下颌骨不对称发育的全颌曲面断层片分析

目的利用口腔全颌曲面断层片测量分析发育正常的、发育性下颌偏斜畸形患者下颌骨硬组织的特征性变化。方法选择成人颞颌关节病变患者78例,正常无颞颌关节病患者115例,比较颞颌关节病变患者、正常无颞颌关节病患者的左右两侧在垂直向上线距、角度的差异。结果颞颌关节病的下颌骨双侧在垂直方向上的线距测量和角度测量均出现明显的不对称,髁状突前后径、下颌骨升支高度、髁状突至下颌平面高度、下颌角点成角、髁突顶点成角双侧比较差异有统计学意义（P〈0．05）;正常无颞颌关节病变的双侧对应比较差异均无统计学意义（P〉0．05）。结论下颌骨不对称发育是引起颞颌关节病变的一个重要因素,应予以注意。     

乌鲁木齐市青少年心理状态与颞下颌关节症状的关系

目的：通过调查和探讨颞下颌关节紊乱（TMD）的3个主要症状、口腔异常功能和精神紧张等情况,评价精神心理因素对TMD的发生的作用。方法：对乌鲁木齐市1408名年龄在12～15岁的青少年（男性774人,女性634人）经问卷调查和临床检查做横断面研究,问卷包括以下六个问题：1）牙关紧闭;2）关节杂音;3）颞下颌关节疼痛;4）白天紧咬牙;5）夜磨牙;6）精神心理因素,问题1～5与问题6的关系用卡方检验。结果：问题1～5与问题6有显著相关性（P〈0.05）。结论：调查发现精神紧张与TMD发生明显相关,有必要进一步对其作用的发病机制和相关治疗方法进行研究。     

Colony-Stimulating Factor (CSF)-Dependent Growth of Two Leukemia Cell Lines

The progressive accumulation of leukemic cells in acute myeloblastic leukemia (AML) results from the self-renewal capacity of leukemic blast progenitors. The growth of leukemic blast progenitors is supported by growth factors and colony-stimulating factors (CSFs) have been shown to stimulate this phenomenon in vitro. After repeated subculture of leukemic cells obtained from a patient with AML M4 in the presence of recombinant G-CSF, a cell line dependent on G-CSF was established. This cell line, designated OCI/AMLla, does not respond to GM-CSF, interleukin-3 (IL-3), IL-1 or stem cell factor as well as G-CSF. The stimulatory effect of G-CSF on OCI/AMLla cells is almost completely blocked by monoclonal anti-G-CSF antibody. With G-CSF added in the culture, the OCI/AMLla cell line has been growing exponentially for over 5 years now.

Another cell line, with growth dependent on IL-3, has also been established from a patient with chronic lymphocytic leukemia in the acute phase. This cell line TMD2 does not respond to G-CSF, GM-CSF, IL-1, or stem cell factor and anti-IL-3-antibody blocks the stimulatory effect of IL-3 on these cells. Receptors for IL-3 have been found on the surface of TMD2 cells. Although the TMD2 cell line is not derived from AML, the novel character of IL-3-dependency provides useful information for the study of the role of growth factor(s) in leukemic cell proliferation. These two CSF-dependent cell lines are expected to be excellent models for the investigation of the precise mechanism by which G-CSF and IL-3 stimulate the growth of leukemic cells.     

Headache children with temporomandibular disorders have several types of pain and other symptoms

The aim was to investigate the association between temporomandibular disorders (TMD) and overall muscle tenderness, depressive symptoms, sleep difficulties, headache frequency and related symptoms in children with primary headache in comparison with controls. Based on an unselected population sample of 1135 Finnish schoolchildren classified according to the type of headache at age 12, altogether 297 children aged 13–14 from different headache groups and healthy controls were randomly selected for an interview and clinical examinations. Children with migraine had more TMD signs than children with nonmigrainous headaches or healthy controls. High TMD total scores were associated with palpation tenderness in other parts of the body and with frequent headache attacks. We conclude that children with overall headache, migraine in particular, and high total TMD scores showed an increased overall tenderness to muscle palpation and multiply manifested hypersensitivity pain.     

Disc displacement without reduction: a retrospective study of a clinical diagnostic sign

Objective: The purpose of this retrospective study is to evaluate a clinical diagnostic sign for disc displacement without reduction (DDWR), the absence of additional condylar translation during opening compared with protrusion.

Method: Thirty-eight electronic axiographic and magnetic resonance imaging (MRI) examinations of the TMJ were analyzed in order to compare the opening/protrusion ratio of condylar translation between non-painful DDWR and non-DDWR.

Result: According to the Mann-Whitney U test, the opening/protrusion ratio in non-painful DDWR differs significantly from non-DDWR (p < 0.0001).

Discussion: Among non-painful DDWR, there is no additional condylar translation during opening in comparison with protrusion, and this is probably also the case for DDWR without limited opening, which is a subtype that has not been validated by the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Comparative condylar palpation can analyze this sign, and therefore, further comparative investigations between MRI and clinical examination are needed to validate the corresponding clinical test.     

Diagnostic accuracy of three screening questions (3Q/TMD) in relation to the DC/TMD in a specialized orofacial pain clinic

Objective: To determine the diagnostic accuracy of three screening questions (3Q/TMD) in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized clinic.

Material and methods: Consecutive patients,?>18 years, referred with a possible TMD complaint to the Orofacial Pain and Dysfunction clinic, Academic Centre for Dentistry Amsterdam, the Netherlands, were included in the study. All patients (n?=?449; mean age 44 years; 72% females), answered the 3Q/TMD and the DC/TMD questionnaire before a DC/TMD examination. The 3Q/TMD constitutes of two questions on weekly pain from the jaw, face and temple region (Q1), and on function (Q2), and one function-related question on weekly catching and/or locking of the jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard.

Results: In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an intra-articular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was high (0.83–0.94), whereas specificity was low (0.41–0.55). For the function-related question, sensitivity was low (0.48), whereas specificity was high (0.96).

Conclusions: In a specialized pain clinic, the two pain questions (Q1, Q2) are positive in most patients with pain-related TMD. Therefore, in case of a positive response, further diagnostic procedures for TMD pain are warranted. For the functional screening question (Q3), a positive response is indicative for an intra-articular DC/TMD diagnosis, while in case of a negative outcome, an intra-articular TMD might still be present.     

Temporomandibular condylar morphology in diverse maxillary–mandibular skeletal patterns: A 3-dimensional cone-beam computed tomography study

Background

The authors evaluated the morphology and symmetry of the temporomandibular joint in participants with normodivergent and hyperdivergent skeletal class I, II, and III patterns.

Use of platelet-rich plasma,platelet-rich growth factor with arthrocentesis or arthroscopy to treat temporomandibular joint osteoarthritis: Systematic review with meta-analyses

Background

The authors conducted a systematic review and meta-analysis to determine whether arthrocentesis or arthroscopy combined with platelet-rich plasma (PRP) or platelet-rich growth factor (PRGF) injection compared with no injection or saline injection (control group) or hyaluronic acid (HA) injection reduced pain and increased maximum mouth opening (MMO) in patients with temporomandibular joint (TMJ) osteoarthritis (OA).

Expression of 5-HT3 receptors and TTX resistant sodium channels (NaV1.8) on muscle nerve fibers in pain-free humans and patients with chronic myofascial temporomandibular disorders

Background

Previous studies have shown that 5-HT₃-antagonists reduce muscle pain, but there are no studies that have investigated the expression of 5-HT₃-receptors in human muscles. Also, tetrodotoxin resistant voltage gated sodium-channels (Na_V) are involved in peripheral sensitization and found in trigeminal ganglion neurons innervating the rat masseter muscle. This study aimed to investigate the frequency of nerve fibers that express 5-HT_3A-receptors alone and in combination with Na_V1.8 sodium-channels in human muscles and to compare it between healthy pain-free men and women, the pain-free masseter and tibialis anterior muscles, and patients with myofascial temporomandibular disorders (TMD) and pain-free controls.

Methods

Three microbiopsies were obtained from the most bulky part of the tibialis and masseter muscles of seven and six healthy men and seven and six age-matched healthy women, respectively, while traditional open biopsies were obtained from the most painful spot of the masseter of five female patients and from a similar region of the masseter muscle of five healthy, age-matched women. The biopsies were processed by routine immunohistochemical methods. The biopsy sections were incubated with monoclonal antibodies against the specific axonal marker PGP 9.5, and polyclonal antibodies against the 5-HT_3A-receptors and Na_V1.8 sodium-channels.

Results

A similar percentage of nerve fibers in the healthy masseter (85.2%) and tibialis (88.7%) muscles expressed 5-HT_3A-receptors. The expression of Na_V1.8 by 5-HT_3A positive nerve fibers associated with connective tissue was significantly higher than nerve fibers associated with myocytes (P < .001). In the patients, significantly more fibers per section were found with an average of 3.8 ± 3 fibers per section in the masseter muscle compared to 2.7 ± 0.2 in the healthy controls (P = .024). Further, the frequency of nerve fibers that co-expressed Na_V1.8 and 5-HT_3A receptors was significantly higher in patients (42.6%) compared to healthy controls (12.0%) (P < .001).

Conclusions

This study showed that the 5-HT_3A-receptor is highly expressed in human masseter and tibialis muscles and that there are more nerve fibers that express 5-HT_3A-receptors in the masseter of women with myofascial TMD compared to healthy women. These findings indicate that 5-HT₃-receptors might be up-regulated in myofascial TMD and could serve as potential biomarkers of chronic muscle pain.     

关节腔冲洗并透明质酸钠注射治疗TMD临床观察

目的：观察颞颌关节上腔冲洗加透明质酸钠注射治疗颞下颌关节紊乱病(TMD)的疗效。方法：对46例TMD患者关节上腔使用生理盐水反复加压冲洗，然后注射透明质酸钠4～6ml。2周后复诊、观察治疗效果。结果：结构紊乱类显效10例；好转6例，无效2例；骨关节病类显效2例，好转3例，无效1例。炎性疾病类显效6例，好转12例，无效4例。结论：该疗法对结构紊乱类疾病，骨关节病的疗效较好，对炎性疾病的疗效欠佳。