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Introduction. The most common nondental orofacial pain conditions are temporomandibular disorders (TMDs). TMD basic examination and clinical management are included in a curriculum of each dentistry programme taught in Poland, but it is not clear how the dentists cope with diagnosis and possible treatment in their routine dental practices. The objective of the present study was to assess a level of self-perceived knowledge of TMD amongst dentists in Poland. Materials and methods. The participants, of whom all studied and graduated from a Polish university, were randomly selected from dental offices in Krakow (Poland). The selected dentists were administered an anonymous questionnaire, which contained questions measuring self-assessment of knowledge of TMD diagnosis and therapy and assessing knowledge of ethology and TMD symptoms. Results. Only 6.5% of the participants identified their TMD knowledge as very good, 32.3% assessed it as good, 39.3% thought it was sufficient, 20.4% as insufficient, and 1.49% considered it as poor. 9.4% of all participants have attempted to diagnose and treat TMD patients very often, 26.4% declared performing it often, 45.8% rarely, and 18.4% had never made such an attempt. There was a significant relationship between the dentists’ knowledge and their attempts at diagnosing and treating TMD patients (p<0.05). Conclusion. The level of TMD knowledge amongst the Polish dentists is still insufficient. Raising its level would considerably help the dentists to refer their patients to right specialists for a diagnosis and TMD treatment and/or interdisciplinary management of TMD patients.

Background: Little is known about the effect of the type of splint material, heat-cured PMMA (HC) or chemical-cured PMMA (CC) on the wear of opposing tooth surfaces. Objective: The aim of this in vitro study was to evaluate two-body wear of dentin, enamel, glass-ceramic or one of four resin composites when opposing splint materials, namely ProBase HC and CC. Methods: The two-body wear of bovine dentine, bovine enamel, glass-ceramic IPS e.max CAD (EMAX) and four composites (Filtek Z250 [Z250], Clearfil AP-X [AP-X], Clearfil Majesty Posterior [CMP], Filtek Supreme XTE [FSE]) opposing three antagonists (HC and CC and stainless steel as control) were evaluated in the ACTA wear machine. In addition, all the surfaces were evaluated with scanning electron microscopy. Results: The highest average wear was observed in the case of dentin. The lowest average wear was found EMAX. In every case—except for EMAX—the wear rate was higher with HC than with CC (all differences being statistically significant). Conclusions: The level of wear of enamel, dentin and various resin composites was higher in contact with HC than in CC, the wear of dentin being the highest. In the case of a patient with no or little tooth wear or whose teeth are restored with composite material or glass-ceramic, the splint HC might be preferred because of its better durability. However, when the splint is in contact with opposing dentin preservation of the dentin, CC might be the best choice.

Little is known about the wear rate of enamel and dentin opposing resin composite following restoration of the occlusal surface in patients with tooth wear. Hence, the aim of this in vitro study was to evaluate the wear of enamel and dentin surfaces when opposing each of three resin composites in a two-body and three-body wear test. The two-body and three-body wear of dentin, enamel, and three resin composites (Clearfil AP-X, Filtek Z250, and Filtek Supreme) opposing four antagonists (stainless steel and three resin composites) were evaluated using the ACTA wear machine. In addition, all the surfaces were evaluated with scanning electron microscopy. The results showed the lowest wear rate in enamel and the highest in dentine, with the composite showing intermediate wear rates. The three-body wear results were not affected by the antagonist and showed pure wear caused by the abrasive food medium. The in vitro enamel/composite wear ratio was 2.5. The results show that tooth wear accelerates as soon as enamel disappears and dentin is exposed to composite resin. Therefore, it is important to protect dentin with a restorative material.

© 2021 by Wroclaw Medical University.Background. Orthodontic tooth movement (OTM) is a complex phenomenon mediated by cytokines, of which interleukin-1 beta (IL-1β) is potently involved in the remodeling of the periodontal ligament (PDL) and bone. Whether the pattern of IL-1β release differs at the sides of tension and compression is not yet clarified. Objectives. The aim of the present study was to evaluate the level of IL-1β and the ratio of IL-1β to interleukin-1 receptor antagonist (IL-1RA) in gingival crevicular fluid (GCF) at the tension and compression sides during orthodontic canine retraction. Material and methods. Seventeen patients scheduled for orthodontic treatment with bilateral extrac-tion of maxillary first premolars and canine retraction were enrolled. Tooth 2.3 was retracted, teeth 1.3 and 3.3 served as controls. Gingival crevicular fluid samples were collected from the tension and compression sides of each tooth at baseline (before the 1st activation – day 0) and at days 2 and 7, and then again before the 2nd activation (day 28) and at days 30 and 35. The levels of IL-1β and IL-RA were evaluated with the enzyme-linked immunosorbent assay (ELISA). Results. After the 1st activation, a statistically significant increase in the level of IL-1β was observed at teeth 2.3 (p < 0.03 mesially and p < 0.05 distally) and 1.3 (p < 0.05 mesially and distally), both at the tension and compression sides. The 2nd activation resulted in a gradual increase in the IL-1β level at both canines; however, statistical significance was reached only for tooth 2.3 (p < 0.05 mesially and p < 0.02 distally). In terms of the IL-1β/IL-1RA ratio, a significant increase was observed only at the compression side of the experimental tooth (p < 0.01). Conclusions. An increase in the IL-1β level in GCF was observed both at the tension and compression sides of the actively retracted canine 2.3 as well as the contralateral canine 1.3; a significant rise in the IL-1β/IL-1RA ratio was noted only at the compression side of the experimental tooth 2.3, indicating the zone of active bone resorption.

Lyme borreliosis (LB) is a zoonotic disease caused by Gram-negative bacteria Borrelia burgdorferi sensu lato. The majority of reported cases of LB originate in the northern hemisphere, mostly in the US and Europe. One of the typical manifestations of LB are musculoskeletal symptoms; they may appear in any of the three LB stages. The diagnosis is based on clinical manifestations and confirmed by serological tests. One course of antibiotic therapy is sufficient for LB to dissipate in most cases, although for some patients, the symptoms subside gradually even after completion of therapy. Patients who have been demonstrated to have specific antibodies but are symptomless should not be treated. In instances where the advised treatment proved to be unsuccessful, patients should be referred to rheumatologist for additional diagnostics. The goal of this review is to update physicians on current scientific knowledge on musculoskeletal manifestations of LB.

The aim of the present study was to assess the potential role of some biological, psychological, and social factors to predict the presence of painful temporomandibular disorders (TMDs) in a TMD-patient population. The study sample consisted of 109 consecutive adult patients (81.7% females, mean age 33.2 &plusmn, 14.7 years) who were split into two groups based on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnoses: painful TMD and non-painful TMD. The presence of pain was adopted as the depended variable to be identified by the following independent variables (i.e., predictors): age, gender, bruxism, tooth wear, chewing gum, nail biting, perceived stress level, chronic pain-related impairment (GCPS), depression (DEP), and somatization (SOM). Single-variable logistic regression analysis showed a significant relationship between TMD pain and DEP with an odds ratio of 2.9. Building up a multiple variable model did not contribute to increase the predictive value of a TMD pain model related to the presence of depression. Findings from the present study supported the existence of a relationship between pain and depression in painful TMD patients. In the future, study designs should be improved by the adoption of the best available assessment approaches for each factor.

Objectives: The aim was to determine the frequency of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)-based pain diagnoses and dynamic/static tests-based pain diagnoses, and to assess the agreement of palpation tests with static/dynamic tests. Materials and methods: Eighty-six (N = 86) adult patients with Lyme disease (mean age 57.0 ± 14.3 years; male/female ratio was 42/44) were examined according to techniques described in the RDC/TMD. Additionally, dynamic/static tests were performed. For RDC/TMD-based pain diagnoses and dynamic/static tests-based pain diagnoses, descriptive frequencies were calculated. Differences between the frequency of palpation-based diagnoses and of dynamic/static-based diagnoses as well as the agreement between pain diagnoses established with the two diagnostic approaches were assessed. Results: RDC/TMD-based pain diagnoses were made in 61 patients for myofascial pain and in 11 patients for arthralgia and/or osteoarthritis. Based on dynamic/static tests, mainly myogenous pain was diagnosed in 6 patients, and a mainly arthrogenous pain in 5. The agreement of palpation tests with static/dynamic tests in Lyme disease population was poor. Conclusion: A high prevalence of TMD symptoms was found in patients with Lyme disease. The results suggest that using palpation tests alone could overestimate primary TMDs when comorbid conditions are present. Clinical relevance: Dynamic/static tests should be used as part of the routine TMD assessment. In case of Lyme disease as the actual cause of the facial pain, while the dentist might be suspecting TMD when dynamic/static TMD tests are negative, referral to an appropriate specialist for the diagnosis and treatment of Lyme disease needs to be made.

Objective: To assess the frequency and age distribution of Axis I and Axis II diagnoses among Polish patients with temporomandibular disorders (TMD).Method: One hundred sixty-three (n = 163) consecutive adult patients seeking TMD treatment were assessed based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines. Descriptive statistics on the frequency of diagnoses and mean age of the diagnostic groups was performed. Result: Frequency of muscle disorders, disc displacements, and other joint disorders was 56.9, 48.9, and 31%, respectively. Disc displacement was the most common diagnosis in younger patients. Severe somatization and depression were shown in 11.9 and 15.8% of patients, respectively. Only 10.5% of the patients showed severe pain-related impairment. Females tended to have higher psychosocial scores than males. Discussion: The frequency of Axis I TMD diagnoses in Polish patients is similar to other populations, whereas Axis II findings slightly differ from previous reports from other countries.

The aim was to determine the occurrence of temporomandibular disorders (TMDs) in patients with Lyme disease (LD), and to estimate the contribution of factors that may identify TMD among LD patients. In seventy-six (N = 76) adult patients with LD (mean age 57.6 &plusmn, 14.6 years) and 54 healthy non-Lyme volunteers with a mean age of 56.4 &plusmn, 13.5 years, possible function (i.e., non-pain) diagnoses were established using the Research Diagnostic Criteria of Temporomandibular Disorders (RDC/TMD). Pain diagnoses were established by means of the function-dependent dynamic and static tests. The two groups did not significantly differ in the frequency of disc displacements diagnoses and function-dependent pain diagnoses. LD showed a significantly higher frequency (p &lt, 0.001) of osteoarthrosis than the control group. For the prediction of pain diagnoses in LD patients, the single regression analyses pointed out an association with age, sleep bruxism (SB), and awake bruxism (AB). Two predictors (i.e., SB (p = 0.002) and AB (p = 0.017)) were statistically significant in the final multiple variable model. The frequency of TMD in patients with LD based on function-dependent tests was not significantly different from that in the control group. This investigation suggests that the contribution of bruxism to the differentiation between patients with Lyme and TMD is high.

Objectives: The aim is to describe the process of translating the smartphone application BruxApp into Polish within the context of an ongoing multicenter project on awake bruxism (AB) epidemiology. Material and Methods: An ongoing cooperation involving 11 universities is based on the adoption of the smartphone-based EMA protocol to collect real time report of AB behaviors in the natural environment. The English version of BruxApp is adopted as a template for the multi-language translation, according to a step-by-step procedure led by mother-tongue experts in the field. A dedicated web platform for translation (viz., POEditor) is used. The process of translation into Polish is here described as an example. Results: There are two software versions available, viz., BruxApp and BruxApp Research. For both versions, back translation from Polish to English was performed to verify the accuracy of the translation procedure. The validity of the translation has been confirmed by the perfect agreement between the original and back-translated English versions, and the Polish version of BruxApp can thus be introduced in the clinical and research setting to get deeper into the study of AB epidemiology in Poland. Conclusions: As far as clinical studies are concerned, the described strategy to record data can be very useful -patients can acknowledge their habits, monitor changes over time, and implement remedial measures. In the field of research, BruxApp makes possible to collect and store a huge amount of data about the epidemiology of different forms of awake bruxism, both at the individual level and at the population level.

Purpose The prevalence of temporomandibular disorders (TMD) in the general Polish population has not yet been thoroughly investigated. The aim of this study was to determine how frequently Polish young adults demonstrated the signs and symptoms of TMD, and how often they were aware of these. Materials and Methods The study involved 260 volunteers of approximately 18 years of age (and with an F:M ratio of 2.8), who had completed the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire in its internationally accepted Polish version. The volunteers were students from three randomly selected high schools in Krakow, Poland. Following the clinical examinations, all participants received none or one or more of the RDC/TMD axis I diagnoses on one or both sides: muscle disorders (group I), disk displacements (group II), arthralgia, osteoarthritis, and osteoarthrosis (group III). Classification on RDC/TMD axis II involved pain-related impairment (Graded Chronic Pain Severity, from 0: no TMD pain in the prior 6 months, to IV: high disability—severely limiting), depression, and somatization levels (normal, moderate, severe). Results On the RDC/TMD axis I, 69 (26.5%) of the participants received one or more of the possible diagnoses. Awareness of TMD was present in 20 (7.7%) people from that group, in the form of self-complaints. The difference between females and males was statistically significant (p = 0.0013). On the RDC/TMD axis II assessment, a diagnosis of pain, depression, or somatization was given in 38 (14.6%) cases from that group. Conclusion Muscle disorders were most frequently diagnosed in the group of Polish young adults, and the prevalence of the disease did not differ across similar groups of young people.

In addition to palpation tests, dynamic/static tests have been proposed to complement temporomandibular disorders (TMD) patients’ evaluation in the clinical setting. The aim of this study was to assess the intra- and inter-observer reliability of the palpation tests and of the dynamic/static tests, and to determine whether those tests would yield comparable outcomes in terms of pain diagnoses. Ninety-eight (N = 98) consecutive adult patients were examined during 2 clinical sessions by 2 independent examiners, based on muscle and joint palpation techniques described in the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). They also underwent dynamic/static tests. The intra-observer reliability of palpation tests was generally poor, with fair-to-good to excellent ICC values only for the superior masseter and intra-oral sites. The inter-observer reliability of palpation was fair-to-good for muscles, but it was poor for the TMJ lateral pole. Both intra- and inter-observer reliability for the dynamic/static tests varied from fair-to-good to excellent. The intra-observer reliability for muscle pain diagnoses based on palpation tests was between poor and fair-to-good, whereas the inter-observer reliability was excellent. The intra-observer reliability for pain diagnoses based on dynamic/static tests was fair-to-good, and the inter-observer reliability varied from fair-to-good to excellent. Conclusions: Some features of the dynamic/static tests make them potentially more useful than palpation tests for selected clinical purposes, such as discriminating between joint and muscle pain as well as monitoring symptoms course. Thus, findings from this investigation suggest that both tests should be included in the TMD diagnostic algorithms.

ObjectiveNowadays direct and indirect resin composites are frequently applied to build up the occlusion when extensive tooth wear took place. To achieve long-lasting restorations it is essential to obtain knowledge about their interactions due to occlusal contacts. Therefore, the two- and three-body wear between frequently used direct and indirect resin composites was investigated.Materials and methodsThe two- and three-body wear of three direct resin composites and three indirect resin composites, with Clearfil AP-X, Filtek Z250, and Filtek Supreme XT as antagonists, were measured, using the ACTA wear device. The wear rates were determined and the surfaces were evaluated with SEM.ResultsThe most remarkable outcome was that the two-body wear rate of the different composites opposing the Z250 wheel were significantly higher. Furthermore, it was shown that the three-body wear rate was independent on the antagonist and in general higher than the two-body wear rate.ConclusionsTo reduce abrasion of the opposing resin composite surface the resin composite fillers should consist of a softer glass, e.g. barium glass or in case of a harder filler the size should be reduced to nano-size.

For several years now, the enigmatic term Evidence- Based Dentistry (EBD) has been addressed in dental literature fuelling a discussion which concerned the question of both the true nature of EMB and the threats it poses to both dental practice and contemporary treatment of the patient. Critics of EBD emphasize the danger of dehumanization of medicine by introducing an analytical and statistical approach, which replaces the individual treatment of each case based on the experience and clinical knowledge of a doctor. This article is an attempt to explain the essence of EBD and to show that it is a useful tool supporting every clinician who should tailor each clinical decision to individual patient’s needs based on EBD as well as on their clinical knowledge and experience. Moreover, the article brings a conclusion that only well- designed and performed clinical trials, carrying new knowledge about the prevention and treatment of oral diseases, are able to ensure the development of EBD, which would help dentists in their clinical practice. Most importantly, such studies need to be described according to very strict criteria so as to provide clear and transparent information on the methodology, findings and conclusions originating from this research. Therefore, this article contains a translation, authorized by the authors of the CONSORT statement, of clinical reporting guidelines from 2010 which was created to facilitate for the Polish pioneers in EBD the process of designing and describing reliable and high- quality clinical trials.