Does pain in the masseter and anterior temporal muscles influence maximal bite force?

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Marcelo Coelho Goiato, Paulo Renato Junqueira Zuim, Amália Moreno, Daniela Micheline dos Santos, Emily Vivianne Freitas da Silva, Fernanda Pereira de Caxias, Karina Helga Leal Turcio
ObjectiveThe aim of this study was to evaluate changes in pain and muscle force, and the relationship between them, in patients with muscle pain and bruxism, prior to and after treatment.MethodsThirty women with bruxism and myofascial pain (Ia) were included in this study. Sleep bruxism diagnosis was made based on clinical diagnostic criteria, and awake bruxism diagnosis was made by patient questionnaires and the presence of tooth wear. The diagnosis of myofascial pain was established according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD). Dentulous or partially edentulous patients (rehabilitated with conventional fixed prostheses) were included in the study according to the inclusion and exclusion criteria. The pain treatment protocol included occlusal splints, patient education, and physiotherapy for 30days. Bite force was measured using a dynamometer at the central incisor and the first molar regions on both sides. The exams were performed at baseline, after 7days, and 30days after treatment. The Wilcoxon test was used to compare patient pain level response among the periods analyzed in the study. Bite force data were submitted to two-way repeated-measures ANOVA, followed by the Tukey HSD test (p<0.05). A simple regression analysis was performed to verify the relation between pain level and bite force.ResultsResults revealed that there was a statistical difference in pain level over time for both muscles and sides (p<0.01). In the molar region, the bite force exhibited significantly higher values after 30days of treatment, when compared with the baseline (p<0.001). There was a correlation between pain level and bite force only for the temporal muscle in all periods analyzed (p<0.05). There was no strong correlation in the response level points to support the association of pain and bite force.ConclusionsPain level decreased and bite force increased in the molar region after treatment. No strong correlation or dispersion in the relationship between pain levels and bite force was seen in women with myofascial pain and bruxism.



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Regenerative capacity of allogenic gingival margin- derived stem cells with fibrin glue on albino rats’ partially dissected submandibular salivary glands

Publication date: October 2017
Source:Archives of Oral Biology, Volume 82
Author(s): Noura Abd El-Latif, Mohamed Abdulrahman, Mohamad Helal, Mohammed E. Grawish
ObjectiveTo evaluate the possible regenerative effect of allogenic gingival margin-derived stem cells (GMSCs) with or without autologous fibrin glue on partially dissected submandibular salivary glands of albino rats.MethodsForty rats were randomly divided into four equal groups. Group I, where no operation was performed, was considered the negative control. Group II rats were considered the positive control and were subjected to a rectangular cut on the outer surface of the center right of the submandibular salivary gland and received no other treatment. Groups III and IV rats were handled as those in group II, but the cut areas of group III were filled with fibrin glue and the cut borders of group IV were injected with 1×10⁵cell/ml GMSCs and then glued with fibrin glue. Five animals from each group were euthanized at the end of the first postoperative week, while the remaining animals were euthanized at the end of the second postoperative week, i.e., end of the experiment.ResultsRegeneration of ductal, acinar, and myoepithelial cells was better in group IV. A two-way ANOVA for proliferating cell nuclear antigen and α-smooth muscle actin revealed an overall significant difference between the different groups (P<0.05). In addition, an LSD post hoc test for multiple comparisons revealed a significant difference between each two groups. An independent sample t-test revealed significant differences between time periods for groups II, III, and IV, but there were no significant differences between the time periods for group I.ConclusionInjecting GMSCs at the cut borders and gluing the cut area with autologous fibrin glue ameliorates the regeneration of partially dissected submandibular salivary gland better than using fibrin glue alone.



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Cervical Chondrocutaneous Branchial Remnants

Abstract

Cervical chondrocutaneous branchial remnants are rare congenital choristomas. These lesions contain a cartilage core surrounded by skin with adnexal structures and subcutaneous fat. Correspondingly, on ultrasound there is a tubular hypoechoic core surrounded by hyperechoic, while on CT there is central intermediate attenuation surrounded by fat attenuation tissues. These features are exemplified in this sine qua non radiology-pathology correlation article. Management includes complete surgical resection and evaluating for potential associated anomalies, such as other branchial apparatus anomalies, as well as cardiac anomalies.

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Black swans: challenging the relationship of anaesthetic-induced unconsciousness and electroencephalographic oscillations in the frontal cortex

The study of general anaesthesia and electroencephalographic oscillations in the frontal cortex spans at least four decades, with several notable findings:

• In 1977, Tinker and colleagues¹ proposed, based on studies of the nonhuman primate, that anteriorization—the shift of electroencephalographic power from posterior cortex to frontal cortex—correlated with unresponsiveness during general anaesthesia.
• In the early 1990s, Steriade contributed to our understanding of the neurophysiology of sleep and general anaesthesia in animals, including descriptions of three distinct oscillations involving corticothalamic networks: a slow rhythm at < 1 Hz, a delta rhythm at 1-4 Hz, and a faster theta/alpha rhythm at 7-14 Hz.²³
• In the mid-1990s, the shift of alpha oscillations to more anterior structures was identified during both propofol sedation⁴ and isoflurane/nitrous oxide anaesthesia.⁵
• In 2001, anteriorized alpha and slow-wave activity was posited by John and colleagues⁶ to be an agent-invariant marker of anaesthetic-induced unconsciousness, based on a study of 176 surgical patients.
• In 2004, the disappearance of occipital alpha oscillations and shift to high-power frontal alpha oscillations was found to be associated with propofol-induced unconsciousness in healthy human participants.⁷
• In 2013, Purdon and colleagues⁸ found, using high-density electroencephalography in human volunteers, that anteriorization of alpha and phase-amplitude coupling patterns correlated with propofol-induced unconsciousness.
• In 2014, both propofol and sevoflurane anaesthesia were found to be associated with anterior alpha and slow oscillations in surgical patients.⁹

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Sclerosing bone dysplasias : genetic, clinical and radiology update of hereditary and non-hereditary disorders

There is a wide variety of hereditary and non-hereditary bone dysplasias, many with unique radiographic findings. Hereditary bony dysplasias include osteopoikilosis, osteopathia striata, osteopetrosis, progressive diaphyseal dysplasia, hereditary multiple diaphyseal sclerosis and pyknodysostosis. Non-hereditary dysplasias include melorheostosis, intramedullary osteosclerosis and overlap syndromes. Although many of these dysplasias are uncommon, radiologists should be familiar with their genetic, clinical and imaging findings to allow for differentiation from acquired causes of bony sclerosis. We present an overview of hereditary and non-hereditary bony dysplasias with focus on the pathogenesis, clinical and radiographic findings of each disorder.

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Will the 8th editions of the UICC & AJCC staging manuals improve the pathological diagnosis of extranodal extension from cervical lymph nodes?

Publication date: Available online 5 July 2017
Source:Oral Oncology
Author(s): Andrew W. Barrett




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Impact of early prophylactic feeding on long term tube dependency outcomes in patients with head and neck cancer

Publication date: September 2017
Source:Oral Oncology, Volume 72
Author(s): Teresa Brown, Merrilyn Banks, Brett G.M. Hughes, Charles Lin, Lizbeth M. Kenny, Judith D. Bauer
ObjectivesProphylactic gastrostomy tube (PGT) is frequently used in patients with head and neck cancer (HNSCC). There are concerns this leads to tube dependency but this phenomena is not well defined. This study aimed to determine whether early feeding via PGT impacted on longer term tube feeding outcomes.Materials and methodsPatients with HNSCC with PGT were observed monthly post-treatment regarding tube use and time to removal up to twelve months. Patients were from a randomised controlled trial comparing an early feeding intervention via the PGT (n=57) versus usual care which commenced feeding when clinically indicated (n=67).ResultsPatient characteristics; male (88%), mean age 60±10.1years, oropharyngeal tumours (76%), receiving chemoradiotherapy (82%). Tubes were used by 87% (108/124) on completion of treatment and 66% (83/124) one month post. No differences in tube use between groups at any time point or tube removal rates over 12months (p=0.181). In patients free of disease (n=99), the intervention had higher tube use at 4months (p=0.003) and slower removal rates (p=0.047). Overall ten patients had their tube in-situ at 12months (8%) but five were awaiting removal (4% true dependency rate). Of the five patients legitimately using the tube, only one (<1%) was from severe dysphagia post definitive chemoradiotherapy.ConclusionPGT use is high in the acute phase post-treatment. Encouraging early use may prolong time to tube removal but it does not increase long term dependency rates beyond four months post treatment. Monitoring tube use is important to prevent over-estimation of dependency rates.Clinical trial registrationThis trial has been registered in the Australian New Zealand Clinical Trials registry as ACTRN12612000579897. Available at http://ift.tt/17L6Qgm.



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