Prevalence of Temporomandibular Pain Dysfunction Syndrome Among 20-23 Years Old Medical and Health Sciences Students in Khartoum State

There have been no previous studies on the prevalence of the temporomandibular pain dysfunction syndrome (TMPDS) among the Sudanese population. Although, thousands of studies were carried on TMPDS, the etiology of this syndrome remains unclear, creating a demand for further studies. This study was carried out to evaluate the prevalence and gender distribution of TMPDS symptoms and the related potential risk factors among 20-23 years old medical and health sciences students in Khartoum state. The present study comprised a cross sectional study as well as a case control study. The sample of the cross sectional study comprised 2949 students who were selected randomly form the 3rd, 4th and 5th levels of the medical and health sciences students in Khartoum state. All subjects completed a questionnaire concerning the medical history, the symptoms of TMPDS, certain parafunctional habits, and history of trauma. The case control study included 150 patients with myofascial pain dysfunction syndrome (MPDS) who were found to satisfy our inclusion and exclusion criteria. The inclusion criteria of the MPDS was a modification of that published by Gray et al in 1994. A control group included 150 cases who were matched by age and gender to the MPDS patients. The clinical assessment was conducted as described by Gray et al in 1994, Khalid et al in 2002 and Von Korff et al in 1992. The prevalence of TMPDS symptoms was found as follows: TMJ sound (22.3%), TM pain (17.7%), feeling of uncomfortable bite (14.9%), jaw stiffness in the morning (3.9%) and limited mouth opening (9.4%). The recurrent headache and tinnitus were reported by 30.3% and 19% of the subjects respectively and were significantly associated with TMPDS symptoms and MPDS group. The prevalence of the parafunctional habits was as follows: bruxism (5.9%), clenching (19.2%), gum chewing (57.7%) and chewing on one side (39.5%). Bruxism, clenching and chewing on one side habits were significantly associated with TMPDS symptoms and MPDS group. As indicated by APSQ, 44.7% of MPDS patients and 12% of the control subjects had depression, 24.7% of MPDS patients and 7.3% of the control subjects had anxiety. At the level of multivariate analysis, the factors that remained significantly associated with MPDS were depression, anxiety, non working side interferences, clenching and chewing on one side. The percentage distribution of pain intensity and disability in MPDS patients was as follows: low pain intensity and low disability (59.3%), high pain intensity and low disability (34%), moderate disability (6%) and high disability (0.7%). Within the limitation of this study, it can be concluded that the prevalence of the TMPDS was relatively high among the Sudanese medical and health sciences students of this age group however, the pain related disability was low. The etiology of MPDS is a multi-factorial thus, regarding diagnosis and treatment of MPDS, the tunnel vision should be avoided

Effect of partial ferrule on fracture resistance of endodontically treated teeth: A meta-analysis of in-vitro studies.

The present meta-analysis aimed to answer the following research question: In endodontically treated teeth (ETT), what is the effect of partial ferrule (PF) on fracture resistance compared to complete ferrule (CF) and/or no ferrule (NF)? PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published until May 20, 2022. In vitro studies that compared the effect of partial ferrule with that of complete ferrule and/or no ferrule on fracture resistance of ETT were included. The studies were assessed for risk of bias, and a meta-analysis was performed. Seventeen in vitro studies comprising 807 teeth were included. Nine studies were at a high risk of bias and eight presented a moderate risk of bias. Overall, the results showed that CF was superior to PF in increasing fracture resistance (SMD= 0.93, CI= 0.57-1.29, P< 0.0001), with no change in the effect based on the type of teeth (P< 0.001). However, the subgroup analysis found that PF 2 mm buccal, lingual, and buccal and lingual ferrule were comparable to CF (P= 0.06). Additionally, the PF group showed significantly higher fracture resistance than the NF group (SMD= 2.02, CI= 1.54-2.49, P< 0.00001). Although CF design provided the highest fracture resistance to restored ETT, PF can still be a viable option for restoring ETT in cases where CF is not feasible