A novel approach for determining instantaneous centers of rotation of the mandible with an intraoral scanner: A preliminary study.

OBJECTIVES: Recording and reproducing mandibular movements have been of key importance in the practice of dentistry for over a century. Recently, it has become possible to use digital technologies for these tasks. This study presents a preliminary method to try to identify the mandibular instantaneous centres of rotation based solely on intraoral scanners. METHODS: The dentitions of four participants were scanned, multiple inter-occlusal registrations and buccal scans were performed in closed and opened positions. Blender software was used to align the meshes during the post-scan digital workflow. Bite alignment accuracy was assessed and then improved with a strict exclusion protocol. An automated algorithm was used to find rotations between closed stage and open stage meshes. RESULTS: Our exclusion protocol reduced the bite alignment error significantly (p = 0.001) and the root-mean-square error value of the meshes decreased from 0.09 mm (SD = 0.15) to 0.03 mm (SD = 0.017). However, the remaining translational error caused an unexpectedly large shift in the axis of rotation (mean = 1.35 mm, SD = 0.77) with a 41.83: 1 ratio. As found in other studies, our results showed even a small amount of error during registration can shift the axis of rotation a large amount. This phenomenon will compromise the results of common pantographic methods which assume a rotation axis of the condyle. It also adds valuable information to the concept of instantaneous centers of rotation by revealing their true characteristics.

In vivo potency of different ligands on voltage-gated sodium channels.

The Ranvier nodes of thick myelinated nerve fibers contain almost exclusively voltage-gated sodium channels (Navs), while the unmyelinated fibers have several receptors (e.g., cannabinoid, transient receptor potential vanilloid receptor 1), too. Therefore, a nerve which contains only motor fibers can be an appropriate in vivo model for selective influence of Navs. The goals were to evaluate the potency of local anesthetic drugs on such a nerve in vivo; furthermore, to investigate the effects of ligands with different structures (arachidonic acid, anandamide, capsaicin and nisoxetine) that were proved to inhibit Navs in vitro with antinociceptive properties. The marginal mandibular branch of the facial nerve was explored in anesthetized Wistar rats; after its stimulation, the electrical activity of the vibrissae muscles was registered following the perineural injection of different drugs. Lidocaine, bupivacaine and ropivacaine evoked dose-dependent decrease in electromyographic activity, i.e., lidocaine had lower potency than bupivacaine or ropivacaine. QX-314 did not cause any effect by itself, but its co-application with lidocaine produced a prolonged inhibition. Nisoxetine had a very low potency. While anandamide and capsaicin in high doses caused about 50% decrease in the amplitude of action potential, arachidonic acid did not influence the responses. We proved that the classical local anesthetics have high potency on motor nerves, suggesting that this method might be a reliable model for selective targeting of Navs in vivo circumstances. It is proposed that the effects of these endogenous lipids and capsaicin on sensory fibers are not primarily mediated by Navs.

The inimitable kynurenic acid: the roles of different ionotropic receptors in the action of kynurenic acid at a spinal level.

Kynurenic acid (KYNA) is a neuroactive metabolite that interacts with NMDA, AMPA/kainate and alpha 7 nicotinic receptors. The goal of this study was to clarify the roles of these receptors in the action of KYNA at a spinal level by using highly specific receptor antagonists alone or in triple combinations. Chronic osteoarthritis-like joint pain was induced with monosodium-iodoacetate in male Wistar rats. Mechanical allodynia and motor function were quantified. In the first series we determined the dose-response and time course effects of intrathecally administered KYNA (10-100 µg), D-(-)-2-amino-5-phosphonopentanoic acid (AP5; an NMDA receptor antagonist; 10-200 µg), methyllycaconitine (MLA; an alpha 7 nicotinic receptor antagonist; 100-200 µg) and 2,3-dioxo-6-nitro-1,2,3,4-tetrahydrobenzoquinoxaline-7-sulfonamide (NBQX; an AMPA/kainate receptor antagonist; 1-20 µg). In the second series, four different triple combinations of MLA, AP5 and NBQX were investigated. Intrathecal administration of KYNA caused a dose-dependent motor impairment and antinociception. The highly specific NMDA receptor antagonist AP5 caused a motor impairment and antinociception with lower potency. High doses of NBQX resulted in significant antinociception with a slight motor impairment, while only the highest dose of MLA gave rise to significant antinociception with a slight motor impairment. After the coadministration of these ligands as combinations, no potentiation was observed. It may be supposed that the effects of KYNA are primarily due to the inhibition of NMDA receptors at both glycine and phencyclidine (PCP) binding sites, and not to the interactions at the different ionotropic receptors, but the mechanisms behind its high bio-efficiency are still unknown.