Immediate effects of rhythmic joint mobilization of the temporomandibular joint on pain,mouth opening and electromyographic activity in patients with temporomandibular disorders

BackgroundRhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD.Materials and methodsThis was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package.ResultsA statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85–1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49).ConclusionIn this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.     

Clinicopathological characteristics and perineural invasion in adenoid cystic carcinoma: a systematic review

IntroductionAdenoid cystic carcinoma is the most frequent malignant tumor of the submandibular gland and the minor salivary glands. It is a malignant neoplasm that, despite its slow growth, shows an unfavorable prognosis.ObjectivesThe aim of this study was to perform a systematic review of the literature on Adenoid cystic carcinoma in the head and neck region and its clinicopathological characteristics, with emphasis on the perineural invasion capacity of the tumor.MethodsA systematic search of articles published between January 2000 and January 2014 was performed in the PubMed/MEDLINE, SciELO, Science Direct, and Scopus databases.ResultsNine articles were selected for this systematic review. These demonstrated that the female gender was more often affected and that malignant tumors showed a high rate of distant metastasis, recurrence, and a low survival rate. The presence of perineural invasion ranged from 29.4% to 62.5% and was associated with local tumor recurrence.ConclusionAdenoid cystic carcinoma is commonly characterized by the presence of pain, high rate of recurrence, metastasis, and a low survival rate. Reporting studies with patient follow-up is of utmost importance for a better clinical-pathological understanding and to improve the prognosis of this pathology.     

148例口腔颌面部恶性肿瘤的临床统计及随访观察

本文将我科1974年至1983年收治的148例口腔颌面部恶性肿瘤就性别、年龄、发病部位、肿瘤性质以及所随访的102例口腔领面部恶肿瘤的存活率与肿瘤性质、部位、治疗等的关系进行了统计分析,并评价了冷冻治疗及颈淋巴结根治术。同时阐明了唇癌、皮肤癌淋巴结根治术的指征。     

人口腔鳞癌演变过程中HLA-DR表达改变的研究

目的 :观察HLA DR在口腔鳞癌发生、发展过程中表达的改变并探讨其临床意义。方法 :采用免疫组织化学的方法检测了 2 6例正常口腔黏膜、8例口腔黏膜白斑、3 2例口腔鳞癌原发灶及 15例颈淋巴结转移灶标本内HLA DR的表达。结果 :口腔鳞癌原发灶与正常口腔黏膜HLA DR的表达存在有显著性差异 (P <0 .0 5) ,其余各组间未见有此差异 ;鳞癌原发灶HLA DR的表达除与局部淋巴细胞浸润有显著性关系外与其余各临床病理资料间均无明显关系。结论 :HLA DR在口腔鳞癌细胞中存在有表达异常增高的现象但并不能作为独立的预后判断因素     

数字图像分析在面部整形中的应用

将数字图像分析、模拟技术应用于隆鼻术及烧伤后口唇畸形的整复中，通过测量分析，在术前模拟出术后的面部图像，并输出手术数据，在医生及患者认可后，指导手术进行，否则，继续图像的修改，在手术允许的范围内，直到医、患双方认可。力求美容手术精确化、定量化及图像化并就如何应用数字图像技术于畸形整复进行了探讨     

口腔颌面部损伤136例分析

本文对136例口腔颌面部损伤的伤因,颌骨骨折、牙损伤及软组织损伤等情况进行了分析。讨论了口腔颌面外伤的特点、急救处理、及骨折线上牙齿的处理等问题。强调对颌面外伤的处理必须注重整体观念。     

保持下颌骨完整性改良联合根治术在中晚期舌癌治疗中的应用

目的:探讨保留下颌骨完整性的改良舌鳞癌联合根治术的操作要点、适应证及临床效果。方法:在研究舌外肌、舌下腺及下颌骨的特点,以及颌周淋巴引流特点的基础上,选择临床39例T3-T4舌鳞癌病例,行改良联合根治术,保留下颌骨及牙槽突的完整性。结果:39例均保存下颌骨及牙槽突的完整性,其中直接拉拢缝合9例,30例采用组织瓣修复舌及口底缺损,所有病例均保存良好的咬合功能;术后1年原发灶复发1例,3年原发灶复发9例,淋巴及远处转移5例;3年生存率为(61.72±5.44)%。结论:对于未侵犯下颌骨内侧黏膜的舌鳞癌病例,改良的保留下颌骨完整性的联合根治术能获得良好的生存质量,而不影响对原发灶的控制。     

改良式牙科吸唾管在人工气道中的应用

目的探讨改良式牙科吸唾管在人工气道护理中的应用效果。方法将2007年6月~2009年1月入住ICU建立人工气道的118例患者分为两组,两组患者进行比较。结果两组患者肺部感染、口腔感染、颜面部皮肤破损发生率及护理工作量实验组少于对照组,差异显著有统计学意义(p<0.01)。结论应用改良式牙科吸唾管持续吸引人工气道患者口腔分泌物,可降低肺部感染、口腔感染、颜面部皮肤破损的发生率,增加患者舒适度,减少护理工作量。     

Chronic neuroleptic-induced mouth movements in the rat: suppression by CCK and selective dopamine D1 and D2 receptor antagonists

Fluphenazine decanoate (25 mg/kg IM every 3 weeks x 6) resulted in spontaneous vacuous chewing mouth movements and jaw tremor in male Sprague-Dawley rats. These movements could be suppressed by the selective D1 or D2 dopamine antagonists SCH 23390 (0.5 mg/kg) and raclopride (0.5 mg/kg), respectively, and by CCK-8S (50 g/kg). Fluphenazine-induced mouth movements were unaffected by the selective CCK antagonist MK-329, and by a dose of physostigmine (50 g/kg) sufficient to stimulate mouth movements in placebo treated rats. Scopolamine (0.1 mg/kg) suppressed spontaneous mouth movements in placebo-treated rats, but the effect on fluphenazine-induced mouth movements was not significant. A higher dose of scopolamine (0.5 mg/kg) did suppress the neuroleptic-induced mouth movements, but also induced hyperactivity, characterized by increased sniffing and grooming. These findings indicate that mouth movements resulting from the chronic administration of neuroleptics to the rat may serve as a useful pharmacological model of tardive dyskinesia in the human, and suggest that a relative increase of D1 activity as well as impaired CCK function may contribute to the pathogenesis of this disorder.     

Methods of leaks detection under therapy with continuous positive airway pressure

To assess the performance of continuous positive airway pressure devices in treatment of sleep breathing disorders during polysomnographic studies, analysis are based essentially on the patient airflow signal measured by a pneumotachograph and the mask pressure. These signals used either by the softwares or the physicians provide powerful information on respiratory events occurring during the night. However, sometimes signals are artifacted by airflow leaks at the mask or the mouth. These artifacts are causes of information loss and then of possible wrong interpretations. We studied the relationship between airflow and mask pressure at the occurrence of leaks. We used analogy with electrical models and Kirchoff laws to estimate mask leaks and to detect mouth breathing. A Starling model connected to a flow generator simulated respiratory movements. A positive pressure was maintained in the model and artificial leaks comparable to mask leaks were provoked. Then, we replaced the Starling model and the flow generator by two healthy volunteers. We computed mask leaks in both conditions and found no contradiction between the simulated model and the subjects. Equations of the analog circuit were helpful to assess mask leaks and to detect mouth breathing. Such equations could be included in polysomnographs or in pressure generator algorithms either for detecting leaks or adjusting airway pressure.