This study investigated the prevalence of the signs and symptoms of temporomandibular disorders (TMD) in a population of children and adolescents. TMD signs and symptoms were recorded in 1134 subjects (593 males and 541 females; age range 5-15 years), divided into various groups according to the: (i) Angle dental class; (ii) presence and type of crossbite; (iii) gender; and (iv) age (ages 5-11 and 12-15 years). The percentages of signs and symptoms were compared using the chi2-test to determine the differences among the groups for the rates of TMD symptoms, bruxism, joint sounds, deviation during opening, reduced opening/lateral/protrusive movements, and myofascial pain. Subjects who were 12-15 years old showed a significantly higher prevalence of myofascial pain than those who were 5-11 years old (chi2 = 4.263; p < 0.05). Females showed a significantly higher prevalence of myofascial pain than males (chi2 = 3.882; p < 0.05). Subjects with posterior, unilateral crossbite showed a significantly higher prevalence of TMD symptoms (chi2 = 33.877; p < 0.001) and reduction of functional movements (chi2 = 10.800; p < 0.05) than those with no crossbite, or with anterior or posterior bilateral crossbite. TMD's signs and symptoms seem to be associated to some definite characteristics of the patient, such as female gender, young age, and presence of posterior unilateral crossbite.
Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that include obesity, impaired glucose tolerance or diabetes, hyperinsulinemia, hypertension, and dyslipidemia. Recently, more attention has been reserved to the correlation between periodontitis and systemic health. MetS is characterized by oxidative stress, a condition in which the equilibrium between the production and the inactivation of reactive oxygen species (ROS) becomes disrupted. ROS have an essential role in a variety of physiological systems, but under a condition of oxidative stress, they contribute to cellular dysfunction and damage. Oxidative stress may act as a common link to explain the relationship between each component of MetS and periodontitis. All those conditions show increased serum levels of products derived from oxidative damage, promoting a proinflammatory state. Moreover, adipocytokines, produced by the fat cells of fat tissue, might modulate the balance between oxidant and antioxidant activities. An increased caloric intake involves a higher metabolic activity, which results in an increased production of ROS, inducing insulin resistance. At the same time, obese patients require more insulin to maintain blood glucose homeostasis – a state known as hyperinsulinemia, a condition that can evolve into type 2 diabetes. Oxidation products can increase neutrophil adhesion and chemotaxis, thus favoring oxidative damage. Hyperglycemia and an oxidizing state promote the genesis of advanced glycation end-products, which could also be implicated in the degeneration and damage of periodontal tissue. Thus, MetS, the whole of interconnected factors, presents systemic and local manifestations, such as cardiovascular disease and periodontitis, related by a common factor known as oxidative stress.
BackgroundThere have been no quantitative standards for volumetric and surface measurements of the mandibular condyle in Caucasian population. However, the recently developed cone-beam computed tomography (CBCT) system allows measurement of these parameters with high accuracy.MethodsCBCT was used to measure the condylar volume, surface and the volume to surface ratio, called the Morphometric Index (MI), of 300 temporo-mandibular joints (TMJ) in 150 Caucasian young adult subjects, with varied malocclusions, without pain or dysfunction of TMJs.ResultsThe condylar volume was 691.26 ± 54.52 mm3 in males and 669.65 ± 58.80 mm3 in, and was significantly higher (p< 0.001) in the males. The same was observed for the condylar surface, although without statistical significance (406.02 ± 55.22 mm2 in males and 394.77 ± 60.73 mm2 in females).Furthermore, the condylar volume (693.61 ± 62.82 mm3 ) in the right TMJ was significantly higher than in the left (666.99 ± 48.67 mm3, p < 0.001) as was the condylar surface (411.24 ± 57.99 mm2 in the right TMJ and 389.41 ± 56.63 mm2 in the left TMJ; t = 3.29; p < 0.01). The MI is 1.72 ± 0.17 for the whole sample, with no significant difference between males and females or the right and left sides.ConclusionThese data from temporomandibular joints of patients without pain or clinical dysfunction might serve as examples of normal TMJ's in the general population not seeking orthodontic care.
AimAim of this study was to compare the volume and the shape of mandibular condyles in a Caucasian young adult population, with different skeletal pattern.Material and methods200 Caucasian patients (15–30 years old, 95 male and 105 females) were classified in three groups on the base of ANB angle: skeletal class I (65 patients), skeletal class II (70 patients) and skeletal class III (65 patients). Left and right TMJs of each subject were evaluated independently with CBCT (Iluma). TMJ evaluation included: condylar volume; condylar area; morphological index (MI). Condylar volumes were calculated by using the Mimics software. The condylar volume, the area and the morphological index (MI) were compared among the three groups, by using non-parametric tests.ResultsThe Kruskal-Wallis test and the Mann Whitney test revealed that: no significant difference was observed in the whole sample between the right and the left condylar volume; subjects in skeletal class III showed a significantly higher condylar volume, respect to class I and class II subjects (p < 0.05); significantly lower condylar volume was observed in class II subjects, respect to class I and class III (p < 0.05). In the whole sample condylar volume (699.8 ± 63.07 mm3 in males and 663.5 ± 81.3 mm3 in females; p < 0.01) as well as condylar surface (423.24 ± 63.03 mm2 in males and 389.76 ± 61.15 mm2 in females; p < 0.01) were significantly higher in males than in females.ConclusionSkeletal class appeared to be associated to the mandibular condylar volume and to the mandibular condylar area in the Caucasian orthodontic population.
This study investigated the prevalence and type of pain experienced during orthodontic treatment in 30 subjects (12 males, 18 females, aged 12-18 years) with crowding. Fifteen patients were treated with conventional brackets (Victory Series) and 15 with self-ligating brackets (Damon SL II). The first archwire for all patients was a 0.014 inch nickel-titanium (NiTi) archwire with a force of approximately 100 g. Conventional brackets were ligated with elastomeric modules. A visual analogue scale (VAS) was used daily to assess the intensity of pain; the use of pain medication was also reported in a specially designed daybook for a total period of 3 months. Pearson's chi-square was used to investigate the difference between groups in the frequency of pain experience, its nature, and the use of analgesia. Non-parametric statistics (Mann-Whitney U-test) were computed to compare pain intensity between the groups. To investigate reported pain assessments, Friedman's two-way analysis of variance was used and the differences were estimated using Wilcoxon's signed-rank test. The results showed that pain was reported for a period of 9 days after archwire insertion. Patients treated with self-ligating brackets reported the highest pain intensity on the day following placement of the first archwire (VAS mean = 42.6), while those treated with conventional brackets experienced the greatest pain intensity at placement of the first archwire (VAS mean = 52) and after the second orthodontic appointment (VAS mean = 59.6). Analgesics were used by 16.5 per cent of patients treated with self-ligating brackets and by 10 per cent of those treated with conventional brackets, most often during the first 2 days after archwire placement. Patients treated with conventional brackets reported significantly more 'constant' pain than those treated with self-ligating brackets who complained of 'chewing/biting' pain. Pain appears to be common during orthodontic treatment but perhaps less intense when self-ligating brackets are used, although no difference was observed in the use of analgesics between those treated with self-ligating or conventional brackets. There were no reports of pain after 7-9 days in either group.
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