Does intra-articular injection of tenoxicam after arthrocentesis heal outcomes of temporomandibular joint osteoarthritis? A randomized clinical trial.

BACKGROUND: Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative disease and manifests itself with pain and limitation of movement in the jaws. Arthrocentesis alone or in combination with intraarticular injections is one of the most commonly used treatment methods in these patients. The aim of the study is to examine the effectiveness of arthrocentesis plus tenoxicam injection and to compare it with arthrocentesis alone in patients with TMJ-OA. METHODS: Thirty patients with TMJ-OA who were treated randomly with either arthrocentesis plus tenoxicam injection (TX group) or arthrocentesis alone (control group) were examined. Maximum mouth opening (MMO), visual analog scale (VAS) pain values, and joint sounds were the outcome variables, which were evaluated at pre-treatment and at 1, 4, 12, and 24 weeks after treatment. Statistical significance was set at p < 0.05. RESULTS: The gender distribution and mean age were not significantly different between the two groups. Pain values (p < 0.001), MMO (p < 0.001), and joint sounds (p < 0.001) improved significantly in both groups. However, there was no significant difference between the groups in terms of outcome variables [pain (p = 0.085), MMO (p = 0.174), joint sounds (p = 0.131)]. CONCLUSIONS: Arthrocentesis plus tenoxicam injection showed no better outcomes in terms of MMO, pain, and joint sounds compared with arthrocentesis alone in patients with TMJ-OA. TRIAL REGISTRATION: Injection of Tenoxicam Versus Arthrocentesis Alone in the Treatment of Temporomandibular Joint Osteoarthritis, NCT05497570. Registered 11 May 2022. Retrospectively registered, https://register. CLINICALTRIALS: gov/prs/app/action/SelectProtocol?sid=S000CD7A&selectaction=Edit&uid=U0006FC4&ts=6&cx=f3anuq.

Therapeutic effect of alendronate in an experimental temporomandibular joint osteoarthritis.

BACKGROUND: Temporomandibular joint osteoarthritis is a common degenerative joint disease. This disease negatively affects the daily life, speech and chewing functions of patients. OBJECTIVE: This study aimed to evaluate the effects of intra-articular injection of alendronate to osteoarthritis, which has a protective effect on bone and cartilage tissue and helps reduce inflammation in temporomandibular joint osteoarthritis. METHODS: A total of 24 Wistar albino rats were used in the study. Rats were divided into four groups: study, saline, control and sham. In both saline and control groups, monosodium iodoacetate was injected intra-articularly to induce osteoarthritis. Alendronate was administered intra-articularly to the study group weekly for 4 weeks. In the saline group, saline was administered by intra-articular injection. At the end of the 12th week, all groups were sacrificed. Mandibular condyle tissues were examined histopathologically. RESULTS: According to the results, osteoarthritic changes in the control group were higher than those in the study group (p < .05). No significant reduction in osteoarthritic changes was observed in the saline group (p > .05). Significant osteoarthritis findings were observed in all groups compared with the sham group (p < .05). CONCLUSION: Intra-articular injection of alendronate was found to have positive results on TMJ osteoarthritis. In addition, it was seen that alendronate has effects on reducing cartilage tissue degeneration and loss of matrix proteins.

Ultrasonographic evaluation of the masseter muscle in patients with temporomandibular joint degeneration.

Purpose: Sonographic elastography can be used to evaluate the hardness of muscle tissue through the application of compression. Strain elastography gauges hardness through the comparison of echo sets before and after compression. This study utilized ultrasonography to measure the thickness and hardness of the masseter muscle in individuals with temporomandibular joint (TMJ) osteoarthritis. Materials and Methods: This study included 40 patients who presented with joint pain and were diagnosed with TMJ osteoarthritis via diagnostic cone-beam computed tomography, along with 40 healthy individuals. The thickness and hardness of each individual's masseter muscle were evaluated both at rest and at maximum bite using ultrasonography. The Mann-Whitney U test and the chi-square test were employed for statistical analysis, with the significance level set at P<0.05. Results: The mean thickness of the resting masseter muscle was 0.91 cm in patients with osteoarthritis, versus 1.00 cm in healthy individuals. The mean thickness of the masseter muscle at maximum bite was 1.28 cm in osteoarthritis patients and 1.36 cm in healthy individuals. The mean masseter elasticity index ratio at maximum bite was 4.51 in patients with osteoarthritis and 3.16 in healthy controls. Significant differences were observed between patients with osteoarthritis and healthy controls in both the masseter muscle thickness and the masseter elasticity index ratio, at rest and at maximum bite (P<0.05). Conclusion: The thickness of the masseter muscle in patients with TMJ osteoarthritis was less than that in healthy controls. Additionally, the hardness of the masseter muscle was greater in patients with TMJ osteoarthritis.

The therapeutic effect of bovine colostrum on 5-Fluorouracil-Induced oral mucositis in rats.

OBJECTIVE: The purpose of this study is to determine the effect of bovine colostrum on 5-fluorouracil-induced oral mucositis in rats. MATERIAL AND METHOD: Twenty-four male Wistar albino rats were randomly divided into three groups as the Preoperative, Postoperative and Control groups. All rats were administered 100 mg/kg 5-fluorouracil on the first day and 65 mg/kg 5-FU on the third day intraperitoneally. On the third and fifth days, a superficial incision was created on the mucosa of the right cheek pouch. The oral mucositis protocol was applied in the control group. The preoperative group was given bovine colostrum by gavage from the 1st day of the 5-FU procedure to the 5th day, while the postoperative group was given bovine colostrum by gavage from the 5th day to the 10th day. RESULTS: According to the scoring made in terms of secondary infections, two cases in the control group had moderate infections, and two cases in each of the preoperative and postoperative groups had severe infections. The difference between the control group and the preoperative and postoperative groups was significant (p=0.020). There was no significant difference between the preoperative and postoperative groups. While the degree of wound healing in the postoperative group was higher than the other groups, the difference was not statistically significant. CONCLUSION: No significant effect of bovine colostrum on the healing of oral mucositis was observed. Additional studies are needed to shed light on the pathogenic inflammatory mechanisms in mucositis and the prophylactic and therapeutic roles of antioxidants.

Analyses of Youtube Videos on Botox Treatment of Gummy Smile.

OBJECTIVE: The purpose of this study was to determine the content quality and accuracy of the YouTube videos about the Botox application during gummy smile treatment and to analyze the efficacy of these videos in informing the healthcare professionals and the patients. MATERIALS AND METHODS: The first 200 videos resulting from the search on YouTube by using the keywords "gummy smile/Botox," which were determined by Google Trends, were evaluated in the study. One hundred fourteen out of these 200 videos were included in the study. The videos were calculated using these descriptive features. A content scale consisting of 8 categories was used to determine the content levels of the videos and the video information and quality index scale was used to determine the quality level. RESULTS: The most mentioned subjects in the videos were "Description" of the gummy smile and Botox treatment (71.9%), "Advantage" of Botox treatment (51.8%), "Procedure" (48.2%), and "Prognosis" (47.4%). The "Contraindication" was mentioned rarely (2.6%). A statistically significant difference was found between the videos with different content levels in terms of Description, Advantage, indication, Procedure, Complication, Prognosis, and Cost. Likewise, there was a statistically significant difference between videos in distinct content level groups in terms of video information and quality index total score. CONCLUSIONS: The quality of the YouTube videos about Botox applications in gummy smile treatment was found to be low in general. it is important for the physician who will perform the procedure to explain the procedure to the patients in detail. in addition, YouTube was determinedto be insufficient for accessing high-quality information for students, assistants, and specialist physicians.

Investigation of neurodegenerative and inflammatory processes in sleep bruxism.

Objective: The present study aimed to evaluate the anxiety and optical coherence tomography (OCT) findings in patients with sleep bruxism (SB) and to develop objective measurements to assess the neurodegenerative and inflammatory processes associated with this disease. Methods: A group of 40 SB patients were compared with a control group consisting of 40 healthy individuals (without SB). Anxiety results and the OCT measurements of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and choroidal thickness were assessed in both groups. Results: Anxiety values in the bruxism group were significantly higher than those in the control group. The measurements of RNFL, IPL, and GCL in the bruxism group were significantly lower than the control group, whereas the choroidal thickness was significantly higher. Conclusion: According to literature, this is the first study that analyzed the changes in the retinal structures in bruxism, which revealed that SB is a neurodegenerative and inflammatory process.

Investigation of the effects of temporomandibular joint arthrocentesis on blood volume of the retinal structures.

OBJECTIVE: Arthrocentesis is a minimally invasive surgical procedure that is used to alleviate the symptoms of temporomandibular joint (TMJ) disorders. The aim of this study was to investigate the effect of arthrocentesis on the blood supply to the retinal structures. MATERIALS AND METHODS: Arthrocentesis was performed on 20 patients with TMJ disorders, and choroidal thickness (CT) in patients was measured to evaluate retinal blood circulation. The blood volume of the retinal structures was evaluated ipsilaterally before and after arthrocentesis, and these measurements were then compared with measurements obtained from the contralateral side. RESULTS: Before arthrocentesis, there were no differences in retinal blood volumes between the ipsilateral and contralateral sides (P = 0.96). When ipsilateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was found to have significantly decreased after arthrocentesis (P = 0.04). When contralateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was also found to have decreased after arthrocentesis, but not significantly (P = 0.19). CONCLUSION: The solution of local anesthesia with epinephrine applied before the arthrocentesis procedure was found to reduce the blood volume of the retinal structures. To the best of our knowledge, this is the first study that has investigated the blood volume of the retinal structures following arthrocentesis.

Comparison of kinesio taping and occlusal splint in the management of myofascial pain in patients with sleep bruxism.

OBJECTIVES: To evaluate the efficacy of Kinesio taping (KT) in patients with sleep bruxism (SB) and to determine whether KT may be an alternative for occlusal splint (OS) for the treatment of SB. MATERIALS AND METHODS: Sixteen patients with SB were treated with KT (kinesio group) and 18 patients were treated with OS (splint group). Masseter and temporal muscle pressure pain thresholds (MPPT and TPPT), visual analogue scale (VAS) values and mouth opening measurements of patients were compared before treatment, and at the 1st and 5th weeks of treatment. RESULTS: Both KT and OS treatments significantly reduced muscle pain, decreased VAS values, and increased mouth opening measurements. No statistically significant difference was found between the kinesio and splint groups in terms of MPPT, TPPT, VAS and mouth opening values before treatment and at the 1st and 5th weeks of treatment except for TPPT values at 1st week of treatment where the TPPT values of the kinesio group were significantly higher than the splint group (p< 0.05). CONCLUSIONS: KT was identified as an easy-to-use treatment method for bruxism and was found to reduce muscle pain and increase mouth opening. KT is at least as effective as OS for the treatment of SB.

Metastasis of a Renal Collecting Duct Adenocarcinoma to the Oral Cavity After Tooth Extraction.

Metastatic tumors rarely occur in the oral cavity. The most common of the oral metastases are lung cancers in males, and breast and genital cancers in females. The most common primary tumor metastasis to the oral cavity is from the lung, kidney, liver, prostate, and colorectal cancers. The metastatic lesions are similar to oral lesions such as pyogenic granuloma, giant cell lesions, gingival polyps, hemangioma, peripheral fibroma, and adenoid squamous cell carcinoma. Therefore, the diagnosis of primary tumors is challenging. To our knowledge, this is the first reported case to feature metastasis of a renal collecting duct adenocarcinoma to the oral cavity after tooth extraction.

Histopathological Effects of Teriparatide in Medication-Related Osteonecrosis of the Jaw: An Animal Study.

PURPOSE: Osteonecrosis of the jaw after tooth extraction is a major complication in patients using bisphosphonates (BPs) for bone lesions, such as for the treatment of osteoporosis. The purpose of this study was to investigate the histopathologic effects of teriparatide (a synthetic parathyroid hormone) on rats developing osteonecrosis with BP use. MATERIALS AND METHODS: Rats (n = 80) that had been injected intraperitoneally with zoledronic acid for 7 weeks were used. Maxillary first molar extractions and bone defects were established in the same region in the eighth week. Teriparatide was administered subcutaneously to prevent osteonecrosis. Animals were sacrificed and histopathologic changes were examined. Osteoblasts, osteoclasts, inflammatory phase of bone healing, and osteonecrotic areas were evaluated. RESULTS: The osteoclast numbers were larger in the experimental groups (teriparatide administered before and immediately after tooth extraction) than in the control group (administered zoledronic acid). The inflammatory phase of bone healing was more pronounced in the experimental group (teriparatide administered before tooth extraction) than in the control group. There were significant differences in osteoclast numbers and in the inflammatory phase of bone healing between the experimental and control groups (P < .05). The osteoblast numbers and osteonecrotic areas were similar in size between the experimental and control groups. There were no significant differences (P > .05). CONCLUSIONS: BPs have negative effects on osteoclasts and the inflammatory phase of bone healing, whereas teriparatide was found to be effective in eliminating the negative effects of BPs. Teriparatide had positive effects in preventing osteonecrosis; therefore, teriparatide could be an effective agent for MRONJ.

Rare involvement of herpes zoster in the mandibular branch of the trigeminal nerve: A case report and review of the literature.

Herpes zoster (HZ) infections rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions may appear on the face, in the mouth, in the eye, or on the tongue. Additionally, this condition may be associated with devitalized teeth, internal resorption and spontaneous exfoliation of the teeth, and osteomyelitis of the alveolar bone. In this paper, the treatment of a case HZ of the mandibular branch of the trigeminal nerve is reported, and 22 articles on HZ cases with involvement of the mandibular branch are reviewed. This is the first literature review of HZ cases involving only the mandibular branch of the trigeminal nerve.

Oxidative imbalance and anxiety in patients with sleep bruxism.

OBJECTIVE: We evaluated the relationship among sleep bruxism (SB), antioxidant/oxidant status, and anxiety level to determine whether antioxidant/oxidant status may be used as a biological marker of SB. STUDY DESIGN: Thirty-three SB and 32 healthy patients of similar age, sex, and body mass index were enrolled, venous blood was collected, and anxiety scores were determined. Plasma samples were analyzed for total oxidant status, antioxidant status, and oxidative stress index. RESULTS: In 2 of the 3 assays performed, SB patients exhibited an oxidative imbalance. A higher anxiety score was observed with SB (P < 0.05). CONCLUSIONS: These results show that oxidant/antioxidant imbalance may be related to SB, either pathophysiologically or as an outcome of the condition. Further biochemical studies could prove useful in determining the importance of antioxidant drugs in the treatment of SB.