Background: Temporomandibular disorders (TMDs) represent a prevalent multifactorial condition that impacts a significant portion of the global population. The objective of this study was to employ Fonseca’s questionnaire for an initial assessment of TMDs. Methods: A cross-sectional study was conducted on a sample of 250 undergraduates from the Dental School of the University of Perugia, Italy. The chi-square test, with a significance level set at p < 0.05, was used to evaluate a statistically significant relationship between TMDs and several variables such as gender, age, employed/unemployed, and physically active or not. Results: The data obtained through the questionnaire indicated that a considerable percentage of students (78%) exhibited signs consistent with TMDs. The most frequently reported signs and symptoms included psychological stress (49.6%), dental clenching and grinding (34%), joint clicking (33.6%), frequent headaches (15.2%), and neck pain (23.2%). Notably, when considering moderate to severe symptoms of TMDs, females were more significantly affected than males. Furthermore, factors such as age, employment status, and physical activity did not appear to influence the prevalence of TMDs. Conclusions: The high prevalence of TMDs identified within this young population (university students), as measured by this questionnaire (albeit warranting validation through more rigorous methodologies) underscores the necessity for the implementation of new preventive strategies that specifically address this demographic.
Background: The surgery-first approach (SFA) in orthognathic surgery eliminates the need for pre-surgical orthodontic treatment, significantly reducing overall treatment time. However, reliance on a compromised occlusion introduces risks of condylar displacement and remodeling. This study employs artificial intelligence (AI) and deep learning to analyze condylar behavior, comparing the outcomes of SFA to the traditional surgery-late approach (SLA). Methods: A retrospective analysis was conducted on 77 patients (18 SFA and 59 SLA) treated at Perugia Hospital between 2016 and 2022. Preoperative (T0) and 12-month postoperative (T1) cone-beam computed tomography (CBCT) scans were analyzed using the 3D Slicer software and its Dental Segmentator extension, powered by a convolutional neural network (CNN). This automated approach reduced segmentation time from 7 h to 5 min. Pre- and postoperative 3D models were compared to assess linear and rotational deviations in condylar morphology, stratified via dentoskeletal classification and surgical techniques. Results: Both the SFA and SLA achieved high surgical accuracy (<2 mm linear deviation and <2° rotational deviation). The SFA and SLA exhibited similar rates of condylar surface remodeling, with minor differences in resorption and formation across dentoskeletal classifications. Mean surface changes were 0.41 mm (SFA) and 0.36 mm (SLA, p < 0.05). Conclusions: Deep learning enables rapid, precise CBCT analysis and shows promise for the early detection of condylar changes. The SFA does not increase adverse effects on condylar morphology compared to SLA, supporting its safety and efficacy when integrated with AI technologies.
Objective: Lower third impacted molar extraction, despite being a routinary procedure for oral and maxillo-facial surgeons, may often result in a significantly negative impact in patient’s post-operatory quality of life. Among others, treatments based on oxygen-enriched oils have been shown to provide valuable therapeutic benefits in promoting wound healing, and therefore improving the immediate post-operatory symptomatology. The aim of this triple-blinded randomized controlled study is to supplement the existing evidence in the scientific literature by assessing the effectiveness of NovoX®-Drop (Moss S.p.A., Lesa, Novara), a specific type of oxygen enriched oil-based device in reducing pain and inflammatory stimulus of post-surgical wounds following the extraction of lower third impacted molars. Materials and methods: Seventy-one patients undergoing surgical extraction of a single lower third impacted molar were randomly assigned to receive either NovoX®-Drop (Group A) or a glycerin-based gel (Group B). Additionally, both patient groups followed the same standard therapy with amoxicillin-clavulanic acid and ibuprofen. Data were collected preoperative (T0) and after three (T3) and seven (T7) days postoperative in order to assess the following outcomes: mean visual analogue scale (VAS) score during the seven days protocol treatment, total duration of nonsteroidal anti-inflammatory drug (NSAID) usage, trismus (maximum mouth opening) and facial oedema. Results: Group A (treatment group) reported significatively lower pain levels at T7 compared to group B (average VAS value during the week: Group A: 3.57 ± 0.39 cm; Group B: 4.47 ± 0.40 cm; p-value = 0.0014) despite a significatively shorter period of NSAID usage (average NSAID usage duration: Group A: 2.43 ± 0.38 days; Group B: 3.38 ± 0.44 days; p-value = 0.00001). Therefore, trismus seems to be better controlled in group A, although the difference between the groups did not reach the threshold for statistical significance. Conclusions: The results of this study suggest that application of NovoX®-Drop is capable of significantly reducing the post-operatory pain as well as NSAID usage, representing a promising and effective option for third impacted molar extraction surgery management.