Impacted maxillary canines occur in 1–3% of the population, and adequate anchorage control during orthodontic traction is essential to prevent incisor root resorption and molar mesialisation. This systematic review and meta-analysis aimed to compare skeletal anchorage (TADs) with conventional palatal anchorage for orthodontic traction of impacted maxillary canines, evaluating anchorage loss, traction duration, root resorption, eruption success, and patient-reported outcomes. Four databases (PubMed/MEDLINE, Web of Science, Scopus, Cochrane) were searched from January 2016 to March 2026 following PRISMA 2020 guidelines. RCTs and controlled clinical studies were included; risk of bias was assessed with Cochrane RoB 2 and the Newcastle–Ottawa scale; evidence certainty was rated using GRADE. Nine studies (n = 481 patients; 241 TADs, 240 conventional anchorage) met the inclusion criteria. Skeletal anchorage was associated with significantly less anchorage loss (WMD −1.24 mm; 95% CI [−1.56, −0.92]; p < 0.001; I2 = 62%), shorter traction duration (WMD −1.89 months; 95% CI [−2.71, −1.07]; p < 0.001), and reduced odds of incisor root resorption (OR 0.41; 95% CI [0.22, 0.77]; p = 0.006); eruption success and patient discomfort were comparable between groups. GRADE certainty was moderate for anchorage loss and low-to-very-low for secondary outcomes. TADs provide clinically meaningful advantages over conventional palatal anchorage, particularly in complex palatal impactions; well-designed multicentre RCTs remain warranted.

Background and Objectives: Dysbiosis of the oral–gut axis is related to several extraintestinal inflammatory diseases, including endometriosis. This study aims to assess the microbial landscape and pathogenic potential of distinct biological niches during endometriosis. Materials and Methods: A microbiome meta-analysis was conducted on 182 metagenomic sequences (79 of fecal and 103 of vaginal origin) from women with and without endometriosis. Fecal and vaginal microbial diversity, differential abundance, and functional analysis based on disease status were assessed. Random forest, gradient boosting, and generalized linear modeling were used to predict endometriosis based on differentially enriched bacteria. Results: Only intestinal microbes displayed distinctive taxonomic and functional characteristics in women with endometriosis compared to control women. Taxonomic differences were quantified using the microbial endometriosis index (MEI), which effectively distinguished between individuals with and without the disease. The observed functional enrichment pointed to proinflammatory pathways previously related to endometriosis development. Conclusions: Dysbiosis in the oral–gut microbial community appears to play a prevalent role in endometriosis. Our findings pave the ground for future studies exploring the potential mechanistic involvement of the oral–gut axis in disease pathogenesis.

ABSTRACT Objectives The market offers many plaque‐controlling mouthrinse options, but recent research reveals fatty acids' antimicrobial potential. Despite limited evidence on their antiplaque effects, fatty acids are intriguing for oral care innovation. Material and Methods This noninferiority randomized clinical trial assessed the antiplaque efficacy of a fatty acids–based (FAG) compared to stannous fluoride (SF) mouthrinse in experimental gingivitis induced by 14 days of oral hygiene cessation. Participants used assigned treatments twice daily for 14 days. Full Mouth Plaque and Bleeding Scores (FMPS/FMBS) served as primary outcomes. Statistical analyses encompassed parametric and nonparametric methods, as well as logistic regression models. Results Thirty‐one volunteers (22.9 ± 1.6 years, 58.1 female) completed the trial, split between FAG (n = 15) and SF (n = 16) groups. Experimental gingivitis increased in both groups, with rates of 60.0% and 50.0% for FAG and SF, respectively. After the 14‐day intervention, FMPS and FMBS were reduced in both groups compared to the post‐induction phase, confirming the noninferiority of FAG. Specifically, FAG's FMPS was 39.7% ± 13.8% with FMBS at 28.9% ± 16.9%, while SF's FMPS was 43.2% ± 14.9% with FMBS at 21.4% ± 11.9%. No significant FMPS/FMBS differences were observed overtime, and there were also no significant differences in gingivitis rates throughout the trial. Crude and adjusted models, accounting for baseline FMPS, age and gender, reiterated the lack of significant association between outcomes and treatments. The adjusted odds ratio was 0.71 (p = 0.662). Conclusion This study establishes the noninferiority of fatty acids–based relative to SF mouthrinse in an experimental gingivitis model. Fatty acids offer promising avenues for oral care enhancement, necessitating further investigation and validation in broader real‐life scenarios.

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, ultimately compromising their oral health outcomes. Methods: This prospective randomized crossover split-mouth study involved the application of Ultra-Low Frequency (ULF) Transcutaneous Electrical Nerve Stimulation (TENS) in 20 adult patients undergoing non-surgical periodontal treatment. Pain and discomfort levels were quantitatively assessed during procedures conducted with and without the ULF-TENS intervention. Results: The assessment of maximum voluntary opening, pain intensity, and overall comfort levels indicated a statistically significant reduction in pain (p < 0.0001) and discomfort (p < 0.0001) when ULF-TENS was employed during the treatment, and an increase in the maximum mouth opening after TENS (p = 0.00062). Conclusions: The findings of this pilot study suggest that ULF-TENS may serve as a valuable adjunctive therapy in non-surgical periodontal treatment by reducing pain and discomfort, potentially enhancing patient comfort and compliance. Further research with larger sample sizes is warranted to confirm these findings.

Introduction:Chronic periodontitis is linked to systemic inflammation and cardiovascular risk, yet the temporal trajectory and magnitude of systemic cytokine reduction following nonsurgical-periodontal-therapy (NSPT) remain underexplored. We conducted a meta-analysis and spline-based meta-regression to assess whether intensive NSPT, compared to standard therapy, produces sustained reductions in circulating TNF-α, IL-1β, IL-6 and high-sensitivity C-reactive protein (hs-CRP). Methods:We systematically searched major databases for interventional studies published until January 2024 comparing intensive vs. standard NSPT on inflammatory markers. Using a custom R pipeline, standardized mean differences (SMDs), 95% confidence intervals (Cis) heterogeneity (I²) and stratified analyses by phenotype (e.g., smoking, diabetes) and time were performed. A spline-based mixed-effects meta-regression explored temporal dynamics of inflammatory reduction in the intensive group. Results:From 216 observations (14,374 paired values), intensive NSPT led to significantly greater reductions in TNF-α (SMD -0.59, 95% CI -1.02 to -0.16; P=0.008), IL-6 (SMD -0.20, 95% CI -0.39 to -0.00; P=0.046) and hs-CRP (SMD -1.17, 95% CI -2.18 to -0.16; P=0.024) compared to standard therapy. IL-1β showed a near-significant reduction (SMD -4.14, P=0.052). Standard therapy was paradoxically associated with greater CRP reduction (SMD -0.30, P=0.001). Age, tooth count and year of publication moderated effects. Early benefits emerged within 3 months for TNF-α and 6 months for IL-1β. Although no strong nonlinear time-response was confirmed (QM = 4.23, P=0.2372),a potential rebound in cytokine suppression was suggested. The overall anti-inflammatory effect remained significant. Discussion:Intensive NSPT reduces systemic inflammation particularly in younger, non-smoking individuals. The potential rebound in inflammatory markers underscores the need for longitudinal studies but, supports the systemic immunoregulatory effect of periodontal therapy. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier CDR42024503063.

Objectives:Evaluate the changes in oral microbiota linked to orthodontic treatment by analyzing the 16S rRNA gene. Materials and Methods:A total of 22 articles was included in the systematic review. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale for nonrandomized studies and the Risk of Bias tool for randomized studies. Results:Orthodontic appliances significantly influenced the composition of oral microbiota. Specifically, fixed orthodontic appliances were linked to an increase in periodontopathogenic bacteria associated with various systemic diseases. In contrast, transparent aligners correlated with an increase in Streptococcus species. Conclusions:In this study, we evaluated the changes in oral microbiota associated with orthodontic treatment by analyzing the 16S rRNA gene. Results revealed significant alterations in oral microbiota following orthodontic treatment; however, significant variability among studies prevents firm conclusions. Additional research is essential to clarify the effects on oral health.

Purpose: This study systematically analyzed the published literature to evaluate the reliability of the caries experience index detection conducted in children (younger than 18 years of age) through teledental systems, comparing it with data obtained through traditional dental consultations. The question to be explored was whether dentists could use teledentistry to assess the caries risk index by calculating the DMFT (decayed, missing, and filled permanent teeth) score, thereby potentially reducing consultation time. Methods: A systematic English-language literature review was conducted, including the period from 2014 to 2024, that included the MeSH terms (("telemedicine"[Mesh]) AND "dental caries"[Mesh]) AND "DMF index"[Mesh]). Inclusion and exclusion criteria were defined according to the PICO methodology. A total of 11 manuscripts met the inclusion criteria. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale (NOS) with specific tools for cross-over studies. Results: From the 11 studies reviewed, it was suggested that teledentistry, through the use of intraoral photographs or video recordings, may represent a reliable, noninvasive, and efficient alternative for the detection of the caries experience index, compared to clinical examinations performed according to the traditional method. In most cases, the results were comparable between the two approaches. Conclusion: Incorporating teledentistry in combination with regular dental appointments could streamline clinical processes, enable effective treatment planning, and facilitate remote monitoring of the oral health status of patients, making it a timely and contemporary solution for a connected and health-conscious society-which is particularly valuable during public health crises such as the COVID-19 pandemic.

Background: A transverse discrepancy refers to a dimensional difference in the transverse component of the upper and lower dental arches with functional and esthetic implications. The main purpose of this study is to compare the effectiveness of transverse expansion movement of dentoalveolar nature performed by two innovative orthodontic appliances: elastodontic devices and clear aligners. Specifically, it is intended to determine which of the two methods is more effective in terms of dentoalveolar expansion in a sample of children with mixed dentition. Methods: In total, 29 patients aged 8 to 13 years with mixed dentition were included in the present study and divided into two groups according to a case–control scheme. Of the subjects, 15 (8 females and 7 males) represented the test group and were treated with Eptamed elastodontic devices, while the control group, consisting of 14 patients (12 females and 2 males), received a Spark aligner. The efficacy of the devices was evaluated by comparing cross-sectional measurements of the arch scans at time T0 (before the start of treatment), T1 (6 months after the start of treatment) and T2 (one year after the start of treatment) by measurement in mm of the distance between the palatal cusps of the first upper premolar (if missing, of the corresponding deciduous molar). Statistical analysis was conducted using a nonparametric approach with the Wilcoxon signed-rank test. Statistical significance was set at p < 0.05. The data resulting from the measurements were expressed as the mean (standard deviation). Results: No statistically significant difference was observed between the two groups at either T0 (p = 0.3), T1 (p = 0.78), or T2 (p = 0.66), thus allowing the conclusion that both treatment modalities are comparable. Conclusions: Both elastodontics and clear aligners proved to be effective devices in the treatment of transverse discrepancies of a dentoalveolar nature. Elastodontics also plays a crucial role in the rebalancing of stomatognathic and extrastomatognathic functions.

AIM:Posterior crossbite is a very frequent malocclusion in the Caucasian population and is most often associated with hypoplasia or retrusion of the upper jaw. Treatment involves palatal expansion with the use of fixed or removable orthodontic devices. The aim of the present study is to compare two different devices used in expansion: the Eptamed Equilibrator elastodontic device (series 00) with the Schwartz plate, which is traditionally used in palatal expansion. MATERIALS:70 children (30 boys and 40 girls, average age: 11 ± 1 years) were recruited and divided into a test group and a control group. The test group underwent palatal expansion with the elastodontic device, the control group with the Schwartz plate. Controls were carried out at 6 months and 12 months after the start of treatment. The distance between the cusps of the first upper premolars was taken as the reference or the width between the second deciduous molars. For statistical analysis, the t-test or Wilcoxon signed-rank test for continuous variables and chi-square test or Kruskal-Wallis test for categorical variables were used. CONCLUSION:The Eptamed Equilibrator device allows palatal expansion like that achieved with traditional expansion devices, but with greater comfort and greater compliance for patients.

BACKGROUND:Trigeminal neurostimulation of the dorsal anterior mucosal surface of the tongue has been proposed to treat a variety of pathologies and to promote neuro-muscular coordination and rehabilitation. Dental ULFTENS can also be considered a form of trigeminal neurostimulation applied to the skin surface bilaterally at the level of the tragus. It has been used for years in dentistry for practical and diagnostic purposes. Previous work has combined the two stimulation techniques showing an efficacy in improving HRV in healthy young women of dental ULFTENS applied to the mucosal surface of the tongue. This work sought to assess whether there is a difference in HRV in relation to the site of application of dental ULFTENS (tragus vs. tongue). If effective in reducing the activity of arousal circuits, this tongue-level stimulation technique could have new clinical applications. MATERIAL AND METHOD:A new intraoral device allowed electrical stimulation of the dorsal anterior mucosa of the tongue in 80 healthy young women divided into two groups: TUD group (ULFTENS stimulation on the mucosa of the tongue) and Tragus group (stimulation with ULFTENS bilaterally in the area of the tragus). The effects on HRV were monitored by photoplethysmographic wave (PPG). The HRV parameters studied were RMSSD, HF, LF, LF/HF. RESULTS:Only the TUD group showed a significant change in selected HRV parameters that was maintained even in the epoch after the end of electrical stimulation. This effect can be considered as a vagal activation and an increased of HRV parameter. The Tragus group did not show significant change in the direction of increased HRV but showed an opposite trend. There were no undesirable or annoying effects of stimulation. CONCLUSION:Stimulation of the dorsal anterior (trigeminal) mucosal surface of the tongue with ULFTENS applied with an intraoral device was shown to be able to increase HRV while the same stimulation on tragus area, according to traditional dental ULFTENS procedure, did not show the same effects. CLINICAL IMPLICATIONS:This stimulation technique could be an aid in the diagnosis and treatment of disorders characterized by autonomic disequilibrium such as, in the dental field, TMDs. TRIAL REGISTRATION:"Effects of Trigeminal Neurostimulation on Heart Rate Variability: Comparing Tragus and Tongue Stimulation". ID number: NCT06549205. Date of first registration: August 1st 2024. https://clinicaltrials.gov/study/NCT06549205?id=%09NCT06549205&rank=1 .

AIM:This paper aims to verify the effectiveness of using elastodontic devices in the treatment of malocclusions in growing patients. An English-language literature search was conducted. The following electronic databases were selected for searching from 2020 to June 2023: PubMed, Web of Science, and Scopus. Eight articles were included based on the inclusion and exclusion criteria. The articles examined highlight the ability of elastodontic devices to act in cases of malocclusion in a safe, simple and more comfortable way for the young patient. However, there is a lack of knowledge about this technique, so this study aims to review the most recent literature to provide the scientific community with new knowledge.

Background: This study aimed to compare the clinical outcomes of using two different devices to treat upper palatal discrepancies evaluated with a digital intraoral scanner. Methods: A total of 64 patients were enrolled and treated with either an elastodontic expansion device (32 patient test group, 16 females and 16 males, mean age 7.08 ± 0.44) or Haas expander (32 patient control group, 16 females and 16 males, mean age 7.32 ± 0.50). The two groups exhibited similar orthodontic features. The orthodontic criteria were: skeletal class I relationship; molar class I relationship; complete eruption of upper sixths; presence of unilateral or bilateral cross bite. All dental casts were examined and subsequently scanned with an intraoral scanner (I-Tero) pre-treatment (T0) and 12 months after the onset of therapy (T1) to assess the distance between the decidous upper canines (ICW, intercanine width) and the distance between the mesiopalatal cusps of the upper first molars (IMW, intermolar width). For statistical analysis, the t-test for continous variables and the chi-square test for categorical variables were used, respectively. Results: There were no statistically significant differences between the mean and SD of the expansions that resulted from the Haas expander and the elastodontic devices (Haas expander vs. Eptamed: ICW_T1 (Haas) = 42.34 (3.09), ICW_T1 (Eptamed) = 42.69 (2.77); p = 0.743; IMW_T1 (Haas) = 34.22 (2.29), IMW_T1 (Eptamed) = 34.00 (2.56); p = 0.800). The two devices were similarly effective. Conclusions: Elastodontic devices and the Haas expander can successfully help the orthodontist to conduct upper arch expansion treatment. However, elastodontic devices are more comfortable during the resolution of palatal discrepancies compared to palatal expander devices.

BACKGROUND: The objective of this study was to evaluate the risk of maxillary canine impaction through cephalometric evaluation. METHODS: One hundred and eighty-two Caucasian patients (80 males and 102 females) with a mean age of 12.4 +/- 0.5 were retrospectively enrolled in the present study. Ninety patients with impacted canines were compared with ninety-two patients with physiologically erupted canines. The following cephalometric variables were analyzed: SNA, ANB, SNGOME, GO-ME, SP-CL, SELLA TURCICA DEPHT, A-Pt LINE, B-Pt LINE, A-Pt LINE degrees, B-Pt LINE degrees, A1s-Pt, A1i-Pt, A1s-Pt degrees, A1i-PT degrees, A-SN, B-SN and SN-U1. When applicable, a paired sample t-test was performed to investigate the difference in means between the two sample groups, while the Mann-Whitney Test was used as a non-parametric test in the case of a non-normal distribution of data. Statistical significance was set at P<0.05. RESULTS: The group with impacted canines showed an increase in Go-Me distance, SNA angle and A1s-Pt angle compared with the control group. In addition, the same group showed a decrease in A-SN and SP-Cl distance compared with the control group. CONCLUSIONS: An increase in mandibular length (GO-ME) and SNA angle associated with a reduction in A-Sn distance and interclinoid distance (SP-Cl) were observed in patients with impacted canines.

Background: The main objective of this study was to compare the clinical efficacy of two different devices, the Eptamed elastodontic device and a common bite sold in pharmacies, by assessing a computer aid evaluation of patients' surface electromyography (sEMG) and kinesiography activity of four pairs of masticatory and postural muscles (anterior temporalis, digastricus, masseters and sternocleidomastoids muscles) before and after 6 months of treatment. Materials and Methods: Twelve adult patients with temporomandibular disorders and in need of orthodontic treatment were enrolled in the study and divided into cases and controls. Cases underwent orthodontic treatment with the Eptamed elastodontic device, while controls were treated with a bite sold in pharmacies. Both groups underwent electromyographic and kinesiographic examinations before and after 6 months from the start of treatment. Results: The Eptamed device was found to guarantee an improvement in the electrical activity of the muscles examined. The subjects in the control group, on the other hand, had a general worsening of electrical activity after wearing a splint purchased in a pharmacy. As for the kinesiographic examination, there was no significant improvement in both groups. Conclusions: the use of the Eptamed device in subjects with TMD ensured a greater relaxation of the chewing muscles than a standard bite, effectively reducing the risk of worsening the symptomatology of temporomandibular disorders.

Background. Enamel plays an essential role in protecting the underlying layers of the human tooth; therefore, preserving it is vital. This experimental study aimed to evaluate the potential ability of L. brevis to counteract the action of a demineralizing agent on dental enamel morphology and mineral composition in vitro. Methods. The sample consisted of 12 healthy human posterior teeth. The coronal portion of each tooth was subdivided into two equal parts longitudinally. The specimens were randomly divided into four groups: artificial saliva, L. brevis suspension, demineralizing agent (DA), and DA plus L. brevis. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) were used to evaluate the surface micromorphology and the mineral content, respectively. The statistical analysis was conducted using a one-way ANOVA, followed by Tukey’s post hoc test. Results. SEM analysis did not highlight significant changes in the enamel microstructure of L. brevis-treated specimens compared to the control. DA-induced damage to the enamel structure was drastically reduced when the specimens were contextually exposed to the probiotic. The treatment with DA substantially reduced the weight % of crucial enamel minerals, i.e., Ca and P. Notably, the probiotic was able to reverse the demineralization process, bringing Ca and P weight % back to basal levels, including the Ca/P ratio. Conclusions. The findings indicate that L. brevis is able to efficiently protect the dental enamel surface from the damage caused by DA and increase the enamel resistance to demineralization. Overall, L. brevis confirms its efficacy in preventing or counteracting the action of carious lesions through a novel mechanism that protects the tooth surface under a chemical challenge that mimics the caries process.

Objective: Lower tooth crowding is considered one of the most common malocclusions in growing patients and due to the potential complications associated with it, it is recommended to intercept this condition as soon as possible. The purpose of this paper is to examine and compare the effectiveness of two different orthodontic devices (elastodontic device and clear aligners) in the treatment of anterior tooth crowding in the jaws of young patients. Materials and methods: Seventy patients aged between 10 and 16 years with anterior inferior tooth crowding were recruited into this study and divided into case and control groups. The former group comprised 35 patients (15 males and 20 females, average age 10.2 years) who were treated with elastodontic devices (EQ CP series, Eptamed), while the control group consisted of 35 patients (15 males and 20 females, average age 10.5 years) who received aligners (Invisalign). All patients underwent periodic visits after 6 months from the start of treatment (T1) and after 1 year (T2) in which the progress of therapy was evaluated by measuring the inferior intercanine distance using a digital caliper. A parametric ANOVA test was conducted for statistical analysis. Results: There is no statistically significant difference between the two groups at either T1 or T2 (p < 0.05), thus making the two treatment modalities comparable. Conclusions: Both elastodontic devices and aligners can be considered as effective tools to successfully conduct inferior expansive treatment for the resolution of tooth crowding; however, the elastodontic devices are considered more comfortable to wear and they are required to be worn for less time during the day.

Introduction: The traditional diagnosis of functional lateral deviation is based on a clinical evaluation and dental casts, supported by an instrumental analysis through X-rays; however, these diagnostic techniques do not provide any information about the neuromuscular system. Several years ago, some authors stressed the importance of the mandibular rest position and its reproducibility as a diagnostic reference, and this became possible with the development of the Myomonitor, TENS. Aim: The aim of this study was to compare mandible position before and after the use of ultra-low-frequency transcutaneous electric nervous stimulation (ULFTENS) in children with diagnosed functional mandibular lateral deviation. Methods: This study was performed on 60 children, aged between 8 and 13 years, with a mean age of 10.1 years (SD 0.81), and with functional mandibular lateral deviation diagnosed clinically, who were referred to the dental clinic for pediatric dental care. Diagnostic neuromuscular registrations were made for all children, and their casts were mounted on a Galetti articulator at the myocentric position. These casts were then compared to those provided by a wax bite registration in the intercuspidal position. Results: Compared with the existing intercuspidal position, neuromuscular registration showed improvement in 30 (50%) patients, 18 patients (30%) showed no changes, and worsening of the tooth midline discrepancy was assessed in the remaining 12 (20%). The molar relationship did not follow the same trend of the midline because of the three-dimensional changes in the maxillo–mandibular relationship induced by TENS. After TENS, there was a significant correlation between the midline and right side deviation (r > 0.65); there was no correlation between the midline and the left side (r < 0.65). Furthermore, the right molar movement showed no correlation with the contralateral molar (r < 0.65). The posterior areas of the arch moved in a very unpredictable way, resulting in the diagnosis and prognosis of mandibular lateral deviation as absolutely individual and unpredictable. Conclusions: This study suggests that TENS-recorded occlusion is an interesting diagnostic approach in orthodontics since it allows for visualizing the trends of the neuromuscular system.

AIM The aim of the study is to observe the statistical relationship between children's habits, oral heath, pregnancy history and breastfeeding. METHODS A cross-sectional study was carried out on the pupils of the first and second grades of the primary schools of the "Silvestro" and "Amiternum" school districts of L'Aquila (Italy). The study population consisted of 496 (244 females and 252 males) students. The data were collected through anamnesis carried out by qualified health personnel before dental examination. According to the WHO criteria clinical teething examination standard, the presence of caries was determined by the dmft index (decayed-filled-missing deciduous teeth). Shapiro-Wilk test, Chi-square test and t test used. P values below 0.05 were considered statistically significant. CONCLUSION There is not enough evidence to advise against breastfeeding lasting more than one year due to the risk of tooth decay. Supportive practices need to be implemented to counteract risk factors. A larger sample is needed to study the role of human milk.

Background Trigeminal electrical stimulation of the dorsal anterior mucosal surface of the tongue has demonstrated its efficacy in a variety of neurological disorders in which anatomical or functional alterations are present. The pathogenesis of such disorders is often linked to altered arousal circuits, and the benefits of tongue stimulation are attributed to the rebalancing of this system. Dental ULFTENS shows efficacy in acting on the muscular, autonomic system and control of the descending pathways that modulate pain. It is administered at the skin level in the area anterior to the tragus and not on the mucosal surface of the tongue. The use of this stimulation technique at the tongue level could have new applications and clinical results if it were able to reduce the activity of arousal circuits. Material and method A new intraoral device allowed electrical stimulation of the dorsal anterior mucosa of the tongue in 32 healthy young women. The effects on HRV were monitored by photoplethysmographic wave (PPG) and compared with a control group. The HRV parameters studied were RMSSD, HF, LF, LF/HF, REC, DET. Results The group of stimulated subjects showed a significant change in some of the HRV parameters that was maintained even in the epoch after the end of electrical stimulation. This effect can be considered as a vagal activation and a change of HRV trend. The control group of unstimulated subjects showed an opposite trend. There were no undesirable or annoying effects of stimulation. Conclusion Stimulation of the dorsal anterior (trigeminal) mucosal surface of the tongue with ULFTENS applied with an intraoral device was shown to be able to increase HRV.

This is a review of the literature on the main neuromodulation techniques, focusing on the possibility of introducing sensory threshold ULFTENS into them. Electro neuromodulation techniques have been in use for many years as promising methods of therapy for cognitive and emotional disorders. One of the most widely used forms of stimulation for orofacial pain is transcutaneous trigeminal stimulation on three levels: supraorbital area, dorsal surface of the tongue, and anterior skin area of the tragus. The purpose of this review is to trigger interest on using dental ULFTENS as an additional trigeminal neurostimulation and neuromodulation technique in the context of TMD. In particular, we point out the possibility of using ULFTENS at a lower activation level than that required to trigger a muscle contraction that is capable of triggering effects at the level of the autonomic nervous system, with extreme ease of execution and few side effects.