Electromyographic and patient-reported outcomes of a computer-guided occlusal adjustment performed on patients suffering from chronic myofascial pain

Objectives: Muscular hyperactivity is a potential source of symptoms in patients with temporal-mandibular disorders. An adequate occlusal adjustment may relieve such symptoms. This study aims to measure the effect of shortening the protrusive disclusion time (DT) and balancing the center of occlusal forces (COF) on the EMG recordings and assess the pain reported by chronic patients one month after the computer-guided occlusal adjustment. Study Design: The sample studied comprised 34 patients suffering from chronic facial pain in which the EMG activity of both masseters was recorded by electromyography. By selective grinding we alleviated all the occlusal interferences during the mandibular protrusion from the habitual closure position in order to establish an immediate posterior disclusion and an equilibration of the COF. Results: At follow-up 76.5% of the patients reported no facial pain. Moreover, the EMG activity and protrusive DT were significantly reduced, and occlusal and muscular function were significantly more symmetric than at baseline. Conclusions: According to this EMG study, this computer-guided occlusal adjustment is able to reduce the activity of the masseters and the self-reported muscular pain of patients one-month after treatment

Patient‐centered treatment outcomes with full‐arch peek rehabilitation supported on four immediate or conventionally loaded implants. A randomized clinical trial

[ES]Este estudio tiene como objetivo evaluar los resultados del tratamiento (funcionales y subjetivos) de rehabilitaciones híbridas fijas de arco completo hechas de PEEK (poliéter-éter-cetona) con coronas fresadas de compuesto nanorelleno (NFC) soportadas sobre cuatro a seis implantes. En este ensayo clínico aleatorizado, 34 pacientes desdentados en la mandíbula superior y/o inferior fueron tratados con dentaduras postizas híbridas fijas. En 16 pacientes (47,1% de la muestra), los implantes fueron cargados inmediatamente (IL) mediante una rehabilitación fija provisional de PMMA (polimetilmetacrilato) atornillada sobre pilares Multi-Unit (MU) conectados tras la colocación del implante; sin embargo, en las contrapartes (n = 18) estos pilares MU se cubrieron con cofias de cicatrización y se dejaron sin carga durante dos meses (protocolo de carga convencional-CL), cuando todos los pacientes recibieron una rehabilitación híbrida fija de PEEK-NFC en la parte superior y/o la mandíbula inferior. Los resultados del tratamiento se evaluaron 12 meses después de la entrega de las prótesis. Los resultados funcionales se calcularon de acuerdo con el rendimiento masticatorio, estimado mediante pruebas de capacidad de mezcla de dos chicles de colores después de diez golpes de masticación, por la fuerza/área oclusal registrada por láminas sensibles a la presión y por electromiografía de los músculos maseteros y temporales con la fuerza de mordida máxima. Los resultados subjetivos del tratamiento se evaluaron utilizando tanto la escala de satisfacción oral (escala visual analógica) como la versión española del Oral Health Impact Profile (OHIP-20). Los hallazgos del presente estudio mostraron que el tratamiento con prótesis híbridas fijas de PEEK-NFC mejoró significativamente el rendimiento masticatorio, la fuerza de mordida, el patrón oclusal, la calidad de vida y la satisfacción, siendo el grupo IL los que presentaron fuerzas de mordida oclusal significativamente mayores y mayor satisfacción. en comparación con el grupo CL. Se debe concluir que las prótesis híbridas PEEK-NFC pueden mejorar varios resultados centrados en el paciente y que el protocolo de carga afecta significativamente la satisfacción autocalificada del paciente.[EN]This study aims to assess the treatment outcomes (functional and subjective) of full-arch fixed hybrid rehabilitations made of PEEK (poly-ether-ether-ketone) with milled crowns of nano-filled composite (NFC) supported on four to six implants. In this randomized clinical trial, 34 edentate patients in the upper and/or the lower jaws were treated with the fixed hybrid dentures. In 16 patients (47.1% of the sample), the implants were loaded immediately (IL) by means of a provisional fixed rehabilitation made of PMMA (polymethylmethacrylate) screwed on Multi-Unit (MU) abutments connected after emplacement of the implant; however, in the counterparts (n = 18) these MU abutments were covered by healing caps and were left unloaded during two months (conventional loading protocol—CL), when all patients received a fixed hybrid PEEK-NFC rehabilitation on the upper and/or the lower jaw. Treatment outcomes were assessed 12 months after prostheses delivery. Functional outcomes were calculated according to masticatory performance, estimated by mixing ability tests of two colored chewing gums after ten chewing strokes, by the occlusal force/area recorded by pressure-sensitive sheets, and by electromyography of masseters and temporal muscles at maximum biteforce. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analog scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study showed that treatment with fixed PEEK-NFC hybrid prostheses significantly improved the masticatory performance, bite force, occlusal pattern, quality of life, and satisfaction, with the IL group being those with significantly higher occlusal bite forces and greater satisfaction in comparison with CL group. It should be concluded that PEEK-NFC hybrid prostheses can improve several patient-centered outcomes and that loading protocol significantly affects the patient’s self-rated satisfaction

Functional and patient-centered treatment outcomes with mandibular overdentures retained by two immediate or conventionally loaded Implants: A randomized clinical Trial

[ES]Este estudio tiene como objetivo evaluar los resultados del tratamiento (funcionales y subjetivos) de sobredentaduras mandibulares retenidas sobre dos implantes con o sin un protocolo de carga inmediata. En este ensayo clínico aleatorizado, veinte pacientes completamente edéntulos fueron tratados con una sobredentadura mandibular retenida por dos implantes y una dentadura maxilar nueva completa. En la mitad de la muestra, los implantes se cargaron inmediatamente mediante pilares VulkanLoc® tras la colocación del implante, pero en las contralaterales, estos pilares VulkanLoc® se conectaron a los implantes dos meses después de la cirugía (protocolo convencional), y hasta ese momento las dentaduras postizas fueron retenidas por pilares de cicatrización. Los resultados del tratamiento se evaluaron a los dos, seis y doce meses después de la cirugía. Los resultados funcionales se calcularon según el rendimiento masticatorio, estimado por la fracción mixta de un chicle bicolor después de cinco, diez y quince golpes de masticación, por la fuerza oclusal registrada por las láminas sensibles a la presión y por la actividad muscular bioeléctrica. Los resultados subjetivos del tratamiento se evaluaron utilizando tanto la escala de satisfacción oral (escala visual analógica) como la versión española del Oral Health Impact Profile (OHIP-20). Los hallazgos del presente estudio muestran que las nuevas dentaduras postizas completas dieron como resultado mejoras significativas en la capacidad de masticación, la satisfacción del paciente y la calidad de vida relacionada con la salud bucal y que las posteriores sobredentaduras implantosoportadas produjeron mejoras significativas adicionales y más rápidas. El protocolo de carga puede influir en esos resultados positivos auto-informados en lugar de las evaluaciones funcionales objetivas[EN]This study aims to assess the treatment outcomes (functional and subjective) of mandibular overdentures retained on two implants with or without an immediate loading protocol. In this randomized clinical trial, twenty fully edentulous patients were treated with a mandibular twoimplant-retained overdenture and a complete new maxillary denture. In half of the sample, the implants were loaded immediately by means of VulkanLoc® abutments after emplacement of the implant, but in the counterparts, these VulkanLoc® abutments were connected to implants two months after the surgery (conventional protocol), and until that time the dentures were retained by healing abutments. Treatment outcomes were assessed at two, six, and twelve months after surgery. Functional outcomes were calculated according to masticatory performance, estimated by the mixed fraction of a two-coloured chewing gum after five, ten, and fifteen chewing strokes, by the occlusal force recorded by pressure-sensitive sheets, and by the bioelectrical muscular activity. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analogue scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study show that new complete dentures resulted in significant improvements in chewing ability, patient satisfaction, and oral health-related quality of life and that subsequent implant-retained overdentures produced further and faster significant improvements. The loading protocol may influence those positive self-reported outcomes rather than the objective functional evaluations

Oral Health Status of Syrian Children in the Refugee Center of Melilla, Spain

Introduction. Little is known about the state of oral health among immigrants from conflict zones, such as the refugee children from the Syrian Civil War. Aim. To determine the oral health status of Syrian immigrant children refugee at the Center for Temporary Stay of Immigrants in Melilla to plan prevention and care programs. Design. Using the criteria set by the World Health Organization, an exploration of the oral cavity of all Syrian children aged 5–13 living at that center was conducted in May 2015. All subjects were clinically evaluated by a calibrated and standardized examiner, accompanied by a dentist who registered the clinical variables, and translators. The sociodemographic and clinical variables were analyzed through a descriptive and analytical study, respectively. Results. The prevalence of caries in both the permanent and deciduous dentition was 75% and 50% in 6- and 12-year-olds, respectively. The dft was 3.2 ± 2.9 in 6-year-old children. At 12 years old, the DMFT was 1.6 ± 2.6 teeth, the DMFM was 1.1 ± 1.7 teeth, the SiC was 3.2, and the IR was 5%. Eighty-six percent of the examined sextants were periodontally healthy. Conclusions. The prevalence of caries was high in the sample population studied, confirming the need for a comprehensive primary oral health care program

The Kiloparsec-Scale Kinematics of High-Redshift Star-Forming Galaxies

We present the results of a spectroscopic survey of the kinematic structure of star-forming galaxies at redshift z ~ 2 - 3 using Keck/OSIRIS integral field spectroscopy. Our sample is comprised of 12 galaxies between redshifts z ~ 2.0 and 2.5 and one galaxy at z ~ 3.3 which are well detected in either HAlpha or [O III] emission. These observations were obtained in conjunction with the Keck laser guide star adaptive optics system, with a typical angular resolution after spatial smoothing ~ 0.15" (approximately 1 kpc at the redshift of the target sample). At most five of these 13 galaxies have spatially resolved velocity gradients consistent with rotation while the remaining galaxies have relatively featureless or irregular velocity fields. All of our galaxies show local velocity dispersions ~ 60 - 100 km/s, suggesting that (particularly for those galaxies with featureless velocity fields) rotation about a preferred axis may not be the dominant mechanism of physical support. While some galaxies show evidence for major mergers such evidence is unrelated to the kinematics of individual components (one of our strongest merger candidates also exhibits unambiguous rotational structure), refuting a simple bimodal disk/merger classification scheme. We discuss these data in light of complementary surveys and extant UV-IR spectroscopy and photometry, concluding that the dynamical importance of cold gas may be the primary factor governing the observed kinematics of z ~ 2 galaxies. We conclude by speculating on the importance of mechanisms for accreting low angular-momentum gas and the early formation of quasi-spheroidal systems in the young universe.(abridged)Comment: 34 pages, 13 figures. Revised version accepted for publication in the Astrophysical Journal. Version with full-resolution figures is available at http://www.astro.ucla.edu/~drlaw/Papers/OSIRIS_data2.pd

High star formation rates as the origin of turbulence in early and modern disk galaxies

High spatial and spectral resolution observations of star formation and kinematics in early galaxies have shown that two-thirds are massive rotating disk galaxies with the remainder being less massive non-rotating objects. The line of sight averaged velocity dispersions are typically five times higher than in today's disk galaxies. This has suggested that gravitationally-unstable, gas-rich disks in the early Universe are fuelled by cold, dense accreting gas flowing along cosmic filaments and penetrating hot galactic gas halos. However these accreting flows have not been observed, and cosmic accretion cannot power the observed level of turbulence. Here we report on a new sample of rare high-velocity-dispersion disk galaxies we have discovered in the nearby Universe where cold accretion is unlikely to drive their high star-formation rates. We find that the velocity dispersion is most fundamentally correlated with their star-formation rates, and not their mass nor gas fraction, which leads to a new picture where star formation itself is the energetic driver of galaxy disk turbulence at all cosmic epochs.Comment: 9 pages, 2 figures, Supplimentary Info available at: http://pulsar.swin.edu.au/~agreen/nature/sigma_mean_arXiv.pdf. Accepted for publication in Natur

Constraints on the Assembly and Dynamics of Galaxies: I. Detailed Rest-frame Optical Morphologies on Kiloparsec-scale of z ~ 2 Star-forming Galaxies

We present deep and high-resolution HST/NIC2 F160W imaging at 1.6micron of six z~2 star-forming galaxies with existing near-IR integral field spectroscopy from SINFONI at the VLT. The unique combination of rest-frame optical imaging and nebular emission-line maps provides simultaneous insight into morphologies and dynamical properties. The overall rest-frame optical emission of the galaxies is characterized by shallow profiles in general (Sersic index n<1), with median effective radii of ~5kpc. The morphologies are significantly clumpy and irregular, which we quantify through a non-parametric morphological approach, estimating the Gini (G), Multiplicity (Psi), and M_20 coefficients. The strength of the rest-frame optical emission lines in the F160W bandpass indicates that the observed structure is not dominated by the morphology of line-emitting gas, and must reflect the underlying stellar mass distribution of the galaxies. The sizes and structural parameters in the rest-frame optical continuum and Halpha emission reveal no significant differences, suggesting similar global distributions of the on-going star formation and more evolved stellar population. While no strong correlations are observed between stellar population parameters and morphology within the NIC2/SINFONI sample itself, a consideration of the sample in the context of a broader range of z~2 galaxy types indicates that these galaxies probe the high specific star formation rate and low stellar mass surface density part of the massive z~2 galaxy population, with correspondingly large effective radii, low Sersic indices, low G, and high Psi and M_20. The combined NIC2 and SINFONI dataset yields insights of unprecedented detail into the nature of mass accretion at high redshift. [Abridged]Comment: 44 pages, 19 figures. Revised version accepted for publication in the Astrophysical Journa

Role-playing para la adquisición de competencias diagnósticas en desórdenes temporomandibulares

Memoria ID-0152. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2016-2017

Propuesta de un curso MOOC denominado: implantoprótesis basada en la evidencia

Memoria ID-0090. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2017-2018

DYNAMO - I. A sample of H alpha-luminous galaxies with resolved kinematics

DYNAMO is a multiwavelength, spatially resolved survey of local (z ∼ 0.1) star-forming galaxies designed to study evolution through comparison with samples at z _ 2. Half of the sample has integrated Hα luminosities of >1042 erg s−1, the typical lower limit for resolved spectroscopy at z _ 2. The sample covers a range in stellar mass (109–1011M_) and star formation rate (0.2–100M_ yr−1). In this first paper of a series, we present integral-field spectroscopy of Hα emission for the sample of 67 galaxies. We infer gas fractions in our sample as high as _0.8, higher than typical for local galaxies. Gas fraction correlates with stellarmass in galaxies with star formation rates below 10M_ yr−1, as found by COLDGASS, but galaxies with higher star formation rates have higher than expected gas fractions. There is only a weak correlation, if any, between gas fraction and gas velocity dispersion. Galaxies in the sample visually classified as disc-like are offset from the local stellar mass Tully–Fisher relation to higher circular velocities, but this offset vanishes when both gas and stars are included in the baryonic Tully–Fisher relation. The mean gas velocity dispersion of the sample is_50 km s−1, and V/σ ranges from 2 to 10 for most of the discs, similar to ‘turbulent’ galaxies at high redshift. Half of our sample show disc-like rotation, while ∼20 per cent show no signs of rotation. The division between rotating and non-rotating is approximately equal for the sub-samples with either star formation rates >10M_ yr−1, or specific star formation rates typical of the star formation ‘main sequence’ at z _ 2. Across our whole sample, we find good correlation between the dominance of ‘turbulence’ in galaxy discs (as expressed by V/σ ) and gas fraction as has been predicted for marginally stable Toomre discs. Comparing our sample with many others at low- and high-redshift reveals a correlation between gas velocity dispersion and star formation rate. These findings suggest the DYNAMO discs are excellent candidates for local galaxies similar to turbulent z _ 2 disc galaxies