Medications and addictive substances potentially inducing or attenuating sleep bruxism and/or awake bruxism

Bruxism is a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. It can occur during sleep, indicated as sleep bruxism, or during wakefulness, indicated as awake bruxism. Exogenous risk indicators of sleep bruxism and/or awake bruxism are, among others, medications and addictive substances, whereas also several medications seem to have the potential to attenuate sleep bruxism and/or awake bruxism. The objective of this study was to present a narrative literature on medications and addictive substances potentially inducing or aggravating sleep bruxism and/or awake bruxism and on medications potentially attenuating sleep bruxism and/or awake bruxism. Literature reviews reporting evidence or indications for sleep bruxism and/or awake bruxism as an adverse effect of several (classes of) medications as well as some addictive substances and literature reviews on medications potentially attenuating sleep bruxism and/or awake bruxism were used as starting point and guidelines to describe the topics mentioned. Additionally, two literature searches were established on PubMed. Three types of bruxism were distinguished: sleep bruxism, awake bruxism and non-specified bruxism. Generally, there are insufficient evidence-based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism. There are insufficient evidence-based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism.Peer reviewe

Treatment of primary Sjogren's syndrome with anti-CD20 therapy (rituximab). A feasible approach or just a starting point?

Introduction: In vitro and in vivo experimental data have suggested new immunopathogenic mechanisms in primary Sjogren's syndrome (pSS). The availability of targeted treatment modalities has opened new ways to selectively target these mechanistic pathways in vivo. Amongst these new treatment modalities, monoclonal antibodies specific for the B-cell surface molecule CD20 have been shown to be the most promising treatment option to date. Areas covered: A search of the Pubmed, MEDLINE, EMBASE, Cochrane and Ovid databases was performed to review literature on the efficacy and safety profile of anti-CD20 therapy in pSS patients. Expert opinion: A single course of the chimeric humanized anti-CD20 antibody rituximab was effective in reducing disease activity in pSS patients for about six to nine months. Retreatment of responders resulted in a similar effect to initial treatment. When combined with corticosteroids during infusion, rituximab was shown to be a safe drug to administer. Thus, anti-CD20 therapy can be considered an effective treatment option in pSS patients. However, large randomized controlled trials with anti-CD20 therapy, for example rituximab, are warranted in order to: 1) assess long-term effects of such treatment, 2) determine which pSS patients will benefit most from anti-CD20 treatment and 3) assess which retreatment schedule should be followed

Dental implants with fixed prosthodontics in oligodontia: A retrospective cohort study with a follow-up of up to 25 years

Statement of problem. Long-term assessments of implant survival and treatment outcome in patients with oligodontia are lacking. Purpose. The purpose of this retrospective clinical study was to assess which factors determine a long-term implant survival and treatment outcome of up to 25 years in a cohort of patients with oligodontia. Material and methods. The medical records of all patients with oligodontia treated with fixed implant prosthodontics between January 1991 and December 2015 in the Department of Oral and Maxillofacial Surgery at the University Medical Center Groningen, the Netherlands, were assessed. Specifically, this involved the retrieval of records on the need for and mode of bone augmentation, implant survival, and survival of and adverse events associated with the prosthodontics. The Kaplan-Meier estimator was used to analyze implant and superstructure survival. Log-rank tests were used to compare the survival of subgroups. Results. A total of 126 patients with oligodontia were treated with dental implants. Of the 777 implants in total, 56 were lost, resulting in a 5-year cumulative survival of 95.7% (95% confidence interval [CI], 94.2% to 97.2%) and a 10-year cumulative survival of 89.2% (95% CI, 86.2% to 92.2%). The survival of implants placed in regions where bone augmentation surgery had been performed was significantly lower. The 5-year cumulative superstructure survival was 90.5% (95% CI, 87.6% to 93.5%), and the 10-year cumulative superstructure survival was 80.3% (95% CI, 75.3% to 85.3%). The performance of the screw-retained and cemented superstructures was comparable, but the survival of single crowns was significantly higher than the survival of fixed partial dentures (P Conclusions. Implant treatment is a predictable treatment option for patients with oligodontia with a favorable long-term outcome. Survival of implants in augmented areas is lower

Dental Implants in Patients with Sjogren's Syndrome

Background: Limited evidence is available for applying dental implants in Sjogren's syndrome (SS) patients. Purpose: This study aims to retrospectively assess clinical outcome of implant therapy in a cohort of well-classified patients with SS. Materials and Methods: All SS patients attending the University Medical Center Groningen for follow-up (n = 406) were asked whether they had implants. In SS patients with implants peri-implant health and implant survival was recorded and compared with data from matched healthy controls. Patients' symptoms, health-related quality of life, oral functioning, and satisfaction were assessed using validated questionnaires. Results: Of the responding SS patients (n = 335), 21% was provided with implants. Of these 69 SS patients, 50 SS patients were willing to join our study. In SS patients, peri-implant health was reasonably good with minor marginal bone loss and a peri-implantitis prevalence of 14%, comparable with healthy controls. Implant survival was 97% (median follow-up 46 months) [IQR 26; 73], and overall patients' satisfaction was high. Oral functioning correlated negatively with dryness, patients' satisfaction, and chewing ability in SS patients. Conclusions: Implant therapy is common in our cohort of SS patients. In spite of shortcomings of our retrospective analysis, implants in SS patients seem to perform comparable with implants in healthy patients