Tag: statistics

Monaldi Arch Chest Dis. 2025 Oct 9. doi: 10.4081/monaldi.2025.3227. Online ahead of print.

ABSTRACT

Acute lower respiratory infections are one of the leading causes of morbidity and mortality in children globally. There is a lack of data reflecting the true burden of viral lower respiratory tract infections from low-middle-income countries like Pakistan. This study aims to describe the epidemiology and outcome of viral lower respiratory infection. This was a cross-sectional and retrospective study carried out from January 1, 2019, to December 31, 2021. We identified 13 different non-COVID viral respiratory pathogens. The statistical association was assessed between different factors, i.e., viral respiratory pathogens, with invasive and non-invasive mechanical ventilation, inotropic support, and mortality. A p-value of <0.05 was taken as significant. Among 234 patients, 187 (80%) had positive viral polymerase chain reaction (PCR). Males were predominant (n=137, 58%). The most common respiratory pathogen was the respiratory syncytial virus (RSV) (n=62, 26%), followed by entero/rhinovirus (n=24, 10%). Half of the patients (n=92, 50%) had a pediatric intensive care stay, and all required non-invasive mechanical ventilation (hi-flow). One-fifth of patients (n=34, 18%) required invasive mechanical ventilation and inotropic support. Overall, 8 (4%) patients with positive viral PCR died during the hospital stay. All the patients had associated comorbidity. RSV is the most common respiratory pathogen identified. Non-invasive mechanical ventilation, particularly high-flow therapy, is crucial in managing patients with viral illnesses, though a subset may still require invasive support. These findings highlight the importance of preventive strategies, including vaccination, which could significantly reduce the burden of viral infections, minimize the need for intensive care interventions, and lower morbidity and mortality.

PMID:41070591 | DOI:10.4081/monaldi.2025.3227

J Oral Facial Pain Headache. 2025 Sep;39(3):191-199. doi: 10.22514/jofph.2025.061. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: This study aimed to determine the frequency and associated factors of cervicogenic headache (CGH) in individuals with forward head posture (FHP). Additionally, craniovertebral angle (CVA)-related factors were examined in patients diagnosed with CGH.

METHODS: This cross-sectional study included 117 patients aged 18-45 years who presented with neck pain and were identified with FHP. CGH diagnosis was based on the International Classification of Headache Disorders (ICHD-3) criteria. CVA was measured using posture analysis software, and assessments included the Neck Disability Index (NDI), Henry Ford Headache Disability Inventory (HDI-T), Headache Impact Scale (HIT-6), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Visual Analog Scale (VAS) for pain. Statistical analyses included independent t-tests, chi-square tests and logistic regression models.

RESULTS: The frequency of CGH in patients with FHP was 53.8%. Compared to the non-CGH group, those with CGH had significantly lower CVA (p = 0.030) and higher PSQI (p = 0.001) and BDI scores (p < 0.001). Logistic regression analysis identified low CVA (Odds Ratio (OR): 0.878, p = 0.014) and poor sleep quality (OR: 1.140, p = 0.025) as independent predictors of CGH. Additionally, Body Mass Index and VAS scores were negatively correlated with CVA (p < 0.05).

CONCLUSIONS: FHP may be associated with CGH, possibly through increased biomechanical load and neuromechanical sensitivity. Interventions such as corrective exercises, weight management, and improving sleep quality may be considered as supportive strategies in CGH management; however, causal relationships cannot be inferred from this study. Further studies are needed to explore the long-term effects of postural interventions on CGH.

PMID:41070580 | DOI:10.22514/jofph.2025.061

J Oral Facial Pain Headache. 2025 Sep;39(3):183-190. doi: 10.22514/jofph.2025.060. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: Burning mouth syndrome (BMS) is a chronic orofacial pain disorder. The etiology and pathophysiology of BMS remain unclear; multiple factors may interact in complex ways. There is a need for simpler and more cost-effective BMS evaluation criteria. This study aimed to evaluate the reliability and validity of the Short Form McGill Pain Questionnaire version 2 (SF-MPQ-2) in patients with BMS and develop a subscale based on factor analysis of the results to classify patients per their symptoms.

METHODS: Several factors such as patient characteristics (age, sex, smoking habit, and medical history), the SF-MPQ-2 (original: eleven-point rating scale and modified: four-point rating scale), and the numerical rating scale (NRS) of BMS were examined and analyzed.

RESULTS: In total, 38 patients were enrolled. Cronbach’s alpha was 0.93 (0.88-0.96) and 0.83 (0.74-0.90) for the SF-MPQ-2 (original) and SF-MPQ-2 (Modified), respectively. Only the correlation between the NRS and the SF-MPQ-2 (Modified) reached statistical significance. These results showed that the SF-MPQ-2 (Modified) were more reliable than the SF-MPQ-2 (Original). Factor analysis led to classification into three new factors.

CONCLUSIONS: SF-MPQ-2 was useful for BMS. In current clinical practice, the modified questionnaire may yield similar or better results, and a more precise treatment strategy can be pursued by classifying responses according to the proposed subscales and examining treatment effects.

PMID:41070579 | DOI:10.22514/jofph.2025.060

J Oral Facial Pain Headache. 2025 Sep;39(3):172-182. doi: 10.22514/jofph.2025.059. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: This study aimed to evaluate the relationships between magnetic resonance imaging (MRI) findings (such as condylar degeneration, disc displacement, joint effusion and disc deformity) and clinical symptoms in patients with temporomandibular joint disorders (TMDs).

METHODS: A total of 54 patients (108 temporomandibular joints (TMJs)) were included. Clinical evaluations assessed joint pain, joint sounds, mouth opening limitations, deviation/deflection and locking. MRI scans were analyzed for condylar degeneration, disc displacement (disc displacement with reduction (DDWR) or disc displacement without reduction (DDWOR)), joint effusion, and disc morphology. Statistical analyses included chi-square tests/Fisher’s exact tests for categorical variables. A p value < 0.05 was considered to be statistically significant.

RESULTS: DDWR and DDWOR were significantly associated with joint pain (p = 0.044) and sounds (p = 0.032). Joint effusion demonstrated no clear correlation with clinical symptoms. Condylar degeneration was frequently observed but had limited clinical impact, except for a reduction in joint sounds (p = 0.03). Moreover, disc deformity was significantly correlated with condylar degeneration and joint effusion (p < 0.001).

CONCLUSIONS: MRI findings provide valuable insights into the structural changes observed in TMDs. Although disc displacement is strongly linked to pain and joint sounds, condylar degeneration and effusion exhibit more complex relationships with clinical symptoms.

PMID:41070578 | DOI:10.22514/jofph.2025.059

J Oral Facial Pain Headache. 2025 Sep;39(3):163-171. doi: 10.22514/jofph.2025.058. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: Temporomandibular disorders (TMD) are common, particularly in females of reproductive age, but it remains unclear if TMD and female reproductive traits directly influence each other. Previous studies have suggested links between reproductive factors, such as the menstrual cycle and menopause, and TMD, yet any causal link is unconfirmed. This study seeks to delineate the reciprocal causal interplay between female reproductive traits and TMD.

METHODS: A bidirectional Mendelian randomization (MR) approach was applied to assess five reproductive traits-age at menarche, first sexual intercourse, first birth, last birth, and menopause-considering TMD as the outcome in one analysis and the exposure in the reverse. Statistical methods, including the inverse variance-weighted method, MR Egger, MR Pleiotropy Residual Sum and Outlier (MR-PRESSO), Cochran’s Q test, and leave-one-out analyses, were used to examine pleiotropy and heterogeneity.

RESULTS: Later age at first sexual intercourse (odds ratio (OR) = 0.51, 95% confidence intervals (CI) 0.37-0.71, p = 6.46 × 10^-5), first birth (OR = 0.86, 95% CI 0.78-0.95, p = 0.003), and last birth (OR = 0.37, 95% CI 0.17-0.78, p = 0.009) were identified to be protective against TMD. No significant associations emerged for age at menarche or menopause. However, TMD onset may contribute to delayed menarche (Beta = 0.04, 95% CI 0.01-0.06, p = 0.035) without affecting other reproductive traits.

CONCLUSIONS: Genetically determined later timing of first sexual intercourse, first birth, and last birth may protect against TMD, while TMD onset may delay menarche, suggesting a bidirectional relationship between reproductive timing and TMD.

PMID:41070577 | DOI:10.22514/jofph.2025.058

J Oral Facial Pain Headache. 2025 Sep;39(3):145-151. doi: 10.22514/jofph.2025.056. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: In everyday clinical practice, the screening of specific genes for awake bruxism (AB) is not a sustainable and feasible practice; most of the time, the only information that clinicians can rely on is investigating the family history of bruxism. Nevertheless, little is known about the relationship between the reported history and AB frequency. The aim of the present paper is to assess the existence of any differences in the frequency of self-reported AB behaviors between healthy young individuals with and without a positive report of family history of bruxism.

METHODS: Participants were recruited within the community of the University of Siena by advertising the possibility of taking part in the investigation through the academic website and mail. All the participants performed a seven-day monitoring of the frequency of self-reported AB via the ecological momentary assessment (EMA). Moreover, for the assessment of bruxism family history, participants were asked to fill out a short questionnaire taken from the Standardized Tool for the Assessment of Bruxism (STAB).

RESULTS: The final sample was composed of 117 individuals (32 males and 85 females, mean age 22.3 ± 2.3). Of the total amount of participants, 48.7% reported a positive family history of bruxism. The Mann-Whitney U test showed a statistically significant difference in the reported frequency of all AB behaviors (i.e., teeth contact, mandible bracing, teeth clenching, teeth grinding) between the two groups (p < 0.05). Conversely, no significant difference in the frequency of AB behaviors was present between individuals with a positive report of family history in first-degree relatives compared to second-degree relatives (p > 0.05).

CONCLUSIONS: Based on these findings, clinicians are recommended to not underestimate a positive family history of bruxism, as it can be an indicator of an ongoing AB.

PMID:41070575 | DOI:10.22514/jofph.2025.056

J Oral Facial Pain Headache. 2025 Sep;39(3):133-144. doi: 10.22514/jofph.2025.055. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: The study aimed to retrospectively evaluate the clinical efficacy of a computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated occlusal splint combined with manual therapy in patients diagnosed with anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ).

METHODS: The medical records of 65 adult patients with ADDwoR, treated between March 2022 and March 2023, were reviewed and allocated into three treatment groups based on the interventions they received, namely, occlusal splint therapy alone (n = 22), occlusal splint therapy combined with manual therapy (n = 22), or health education alone (n = 21). All participants received standardized health education. Clinical outcomes, including Maximum Mouth Opening (MMO), Visual Analog Scale (VAS) for pain, and the Mandibular Functional Impairment Questionnaire (MFIQ), were assessed at baseline and one and three months post-treatment by blinded evaluators. Statistical analyses were conducted using Python with Welch’s analysis of variance (ANOVA) and repeated measures ANOVA, and significance was set at p < 0.05.

RESULTS: The baseline demographic and clinical characteristics were similar among the three groups (all p > 0.05). At the three-month follow-up, no significant changes were observed in the health education group (p > 0.05). In contrast, both the occlusal splint group and the combined treatment group demonstrated significant improvements in MMO, VAS and MFIQ scores at both one and three months compared to baseline (all p < 0.05). Moreover, the combined treatment group showed significantly greater improvement in all measured outcomes than the splint-only group at each follow-up, with the most substantial differences observed at the three-month follow-up (all p < 0.05).

CONCLUSIONS: This short-term non-randomized retrospective study suggests that combining CAD/CAM-fabricated occlusal splint therapy with manual therapy yielded superior pain relief and functional improvement compared to splint therapy alone or health education in patients with ADDwoR.

PMID:41070574 | DOI:10.22514/jofph.2025.055

J Oral Facial Pain Headache. 2025 Sep;39(3):113-120. doi: 10.22514/jofph.2025.053. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: Burning mouth syndrome (BMS) is a chronic pain disorder affecting the oral mucosa, often accompanied by psychological comorbidities. Higher levels of mindfulness have been associated with reduced pain and fewer emotional symptoms in some chronic pain conditions, but its role in BMS remains inadequately explored.

METHODS: 146 patients diagnosed with BMS, according to the International Classification of Orofacial Pain, 1st edition, were recruited from the Department of Oral Medicine at a stomatology hospital. Mindfulness, pain intensity and psychological symptoms were assessed using the Five Facet Mindfulness Questionnaire, visual analog scale, and self-report screening tools, respectively. Spearman’s correlation and multiple regression analyses were conducted to evaluate the relationships between mindfulness and levels of pain, anxiety, and depression.

RESULTS: Mindfulness showed significant negative correlations with pain (r = -0.204, p < 0.05), anxiety (r = -0.309, p < 0.01), and depression (r = -0.299, p < 0.01). After controlling for confounding variables, higher overall mindfulness remained significantly associated with lower pain intensity (β = -0.268, p < 0.05), although the associations with anxiety and depression were no longer statistically significant (p > 0.05). Among the mindfulness facets, higher scores on the “describing” facet were associated with reduced pain intensity (β = -0.231, p < 0.05). Additionally, higher scores on the “non-judging” (Odds Ratio (OR) = 0.871, p < 0.05) and “non-reactivity” (OR = 0.869, p < 0.05) facets were associated with fewer anxiety symptoms, while the “acting-with-awareness” facet was significantly associated with fewer depressive symptoms (OR = 0.869, p < 0.05).

CONCLUSIONS: The overall mindfulness level and the “describing” facet appear to be associated with pain severity, whereas the “non-judging” and “non-reactivity” facets are related to anxiety symptoms, and the “acting-with-awareness” facet is linked to depressive symptoms, suggesting that mindfulness-based interventions may offer a beneficial approach in the management of BMS.

PMID:41070572 | DOI:10.22514/jofph.2025.053

J Oral Facial Pain Headache. 2025 Sep;39(3):105-112. doi: 10.22514/jofph.2025.052. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: Temporomandibular disorders (TMD) encompass musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ), masticatory muscles and other associated structures. While all dentists, regardless of their specialty, should possess a comprehensive understanding of TMD diagnosis and treatment, there is a limited number of studies assessing the knowledge and attitudes of pediatric dentists on this subject. The objective was to evaluate the knowledge and attitudes of pediatric dentists regarding the diagnosis and management of TMD in pediatric patients.

METHODS: This observational, analytical, cross-sectional study included 266 pediatric dentists who completed a 41-item questionnaire. Of these, 35 items assessed knowledge, while six evaluated attitudes. Descriptive statistics were analysed, and the chi-square test was applied for comparisons, with statistical significance set at p < 0.05.

RESULTS: The mean correct response rate across the four assessed domains was 49.5%. The lowest accuracy was observed in the pathophysiological domain (33%), followed by the psychophysiological domain (50%), the psychiatric disorders domain (64.1%) and the chronic pain domain (50.4%).

CONCLUSIONS: Pediatric dentists exhibited limited knowledge of TMD but expressed positive attitudes toward its diagnosis and treatment. Morever, they demonstrated a lack of awareness regarding their role in preventive education on this condition.

PMID:41070571 | DOI:10.22514/jofph.2025.052

J Oral Facial Pain Headache. 2025 Sep;39(3):77-83. doi: 10.22514/jofph.2025.049. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: Restrictive lingual frenula, commonly referred to as ankyloglossia, are well documented in pediatric literature, with established impacts on breastfeeding, swallowing, reflux, speech, maxillary development, breathing, and sleep in children. However, data on its effects in adolescents and adults remains limited. This study aimed to investigate the correlation between restrictive lingual frenula and the development of temporomandibular disorders (TMD) in an adult population.

METHODS: A total of 129 patients (aged 18-80 years; 41 males and 88 females) were assessed for TMD signs and symptoms using the three Lövgren screening questions, supplemented by a clinical examination following the German Association for Craniomandibular Function and Diagnostics (DGFDT) screening protocol. The presence and severity of ankyloglossia were evaluated using the Tongue Range of Motion Ratio (TRMR 2019) and Kotlow’s free tongue classification. Association between variables were analyzed using Chi-square tests.

RESULTS: TMD was identified in 49.1% of the cohort, while ankyloglossia was observed in 46.7% based on the TRMR. No significant association was found between TMD and either anterior (39.6%) or posterior (34.9%) tongue restriction using the TRMR criteria. However, when categorized according to Kotlow’s classification, mild to severe ankyloglossia (59.2%) showed a statistically significant association with TMD (p = 0.026). Age and sex were not significantly associated with the presence of ankyloglosson, while TMD occurrence was found to be correlated with sex.

CONCLUSIONS: A weak but significant correlation was observed between TMD and the degree of ankyloglossia, particularly when assessed using Kotlow’s method. Further studies with larger sample sizes, stratified by age and sex, incorporating occlusal factors, and employing a standardized validated assessment tool adapted for adults, accounting for both anatomical and functional criteria are warranted to explore potential causal relationships.

PMID:41070568 | DOI:10.22514/jofph.2025.049