doi: 10.1111/j.1741‐2358.2011.00456.x Tonsillolithiasis and orofacial pain Tonsilloliths are rare calcified structures that usually result from chronic inflammation of the tonsils. Concretions show differences in size, shape and colour. They are usually asymptomatic but can be associated with halitosis, foreign body sensation, dysphagia and odynophagia, otalgia, and neck pain. A patient was referred because panoramic radiography performed by a general dentist revealed radiopaque shadows over the ascending rami of the mandible, located bilaterally: a solitary structure on the higher portion of the right side and two small structures on the left side. Paroxysmal attacks of orofacial pain and symptoms such as dysphagia and swallowing pain on the left side distributed within the tonsillar fossa and pharynx and the angle of the lower jaw were present. The computed tomography images revealed bilateral tonsilloliths. Clinically, there was no sign of inflammation, and the patient’s past history revealed an approximately 2‐year history of dysphagia, swallowing pain and left‐sided neck pain. At the request of the patient, no surgical intervention was carried out. Glossopharyngeal neuralgia is a rare entity, and the aim of this report was to indicate the importance of tonsilloliths as a cause of orofacial pain.

To assess the effectiveness of low-dose amitriptyline in reducing pain and improving oral health-related quality of life in individuals with chronic temporomandibular disorders (TMD) over a 2-month period, compared to placebo. Forty participants were randomly assigned to receive either 25 mg of amitriptyline or a placebo pill for 2 months. The primary outcome was pain intensity, measured using a visual analogue scale (VAS). The secondary outcome was the impact of pain on oral health-related quality of life, assessed by the Oral Health Impact Profile questionnaire (OHIP-14). Evaluations were conducted at baseline and after the 1st and 2nd months of treatment. No statistically significant differences were observed between the treatment groups at baseline (p > 0.05). After 2 months of treatment participants in amitriptyline group experienced a significantly greater reduction in spontaneous pain, with a 63.3% decrease in VAS scores. Participants in placebo group showed a much smaller reduction in spontaneous pain, with only a 16.2% decrease in VAS scores. Additionally, the amitriptyline group demonstrated a significant improvement in OHIP-14 scores (p < 0.001), whereas the placebo group showed no significant change in oral health-related quality of life (p = 0.184). This study highlights low-dose amitriptyline as an effective treatment for chronic TMD, showing significant pain reduction and improved quality of life, underscoring its value in a multimodal approach despite the need for further research to personalize care. This study was registered retrospectively in ISRCTNregistry under the number ISRCTN17622685, on 01/10/2024.

Objectives: The primary aim was to compare the amount of bone height change that occurs around the tooth and the implant when having tooth-implant-supported prosthetic restorations versus bone height change that appears around implants in only implant-supported prosthetic restorations. The secondary aim was to examine the influence of various factors such as the number of teeth involved in the construction, their endodontic treatment, number of implants, the type of implantology con-struction, the jaw in which the construction is located, the condition of the opposite jaw, gender, age, and working time, as well as to examine whether the initial bone level influenced the amount of change in bone height itself. Materials and methods: With a total of 50 respondents, 25 X-ray pan-oramic images were representing tooth-implant-supported prosthetic restorations, while the other 25 were representing implant-supported prosthetic restorations. Bone measures were taken (from enamel-cement junction/implant neck to the most apical bone point) from 2 panoramic radiographs. The first one is immediately after the implant placement and the second and the last one again in half a year up to seven years after, depending on the time when the photo was taken for each patient. The obtained difference represented the bone resorption, the bone formation, or a state without change. Influence of different factors, such as sex, age of the patient, working time, the number of teeth in-volved in the construction, endodontic treatment, number of implants, the type of implant construc-tion, the jaw where the construction is located, the condition of the opposite jaw, as well as the ini-tial bone condition, was examined. During the statistical analysis, frequency tables, basic statistical parameters, the Mann-Whitney U test, the Kruskal-Wallis Anova, Wilcoxon test, and regression anal-ysis were used, and the results were presented in tabular form and the form of the Pareto diagram of t-values. Results: No statistically significant difference in bone change (whether we are talking about the place of the implant (-0.359 & PLUSMN;1.009 and median value 0.000), the place of a tooth (-0.428 & PLUSMN;0.746 and median value-0,150) in tooth-implant supported restorations, or the place of the implant in case of implant-supported structures (-0,059 & PLUSMN;0,200 and median value-0,120)) was proven. When talking about the influence of other factors, by regression analysis, the number of implants was shown to be the only factor with a statistically significant influence (& beta;=0.54; P=0.019) in a change of bone level, but only when talking about implant-supported restorations. Conclusion: No significant difference was proven between bone height change, neither around the tooth nor the implant in tooth-implant -supported prosthetic restorations compared to the bone height changes around the implant in only implant-supported prosthetic restorations. Among all the examined factors, the number of implants has shown to have statistically significant contribution to the amount of bone height change in im-plant-supported prosthetic restorations.