Nicola Mobilio

Prevalence of self-reported symptoms related to temporomandibular disorders in an Italian population

The aim of this study was to estimate the prevalence of temporomandibular disorders (TMD) symptoms in an Italian population sample, focusing on gender and age differences. We selected 2005 individuals by telephone survey and asked them about TMD symptoms like difficulty in jaw movement, jaw pain and joint sounds. Also, tooth-clenching and/or tooth-grinding habits were investigated. Of the study population, 8·1% reported limitations in jaw movements, 5·1% reported jaw pain and 33·3% reported joint sounds. Furthermore, 37·3% reported tooth-clenching/tooth-grinding. Confidence intervals of proportions were calculated. Significant gender differences were found for jaw limitation and pain (chi-square test; P < 0·05). Symptoms reduced with increasing age. The prevalence of TMD symptoms in the Italian population was consistent with data reported from similar studies. Gender and age differences were found for jaw pain and limitation in jaw movements.

Explaining pain after lower third molar extraction by preoperative pain assessment.

PURPOSE To evaluate whether preoperative pain sensitivity testing and emotional perception of pain could explain the level of postoperative pain after lower third molar extraction. PATIENTS AND METHODS Twenty-three patients (16 women, 7 men) scheduled for lower third molar extraction were enrolled in the study. Patients preoperatively were submitted to a nociceptive stimulus by a cold pressor test (immersion of the hand into ice water). Preoperative pain tolerance (seconds), algosity and unpleasantness (visual analog scale), and dental anxiety (Modified Dental Anxiety Scale) were assessed. The duration of surgery was recorded (minutes). Postoperative pain ratings were taken by self-reported registrations on a 100-mm visual analog scale during the 6 days after surgery. Separate stepwise regression analyses were performed to evaluate the usefulness of preoperative scores in explaining the overall maximum postoperative pain level and postoperative pain rates at different intervals. RESULTS Preoperative unpleasantness related to the nociceptive stimulus was found to be the best predictor of maximum postoperative pain (adjusted R(2) = 0.39, P = .001). Demographic information (age) and preoperative (dental anxiety, pain tolerance, algosity) and intraoperative (duration of surgery) factors were not correlated with postoperative pain. CONCLUSIONS These results show that a simple preoperative test is useful to identify patients at risk of developing greater pain after third molar surgery. They are characterized by a higher level of reported pain or unpleasantness after exposure to a nociceptive stimulus. This test may be tailored to specific patient needs for postoperative treatment.

Effect of experimental jaw muscle pain on occlusal contacts.

The aim of the study was measuring the effect of experimental jaw muscle pain on number and position of posterior occlusal contacts. Eleven adult voluntary subjects were enrolled. A lower impression was taken for each subject and two dental casts were obtained from each impression. The study was carried out in a randomised cross-over fashion. Each subject participated in two experimental sessions (30-day interval) in which he/she received an injection in the central part of the right masseter muscle consisting of 0·5 mL of either hypertonic or isotonic saline. Each subject was asked to rate pain intensity on a visual analogue scale. Three occlusal bite checks (polyvinylsiloxane) at the maximal intercuspal position were obtained during the experimental session: the first before the injection, the second between 60 and 90 s after the injection and the third 15 min after the injection. Evaluation of contacts was performed on dental casts with the use of different colours (black for baseline, red for intermediate and green for final contacts). Repeated-measures analysis of variance was used to compare the overall number of contacts among groups and the number of contacts of different colours. No significant difference was found between the overall number of occlusal contacts (P>0·05), but significant differences were found between contacts according to different colours: confirmed (P=0·006), disappeared (P=0·007) and new (P<0·001). Assuming different colours as change in contact position, the overall number of contacts did not change, but the position did. Experimentally induced jaw muscle pain affected the pattern of posterior occlusal contacts.

Milled bar-supported implant overdenture after mandibular resection: a case report.

After surgical treatment for oral cancer, patients often are affected by disfigurements, thwarted function, and psychological and social problems. Prosthodontic rehabilitation has the aim of restoring function and esthetics. Implant-supported prosthodontic rehabilitation is useful for patients with compromised residual ridge anatomy, such as patients with oral cancer following treatment. This clinical report describes the rehabilitation of a patient after mandibular resection with a milled bar-supported implant overdenture. Overdenture achieves best hygienic maintenance, easy soft tissue follow-up, and low realization cost. This rehabilitation increased prosthesis retention and stability and improved oral conditions and the patients quality of life.

Experimental and numeric stress analysis of titanium and zirconia one-piece dental implants.

PURPOSE To compare the stress in bone around zirconia and titanium implants under loading. MATERIALS AND METHODS A one-piece zirconia implant and a replica of the same implant made of commercially pure titanium were embedded in two self-curing acrylic resin blocks. To measure strain, a strain gauge was applied on the surface of the two samples. Loads of 50, 100, and 150 N, with orientations of 30, 45, and 60 degrees with respect to the implant axis were applied on the implant. Strain under all loading conditions on both samples was measured. Three-dimensional virtual replicas of both the implants were reproduced using the finite element method and inserted into a virtual acrylic resin block. All the materials were considered isotropic, linear, and elastic. The same geometry and loading conditions of the experimental setup were used to realize two new models, with the implants embedded within a virtual bone block. RESULTS Very close values of strain in the two implants embedded in acrylic resin were obtained both experimentally and numerically. The stress states generated by the implants embedded in virtual bone were also very similar, even if the two implants moved differently. Moreover, the stress levels were higher on cortical bone than on trabecular bone. CONCLUSIONS The stress levels in bone, generated by the two implants, appeared to be very similar. From a mechanical point of view, zirconia is a feasible substitute for titanium.

High risk of temporomandibular disorder in irritable bowel syndrome: Is there a correlation with greater illness severity?

AIM To investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population. METHODS Between January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD. RESULTS We enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression. CONCLUSION IBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.

Qualitative evaluation of the adesive interface between lithium disilicate, luting composite and natural tooth

Aim of this work was to qualitatively evaluate the interface between tooth, luting composite and lithium disilicate surface using a scanning electron microscope (SEM). An extracted restoration-free human molar was stored in physiological solution until it was embedded in an autopolimerysing acrylic resin. A standard preparation for overlay was completed and after preparation an anatomic overlay was waxed on the tooth and then hot pressed using lithium disilicate ceramic. After cementation the sample was dissected and the section was analysed using an Automatic Micromet (Remet s.a.s) and the section was analyzed using a scanning electron microscope (SEM). SEM evaluation of the tooth showed the three layers seamlessly; by increasing the enlargement the interface did not change.

Effect of Different Luting Agents on the Retention of Lithium Disilicate Ceramic Crowns

No studies are available that evaluate the retention of disilicate crowns according to different cementation procedures. The purpose of this study was to measure the retention of lithium disilicate crowns cemented using two different cementation systems. Twenty extracted mandibular premolars were prepared. Anatomic crowns were waxed and hot pressed using lithium disilicate ceramic. Teeth were divided into two groups (n = 10): (1) self-curing luting composite and (2) glass-ionomer cement (GIC). After cementation, the crowns were embedded in acrylic resin block with a screw base. Each specimen was pulled along the path of insertion in Universal Testing Machine. Failure load in Newtons (N) and failure mode were recorded for each specimen. Failure mode was classified as decementation or fracture. Failure load data were analyzed using one-way analysis of variance (ANOVA). Failure modes were compared using Pearson’s Chi-square test. Mean failure load was 306.6(±193.8) N for composite group and 94.7(±48.2) N for GIC group (p = 0.004). Disilicate crown cemented with luting composite most often failed by fracture; otherwise, crown cemented with glass-ionomer cement most often failed by decementation (p = 0.02). Disilicate full crown cemented with luting composite showed higher failure load compared with conventional cementation with glass-ionomer cement.

Survival Rates of Lithium Disilicate Single Restorations: A Retrospective Study

PURPOSE To assess the clinical performance of lithium disilicate single restorations on natural teeth. MATERIALS AND METHODS All patients who received lithium disilicate single restorations between 2009 and 2013 at the dental clinic of the University of Ferrara were recalled for clinical evaluation. A total of 43 partial and total restorations in 17 patients were evaluated from a minimum of 36 months follow-up to a maximum of 81 months follow-up, with a mean follow-up of 51 months. RESULTS The cumulative survival rate was 97.7%, and the cumulative success rate was 94.2%. CONCLUSION Lithium disilicate can be successfully used for single-tooth restorations.

The use of monolithic lithium disilicate for posterior screw-retained implant crowns

Lithium disilicate is typically used for fabricating prosthetic crowns to be cemented on teeth or implant abutments. However, its use for producing screw-retained implant crowns has been less commonly described. This report describes the use of monolithic lithium disilicate for a screw-retained implant crowns.