Prevalence of Temporomandibular Joint Disorders in Patients with Ankylosing Spondylitis: A Cross-Sectional Study.

BACKGROUND: This study sought to investigate which temporomandibular disorders (TMD) can be expected in patients with ankylosing spondylitis (AS) and to determine the combined impact of these conditions on the psychological status, chronic pain, and functional disability. MATERIAL AND METHODS: A cross-sectional study composed of 30 patients between 18 and 65 years with ankylosing spondylitis was performed. The research protocol considered the evaluation of outcomes related to the ankylosing spondylitis (HLA-B27 antigen, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire - Spondylitis (HAQ-S)) and temporomandibular disorders (axis I and II of the Research Diagnostic Criteria for Temporomandibular Disorders - RDC/TMD). Descriptive analyses were applied to express the results. RESULTS: The sample presented both AS and TMD, most of them (24) were diagnosed with conventional AS (HLA-B27 positive). The BASDAI was scored as 7.70 (2.30) (high activity of AS disease). Functional disability represented by high scores of BASFI [7.00 (2.63)] and HAQ-S [1.79 (0.62)] demonstrates the severe impact of the disease on the daily routine and quality of life. According to RDC/TMD diagnostic criteria, 17 (57%) share the three groups of TMD, and 9 (30%) share two groups of TMD (Group I and III). Over 73% of the volunteers scored high levels of chronic pain (Grade III and IV) associated with a high depression scale score. The sample scored the somatization scale (with and without pain) as severe. CONCLUSION: Patients with ankylosing spondylitis presented a high prevalence of temporomandibular disorder, most of them having the degenerative forms of TMJ disease. AS and TMD cause moderate to severe chronic pain and a negative impact on psychological status and functional capacities.

Effectiveness of Selegiline Hydrochlorate in Treating Neurosensory Disorders of the Lower Alveolar Nerve Resulting From Mandibular Sagittal Osteotomy: Preliminary Study.

INTRODUCTION: Peripheral nerves transmit nerve signals between periphery and the spinal cord or brain stem. Its function can be compromised by trauma to the nerve, such as those that occur in surgical procedures such as orthognathic surgery. Depending on the type of injury, treatment may be proposed, but this is still a controversial point in literature. Alternative methods that assist in the treatment of paresthesia should be studied, and in this context, selegiline hydrochloride seems to be a promising drug. AIM: Based on the above, the aim of this study was to evaluate the effectiveness of selegiline hydrochloride in the treatment of facial sensory changes resulting from nerve injuries in patients undergoing maxillary orthognathic surgery. METHODS: This was a double-blind randomized clinical trial with the voluntary participation of individuals who underwent orthognathic surgery. The facial sensitivity of these patients was evaluated by 2-point discrimination tests and directional perception in the region related to the lower alveolar nerve. Tests were comparatively applied at times T0 (before surgery), T8 (8 days after surgery), T15 (15 days after surgery), T30 (30 days after surgery), T60 (60 days after surgery), and T90 (90 days after surgery). RESULTS: The mean age of patients was 31.14 years. With the comparative analysis of the 2-point static test on the chin, difference was observed between groups at times T15 (P = 0.007), T30 (P = 0.010), and T90 (P = 0.027) in the intergroup evaluation. Regarding results of the comparative analysis of the 2-point static test on the lip, difference was observed between groups at times T30 (P = 0.023), T60 (P < 0.001), and T90 (P = 0.005) in the intergroup evaluation. In the direction test on the chin, difference was observed between groups at times T30 (P = 0.015), T60 (P = 0.001), and T90 (P < 0.001) in the intergroup evaluation. CONCLUSIONS: Selegiline hydrochloride has shown promising results in the treatment of neurosensory disorders resulting from maxillary orthognathic surgery.

Eritema multiforme mayor desencadenado por antimicrobianos / Big multiform erythema triggered by antimicrobials

El eritema multiforme, aparece como una enfermedad sistémica con la participación de la piel y las membranas mucosas en relación con varios factores como las infecciones bacterianas o virales, y en particular la administración de drogas, analgésicos y antibióticos en general. Se presenta un paciente masculino de 29 años de edad con eritema multiforme mayor desencadenado por antimicrobianos con la aparición de lesiones vesiculares-bulloso-ulcerosas en las regiones de los labios, encías, la lengua y la mucosa genital en tratamiento de una infección del tracto urinario con norfloxacino 400 mg por una semana. Fue realizado un tratamiento de soporte con el uso de colutorios para la higienización bucal y pomada a base de corticoide para protección de las úlceras, antihistamínicos y orientación nutricional de dieta líquida hipercalórica e hiperproteica. Este síndrome está caracterizado como un proceso eruptivo buloso agudo que compromete la calidad de vida del paciente y no hay pruebas de laboratorio específicas por lo que su diagnóstico debe estar basado en la revisión minuciosa de la anamnesis y en los hallazgos clínicos(AU)

The multiform erythema appears as a systemic disease where skin and the mucous membranes have participation in relation to some factors such as bacterial or viral infections and in particular the drugs administration, analgesics and antibiotics in general. The aim of present paper was the presentation of case of big multiform erythema triggering by antimicrobials. Authors present the case of a male patient aged 29 with appearance of ulcerous bullous-vesicular lesions in lips, gums, tongue and genital mucosa under treatment with 400 mg norfloxacin due to urinary tract infection for a week. We made support treatment using mouthwashes for oral hygiene and corticoids ointment for ulcer protection, antihistaminics and nutritional guiding of a hypercaloric and hyperprotein liquid diet. This syndrome is characterized as an acute bullous eruptive process involving the patient's quality of life and there are not specific laboratory tests thus its diagnosis must to be based on a highly detailed review of anamnesis and the clinical findings(AU)