Correlation between temporomandibular joint dysfunction and Eichner classification

Introduction: The Dental Prosthetics Department's most common patients are elderly who have lost their teeth. Dental deficiencies not only impair the functions of the stomatognathic system but can also be the cause of temporomandibular disorders (TMD). Deficiencies in the lateral sections lead to a decrease in the occlusion height in patients, which negatively affects the aesthetics of the face by shortening the lower floor and overloading the remaining teeth, eventually leading to their pathological wear. Loss of occlusion height changes the spatial arrangement of the lower jaw to the upper jaw, which can lead to changes in the temporomandibular joint. The loss of a tooth or group of teeth is an indication for proper prosthetic treatment. The dentist should be able to take into account, evaluate and, if necessary, cure TMD, but this is not a common skill among dentists. Such treatment requires an appropriate comprehensive approach. There are currently no standards for such treatment. We presented one of the methods as part of our study.Purpose of work:The aim of the study was to check the correlation between the occurrence of temporomandibular disorders and missing teeth and used prosthetic restorations. Material and methods:Medical history records of 58 patients under the care of the Department of Dental Prosthetics at Medical University of Lublin were analyzed. Factors such as age and gender, occlusion height, distribution of missing teeth according to the Eichner classification and symptoms of temporomandibular joint disorders, i.e. crackling, pain, limited and excessive abduction of the jaw were checked. Before starting prosthetic treatment, every patient underwent comprehensive conservative, surgical and periodontics treatment in accordance with existing needs. Results:The study group consisted of 38 women and 20 men. The average age of all patients was 69.6 years; - average for men - 70.45 years, women 68.16 years. The oldest patient was an 88-year-old man, and the youngest was a 43-year-old woman. 31% of patients were toothless. 25.9% of patients had pain within the stomatognathic system, of which 86.7% were women and 13.3% men. Relaxation splint was made in 24.1% of patients.Summary:The study showed that the ailments associated with the stomatognathic system are correlated with a reduction in occlusion height. Larger dental deficits are more common in older people. Pain symptoms are the most common cause of making relaxation splints. Women more often than men complain of pain. The correct treatment scheme for patients with missing teeth and long-term loss of support zones is staggered treatment - two-stage. The first stage of treatment is to restore the correct occlusion height by using the occlusal splint. Then, after the adaptation period, there is a transition to the second stage of treatment - the use of proper prosthetic restoration maintaining the correct height of occlusio

Andersen Tawil syndrome – a case study

The first case of a patient with periodic paralysis of muscles accompanied by ventricular arrhythmias was described in 1963 by Klein and colleagues[1]. In 1971, the team led by E.D. Andersen published a paper on the familial coexistence of neurological disorders and arrhythmias accompanied by dysmorphic features, suggesting a new, unclassified disease syndrome [2]. Another report, this time by the Tawil team, analized 10 cases described up to the time and 4 new diagosed by him, giving the genetic basis for understanding the mechanisms of the disease inheritance [3]. In 2003, the syndrome described by Tawilla was named after Andersen and Tawill (Andersen Tawil Syndrome - ATS).ATS (syn. long QTc syndrome, type 7, LQTS 7,) is a rare genetic disorder inherited in an autosomal dominant manner. So far around 200 diagnoses of ATS have been made in the world. Mutations in the KCNJ2 gene located on the long arm of chromosome 17, encoding the Kir 2.1 protein, are responsible for the disease subtype 1, which accounts for 60% of the described cases. This protein is a component of the potassium ion channel, and its abnormal structure and function is the cause of repolarization disorders in the cells of the heart and skeletal muscles. However, in 6-20% of patients from families with confirmed presence of KCNJ2 mutations, no clinical symptoms of the syndrome were reported. It proves its differentiated penetration, and the genetic mechanism in the remaining patients remains unknown.Despite the fact that patients with ATS are a very heterogeneous group in terms of the observed symptoms, this syndrome has a classic triad:changes in the ECG trace of the T wave and the presence of the U wave (extended duration of the descending arm of the T wave, a characteristic wide U wave and a wide combination of T and U waves - these features distinguish ATS from other long QTc syndromes) and arrhythmias in the form of single multifocal premature ventricular beats, polymorphic, bidirectional ventricular tachycardia, which may be asymptomatic or, more often, cause palpitations. Less common manifestations of arrhythmias are fainting, cardiac arrest and sudden cardiac death[4].2. periodic muscle strenght impairment (periodic paralysis) occurring most often after a prolonged period of rest or during rest after intense exercise, accompanied by a decrease in the concentration of potassium in the blood serum; in some cases, there is a constant, albeit slight, weakening of muscle strength3. typical malformations (dysmorphia), most often including short stature, hypertelorism, small mandible, low-set auricles and abnormalities of curvature within the spine.In patients with an unconfirmed genetic mutation, the diagnosis of ATS requires at least two of the above-mentioned symptoms. However, in some genetically confirmed cases their expression may be very low[5]Due to the described dysfunctions in the cognitive sphere, mainly in the field of reading skills and mathematical skills, patients should also be covered by psychological care, and due to behavioral changes, in some cases also psychiatric.</p

The Autoimmune pituitary inflammation

Autoimmune Hypophysitis (AH) is often refereed in the literature as lymphocytic pituitary inflammation. It is the most common form of rare, chronic inflammation states affecting this gland. In most cases it has autoimmune character. Symptoms of pituitary inflammation are mostly headaches, dysfunction of anterior and/or posterior pituitary lobe and visual disturbances. Diagnostics is extremely difficult and inflammation itself is probably diagnosed too rare. Autoimmune Hypophysitis coexist with other autoimmune endocrinopathies. The golden standard in Autoimmune Hypophysitis diagnosis is biopsy and magnetic resonance imaging (MRI) is also used. In relation to rare occurrence of the  Autoimmune Hypophysitis, varied clinical picture and lack of standardized research on large group of patients there are no described standards of conduct with those patients.Autoimmune Hypophysitis (AH) is often refereed in the literature as lymphocytic pituitary inflammation. It is the most common form of rare, chronic inflammation states affecting this gland. In most cases it has autoimmune character. Symptoms of pituitary inflammation are mostly headaches, dysfunction of anterior and/or posterior pituitary lobe and visual disturbances. Diagnostics is extremely difficult and inflammation itself is probably diagnosed too rare. Autoimmune Hypophysitis coexist with other autoimmune endocrinopathies. The golden standard in Autoimmune Hypophysitis diagnosis is biopsy and magnetic resonance imaging (MRI) is also used. In relation to rare occurrence of the Autoimmune Hypophysitis, varied clinical picture and lack of standardized research on large group of patients there are no described standards of conduct with those patients