Increased pain sensitivity to intraoral capsaicin in patients with atypical odontalgia

AIMS: To use 2 well-characterized stimuli, the intraoral capsaicin model and the "nociceptive-specific" electrode, to compare superficial nociceptive function between patients with atypical odontalgia (AO) and matched healthy controls. Furthermore, the authors aimed to describe the sensitivity, specificity, and positive predictive values (PPV) of the techniques if group differences could be established. METHODS: Thirty-eight patients with AO and 27 matched healthy controls participated in this study. Thirty microliters of 5% capsaicin was applied to the gingiva on the left and right sides of all participants as a pain-provocation test. The participants scored the capsaicin-evoked pain continuously on a 0-to-10 visual analog scale (VAS). Furthermore, individual electrical sensory and pain thresholds to stimulation with a "nociceptive-specific" electrode on the facial skin above the infraorbital or mental nerve were determined. RESULTS: AO patients had higher VAS pain scores for capsaicin application than healthy controls (ANOVA: F > 4.88; P < .029). No differences between the painful sides and the nonpainful sides of the patients were found (ANOVA: F < 1.26; P > .262). No main effects of group or stimulation side on the electrical sensory and pain thresholds were detected (ANOVA: F < 0.309; P > .579). Sensitivity was 0.51; specificity, 0.81; and PPV, 0.77 when a VAS value of > or = 8 for capsaicin-evoked pain was used. CONCLUSION: AO patients show increased sensitivity to intraoral capsaicin but normal sensitivity to "nociceptive-specific" electrical stimulation of the face in an area proximal to the painful site. The use of the intraoral pain-provocation test with capsaicin as a possible adjunct to the diagnostic workup is hampered by the only moderately good sensitivity and specificity.     

Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome

AIM: The aim of this study was to examine the effectiveness of a particular behavioral medicine treatment modality, medical hypnosis, on reducing the pain symptoms of temporomandibular disorders (TMD). METHODS: Twenty-eight patients who were recalcitrant to conservative treatment for TMD participated in a medical hypnosis treatment program and completed measures of their pain symptoms on 4 separate occasions: during wait list, before treatment, after treatment, and at a 6-month follow-up. In addition, pretreatment and posttreatment medical use were examined. RESULTS: Statistical analysis of this open trial suggests that medical hypnosis is a potentially valuable treatment modality for TMD. Patients reported a significant decrease in pain frequency (F [3, 87] = 14.79, P<.001), pain duration (F [3, 87] = 9.56, P<.001), and pain intensity (F [3, 87] = 15.08, P<. 001), and an increase in daily functioning. Analysis suggests that their symptoms did not simply spontaneously improve, and that their treatment gains were maintained for 6 months after hypnosis treatment. Further, after hypnosis treatment, patients exhibited a significant reduction in medical use. CONCLUSION: Medical hypnosis appears to be an effective treatment modality for TMD, in terms of reducing both symptoms and medical use.     

Behavioral characteristics of capsaicin mediated cutaneous,myogenic, and arthrogenic orofacial nociception in rats

ObjectiveTo assess changes in orofacial tactile sensitivity and gnawing related to capsaicin-mediated cutaneous, myogenic, and arthrogenic nociception in the rat.DesignAfter recovery from anesthesia, orofacial tactile sensitivity and gnawing were assessed using operant testing methods following capsaicin application. Twenty female CD-Hairless rats were tested with bilateral capsaicin cream application to the cheek or with isoflurane anesthesia alone. Following several weeks of recovery, animals (n = 20) received either 10 μL unilateral masseter injections of vehicle, or phosphate buffered saline (PBS) to assess injection sensitization. After several weeks, masseter capsaicin (1.0%) injections (10 μL) were assessed compared to vehicle and PBS (n = 13). Weeks later capsaicin TMJ injections were evaluated. Animals (n = 11) received either 10 μL unilateral TMJ injections of capsaicin solution (1%) or vehicle.ResultsCapsaicin cream to the skin significantly altered gnawing activity (increased puncture time by 248 s (p = 0.0002)) and tactile sensitivity (decreased tolerated bottle distance by 0.980 cm compared to isoflurane only (p = 0.0001)). Similarly, capsaicin masseter injection increased puncture time (339.6 s, p = 0.07) and decreased tolerated bottle distance (1.04 cm, p = 0.005) compared to vehicle. However, intra-articular capsaicin in the TMJ only modified gnawing (increased puncture time by 133 s), with no changes found in tactile sensitivity compared to vehicle.ConclusionApplication of capsaicin to the skin and masseter had similar behavioral effects; however, intra-articular injections to the TMJ only affected gnawing. These data indicate the behavioral changes in rodent models of myogenic and cutaneous pain may be markedly different than models of arthrogenic pain originating from the TMJ.     

Pain and anxiety following the placement of dental implants

PURPOSE: This study investigated pain experience and anxiety following dental implant placement using questionnaires and salivary cortisol measurements. MATERIALS AND METHODS: Patients about to undergo implant placement were instructed to keep recovery diaries to assess pain experience (limitation of activities, postoperative symptoms) and to record average pain, worst pain, and interference with daily activities on a visual analog scale (VAS). To assess anxiety, patients completed the Spielberger self-evaluation questionnaire and collected salivary samples to measure cortisol levels. Saliva was collected 1 week before surgery, the day of surgery, and 3 and 6 days postoperatively. A repeated-measure analysis of variance was used to analyze pain and anxiety data. RESULTS: Eighteen patients (12 women and 6 men) who received 30 implants were recruited for the study. Following implant placement, most patients reported mild to moderate interference with daily activities and postoperative symptoms. No patient reported high levels of any symptom. Average pain experience decreased significantly with time (F = 6.17; P < .001), from a VAS score of 24/100 on day 1 to 12 on day 3 and 9 on day 6. Worst pain (F = 7.84; P < .001) and limitation of daily activities (F= 6.26; P < .001) were also highest on the first postoperative day; they also decreased to about half the maximum level by the second or third day. State anxiety, as evaluated by the Spielberger self-evaluation scale, was highest on the day of surgery. The salivary cortisol level did not validate this, as it did not differ with the time of collection (F = 2.22; P = .075). CONCLUSIONS: Patient self-assessment indicates that implant placement is a mild to moderately painful and anxiety-provoking procedure. Some limitation of daily activities and symptoms are expected to occur, particularly during the first 3 postoperative days.     

Effect of silanization on bond strengths of fiber posts to various resin cements.

OBJECTIVES: To investigate the effects of pretreatment (silanization) on bond strengths between 3 different types of fiber posts and 4 resin cements, respectively. METHOD AND MATERIALS: Prefabricated quartz-fiber (Unicore Post, Ultradent) and prefabricated glass-fiber (FRC Postec, Ivoclar Vivadent) posts with a cross-linked polymer matrix and individually formed glass-fiber posts with an interpenetrating polymer network (IPN Post, Stick Tech) (n = 160 each) were inserted into resin composite disks (2 mm thick) using the following resin cements and silane solutions: Panavia F/Porcelain Bond Activator (Kuraray), PermaFlo DC/Silane (Ultradent), Variolink II/Monobond S (Ivoclar Vivadent) and RelyX Unicem/Espe Sil (3M Espe). Nonsilanated posts served as controls. The push-out bond strengths were determined before (n = 10) and after (n = 10) thermocycling (2,000 cycles, 5 degrees C to 55 degrees C, dwelling time 30 seconds). RESULTS: Bond strengths (mean [SD]) were significantly affected by the resin cement (P < .001), the pretreatment (P < .001), and the type of post (P < .001), but not by thermocycling (P = .955, 4-way ANOVA). The IPN post demonstrated significantly higher bond strengths compared to the other posts (P < .05; Tukey B). Silanization significantly increased bond strengths (15.2 [5.2] MPa) compared to those of the control groups (13.9 [4.9] MPa). CONCLUSION: The type of fiber post revealed a significant influence on bond strengths, whereas the effects of silanization appeared to be clinically negligible.     

Estimation of skeletal bone mineral density by means of the trabecular pattern of the alveolar bone, its interdental thickness, and the bone mass of the mandible

OBJECTIVE: We sought to evaluate the use of the alveolar trabecular pattern, the mandibular alveolar bone mass (MABM) measured by photodensitometry, and the interdental alveolar thickness for prediction of the skeletal bone mineral density (BMD). STUDY DESIGN: MABM and the coarseness of trabeculation were assessed by using periapical radiographs in 80 dentate women. The interdental alveolar thickness was measured on casts, and BMD of the forearm with dual X-ray absorptiometry. RESULTS: Significant correlations were found between skeletal BMD and MABM (r = 0.46, P <.001) as well as the coarseness of the trabeculation (r = 0.62, P <.001). The interdental alveolar thickness improved the correlation between skeletal BMD and MABM (R2 = 0.44, P <.001). Age, but not interdental thickness, improved the correlation between the coarseness of trabeculation and skeletal BMD (R2 = 0.52, P <.001). CONCLUSION: Evaluation of the coarseness of trabeculation of the alveolar bone as seen on intraoral radiographs is a helpful clinical indicator of skeletal BMD and better than densitometric measurements of the alveolar bone. Dense trabeculation is a strong indicator of high BMD, whereas sparse trabeculation may be used to predict low BMD.     

The transmission of BANA-positive periodontal bacterial species from caregivers to children

BACKGROUND: The purpose of the authors' study was to use the N-benzoyl-DL-arginine-2-naphthy-lamide (BANA) test (BANAMet LLC, Ann Arbor, Mich.) to obtain information regarding the prevalence of an enzyme unique to certain periodontal pathogens in plaque samples of children, as well as the potential transmission of these pathogens from caregivers to children. METHODS: The authors tested 218 subjects (3 to 10 years old) and 195 care-givers at four pediatric dentistry clinics in Taipei, Taiwan. RESULTS: Forty-four percent of the children had at least one plaque sample that tested positive and/or weakly positive. Positive results were more frequent in the mixed dentition, as well as in children with gingivitis (P < .001). A logistic regression model showed that if the BANA test results for the care-giver were positive, the odds of the child's also having positive test results were 55 times greater (P < .001; confidence interval [CI] = 14 to 224) than those for a child whose caregiver had negative BANA test results. Other predictors were the presence of a mixed dentition (P < .001; odds ratio [OR] = 11; CI = 3.5 to 33.5) and the children's papillary bleeding scores (P < .001, OR = 3.1, CI = 2.0 to 4.7). CONCLUSION: The BANA test results were positive for almost one-half of the children. A positive reaction was associated with gingivitis, a mixed dentition, a BANA-positive caregiver or a caregiver with a history of periodontal disease in the family. CLINICAL IMPLICATIONS: The authors propose an anaerobic periodontal infection risk model in which children with a mixed dentition who have gingivitis and a caregiver with a history of periodontal disease would undergo the BANA test.     

Hypnotizability, absorption and negative cognitions as predictors of dental anxiety: two pilot studies

BACKGROUND: The authors conducted two pilot studies that investigated the roles of hypnotizability, absorption (defined as the ability to maintain focused attention on a task or stimulus) and state versus trait anxiety as predictors of dental anxiety. One of the studies also examined the effectiveness of hypnosis in managing dental anxiety. METHODS: Participants in study 1 completed measures of hypnotizability and anxiety, viewed a video of a dental procedure either under hypnosis or not, and completed dental anxiety questionnaires. Participants in study 2 were told either that the video showed major dental work or a routine polishing. All subjects watched the video and then completed measures assessing their perceptions of the video and their anxiety. RESULTS: The authors found a positive relationship between hypnotizability and scores on the Dental Anxiety Scale (DAS) (F(1,290) = 3.45, P = .06), as well as an interaction between hypnotizability and hypnosis (F(1,290) = 6.55, P = .01). An analysis of covariance found a relationship between trait and dental anxiety (F(1,290) = 11.50; P = .001). A two-way analysis of variance found a main effect for hypnosis (F(1,290) = 3.20, P = .07). The authors found an effect for group on the DAS (F(1,228) = 3.67, P = .057), such that subjects in the negative-cognition group scored higher on the DAS. The authors found an interaction between absorption and cognition in perceptions of pain experienced by the patient in the video (F(1,228) = 3.70, P = .05) and in ratings of one's own pain level if in the same situation (F(1,228) = 4.38, P < .05). CONCLUSIONS: Hypnotizability or absorption, pre-existing anxiety and cognitions about dental procedures predict dental anxiety, and hypnosis may be helpful for some, but not all, patients. CLINICAL IMPLICATIONS: Characteristics such as hypnotizability, trait anxiety and negative cognitions predict which people develop dental anxiety and who will be more responsive to hypnosis. The authors provide suggestions for dentists treating anxious patients.     

A randomized,single-blind,placebo-controlled trial to evaluate the effectiveness of verbal behavior modification and acetaminophen on orthodontic pain

Objectives:To evaluate the effectiveness of verbal behavior modification, acetaminophen, and the combined effectiveness of verbal behavior modification along with acetaminophen on orthodontic pain.Materials and Methods:One hundred and forty orthodontic fixed appliance patients were randomly assigned to four groups. Group A was administered acetaminophen, group B was given verbal behavior modification, group C was administered acetaminophen as well as verbal behavior modification, and group D was placebo-controlled. A visual analog scale was used to assess pain intensity after 1 week of separator placement.Results:Group A had less mean pain intensity when compared to group B at 6 hours (P < .001) and at 1 (P < .001) and 2 (P = .002) days. Group C patients encountered less mean pain intensity when compared to group B patients at 6 hours (P < .001) and at 1 (P < .001), 2 (P < .001), and 4 (P = .001) days. There was a statistically significant difference between groups A and C (group C experienced less pain intensity) after 6 hours (P = .004) and at day 4 (P = .009) after separator placement.Conclusions:Acetaminophen is the main agent of orthodontic pain reduction after separator placement, with verbal behavior serving as an adjunct to it.     

A comparison of ropivacaine and lidocaine with epinephrine for intraligamentary anesthesia

OBJECTIVE: The purpose of this study was to compare the efficacy of 2 different concentrations of ropivacaine with lidocaine containing epinephrine for intraligamentary anesthesia. STUDY DESIGN: Ethical approval was obtained and a randomized, double-blind, cross-over volunteer investigation was conducted. Twenty-four volunteers had intraligamentary injections of 2% lidocaine with 1:80,000 epinephrine, 0.75% ropivacaine, or 1% ropivacaine at the upper lateral incisor and lower first bicuspid teeth. The response of the test teeth to electrical pulp testing and the reaction of the gingiva to sharp probing were assessed up to 29 minutes after injection. Injection discomfort and side effects were also recorded. Data were analyzed by using the chi-square test and analysis of variance. RESULTS: Lidocaine with epinephrine was more successful than the ropivacaine solutions in obtaining pulpal anesthesia (chi-square = 12; P <.002) and produced longer-lasting pulpal (F = 21; P <.001) and soft tissue (F = 16; P <.001) anesthesia. Injection discomfort and incidence of side effects were similar between solutions, and none produced serious adverse effects. CONCLUSION: Lidocaine with epinephrine is more effective than ropivacaine as an intraligamentary anesthetic.     

Effects of capsaicin and menthol on oral thermal sensory thresholds

OBJECTIVE: To determine the long-term effect of capsaicin and short-term effect of menthol on oral thermal thresholds. DESIGN: The thresholds for cold detection (CDT), warm detection (WDT), cold pain (CPT) and warm pain (WPT) were determined in 11 regular chilli-eaters (capsaicin group) and 11 control subjects that were closely matched for age, gender and ethnicity. The effect of menthol was determined by asking all 22 participants to suck a lozenge containing 0.52% menthol for 5min. RESULTS: An ANOVA revealed a significant difference between the capsaicin and control groups (P=0.014), with the greatest difference in the WDT (capsaicin group 4.7+/-2.7[S.D.] degrees C; control group 2.3+/-2.2 degrees C). Immediately after sucking a menthol lozenge there was a significant rise in the CDT (2.2+/-1.1 degrees C to 5.9+/-6.2 degrees C; P<0.01) and WDT (3.6+/-2.7 degrees C to 7.6+/-4.4 degrees C; P<0.001). CONCLUSIONS: The consumption of foods containing capsaicin and menthol significantly alters thermal sensory thresholds in the oral cavity. Dietary habits should therefore be taken into account when intra-oral thermal thresholds are determined.     

关节腔注射透明质酸与物理疗法治疗颞下颌关节不可复性盘前移位的临床疗效对比

目的 比较关节腔注射透明质酸和物理疗法治疗颞下颌关节不可复性盘前移(anterior disc displacement without re-duction,ADDwoR)的临床疗效.方法 回顾性纳入2018年2月—2020年8月于我院康复科门诊就诊的ADDwoR患者72例,注射组和物理治疗组各36例.比较治疗前、治...     

Effect of a peripheral NMDA receptor antagonist on glutamate-evoked masseter muscle pain and mechanical sensitization in women

AIMS: To test the hypothesis that local injection of the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine would significantly attenuate glutamate-evoked masseter mechanical sensitization and muscle pain in healthy young women either taking oral contraceptives (W+OC) or not taking oral contraceptives (W-OC). METHODS: Experimental pain was evoked in 47 healthy female subjects (W+OC, n=25; W-OC, n=22) by 2 injections of glutamate (0.2 mL, 1 mol/L) into the masseter muscle. A first injection of glutamate alone was followed by a second injection, 35 minutes later, of glutamate combined with ketamine (0, 1, or 10 mmol/L). Evoked pain intensity was scored on a 10-cm electronic visual analog scale (VAS). Distribution of perceived pain was drawn on a lateral view of the face (pain drawing). Masseter muscle pressure pain thresholds (PPT) and pressure-pain tolerances (PPTOL) were determined bilaterally before and at regular time intervals after injections. Analyses of variance (ANOVA) were used to test the data. RESULTS: There were no main effects of ketamine on any of the VAS pain parameters or on the pain drawing (ANOVAs: P > .055). Furthermore, there were no differences in PPT, PPTOL, VAS peak pain, duration, overall VAS pain, or pain drawing when W-OC were compared with W+OC (ANOVAs: P > .087). Repeated injection of glutamate alone significantly decreased PPT and PPTOL (ANOVAs: P < .001); however, this effect was not significantly attenuated by ketamine. CONCLUSIONS: Peripherally administered ketamine had no effect on glutamate-evoked masseter muscle pain and sensitization in healthy young women, which contrasts with recent observations in healthy young men. Further studies will be needed to reveal the mechanisms that underlie this apparent sex-related difference in ketamine-mediated analgesia.     

提取元音第三共振峰测试腭咽闭合功能的研究

应用计算机语音信号分析技术测试了２４名腭裂患者及１０名正常儿童的汉语普通话单元音第三共振频率值,同时测定了正常儿童各单元音腭咽闭合不全率,并作了高元音ｉ和低元音ａ第三共振频率值与其ＲＶＰＩ的相关性性分析。结果表明：腭裂患者的各单元音第三共振璋无统计学差异。     

Quantitative sensory tests before and 1½ years after orthognathic surgery: a cross‐sectional study

Summary Quality control is very important in relation to invasive and lengthy treatments, such as integrated orthodontic and surgical correction of dentofacial deformities. The aim of this cross‐sectional study was to compare self‐reported somatosensory disturbances and quantitative sensory testing (QST) findings between two groups of patients and a healthy control group (n = 24); one group (n = 21) scheduled for bimaxillary orthognathic surgery (BOS) (pre‐op) and one group (n = 24) examined 1½ years after BOS (post‐op). Self‐reported data on pain and somatosensory disturbances were collected, and QST was performed at six trigeminal and one extratrigeminal site. Sensitivity to brush stroke, tactile stimuli, pinprick, two‐point‐discrimination threshold (2P‐DT), pinch pain threshold (PiPT) and pressure pain threshold (PPT) was evaluated. Results were analysed with anova s, Spearman’s Correlation, and chi square tests. Eight per cent of post‐op patients reported intra‐oral, 46% extra‐oral, and 46% no somatosensory disturbances. Sensitivity to brush stroke, pinprick and 2P‐DT was significantly increased at all examination sites in the post‐op patients compared with healthy controls (P < 0·002). Tactile thresholds and PPT did not differ between groups (P > 0·071). Pinch pain threshold were decreased in pre‐op patients compared with controls (P < 0·040). Self‐reported somatosensory disturbances were not correlated with QST findings. In conclusion; 1½ years after BOS, a large proportion of patients reported somatosensory disturbances and was hypersensitive to mechanical stimuli when compared with pre‐op patients and healthy controls. Pre‐op patients showed minor somatosensory changes. In addition to patients serving as their own control in prospective studies, a healthy control group and extratrigeminal control sites should be included in future studies.     

Antiplaque and antigingivitis efficacy of cetylpyridinium chloride with zinc lactate compared with essential oil mouthrinses: Randomized clinical trial

BackgroundThe authors of this study aimed to evaluate the clinical antiplaque and antigingivitis effects of 3 oral hygiene regimens: toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing cetylpyridinium chloride, zinc lactate, and fluoride (CPC + Zn + F) in an alcohol-free base; toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing essential oils (EO) in an alcohol-free base; and toothbrushing with manual toothbrush and standard fluoride toothpaste and manual toothbrush (control).MethodsThe participants (N = 120) were randomly assigned to study groups and followed the assigned regimens twice daily for 6 weeks. The participants were examined by a calibrated examiner for the Quigley-Hein plaque index (Turesky modification) and Löe-Silness gingival index at baseline, week 4, and week 6. Statistical analyses were performed separately for plaque and gingival indexes by means of analysis of variance, paired t test, and analysis of covariance (α = 0.05).ResultsAt week 4, the CPC + Zn + F group presented additional reductions in dental plaque compared with EO and control groups of (21.4% [P < .001] and 31.4% [P < .001], respectively). After 6 weeks, these values were 26.7% (P < .001) and 44.8% (P < .001), respectively. For Löe-Silness gingival index, additional reduction in the CPC + Zn + F group compared with EO were 10.6% (P < .001) and 13.7% (P < .001) at 4 and 6 weeks, respectively. Compared with control, these reductions were 13.6% (P < .001) and 17.8% (P < .001), respectively.ConclusionsThe regimen including a mouthrinse containing CPC + Zn + F presented higher antiplaque and antigingivitis effects than EO and control regimens.Practical ImplicationsA mouthrinse containing CPC + Zn + F is an effective protocol for the control of dental plaque and gingivitis.     

A psychological intervention for reducing pain during dental hygiene treatment

Previous research has shown that individuals who "catastrophize" are more likely to experience high levels of pain and emotional distress during dental treatment. In the present study, we examined the effects of emotional disclosure on the pain and emotional distress experienced by "catastrophizers" and "noncatastrophizers" during dental hygiene treatment. Eighty undergraduate students were randomly assigned to a dental-worry disclosure condition or a control condition prior to scaling. In the disclosure condition, participants were asked to write about their dental worries before having dental hygiene treatment. In the control condition, participants were asked to write about their activities of the previous day. Consistent with previous research, catastrophizers in the control condition reported significantly more pain and emotional distress than noncatastrophizers, F (1, 76) = 9.86, P < .001. Disclosure reduced the pain and emotional distress of catastrophizers, but increased the pain and emotional distress of noncatastrophizers, F (1, 76) = 6.1, P < .01. While catastrophizers benefited from disclosure in regard to their immediate physical and emotional experience, their levels of catastrophizing and dental anxiety remained essentially unchanged. Clinical implications of the findings are discussed.     

Psychological correlates of medical comorbidities in patients with temporomandibular disorders

BackgroundMedical comorbidities are common among patients with temporomandibular disorders (TMDs). The authors examined the relationship between the medical comorbidities in patients with TMDs and their psychological functioning.MethodsThe sample consisted of 1,060 adults with TMDs, of whom 85 percent (n = 901) were female. At the time patients were evaluated at a university orofacial pain center, from 1997 through 2007, they completed medical history and psychological questionnaires. On the basis of retrospective chart reviews, the authors assessed the relationship between medical comorbidities and psychological functioning, controlling for pain severity, by using multivariate analyses of covariance.ResultsThe mean total number of medical comorbidities was 3.49 (standard deviation [SD] = 2.87; range, 0–16). The authors found a linear relationship between number of medical comorbidities and overall psychological distress (t[1, 959] = 16.79, P < .001) and interference owing to pain (t[1, 1,028] = 18.03, P < .001).ConclusionsPatients with TMDs who have medical comorbidities may be at increased risk of experiencing poor psychological functioning. Further study is needed to investigate whether the observed relationship changes across time.Clinical ImplicationsThe physical and psychological health of patients with TMDs may influence the course of their pain condition. When treating these patients, dentists routinely should assess not only the symptoms of their TMDs but also their general health status.     

Systemic betamethasone accelerates functional recovery after a crush injury to rat sciatic nerve.

PURPOSE: The aim of the study was to evaluate the effect of perioperatively systemically administered betamethasone on nerve recovery (within or outside a confined space) after induced nerve crush injury. MATERIALS AND METHODS: The sciatic nerve of 40 adult Wistar rats was crushed. In half of the animals, the injured nerve was entrapped in a silicone tube to simulate the environment of a closed space, and in the other half the nerve was left to heal. Half of the rats in each group were treated with subcutaneous betamethasone (2 mg/kg body weight/day) during the first 24 hours, starting preoperatively, whereas the other half, the control animals, were given the same amount of physiological saline. All animals underwent preoperative and postoperative walking track analysis (toe spread [TS] and intermediate toe spread [ITS]) twice weekly for 6 weeks. RESULTS: For nonconfined space groups, there was no significant difference between the 2 groups (P = .052 for ITS and P = .315 for TS) during the first 2 weeks. Starting from the end of the second week, animals treated with betamethasone recovered more rapidly than did the controls (P < .001) and continued to do so until the end of the observation period. In the confined space groups, there was a significant difference between the 2 groups for ITS (P < .001) and for TS (P < .05) during the first 2 weeks. The difference continued at almost the same level of significance (P = .001) for ITS, whereas for TS, the difference disappeared after the second week. CONCLUSIONS: We conclude that short-term perioperative administration of betamethasone has a beneficial effect on the recovery of the injured rat sciatic nerve.     

口腔鳞状细胞癌中整联蛋白连接激酶的表达及意义

目的 研究整联蛋白连接激酶(integrin-linked kinase,ILK)在口腔鳞状细胞癌中的表达特点,以期进一步揭示其与口腔鳞状细胞癌的生物学行为的关联.方法 采用免疫组织化学及组织化学方法研究ILK在170例口腔鳞状细胞癌中的表达情况及规律.结果 ILK的阳性表达可以出现在癌巢或癌细胞条索内和(或)癌组织外围的间质.随着口腔鳞状细胞癌病理分级的提高,ILK具有从阴性表达、仅在上皮表达、上皮间质均表达发展为仅在间质表达的趋势.经非参数检验,无论在无转移组[高、中、低分化组ILK仅在间质表达者分别为2%(1/50)、18%(6/33)和64%(18/28)]和转移组[高、中、低分化组仅在间质表达者分别为16%(4/25)、9/18和10/16],ILK的表达模式与病理分级间差异均有统计学意义(F=17.742,P＜0.001;F=4.394,P=0.017).ILK的这种表达模式在有、无淋巴结转移组间的差异也具有统计学意义(x2=14.418,P=0.002).结论 在口腔鳞状细胞癌的发展过程中ILK更趋向表达于间质,其本质值得深入研究.