Long-term outcome after treatment of temporomandibular joint osteoarthritis with exercise and manual therapy

In a previous study, exercise and manual therapy demonstrated a 90% success rate in patients with osteoarthrosis of the temporomandibular joints in the short-term. The aim of this follow-up study was to assess the long-term effect of these treatment modalities. Seventeen patients were evaluated. All patients suffered from osteoarthrosis of the temporomandibular joints with pain in the temporomandibular joint at baseline and were treated successfully in a prior short-term study. The parameters were pain at rest and at chewing, impairment in daily life, and mouth opening. At follow-up, 11 patients (65%) experienced no pain and 13 patients (76%) had no pain at rest (Fisher's Exact Test: p<0.02). Thirteen patients (76%) had a normal incisal edge clearance, and ten patients (59%) felt no impairment due to the disease (Fisher's Exact Test: p=0.01). Thirteen patients (76%), who had been treated once successfully, have not needed treatment within the three years after cessation of their therapy. Exercise therapy is an effective tool to treat osteoarthrosis of the temporomandibular joints.     

An investigation of the efficacy of super-oxidised (Optident/Sterilox) water for the disinfection of dental unit water lines

AIMS: To determine the efficacy of super-oxidised water (Optident/Sterilox) in the decontamination of dental unit water lines. METHODS: Dental units (10) were first purged with concentrated super-oxidised water. After purging, a 5% (v/v) super-oxidised water was used as a maintenance dose. Samples for microbiology were taken after 0,1,2,3,4,5,6,7 d, and each week for a further 13 weeks. RESULTS: After purging, 5% (v/v) super-oxidised water was successful in reducing the microbial counts to zero, although in three of the units some bacteria were intermittently isolated in the first week of treatment. CONCLUSIONS: Super-oxidised water was successful in the removal of bacteria from dental unit water supplies. Complete removal required the treatment with a purge phase of concentrated disinfectant and a maintenance phase of at least two weeks.     

Template fabrication for a midpalatal orthodontic implant: technical note

An implant has been developed as an adjunct to conventional orthodontic anchorage. Planning is advisable to determine the available bone and soft tissue thickness and the optimum position for orthodontic utilization. A simple method is described for fabrication of a radiographic and surgical template to aid in optimal placement of the implant.     

Repair of alveolar clefts with recombinant human bone morphogenetic protein (rhBMP-2) in patients with clefts

This article demonstrates the feasibility of using recombinant human bone morphogenetic protein (rhBMP-2) as a substitute for autogenous iliac crest bone for repair of congenital facial clefts in humans. In this series, 50 cleft sites were repaired in 43 patients using rhBMP-2 without the use of autogenous graft tissue. Successful osseous union was achieved in 49 of the 50 sites. In one patient, the graft failed to consolidate. Severe clefts were managed by combining distraction osteogenesis and rhBMP-2. Eliminating the need to harvest autogenous iliac crest bone resulted in substantial decrease in morbidity. The constructed alveolus performed clinically as normal bone and responded to natural tooth eruption and orthodontic movement. Histology of the tissue constructed showed normal, vital bone. Although additional investigation is warranted to determine the optimum protocol for the use of this material in alveolar cleft repair, the technique should be considered as a viable treatment option in cases in which avoiding iliac crest harvesting is desirable.     

Optimum force magnitude for orthodontic tooth movement: a mathematic model.

The aim of this study was to develop a mathematic model to describe the relationship between magnitude of applied force and rate of orthodontic tooth movement. Initially, data were extracted from experimental studies in dogs (beagles), in which controlled, standardized forces were used to move mandibular second premolars distally. Curve-fitting by nonlinear regression analysis provided an equation describing the relationship between force magnitude and rate of tooth movement in beagles. A similar equation was subsequently used to analyze the limited available data from the literature on human canine retraction. The maximum rates of tooth movement in humans and dogs are very similar. A threshold for force magnitude that would switch on tooth movement could not be defined. The model showed that a wide range of forces can be identified, all of which lead to a maximum rate of tooth movement.     

Peripheral nerve response to injury

Oral and maxillofacial surgeons caring for patients who have sustained a nerve injury to a branch of the peripheral trigeminal nerve must possess a basic understanding of the response of the peripheral nerves to trauma. The series of events that subsequently take place are largely dependent on the injury type and severity. Regeneration of the peripheral nerve is possible in many instances and future manipulation of the regenerative microenvironment will lead to advances in the management of these difficult injuries.