The number of studies on the subject of effects of zirconium dioxide (ZrO2) nanoparticles addition on the mechanical parameters of polymethyl methacrylate (PMMA) is still very limited. Therefore, in this research, the authors wanted to assess PMMA modified with the nano-ZrO2 additive in terms of changes in flexural, impact and tensile strength values in relation to PMMA without such component. A systematic review and meta-analysis were performed to evaluate the effect of incorporating nano-ZrO2 into PMMA on individual types of material strength. The obtained numerical data were tabulated and analyzed in the search for percentage changes in those parameters. It was then calculated for each set and the procured model was examined using residual sum of squares (RSS) to assess the discrepancy between the data and the estimation model whilst mean absolute deviation (MAD) was employed to determine robustness. The results of the systematic review were composed of data obtained from individual studies presented in eight independent articles. Overall, the addition of nano-ZrO2 increases the flexural strength of the composite with the PMMA matrix depending on the size of the ZrO2 grains administered. Unfortunately, these conclusions are based on a very limited amount of research and require further verification, especially regarding tensile strength.
Background: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction. Methods: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis. Results: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle. Conclusions: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.
The study described in this paper was conducted to assess the short-term outcomes of intra-articular administration of hyaluronic acid in patients with symptoms of temporomandibular joint disorders. A group of 40 patients suffering from temporomandibular joint disorders underwent a series of hyaluronic acid intra-articular injections. Questionnaires and clinical examinations were conducted to assess stress exposure of the subjects and to evaluate short-term treatment outcomes, i.e., reducing joint and muscle pain and increasing the mobility of the mandible. A weak positive correlation between stress exposure and pain was observed. As a result of treatment, 61% of subjects revealed a total reduction of muscle pain, while joint pain completely resolved in 88% of patients. Mandibular mobility increased by 11%, 31%, 9%, and 11% regarding opening, protrusive, and lateral right and left movements, respectively. The study confirms the short-term effectiveness of intra-articular administration of hyaluronic acid on reducing joint and muscle pain in patients with articular disc displacement. The treatment positively affected the mobility of the mandible in all directions. The verification of late treatment effects of hyaluronic acid viscosupplementation requires the continuation of the research.
Introduction: Hyaluronic acid, steroids and blood products are popularly injected into the temporomandibular joint (TMJs) to relieve pain and increase the extent of mandibular abduction. The purpose of this review is to identify other injectable substances and to evaluate them in the above-mentioned domains. Material and methods: The review included articles describing clinical trials of patients treated with intra-articular injections with or without arthrocentesis. Results: The following emerging substances were initially evaluated to be effective in treating TMJ pain and increasing the amplitude of mandibular abduction: analgesics, dextrose with lidocaine, adipose tissue, nucleated bone marrow cells and ozone gas. Discussion: Better effects of intra-articular administration are achieved by preceding the injection with arthrocentesis. Conclusions: The most promising substances appear to be bone marrow and adipose tissue.
Background/Objectives: The role of artificial intelligence (AI) in dentistry is becoming increasingly significant, particularly in diagnosis and treatment planning. This study aimed to assess the sensitivity, specificity, accuracy, and precision of AI-driven software in analyzing dental panoramic radiographs (DPRs) in patients with permanent dentition. Methods: Out of 638 DPRs, 600 fulfilled the inclusion criteria. The radiographs were analyzed by AI software and two researchers. The following variables were assessed: (1) missing tooth, (2) root canal filling, (3) endodontic lesion, (4) implant, (5) abutment, (6) pontic, (7) crown, (8) and sound tooth. Results: The study revealed very high performance metrics for the AI algorithm in detecting missing teeth, root canal fillings, and implant abutment crowns, all greater than 90%. However, it demonstrated moderate sensitivity and precision in identifying endodontic lesions and the lowest precision (65.30%) in detecting crowns. Conclusions: AI software can be a valuable tool in clinical practice for diagnosis and treatment planning but may require additional verification by clinicians, especially for identifying endodontic lesions and crowns. Due to some limitations of the study, further research is recommended.
This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more efficient than analogous superior compartment interventions. Publications reporting differences between the above-mentioned techniques in the domains of revealing articular pain, decreasing the Helkimo index, and abolishing mandibular mobility limitation were included. Medical databases covered by the Bielefeld Academic Search Engine, Google Scholar, PubMed, ResearchGate, and Scopus engines were searched. The risk of bias was assessed using dedicated Cochrane tools (RoB2, ROBINS-I). The results were visualized with tables, charts, and a funnel plot. Six reports describing five studies with a total of 342 patients were identified. Of these, four trials on a total of 337 patients were qualified for quantitative synthesis. Each eligible report was at moderate risk of bias. From 19% to 51% improvement in articular pain, 12–20% lower Helkimo index, and 5–17% higher maximum mouth opening were observed. The evidence was limited by the small number of eligible studies, discrepancies regarding the substances used, possible biases, and the differences in observation times and scheduled follow-up visits. Despite the above, the advantage of inferior over superior compartment temporomandibular joint intra-articular injections is unequivocal and encourages further research in this direction.