Temporomandibular disorder pain is related to the general disposition to be anxious.

AIMS: To assess whether trait anxiety as a person's general disposition to be anxious is a risk factor for temporomandibular disorder (TMD) pain. METHODS: A total of 320 adult TMD patients with at least one pain-related TMD diagnosis according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were included in the study. Subjects from the general population without pain-related TMD were used as controls (n = 888). All study participants completed the State-Trait Anxiety Inventory (STAI). The association between the level of trait anxiety (STAI-Trait scores) and case-control status (patients diagnosed with pain-related TMD and controls) was analyzed using logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were computed. RESULTS: The level of trait anxiety was associated with the subject status (case vs control). A one-point increase in STAI-Trait sum scores (range: 20 to 80) was related to an increase of the odds for pain-related TMD by the factor 1.04 (CI: 1.02-1.05; P < .001). Severe trait anxiety (above the 90th percentile of general-population subjects) doubled the odds (OR: 2.05; CI: 1.42-2.98; P < .001). Analyses adjusted for age, gender, and level of education did not change the results. CONCLUSION: Trait anxiety is significantly associated with diagnoses of TMD pain.

Does enamelin have pleiotropic effects on organs other than the teeth? Lessons from a phenotyping screen of two enamelin-mutant mouse lines.

We analyzed two mutant mouse lines, ATE1 and ATE2, that carry point mutations in the enamelin gene which result in premature stop codons in exon 8 and exon 7, respectively. Both mutant lines show amelogenesis imperfecta. To establish the effect of mutations within the enamelin gene on different organs, we performed a systematic, standardized phenotypic analysis of both mutant lines in the German Mouse Clinic. In addition to the initially characterized tooth phenotype that is present in both mutant lines, we detected effects of enamelin mutations on bone and energy metabolism, as well as on clinical chemical and hematological parameters. These data raise the hypothesis that enamelin defects have pleiotropic effects on organs other than the teeth.

Stress-related adaptive versus maladaptive coping and temporomandibular disorder pain.

AIMS: To test whether patients with temporomandibular disorder (TMD) pain differ from subjects from the general population with regard to their stress-related coping styles. METHODS: Consecutive adult TMD patients (n = 70) and adult subjects of a regional general population sample (n = 868), examined according to the German version of the Research Diagnostic Criteria for TMD (RDC/TMD), were included in this study. The inclusion criterion for TMD patients was at least one pain-related diagnosis according to the RDC/ TMD, while general-population subjects were excluded if they had any pain-related TMD diagnosis. Coping styles were assessed using a common and well-accepted German 114-item stress-coping questionnaire ("Stressverarbeitungsfragebogen" SVF 114). The coping style-TMD pain relationship was investigated using logistic regression analyses adjusted for possible confounders (age, sex, level of education), as well as the influence of psychosocial measures (RDC/TMD Axis II). Odds ratios (OR) with 95% confidence intervals (CI) were calculated. RESULTS: Study participants who used fewer adaptive coping styles (OR = 0.47, CI: 0.26-0.83) and more maladaptive coping styles (OR = 1.55, CI: 1.05-2.29) were at greater risk for TMD pain. After adjustment for sociodemographic confounders, the coping style-TMD pain relationship changed only slightly in magnitude. In an analysis adjusted for sociodemographic confounders and psychosocial RDC/TMD Axis II measures, adaptive coping styles were even more profoundly related to TMD pain (OR: 0.27, 95 CI: 0.09-0.83), but maladaptive coping styles were less related to TMD pain (OR: 1.17, 95% CI: 0.51-2.72). CONCLUSION: Differences in the applied stress-related coping styles of TMD patients and subjects without TMD may have implications for clinical decision making and choosing among treatment alternatives.

New mouse models for metabolic bone diseases generated by genome-wide ENU mutagenesis.

Metabolic bone disorders arise as primary diseases or may be secondary due to a multitude of organ malfunctions. Animal models are required to understand the molecular mechanisms responsible for the imbalances of bone metabolism in disturbed bone mineralization diseases. Here we present the isolation of mutant mouse models for metabolic bone diseases by phenotyping blood parameters that target bone turnover within the large-scale genome-wide Munich ENU Mutagenesis Project. A screening panel of three clinical parameters, also commonly used as biochemical markers in patients with metabolic bone diseases, was chosen. Total alkaline phosphatase activity and total calcium and inorganic phosphate levels in plasma samples of F1 offspring produced from ENU-mutagenized C3HeB/FeJ male mice were measured. Screening of 9,540 mice led to the identification of 257 phenodeviants of which 190 were tested by genetic confirmation crosses. Seventy-one new dominant mutant lines showing alterations of at least one of the biochemical parameters of interest were confirmed. Fifteen mutations among three genes (Phex, Casr, and Alpl) have been identified by positional-candidate gene approaches and one mutation of the Asgr1 gene, which was identified by next-generation sequencing. All new mutant mouse lines are offered as a resource for the scientific community.

Pathophysiology of the Eustachian tube--relevant new aspects for the head and neck surgeon.

OBJECTIVES: The impact of cranio-maxillofacial procedures upon Eustachian tube function is still largely unknown. The aim of this presentation is to depict new aspects of Eustachian tube function and to demonstrate its importance to cranio-maxillofacial surgery. METHODS: Two different groups of patients were examined both clinically and by MRI of the Eustachian tube region. One of these groups comprised 15 adult patients with a history of cleft palate; another consisted of 32 patients with a history of a so-called patulous Eustachian tube. RESULTS: Clinical and MRI-findings revealed that the problem of persistent chronic middle ear disease with cleft palate patients depends crucially on the integrity of the pterygoid hamulus and of the tensor veli palatini muscle after cleft palate repair. The masticatory muscles on the other hand also play an important role in Eustachian tube function in non-cleft patients. CONCLUSION: The maxillofacial surgeon should be aware that he holds a key position for preventing as well as treating Eustachian tube pathophysiology.

In vitro study on the fatigue limit of single-lap joints.

Lasting adhesion between attachment and tooth is an essential prerequisite for all adhesive techniques in dentistry. However, the maximum static fatigue load is only one material-related parameter for the quality of this adhesion. Another parameter is the dynamic loading capacity of a bonded joint, which was determined in the present study for Dual adhesive resin by means of fatigue testing. This revealed a significant correlation between the recorded static and dynamic fatigue load and the gap width, which varied between 0.01 mm, 0.15 mm and 0.5 mm in the experimental setup. At 18.8 MPa, the median gap width of 0.15 mm yielded the highest static resistance, with a dynamic resistance 15% below this figure. Both the smaller and the larger gap showed significantly lower static fracture strengths (0.01 mm: 13.6 MPa; 0.5 mm: 13.7 MPa), whereas a dynamic load on the 0.01 mm bond, in contrast to the 0.5 mm bond, led to only a 5% reduction in bonding strength.