Treatment of temporomandibular disorders with a combination of hard acrylic stabilisation appliance and a soft appliance in the opposing jaw. A retro- and prospective study

The aim of this study was to evaluate the treatment effect of a combined treatment with a stabilisation appliance and a soft appliance in the opposing jaw in patients refractory to previous TMD treatment. During a 5-year-period, 2001-2005, a total of 98 patients received the combined treatment at the Department of Stomatognathic Physiology, the Institute for Postgraduate Dental Education, J?nk?ping, Sweden. Before the patients received the combined treatment, they had already been given several different TMD treatments during a long period of time, either before referral or at the specialist clinic, with only minor or no effect on their TMD symptoms. The patients were followed prospectively (n=10), or analysed retrospectively (n=88). The data registered were gender, age, main indication for TMD treatment, number of visits to the clinic before and after the introduction of the combined treatment, as well as according to a clinical (Di) and anamnestic (Ai) dysfunction index. The most common causes for treatment in the retrospective material were problems of muscular origin and problems of both muscular and TMJ origin. In the prospective material, most of the patients had mainly muscular symptoms. Both the clinical and anamnestic dysfunction index decreased statistically significantly in the retrospective material after the introduction of the combined treatment. There was a numerical improvement of both indices also in the prospective material. In conclusion, the present investigation showed that a combined treatment with a hard acrylic stabilisation appliance and a soft appliance in the opposing jaw seems to give a remarkable improvement of TMD signs and symptoms in apparently therapy resistant TMD patients. General conclusions should, however, be made with caution due to the fact that the study did not include any control group. There is an obvious need for randomized controlled studies concerning the efficacy and effectiveness of the combined treatment presented in this study.     

Dental treatment improves self-rated oral health in homeless veterans--a brief communication

OBJECTIVE: The aim of this study was to assess homeless veterans' perception of their oral health and the impact that oral disease and treatment have on self-assessed quality of life. METHODS: Outcomes included measures of general and oral-specific quality of life and functional status. Single-item self-report of oral health and the General Oral Health Assessment Index were assessed at baseline and after treatment. RESULTS: One hundred and twelve veterans completed the baseline questionnaire, and 48 completed the follow-up. Veterans who were eligible for ongoing dental care had improved General Oral Health Assessment scores, while patients who received only emergency dental care saw a decreased score (2.46 versus -2.12). General Oral Health Assessment improvement was significantly related to fewer teeth at baseline (18 versus 23), a lower baseline General Oral Health Assessment (23.6 versus 28.1), having a denture visit (22 versus 35 percent), and improvement in self-reported oral health (25 versus 42 percent). CONCLUSION: There was significant improvement in homeless veterans'perceived oral health after receiving dental care.     

Growth of acellular extrinsic fiber cementum (AEFC) and density of inserting fibers in human premolars of adolescents

The present study describes for the first time the changes of both AEFC thickness and the numerical density of collagen fibers inserting into AEFC at specified levels and sites of human premolars at different stages of development. The investigation was based on 45 premolars (25 maxillary, 20 mandibular; 25 first and 20 second), extracted from adolescents and young adults. All teeth were free of disease and presented with roots developed from 30-100% of their final length. They were prefixed in Karnovsky's fixative, decalcified in EDTA and subdivided into about 14 slices each, cut from mesial and distal root surfaces, vertical to and along the root axis. The slices were postfixed in OsO4, embedded in Epon and cut for light-microscopic study. AEFC thickness (4086 measurements) and the density of the collagenous fiber fringe (454 counts) inserting in AEFC were measured at 1, 3, 5 and 7 mm apical to the cementoenamel junction. The data obtained showed: AEFC thickness increased with age and varied between 0 and 57.5 microns. Between 9 and 17 years, cervical AEFC thickness increased in maxillary first premolars from an average of 5 to 30 microns, and in mandibular second premolars from 6 to 20 microns, i.e., AEFC grew at approximately the same rate as later in life. Depending on the differences in tooth development, AEFC on maxillary first premolars became thicker than that on mandibular second premolars. Due to the corono-apically decreasing gradient of AEFC development, its increase in mid-root regions lagged behind that in cervical regions of all teeth in people younger than about 14 yr.(ABSTRACT TRUNCATED AT 250 WORDS)     

The α-MSH analogue AP214 attenuates rise in pulmonary pressure and fall in ejection fraction in lipopolysaccharide-induced systemic inflammatory response syndrome in pigs

Background: The effect of an α‐melanocyte stimulating hormone (α‐MSH) analogue (AP214) on experimentally endotoxin‐induced systemic inflammatory response syndrome (SIRS) was studied, because α‐MSH in rodent models has shown promise in attenuating inflammatory response markers and associated organ damage in SIRS. SIRS is associated with considerable morbidity and mortality. Consequently, new treatment modalities are still warranted to address the different aspects of the pathophysiological process. Methods: SIRS was induced by lipopolysaccharide (LPS) (Escherichia coli endotoxin) infusion in anaesthetized Danish Landrace pigs (20–25 kg). The pigs received an α‐MSH analogue (AP214) or saline as a bolus at the initiation of the LPS infusion. The hemodynamic response was registered as well as echocardiographic indices of left ventricular function. Results: The cardiovascular response was recorded together with echocardiographic indices of left ventricular function in control and in intervention animals. AP214 reduced the early peak in pulmonary pressure and pulmonary vascular resistance by approximately 33%. Furthermore, AP214 prevented the decline in left ventricular fractional shortening as observed in the control group. Mean change and standard deviation in fractional shortening (ΔFS) in control group: ‐ 7·3 (4·7), AP214 (low dose): 0·9 (8·2) and AP214 (high dose) 4·1 (6·0), P < 0·05 for both intervention groups versus control. Conclusions: In the porcine model, the peak increase in pulmonary pressure was attenuated, and the LPS‐induced decline in left ventricular function was prevented.     

Computer-Delivered Social Norm Message Increases Pain Tolerance

Background

Few experimental studies have been conducted on social determinants of pain tolerance.

Purpose

This study tests a brief, computer-delivered social norm message for increasing pain tolerance.

Methods

Healthy young adults (N?=?260; 44 % Caucasian; 27 % Hispanic) were randomly assigned into a 2 (social norm)?×?2 (challenge) cold pressor study, stratified by gender. They received standard instructions or standard instructions plus a message that contained artifically elevated information about typical performance of others.

Results

Those receiving a social norm message displayed significantly higher pain tolerance, F(1, 255)?=?26.95, p?<?.001, η _p ² ?=?.10 and pain threshold F(1, 244)?=?9.81, p?=?.002, η _p ² ?=?.04, but comparable pain intensity, p?>?.05. There were no interactions between condition and gender on any outcome variables, p?>?.05.

Conclusions

Social norms can significantly increase pain tolerance, even with a brief verbal message delivered by a video.