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To prevent single-implant overdenture (SIO) fracture, the inclusion of a framework in the overdenture has been suggested. However, no investigations verified their benefits.To evaluate prosthetic maintenance events, patient satisfaction, and mastication of SIO reinforced by metallic framework users.Fifteen volunteers had a new set of complete dentures converted into an SIO containing a framework. Maintenance events were recorded, while patient satisfaction was assessed using a visual analog scale. Masticatory performance (MP) was evaluated using the sieving method, maximum bite force (MBF) by pressure sensors, and masseter thickness by ultrasound. Measurements were performed 2, 12, and 24 months after SIO use. Repeated-measures ANOVA and paired Student's t-tests (p 0.05) were applied.Matrix exchange was the most prevalent maintenance event (83.6%), and no SIO was fractured during the entire follow-up. Satisfaction with the SIO stability decreased (p 0.01) after 12 months. MP did not change between evaluations (p 0.05). Conversely, MBF and masseter thickness improved after 12 and 24 months of SIO use (p 0.05).Reinforced SIO did not fracture during 2 years but requires maintenance. It improves bite force and muscle thickness, maintaining MP values. Satisfaction with SIO stability decreased in the first year of use.

To assess the frequency of reported masticatory muscles activity during wakefulness (i.e., awake bruxism [AB]), levels of anxiety, depression, stress, and the oral health-related quality of life (OHRQoL) in college preparatory students.Sixty-nine college preparatory students participated in the study. AB was evaluated by the Oral Behaviors Checklist (OBC) and a smartphone-based ecological momentary assessment (EMA; [Bruxapp®]). Anxiety and depression were measured by the Hospital Anxiety and Depression Scale, stress was evaluated by the Perceived Stress Scale, and OHRQoL was obtained by The Oral Health Impact Profile-14. Data were analyzed by Pearson's correlation coefficient (α = 0.05).The average EMA-reported frequency of AB behaviors was 38.4%. Significant correlations were found between AB and the OBC, anxiety, depression, stress, and OHRQoL (p0.001).College preparatory students demonstrated moderate frequency of AB, which was significantly correlated with psychosocial factors.

Objective: To evaluate the maximum bite force (MBF), masticatory performance and oral sensory function (OSF) of frail edentulous elderly. The correlation of MBF with maximum grip strength (MGS) was also assessed. Methods: Twenty edentulous elderly [10 with and 10 without the frailty phenotype (FP)] were selected to participate in this case–control study. The FP was diagnosed using the criteria of Fried et al., which consider weight loss, exhaustion, physical activity level, weakness and slowness to the evaluation. All volunteers received new complete dentures (CDs) to standardise the occlusal status, and after 2 months of use with no complaint, all variables were assessed. MBF was measured by pressure sensors positioned bilaterally on the first artificial molars. Masticatory performance was assessed using the sieving method and was expressed as the median particle size (X(50)) of Optocal after 40 masticatory cycles. OSF was evaluated using the oral stereognosis test, and MGS was measured using a dynamometer. Groups were compared using one-way analysis of variance. The Pearson coefficient of correlation between MBF and MGS was calculated. Results: Frail elderly people showed reduced MBF (P = 0.0431) and larger X(50) values (P = 0.0053) than did non-frail elders, while OSF did not differ between the groups. MBF had a moderate positive correlation with MGS (r = 0.690, P = 0.003). Conclusions: Frail elderly had reduced MBF and impaired mastication. On the other hand, OSF does not seem to be affected by frailty. MBF was moderately correlated with MGS.

AIMS To compare the effect of new complete dentures (CDs) on self-perceived masticatory ability (MA) and oral health-related quality of life (OHRQoL) in frail and nonfrail elders. METHODS AND RESULTS Twenty completely edentulous elders were assigned to two groups: frail and nonfrail (n = 10/each). MA was evaluated using a visual analogue scale. OHRQoL was assessed with the Oral Health Impact Profile (OHIP-Edent). Variables were evaluated with volunteers wearing their old and unsatisfactory CDs. Then, a new set of CDs was manufactured and all outcomes were reassessed 2 months after the insertion. Data were analyzed by repeated measures' analyses of variance and Tukey tests. MA for lettuce and peanuts was improved (P

Denture adhesives improve the mastication of complete denture wearers. However, the impact of denture adhesives with different presentations on mastication remains unclear.The purpose of this systematic review was to answer the focused question, "Do different presentations of denture adhesives affect the masticatory function of complete denture wearers?".This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and the non-peer-reviewed literature were searched up to July 2021. Only clinical studies (randomized clinical trials and nonrandomized clinical trials) comparing the use of different denture adhesive presentations (cream, powder, or strips) were included, without language or follow-up restrictions. The risk of bias was assessed by using the Cochrane tools (RoB 2.0 and ROBINS-I). Masticatory performance, by using single and multiple sieves, masticatory performance with color-changing chewing gum (mixing ability), swallowing threshold (particle size and number of cycles), jaw kinematics, and occlusal force were considered. Meta-analyses were conducted to evaluate masticatory performance (single sieve) and occlusal force outcomes (α=.05), and the certainty of the evidence was determined with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) evaluations.Nine studies (6 randomized and 3 nonrandomized clinical trials) were included. The risk of bias was considered moderate. Meta-analyses showed no differences between cream and powder denture adhesives for masticatory performance (standard mean difference=0.02; 95% CI=-0.46 to 0.50, P=.93) or between cream and strip denture adhesives for occlusal force (mean difference=14.35; 95% CI=-11.14 to 39.84, P=.27). Similarly, in qualitative analysis, cream and powder denture adhesives' performances were similar regarding masticatory performance with color-changing chewing gum (mixing ability), occlusal force, swallowing threshold (particle size and number of cycles), and jaw kinematics (P.05). However, for resorbed ridges, cream denture adhesive resulted in a higher masticatory performance than strip (P.05). When comparing powder to strip denture adhesives, the occlusal force was higher in the powder group (P.05). The certainty of evidence was very low for all evaluated outcomes.Different presentations of denture adhesives seem to improve the masticatory function of complete denture wearers in a similar way. However, the qualitative analysis showed that, in patients with a resorbed ridge, a cream denture adhesive may be better than strips to improve mastication, although the certainty of evidence was very low.

PURPOSE To compare maximum bite force, masseter thickness, and oral health-related quality of life (OHRQoL) in elderly patients rehabilitated with conventional complete dentures (CDs) and single-implant overdentures (SIOs). MATERIALS AND METHODS A paired design was conducted, and 12 elderly patients were selected. Initially, a set of new CDs was manufactured and placed. After a 2-month adaptation period, the mandibular CD was transformed into an SIO by inserting one osseointegrated implant into the symphysis region. All variables were evaluated 2 months after both treatments (CD and SIO). Maximum bite force was evaluated using pressure sensors, while masseter thickness was obtained via ultrasound during muscle contraction and relaxation. The Oral Health Impact Profile for edentulous people (OHIP-Edent) was used to measure OHRQoL. Data were analyzed using Student t test and Wilcoxon test. Pearson coefficient of correlation between bite force and masseter thickness was calculated. RESULTS Values for maximum bite force and masseter thickness during contraction increased significantly after SIO use (P < .001), indicating an improvement in muscle function. Considering OHRQoL, the general score and the domains functional limitation and physical pain were reduced (P < .05), indicating better perception of OHRQoL, with SIO use. Moreover, masseter thickness during contraction was moderately correlated with bite force (r = 0.480; P = .018). CONCLUSION Using SIO increased the maximum bite force and masseter thickness of elderly patients, leading to an improved OHRQoL.

BoNT-A has been widely used for TMD therapy. However, the potential benefits compared to dry needling techniques are not clear. Objective this study aimed to compare the immediate effects of botulinum toxin type A (BoNT-A) injections and Acupuncture in myofascial temporomandibular disorders (TMD) patients. Methodology 54 women were divided into three groups (n=18). AC patients received four sessions of traditional acupuncture, being one session/week during 20-min. BoNT-A patients were bilaterally injected with 30U and 10U in masseter and anterior temporal muscles, respectively. Moreover, a control group received saline solution (SS) in the same muscles. Self-perceived pain was assessed by visual analog scale, while pressure pain threshold (PPT) was verified by a digital algometer. Electromyographic evaluations (EMG) of anterior temporal and masseter muscles were also measured. All variables were assessed before and 1-month after therapies. The mixed-design two-way repeated measures ANOVA and Tukey’s post-hoc tests were used for analysis, considering a=0.05. Results Self-perceived pain decreased in all groups after one month of therapy (P

Teeth absence in the anterior region of the maxilla can lead to psychosocial impairments, especially in young patients. Thus, the treatment of congenital agenesis of upper lateral incisors should consider prosthetic, restorative, and periodontal approaches to recover the patient's social and aesthetic functions. This article aims to present the case report of a 23-year-old male patient, who visited the Prosthodontic Clinic of the Piracicaba Dental School for the treatment of congenital agenesis of teeth 12 and 22. Implant-supported metal-free ceramic crowns, homemade dental bleaching, and restoration of maxillary canines with composite resin were planned. In addition, to improve gingival thickness around the peri-implant region of tooth 12, a periodontal surgery was performed using the vestibular tunnel access surgical technique (VISTA - Vestibular Incision Subperiosteal Tunnel Access). Thus, a multidisciplinary approach in the treatment of congenital agenesis of the upper lateral incisors has proved to be a reliable alternative to achieve patient's functional and aesthetic demands. La ausencia de dientes en la región anterior del maxilar puede provocar alteraciones psicosociales, especialmente en pacientes jóvenes. Así, el tratamiento de la agenesia congénita de incisivos laterales superiores debe considerar abordajes protésicos, restauradores y periodontales para recuperar las funciones sociales y estéticas del paciente. Este artículo tiene como objetivo presentar el caso clínico de un paciente masculino de 23 años que acudió a la Clínica de Rehabilitación Oral de la Facultad de Odontología de Piracicaba para tratar la agenesia congénita de los dientes 12 y 22. Se planificaron coronas cerámicas libres de metal en implantes, blanqueamiento dental casero y restauración con resina compuesta de caninos superiores. Además, para mejorar el grosor gingival alrededor de la región periimplantaria del diente 12, se realizó cirugía periodontal utilizando la técnica quirúrgica para acceder al túnel vestibular (VISTA - Acceso al túnel subperióstico de incisión vestibular). Así, el abordaje multidisciplinar en el tratamiento de la agenesia congénita de los incisivos laterales superiores ha demostrado ser una alternativa satisfactoria para cumplir las demandas funcionales y estéticas del paciente. A ausência de dentes na região anterior da maxila pode levar a comprometimentos psicossociais, especialmente em pacientes jovens. Assim, o tratamento da agenesia congênita de incisivos laterais superiores deve considerar abordagens protéticas, restauradoras e periodontais para recuperar as funções social e estética do paciente. Este artigo tem como objetivo apresentar o relato de caso de um paciente do sexo masculino, 23 anos, que procurou o Ambulatório de Prótese da Faculdade de Odontologia de Piracicaba para tratamento de agenesia congênita dos dentes 12 e 22. Foram planejadas coroas cerâmicas sem metal sobre implantes, clareamento dental caseiro e restauração dos caninos superiores com resina composta. Além disso, para melhorar a espessura gengival ao redor da região peri-implantar do dente 12, foi realizada cirurgia periodontal por meio da técnica cirúrgica de acesso ao túnel vestibular (VISTA - Vestibular Incision Subperiosteal Tunnel Access). Assim, a abordagem multidisciplinar no tratamento da agenesia congênita dos incisivos laterais superiores demonstrou ser uma alternativa satisfatória para suprir demandas funcionais e estéticas do paciente.

Objective: To verify the level of agreement among different indexes used to achieve the prevalence of Temporomandibular Disorders (TMD). Material and Methods : One hundred one dental students were selected by a randomized process. TMD were evaluated by the Fonseca’s Anamnestic Index (FAI), Helkimo’s Clinical Index (HCI), and the Research Diagnostic Criteria for TMD (RDC/TMD). Data was analyzed using Chi-square and Kappa tests, considering a significance level of 5%. Results: HCI showed the highest prevalence of TMD, and the comparison between RDC/TMD, FAI, and HCI showed low agreement (k=0.17 and k=0.35 respectively). Most individuals presented mild TMD for both FAI and HCI indexes. A moderate correlation for TMD severity was obtained (k w =0.53) between FAI and HCI, and a high sensitivity and low specificity were observed for both diagnosis when compared to RDC/TMD. Conclusion : The prevalence of TMD may vary significantly depending on the index used for its diagnosis, which may lead to a large number of false positives and overtreatments. Keywords: Epidemiology; Prevalence; Temporomandibular joint; Temporomandibular joint disorders; Young adult.

Objective: To evaluate the relationship between temporomandibular disorders (TMD) and craniocervical posture in the sagittal plane measured from lateral radiographs of the head. Methods: The sample was comprised of 80 randomly selected students of dentistry at the Federal University of Rio Grande do Norte. Research Diagnostic Criteria for TMD (RDC/TMD) was used to evaluate the signs and symptoms of TMD. Lateral radiographs of each individual were used to measure the position of the hyoid bone, the craniocervical angle, and the occiput–atlas distance. A chi-square test was used to evaluate the relationships between craniocervical posture measures and TMD. Results: No relationship was found between TMD and the craniocervical posture measured by the positioning of the hyoid bone, head rotation, and the extension/flexion of the head (p > 0.05). Conclusion: It can be concluded, therefore, that no relationship exists between cervical posture in the sagittal plane and TMD.

The objective of the study was to conduct a systematic review of the literature assessing the effects of botulinum toxin (BoNT-A) injections in the management of bruxism. Search for articles involved the PubMed, Scopus, Web of Science, Embase, Cochrane, Scielo and Lilacs databases. Specific terms were used and the search carried out from 1980 to March 2016 by three independent researchers. Randomized controlled studies (RCTs), prospective and before–after studies that applied BoNT-A at the masseter and/or temporalis muscles were included. Three RCTs and two uncontrolled before–after studies out of 904 identified citations were included in this review. All five articles dealt with sleep bruxism and featured a small sample size. None of them was about awake bruxism. Two randomized clinical trials were double-blinded, with a control group using saline solution. Two studies used polysomnography/electromyography for sleep bruxism diagnosis, whilst others were based on history taking and clinical examination. All studies using subjective evaluations for pain and jaw stiffness showed positive results for the BoNT-A treatment. In contrast, the two studies using objective evaluations did not demonstrate any reduction in bruxism episodes, but a decrease in the intensity of muscles contractions. Despite the paucity of works on the topic, BoNT-A seems to be a possible management option for sleep bruxism, minimizing symptoms and reducing the intensity of muscle contractions, although further studies are necessary especially as far as the treatment indications for bruxism itself is concerned. BoNT-A has been increasingly diffused in dentistry over recent years, being also used for pain management in patients with bruxism. Nonetheless, there is no consensus about its effects in this disorder.

Occlusal devices are the gold standard for managing the signs and symptoms of sleep bruxism (SB). Nevertheless, their influence on the tongue, quality of life, and sleep quality is not clear.The purpose of this prospective clinical study was to evaluate the effects of an occlusal device on maximum tongue force, oral health-related quality of life (OHRQoL), and subjective sleep quality in individuals with SB. The correlation between maximum tongue force and tongue size and that between tongue size and dental arch size ratio were also assessed.SB was diagnosed by clinical examination and by using the Bruxoff device. Fifteen bruxers received occlusal devices, and another 15 received palatal devices without occlusal coverage (control). Maximum tongue force was measured by using force sensors, while the Oral Health Impact Profile (OHIP-14) was used to evaluate OHRQoL. Subjective sleep quality data were obtained by using the Pittsburgh Sleep Quality Index (PSQI). Tongue size was measured by ultrasonography, while the dental arch size was considered as the distance between the mandibular right and left first molars. After baseline measurement, participants used the devices at night, and the variables were reevaluated after 30 and 60 days. Comparisons between groups and among time points were performed with analysis of variance in a generalized linear mixed model and Tukey-Kramer test as post hoc. Correlations were analyzed by the Pearson test.Maximum tongue force decreased after wearing both devices for 30 days (P.001). OHIP-14 and PSQI scores also reduced on day 30 (both P.001). Maximum tongue force was not correlated with tongue size nor the ratio between tongue size and dental arch size.Intraoral devices reduced maximum tongue force and improved OHRQoL and subjective sleep quality in bruxers.

AIMS To evaluate masticatory function and oral sensorimotor ability (OSA) in elders with Parkinson's disease (PD) during the levodopa on and off-periods. METHODS AND RESULTS Participants were 11 partially and completely edentulous elders with PD. Masticatory function was evaluated by mandibular movements, maximum bite force (MBF), and masticatory performance (MP). Mandibular movements reflecting jaw range of motion (ROM) and jaw movements while chewing silicone test material (Optocal), were evaluated using a kinesiograph. MBF was assessed by strain sensors, and MP was determined using the median Optocal particle size (X50 ) after 40 masticatory cycles. OSA was evaluated using oral stereognosis test scores and response time. Evaluations were carried out 30 min before levodopa intake (off-period) and within a 3-day interval 1 h after levodopa intake (on-period). Data were analyzed by Student's t-test, considering a significance level of 5%. During the levodopa off-period, elders showed decreased ROM during protrusion and lateral movements, while no difference was found in maximum opening and mandibular movements during chewing. MBF was lower and X50 was higher during the off-period, indicating worse mastication. However, OSA did not differ between the evaluated times. CONCLUSION Elders with PD had impaired mastication during the levodopa off-period, although OSA was not altered.

Objective: To compare the mastication and oral sensory function of individuals with and without sleep bruxism. Methods: The sample comprised 60 volunteers, of which 30 were bruxers (mean age = 30.5...

Background Several studies have described high levels of psychosocial disorders in patients with temporomandibular disorders (TMD), but an estimate of their prevalence in populations of TMD patients has never been assessed systematically. Objective To conduct a systematic review of the literature on the prevalence of research diagnostic criteria for TMD (RDC/TMD) Axis II findings in TMD patients. Methods Search for articles was carried out by two independent researchers to retrieve papers published after 1992. Inclusion was reserved to observational studies with a minimum sample size of 100 individuals, which used RDC/TMD diagnostic protocol. Quality assessment was performed with the adoption of the methodological evaluation of observational research (MORE). Results A total of 1186 citations were obtained from search strategy, but only 14 filled the inclusion criteria. Included papers reported somatisation, depression and/or pain-related disability prevalence or scores from populations of 12 different countries. A broad range in the prevalence of moderate-to-severe somatisation in patients with TMD was observed, ranging from 28.5% to 76.6%. Similar results were found for depression, with moderate-to-severe levels in 21.4%-60.1% of patients. Finally, most patients were rated as grade I or II of the Graded Chronic Pain Scale, whereas high pain-related impairment was present in 2.6% to 24% of the individuals. Conclusion The prevalence of severe-to-moderate somatisation and depression was high in TMD patients, while severe physical impairment was not commonly reported.

To evaluate the prevalence of temporomandibular disorder (TMD) in dental students and its correlation with anxiety.After probability sampling, 105 students were selected. The diagnosis of TMD was carried out using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I; the anxiety level was obtained by the State-Trait Anxiety Inventory (STAI). Data from TMD and anxiety were calculated through frequency and Chi-square test to assess the association between TMD and anxiety, considering a significance level of 5%.TMD was present in 36.2% of the students; disc displacement (42.1%), and arthralgia (42.1%) were the most prevalent subtypes. The majority of students presented both traits (57.1%) and state (65.7%) anxiety in mild levels, followed by moderate levels. No statistical association between TMD and anxiety was found (p 0.05).Joint TMD was the most prevalent subtype of TMD in dental students and was not associated with anxiety levels.

To compare the oral health-related quality of life (OHRQoL) and sleep quality of subjects with and without sleep bruxism (SB). Participants of both genders were assigned as bruxers (n = 30, age 21–45 years) and non-bruxers (n = 30, age 24–40 years). SB was clinically diagnosed and confirmed with an electromyography/electrocardiograph portable device (Bruxoff). The OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14). The sleep quality was determined using the Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires. OHIP-14, PSQI, and ESS data were analyzed by one-way ANOVA, considering a significance level of 5%. Bruxers had worse OHRQoL (mean = 16.43) than controls (mean = 4.1), with an effect size (ES) of 1.58. Moreover, SB volunteers showed the highest PSQI scores (mean = 7.07; ES = 0.82) and excessive daytime sleepiness (mean = 10.33; ES = 0.65), compared to non-bruxers (means = 4.7 and 7.8, respectively). SB may be associated with a negative impact on OHRQoL and sleep quality. Determining that SB may have a marked role in OHRQoL and sleep quality is important for dental professionals establish proper multifactorial management, and understand patient-related psychosocial aspects.

Oral rehabilitation with mandibular single-implant overdentures (SIO) has been characterized as a solution to improve retention and stability of conventional complete dentures (CD). Among the benefits of this therapy, it can be mentioned minimally invasive surgery, simple prosthetic technique, better retention, and significantly reduced costs. However, the application of this protocol in daily clinic is still not widespread. Aim: Thus, this study aimed to perform a literature review to address the clinical characteristics of this rehabilitation, when compared to two-implant mandibular overdentures and CD. Methods: For this, searches were conducted in the PubMed, Scopus and Scielo databases, considering articles published in English language, without date limitation. Results: It was found 243 manuscripts, of which 20 were compatible with the aim of this study after title/ abstract reading. The selected papers focused on masticatory muscles function, satisfaction levels and self-reported quality of life, as well as surgical and prosthetic outcomes, such as need of maintenance and repair, costs, and implant failure rates. All evaluated manuscripts showed similar masticatory function and patients’ satisfaction with SIO and two-implant overdenture, while results for SIO were greater when compared to rehabilitations with CD. In addition, SIO costs were half of the TIO, and SIO have proven to do not damage the implant, being implant loss close to zero. However, the prosthesis fracture adjacent to the implant was a recurrent clinical outcome, which requires further studies to solve this impairment. Conclusion: Thus, it can be concluded that SIO represents an alternative treatment for frail elders or low-income patients, by increasing masticatory function and improving quality of life.