitioners possibilities for treatment generally at all patients, especially at denture wearers in solving this problem. Matherials and methods: Review of literature was used to analyze the etiological factors for BMS, pain characteristics, diagnostic criteria and treatment possibilities for BMS condition at patients with dentures. Results: BMS can be divided into three types depending on the intensity of pain. There are also few possible theories behind the cause of BMS. Local oral factors are: denture acrylic allergies, poorly fitting dentures, para functional activities, salivary gland dysfunction, taste dysfunction, infectious agents, periodontal diseases, peripheral nerve damage. Systemic factors are: nutritional deficiency/anemia, central nervous system disorders, psychological disorders, hormonal changes and diabetes mellitus, xerostomia and Sjogren's syndrome. Discussion: Problems with dentures are important factors in the burning symptoms. Inadequate denture retention and stability can induce abnormal tongue activity and become a habit to retain the denture extensions and in adequate freeway space increase load on the denture bearing areas which results of burning mouth sensation. It is clinically helpful if patients find that removal of the denture reliefs their symptoms. Although the short‐term follow‐up studies may show potential symptomatic improvement with treatment in patients with BMS, the long‐ term outcomes for BMS remain unclear. In perspective, complete understanding of the etiology and pathogenesis is imperative to the development of novel and efficacious therapeutic strategies and will guide overall prognosis of the disease in the future. Conclusion: Although different etiological theories have been proposed to explain primary burning mouth syndrome, none have received universal acceptance to date. BMS is a difficult and challenging problem for the dental practitioner. It is a clinical diagnosis made via the exclusion of all other causes. No universally accepted diagnostic criteria, laboratory tests, imaging studies or other modalities definitively diagnose or exclude BMS. The key to successful management is a good diagnostic work-up and coordination between the prosthodontic practitioners and appropriate physicians and psychologists. All this together will help prosthodontics practitioners to better diagnose and treat the BMS.

Bruxism awareness and self-assessment in dental clinical students: a questionnaire-based study

BackgroundBruxism is a recurrent parafunctional habit characterized by clenching or grinding teeth and/or jaw contractions. It is quite common among dental students and is associated with psychosocial factors such as stress and anxiety. This study aimed to compare bruxism awareness and self-assessment among clinical students with and without bruxism.MethodsThis study included systemically healthy individuals aged 18 to 27 years. Intraoral and extraoral examinations were performed on 128 4th- and 5th-grade dental students with (64) and without bruxism (64), 4th and 5th-grade dental students at Bolu Abant İzzet Baysal University who met the inclusion criteria. The diagnosis of bruxism was based on the 2018 International Consensus and data collected through a validated 33-item questionnaire covering general information and bruxism awareness. The questionnaire included multiple-choice questions on bruxism types, risk factors, symptoms, and impact on periodontal tissues. Statistical analyses were performed via IBM SPSS Statistics, and p < 0.05 was considered statistically significant.ResultsClenching and teeth grinding during sleep, tooth wear, muscle fatigue, pain in the temples, jaw pain, joint trismus, neck pain, and jaw joint pain and clenching while awake were significantly different in bruxism patients (p < 0.05). There was no significant difference between the two groups in terms of bruxism type, symptoms, treatment methods, periodontal tissues, occlusal trauma, diagnostic methods, or the relationship between lifestyle and bruxism (p > 0.05). While 71.9% of those diagnosed with bruxism stated that they had bruxism, 68.8% of those who were not diagnosed stated that they did not have bruxism.ConclusionAlthough dental students are aware of bruxism, their understanding of its multifactorial nature and treatment options needs improvement. Increasing this knowledge could reduce the prevalence of bruxism among dental students and improve patient care.Clinical trial registrationThe clinical trial was retrospectively registered on ClinicalTrials.gov under the identifier NCT06583044, with a registration date of 03/09/2024. https://register.clinicaltrials.gov/prs/beta/studies/S000EUYA00000023/recordSummary.

Ultrasound assessment of the structure of the masticatory muscles against the background of relief of myofascial pain syndrome

INTRODUCTION. Restricted mouth opening, parafunctional activity of the chewing muscles are a symptom of the development of many dental diseases caused by intra- and extra-articular causes. To verify the diagnosis, it is necessary to conduct an ultrasound examination, according to the assessment of the dynamics of qualitative and semi-quantitative parameters, it is possible to analyze the results of the treatment according to the BOS principle, which was the purpose of this study.AIM. The aim of the study was to conduct an ultrasound assessment of the structure of the masticatory muscles against the background of relief of myofascial pain syndrome.MATERIALS AND METHODS. 104 people were examined and treated, the relief of myofascial pain syndrome was carried out using combined treatment – injections of botulinum toxin type A, cross-taping and ozonation of the chewing muscle. Clinical criteria were evaluated – the intensity and duration of pain, the degree of mouth opening. According to the developed ultrasound criteria, the features of the structure of the masticatory muscles, the presence or absence of trigger points with diameter determination were studied. Using qualitative indicators, the length, width and depth of muscle tissue were studied.RESULTS AND CONCLUSIONS. In patients with myofascial pain syndrome, starting at 14 days and for 6 months, stable positive dynamics was achieved, as evidenced by a statistically significant change in the studied parameters. A correlation was revealed between the degree of mouth opening and changes in the width of the chewing muscles according to the ultrasound method of investigation. The inclusion of this method makes it possible to timely, accurately and non-invasively assess the condition of the chewing muscles, while studying the size changes of which it is possible to adjust the treatment.

Problematic screen exposure and oral health in preschool children: a comparison study

ObjectivesRecent studies have highlighted the association between problematic screen exposure (PSE) in preschool children and various health issues. This study aims to determine the relationship between PSE and oral/dental health as well as parafunctional oral habits in this population.MethodsHealthy children aged 3 to 6 years who visited the pediatric dentistry outpatient clinic were included in the study. PSE was evaluated using the parent-reported ‘Seven-in-Seven-Screen-Exposure Questionnaire’. An intraoral examination was conducted to record the number of decated, missing, and filled teeth, along with scores from the International Caries Detection and Assessment System II (ICDAS II), as well as dental plaque and gingival indices.ResultsA total of 210 mother–child pairs were included in the study, comprising 70 pairs with PSE and 140 pairs without PSE. The sociodemographic characteristics, frequency of daily tooth brushing behaviors, use of children's toothpaste, and regular dental examinations were statistically evaluated between the PSE and non-PSE group (p > 0.05). Additionally, there was no statistically significant difference between the groups in terms of having abnormal oral habits (p > 0.05). In the PSE group, the median scores for gingival and plaque index were significantly higher (p = 0.011 and p = 0.006, respectively). The median number of decayed teeth was significantly higher in the PSE group (p = 0.039).ConclusionsTurkish preschool children with PSE were found to have a significantly higher likelihood of experiencing poor oral health. Consequently, it is essential to conduct oral health examinations for Turkish preschool children exhibiting PSE. The study may have clinical implications for the evaluation of preschool children with problematic media use within dental practice.

Influence of gender and bruxism on the masseter muscle: A population-based magnetic resonance imaging study

This study aimed to (1) examine the cross-sectional area (CSA) of the masseter muscle in relation to bruxism and (2) investigate if there are gender-related differences in the masseter muscle in a population-based magnetic resonance imaging (MRI) study. The study included 720 subjects aged 30-89 years (391 women and 329 men) from the Study of Health in Pomerania, a cross-sectional population-based study assessing the prevalence and incidence of common population-relevant diseases and their risk factors in Northeastern Germany. The participants underwent both a whole-body MRI and a full oral examination. The CSAs of the masseter muscles on both sides were measured from MRI images. The presence or absence of awake and/or sleep grinding and clenching, unilateral chewing, and other parafunctional activities were obtained from the dental interview. Linear and ordinal logistic regression models were used to examine the associations between the CSAs of the masseter, bruxism, and gender. The frequency of bruxism and reports of muscle or joint pain were significantly higher in women. The analysis revealed that a larger masseter CSA was significantly associated with bruxism only in men. The larger CSA was manifested only in the higher frequency bruxers. Bruxism had heterogeneous effects on the masseter muscle between genders. Although a higher prevalence of bruxism was reported by women, the larger CSA of the masseter muscle was significantly higher in bruxing men but not in women. This study emphasizes the need for a gender-specific approach when evaluating the clinical implications of bruxism on the masseter muscle.

Changes in the composition and mechanical properties of dentin in mouse models of diabetes

ObjectivesThis study employed mouse models of type 1 (T1D) and type 2 (T2D) diabetes to characterize the changes in tooth dentin composition and its mechanical properties. MethodsThirty-two mice were used in this study and divided into T1D, T2D and corresponding control groups. Mandibles were extracted 12 weeks after the onset of diabetes, and dentin from the first molars was evaluated in varying regions of the root. The composition was assessed using Raman Spectroscopy. Nanoindentation and Vickers indentation were employed to study the mechanical properties of the tissue. Statistical significance was evaluated by two-way analysis of variance with respect to the diabetic group and region of the tooth (p ≤ 0.05). ResultsIn the T2D model, the mineral-to-collagen ratio, hardness, and storage modulus of the intertubular dentin were significantly reduced compared to tissue from the controls, especially in the cervical regions of the tooth. The reduction in the mineral-to-collagen ratio was also observed in the T1D model, but changes in nanomechanical properties were not evident. However, the bulk hardness of the teeth in the T1D model was lower than in the littermate controls. Optical microscopy revealed significant wear of the tooth crowns in both models of diabetes, which appear to result from parafunctional activities. ConclusionThis study suggests that both type 1 and type 2 models of diabetes are associated with detrimental changes in dentin. Clinical significanceBetter understanding of how diabetes affects dentin and the contributing mechanisms will be key to improving treatments for people with diabetes.

Long-Term Prognosis and Influencing Factors of Chinese Adolescents With Temporomandibular Disorder After Physical Therapy.

Physical therapy is the preferred conservative treatment for patients with temporomandibular disorder (TMD). However, few studies have investigated the application of physical therapy in adolescents, especially follow-up studies on the long-term prognosis of these patients. This study investigated the short-term effects and long-term prognosis of physical therapy in adolescent patients with TMD and the factors influencing long-term symptoms. Information regarding baseline data, specific treatment methods, treatment times and evaluation results was collected retrospectively for adolescent patients with TMD who received physical therapy. Patients were followed up via telephone and online questionnaires, and the influence of age, sex, disease course, mouth opening, pain intensity, oral parafunctional habits and treatment methods on long-term symptoms was analysed. Pain intensity, maximum mouth opening and the joint noise score improved significantly in 270/286 patients who received individualised comprehensive physical therapy. TMD-related symptoms improved with no noticeable impact on daily life in 187/199 patients who were followed up for an extended period (average, 30.71 ± 10.86 months) and were divided into asymptomatic or symptomatic groups according to the persistence of symptoms. Logistic regression analysis revealed that uncorrected oral parafunctional habits and fewer treatments were related to long-term symptoms. The long-term prognosis of adolescent patients with TMD after physical therapy was satisfactory. However, 52.8% of the patients experienced persistent TMD-related symptoms for an extended period, possibly due to insufficient treatment times and parafunctional habits. ClinicalTrials.gov identifier: NCT05781607.

The Association Between the Central Sensitisation Inventory and Temporomandibular Disorders Is Confounded by Migraine, Depression, Widespread Pain and Parafunction. A Cross-Sectional Telehealth Study.

Temporomandibular disorders (TMDs) are conditions that involve the temporomandibular joints, masticatory muscles, and associated tissues, causing orofacial pain. Central sensitisation (CS) is a relevant part of the TMD pathophysiology. Migraine, psychological aspects, parafunctional oral habits and widespread pain are commonly associated with both TMD and CS and could confound the association between them. To investigate the association between painful TMD and the Central Sensitisation Inventory (CSI) score, and to assess the presence of confounders in this association. Cross-sectional study that assessed women with and without orofacial pain complaints using telehealth. The TMD Pain Screener and an online physical examination determined the presence of painful TMD. The following questionnaires were applied: CSI, Headache Screening Questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Oral Behavior Checklist, Jaw Functional Limitation Scale and the Nordic musculoskeletal questionnaire. A single regression investigated the association between the CSI score and TMD, and a multiple regression investigated the effect of the other outcomes as possible confounders. Confounding was considered present when the association between TMD and the CSI score changed more than 10% after adding a possible confounder to the regression model. Forty-two women with painful TMD and 53 without TMD were included. There was a significant association between the CSI score and the presence of painful TMD (R2 = 0.639; p < 0.001). This association changed when the following outcomes were added to the model: presence of migraine, symptoms of depression, widespread pain and parafunctional oral habits. The positive association between TMD and the CSI score was confounded by migraine, symptoms of depression, widespread pain and parafunctional oral habits.

Multifactorial Contributors to the Longevity of Dental Restorations: An Integrated Review of Related Factors.

This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. A search of the literature was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, on papers published between 1980 and 2024. The titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity. Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival. The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations.

The Potential of Percent Agreement as an Adjunctive Diagnostic Tool for Acute Temporomandibular Disorder.

Background/Objectives: It is well established that individuals with chronic temporomandibular disorder (TMD) exhibit differences in their physical and psychosocial characteristics from those with acute TMD. However, few studies have analyzed the physical and psychosocial characteristics of patients with acute TMD. The objective of this cross-sectional study is twofold: first, to ascertain whether there are differences in physical and psychosocial factors among patients with acute TMD based on the percent agreement between patient-reported pain sites and pain sites identified through standardized palpation and, second, to determine the potential of percent agreement as a diagnostic and prognostic factor. Methods: We analyzed physical and psychosocial factors in 309 patients diagnosed with acute TMD. Of these, 171 patients were selected for an analysis of their response to treatment. These patients were divided into three groups based on their percent agreement: Group A (agreement under 80%), Group B (agreement 80-89%), and Group C (agreement 90% or over) in the initial analysis and Group a (agreement under 80%), Group b (agreement 80-89%), and Group c (agreement 90% or over) in the subsequent analysis. This study was approved by the Ethics Committee of Pusan National University Dental Hospital (IRB No. 2023-05-011, 25 May 2023). Results: The lower the percent agreement, the greater the parafunctional oral habits, stress, chronicity, somatization, depression, anxiety, and number of painful sites. A lower percent agreement was associated with poorer treatment outcomes. The percent agreement demonstrated a 41.2% capacity to predict residual pain after treatment. Conclusions: Clinicians can utilize percentage agreement as an adjunctive diagnostic tool to provide more suitable treatments to patients.

Bruxismo del sueño en el paciente infantil: revisión narrativa de la literatura.

Introduction: Sleep bruxism is a parafunctional activity in which clenching and/or grinding of teeth occurs in both the paediatric and adult population. Objective: To gather the most current knowledge available on the causes, diagnosis and treatment of sleep bruxism in children in order to facilitate the dentist and/or paediatric dentist's identification and appropriate management in daily clinical practice. Material and methods: An electronic bibliographic search of articles published in English between 1986 and 2023 on sleep bruxism in children under 14 years of age was carried out. Thirty-six articles were selected. Results: The prevalence of sleep bruxism in children ranges from 5 to 46%. Of multifactorial aetiology, its clinical manifestations are both intraoral and extraoral. Diagnosis in most cases is not easy and must be made by assessing not only its consequences but also the aetiological elements involved. Comprehensive treatment always requires an early and multidisciplinary approach combining psychological and dental techniques. The available evidence does not support the use of rigid splints in children. Conclusion: Current knowledge on sleep bruxism in children aims to focus on early diagnosis and aetiological treatment, but further studies are still needed to achieve a standardised and protocolised early diagnosis that will help clinicians' decision-making and improve the patient's quality of life in the short, medium and long term.

Fretting-corrosion at the Implant–Abutment Interface Simulating Clinically Relevant Conditions

ObjectiveImplant treatment is provided to individuals with normal, idealized masticatory forces and also to patients with parafunctional habits such as grinding, clenching, and bruxing. Dental erosion is a common increasing condition and is reported to affect 32 % of adults, increasing with age. This oral environment is conducive to tribocorrosion and the potential loss of materials from the implant surfaces and interfaces with prosthetic components. Although several fretting-corrosion studies have been reported, until now, no study has simulated clinically relevant micromotion. Therefore, our aim is to investigate fretting-corrosion using our new micro-fretting corrosion system, simulating clinical conditions with 5 µm motion at the implant-abutment interface under various occlusal loads and acidic exposures. MethodsWe simulated four conditions in an oral environment by varying the contact load (83 N and 233 N) and pH levels (3 and 6.5). The commonly used dental implant material, Grade IV titanium, and abutment material Zirconia (ZrO2)/ Grade IV titanium were selected as testing couple materials. Artificial saliva was employed to represent an oral environment. In addition, a standard tribocorrosion protocol was followed, and the pin was controlled to oscillate on the disk with an amplitude of 5 μm during the mastication stage. After the testing, 3D profilometry and scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) were utilized to analyze the worn surfaces. Inductively coupled plasma mass spectrometry (ICP-MS) was also used to measure the metal ion release. ResultsEnergy ratios were below 0.2, indicating a fretting regime of partial slip for all groups. Open-circuit potential (OCP) and electrochemical impedance spectroscopy (EIS) were analyzed to compare the electrochemical behavior among groups. As a result, corrosive damage was observed to be more in the Ti4- Ti4 groups than in Zr-Ti4 ones, whereas more mechanical damage was found in the Zr-Ti4 groups than in the Ti4-Ti4 groups. Possible mechanisms were proposed in the discussion to explain these findings. SignificanceThe results observed from this study might be helpful to clinicians with implant selection. For example, for patients with bruxism, a titanium implant paired with a titanium abutment may be preferable, while patients with GERD may benefit more from a titanium implant paired with a zirconia abutment.

Identifying phenotypes in persons with temporomandibular disorders, using latent class analyses: Temporomandibular disorders and phenotypes.

The heterogeneity of persons with temporomandibular disorders (TMD) and the lack of effective treatments have called for a biopsychosocial model and the development of a more personalised treatment approach. Emphasis on phenotypes might be a beneficial approach. Identifying phenotypes among persons with TMD using potential prognostic factors, including personal characteristics and responses to clinical tests. Additionally, examining the distribution of TMD diagnoses within the identified phenotypes. A cross-sectional study including 208 persons (85% females) seeking physiotherapy for problems in the temporomandibular area. All participants were examined clinically and answered questionnaires electronically. The phenotypes were identified using latent class analysis based on seven potential prognostic factors selected within pain, function and psychological domains. Table analysis was used to explore the distribution of TMD diagnoses within the identified phenotypes. Most participants fit into one of three identified phenotypes. Phenotype 1 (32%) was characterised by functional disability, low psychosocial scores and low risk for developing chronicity and future work disability; Phenotype 2 (29%) by parafunctional habits, low psychosocial score and seeking treatment to reduce pain; and Phenotype 3 (39%) by high levels of mental distress, fear avoidance and a large risk of future work disability. Intra-articular disorders dominated Phenotype 1, myalgia and TMD-related headache Phenotype 2, while Phenotype 3 included all the different TMD diagnoses. The knowledge about the three identified phenotypes might be useful for clinicians treating persons with TMD and for the development of preventive strategies and more personalised treatment.

Alveolar ridge preservation and its impact on marginal bone level changes around dental implants: A retrospective, cohort comparative study.

This retrospective study compared the outcomes of implants placed in alveolar ridge preservation (ARP) treated sites with those in spontaneously healed (SH) sites. The study included patients presenting with one implant placed in an ARP-treated socket and one in an SH site. The primary outcome was the comparison of Marginal Bone Level Changes (MBLC). Statistical analysis was performed to identify factors influencing MBLC, including age, gender, smoking, parafunctional habits, and prosthetic emergence angle. Of these, 28 patients (23 females, 82.1%) were included in this analysis. Sockets in the SH group were classified as type I, whereas type II sockets were more common in the ARP group. The SH group exhibited significantly higher MBLC than the ARP group (p = 0.032), with values, respectively, of 1.00 [0.25; 1.62] and 0.40 [0.00; 1.00] mm. Among all evaluated parameters, the performance of ARP was the only factor significantly affecting MBLC (β = -0.72, SE: 0.32, p = 0.026). Age, gender, smoking, parafunctional habits, and prosthetic emergence angle did not significantly affect MBLC. The study shows the potential role of ARP in maintaining stable marginal bone levels around implants. In our sample, ARP significantly reduced MBLC compared with spontaneous healing, highlighting its possible impact in clinical practice for better peri-implant bone stability.

Evaluation of Survival and Durability of Fixed Prosthodontic Restorations in a Tertiary Dental Centre of Eastern Nepal

Background: Fixed prosthodontic restorations play a pivotal role in dental rehabilitation, providing essential functions such as mastication, aesthetics, and oral health preservation. This study aims to assess the survival of fixed prosthodontic restorations within the context of a tertiary dental centre in Eastern Nepal. Materials and Methods: A retrospective cohort study was conducted among 228 patients, involving a comprehensive analysis of patient records from the tertiary dental centre. Data were collected on patient demographics, types of fixed prosthodontic restorations (e.g., crowns, bridges), materials used, adhesive systems, follow-up durations, and any recorded instances of restoration failure. Patient satisfaction scores, including aesthetic outcomes, comfort, and functionality, were also assessed. Results: The mean age of patients undergoing fixed prosthodontic restorations was 43.1 years, predominantly male (66.7%), with good systematic health (68.4%) and varying levels of oral hygiene. Oral hygiene status, parafunctional habits, restoration type, and subjective experiences such as comfort, functionality, and aesthetic satisfaction were all significantly associated with survival rates (p &lt; 0.001). Conclusion: The results may have implications for clinical decision-making, informing practitioners about the most effective materials and techniques for enhancing the durability of fixed prostheses in this region. Further research and continuous evaluation are crucial for refining prosthodontic practices and ensuring optimal patient care in the unique healthcare landscape of Eastern Nepal.

Effects of Nail Biting (Onychophagy) on Upper Central Incisors in Children and Young Adolescents

Nail biting (NB) is a repetitive and uncontrolled parafunctional activity that can affect oral health by altering tooth shape and intraoral position. Nowadays, there is not enough scientific evidence about the impact of NB on teeth; therefore, this study aimed to evaluate the effects of NB on the length, width and inclination of upper central incisors. This retrospective study involved 76 patients, 40 males and 36 females, with a mean age of 10.6 ± 0.3 years. Digital scans of the maxillary arch of each patient were recorded. Next, the length, width and inclination of upper central incisors used and not used for NB were measured. Finally, data were analysed with a paired t-test. Statistical analysis showed statistically significant differences in the length and inclination of upper central incisors used for NB compared with those of upper central incisors not used for NB, while the width did not show a significant difference. There were relevant changes in upper central incisors subjected to NB, demonstrating that NB impairs the shape, morphology and inclination of teeth. Therefore, because of the potentially negative consequences of NB, it is recommended that NB not be underestimated.

Driving Stress-Induced Effects on the Orofacial Region and Its Functions and Health Behaviors in Riyadh: A Cross-Sectional Survey.

Driving stress is a multifaceted phenomenon, and the experience of driving invokes stress. Driving causes the activation of stress-response mechanisms, leading to short-term and long-term stress responses resulting in physiological and behavioral changes. The aim of this study was to evaluate driving stress-initiated effects on orofacial functions and health behaviors in the Riyadh population. A cross-sectional survey was conducted in Riyadh using a pre-validated set of questionnaires for habitual information, a driving stress assessment using a driving-behavior inventory, and an assessment of parafunctional habits and effects on orofacial functions. The results indicate that nearly 50% of the sample spends more than two hours commuting, and more than 50% of the sample has inadequate sleep and insufficient exercise. Oral parafunctional habits like nail biting (p = 0.039) and lip or object biting (p = 0.029) had a significant correlation with aggressive driving behaviors, whereas the grinding of teeth (p = 0.011), the clenching of jaws (p = 0.048), lip or object biting (p = 0.018), and pain in mastication (p = 0.036) had a positive correlation with driving dislikes. Driving stress can be detrimental to one's health and not only impacts health behaviors but also induces oral parafunctional habits and adversely affects orofacial regions and functions. Acute driving stress responses may be transient. However, prolonged driving stress can be maladaptive and can increase the risk of chronic diseases including chronic temporomandibular joint disorders and parafunctional habit-related changes in the oral cavity.