Background and aimThis review aims at presenting a current view on the most frequent factors involved in the mechanisms causing temporomandibular disorders (TMD).MethodWe conducted a critical review of the literature for the period January 2000 to December 2014 to identify factors related to TMD development and persistence.ResultsThe etiology of TMD is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. Occlusal overloading and parafunctions (bruxism) are frequently involved as biomechanical factors; increased levels of estrogen hormones are considered biological factors affecting the temporo-mandibular-joint. Among bio-psychosocial factors, stress, anxiety or depression, were frequently encountered.ConclusionsThe etiopathogenesis of this condition is poorly understood, therefore TMDs are difficult to diagnose and manage. Early and correct identification of the possible etiologic factors will enable the appropriate treatment scheme application in order to reduce or eliminate TMDs debilitating signs and symptoms.

Oral lichen planus (OLP) is a chronic inflammatory disease, associated with altered cell-mediated immunological function. It has long-term evolution, repeated exacerbations, sometimes painful and resistant to treatment, even all of these, OLP significantly affects patient's life quality. Not least, OLP is accompanied by an increased risk of malignant transformation. A wide spectrum of therapeutic options is available, but none are curative. In this review, 58 structured studies on the clinical symptomatology and treatment strategy of OLP were analyzed. The literature research was performed according to the criteria of the PRISMA system. This study summarizes current knowledge regarding management of OLP and oral lichenoid lesions, discusses the challenges of choosing an adequate treatment and, in attempt to improve the quality of patient life, trying to describe a therapeutic algorithm that takes into consideration the clinical features of the disease. Current OLP therapy aims at eliminating all mucosal-related lesions, reduce symptomatology and decrease the risk of oral cancer and include corticosteroids, immunomodulatory agents, retinoids, ultraviolet irradiation and/or laser therapy.

Background and aims. The decision-making process when restoring a non-vital tooth is influenced by multiple factors. This study aimed to survey the dentists’ preferences regarding cast post-and-core and fiber post techniques for the reconstruction of non-vital teeth and to identify a correlation between reconstruction technique and practitioners characteristics, or dental characteristics. Methods. The survey instrument was a questionnaire, which included a general part with questions regarding the practitioner’s profile (gender, age, years of experience, pattern and location of practice, etc.) and the dental characteristics (anterior or posterior position of the tooth on the arch, the amount of dental remaining tissues, etc.). and a technical part, containing more specific questions regarding the manufacture and performance of root-coronal reconstructions. Results. Among the surveyed practitioners (n=35), 69.7% use more often cast post-and-core reconstructions (CPR) while 30.3% choose fiber post reconstructions (FPR). No difference in the reconstruction type was observed regarding patient’s age (p=0.23) or gender (p=0.092). The para-function criterion was considered important by 8.23% of the participants. When deciding the type of the root-coronal reconstruction depending on the remaining dentine walls, CPRs are significantly more frequently used in posterior areas (p=0.043) or when para-functional habits exist (p=0.022). Conclusion. Cast post-and-core represent the most frequently used type of reconstruction for non-vital teeth. Fiber post reconstructions are indicated in the aesthetic zone and when the amount of healthy remaining dental structure is higher.

Background and aim. Dental erosion (DE) represents a frequent condition in adults and the elderly. The gastroesophageal reflux disease (GERD) is considered an important endogenous factor causing dental erosions. The objective of this study was to assess the prevalence of DE in GERD patients and to establish the correlation between pathogenic intrinsic and extrinsic factors of DE and their relation to GERD. Methods. A cross-sectional study was conducted on 263 patients (median age 43). Patients with heartburn were recruited in two countries with different prevalence of GERD. Patients were recruited from France (n=158, 60%) and Romania (n=105, 40%) including 163 females and 100 males. The Basic Erosive Wear Examination (BEWE) index for diagnosis and evaluation of dental erosion was used. Based on the value of BEWE score, each patient was included in a risk group for DE development (low risk: BEWE=3-8, medium risk: BEWE=9-13, high risk: BEWE ≥14). Patients filled a questionnaire regarding GERD symptoms, medications, life style. Salivary parameters (pH and buffering capacity) were also assessed and analyzed. Results. DE was significantly more frequent and more severe in GERD subjects than in the non-GERD controls. Low salivary pH but not salivary buffering capacity was associated with BEWE scores. Buffering capacity however was significantly more altered in patients with BEWE score over 9 (medium DE) than in patients with mild DE (BEWE <9). Although extrinsic factors (consumption of citrus fruits, soda drinks) were associated with DE in GERD, there was no statistical correlation with the BEWE score. From the total of 263 patients, 229 (87.1%) presented BEWE score <9, and 34 (12.9%) presented BEWE ≥9. The DE was significantly associated with the presence of GERD (p<0.001). BEWE score >9 was more frequently present in GERD patients (30 patients: 21.3%) than in non GERD patients (4 patients: 3.3%). DE were more frequent in French subjects compared to Romanian subjects. Romanians had lower BEWE scores than the French. Conclusions. DE is more frequent and more severe with GERD vs. non-GERD. DE in GERD is associated with extrinsic dietary factors like citrus fruits and soda drinks.

Dental occlusion anomalies and posture pathological modifications can be inter-related. PostureScreen® Mobile app might represent a useful tool in the early diagnosis of dental occlusion pathology.