Superficial cervical plexus block on pain control in patients with temporomandibular joint internal derangement with headache: a retrospective cohort study.

OBJECTIVES: Temporomandibular disorders (TMDs) are a group of disorders with varied pathophysiology and clinical manifestations. Masticatory and cervical motor systems have a functional relationship. Superficial cervical muscles have greater hyperactivity in myogenous and mixed TMDs than in healthy individuals, demonstrating an abnormal pattern of contraction. This study aimed to demonstrate the effects of superficial cervical plexus block (SCPB) anesthesia during arthrocentesis in patients with temporomandibular joint (TMJ) internal derangement and headache. METHOD AND MATERIALS: This retrospective cohort study included 2 men and 23 women with cervicogenic headache and TMJ internal derangement treated by arthrocentesis, and 40 TMJs with established cervicogenic headaches. The average follow-up period was 9.36 ± 2.679 months. TMJ and muscle pain during mastication, maximum and non-assisted mouth opening, and lateral excursion were recorded. Pain and dysfunction were determined using the visual analog scale. Patients were monitored before, during, and after arthrocentesis while inducing SCPB anesthesia, and vital findings were recorded. In addition, skin surface temperature was measured. RESULTS: Patients experienced a significant increase in their clinical values. Changes in non-assisted mouth opening (mean from 29.65 ± 6.31 to 33.3 ± 5.21 mm) (P < .05), assisted mouth opening (mean from 38.98 ± 7.62 to 43.35 ± 6.17 mm), right excursions (mean from 7.28 ± 2.08 to 9.13 ± 1.86 mm), and left excursions (mean from 7.48 ± 1.71 to 8.90 ± 1.82 mm) were statistically significant (P < .05). Patients were relieved after SCPB, resulting in decreased pain and hemodynamic values. Increase in mean temperature after SCPB was statistically significant (P = .002, P < .05). CONCLUSION: This study presents a straightforward novel protocol, clinically efficient for arthrocentesis on pain control in patients with TMJ internal derangement and cervicogenic headache.

Comparison of Oxygen Saturation During Impression Taking Before and After Presurgical Orthopedic Therapy in Babies With Cleft Lip and Palate.

AIM: The objective of this study was to (1) evaluate the oxygen saturation (SpO2) levels during intraoral and extraoral impression taking and (2) compare the SpO2 levels during impression taking before and after presurgical orthopedic therapy (POT) of infants with cleft lip and palate (CLP). PATIENTS AND METHODS: In our study, 31 babies with CLP before (mean age 7.6 ± 3.2 days) and after (mean age 108.3 ± 24.2 days) POT were monitored, and SpO2 levels were measured under operating conditions before any intervention (T1), after oxygenation (T2), during taking intraoral (T3), and extraoral (T4) impressions with oxygen support and immediately before the discharge from the operating room (T5). RESULTS: In both groups, statistically significant differences in SpO2 measurements at T1, T2, T3, T4, and T5 stages were found (P < .01). For the pre-POT measurements, increases in SpO2 levels from T1 to T2 and T4 to T5 (P < .05) and decreases from T2 to T3 and T3 to T4 (P < .01) were noted. Similarly, SpO2 levels decreased significantly from the intraoral (T3) to extraoral (T4) post-POT impression periods (P < .01). Comparisons of pre- and post-POT measurements revealed that the SpO2 level of each time period was higher at the post-POT impression taking except for stages T2 and T5 (P < .01). CONCLUSION: The SpO2 values were low at the onset of POT in infants with CLP before any intervention. Oxygen saturation levels may decrease particularly during extraoral impression taking in infants with CLP despite the supplemental oxygen. SpO2 measurements were higher during post-POT intraoral and extraoral impression taking when compared with pre-POT measurements.

Evaluation of Oxygen Saturation and Heart Rate During Intraoral Impression Taking in Infants With Cleft Lip and Palate.

OBJECTIVE: The aim of the study was to evaluate the changes in oxygen saturation and heart pulse during intraoral impression taking from infants with cleft lip and palate (CLP) at onset of presurgical orthopedic therapy. SUBJECTS AND METHODS: In our study, 21 uni- and bilateral infants with CLP (9 female, 12 males, mean age 5.90 ±â€Š2.46 days) were monitored and heart pulse and oxygen saturation were measured under operating conditions before any intervention (T1), after delivery of 50% supplemental oxygen (T2), during impression taking with oxygen support (T3), and immediately before the discharge from the operating room (T4). RESULTS: Statistically significant differences were found in the average oxygen saturation levels (P < 0.01), but not in heart rates (P > 0.05) between T1, T2, T3, and T4. Decreases in the oxygen levels from T2 to T3 were noted (P < 0.01). Overall, oxygen levels increased from T1 to T4 (P < 0.01). CONCLUSIONS: Oxygen saturation levels may decrease during intraoral impression taking in infants with CLP despite the supplemental oxygen under operating conditions. No changes in the heart rate during the procedure showed that the cardiac output was sufficient, whereas the decrease in oxygen saturation demonstrated hypoventilation because of the anatomic structure and impression-taking process. It may be advised that the impression should be taken under the supervision of the anesthetist, with monitoring of, and supplying oxygen to, the infant with CLP.

Implant-supported overdenture in an elderly patient with Huntington's disease.

Huntington's disease is a hereditary, progressive, neuro-degenerative disorder characterised by increasingly severe motor impairment, cognitive decline and behavioural manifestations leading to functional disability. Dyskinesia and hyperkinesia of the tongue and the peri-oral musculature make it impossible for the patient to wear a conventional complete denture, despite an adequate alveolar ridge. The present paper reports on a patient with Huntington's disease who was rehabilitated with a mandibular overdenture supported by two endosteal implants. One year follow-up examination showed that the prosthesis was stable and there was considerable improvement in the patient's masticatory function.