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Temporomandibular joint (TMJ) involvement with bone resorption of the mandible is a rare complication in systemic sclerosis (SSc), leading to restrictive mandibular movements, malocclusion, difficult swallowing and mastication, and subsequently altered nutrition. We report a case of SSc-related TMJ pathology in a 23-year woman, emphasizing the relevance of advanced imaging. Extensive bone resorption of mandibular condyle reveled on dental panoramic image explains the malocclusion and impaired interincisal opening, while CBCT demonstrates reshaping of the mandibular condyle with cortical lysis, osteophytes, decreased height and flattening. Furthermore, electromyography confirms masticatory muscles involvement.

The term “diabetes mellitus” includes a varied number of chronic diseases characterized by hyperglycemia and relative or absolute insulin deficiency. Hyperglycemia is the most obvious biochemical marker in the complex of metabolic changes that affect carbohydrate, lipid, protid and electrolyte metabolism and can alter many organs and functions of the whole organism.The diagnosis of diabetes is based on clinical signs and laboratory explorations. The clinical picture is typical in about half of the cases and the main signs are polyuria, polydpsia, weight loss. In addition to these, others may be present in the clinical picture: asthenia, fatigue, decreased physical and intellectual strength, polyphagia. Sometimes, the diagnosis of diabetes can be revealed by the presence of signs of infectious complications, of the symptoms and signs of acute metabolic complications of diabetes or of the symptoms and signs of chronic degenerative complications. The terms of insulin-dependent and non-insulin-dependent have been eliminated, in favor of type 1 diabetes and type 2 diabetes. Type 1 is caused by autoimmune destruction of pancreatic beta cells, resulting in absolute insulin deficiency. Type 1 includes idiopathic and immune-mediated forms of β-pancreatic cell dysfunction that result in total insulin deficiency. Diabetes LADA (latent autoimmune diabetes in adults) is a recently recognized category of diabetes mellitus, which falls within the complex of type 1 diabetes. The study group consisted of 96 patients, 38 women (39.58%). and 58 men (60.42%) with oral manifestations in patients with diabetes and obesity.

Professional activity of a dental practitioner is widely recognized not only for the excessive biomechanical stress of the spine and the peripheral joints, but also for the high percentage of axial and peripheral musculoskeletal disorders. The aim of this study was to identify the risk factors and their consequences on the cervical spine in a cohort of dental practitioners who are currently involved in endodontic therapy. We included 30 dentists who worked daily in private offices in Iasi and in the Iasi county area. They were classified as belong to group A or B based on specific ergonomic criteria. We performed a complex analysis of all the participants in the current study based on a standard questionnaire aiming to identify if specific ergonomic measures may positively influence the musculoskeletal morbidity in dental practitioners. the endodontic field of the professional activity also generates different pathological conditions at this level. As a consequence, chronic pain, paresthesias, decreased muscle strength developed on a background of X-ray modifications including the malalignment of the cervical spine and degenerative disco-vertebral processes are commonly reported among dental practitioners, especially in those performing their daily activities in a non-ergonomic environment.

Rheumatoid arthritis (RA) is one of the main chronic inflammatory rheumatic disorders characterized by chronic destructive peripheral arthritis as well as a wide range of systemic features, resulting in irreversible damage, significant disability, functional impairment and altered quality of life. Clinical temporomandibular joint (TMJ) involvement is commonly reported in up to 80% of RA patients. Although conventional radiological examination remains an important tool for diagnosis and assessment of TMJ disease, newer modern techniques including TMJ ultrasound, CT and cone beam CT (CBCT) are largely available and able to depict earlier changes in the TMJ. This report presents the clinical case of an established RA, emphasizing the potential diagnostic algorithm and therapeutic options for TMJ arthritis

The main aims of this paper were (i) to identify the pathology that occurs in the dentist’s hand in relation to different professional risk factors, particularly the trapezio-metacarpal osteoarthritis – a painful and highly disabling entity related to subluxation or dislocation complications, and (ii) to highlight the role of kinetotherapy for the prevention as well as therapy of the dentist’s hand. We enrolled twenty experienced dentists selected according to several inclusion criteria: a daily program of minimum 6 working hours, more than 15 years of professional experience, performing all techniques and procedures commonly encountered in a dental office. Dentists included in our research were classified in two main groups: group A performing an individual kinetotherapy program and group B without the kinetic program. Individualized kinetic programs aiming to reduce pain, restore joint mobility, tone different muscle groups and improve coordination are successful in refining work-related hand pathology in dentists.

Temporomandibular joint (TMJ) may be involved in different JIA subtypes, with a prevalence ranging between 40 to 70%, leading to various degrees of disability, mainly related to pain, inflammation, reduced mandibular mobility, damage of the condyle and secondary masticatory muscle impairment. The aim of the present work was to describe TMJ involvement in different subtypes of JIA, based on a complex epidemiological, clinical and imaging approach. We performed a prospective observational study on 22 consecutive JIA attending an academic rheumatology department. Imagistic assessments comprised: (i) an X-ray of vertebral (lumbar and cervical spine) as well as peripheral joints in order to support the diagnosis and to evaluate the stage of the disease; (ii) a TMJ ultrasonography; (iii) a TMJ CT scan; and (iv) a CBCT. The following parameters were evaluated in our patients: demographics and general characteristics (sex, age, duration of disease, JIA onset); TMJ-related data e.g. spontaneous or provoked unilateral or bilateral TMJ pain measured on a visual analog scale (VAS), accompanied by morning stiffness or stiffness after rest; clicking and crepitation were noted in the context mandible mobilization; muscle contracture (masseter, temporal, internal pterygoid); parafunctions; TMJ imaging; dental, gingival and occlusal status. TMJ involvement is classically described among JIA patients, presenting with various clinical signs and symptoms and different degrees of inflammation and condylar damage.

Dentistry is acknowledged as an outstandingly practical domain of medicine, with an excessive and extensive role of the hand acting in a professional dental environment, with specific working postures, repetitive movements and using different dental instruments. The main objective of our study was to evaluate occupational-hand pathology in dentists and potential trigger factors and to highlight the role of physical therapy in preventing and management of different musculoskeletal issues in dentistry settings. We performed a prospective 12-months study on 30 dentists (20 women), aged between 30 and 60 years, working in private practice aiming to assess professional hand involvement. Enrolled dentists were classified in two equal groups, according to their participation in a kinetic program: group A, dentists performing an individual kinetic program on a daily basis, and group B, dentists without being involved in a physical therapy program. All subjects were followed-up for 12 months. A specific questionnaire derived from the Cornell Musculoskeletal Discomfort Questionnaire was applied in all cases, evaluating different musculoskeletal items such as pain, paresthesias, muscle spasm and amyotrophy, but also joint mobility (wrist, metacarpophalangeal joints).Work-related hand pathology is widely confirmed among dentists, specifically connected to different professional factors such as working postures and movements, number of working hours, cumulative time and experience, as well as type of devices and tools handled. Moreover, dentistry performed according to ergonomic settings is essential in order to reduce the burden of musculoskeletal features and to improve related disability and working performance. Work-related hand pathology accounts for significant morbidity and physical discomfort among dental professionals. With a multifaceted pathobiology ranging from inflammatory to degenerative damage of both soft tissue, nerve and joints (wrist and fingers), musculoskeletal issues are typically linked to professional triggers during routine practice in dentistry.

The burden of work-related musculoskeletal pathology among dental professionals is widely recognized, particularly associated with specific risk factors in routine practice. Aim of the study: The main objective of our study was to evaluate musculoskeletal issues in students in dentistry based on their participation in different levels of professional activities, and to identify potential risk factors. Material and methods: We performed a cross-sectional study in 100 consecutive students attending the School of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, classified in two main groups: 50 students in their first and second year of study, not engaged in specific dental work (group A) and 50 students in their third to sixth year, already performing professional activities in patient (group B). A predefined questionnaire survey was applied in all students, including general data, risk factors for musculoskeletal problems, and information on pain (vertebral, hand) and muscle spasm as main musculoskeletal complains potentially related to their professional doings. Conclusions: Ergonomic postures adopted by the student / dentist in routine practice as well as ergonomic dental instruments are usually associated with less vertebral (lumbar spine) and hand pathology. Ergonomic principles must be applied in routine dental practice and the student educated about prevention of musculoskeletal pathology.

The Smith-Lemli-Opitz syndrome (SLOS) is a plurimalformative syndrome transmitted by autosomal recessive inheritance. SLOS is caused by the deficiency in the enzyme 7-dehydrocholesterol-delta-reductase (DHCR7) resulting in cholesterol metabolism disorders, more precisely the incapacity to transform dehydrocholesterol into cholesterol. The syndrome is marked by characteristic facial dysmorphism, multiple malformations and intellectual disability. We are reporting the case of a 15 year old patient diagnosed postnatally with bilateral hands and feet polydactyly, and clinodactyly in the 5th toe of the right foot which was surgically treated when the patient was 6 months old. The association with suggestive modifications of the oral cavity (dental impactions, palatoschisis, enlarged alveolar ridges and uvula bifida) that required complex orthodontic therapy and the genetic consult establish the diagnosis of Smith-Lemli-Opitz syndrome.

As the market offer for bioadhesive materials is constantly increasing, while the dental surfaces on which they are applied show specific features, different from those commonly resulting from the preparation of carious processes, knowledge on their behavioral characteristics is absolutely necessary for their utilization under optimum conditions, through methods assuming prolongued clinical performances, assured by dimensional and colouristic stability and by a reduced cure contraction, for diminishing as much as possible the space of marginal percolation and fracture of the free enamel-free margins, as well as for delamination of immobilization from the afferent dental structure. Selection of the type of material for periodonthic teeth immobilization and of the technique to be applied is decided on the basis of a systematic, clinical and radiological analysis meant at establishing: the number of affected teeth, the type of occlusion and the possible parafunctions, oral hygiene, the aesthetic requirements of the patient, his/her age and motivation for a periodical monitorization. Numerous modern materials employed in the immobilization of periodonthic teeth are closely related not only to their physical properties and long-term stability, but also to the oral environment in which they are functioning. Modern adhesive materials are well-suited for dental recovery of the remaining healthy structures, due to their capacity of chemically and micromechanically adhering onto them.