Personality and psychopathology in patients with temporomandibular joint pain-dysfunction syndrome. A controlled investigation.

OBJECTIVE: Our aim was to deepen the understanding of the psychosomatic aspects of temporomandibular joint (TMJ) pain dysfunction syndrome. Patients affected by this syndrome were compared with both healthy subjects and psychiatric patients, using both self-report and physician-scored psychological measures. METHODS: Three sex- and age-matched groups were recruited: a TMJ group (n = 32), a healthy group (n = 22) and a psychiatric group (n = 22). The psychiatric group consisted of outpatients diagnosed as having a DSM-IV anxiety or depressive disorder of mild to moderate severity. Psychometric assessment included the Minnesota Multiphasic Personality Inventory (MMPI) and the Hamilton Anxiety Rating Scale (HARS). RESULTS: Psychiatric patients scored higher than both the comparison groups on all but one of the MMPI scales; the majority of the differences were significant or approached significance. TMJ patients scored higher than healthy controls on the Hs (hypochondriasis; p< or =0.01), Hy (hysteria; p< or =0.01) and D (depression; p< or =0.05) scales. Psychiatric patients scored higher than TMJ patients on the HARS psychic anxiety subscale (p< or =0.05), while TMJ patients scored higher than psychiatric patients on the somatic anxiety subscale (p< or = 0.05). CONCLUSIONS: Certain personality characteristics were associated with TMJ dysfunction. However, further longitudinal studies should be performed to properly assess causal relationships. Despite signs of neuroticism, anxiety and depression, patients with TMJ dysfunction differed from anxious and depressed patients. While the latter displayed a higher level of psychopathology, each group was characterised by a distinct pattern of anxiety symptoms. In addition, a substantial proportion of TMJ patients had little awareness of their inner states and emotions.

[The Papillon-Lefèvre syndrome. A clinical and ultrastructural study of 2 cases]. / Sindrome di Papillon-Lefèvre. Studio clinico e ultrastrutturale su due casi.

Two cases of Papillon-Lefèvre syndrome, a rare hereditary affection of unknown etiology, whose clinical signs are hyperkeratosis palmoplantaris and parodontitis, are described. The results obtained with the ultrastructural examination of the lesions are shown. A therapeutic protocol which can reduce the evolution of the pathology, is also suggested.

[Classification and etiopathogenesis of upper canine impaction]. / Classificazioni ed etiopatogenesis dell'inclusione del canino superior.

Classification and aetiopathogenesis of upper canine inclusion. The possible causes of upper canine inclusions are reviewed. After a detailed description of the factors that generally contribute to determining inclusions, it is stressed that correct aetiopathogenetic classification of this pathology can contribute to making the complex protocol for its treatment easier.

[The superior median frenulum. Surgical-orthodontic treatment of a recurrence]. / Il frenulo mediano superiore. Trattamento chirurgico-ortodontico di una recidiva.

The authors illustrate the etiopathogenic factors of the pathology resulting from superior inter-incisal diastema combined with labial frenulum. They point out that it is not possible to solve the examined pathology without an adequate program set out in close cooperation between orthodontist and periodontal surgeon. They also describe a case of relapse after frenectomy carried out before the suitable age for obtaining a final result which is lasting and constant.

[Prosthetic rehabilitation in the sequelae of labiopalatoschisis]. / La riabilitazione protesica negli esiti di labiopalatoschisi.

Labiopalatoschisis patients present functional and aesthetic alterations in the maxillomandibular area that often require prosthetic correction. Given the features of these malformations therapy and rehabilitation should be programmed as soon as possible after birth and the plastic surgeon should be informed of the factors that cause the malformations and influence the growth of such patients. The present paper briefly outlines the pathogenesis of L.P.S. and proposes a classification system for L.P.S. since both are considered essential for the understanding and assessment of its sequelae. The prosthetic-reconstructive problems in cases of cheilognathopalatoschisis subjected to orthodontic and surgical treatment are described since this is considered the most difficult form of rehabilitation the prosthesis is faced with.

[Orthodontic-surgical treatment of impacted canines. Clinical and therapeutic aspects of disimpaction]. / Il trattamento ortodontico-chirurgico dei canini inclusi. Considerazioni cliniche e terapeutiche della disinclusione.

An attempt was made to classify the various positions assumed by included canines in order to identify the most appropriate treatment. The surgical phase is indubitably decisive for correct repositioning. The possible corrective techniques are described together with several useful ideas for use in the exposure phase in order to facilitate the procedure and minimal subsequent orthodontic work, while ensuring maximum stability of both tooth and periodontal tissue at the end of the repositioning.