Relationship between self-reported pain, pain threshold, pain catastrophization and quality of life in patients with TMD.

Background: The aim of this study was to verify if there is a relationship between self-reported pain, PPT (pressure pain threshold) of the masseter, temporal and sternocleidomastoid muscles, pain catastrophizing and quality of life in patients with TMD (temporomandibular disorder) of muscular origin. Material and Methods: Ninety-seven patients with muscular TMD (TMD group) and 97 asymptomatic (control group) were included in the study. The evaluation methods used were: 1) Self-reported pain was assessed using the Visual Analogue Scale (VAS) for questions 7, 8 and 9 of the RDC/TMD Axis I questionnaire; 2) The PPT assessment was performed using a digital algometer on the masseter, temporal, and sternocleidomastoid muscles (both sides); 3) Pain catastrophizing was assessed using the PCS (Pain Catastrophizing Scale); and 4) Oral health-related quality of life was assessed using the OHIP-14 (Oral Healthy Impact Profile-14). Data were submitted to Spearman correlation and logistic regression (p<0.05). Results: There were significant positive correlations between self-reported pain (VAS-Q7, VAS-Q8 and VAS-Q9), pain catastrophizing (PCS-Helplessness, PCS-Magnification, PCS-Rumination and PCS-Total) and quality of life (OHIP-14) (p<0.05). There was a significant negative correlation of self-reported pain (VAS-Q8) with PPT of the temporal (left) and sternocleidomastoid (both sides) (p<0.05). The rumination and magnification domains increased the chance of high self-reported pain in all situations (VAS-Q7, VAS-Q8 and VAS-Q9) (p<0.05). The helplessness domain only increased the chance of high self-reported pain for VAS-Q8 (p<0.05). The presence of TMD of muscular origin, high self-reported pain (VAS-Q7) or pain catastrophizing increased the chance of a low quality of life in relation to the control group (p<0.05). In addition, the reduction in sternocleidomastoid PPT increased the chance of poor quality of life (p<0.05). Key words:Myofascial pain syndromes, pain catastrophizing, myalgia, quality of life, surveys and questionnaires, temporomandibular joint disorders.

Antimicrobial effects of photodynamic therapy on Staphylococcus aureus biofilm grown on a specific acrylic resin surface for ocular prostheses.

BACKGROUND: Photodynamic therapy (PDT) is a treatment for the specific control of oral biofilms. However, its effects on maxillofacial prostheses have been barely explored. In this study, we evaluated the antimicrobial effect of PDT using methylene blue (MB) and laser against a Staphylococcus aureus biofilm developed on the surface of scleral acrylic resin. METHODS: Sixty-six specimens of acrylic resin designed for ocular prostheses were fabricated in a disk-shaped format (3 × 10 mm). S. aureus biofilm was grown on the surface of the specimens for 24 h and the disks were then treated with MB at different concentrations (25, 50, 75 or 100 µg/mL), with or without PDT (GaAlAs diode laser; 660 nm; 100 mW; 9 J; 321.4 J.cm-2; 3.5 W.cm-2 and 90 s). Control groups were treated with 2% chlorhexidine gluconate (CHX) or phosphate buffered saline. After the treatments, colony forming units (CFU) were counted and the samples were qualitatively evaluated by scanning electron microscopy (SEM). Data were analyzed descriptively and by nested ANOVA and the Tukey test (α = .05). RESULTS: PDT groups with MB concentrations at 75 and 100 µg/mL formed fewer CFU compared to the other groups (P < 0.001) and the 2% CHX group did not form any CFU. SEM images revealed that the surface of the polymers in these groups did not show bacterial colonies. CONCLUSIONS: PDT significantly reduced S. aureus biofilm in the scleral acrylic resin when associated with an MB dilution of 75 µg/mL or higher. Thus, PDT can be a promising candidate for disinfecting ocular prostheses.

The Impact of Surgery and Radiotherapy on Health-Related Quality of Life of Individuals with Oral and Oropharyngeal Carcinoma and Short-Term Follow up after Treatment.

OBJECTIVE: This study aimed to evaluate the quality of life of patients with oral or oropharyngeal cancer by using specific questionnaires (QLQ-C30 and QLQ-HandN35), varying according to the location of the tumor (oral cavity or oropharynx) and the treatment performed (only surgery or surgery associated with radiotherapy). METHODS: Fifty patients were enrolled in this study and answered the EORTC QLQ-C30 and EORTC HandN35 questionnaires, before (baseline), at 1 week, and 3 months after treatment. Internal consistency reliability was calculated with the Cronbach coefficient. The Kruskal-Wallis and Wilcoxon tests were applied and P.

Anxiety and pain perception in patients undergoing mandibular autogenous block bone surgery.

BACKGROUND: The aim of the present study was to investigate pain perception and anxiety within the context of surgery for the placement of mandibular block bone and to evaluate the causality effect between theses variables. MATERIAL AND METHODS: A total of 13 patients were recruited for the study and were submitted to mandibular autogenous block bone surgery. Demographic data were collected and the anxiety level was determined using the State-Trait Anxiety Inventory (STAI). The STAI was administered on the day of surgery and on the 14th postoperative day. Pain was determined using the visual analogue scale (VAS) and limitation of daily activities and postoperative symptoms were also reported. Data were analyzed using parametric tests (α=0.05) and cross-lagged analysis was performed to verify a causality effect. RESULTS: Few patients reported interference with daily activities or the presence of postoperative symptoms. A significant association of bad breath/taste with STAI-State was detected on the 14th postoperative day. No evidence of causality between STAI and VAS was detected. CONCLUSIONS: The patient's self-evaluation indicates that the pain and anxiety level felt during treatment was not directly associated with the clinical aspects of the surgical procedure or with postoperative activities/symptoms limitations. Key words:Anxiety pain, questionnaires, autogenous bone block, treatment, outcomes.

Optical parameters and hardness of two maxillofacial elastomers after immersion in different solutions of Brazilian green propolis extract.

STATEMENT OF PROBLEM: Maxillofacial elastomers undergo physical and mechanical degradation with disinfecting solutions. Solutions of Brazilian green propolis extract may be suitable alternatives for infection control of maxillofacial prostheses. However, their effects on the properties of the material are unknown. PURPOSE: The purpose of this in vitro study was to evaluate the effect of disinfection with solutions of Brazilian green propolis extract on the transmittance, translucency parameter, contrast ratio, and hardness of 2 maxillofacial elastomers (MDX4-4210 and MED-4014). MATERIAL AND METHODS: Fifty disk-shaped specimens (3×10 mm) of each elastomer were randomly and equally divided into 4 groups of disinfectant agents and 1 control group: 3 separate groups of 11% green propolis extracts including aqueous (PAQ), glycolic (PGL), and alcoholic (PAL), a 2% chlorhexidine gluconate (CHX) group, and the control group of distilled water. Specimens were subjected to disinfection by immersion 3 times a week for 60 days. Color differences (ΔE values) were calculated with CIELab and CIEDE2000 formulas. Optical parameters and Shore A hardness were determined at 2 time points: at baseline and after the period of specimen disinfection. Data were analyzed by parametric and nonparametric analysis of variance and by multiple-comparison tests (α=.05). RESULTS: The ΔE values of specimens immersed in 11% PAL were not clinically acceptable for either elastomer. Regarding translucency parameter and contrast ratio, the immersion in 11% PAL and 11% PGL resulted in greater opacity and lower translucency of the material. Mean Shore A hardness values were not statistically significantly different at baseline or after 60 days of immersion in the solutions. CONCLUSIONS: The solution of Brazilian green propolis extract tested showed changes in optical parameters. Elastomers immersed in 11% alcoholic green propolis extract showed clinically unacceptable color and translucency changes. All hardness values of the tested elastomers were clinically acceptable after immersion in all tested disinfectant groups.