Digital evaluation of occlusal forces: comparison between healthy subjects and TMD patients

ABSTRACT Aim: Continuous technological innovation has provided the clinicians to access to a computerized device that can analyse the different characteristics of occlusal contacts. The purpose of this research was to use this device to study the occlusal forces comparing healthy subjects and TMD patients. Materials and Methods: The study was conducted by following specific criteria to select participants, the sample was divided into two homogeneous groups: control group (CG) comprising healthy subjects, and dysfunctional group (DG) comprising TMD patients. The occlusal force analysis was performed using the computerized system T-Scan III V 5.20 T. The data were analysed with statistical methods. Results: The most significant differences emerged between the groups in the average occlusal load distribution and in the location of the centre of occlusal forces (COF). In particular, compared with the CG and the functional standard, reductions in the molar field forces on the second and first molars of 27% and 6.9%, respectively, were observed in the DG. The COF was located in the most forward position in TMD patients compared with healthy subjects. Conclusions: Although the differences in the distribution of the occlusal forces and the location of the occlusal centre of gravity were significant, the relationship between occlusal contacts and TMD remains to be fully clarified. Further research is needed to investigate whether studying occlusal force distributions in both healthy subjects and TMD patients

Clinical insights on Tolosa Hunt syndrome: a multidisciplinary approach on neurological-related symptomatology in maxillofacial region

Background Tolosa–Hunt syndrome (THS) related neurological symptoms are described in literature as “unilateral”, “recurrent”, “episodic”, “intense”, “severe”, “lancinating” or “stabbing” pain on the upper face and forehead and may be misdiagnosed due to the similarity of few symptoms and a significant number of common characteristics between both conditions. Aims The aim of this brief report is to indicate some important clinical insights related to Tolosa Hunt syndrome, and to give a frank account on the multidisciplinary approach on neurological-related symptomatology in maxillofacial region. Methods We analysed a selection of patients with such clinical picture. To better describe the proper management of clinical cases, we report a 50-year-old female reporting an history of two years of recurrent, severe stabbing pain around the right eye, prominence of her cheek and forehead. Her general dentist first mistakenly diagnosed toothache and, thus, it was subsequently misdiagnosed the trigeminal neuropathy (TN). Results Reported exemplificative case presented a mild ptosis, diplopia of the right eye, corneal reflex loss, paresthesia and hyperesthesia of upper part of left side of face. Magnetic resonance imaging (MRI) findings were suggestive of THS. Complete resolution of symptoms was achieved with oral Prednisolone and constant monitoring of symptoms. Conclusion THS may be added to the long list of differential diagnosis of TN and general dentist and oral surgeons should be informed about such rare causes of facial pain through continued medical education programs

Innovative approach for the in vitro research on biomedical scaffolds designed and customized with CAD-CAM technology

Studies on biomaterials involve assays aimed to assess the interactions between the biomaterial and the cells seeded on its surface. However, the morphology of biomaterials is heterogeneous and it could be tricky to standardize the results among different biomaterials and the classic plastic plates. In this light, we decided to create, by means of computer-aided design (CAD) technology, a standardized sample model, with equal shape and sizes, able to fit into a classic shape of a 96-wells tissue culture plate (TCP)

The effects of surgical preparation techniques and implant macro-geometry on primary stability : an in vitro study

The attainment of a good primary stability is a necessary condition to ensure the success of osseointegration in implantology. In type IV cancellous bone, however, it is possible that a reduced primary stability can lead to an increased rate of failure. The aim of this study was therefore to determine, with the help of the resonance frequency (Osstell mentor), which technique of implant site preparation (piezo surgery, conventional, under-preparation, bone compaction, osteodistraction) and macro-geometry is able to improve implant stability in type IV cancellous bone. 10 pig ribs were prepared with a surgical pre-drilled guide, calibrated for a correct implant positioning. On each rib, 5 implant sites (one for each technique) were prepared. Successively, 50 conical implants (Tekka Global D) were inserted and measured with the resonance frequency to evaluate the primary stability. Data collected were analyzed by analysis of variance (ANOVA) to test whether the Implant Stability Quotient (ISQ) values of the five techniques were significantly different. The results showed that no significant differences among the ISQ values of the five techniques used were found. Also, no significant differences in the macro-geometry of the two types of compared implants were observed. However, the macro-geometry of Tekka implants, characterized by a double condensing thread, seems to provide greater ISQ values than those of single thread implants when using the same technique. In light of these preliminary data, it is conceivable that in cases of reduced stability, such as those occurring with a type IV bone, all means ameliorating the primary stability and accelerating the osseointegration can be utilized

Clinical decision-making review on magnetic attachments versus mechanical attachments in dental prosthetics

BackgroundConventional dentures in edentulous patients show some limitations due to the lack of retention, support and stability thus resulting in difficulty to chew. The modern implantology allows to use different implant overdentures and different attachment systems. The selection of the attachment by practitioners is mainly influenced by the clinical experience or technical preferences. AimsThe aim of the present review is to provide an adequate background to the clinicians, in order to select the prosthetic attachments according to the current literature. The mechanical attachments have been compared to the magnetic devices, with the aim to guide the decision of the practitioners. Methods Articles topics selection was based on the use of magnetic attachments in dentistry and the comparison between them and mechanical connectors. The databases used were PubMed/MEDLINE, Google Scholar and ISI Web of Science. A critical evaluation of the selected paper has been made to choose the ones that matched the inclusion criteria.Results Nowadays, few studies have compared different attachments in a manner useful for clinical decision-making. The main problem limiting long-term durability of magnetic attachments in the oral fluid is the poor corrosion resistance of permanent magnets and the consequent leaching of cytotoxic ions. ConclusionMagnetic attachments in comparison with other attaching systems can be useful in patients with special needs, in patients with limited interocclusal space, or in patients with neuromuscular limitations, thanks to the automatic reseating properties. However, it’s important to highlight that the mechanical attachments still represent the best choice in common conditions requiring dental prostheses

Clinical insights on Tolosa Hunt syndrome: A multidisciplinary approach on neurological-related symptomatology in maxillofacial region

BackgroundTolosa–Hunt syndrome (THS) related neurological symptoms are described in literature as “unilateral”, “recurrent”, “episodic”, “intense”, “severe”, “lancinating” or “stabbing” pain on the upper face and forehead and may be misdiagnosed due to the similarity of few symptoms and a significant number of common characteristics between both conditions.AimsThe aim of this brief report is to indicate some important clinical insights related to Tolosa Hunt syndrome, and to give a frank account on the multidisciplinary approach on neurological-related symptomatology in maxillofacial region.Methods We analysed a selection of patients with such clinical picture. To better describe the proper management of clinical cases, we report a 50-year-old female reporting an history of two years of recurrent, severe stabbing pain around the right eye, prominence of her cheek and forehead. Her general dentist first mistakenly diagnosed toothache and, thus, it was subsequently misdiagnosed the trigeminal neuropathy (TN). Results Reported exemplificative case presented a mild ptosis, diplopia of the right eye, corneal reflex loss, paresthesia and hyperesthesia of upper part of left side of face. Magnetic resonance imaging (MRI) findings were suggestive of THS. Complete resolution of symptoms was achieved with oral Prednisolone and constant monitoring of symptoms.ConclusionTHS may be added to the long list of differential diagnosis of TN and general dentist and oral surgeons should be informed about such rare causes of facial pain through continued medical education programs

Management of Uncommon Secondary Trigeminal neuralgia related to a rare Arnold Chiari type I malformation

BackgroundTrigeminal neuralgia (TN) may sometimes present secondary to an intra-cranial cause. Arnold Chiari Malformation (ACM) is downward herniation of the cerebellar tonsils through the foramen magnum that may be a cause of TN like pain in very rare cases.AimsThe aim of this brief report is to suggest the proper management of uncommon secondary trigeminal neuralgia related to a rare Arnold Chiari type I malformation.Methods A male patient presented electric shock like stabbing pain on the right side of the face for more than ten years. The symptoms were typical of trigeminal neuralgia except that there was loss of corneal reflex on the right side and the patient also complained of gait & sleep disturbances. Complex and multilevel diagnosis was made. Results A multiplanar imaging through brain acquiring T1/T2W1 revealed ACM Type I Malformation with caudal displacement of cerebellar tonsils through foramen magnum.ConclusionDental surgeons and oral and Maxillofacial Surgeons should exclude intra-cranial causes by Magnetic Resonance Imaging(MRI) in patients of TN presenting with loss of corneal reflex, gait and sleep disturbances due to night time pain episodes

Integration of B-cell receptor-induced ERK1/2 phosphorylation and mutations of SF3B1 gene refines prognosis in treatment-na\uefve chronic lymphocytic leukemia

ADP-ribosyl Cyclase 1; Disease Progression; Humans; Immunoglobulin Heavy Chains; Immunoglobulin Variable[no abstract available

Self-bone graft and simultaneous application of implants in the upper jawbone

The implant supported rehabilitation of upper back sectors, sometimes, is conditioned to the pneumatization of the jawbone and so, reducing the possibility to apply the implants when the bone portion is inferior to 4 mm (important condition for the primary stability).The great rise of the jawbone and the simultaneous application of implants is, surely, the condition to have the best success guarantees compared to the only application of filling material.The surgical technologies used in the self bone grafts are various (Ilium crest, calvaria, fibula) and so also for implant applications.In this article we want to put in evidence a new technology in order to reduce at the minimum the invasive surgery of the removal and the patient morbidity.It has been executed a longitudinal study on 21 consecutive cases and illustrated by a clinical one; the success was of 94.5%. The advantages of this technique are: Functional and anatomical recovery of the jaw cavityImmediate application of implants with a thickness of remaining bone in fervor to 4 mm.Reduction of surgical timesReduced morbidity of the patientLocal an anesthesia

A new aid in TMD Therapy: the Universal Neuromuscular Immediate Relaxing appliance "UNIRA"

Among the various treatment options currently indicated for the temporomandibular joint disorders (TMD) tackle an important role is played by occlusal devices which can be used in an individualized and or universal.At the Service of Clinical Gnathology of the Head-Neck Department of the Umberto I Polyclinic at the Sapienza University of Rome, has been tested a new universal occlusal appliance, invented and patented by dott. Rampello.To assess the applicability and efficacy was carried out a preliminary study on a sample of 50 patients selected according to the criteria RDC-TMD and divided in random into two groups, the patient group (PG), treated with the device, and a control group (CG) does not undergo any treatment.The two groups were evaluated according to an analysis of segmentation by comparing the clinical data. Were considered some aspects of the application of the device using a self-evaluation questionnaire administered to the PG.CONSIDERATIONS DERIVED FROM THIS INITIAL APPLICATION ARE: none of the 25 patients in the sample PG has worsened the initial situation. 6 patients (24%) were healed and were included in a protocol of regular six-monthly visits. 16 patients (64%) have improved and incorporated into treatment to complete the treatment cycle. 3 patients (12%) were stationary and subjected to a diagnostic reassessment.The patients in the CG have all been included in the multidisciplinary treatment program.The findings of our preliminary study are favorable to this new device occlusion, however, requires further verification in time and on a sample of patients numeroso