Periodontitis is a highly prevalent disease. As it progresses, it causes serious morbidity in the form of periodontal abscesses and tooth loss and, in the latter stages, pain. It is also now known that periodontitis is strongly associated with several nonoral diseases. Thus, patients with periodontitis are at greater risk for the development and/or exacerbation of diabetes, chronic obstructive pulmonary disease, and cardiovascular diseases, among other conditions. Although it is without question that specific groups of oral bacteria which populate dental plaque play a causative role in the development of periodontitis, it is now thought that once this disease has been triggered, other factors play an equal, and possibly more important, role in its progression, particularly in severe cases or in cases that prove difficult to treat. In this regard, we allude to the host response, specifically the notion that the host, once infected with oral periodontal pathogenic bacteria, will mount a defense response mediated largely through the innate immune system. The most abundant cell type of the innate immune system – polymorphonuclear neutrophils – can, when protecting the host from microbial invasion, mount a response that includes upregulation of proinflammatory cytokines, matrix metalloproteinases, and reactive oxygen species, all of which then contribute to the tissue damage and loss of teeth commonly associated with periodontitis. Of the mechanisms referred to here, we suggest that upregulation of reactive oxygen species might play one of the most important roles in the establishment and progression of periodontitis (as well as in other diseases of inflammation) through the development of oxidative stress. In this overview, we discuss both innate and epigenetic factors (eg, diabetes, smoking) that lead to the development of oxidative stress. This oxidative stress then provides an environment conducive to the destructive processes observed in periodontitis. Therefore, we shall describe some of the fundamental characteristics of oxidative stress and its effects on the periodontium, discuss the diseases and other factors that cause oxidative stress, and, finally, review potentially novel therapeutic approaches for the management (and possibly even the reversal) of periodontitis, which rely on the use of therapies, such as resveratrol and other antioxidants, that provide increased antioxidant activity in the host.

The objective of this study was to systematically evaluate gender differences in the prevalence of TMD. A systematic review was performed in PubMed, EMBASE, Web of Science and LILACS in duplicate by two independent reviewers. The inclusion criteria were cross-sectional studies that reported the prevalence of TMD for men and women and that used the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I group diagnostic criteria:(group I = muscle disorders; group II = disc displacements; group III = arthralgias/arthritis/arthrosis).To be eligible for inclusion, studies must include adult individuals (>18 years) from a non-clinical population (ie without pre-diagnosis of TMD); in other words, from population-based studies. There were no restrictions on the year and language of publication. The quality of the articles was assessed by an adapted version of the Newcastle-Ottawa Scale(NOS), and the publication bias was assessed by a funnel plot graph. Data were quantitatively analysed by meta-analysis using odds ratio (OR) as the measure effect. The electronic search retrieved a total of 6104 articles, of which 112 articles were selected for full-text reading according to the eligibility criteria. By means of manual search, one study was retrieved. Five articles were selected for meta-analysis with a combined sample of 2518 subjects. Women had higher prevalence of TMD in all RDC/TMD diagnostic groups. The meta-analysis yielded the following results: (a) OR = 2.24 for global TMD (groups I, II and III combined), (b) OR = 2.09 for group I, (c) OR = 1.6 for group II and (d) OR = 2.08 for group III. The importance of gender in the development of TMD has been demonstrated, with a two times greater risk of women to develop it as compared to men.

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The primary objective of this study was to assess the prevalence of temporomandibular disorders (TMDs) and comorbid factors (sleep bruxism and headaches). This study was a cross-sectional population survey in the city of Maringá, state of Paraná, Brazil. Materials and Methods: Axes I and II of the Research Diagnostic Criteria for TMD (RDC/TMD) were used for assessment of TMD signs and symptoms. The population was users of the Brazilian public health system (SUS), of both sexes, between the ages of 20 and 65 years, and not seeking treatment for TMD. Results: The selected population (N = 1,643) was composed mostly of (a) women (65.9%), (b) married or single individuals (90.6%), (c) Caucasians (70.1%), (d) individuals aged 32.7 ± 10.3 years, (e) individuals earning a medium income (75.1%), and (f) those who had completed a high school education or higher (79.9%). According to the chronic pain grade classification (CPG) in the RDC/TMD Axis II, 36.2% of the population had some degree of TMD pain (CPG I to IV); however, only 5.1% had severe limitation due to pain (CPG III or IV). In the RDC/TMD Axis I diagnoses, 29.5% presented with muscle disorders (group I), 7.9% with disk displacements (group II), and 39.1% with other joint disorders (group III). Headaches were present in 67.9% and awake and sleep bruxism in 30% and 33.4% of the population, respectively. Conclusion: The prevalence of signs and symptoms of TMD was high in this population, but with low disability; however, the proportion of patients in need of treatment was much lower.

Absence of bilateral canine guidance on lateral excursion and particularly Angle Class II malocclusion were considered important risk indicators for the development of TMD in this investigation, even when some sociodemographic factors were considered as effect modifiers.