Musculoaponeurotic architecture of the human masseter muscle: an in vivo ultrasonographic study of architectural changes during mandibular protrusion and lateral excursions.

OBJECTIVE: The present study evaluated the in vivo musculoaponeurotic architecture of the superficial head (SH) of the masseter muscle (MM) of asymptomatic participants in excursive mandibular movements compared to the relaxed state as examined with ultrasonography. It was hypothesized that the mean fiber bundle length (FBL) and mean height of the aponeurosis (HA) of the laminae of the SH would differ significantly between the relaxed state and protrusion, ipsilateral excursion, and contralateral excursion. STUDY DESIGN: The MM was studied volumetrically in 12 female and 12 male asymptomatic participants bilaterally by using ultrasound imaging. Mean FBL and HA in protrusion and ipsilateral and contralateral excursion were compared to these values in the relaxed state using paired t tests (P < .05). The intraclass correlation coefficient was used to assess intraexaminer reliability. RESULTS: The SH exhibited multiple laminae. Fiber bundles were found to attach to bone and the superior and inferior aponeuroses. Mean FBL was significantly shorter and mean HA significantly longer in protrusion and the excursions than in the relaxed state although the pattern of altered laminae and aponeuroses differed among the mandibular movements. Intraexaminer reliability was excellent. CONCLUSION: Specific changes in mean FBL and mean HA suggest differential contraction of the SH of the MM based on laminar morphology. These findings provide a baseline to investigate musculoaponeurotic changes in patients with myogenic masseter muscle pain.

Prevalence of Bifid Mandibular Canal Amongst Indian Population: A Radiographic Study.

BACKGROUND: Bifid mandibular canal (BMC) is a normal anatomical variation and has been less studied in the Indian population. This study was aimed at estimating the prevalence of BMC amongst Indian population. MATERIALS AND METHODS: The study sample comprised of 5800 digital orthopantomograms (OPGs) which were from four zones of India, i.e. North India, South India, East India, and West India (1700 OPGs from each zone). Any pathological or normal digital OPGs having age between 15 and 80 years in the format of jepg or jpg image were included, while OPGs of operated case of hemimandibulectomy and blurred in which mandibular canal was not traceable were excluded from this study. Each radiograph was assessed for BMC based on the classification given by RP Langlais. Four examiners (two Oral and Maxillofacial surgeons and two Oral and Maxillofacial Radiologists) individually assessed every OPG for the presence of BMC. BMC was considered present, if all the examiners detected it independently. RESULTS: There were 5800 OPGs examined, out of which 2576 were of women and 3224 were of men. Bifid mandibular canals were observed in 135 (2.3%) out of 5800 digital panoramic images. There was no statistically significant correlation found with regard to age. Bifid mandibular canals were found with a female-to-male ratio of 1:1.2. The most frequently encountered type of BMC was type II (1.34%) followed by type I (0.72%), type IV (0.15%), and type III (0.1%).

Qualitative and quantitative salivary changes and subjective oral dryness among patients with thyroid dysfunction.

CONTEXT: There is a paucity of literature regarding the effects of thyroid disorders on the oral cavity by influencing the salivary gland function. AIMS: This study aims to understand the qualitative and quantitative changes that thyroid disorder can cause in the salivary function. SETTINGS AND DESIGN:: After obtaining ethical clearance, 46 consecutive newly diagnosed thyroid dysfunction patients were enrolled in this cross-sectional study, along with 45 age-and sex-matched controls. SUBJECTS AND METHODS:: Unstimulated and stimulated salivary flow rates, pH, and buffering capacity of the whole saliva were studied in addition to subjective oral dryness in the study participants. STATISTICAL ANALYSIS USED:: The independent t-test was employed to compare the means between the two groups and Pearson's Chi-square test was used to assess the goodness of fit. RESULTS: The findings showed that females are more affected with thyroid disorders and that hypothyroidism is more commonly reported than hyperthyroidism. A significant reduction in the salivary flow rates and buffering capacity was observed among the affected group compared to the controls, whereas the salivary pH did not show significant differences between genders and also between the case and control groups. A feeling of subjective oral dryness was perceived by many affected patients. CONCLUSIONS: The study was able to establish an association between thyroid dysfunction and salivary gland function. We hope that this study leads to more high-impact research in this field as salivary diagnostics is gaining more popularity with every passing day.

Comparison of Therapeutic Efficacy of Placental Extract with Dexamethasone and Hyaluronic Acid with Dexamethasone for Oral Submucous Fibrosis - A Retrospective Analysis.

INTRODUCTION: Oral Submucous Fibrosis (OSMF) is a potentially malignant disease of the oral cavity associated with betel nut chewing. The management of OSMF has been a subject of controversy and no definitive and widely accepted treatment is currently available for this condition. AIM: To retrospectively evaluate the therapeutic efficacy of two treatment regimens (placental extract with dexamethasone and hyaluronic acid with dexamethasone) for the treatment of OSMF. MATERIALS AND METHODS: The records of the patients diagnosed with OSMF were obtained from the departmental archives. A total of 25 records were selected and divided into two study groups based on the treatment regimens, as Group A (placental extract + dexamethasone) and Group B (hyaluronidase + dexamethasone). The records were studied for improvement in mouth opening and reduction in burning sensation. Descriptive statistics, paired t test and student's t test were used for statistical analysis. RESULTS: In Group A and Group B, the average increase in mouth opening from baseline record to 8th week of treatment was 3.53±1.26mm and 3.65±1.42mm respectively and average decrease in burning sensation, noted by VAS scale, was 5.13±1.13 and 4.90 ±1.29 respectively. The pre- and post-treatment differences were found to be statistically significant for both the groups (p<0.001) and for both the treatment outcomes. When the average difference of the treatment outcomes was compared between the two study groups, no statistically significant difference was noted (p>0.05). CONCLUSION: The results of the present study indicate that both the treatment regimens studied are equally effective in the treatment of oral submucous fibrosis.