Neurophysiologic and long-term effects of clinical hypnosis in oral and maxillofacial treatment--a comparative interdisciplinary clinical study.

This prospective comparative clinical study evaluated the effectiveness of clinical hypnosis and its long-term effect in oral and maxillofacial treatment. A total of 45 highly anxious and nonanxious subjects were evaluated by subjective experience and objective parameters. Parameters were EEG, ECG, heart rate, blood pressure, blood oxygen saturation, respiration rate, salivary cortisol concentration, and body temperature. During and subsequent to the operative treatment, hypnosis led to a significant reduction of systolic blood pressure, and respiration rate and to significant changes in the EEG. The subjective values of the parameters evaluated existing anxiety mechanisms and patterns and possible strategies to control them, whereas the objective parameters proved the effectiveness of hypnosis and its long-term effect.

Is there a difference in the reliable measurement of temporomandibular disorder signs between experienced and inexperienced examiners?

AIMS: To determine whether there is a difference in terms of reliability between experienced examiners and inexperienced examiners in the measurement of signs of temporomandibular disorders (TMD). METHODS: A total of 27 patients seen for treatment of TMD were rated blindly and in random sequence by 2 experienced and 2 inexperienced examiners. The examiners participated in a 4-hour calibration session on the day preceding the reliability study. Both experienced and inexperienced examiners participated in the calibration session to reduce the effect of examiner subjectivity and allow the study focus to be on the effect of experience. The rating followed the Research Diagnostic Criteria for Temporomandibular Disorders and included mandibular movements, joint sounds, and digital palpation of muscles and joints. Intraclass correlation coefficients and kappa statistics were calculated to estimate interrater reliability. The Wilcoxon signed rank test was performed to test for differences between experienced and inexperienced examiners' results, and the Friedman test was used for differences between all 6 examiner combinations. RESULTS: Excellent overall reliability was found for vertical mandibular motions, acceptable reliability was found for the summed muscle palpation pain sites, and moderate to poor reliability was found for excursive movements, joint sounds, and single muscle palpation pain sites. No significant differences in the measurement results could be found between the experienced examiners and the inexperienced examiners. CONCLUSION: Examiner calibration rather than professional experience seems to be the most important factor for reliable measurement of TMD symptoms.

Abnormalities of the TMJ and the musculature in the oculo-auriculo-vertebral spectrum (OAV). A CT study.

The abnormalities covered by the generic term "oculo-auriculovertebral spectrum" (OAV) form an exceptional heterogeneous dysmorphic complex characterized by unilateral malformations of miscellaneous craniofacial structures. The aim of the present study was to analyze morphometrically the developmental deficits concerning the temporomandibular joints, the mandibular rami and the mastication muscles by comparing the affected with the non-affected side. The volume, maximum horizontal diameter, and trabecular bone density of the head of the mandible, as well as the ramus height were acquired from CT data of 16 patients suffering from this syndrome. The volume and maximal cross-sectional area of the masseter muscles and the pterygoid muscles were defined by quantifying CT data of nine patients. The skeletal parameters were evaluated with VoXim software. The comparison of the mandibular structures on the affected and on the non-affected side was based on the Wilcoxon signed rank test. The results recorded on the affected side showed that the TMJ volume was reduced by a mean factor of 7.98, and the spongiodensity of the head of the mandible by a mean factor of 1.33, while the mean reduction in ramus height was 14.89 mm. The muscle volumes on the affected side had also undergone a mean reduction of 9.10 cm(3). The CT-based data analysis proved to be an excellent tool for quantitative three-dimensional evaluation of both the skeletal and the muscular parameters.