3D superimposition and understanding temporomandibular joint arthritis

Structured AbstractObjectivesTo investigate the 3D morphological variations in 169 temporomandibular ioint (TMJ) condyles, using novel imaging statistical modeling approaches.Setting and sample populationThe Department of Orthodontics and Pediatric Dentistry at the University of Michigan. Cone beam CT scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA, mean age 39.115.7years), 15 subjects at initial consult diagnosis of OA (mean age 44.914.8years), and seven healthy controls (mean age 4312.4years).Materials and methods3D surface models of the condyles were constructed, and homologous correspondent points on each model were established. The statistical framework included Direction-Projection-Permutation (DiProPerm) for testing statistical significance of the differences between healthy controls and the OA groups determined by clinical and radiographic diagnoses.ResultsCondylar morphology in OA and healthy subjects varied widely with categorization from mild to severe bone degeneration or overgrowth. DiProPerm statistics supported a significant difference between the healthy control group and the initial diagnosis of OA group (t=6.6, empirical p-value=0.006) and between healthy and long-term diagnosis of OA group (t=7.2, empirical p-value=0). Compared with healthy controls, the average condyle in OA subjects was significantly smaller in all dimensions, except its anterior surface, even in subjects with initial diagnosis of OA.ConclusionThis new statistical modeling of condylar morphology allows the development of more targeted classifications of this condition than previously possible.

Antidepressant treatment decreases daily salt intake and prevents heart dysfunction following subchronic aortic regurgitation in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual Dysfunction

This is a qualitative-quantitative study based on hospital records of female patients of reproductive age, presenting sexual dysfunction, and treated with 250 mg Tribulus terrestris extract (1 tablet thrice daily for 90 days). Safety monitoring included vital signs, physical examination, laboratory tests, and occurrence of adverse events. Efficacy analysis included results of the Female Sexual Function Index (FSFI), dehydroepiandrosterone (DHEA) levels together with total and free testosterone, and the patient and physician assessments. There was a statistically significant improvement in total FSFI scores (P < 0.0001) post-treatment, with improvement among 106 (88.33%) subjects. There was a statistically significant (P < 0.0001) increase in the level of DHEA, while the levels of both serum testosterone (P = 0.284) and free testosterone decreased (P < 0.0001). Most adverse events recorded were related to the gastrointestinal tract. Physical examination showed no significant changes post-treatment. Based on the results, it is concluded that the T. terrestris extract is safe and effective in the treatment of female sexual dysfunction.

Cardiac dysfunction induced by obesity es not related to beta-adrenergic system impairment at the receptor-signalling pathway

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Rutin administration attenuates myocardial dysfunction in diabetic rats

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Low intensity physical exercise attenuates cardiac remodeling and myocardial oxidative stress and dysfunction in diabetic rats

We evaluated the effects of a low intensity aerobic exercise protocol on cardiac remodeling and myocardial function in diabetic rats. Wistar rats were assigned into four groups: sedentary control (C-Sed), exercised control (C-Ex), sedentary diabetes (DM-Sed), and exercised diabetes (DM-Ex). Diabetes was induced by intraperitoneal injection of streptozotocin. Rats exercised for 9 weeks in treadmill at 11 m/min, 18 min/day. Myocardial function was evaluated in left ventricular (LV) papillary muscles and oxidative stress in LV tissue. Statistical analysis was given by ANOVA or Kruskal-Wallis. Echocardiogram showed diabetic groups with higher LV diastolic diameter-to-body weight ratio and lower posterior wall shortening velocity than controls. Left atrium diameter was lower in DM-Ex than DM-Sed (C-Sed: 5.73 ± 0.49; C-Ex: 5.67 ± 0.53; DM-Sed: 6.41 ± 0.54; DM-Ex: 5.81 ± 0.50 mm; P < 0.05 DM-Sed vs C-Sed and DM-Ex). Papillary muscle function was depressed in DM-Sed compared to C-Sed. Exercise attenuated this change in DM-Ex. Lipid hydroperoxide concentration was higher in DM-Sed than C-Sed and DM-Ex. Catalase and superoxide dismutase activities were lower in diabetics than controls and higher in DM-Ex than DM-Sed. Glutathione peroxidase activity was lower in DM-Sed than C-Sed and DM-Ex. Conclusion. Low intensity exercise attenuates left atrium dilation and myocardial oxidative stress and dysfunction in type 1 diabetic rats.

Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

Novel markers of inflammatory response and hepatic dysfunction in canine leishmaniasis

Dogs are the main host of Leishmania infantum, and the clinical presentation may range from asymptomatic to systemic manifestations. The immune mechanisms in infected, but clinically healthy dogs, prevails Th1 response mediated by cytokines. In this sense, adenosine deaminase (ADA) and butyrylcholinesterase (BChE) are considered as key enzymes in several physiological processes, including the modulation of inflammatory process. Considering the variable immune response against Leishmania and the known participation of ADA and BChE, the aim of this study was to assess the relation between these two enzymes with the inflammatory response as well as hepatic function in dogs naturally infected with L. infantum. For this purpose, the activity of ADA and BChE was assessed in sera of 24 dogs naturally infected with L. infantum, plus 17 healthy dogs. The naturally infected dogs had clinical signs compatible with leishmaniasis and sera activities of ADA (P<0.01) and BChE (P<0.05) decreased, when compared to the healthy group. The reduction of ADA activity probably represented an effect on inflammatory response, especially due to the decreased hydrolysis of extracellular adenosine, might in order to protect against tissue damage and, also, setting a down-regulation on pro-inflammatory cytokines. BChE enzyme had no effect on modulating the immune response in leishmaniasis, but it decreased, a fact may related to deficiency of synthesis in the liver. Therefore, ADA and BChE activities reduced probably in order to protect against extra tissue damage and due failure in synthesis, respectively.

Acessos cirúrgicos a articulação temporomandibular: revisão de literatura

The choice of surgical approach to diseases that affect the pre-auricular region has been subject of much discussion in the literature. Access pre-hearing, have been used with high compliance rate of success, and during the history of surgery, several modifications were made in this approach with the goal of reducing the irreversible consequences especially regarding common in condylar fractures as paralysis and facial scars. The views range from the indication of surgical treatment for all fractures, until the conviction that no fracture of the bone segment should be surgically treated. Therefore, this study is of relevance, since offers surgeons warn about the care on the anatomical structures involved in these surgical approaches and describe, seeking a comparison between them, the advantages of them by means of a literature review covering from the extensive bouts of Bellinger (1940) and Al-Kayat (1979) that provide a broad view of the surgical field to access modified and increasingly smaller as the endaural (2001) which not only allows a satisfactory field of aesthetics as maintenance the patient without any signs of scarring.

Acupuntura em disfunção temporomandibular: relato de caso clínico

A técnica milenar da Acupuntura vem sendo empregada na Odontologia e obtendo bons resultados em diversas situações. Analgesia, relaxamento muscular e inflamação vêm sendo controlados, demonstrando assim conexão entre Acupuntura e redução de certas sintomatologias. As reações locais e à distância necessitam de correto posicionamento das agulhas assim como integridade do sistema nervoso, e são decorrentes da liberação de neurotransmissores (noradrenalina, acetilcolina, serotoninas e dopamina). Dentro da Odontologia, podemos nos utilizar dos seus efeitos no pré e pós operatório, em xerostomia, cefaléias, trismos, disfunção de ATM por estresse, parestesias, paresias, ansiedade, entre outras condições. Nos casos de disfunção de Articulação Temporomandibular por hiperatividade muscular, podemos utilizar a Acupuntura ao invés de relaxante muscular e antiinflamatório. Nesse trabalho, apresentaremos um caso clínico (paciente MCH, 23 anos, gênero feminino), a qual apresentava crises de dor de cabeça (região temporal), fazendo uso constante de medicação analgésica e antiinflamatória, o diagnóstico estabelecido foi Dor Muscular Local associado à hiperatividade muscular. Através do uso da Acupuntura, após aplicações semanais por 3 meses, houve remissão da dor por completo.

Sintomas auditivos e desordens temporomandibulares

Introduction: A variety of hypotheses have been proposed to explain the association between temporomandibular disorders and hearing symptoms, including the many anatomical and/or neurological ways, as of a muscle or joint dysfunction, can cause such symptoms. Objective: The purpose of this study is to discuss, through a systematic review of literature, the interrelation between hearing symptoms and temporomandibular disorders. Material and Methods: We consulted the Medline/PubMed, ISI and Scielo in the period 1918 to 2008. The terms related to the research were: “temporomandibular disorders”, “signs and symptoms of temporomandibular disorders”, “otologic symptoms” and “aural symptoms”, where 19 papers were included using the pre-selected criteria for the manufacture of a meta-analysis. Results: According to the findings, the hearing symptoms most often associated with temporomandibular disorders were otalgia and tinnitus, followed by vertigo and hearing loss, respectively. Conclusions: It’s clear the correlation between hearing symptoms and temporomandibular disorders, however there is a need clinical and scientific research more complex to prove the specific cause-effect relationships between them.

Dor orofacial

The orofacial pain, also known by the generic term dysfunction, is highly prevalent in the general population, causing great discomfort to the patients. For this reason, there is great importance of dentist’s participation in practice and in the process of proper diagnosis of this disease, which in modern times has become increasingly important as guides the best treatment. Thus, this study was aimed to review the main causes, diagnosis, main symptoms and treatment modalities, to serve as a guide to the dentist. Moreover, it also aims to review the main etiologic factors commonly associated, as emotional stress and muscular hyperactivity, to clearly identify signs and symptoms, so the dentist is able to realize simple treatment in your particular office or recognizes complex cases that could be send for treatment to multidisciplinary teams.

Temporomandibular disorders in females: acupuncture compared to occlusal splint

To compare the effect of acupuncture and occlusal splint in the treatment of temporomandibular disorders (TMD) in female patients.Method: Forty-eight female patients (mean age of 39.3±6.8 years) with diagnosed pain in muscles or joint according to RDC/TMD criteria were attended at UNESP - Aracatuba Dental School. Including criteria were reported pain in the chewing muscles and/or in the temporomandibular joint measured by a visual analogue scale (range from 0 to 10) and a reported reduction of the maximum mouth opening. Excluding factors were major occlusal problems, systemic diseases, pregnancy and age below 18 years. After randomization, the first group was treated with acupuncture performed by instructed dentist. The second group was treated with occlusal splint. The outcome variables were assessed at baseline (prior to the first treatment session) and after 1, 3 and 6 months. Primary criteria of success were improvement of mouth opening and pain reduction.Result: Acupuncture group exhibited chewing pain decrease from 5 (at baseline) to 1, 2 and 1 after 1, 3 and 6 months, respectively. In the splint group, chewing pain decreased from 4 to 2, 1 and 2 after 1, 3 and 6 months, respectively. The mouth opening (in mm) increased from 28 (at baseline) to 42, 44 and 46 after 1, 3 and 6 months, respectively in the acupuncture group. In the splint group, mouth opening improved from 29 to 40 after 1 month, and to 43 and 42 after 3 and 6 months. A significant pain reduction was noted for both groups when compared to the baseline (p<.001; Wilcoxon test). Acupuncture group had a significant clinical improvement of opening mouth (Mann-Whitney). Conclusion: The present outcomes suggest a positive association among acupuncture and occlusal splint on the reduction of chewing pain. Acupuncture was more effective in the mouth opening increase.