Jolanta Szymańska

Psychological aspects of temporomandibular disorders – literature review

Abstract Temporomandibular disorders (TMD) constitute a group of clinical problems involving the masticatory muscles, the temporomandibular joint and associated structures. An etiological connection of TMD with psychological factors was proposed as early as the 1980’s. Indeed, the interdependence of psychological and health aspects in the patient’s treatment, place light upon the more important variables contributing to the various mental disorders that may accompany TMD. Current literature suggests a close relationship between TMD and selected psychological factors, such as personality traits, stress, depression, anxiety, and catastrophizing. Of note, anxiety-depressive disorders, somatisation and catastrophizing contribute to chronic TMD, mainly in the form of myofascial pain. Hence, knowledge of the influence of psychological factors affecting TMD, enables the identification of patients with an increased risk of chronic painful TMD.

Opportunistic bacteria in dental unit waterlines: assessment and characteristics

AIM The study aimed to determine qualitative and quantitative contamination of dental unit reservoir water with aerobic and facultative anaerobic bacteria, with regards to health risk to dental staff and patients. MATERIALS & METHODS The study material included water samples from 107 unit reservoirs. Conventional microbiological methods were used. The isolated bacteria were divided into three groups according to pathogenic mechanisms. RESULTS Dental unit water contamination was widespread. The isolated bacteria average concentration was 1.1 × 10(5) CFU/ml, with Ralstonia pickettii as the prevailing species (49.33%). The total potentially pathogenic bacteria were 54.54% of all the isolated bacteria. Bacteria causing infectious and invasive diseases constituted over one-half of this group, while allergizing and immunotoxic bacteria occurred in smaller quantities. CONCLUSION The presence of over 50% potentially pathogenic microorganisms among the isolated bacteria and their very high concentrations call for the daily use of effective methods to reduce dental unit water contamination and health risk.

Bartonella henselae in eastern Poland: the relationship between tick infection rates and the serological response of individuals occupationally exposed to tick bites.

ABSTRACT: To explore the potential role of Ixodes ricinus as the presumed vector of Bartonella henselae in eastern Poland, ticks collected in various geographic locations were examined for the presence of B. henselae, and the results were matched against the prevalence of anti-B. henselae antibodies in individuals occupationally exposed to tick bites. The presence of Bartonella DNA was investigated by PCR in a total of 1,603 unfed Ixodes ricinus ticks. The presence of IgG antibodies against B. henselae was investigated in serum samples from 332 people occupationally exposed to tick bites (94 farmers and 238 forestry workers). The total prevalence of B. henselae in ticks was 1.7%; the infection rates in males (3.1%) and females (2.7%) were nearly ten times greater than in nymphs (0.3%). The prevalence of seropositive results in the risk group (30.4%), farmers (27.7%) and forestry workers (31.5%), was significantly greater compared to the control group (8.9%). The results showed a weak positive correlation between the degree of infection of ticks and humans living in the same geographic region. The lack of a direct relationship indicates that exposure to tick bites is only one of the factors contributing to the significant preponderance of a seropositive response to B. henselae in the forestry workers and farmers over the control group. Other factors must be considered, such as contact with cats, which are popular domestic animals in Polish villages, and exposure to cat fleas.

Effects of selected factors on the osseointegration of dental implants.

Introduction Osseointegration of dental implants with the maxillary and/or mandibular bone is the basis for implant prosthetic treatment. The aim of the study was to assess the influence of the patients’ gender, age, and in the case of women, their menopausal status (before menopause/after menopause/during hormone replacement therapy) on the osseointegration of dental implants. Material and methods The study evaluated the bone loss after implant loading and the success rate of the procedure in 71 women and 30 men. In the postmenopausal group, 20 (28.1%) women were receiving hormone replacement therapy. The implants used in the treatment of the studied patients were the two-phase dental implants. The extent of bone loss was estimated by comparing the post-implantation radiographs and the post-loading ones. Results The implantation procedure was entirely successful in 81 patients (80.2%). The patients’ age, gender and menopausal status did not significantly affect the implantation procedure success rate or bone loss (p > 0.05). A correlation between bone loss and hormone replacement therapy (p = 0.002) was found. Conclusions The hormone replacement therapy contributes to a greater peri-implant bone loss. The patients receiving hormone replacement therapy who consider replacement of missing teeth with implants should be informed about a greater risk of osseointegration failure, which may affect the success of implant therapy.

The influence of upper airways diameter on the intensity of obstructive sleep apnea

INTRODUCTION AND OBJECTIVE Obstructive sleep apnea (OSA) is characterized by at least 5 ten-second-long episodes of apnea or hypopnea, per hour of sleep. This disease may lead to severe, life-threatening complications. Therefore, risk analysis and its influence on disease intensity is crucial for proper implementation of preventive treatments. OBJECTIVE To determine the relation between the intensity of OSA expressed in Apnea-Hypopnea Index (AHI), and the anterior-posterior diameter of upper airways at the levels of soft palate and tongue base. MATERIAL AND METHOD Medical records of 41 patients with sleep apnea (AHI>4) diagnosed through polysomnographic examination obstructive were used for the study. The data consisted of: age and gender, polysomnographic examination results (AHI), lateral cephalogram with cephalomertic analysis, together with measurements of the upper and lower pharyngeal depth according to McNamara. Statistical analysis was carried out in accordance with Pearsons r correlation coefficient test (Statistica 8.0 software package). RESULTS Analysis of the influence of upper airways diameter on the intensity of OSA showed that the value of upper Airways diameter at the tongue base level had no statistically significant impact on the value of AHI (p=0.795). However, a statistically significant impact of the value of upper airways diameter on the AHI value (p=0.008) at the soft palate level was observed. Patients with OSA have narrowed upper airways diameter. The value of AHI increases with the decrease of upper diameter and is not dependent on a lower diameter value. Patients with a decreased upper airways diameter should be informed about potential breathing disorders during sleep.

Characteristics of oral probiotics – a review

Abstract Probiotics are a group of microorganisms able to have a positive influence on a host organism when applied in adequate amounts. They are grouped either as: bacteria (mainly Lactobacillus spp and Bifidobacterium) or fungi (Saccharomyces boulardii). Recent studies have revealed many opportunities for their use in several fields of medicine, such as in: reducing the level of cholesterol in the body, cancer therapy, human immune system regulation, skin regeneration, pancreas necrosis, cirrhosis of liver treatment, regulation of post- antibiotic bowel function, constipation and digestive disorders in infants. Probiotics efficacy has also been demonstrated in oral cavity malfunctions. With the use of modern scientific methods, probiotics have the potential to become an important part of the daily diet and a natural drug supplementation in severe diseases.

BMI in patients with obstructive sleep apnea

Abstract Obstructive sleep apnea (OSA) is a disease of multicasual etiology. The risk factors include obesity, among other issues. Hence, it is extremely important to determine the effect of body weight on the severity of OSA. The aim of the study was to evaluate the influence of the body weight expressed as body mass index (BMI), on the value of upper airways diameter and on the AHI (Apnea-Hypopnea Index) value. The study was comprised of 41 patients diagnosed with OSA by way of polysomnography. Each patient was first examine via a lateral cephalometric image of the skull, which served to measure the upper and lower diameter of the upper airways. BMI was also calculated for each patient. Statistical analysis was carried out in accordance with Pearson’s correlation coefficient test. Our work demonstrated a negative correlation between BMI and the diameter of the upper airways, and a positive correlation between BMI and AHI value. We thus put forward that the increase in body weight in patients with OSA can contribute to the severity of the disease, regardless of the fact that it may not lead to a reduction of the lumen of the upper airways.

The knowledge of pregnant women regarding appropriate oral hygiene practices of young children – a questionnaire survey

Abstract Maintaining appropriate oral cavity hygiene in a young child is closely related to the health awareness and health-promoting behaviours of their parents/guardians, and especially that of the child’s mother. The aim of the study was to evaluate the knowledge of pregnant women regarding best practice oral hygiene procedures in young children. The survey involved 327 pregnant women aged 16-49 years, and the tool utilized was an anonymous questionnaire survey. The questionnaire included seven one-choice questions concerning basic information on proper oral hygiene procedures as should be practiced by young children. The statistical analysis was performed using Statistica PROGRAM 10 (StatSoft). The results of the survey reveal 60.55% of all surveyed had correct knowledge with regard to appropriate cleaning practices for the toothless oral cavity of an infant, that concerning the beginning of tooth brushing - 70.03%, tooth cleaning after night feeding - 39.76%, the duration of tooth brushing (at least 3-4 minutes) - 43.12%. What is more, the result of the survey demonstrate that slightly more than a half of the surveyed mothers (53.82%) would encourage their children to brush their teeth on their own from the first year of age, while 18.35% believe that children should be assisted in tooth brushing at least to their eighth year of age, and 59.63% would use fluoride toothpaste to brush their child’s teeth before he or she is one year old. Of the participants in this survey, pregnant women with university education, those living in large cities, or who are older, and those who had had previous pregnancies, show greater knowledge regarding suitable oral hygiene practices among young children. Our results reveal that extensive application of modern information technologies can be a means of preventing early childhood caries by facilitating the transmission of knowledge on proper nutrition and oral hygiene practices among young children.

The Relationship Between Marginal Bone Loss Around Dental Implants and the Specific Characteristics of Implant-Prosthetic Treatment

Abstract The marginal bone loss around dental implants is an important indicator that helps to evaluate the course and the final outcome of implant-prosthetic treatment. It is, therefore, important to understand the factors that may affect this. The aim of the study was to assess the impact of the specific characteristics of implant-prosthetic treatment on the marginal bone loss around implants. The study included 28 patients, aged 37-66 years, treated with dental implants. Every patient received at least one of the two types of implants: with Morse taper connection and with internal hexagonal connection. The average marginal bone loss around the implants was evaluated on the basis of the panoramic radiographs. The maximum follow-up period after implantation was 46 months. The peri-implant marginal bone loss was evaluated taking into consideration the implant localisation, the procedure of sinus lift with bone augmentation, implant type, implant diameter, vertical implant position relative to the compact bone level and the type of prosthetic restoration, the time between implantation and loading with prosthetic restoration, as well as the time between loading and the measurement of marginal bone loss. The correlation between bone loss and the selected characteristics of the treatment was assessed using generalised estimating equations (GEE). An objective analysis was enabled via the applied research model: evaluation of an impact of the specific implant-prosthetic treatment characteristics on peri-implant marginal bone loss in patients treated with implants with different implant-abutment interface systems. The results of the study showed that peri-implant marginal bone loss increased significantly with implant localisation in canine sites (compared to the localization in premolar sites), as well as with prosthetic restorations in the form of dentures (compared to bridges), and decreased when implants were placed below the compact bone level (compared to those placed at the bone level). At the same time, marginal bone loss was not significantly related to implant diameter or to the sinus lift procedure. The results obtained seem extremely useful in everyday clinical practice

The effectiveness of manual and powered toothbrushes

Abstract Proper oral hygiene is a basis for preventing dental caries and periodontal diseases. The most popular method of mechanical plaque removal is brushing teeth using manual and powered toothbrushes. The review of literature shows that removal of dental calculus using the powered toothbrushes is more effective, what is supported by greater reduction of plaque and symptoms characteristic for soft tissue inflammation. It needs to be underlined that the effectiveness of tooth brushing, regardless of the kind of toothbrush, to a great extent depends on the frequency and technique of brushing, on the time devoted to this hygienic procedure, and on the type of toothbrush bristles.