The effects of Biofreeze and superficial heat on masticatory myofascial pain syndrome.

PURPOSE: This study aims to assess the influence of superficial heat and Biofreeze on pain, mouth opening (mm), and quality of life in patients with masticatory myofascial pain syndrome (MPS). MATERIALS AND METHODS: 52 patients with MPS were included in the study. They were randomly divided into two groups. Patients in the Biofreeze group (n = 26) applied 3.5% menthol gel to the masseter and temporal muscles twice a day for seven days, while the other group applied superficial heat. Baseline, 7th, and 21st days of VAS, mouth opening (mm), and Oral Health Impact Profile-14 (OHIP-14) scores of the patients were evaluated statistically. RESULTS: The mouth opening increased by 4.27 ± 3.80 mm in the Biofreeze group and 2.58 ± 2.16 mm in the superficial heat group. In each group, a significant decrease in VAS and OHIP-14 scores was observed on the 7th day compared to the baseline values (p<0.001). There was no statistically significant difference between the two applications on myofascial pain, mouth opening (mm), and OHIP-14 total score variables. The favorable effects of both applications on these parameters were limited to the duration of use. CONCLUSION: Biofreeze and superficial heat in MPS were found to increase the quality of life, but the limited effectiveness of these applications underlines the importance of the underlying factors.

Correlation of molecular biomarker concentrations between synovial fluid and saliva of the patients with temporomandibular disorders.

OBJECTIVES: The synovial membrane and fluid are involved in the pathogenesis of temporomandibular joint (TMJ) disorders. This study aims to assess the relationship between matrix metalloproteinase-2 (MMP-2), chemerin and prostaglandin (PGE2) levels in the synovial fluid (SF) and saliva of patients with TMJ disorder regarding their role in inflammation and the value of being a candidate for predictive biomarkers in the disease. Also, it is aimed to find out whether chemerin's main function triggers the formation inflammatory cytokine markers in the associated area. MATERIALS AND METHODS: Thirty-two samples of SF and saliva were obtained from patients with disc displacement without reduction with limited opening (DDWORwLO). Mann-Whitney-U test was used for the comparisons of the biomarker levels in SF and saliva. The correlation between chemerin and BMI (Body Mass Index) is analyzed by non-parametric Spearman's rho correlation coefficient. RESULTS: For all of the three biomarkers, statistically significant differences were found between SF and saliva. An unexpectedly high level expression of chemerin was observed in SF. A statistically significant, positive correlation was observed between PGE2 -MMP-2, and chemerin-PGE2 in saliva, chemerin and MMP-2 in SF, respectively (p = 0.031, r = 0.382 / p = 0.039, r = 0.366 / p = 0.032, r = 0.379). A positive correlation was determined between saliva and SF levels of PGE2 (p = 0.016, r = 0.421). CONCLUSIONS: Chemerin, MMP-2, and PGE2 can play a role as an inflammatory factor for the development of TMJ disorder. CLINICAL RELEVANCE: The search for molecular markers in TMJ and the inhibition of the associated molecular signaling mechanism is important to reduce joint inflammation and cartilage degradation.

Influence of coping strategies on oral health-related quality of life in patients with myalgia.

OBJECTIVE: To identify coping strategies used by patients with myalgia and to assess the influence of pain characteristics and coping attitudes on their oral health-related quality of life (OHRQoL). METHODS: One hundred patients diagnosed with myalgia due to temporomandibular disorders were included in this study. They were administered a three-part questionnaire. For preselecting associated coping variables, correlation analysis was performed between coping strategies and OHRQoL domains. A block-wise hierarchical multiple regression analysis was carried out to evaluate whether coping strategies had any influence on OHRQoL. RESULTS: Notable trends were found between coping strategies and demographic variables and pain characteristics. OHRQoL appeared to worsen with pain severity and with coping strategies that reveal passive or avoidant attitudes of the patient. DISCUSSION: Individual coping strategies should be considered while managing myalgia. A multidisciplinary approach that aims to help these patients acquire suitable coping strategies may be useful in improving their OHRQoL.

Oral and dental alterations and growth disruption following chemotherapy in long-term survivors of childhood malignancies.

PURPOSE: More attention has been focused on the long-term side effects of treatment protocols since impressive advances in childhood cancer treatment have resulted in a growing population of patients. The purpose of this study was to investigate the disturbances of dento-facial development in children who were long-term survivors of childhood malignancies. METHODS: Fifty-three children (mean age, 10 years + 4 months) in long-term remission underwent oral/dental and radiographic examinations after completion of therapy. Crown and root malformations, gingival/periodontal status, enamel defects, discolorations, decayed and unerupted teeth, premature apexifications, agenesis, maximal interincisal opening and lateral movement of jaws, and soft tissue abnormalities were noted. Caries were evaluated by the decayed-missing-filled teeth (DMFT) index. Forty healthy children (mean age, 12 years + 4 months) belonging to the same age group and socioeconomic community were served as controls. All participants in the study were evaluated in terms of craniofacial development. RESULTS: The data of the study showed that higher prevalence of root malformation, unerupted teeth, and enamel hypoplasia were detected as a consequence of childhood cancer and/or antineoplastic therapy. Although no differences of craniofacial growth and development were observed between groups (P > 0.05), plaque and gingival index scores were statistically higher in the study group (P < 0.05). CONCLUSION: A range of variations in dental structures is recognized as a side effect of childhood cancer therapy in long-term survivors of pediatric malignancies that may affect their quality of life.

The effect of Hypericum Perforatum on wound healing of oral mucosa in diabetic rats.

PURPOSE: This study aims to investigate the histopathological and biochemical effects of the topical application of Hypericum perforatum on the healing of surgical wounds created in the oral mucosa of rats with experimentally induced diabetes mellitus. MATERIALS AND METHODS: The study was carried out on 48 adult male Wistar albino rats. The animals were divided into two main groups as control and study groups. Two main groups were divided into three subgroups according to the sacrification days. All rats were given streptozotocin 60 mg/kg, after 72 hours, and those having blood glucose levels above 200 mg/dL were included in the study. Mucosal defects were created in the palatal area of the rats. H. perforatum oil was applied topically twice a day to the wounds of the rats in the study group. Animal were sacrificed on the 3rd, 7th and 10th days and samples taken from the palatal wounds were examined histologically and biochemically. RESULTS: On the 7th day, ulceration, necrosis, epithelialization, polymorphonuclear leucocytes and hydroxyproline variables showed statistically significant differences (p<0.05). Ulceration, necrosis and polymorphonuclear leukocytes values were higher in the control group, whereas epithelialization and hydroxyproline values were found to be higher in the H. perforatum group. Among 10th-day groups, there was only a statistically significant difference between the values of hydroxyproline, whereas H. perforatum-treated group showed high hydroxyproline levels (p<0.05). CONCLUSION: Topically applied H. perforatum did not create any difference on the 3rd day, but it has positively affected the wound healing on the 7th and 10th days in diabetic rats.

Clinical and radiographic evaluation of the efficacy of platelet-rich plasma combined with hydroxyapatite bone graft substitutes in the treatment of intra-bony defects in maxillofacial region.

OBJECTIVE: The aim of this study is to evaluate the efficacy of platelet-rich plasma (PRP) clinically and radiographically when combined with bovine derived hydroxyapatite (HA) bone grafting materials and resorbable collagen membranes for the treatment of intra-bony defects frequently seen at the distal aspect of mandibular second molars following the surgical extraction of fully impacted mandibular wisdom teeth. STUDY DESIGN: Eighteen patients were scheduled for post-operative visits at 1, 3 and 6 months post-operatively, probing depths were measured and digital panoramic radiographs were taken. RESULTS: There were no significant differences on probing depths among two groups. Radiographic assessment also showed no significant difference among groups at 1st and 6th month intervals, while 3 months post-operatively the amount of radiographic density at the PRP side was significantly higher. CONCLUSION: Combined use of PRP and bovine-derived HA graft materials for the treatment of intra-bony defects might be an appropriate approach when the main goal is providing earlier bone regeneration.

Long-term effects of cancer therapy on dental development: a case report.

As the prognosis of malignant conditions in children improve by cancer therapy, long-term side effects due to antineoplastic treatment may be encountered. This case report demonstrates the long-term alterations on dental development in patient who had been treated for malignant condition. Alterations were observed during radiographic control 8 years after the therapy and included short, blunted, tapered and V-shaped root malformations as well as delayed and ectopic eruptions.

Long-term effects of chemotherapy on orodental structures in children with non-Hodgkin's lymphoma.

The aim of this study was to investigate the late effects of treatment for childhood non-Hodgkin's lymphomas (NHL) on oral health and dental development. Thirty-six long-term survivors that had been treated with chemotherapy of childhood NHL were included in this study and 36 volunteers with similar age and sex distribution served as controls. Both groups underwent a complete orodental examination for decayed, missing and filled teeth and surfaces, gingival and periodontal health according to the Loe-Silness Gingival Index and Sillnes-Loe Plaque Index, enamel defects and discolorations, root malformations, eruption status, agenesis, premature apexifications and microdontia. The severity of these disturbances related to age at the time of NHL diagnosis were also evaluated by creating two groups as < 5 yr and > 5 yr. Although none of the parameters altered with age, patients had significantly higher plaque index, more enamel discolorations and root malformations than did the controls. The results show that long-term survivors of NHL patients exhibit some orodental disturbances that may be attributed to the chemotherapy regimens.

Osteoclast differentiation in ectopic bone formation induced by recombinant human bone morphogenetic protein 2 (rhBMP-2).

Osteoclast differentiation in the process of ectopic bone formation induced by recombinant human bone morphogenetic protein 2 (rhBMP-2) was examined to clarify the relationship between osteoclast development and rhBMP-2-induced bone formation. A combination of rhBMP-2 with a porous microsphere (PMS) and blood clot was implanted subcutaneously on the bilateral chest muscles of rats. Tartrate-resistant acid phosphatase (TRAPase) activity, cathepsin K (cath K), and calcitonin receptor (CTR), as markers of osteoclasts and their precursors, were examined using enzyme and immunohistochemical analysis up to 7 days after implantation. Mononuclear cells positive for TRAPase, cath K, and CTR first appeared on day 3 in connective tissue surrounding the PMS after implantation of rhBMP-2. Simultaneously, alkaline phosphatase activity became detectable in mesenchymal cells in the connective tissue. Electron microscopy demonstrated some mononuclear cells with abundant mitochondria and poorly developed rough endoplasmic reticulum in the proximity of mesenchymal cells. However, there was no evidence of cartilage or bone matrix formation on day 3. Osteoclasts in various stages of development, classified by the pattern of immunoreactivity for cath K, were observed by day 7. The polarized intracellular distribution of cath K was found only in osteoclasts attached to bone matrix. In conclusion, we have demonstrated for the first time the appearance of osteoclast precursors before bone matrix formation induced by rhBMP-2, suggesting that bone matrix is not a prerequisite for osteoclast precursor recruitment. Furthermore, we suggest that differentiation into polarized functional osteoclasts is accomplished when the osteoclasts attach to the bone matrix.

The early tissue response to titanium and LactoSorb screws.

Fractures of the maxillofacial region are common in the elderly people. Titanium and LactoSorb screws are the widely accepted materials for use in the maxillofacial fractures. This study was undertaken to evaluate the early tissue response following the insertion of both titanium and LactoSorb screws composed of 82% PLLA and 18% PGA in an elderly animal model. In this study, 22 titanium and 22 LactoSorb screws were applied to calvaria of 44 guinea pigs that were 10-11 months old. Animals were sacrificed on postoperative days 3, 7, 14, 30 and 60. Screws were retrieved with surrounding bone tissue and the specimens were prepared for routine histologic examination. All the specimens were evaluated by light microscopy. Histometric analysis revealed that there was no significant difference between LactoSorb and titanium screws for the new bone formation. The biodegradation of LactoSorb screws was not complete by the end of day 60. In conclusion, both materials were well tolerated and induced bone formation without causing adverse tissue response in an elderly animal model. Our results suggest that both LactoSorb and titanium miniplates and screws can be used safely, regardless of the increasing age. However, LactoSorb may be the first choice as it does not require a second operation for removal and has late biodegradation in elderly that keeps its support for a relatively longer time during fracture healing.