Physiotherapeutic possibilities in the treatment of complications after tooth extraction

Introduction: One of the most common complications occurring during or after tooth extraction is paralysis of the lower alveolar nerve. The nerve may be damaged or affected during removal of the retained lower third molars. Nerve damage may occur in the form of paresthesia, pseudoneuralgia or complete abolition of sensation in the surgical area. Aim: A review of the literature to verify the physiotherapeutic possibilities in the treatment of complications after tooth extraction. Material and research method: A literature review was conducted in terms of physiotherapeutic treatment methods as a result of disorders resulting from complications after tooth extraction. PubMed and Google Schoolar were analyzed. Keywords used in the search were: "physiotherapy and tooth extraction", "manual therapy and tooth extraction" and "electrotherapy and tooth extraction". Five reports were analyzed. Results: There is a need to combine standard therapy with physiotherapy in order to accelerate the healing process as a result of complications after extraction. Conclusions: Physiotherapy is highly effective and non-invasive in the treatment of many complications that occur in dental surgery. The physiotherapist offers a range of therapeutic procedures that improve the function of damaged nerves

Characteristics of dental pulp in human upper first premolar teeth based on immunohistochemical and morphometric examinations

Teeth extracted for orthodontic reasons are commonly considered as healthy. Therefore, it is possible to examine structure of the dental pulp can be fully recognized and how it is affected by malocclusion. The aim of the study was to evaluate by immunohistochemistry (IHC) and morphometry dental pulp in human upper first premolar teeth extracted for orthodontic reasons. The material comprised 36 teeth of 20 patients in the age range 16–26 years. By the use of IHC markers the presence of immunocompetent cells (CD20, CD45RO, and CD68), blood vessels (CD31) and nerves (PGP9.5) were examined in the pulp. Inflammatory infiltrates and tissue atrophy were observed in 24 and 10 teeth, respectively. Strong positive correlation between the width of the odontoblastic layer, the number of rows of odontoblast nuclei and the increase of MVA (microvessel area) in the pulp of atrophic teeth was found. The cellular infiltrations found in H&E-stained sections were identified by IHC as memory T cells (CD45RO+) and B lymphocytes (CD20+) with macrophages (CD68+) present at the periphery. The CD20 antigen was intensively expressed in 13 teeth, CD45RO in 33 teeth, and CD68 in 20 teeth. Thus, despite the lack of any clinical signs of pulp disease many teeth extracted for orthodontic reasons show focal pulp inflammation and atrophy which probably results from the malocclusion stress accompanying teeth crowding

Cleidocranial dysplasia-dental disorder treatment and audiology diagnosis

A review of numerous case reports was made, in order to demonstrate the possibilities for treatment of dental disorders in patients with Cleidocranial dysplasia (CCD). In this paper, our own report, including a diagnosis of the effect on the auditory system, is presented. In addition to the triad of CCD symptoms that include hypoplastic or aplastic clavicles, impacted and supernumerary teeth, delayed closure of fontanelles and cranial sutures, impairment of the hearing system resulting in conductive hearing loss also occurs. Our own report is based on the case of a 12-year-old CCD patient, in whom Cone Beam Computed Tomography (CBCT) revealed the presence of 12 supernumerary teeth. Furthermore, a clinical examination pointed to the presence of retained deciduous teeth and a delayed eruption of permanent teeth. Orthodontic-surgical procedures were implemented, in accordance with the literature. During the course of the orthodontic treatment, a decrease in auditory sensitivity was observed, for which reason hearing tests were also performed. Conductive hearing loss was detected. As such, it is important to remember that in such cases, auditory check-ups need to be performed between the many surgical and orthodontic interventions, which usually last a few years

Disorders in the temporomandibular joints in pediatric patients - frequency of physiotherapy visits

Introduction: Temporomandibular disorders can be a challenge for both clinicians and patients. It is unclear what factors are associated with prolonged conservative care and patient dissatisfaction with treatment outcomes.Material and research method: A literature review was carried out in terms of methods of physiotherapeutic treatment following disorders of temporomandibular joints in pediatric patients. This work is for reference only. The PubMed and Google Schoolar databases were analyzed. The keywords used in the search were: "physiotherapy, temporomandibular joints and children", "manual therapy, temporomandibular joints and children". The authors focused on reports published in Polish and English from the last 10 years.Results: There is a need to combine standard therapy with physiotherapy in order to accelerate the treatment process.Conclusions: Physiotherapy is highly effective and non-invasive in the treatment of stomatognathic system disorders. A physiotherapist provides a number of therapeutic treatments that improve disorders in the temporomandibular joints

Cleidocranial dysplasia-dental disorder treatment and audiology diagnosis

A review of numerous case reports was made, in order to demonstrate the possibilities for treatment of dental disorders in patients with Cleidocranial dysplasia (CCD). In this paper, our own report, including a diagnosis of the effect on the auditory system, is presented. In addition to the triad of CCD symptoms that include hypoplastic or aplastic clavicles, impacted and supernumerary teeth, delayed closure of fontanelles and cranial sutures, impairment of the hearing system resulting in conductive hearing loss also occurs. Our own report is based on the case of a 12-year-old CCD patient, in whom Cone Beam Computed Tomography (CBCT) revealed the presence of 12 supernumerary teeth. Furthermore, a clinical examination pointed to the presence of retained deciduous teeth and a delayed eruption of permanent teeth. Orthodontic-surgical procedures were implemented, in accordance with the literature. During the course of the orthodontic treatment, a decrease in auditory sensitivity was observed, for which reason hearing tests were also performed. Conductive hearing loss was detected. As such, it is important to remember that in such cases, auditory check-ups need to be performed between the many surgical and orthodontic interventions, which usually last a few years

Cleidocranial dysplasia-dental disorder treatment and audiology diagnosis

A review of numerous case reports was made, in order to demonstrate the possibilities for treatment of dental disorders in patients with Cleidocranial dysplasia (CCD). In this paper, our own report, including a diagnosis of the effect on the auditory system, is presented. In addition to the triad of CCD symptoms that include hypoplastic or aplastic clavicles, impacted and supernumerary teeth, delayed closure of fontanelles and cranial sutures, impairment of the hearing system resulting in conductive hearing loss also occurs. Our own report is based on the case of a 12-year-old CCD patient, in whom Cone Beam Computed Tomography (CBCT) revealed the presence of 12 supernumerary teeth. Furthermore, a clinical examination pointed to the presence of retained deciduous teeth and a delayed eruption of permanent teeth. Orthodontic-surgical procedures were implemented, in accordance with the literature. During the course of the orthodontic treatment, a decrease in auditory sensitivity was observed, for which reason hearing tests were also performed. Conductive hearing loss was detected. As such, it is important to remember that in such cases, auditory check-ups need to be performed between the many surgical and orthodontic interventions, which usually last a few years

Selected visual parameters related to the working conditions of musicians

Professional musicians are required to practice playing instruments for long hours, which often exerts significant impact on their health. Attention should be given to the specificity of playing each instrument, including uncomfortable and sustained body position and repetitive movements causing long-term strain of certain parts of the body. The aim of this study was to evaluate the impact of long-term playing wind and string instruments on the visual system. Ninety male and female subjects aged 15 to 30 years were included in the study and divided into two groups: musicians (Msc) and non-musicians (nMsc). Significantly less subjects in the Msc group had properly corrected vision, wore optical prescription recommended by an ophthalmologist/optometrist, and/or underwent any eye examination at all in their lifetime, even though more subjects in this group experienced certain asthenopic symptoms. Also, accommodative amplitude got statistically worse under dim illumination conditions, accommodative facility was significantly different between musicians and non-musicians, although there were no differences between the groups when tested in bright illumination. None of the music stands used by the study subjects met the respective standards concerning uniform illumination rates. Playing string and wind instruments is a challenge for the visual system due to the forced body and head positions, and asymmetry between the visual plane and the plane of regard as well as non-uniform illumination in the working environment. However, conditions such as correct working distance and proper tilt of the music stand may be beneficial to the visual system. It is the role of optometrists to properly educate their patients about the importance of appropriate vision correction, especially in dim light and under adverse working conditions and to communicate the impact of such conditions on the visual system

Can EGCG Alleviate Symptoms of Down Syndrome by Altering Proteolytic Activity?

Down syndrome (DS), also known as “trisomy 21”, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. Silencing these extra genes is beyond existing technology and seems to be impractical. A number of pharmacologic options have been proposed to change the quality of life and lifespan of individuals with DS. It was reported that treatment with epigallocatechin gallate (EGCG) improves cognitive performance in animal models and in humans, suggesting that EGCG may alleviate symptoms of DS. Traditionally, EGCG has been associated with the ability to reduce dual specificity tyrosine phosphorylation regulated kinase 1A activity, which is overexpressed in trisomy 21. Based on the data available in the literature, we propose an additional way in which EGCG might affect trisomy 21—namely by modifying the proteolytic activity of the enzymes involved. It is known that, in Down syndrome, the nerve growth factor (NGF) metabolic pathway is altered: first by downregulating tissue plasminogen activator (tPA) that activates plasminogen to plasmin, an enzyme converting proNGF to mature NGF; secondly, overexpression of metalloproteinase 9 (MMP-9) further degrades NGF, lowering the amount of mature NGF. EGCG inhibits MMP-9, thus protecting NGF. Urokinase (uPA) and tPA are activators of plasminogen, and uPA is inhibited by EGCG, but regardless of their structural similarity tPA is not inhibited. In this review, we describe mechanisms of proteolytic enzymes (MMP-9 and plasminogen activation system), their role in Down syndrome, their inhibition by EGCG, possible degradation of this polyphenol and the ability of EGCG and its degradation products to cross the blood–brain barrier. We conclude that known data accumulated so far provide promising evidence of MMP-9 inhibition by EGCG in the brain, which could slow down the abnormal degradation of NGF

Electromyographic Analysis of Masticatory Muscles in Cleft Lip and Palate Children with Pain-Related Temporomandibular Disorders

Aim. The aim of this study was to assess the electrical activity of temporalis and masseter muscles in children with cleft lip and palate (CLP) and pain-related temporomandibular disorders (TMD-P). Methods. The sample consisted of 31 CLP patients with a TMD-P (mean age 9.5 ± 1.8 years) and 32 CLP subjects with no TMD (mean age 9.2 ± 1.7 years). The children were assessed for the presence of temporomandibular disorders (TMD) using Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the mandibular rest position and during maximum voluntary contraction (MVC). Results. The rest activity of the temporalis and masseter muscles was significantly higher in TMD-P group compared with non-TMD children. A significant decrease in temporalis muscle activity during MVC was observed in TMD-P patients. There was a significant increase in the Asymmetry Index for temporalis and masseter muscle rest activity in the TMD-P group. Conclusion. Cleft children diagnosed with TMD-P have altered masticatory muscle activity, and this can affect their muscle function