Scleroderma is a disorder involving oral and facial tissues, with skin hardening, thin lips, deep wrinkles, xerostomia, tongue rigidity, and microstomia. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD) in Systemic Sclerosis (SSc) patients compared with healthy people. Eighty patients (6 men, 74 women) fulfilling ACR/EULAR SSc Criteria were enrolled. A randomly selected group of 80 patients, matched by sex and age served as control group. The examination for TMD signs and symptoms was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a questionnaire and clinical examination. SSc patients complained more frequently (78.8%) of oral symptoms (Xerostomia, dysgeusia, dysphagia and stomatodynia) than controls (28.7%) (χ2 = 40.23 p = 0.001). TMD symptoms (muscle pain on chewing, difficulty in mouth opening, headaches) were complained by 92.5% of SSc patients and by 76.2% of controls (χ2 = 8.012 p = 0.005). At the clinical examination, 85% of SSc patients showed restricted opening versus 20.0% of controls (χ2 = 67.77 p = 0.001), 81.2% of SSc showed reduced right lateral excursion versus 50% of controls (χ2 = 17.316 p = 0.001); 73.8% of SSc showed limited left lateral excursion versus 53.8% of controls (χ2 = 6.924 p = 0.009); and 73.8% of SSc had narrow protrusion versus 56.2% of controls (χ2 = 5.385 p = 0.02).

Coronoid process hypertrophy (CPH) consists of an abnormal volumetric increment of the mandibular coronoid process; as this process grows gradually, the infratemporal space needed for the rotation and translation of the mandible is reduced, which results in a reduction of the range of mouth opening and lateral excursion, limiting mouth opening. The purpose of this case report was to describe a rare case of hypertrophy of coronoid processes with associated temporomandibular ankylosis, monitored for over 20 years. The patient was first visited when he had a facial trauma at the age of 4. Then he was followed through clinical, functional, instrumental, bi-dimensional and three-dimensional radiological evaluations up to the age of 24. Physical therapy was initiated at the age of 10 to improve the condition of the masticatory muscles, while at the age of 14, Transcutaneous Electrical Nerve Stimulations were performed to reduce muscle tension and, a bite plane was delivered to control the parafunctional activity of the jaw in the night and self-control instruction was provided for daytime habits. The adult patient has not accepted surgical intervention; thus, the future objective is to continue monitoring over the years to avoid a detrimental progression of the medical condition through physical and functional therapies while waiting for patient consent to surgery if needed.

AIMS: Sjӧgren Syndrome is a disorder involving oral tissues, with xerostomia, dysgeusia, dysphagia, tooth decay, gingivitis, angular cheilitis and glossitis. Temporomandibular disorders are a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD) in Sjӧgren Syndrome (SS) patients compared with healthy people.METHODS: The study group included 72 SS patients (2 men, 70 women) diagnosed according to the American-European Consensus Group (AECG) Criteria. A randomly selected group of 72 patients, matched by sex and age, served as control group. The examination for TMD signs and symptoms was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a questionnaire and clinical examination.RESULTS: SS patients complained more frequently (95.8%) of oral symptoms (xerostomia, dysgeusia, dysphagia) than controls (22.2%) (χ2= 80.66 p< 0.001). TMD symptoms (muscle pain on chewing, difficulty in mouth opening, arthralgia, headaches, tinnitus) were complained by 91.7% of SS patients and by 84.7% of controls (χ2= 1,667 p= 0,196). At the clinical examination, 91,7% of SS had at least one oral sign respect to 75 % of controls. The salivary flow measurements showed high statistical significance between the two groups (Unpaired test, p< 0,0001). Myofascial pain (caused by muscular contracture) was significantly higher in the study group than in the control one (p≤ 0,05). Furthermore 18,05% of SS patients showed deflection versus 5,5% of controls (χ2=5,402 p=0,020).CONCLUSIONS: Sjӧgren's Syndrome seems to play a role in temporomandibular joint disorders.

Adolescents with bad malocclusion can more often be victims of bullying and the improvement of their facial appearance through oral rehabilitation is nowadays an important issue. The aim of this case report was to describe the orthodontic treatment in a teenager with a dentoskeletal malocclusion exposed to bullying to correct his occlusal problems and improve facial esthetics and quality of life. The patient, a boy aged 13.5 years, had a class II, division 1, malocclusion with hyperdivergent pattern, mandibular asymmetry, constricted maxillary arch and molar crossbite, increased overjet, lower mild crowding and lip sucking. A two-phase approach was necessary to achieve proper occlusion, better esthetics and promote the patient's self-esteem with consequent greater serenity of his family.

ObjectivesThe objectives of this systematic review were to evaluate the correlation between Ultrasound (US) and Magnetic Resonance Imaging (MRI) in patients with JIA and to investigate the association with Temporomandibular Disorders (TMD).Materials and MethodsThe protocol was registered in PROSPERO (CRD42022312734). Databases Medline, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature were searched. Eligibility criteria were patients with JIA subjected to diagnostic evaluation using US and MRI. No language restrictions were applied. After duplicate study selection, data extraction and risk of bias assessment according to Cochrane were conducted. Data extraction of patients was conducted by two independent authors.ResultsFive observational studies were included with 217 participants (153 females and 64 males; mean age 11.3 years). The quality of the studies was overall satisfactory. The correlation between US and MRI in children with JIA was ‘moderate’ in acute arthritis while the chronic arthritis correlated positively in two studies.ConclusionsEven if MRI remains the more accurate imaging modality for the detection of TMJ of patients with JIA, US may be useful to early detect pathological conditions and to address the patient with JIA and putative TMJ involvement to a more accurate diagnosis with MRI and consequent appropriate treatment management.Clinical RelevanceMRI should be deemed necessary only secondary to less‐invasive assessments with US just to confirm the diagnosis or to increase sensitivity, accuracy of positive predictive values detected.