Background/Objectives: The study aimed to validate the diagnostic system proposed by the Standardized Tool for the Assessment of Bruxism (STAB) by correlating the results obtained based on questionnaire and non-instrumental and instrumental tools. Methods: The study had three stages (questionnaire, clinical examination, and electromyographic study). The subjects completed a questionnaire and clinical exam. Positive signs of bruxism included oral mucosal signs and the presence of dental wear according to the BEWE index. In stage three, sEMG was performed after allocating subjects into four groups according to the questionnaire and clinical exam results: sleep bruxism (SB), awake bruxism (AB), sleep and awake bruxism (SB AB), and no bruxism (no B). After the third stage, a new selection was made, and the subjects were divided into four groups, according to sEMG results. Diagnostic accuracy was computed for possible bruxism SB and grinding and clenching sound diagnosis, possible bruxism AB and AB acknowledgment, possible bruxism SB AB, and tooth wear index. Results: For SB, the sensitivity and specificity of the tools were the highest. The non-instrumental questionnaire and clinical assessment identified 67% of SB cases and 89% without SB. For AB, the specificity was higher (84%), while the sensitivity was lower (55%), as almost half of the subjects were not aware of the presence of AB. The tests showed a low sensitivity (15%) but a high specificity (83%) for tooth wear. The absence of tooth wear was frequently associated with the absence of bruxism, while the presence of tooth wear did not necessarily imply the existence of bruxism. Conclusions: Non-instrumental evaluation of bruxism through questionnaires and clinical exams is valuable, especially for SB. Instrumental evaluation through electromyography remains a gold standard for bruxism diagnosis.

Background/Objectives: Excessive occlusal forces manifest in bruxism and have consequences on teeth and jaws. The aim of this study was to determine the association of bruxism with clinical and radiological signs of excessive occlusal forces, such as tooth wear, fatigue dental fissures and fractures, abfraction, masseter muscle hypertrophy, and bone apposition at the mandibular angle. Methods: This cross-sectional clinical study included 181 patients presented for treatment in a general dentistry clinic. For each patient, data were extracted from the dental chart, as follows: demographic data (sex, age, and smoking), clinical data (number of teeth present, Eichner edentulous score, TWI wear score, number of fractured teeth, number of teeth with abfraction, presence of masseter hypertrophy, presence of hypersensitivity), and radiological data (bone apposition at the mandibular angle). The patients were divided into two groups according to the presence or absence of bruxism. A binomial logistic regression model was run to determine the association between bruxism and clinical and radiological signs of excessive occlusal forces. The data were statistically processed in SPSS. Results: In total, 99 women and 82 men with mean age 44.87 ± 12.67 were included in the study. Compared to the group without bruxism, the group of patients with bruxism (39.78%) showed statistically significant higher tooth wear index (TWI) (p < 0.0005), a higher number of fractured teeth (p = 0.037), a higher number of teeth with abfraction lesions (p = 0.001), and a significantly higher bone apposition score (p < 0.0005). The binomial logistic regression model showed a high prediction bruxism score for masseter muscle hypertrophy (15 times, p < 0.0005), for tooth wear index (almost 7 times, p = 0.010), and for bone apposition score (almost 3 times, p = 0.044). Conclusions: Patients with bruxism showed masseter muscle hypertrophy, higher attrition-type tooth wear index, and more teeth with fatigue fractures and abfractions than those without bruxism. Bruxism clinical signs were positively correlated with a higher bone apposition score.

Background/Objectives: Bruxism is a masticatory muscle activity, phasic or tonic, with/without teeth contact, that appears in sleep or an awake state. An instrumental technique used to measure the surface electromyographic (sEMG) activity of the masseter muscle is used to diagnose bruxism activity during sleep and while awake. The objective of this study was to compare the variation in bruxism (sleep and awake) indices and masseter activity indices in low sleep bruxism and moderate sleep bruxism before and after wearing an occlusal appliance (OA) for 3 months each night. Methods: A clinical interventional study was designed in which subjects diagnosed with sleep bruxism were randomly selected to be included in the study. After the first sEMG recording, two groups were formed: a low sleep-bruxism group (number of sleep-bruxism events/h between 2 and 4) and a moderate sleep-bruxism group (number of sleep-bruxism events/h equal or higher than 4). All subjects received treatment with a 3D-printed occlusal appliance and wore it each night for 3 months, at which point the second sEMG recording was performed. For each participant of this study, a chart was created that included anamnestic data, clinical data, and sEMG data. The data were statistically analyzed with SPSS, using the Mann–Whitney U and Wilcoxon signed-rank tests. Results: A total of 21 participants were included in the final analysis, 18 women and 3 men, with a mean age of 24.5 ± 2.7 years. The OA lowered all bruxism indices in the whole group, but clusters analysis showed a significant reduction in sleep-bruxism indices in the moderate sleep-bruxism group, while in the low-bruxism group, the sleep and awake indices varied insignificantly, and the number of sleep-bruxism events/h remained constant. Conclusions: The 3D-printed occlusal appliances significantly lowered the sleep-bruxism indices and sleep masseter activity indices recorded with a portable sEMG device in the moderate sleep-bruxism group. The OA lowered the awake-bruxism indices and awake masseter activity indices in the moderate sleep-bruxism group.

Background/Objectives: Saliva plays an essential role in maintaining the oral ecological balance, and its quantitative and qualitative characteristics may influence susceptibility to dental caries. The aim of this study was to determine susceptibility to dental caries based on the DMFT index and to establish a correlation between caries experience and salivary parameters in a group of young adults. Methods: This cross-sectional study was conducted between July and November 2025 on a sample of 87 fourth-year students from the Faculty of Dentistry in Craiova. Each participant underwent an intraoral clinical examination to determine the DMFT index. The salivary parameters assessed included unstimulated salivary flow rate, saliva consistency, salivary pH, stimulated salivary flow rate, and buffering capacity, using the GC Saliva-Check Buffer kit. Statistical analyses were performed using SPSS (Statistical Package for Social Sciences) software, version 26 (SPSS Inc., Armonk, NY, USA). Results: The mean DMFT index value for the entire sample was 8.26 ± 4.481, with higher values observed among female participants. Low salivary pH was significantly associated with higher DMFT values. Participants with low or very low buffering capacity exhibited higher DMFT values compared to those with normal capacity, indicating that a reduced ability to neutralize salivary acidity is associated with increased caries activity. Conclusions: The results indicate that salivary pH and buffering capacity are important factors in dental caries susceptibility among young adults. The integration of salivary testing into the diagnostic assessment of caries risk may contribute to personalized and effective preventive strategies.

Background/Objectives: Occlusal analysis is an important component of oral rehabilitation with a determining role in the prognosis of restorations. Over time, several qualitative and quantitative occlusal analysis methods have been proposed, starting with occlusion wax up to the most advanced digital systems. The objective of the present study was to evaluate and compare the data obtained through dental occlusion analysis using the Medit i700 and Exocad Elefsina v3.2 in a group of subjects, in order to establish the reliability or compatibility between the two occlusal analysis systems. Methods: The study was conducted on 20 subjects, aged between 24 and 53 years, who presented in the Dental Prosthetics Clinic of the University of Medicine and Pharmacy of Craiova. Digital impressions were acquired using the Medit Link v.3.3.6 intraoral scanner, and the digital files were subsequently uploaded from the Medit i700 into the Medit Occlusion Analyzer application and the Dental CAD Exocad software. For the analysis of occlusion in dynamics, mandibular movements and data acquisition, positions of edge-to-edge in protrusion, edge-to-edge in right laterotrusion and edge-to-edge in left laterotrusion were recorded, using the corresponding print screens. The 2D occlusal contact images generated by the two software programs were converted into .jpeg format and subsequently imported into Adobe Photoshop CS6 (2021) for comparative analysis. The data were statistically processed for each software used and the obtained data were subsequently compared. Results: The occlusal surfaces recorded with the Medit Occlusion Analyzer application represent 94% of the occlusal surfaces recorded with the Exocad software for the maxilla and 90% of the occlusal surfaces recorded for the mandible. In maximum intercuspation, the highest values were recorded by the Medit i700 software, whereas in edge-to-edge protrusion and both right and left edge-to-edge laterotrusion positions, the highest values were reported by the Exocad software. The discrepancy between maxillary and mandibular values arises from the conversion of the data from a three-dimensional to a two-dimensional format during image processing. Conclusions: The occlusal areas recorded by the DentalCAD Exocad software show higher values than those provided by the Medit Link software with the Medit Occlusion Analyzer application. The differences in recorded values, in the case of the digital flow of prosthetic restorations, require the intervention of the dentist to perform clinical adjustments to optimize occlusal relationships after the fabrication and cementation of restorations.

Background/Objectives: Fixed prosthetic dentures (FPD) represent a reliable treatment option to rehabilitate oral function and aesthetics. The concentration of loads at a certain level of the bridge causes overloading of the bridge components. The objectives of this study were to identify the frequency and severity of complications in FPDs associated with occlusal overload for patients prosthetically treated with metal–ceramic and metal–acrylic FPDs. Methods: This retrospective cross-sectional clinical study included 306 patients of both sexes, aged 30+, with an FPD requiring rehabilitation. The following data were collected: general demographic data of the patients, data on dental bridges, data on occlusal overloads, and complications of FPDs according to severity. Statistical processing was performed in SPSS. Results: Metal–ceramic FPDs had more abutment teeth (p = 0.035), fewer intermediaries (p < 0.0005), and less severe complications (p = 0.001). Maxillary FPDs had a higher number of abutment teeth, compared to mandible FPDs (p < 0.001). As the life duration of the FPDs increased, the number of intermediaries and the severity grade also increased (p < 0.001). Compared to intercalated and pontics, cantilever pontics of FPDs had a longer duration (p < 0.001), a lower number of intermediaries (p < 0.001), and a higher severity grade (p < 0.001). The presence of occlusal interferences was associated only with a lower FPD duration (p = 0.007). The presence of unbalanced occlusion planes was associated with a higher severity grade, while the presence of shortened arches was associated with a longer FPD duration (p < 0.001), a higher number of intermediaries (p = 0.005), and a higher severity grade (p < 0.001). Conclusions: The most severe complications of FPDs were recorded in the case of shortened arches and cantilever bridges. This study draws attention to the need for preprosthetic and postprosthetic occlusal balancing and the need for complete rehabilitation of the dental arches.