Search Results (45)

Background/Objectives: Burning Mouth Syndrome (BMS) is a chronic orofacial pain disorder characterized by persistent intraoral burning sensations without visible mucosal lesions. Although its biopsychosocial complexity is increasingly recognized, cross-cultural comparison data remain limited. Methods: This cross-sectional study assessed 60 patients with BMS (30 Italian, 30 Romanian) who underwent standardized clinical, psychological, and sleep evaluations. Data collected included sociodemographics, clinical characteristics, diagnostic history, comorbidities, and symptomatology. The assessment tools used included the Numeric Rating Scale (NRS), Short Form of the McGill Pain Questionnaire (SF-MPQ), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Statistical comparisons were conducted using Mann–Whitney U and Fisher’s exact tests with Bonferroni correction. Results: No significant differences were observed in age, sex, or body mass index. Italian patients had fewer years of education (p = 0.001), higher pain intensity (NRS, p < 0.001), poorer sleep quality (PSQI, ESS, p = 0.001), and more frequent pre-existing sleep disorders (p < 0.001). Romanian patients showed higher levels of anxiety (HAM-A, p < 0.001), longer diagnostic delays (p = 0.002), and more dysesthetic or perceptual symptoms, including tingling and oral dysmorphism (p < 0.05). Stressful events before onset were more common among Romanians (p < 0.001), while Italians more often received a correct diagnosis at first consultation (p = 0.005). Conclusions: This first cross-national comparison of BMS in Western and Eastern Europe shows that cultural, healthcare, and clinician education differences can shape symptom profiles, comorbidities, and diagnostic delays, underscoring the need for personalized, country-specific management strategies. Full article

Background/Objectives: Dyslexia and dysgraphia are common childhood neurodevelopmental disorders characterized by persistent reading and writing difficulties, despite normal intelligence and access to education. While typically described as cognitive–linguistic deficits, emerging research suggests potential links to orofacial dysfunction and emotional regulation issues. This study examines associations between stomatognathic anomalies, emotional dysregulation, and early indicators of dyslexia-dysgraphia risk in preschool children, aiming to strengthen early screening and intervention strategies. Methods: A cross-sectional case–control study included 689 Romanian children aged 5–7 from 11 kindergartens. Screening involved the ACTIV-BURLEA psychometric battery to evaluate language, motor, and cognitive abilities. Clinical assessments targeted dental arch form, occlusal balance, and tongue and lip function. Emotional regulation was evaluated using a standardized child behavior scale. Thirty-two children were identified as at risk for dyslexia-dysgraphia and followed longitudinally, and then compared to matched controls. Statistical analysis employed chi-square tests, Pearson correlations, t-tests, and logistic regression. Results: At follow-up, 74.19% of at-risk children received confirmed diagnoses. Tongue dysfunction (TD) (OR = 4.81, p = 0.06) and emotional dysregulation (ED) (OR = 3.94, p = 0.09) emerged as key risk indicators, though not statistically significant. Tongue dysfunction (TD) correlated with school avoidance (r = 0.76, p < 0.01), while occlusal anomalies (OAs) correlated with emotional distress (ED) (r = 0.64, p < 0.05). Conclusions: The findings suggest that early dyslexia-dysgraphia risk involves orofacial and emotional components. Tongue dysfunction (TD), occlusal disturbances (OA), and emotional dysregulation (ED) may offer important clinical markers. Integrating dental and emotional assessments into preschool screening may improve early identification and enable personalized intervention. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

Background: Chronic primary orofacial pain (COFP) affects approximately 7% of the population and often leads to reduced quality of life. Patients frequently undergo multiple assessments and treatments across healthcare disciplines, often without a definitive diagnosis. The 2019 ICD-11 classification of chronic primary pain clusters together COFP subtypes based on chronicity and associated functional and emotional impairment. Objective: This study aimed to evaluate whether these subtypes of COFP share common underlying mechanisms by comparing neuroimaging findings. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Searches were performed using Medline (OVID) and Scopus up to April 2025. Inclusion criteria focused on MRI-based neuroimaging studies of participants diagnosed with COFP subtypes. Data extraction included participant demographics, imaging modality, brain regions affected, and pain assessment tools. Quality assessment used a modified Coleman methodological score. Results: Fourteen studies met the inclusion criteria, all utilising MRI and including two COFP subtypes (temporomandibular disorder and burning mouth syndrome). Resting- and task-state imaging revealed overlapping alterations in several brain regions, including the thalamus, somatosensory cortices (S1, S2), cingulate cortex, insula, prefrontal cortex, basal ganglia, medial temporal lobe, and primary motor area. These changes were consistent across both TMD and BMS populations. Conclusions: The findings suggest that chronic primary orofacial pain conditions (TMD and BMS) may share common central neuroplastic changes, supporting the hypothesis of a unified pathophysiological mechanism. This has implications for improving diagnosis and treatment strategies, potentially leading to more targeted and effective care for these patients. Full article

Background/Objectives: Tongue thrust (TT) occurs when abnormal tongue movements cause anterior tongue placement with pressure and contact against or between the teeth, potentially affecting the oral phase of swallowing, impacting eating, breathing and speaking. There is limited literature on the diagnostic and treatment approaches for TT, as well as involvement of health practitioners in its management. This study aims to examine the current knowledge and practices related to TT diagnosis and treatment among health professionals in Australia. Methods: A two-phase explanatory sequential mixed methods approach was adopted, comprising an online survey that collected participants’ demographic information and details on assessment, diagnosis, management, referral practices, and relevant experience and training. Phase one involved 47 health professionals from various disciplines in Australia who completed an online survey in its entirety. Phase two included in-depth interviews with seven speech-language pathologists (SLPs) to gain further insights into their experiences in managing TT. Survey data were analysed descriptively, and interview data was analysed thematically. Results: Most participants diagnosed TT using clinical assessments, such as general observation and oral motor examinations. Treatment approaches commonly included orofacial myofunctional therapy and the use of myofunctional devices. Interviews with SLPs identified four key themes: tongue thrust as a symptom rather than a diagnosis, facilitators to effective treatment, multidisciplinary approaches to management, and training and education gaps in clinical practice. Conclusions: This study provides valuable insights into how TT is identified, assessed, diagnosed, and managed by health professionals in Australia. It highlights the perspectives of SLPs on treatment approaches, as well as their views on the availability and adequacy of training and education in this field. The findings suggest the need for a broader understanding of TT management, emphasising the importance of multidisciplinary collaboration and professional development. These insights are globally relevant, as they stress the shared challenges and the value of international collaboration in improving TT diagnosis and treatment practices. Full article

Background: Myofunctional therapy has emerged as a treatment option for obstructive sleep apnea (OSA). The Iowa Oral Performance Instrument (IOPI) enables objective measurement of lingual and orofacial muscle strength, although it was originally designed for evaluating dysphagia. OSA is frequently associated with a hypotonic phenotype characterized by reduced strength in upper airway muscles, but its identification remains unclear. Objective: We evaluated the usefulness of IOPI measurements in identifying hypotonic phenotypes among patients with obstructive sleep apnea (OSA). Methods: We carried out a cross-sectional study analyzing the relationship between IOPI scores, sleep polygraphy metrics—such as the apnea–hypopnea index (AHI)—and findings from physical examination. In addition to the standard IOPI protocol, we introduced novel maneuvers aimed at providing a more comprehensive assessment of oropharyngeal muscle function. Results: Although IOPI conventional maneuvers showed no clear association with AHI or ODI, the inferior tongue maneuver showed higher awake tongue strength, with a statistically significant correlation to both AHI (r = 0.2873; p = 0.008) and ODI (r = 0.2495; p = 0.032). Performing each exercise three times yielded highly consistent results across trials (r > 0.94), but did not significantly alter the overall outcome. Interestingly, lower tongue strength values were observed in patients with a high-arched palate (p < 0.05), whereas no relevant associations were found with the presence of a restricted lingual frenulum or CPAP use. Conclusions: Incorporating specific IOPI maneuvers, especially the inferior tongue exercise, may provide additional insight into muscle function in OSA. Selective repetition is advisable for borderline values. Full article

Objective: This review aimed to examine and highlight the treatment protocols and optimal duration of antibiotic regimens used in managing maxillofacial space infections of odontogenic origin, along with the associated clinical outcomes. Materials and methods: This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD42024621000). A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies from January 2003 to October 2024 using relevant MeSH terms. Studies were selected based on PEO criteria, focusing on the antibiotic treatment protocols and duration for odontogenic maxillofacial space infections, with inclusion of original human research and exclusion of non-relevant or unclear studies. Two independent reviewers performed study selection, data extraction, and risk of bias assessments using the Cochrane RoB 2 and ROBINS-I tools, resolving disagreements through discussion. Results: After data extraction, 277 papers were initially identified. Following the removal of duplicates, 141 articles were screened, of which 64 were selected for full-text assessment and 55 were excluded with justification. Ultimately, nine studies met the inclusion criteria for this review. These included two prospective double-blinded randomized clinical trials (RCTs), two prospective RCTs, four retrospective studies, and one prospective study, all involving patients with dentoalveolar orofacial infections. Risk of bias (RoB) assessment using RoB 2 indicated that two RCTs had a high risk of bias, one had a low risk, and one raised some concerns. ROBINS-I assessment showed moderate risk of bias in three studies, while two were not evaluated. Conclusion: This review concludes that prompt incision and drainage combined with a short-course antibiotic regimen of two to five days is generally effective for managing odontogenic maxillofacial space infections, though further high-quality randomized trials are needed to standardize treatment protocols. Full article

Objective: Given the side effects and reduced efficacy of conventional local anesthetics in inflammatory conditions, there is a compelling need for complementary alternative medicine (CAM), particularly those based on phytochemicals. While a previous study showed that in vivo local injection of (-)-epigallocatechin-3-gallate (EGCG) into the peripheral receptive field suppresses the excitability of rat trigeminal ganglion (TG) neurons in the absence of inflammation, the acute effects of EGCG in vivo, especially on TG neurons under inflammatory conditions, are still unknown. We aimed to determine if acute local EGCG administration into inflamed tissue effectively attenuates the excitability of nociceptive TG neurons evoked by mechanical stimulation. Methods: The escape reflex threshold was measured to assess hyperalgesia caused by complete Freund’s adjuvant (CFA)-induced inflammation. To assess neuronal activity, extracellular single-unit recordings were performed on TG neurons in anesthetized CFA-inflamed rats in response to orofacial mechanical stimulation. Results: The mechanical escape threshold was significantly lower in CFA-inflamed rats compared to before CFA injection. EGCG (1–10 mM) reversibly and dose-dependently inhibited the mean firing frequency of TG neurons evoked by both non-noxious and noxious mechanical stimuli (p < 0.05). For comparison, 1% lidocaine (37 mM), a local anesthetic, also caused reversible inhibition of the mean firing frequency in inflamed TG neurons responding to mechanical stimuli. Importantly, 10 mM EGCG produced a significantly greater magnitude of inhibition on TG neuronal discharge frequency than 1% lidocaine (noxious, lidocaine vs. EGCG, 19.7 ± 3.3% vs. 42.3 ± 3.4%, p < 0.05). Conclusions: Local injection of EGCG into inflamed tissue effectively suppresses the excitability of nociceptive primary sensory TG neurons, as indicated by these findings. Significantly, locally administered EGCG exerted a more potent local analgesic action compared to conventional voltage-gated sodium channel blockers. This heightened efficacy originates from EGCG’s ability to inhibit both generator potentials and action potentials directly at nociceptive primary nerve terminals. As a result, EGCG stands out as a compelling candidate for novel analgesic development, holding particular relevance for CAM strategies. Full article

Background/Objectives: The Nordic Orofacial Test-Screening (NOT-S) is a versatile tool used for the assessment of orofacial function. The aim of this study was to introduce the Polish version of the NOT-S along with the results of its cultural adaptation. Methods: The original NOT-S was validated into the Polish language in accordance with the current questionnaire translation standards, including the cultural adaptation, which consisted of an examination of Polish society. The pilot study, as a cultural adaptation, was carried out among fifty people between the ages of 3 and 34 (Mean—15.8, SD—8.9). Results: During the translation, three word discrepancies were noted, and also many linguistic equivalences, such as semantic, empirical, conceptual, and other differences, were reported. The average total NOT-S score during cultural adaptation was 1.62 (SD 1.16; Range 0–5). Abnormalities in section III, i.e., habits (78%), were found most frequently in the subjects. A thorough data analysis showed statistically significant results in section IV of the interview, i.e., chewing and swallowing (p = 0.00073), and also significant results in section 3 of the examination, i.e., facial expression (p = 0.00006). Conclusions: The Polish version of the NOT-S is linguistically comprehensible and culturally equivalent, and can be used for the examination of children, adolescents, and adults. The findings of this study indicate that orofacial function screening is advisable in the healthy population. Full article

Stomatognathic dysfunctions, particularly bruxism, orofacial pain, and temporomandibular joint (TMJ) disorders, are frequently associated with anxiety and depression. However, the reverse hypothesis that these dysfunctions may act as peripheral stressors contributing to neuropsychological imbalance by activating the hypothalamic–pituitary–adrenal (HPA) axis remains underexplored. Objective: To assess the relationship between the severity of stomatognathic symptoms and both physiological and psychological stress markers to determine whether such dysfunctions may influence or exacerbate anxiety and depressive disorders. Methods: A cross-sectional observational study was conducted on 120 adult patients. Clinical assessment was included evaluation of TMJ function, bruxism, and orofacial pain. Psychological screening was performed using validated questionnaires (GAD-7 for anxiety and PHQ-9 for depression). Electromyographic (EMG) analysis of the masseter and temporalis muscles was conducted, along with the quantification of salivary cortisol using an enzyme-linked immunosorbent assay (ELISA). Multiple regression models were applied to identify statistically significant correlations (p < 0.05). Results: A positive correlation was found between the severity of stomatognathic dysfunction and scores on anxiety and depression measures, along with elevated salivary cortisol levels and increased masticatory muscle activity. Conclusions: These findings suggest a bidirectional relationship between stomatognathic dysfunctions and neuropsychological status, underscoring the potential value of integrated therapeutic approaches that combine dental care with psychological support. Full article

Background/Objectives: Acromegaly is a rare chronic disease caused by excess growth hormone (GH) and insulin-like growth hormone 1 (IGF-1) due to a pituitary adenoma. In acromegaly patients, oral and facial manifestations, such as mandibular growth, macroglossia, and dental malocclusion, are common and can affect quality of life. The aims of the present study were to evaluate the diagnostic path of these patients, the impact that acromegaly had on their oral health, the medical figures involved, and the role played by their dentist. Methods: The data were collected via an anonymous questionnaire to study dental health, dental care, and acromegaly diagnosis and history and via validated questionnaires. The validated questionnaires used were the ESS (Epworth Sleepiness Scale) to assess daytime sleepiness, OHIP-14 (Oral Health Impact Profile-14) to study perceptions of oral health, and AcroQoL to explore quality of life. Results: We enrolled 90 acromegaly patients: 48% of the patients reported acromegaly oral manifestations and 73% reported facial changes. The most frequent oro-facial manifestations reported by the patients were jaw growth (41%), diastema (40%), macroglossia (39%), and increased size of cheekbones (35%). The median OHIP-14 value was 5 (min 0–max 43), and the highest values were recorded in the questions relating to pronunciation difficulties and problems eating due to dental problems, as well as discomfort with dental aesthetics. The patients’ sleep quality was rated as good by 33% of patients, decent by 47%, and bad by 20%. The median ACROQol score achieved by the patients was 69 (min 19, max 98). An inverse and statistically significant correlation was observed between OHIP-14 and AcroQoL scores (Spearman correlation coefficient—0.44, p = 0.0002). Conclusions: Oro-facial changes significantly affect quality of life in cases of acromegaly, yet dental professionals’ involvement in diagnosis and management is limited. Greater awareness among and integration of dental professionals could support earlier detection and improve patient outcomes. Full article

Objectives: Oro-facial trauma affects physical, psychological, and social well-being. This study assesses changes in oro-facial trauma hospitalisation rates among adults during the pre-lockdown period, ‘lockdown year’, and post-lockdown period in Australia and the United Kingdom (UK). The findings provide insights into healthcare delivery and resource allocation during public health emergencies to inform future preventive strategies. Methods: Hospitalisation data for adults (aged 20+) with oro-facial trauma, classified using ICD-10 codes, were collected. Age-standardised rates (ASRs) per 100,000 population were calculated for each period. Comparative analyses evaluated hospitalisation rates during the ‘lockdown year’ relative to three years before and after. The 11 oro-facial trauma ICD codes were grouped into major and minor trauma to evaluate differential impacts. Results: This study highlighted a statistically significant reduction in oro-facial trauma hospitalisation rates during the ‘lockdown year’ in both Australia (38.8%) and the UK (35.7%) compared to the pre-lockdown period. Although rates increased post-lockdown, they remained lower than pre-lockdown levels, with a 35.5% reduction in Australia and a 25.1% reduction in the UK. Additionally, while the ASR significantly increased for major trauma in the post-lockdown years compared to the lockdown year, the increase for minor trauma was not statistically significant in both countries. Conclusions: COVID-19 lockdowns led to a significant reduction in oro-facial trauma hospitalisations. Post-lockdown rates increased as activities resumed but did not return to pre-lockdown levels, suggesting lasting behavioural shifts. These findings highlight the role of external factors (e.g., mobility and social behaviour) in oro-facial trauma rates and can inform targeted preventive strategies for high-risk periods. Full article

Background and Objectives: Sleep and pain are non-motor symptoms encountered frequently in Parkinson’s disease (PD). Several subtypes of pain have been identified in PD, with different associations with other non-motor symptoms. To evaluate the prevalence of various subtypes of pain in a PD cohort and their associations with sleep disturbances and quality of sleep. Materials and Methods: In this study, 131 consecutive PD patients were assessed, focusing on pain and sleep using several validated scales and questionnaires. Results: According to KPPQ, the most reported types of pain were musculoskeletal pain (82.44%), nocturnal pain (58.77%), and radicular pain (55.72%). “Bad sleepers” (PSQI score > 5) reported significantly more pain than “good sleepers” regarding all KPPS subdomains, with statistically significant differences observed in the following domains: musculoskeletal pain (5.48 ± 3.50 vs. 2.70 ± 2.67, p < 0.001), chronic pain, specifically central pain (1.19 ± 2.01 vs. 0.15 ± 0.71, p = 0.004), nocturnal pain, specifically pain related to akinesia (2.26 ± 2.74 vs. 0.64 ± 1.22, p = 0.001), and radicular pain (4.35 ± 4.20 vs. 2.45 ± 3.55, p = 0.022). The prevalence of sleep disturbances was higher in patients with nocturnal pain (odds = 1.165, 95% CI: 1.064–1.276, p = 0.001), orofacial pain (odds = 1.108, 95% CI: 1.051–1.167, p < 0.001), and radicular pain (odds = 1.015, 95% CI: 1.015–1.149, p = 0.015). Conclusions: Pain is common in PD patients with sleep disorders. Identifying specific types of pain that are associated with sleep disorders and their correct management may improve sleep quality. Full article

Background/Objectives: This study aimed to assess the knowledge of dental injuries in both soccer coaches and players, as well as the impact of educational intervention on coaches and the prevalence of traumatic dental injuries and mouthguard usage among soccer players. Methods: The study involved 94 male soccer players (median age 18, IQR: 12–19) and 39 coaches. Data were collected through questionnaires covering age, gender, years of experience, injury history, mouthguard use, and knowledge of tooth rescue kits and tooth repositioning. Results: Of the players, 34 (36.2%) experienced orofacial injuries during soccer, while only 7 (7.4%) used mouthguards. Reasons for not using mouthguards included discomfort (26.1%), belief they are unnecessary (26.1%), and difficulty purchasing them (8.0%). Among coaches, 24 (61.5%) reported handling dental injuries during training, including crown fractures (41.7%), tooth avulsions (33.3%), and tooth luxations (25.0%). Only four (10.3%) coaches personally used mouthguards. Conclusions: The study identified a significant lack of knowledge about dental injuries and limited use of mouthguards among Croatian soccer players. Coaches, while influential in athlete development, should also focus on injury prevention, including dental trauma. Full article

Background and Objectives: Pain in the TMJ is the second most common in the orofacial region. The objective of this systematic review was to assess whether a decrease in estrogen levels increases the risk of idiopathic condylar resorption by reviewing relevant literature and evidence. Material and Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search was performed in the PubMed (Medline), Science Direct (Elsevier), and Web of Science electronic databases. Results: The initial database search identified a total number of 453 studies. After applying the selection criteria, 36 articles were selected for a full-text analysis, and nine studies involving 1105 patients were included in the systematic review. According to the Newcastle–Ottawa Scale (NOS), two of the included articles were graded as being of “Moderate” quality and one was of “Fair” quality. After evaluating the rest of the articles according to the AXIS tool for cross-sectional studies, we generally found that the reliability is moderate. The results show that the decrease in estrogen promotes the occurrence of inflammation in the temporomandibular joint, and some sources mention that it increases the occurrence of idiopathic joint resorption, but we did not establish a complete correlation between the level of estrogen and idiopathic joint resorption. Conclusions: This systematic review indicates that there is no evidence suggesting that fluctuations in estrogen levels contribute to idiopathic mandibular condylar resorption, but reduced estrogen levels can be associated with chronic pain in the temporomandibular joint. Full article