The basolateral amygdala-anterior cingulate pathway contributes to depression-like behaviors and comorbidity with chronic pain behaviors in male mice.

While depression and chronic pain are frequently comorbid, underlying neuronal circuits and their psychopathological relevance remain poorly defined. Here we show in mice that hyperactivity of the neuronal pathway linking the basolateral amygdala to the anterior cingulate cortex is essential for chronic pain-induced depression. Moreover, activation of this pathway in naive male mice, in the absence of on-going pain, is sufficient to trigger depressive-like behaviors, as well as transcriptomic alterations that recapitulate core molecular features of depression in the human brain. These alterations notably impact gene modules related to myelination and the oligodendrocyte lineage. Among these, we show that Sema4a, which was significantly upregulated in both male mice and humans in the context of altered mood, is necessary for the emergence of emotional dysfunction. Overall, these results place the amygdalo-cingulate pathway at the core of pain and depression comorbidity, and unravel the role of Sema4a and impaired myelination in mood control.

Dental Education for Prevention of Oral Cancer in Turkey: Needs for Changing the Curriculum.

The aim of the present study is to evaluate the knowledge, attitudes, and behaviors of dental students on oral cancer in Istanbul, Turkey. A self-administered questionnaire adapted from Tanriover et al. consisting of 48 questions was distributed to 311 students enrolled in the fourth and fifth grades of a dental faculty in Istanbul, Turkey. Questions were grouped under 5 main headings: socio-demographic features, knowledge on risk factors and diagnostic procedures, history taking regarding to alcohol and smoking status, opinions and behaviors of oral cancer, and distribution of dental students according to diagnostic practice of oral cancer. The frequencies and percentages were calculated with descriptive analysis. The differences in distributions were analyzed using the chi-squared test. The p value was set at 0.05 for statistical significance. The overall response rate was 98% (305/311). The majority of the students identified tobacco and alcohol as risk factors (82% and 75.1%, respectively), while older age and inadequate consumption of fruits and vegetables were less likely to be known (60.2% and 52.8%, respectively). Almost one-fifth of the students stated that they have never performed oral cancer examinations during their first or subsequent dental examinations of their patients. Female students thought that dentists were authorized to make oral cancer examinations with a higher frequency compared to males (65.8% and 34.2%, respectively; p = 0.006). On the other hand, female students reported that they did not receive adequate education regarding cessation of smoking with a higher frequency compared with males (69.2% female and 30.8% male respectively; p = 0.0001). As this present study revealed that future dentists had insufficient knowledge in some of the main concepts on oral cancer risk factors, and they lacked the confidence in performing oral examinations in their patients, it is concluded that there is a need for a more structured teaching program with greater emphasis on the early signs and risk factors of OC. Reorganization of the dental curriculum, and courses which further draw attention on the responsibility of the dental practitioner in the detection of oral cancers will be beneficial for the creation of awareness on this significant topic among future dental workforce. Understanding the knowledge and perception of dental students on oral cancers is not only limited to a specific country but it is a worldwide critical issue in which information should be exchanged.

Mapping the living mouse brain neural architecture: strain-specific patterns of brain structural and functional connectivity.

Mapping brain structural and functional connectivity (FC) became an essential approach in neuroscience as network properties can underlie behavioral phenotypes. In mouse models, revealing strain-related patterns of brain wiring is crucial, since these animals are used to answer questions related to neurological or neuropsychiatric disorders. C57BL/6 and BALB/cJ strains are two of the primary "genetic backgrounds" for modeling brain disease and testing therapeutic approaches. However, extensive literature describes basal differences in the behavioral, neuroanatomical and neurochemical profiles of the two strains, which raises questions on whether the observed effects are pathology specific or depend on the genetic background of each strain. Here, we performed a systematic comparative exploration of brain structure and function of C57BL/6 and BALB/cJ mice using Magnetic Resonance Imaging (MRI). We combined deformation-based morphometry (DBM), diffusion MRI and high-resolution fiber mapping (hrFM) along with resting-state functional MRI (rs-fMRI) and demonstrated brain-wide differences in the morphology and "connectome" features of the two strains. Essential inter-strain differences were depicted regarding the size and the fiber density (FD) within frontal cortices, along cortico-striatal, thalamic and midbrain pathways as well as genu and splenium of corpus callosum. Structural dissimilarities were accompanied by specific FC patterns, emphasizing strain differences in frontal and basal forebrain functional networks as well as hubness characteristics. Rs-fMRI data further indicated differences of reward-aversion circuitry and default mode network (DMN) patterns. The inter-hemispherical FC showed flexibility and strain-specific adjustment of their patterns in agreement with the structural characteristics.

Comparisons of measures that evaluate oral and general health quality of life in patients with temporomandibular disorder and chronic pain.

Objective: To analyze the oral and general health related quality of life (HRQOL) measures, and to establish their ability to categorize chronic temporomandibular disorders (TMD).Methods: Data were collected from 104 patients through a questionnaire with detailed socio-demographic information, the Oral Health Impact Profile (OHIP-14), the Short-Form-36 (SF-36), the Revised Symptom Checklist-90-R (SCL-90-R), and the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II. Descriptive statistics were computed.Results: Better self-rated health and having no muscle pain were the key predictors for better physical HRQOL, whereas higher levels of depression, worse self-rated health and mandibular functioning were highly associated with worse mental HRQOL. The oral HRQOL were significantly lower in TMD patients with higher pain-related disability and worse oral health rating.Discussion: The use of the OHIP-14 in chronic TMD patients may provide valuable clinical information for better assessing the pain-related disability when compared to SF-36.

Brain network remodelling reflects tau-related pathology prior to memory deficits in Thy-Tau22 mice.

In Alzheimer's disease, the tauopathy is known as a major mechanism responsible for the development of cognitive deficits. Early biomarkers of such affectations for diagnosis/stratification are crucial in Alzheimer's disease research, and brain connectome studies increasingly show their potential establishing pathology fingerprints at the network level. In this context, we conducted an in vivo multimodal MRI study on young Thy-Tau22 transgenic mice expressing tauopathy, performing resting state functional MRI and structural brain imaging to identify early connectome signatures of the pathology, relating with histological and behavioural investigations. In the prodromal phase of tauopathy, before the emergence of cognitive impairments, Thy-Tau22 mice displayed selective modifications of brain functional connectivity involving three main centres: hippocampus (HIP), amygdala (AMG) and the isocortical areas, notably the somatosensory (SS) cortex. Each of these regions showed differential histopathological profiles. Disrupted ventral HIP-AMG functional pathway and altered dynamic functional connectivity were consistent with high pathological tau deposition and astrogliosis in both hippocampus and amygdala, and significant microglial reactivity in amygdalar nuclei. These patterns were concurrent with widespread functional hyperconnectivity of memory-related circuits of dorsal hippocampus-encompassing dorsal HIP-SS communication-in the absence of significant cortical histopathological markers. These findings suggest the coexistence of two intermingled mechanisms of response at the functional connectome level in the early phases of pathology: a maladaptive and a likely compensatory response. Captured in the connectivity patterns, such first responses to pathology could further be used in translational investigations as a lead towards an early biomarker of tauopathy as well as new targets for future treatments.

Common functional networks in the mouse brain revealed by multi-centre resting-state fMRI analysis.

Preclinical applications of resting-state functional magnetic resonance imaging (rsfMRI) offer the possibility to non-invasively probe whole-brain network dynamics and to investigate the determinants of altered network signatures observed in human studies. Mouse rsfMRI has been increasingly adopted by numerous laboratories worldwide. Here we describe a multi-centre comparison of 17 mouse rsfMRI datasets via a common image processing and analysis pipeline. Despite prominent cross-laboratory differences in equipment and imaging procedures, we report the reproducible identification of several large-scale resting-state networks (RSN), including a mouse default-mode network, in the majority of datasets. A combination of factors was associated with enhanced reproducibility in functional connectivity parameter estimation, including animal handling procedures and equipment performance. RSN spatial specificity was enhanced in datasets acquired at higher field strength, with cryoprobes, in ventilated animals, and under medetomidine-isoflurane combination sedation. Our work describes a set of representative RSNs in the mouse brain and highlights key experimental parameters that can critically guide the design and analysis of future rodent rsfMRI investigations.

Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world.

BACKGROUND: The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow-up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL). METHODS: Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias. RESULTS: There were 2136 patients with a median total number of PCI items selected of 5 (2-10). "Fear of the cancer returning" (39%) and "dry mouth" (37%) were most common. Twenty-five percent (524) reported less than good QOL. CONCLUSION: There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case-mix variables. There was a strong progressive association between the number of PCI items and QOL.

In vitro study of effects of aging and processing conditions on colour change in maxillofacial silicone elastomers.

BACKGROUND: The inherent colour change in maxillofacial silicone elastomers becomes perceptible 6-12 months after fabrication. Determining the factors that accelerate the degradation of the prosthesis can help the clinicians increase its life span. Therefore, the aim of the study was to investigate the effect of time passage, processing temperature, and molding-stone colour on the colour change of maxillofacial silicone elastomers after darkroom storage for 6000 h. METHODS: A total of ten study molds, each incorporating ten specimen gaps were fabricated using five different colors of dental stones. The gaps were filled with coloured Cosmesil M511 maxillofacial silicone elastomer. Five of the study molds, one of each stone color, were processed at room temperature (25 °C) for 24 h while the remainder were vulcanized at 100 °C for 1 h. Two stainless-steel molds were also fabricated to obtain a total of twenty control-group specimens of the same dimensions that were processed under the same conditions as the study molds. Colour measurements of the vulcanized silicone samples were performed using a Konica Minolta spectrophotometer. Initial measurements were obtained after the blocks were removed from the molds and the final measurements were recorded 6000 h after storage in the dark at 25 °C and 40% relative humidity. The CIEDE2000 colour-difference formula was used to measure the changes in the colour. One-way and two-way ANOVA, and an independent-sample t-test were used for statistical assessments. RESULTS: For every group, the colour change exceeded the perceptible thresholds. Thus, either the vulcanization temperature or the colour of the molding stone has a significant effect on the colour change over time. Those samples vulcanized in green and white molding stones at 100 °C exhibited a significantly higher ∆L*, ∆a*, and ∆b* values relative to the samples vulcanized at room temperature. CONCLUSION: The molding-stone colour and vulcanization temperature both affect the degree of colour change after storage in a dark environment. The L*, a*, and b* values for the maxillofacial silicone elastomers are influenced by the direction of the increase or decrease according to the selected colour. This effect varies as the temperature increases.

Correction of cognitive deficits in mouse models of Down syndrome by a pharmacological inhibitor of DYRK1A.

Growing evidence supports the implication of DYRK1A in the development of cognitive deficits seen in Down syndrome (DS) and Alzheimer's disease (AD). We here demonstrate that pharmacological inhibition of brain DYRK1A is able to correct recognition memory deficits in three DS mouse models with increasing genetic complexity [Tg(Dyrk1a), Ts65Dn, Dp1Yey], all expressing an extra copy of Dyrk1a Overexpressed DYRK1A accumulates in the cytoplasm and at the synapse. Treatment of the three DS models with the pharmacological DYRK1A inhibitor leucettine L41 leads to normalization of DYRK1A activity and corrects the novel object cognitive impairment observed in these models. Brain functional magnetic resonance imaging reveals that this cognitive improvement is paralleled by functional connectivity remodelling of core brain areas involved in learning/memory processes. The impact of Dyrk1a trisomy and L41 treatment on brain phosphoproteins was investigated by a quantitative phosphoproteomics method, revealing the implication of synaptic (synapsin 1) and cytoskeletal components involved in synaptic response and axonal organization. These results encourage the development of DYRK1A inhibitors as drug candidates to treat cognitive deficits associated with DS and AD.

Hyperactivity of Anterior Cingulate Cortex Areas 24a/24b Drives Chronic Pain-Induced Anxiodepressive-like Consequences.

Pain associates both sensory and emotional aversive components, and often leads to anxiety and depression when it becomes chronic. Here, we characterized, in a mouse model, the long-term development of these sensory and aversive components as well as anxiodepressive-like consequences of neuropathic pain and determined their electrophysiological impact on the anterior cingulate cortex (ACC, cortical areas 24a/24b). We show that these symptoms of neuropathic pain evolve and recover in different time courses following nerve injury in male mice. In vivo electrophysiological recordings evidence an increased firing rate and bursting activity within the ACC when anxiodepressive-like consequences developed, and this hyperactivity persists beyond the period of mechanical hypersensitivity. Whole-cell patch-clamp recordings also support ACC hyperactivity, as shown by increased excitatory postsynaptic transmission and contribution of NMDA receptors. Optogenetic inhibition of the ACC hyperactivity was sufficient to alleviate the aversive and anxiodepressive-like consequences of neuropathic pain, indicating that these consequences are underpinned by ACC hyperactivity.SIGNIFICANCE STATEMENT Chronic pain is frequently comorbid with mood disorders, such as anxiety and depression. It has been shown that it is possible to model this comorbidity in animal models by taking into consideration the time factor. In this study, we aimed at determining the dynamic of different components and consequences of chronic pain, and correlated them with electrophysiological alterations. By combining electrophysiological, optogenetic, and behavioral analyses in a mouse model of neuropathic pain, we show that the mechanical hypersensitivity, ongoing pain, anxiodepressive consequences, and their recoveries do not necessarily exhibit temporal synchrony during chronic pain processing, and that the hyperactivity of the anterior cingulate cortex is essential for driving the emotional impact of neuropathic pain.

The Effects of Yoga in Patients Suffering from Subjective Tinnitus.

Introduction Tinnitus is a perception of sound in the absence of an external source and it is a distressing issue. Yoga is a system of mind-body practices with the goal of uniting the body, mind and soul. It has been shown to reduce anxiety and stress, as well as improving the quality of life. Objective The aim of this study is to investigate the effects of yoga in patients suffering from chronic subjective tinnitus. Methods Twelve subjects previously diagnosed with chronic subjective tinnitus were selected for the study. The patients were asked to attend to yoga classes once a week and to practice yoga at home using a worksheet for 3 months. Each yoga class consisted of body exercises (asana), breathing (pranayama) and meditation (shavasana and yoga nidra). Tinnitus scores before and after the yoga classes were compared using the Wilcoxon test. Results Among the 12 patients, there were 4 men and 8 women and their mean age was 52.5 years. The median duration of tinnitus among the group was 5.4 years. There were statistically significant differences in the stress ( p = 0.01), handicap ( p = 0.004) and severity ( p = 0.007) questionnaires scores. Conclusion This study indicated that yoga practices may reduce life stress and symptoms of subjective tinnitus.

Predictors of obturator functioning and satisfaction in Turkish patients using an obturator prosthesis after maxillectomy.

OBJECTIVE: The aim of this study was to determine the sociodemographic, behavioral, and clinical factors affecting obturator function and satisfaction using the obturator functioning scale (OFS) in maxillectomy patients rehabilitated with obturator prostheses. STUDY DESIGN: The study sample consisted of 41 maxillectomy patients. The OFS was translated into Turkish and adapted for assessing obturator functioning and patient satisfaction among Turkish patients. Data were collected from patients' medical records and self-completed questionnaires, including the Turkish version of the OFS, sociodemographic and behavioral characteristics. Descriptive statistics, Mann-Whitney U test, Spearman's correlation coefficient, and backward stepwise multiple linear regression were used for data analysis. RESULTS: Internal consistency (Cronbach's alpha = 0.85) and test-retest reliability (intraclass correlation coefficient = 0.86) were acceptable for the OFS. The most frequently reported problem was "difficulty chewing." Bivariate analysis revealed significant differences in total OFS scores in terms of surgery type, defect size, and education level, except for the other clinical and sociodemographic characteristics and behavioral factors. Education level and surgery type were found to be the most important predictors of patient satisfaction and functioning of the obturator. CONCLUSIONS: The Turkish version of the OFS might be a useful tool for clinicians to identify patients who are at risk for poor functioning of the obturator, lack of satisfaction, and unmet needs.

Cingulate Overexpression of Mitogen-Activated Protein Kinase Phosphatase-1 as a Key Factor for Depression.

BACKGROUND: Depression is frequently associated with chronic pain or chronic stress. Among cortical areas, the anterior cingulate cortex (ACC, areas 24a and 24b) appears to be important for mood disorders and constitutes a neuroanatomical substrate for investigating the underlying molecular mechanisms. The current work aimed at identifying ACC molecular factors subserving depression. METHODS: Anxiodepressive-like behaviors in C57BL/6J male mice were induced by neuropathic pain, unpredictable chronic mild stress, and optogenetic ACC stimulation and were evaluated using novelty suppressed feeding, splash, and forced swim tests. ACC molecular changes in chronic pain-induced depression were uncovered through whole-genome expression analysis. Further mechanistic insights were provided by chromatin immunoprecipitation, Western blot, and immunostaining. The causal link between molecular changes and depression was studied using knockout, pharmacological antagonism, and local viral-mediated gene knockdown. RESULTS: Under chronic pain-induced depression, gene expression changes in the ACC highlighted the overexpression of a regulator of the mitogen-activated protein kinase pathway, mitogen-activated protein kinase phosphatase-1 (MKP-1). This upregulation is associated with the presence of transcriptionally active chromatin marks (acetylation) at its proximal promoter region as well as increased cyclic adenosine monophosphate response element-mediated transcriptional activity and phosphorylation of cyclic adenosine monophosphate response element binding protein and activating transcription factor. MKP-1 overexpression is also observed with unpredictable chronic mild stress and repeated ACC optogenetic stimulation and is reversed by fluoxetine. A knockout, an antagonist, or a local silencing of MKP-1 attenuates depressive-like behaviors, pointing to an important role of this phosphatase in depression. CONCLUSIONS: These data point to ACC MKP-1 as a key factor in the pathophysiology of depression and a potential target for treatment development.

Effect of vulcanization temperature and dental stone colour on colour degradation of maxillofacial silicone elastomers.

BACKGROUND: Colour degradation is a major problem in maxillofacial silicone elastomers. Recent studies have focused on colour stability and the mechanical properties of the silicone elastomers. A colour match is also essential for the acceptance of the prosthesis by the patient. The aim of this study is to assess the colour degradation of the silicone elastomer after being moulded in different colours of dental stones at two different vulcanization temperatures. METHODS: Five different colours of dental stones were used to fabricate a total of 120 silicone blocks using a Cosmesil M511 maxillofacial silicone elastomer. Vulcanization was completed at two different temperatures (25 and 100° Celsius). Colour measurements were obtained with a Conica Minolta spectrophotometer. The CIEDE2000 formula was used to calculate the colour differences (∆E00). Two-way ANOVA, one-way ANOVA with Bonferroni corrected post-hoc p values and independent samples t-test were used for the statistical analyses. RESULTS: High temperature vulcanization causes lightening of the maxillofacial silicone elastomers without regard to the dental stone colour (p = 0.001). Specimens moulded in green stone lightened least at room temperature (p = 0.999). Compared to the control group, at high temperature, all specimens moulded in coloured dental stones darkened significantly (p < 0.001 for white, blue and yellow; p = 0.006 for green; p = 0.045 for reddish-brown). In the high temperature group, the shift to a green chroma was significant in the white, yellow and green dental stones groups (p = 0.001, p = 0.002, p < 0.001, respectively). The mean b* of the high temperature control group was higher than that of the room temperature control group (p < 0.001). The only ∆E00 score lower than the perceptibility threshold for dental materials (∆E00 = 1.30) was between the room temperature control group and the room temperature green dental stone group (∆E00 = 0.96). CONCLUSIONS: Green and blue dental stones cause less colour degradation in silicone elastomers. Reddish-brown dental stones cause the most colour degradation in silicone elastomers. At 100 °C, the colour of the silicone elastomer lightens and yellows even if the elastomer is vulcanized in a stainless steel mould. White, yellow and reddish-brown dental stones make the silicone elastomer appear more yellow even if the elastomer is vulcanized at room temperature.

Soft Tissue Response and Survival of Extraoral Implants: A Long-Term Follow-up.

Maxillofacial defects may be reconstructed by plastic surgery or treated by prosthetic mean rehabilitation. In case of large defects, prosthetic rehabilitation rather than surgical reconstruction is preferred due to the insufficient esthetic results of surgical interventions. However, retention of the craniofacial prosthesis is a great problem despite the satisfactory esthetic results. With the presentation of extraoral implants, the retention of maxillofacial prostheses was improved, and osseointegrated craniofacial implants have become indispensable for retention and stability. However, there are conflicting results regarding the success rates of osseointegrated implants used at the craniofacial region. A total of 24 patients with 64 implants (30 in auricular region of 13 patients, 24 in nasal region of 8 patients, and 10 in orbital region of 3 patients) ranging in age from 16 to 83 years (mean age = 45.45 years) were evaluated. One patient among 13 patients (1/13) has lost his implants in the auricular area, 1 patient among 8 patients (1/8) lost his implants, and 1 patient among 3 patients (1/3) has lost all of her implants. Peri-implant soft tissue response was evaluated for a 60-month period and a total of 654 visits/sites recorded. Grade 0 (no irritation) was present in 72.8% (476/654) of the visits/sites. Grade 1 (slight redness) was observed for 18.8% (123/654). Grade 2 (red and slightly moist tissue) was scored in 6.9% (45/654). Grade 3 (red and slightly moist tissue with granulation) was noted in 1.5% (10/654) and grade 4 (infection) could not be found. Ossseointegrated implants provide reasonable support and show successful results when used with maxillofacial prostheses.

A surface roughening technique for maxillofacial prostheses.

Giving a natural surface texture to the maxillofacial prostheses is one of the major goals for the maxillofacial prosthodontists. This article describes a technique for application of an antiskid epoxy resin to the surface of the definitive mold before pouring the maxillofacial silicone elastomer. This technique produces evenly distributed and same-size pores that are more similar to the natural appearance of human skin.

Validation of the Turkish version of the Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) in prosthetically rehabilitated patients with head and neck cancer.

BACKGROUND: The Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) is a measure assessing the impact of oral rehabilitation on patients' health-related quality of life (HRQOL).The aims of the study were to adapt culturally the LORQv3 for Turkish-speaking head and neck cancer patients who had undergone prosthetic rehabilitation and to undertake an initial investigation of its psychometric properties. METHODS: The Turkish version of the LORQv3 was translated and culturally adapted into Turkish, and tested on a sample of 46 head and neck cancer patients who had undergone prosthetic rehabilitation at a university clinic. Patients were categorized into three groups: Patients with maxillary obturator prostheses treated by surgery alone (n = 15); Patients with maxillary obturator prostheses treated by surgery plus radiotherapy, with or without chemotherapy (n = 23); and, Nasopharyngeal cancer patients without maxillary defects wearing conventional dental prostheses who had been treated by radiotherapy with or without chemotherapy (n = 8). Data were collected through clinical examinations and self-reported questionnaires, including socio-demographic characteristics, the LORQv3, and the University of Washington Quality of Life questionnaire version 4 (UW-QOLv4). The psychometric evaluation included validity (content, face, construct, and criterion) and reliability (internal consistency and test-retest). RESULTS: All sections of the LORQv3 showed satisfactory internal consistency, with Cronbach's alpha between 0.71 to 0.82. Kappa statistics showed moderate to perfect test-retest reliability for the 33 LORQv3 items. We found significant negative correlations between the LORQv3 and the UW-QOL v4 for some related items. The LORQv3 also identified differences in responses among patient groups, supporting its construct and criterion validity. CONCLUSIONS: This study provides initial evidence in support of the validity and reliability of the Turkish version of LORQv3 in prosthetically rehabilitated patients with head and neck cancer; it could be used in clinical practice in Turkey.

Craniodentofacial Manifestations in a Rare Syndrome: Orofaciodigital Type IV (Mohr-Majewski Syndrome).

Background. The orofaciodigital syndromes (OFDS) are a heterogeneous group of syndromes that affect the face, oral cavity, and the digits. OFDS type IV (OMIM %258860) is rare and characterized by broad nasal root and tip, orbital hypertelorism or telecanthus, micrognathia, hypoplastic mandible, and low-set ears. Oral symptoms may include cleft lip, cleft or highly arched palate, bifid uvula, cleft or hypoplastic maxillary and mandibular alveolar ridge, oral frenula, lingual hamartoma, and absent or hypoplastic epiglottis. Dental anomalies are common and generally include disturbances in the number of teeth. Case Report. This report presents a six-year-old girl, referred with the chief complaint of missing teeth. She was diagnosed as having OFDS type IV based on clinical findings. Her parents reported three deceased children and two fetuses that had the same phenotype. She was the seventh child of consanguineous parents who were first cousins. Conclusion. This is a very rare syndrome. Many reported OFDS type IV cases have consanguineous parents, consistent with an autosomal recessive trait. Manifestation of cleft palate in the healthy sibling may be mild expression of the disorder or an unrelated isolated cleft.

Identifying potential predictors of pain-related disability in Turkish patients with chronic temporomandibular disorder pain.

BACKGROUND: The aims of this study were to examine whether patients' psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6 months in duration. METHODS: The Research Diagnostic Criteria of TMD (RDC/TMD) data for Axis I and II were obtained for 104 consecutive patients seeking treatment.Data were analyzed using descriptive statistics, t-test, Mann-Whitney U-test, chi-square test, One-way ANOVA, Kruskal-Wallis test, and binary multiple logistic regression tests. Patients were classified into two groups according to Graded Chronic Pain Scale scores: Grade III and IV were scored for patients with high levels of pain-related disability, whereas Grade I and II were scored for patients with low disability. RESULTS: Muscle and joint pain were found in 64.9% and 31.8% of the patients, respectively, and 27.3% of the patients suffered from both muscle and joint pain.Psychosocial disability was found in 26% of patients. There were no statistically significant differences among the diagnostic subgroups with regards to the demographic, behavioral, psychological, and psychosocial characteristics. Patients with high levels of pain-related disability had significantly higher depression, somatization, pain intensity and jaw disability scores than those with low levels of pain-related disability.Patients with high levels of pain-related disability were more likely to have higher pain intensity, to report higher somatization symptoms and functional impairment, and were less likely to have joint pain than those with low levels of pain related disability. CONCLUSION: In conclusion, the Turkish version RDC/TMD, based on a dual axis system, may be used to screen chronic TMD patients at high-risk for pain-related disability who need comprehensive care treatment program.

Effects of different abutment connection designs on the stress distribution around five different implants: a 3-dimensional finite element analysis.

The stability of the bone-implant interface is required for the long-term favorable clinical outcome of implant-supported prosthetic rehabilitation. The implant failures that occur after the functional loading are mainly related to biomechanical factors. Micro movements and vibrations due to occlusal forces can lead to mechanical complications such as loosening of the screw and fractures of the abutment or implants. The aim of this study was to investigate the strain distributions in the connection areas of different implant-abutment connection systems under similar loading conditions. Five different implant-abutment connection designs from 5 different manufacturers were evaluated in this study. The investigation was performed with software using the finite element method. The geometrical modeling of the implant systems was done with CATIA virtual design software. The MSC NASTRAN solver and PATRAN postprocessing program were used to perform the linear static solution. According to the analysis, the implant-abutment connection system with external hexagonal connection showed the highest strain values, and the internal hexagonal implant-abutment connection system showed the lowest strain values. Conical + internal hexagonal and screw-in implant abutment connection interface is more successful than other systems in cases with increased vertical dimension, particularly in the posterior region.