Pain symptoms are associated with two-point discrimination threshold in patients with temporomandibular disorders.

OBJECTIVE: This study aimed to explore the associations of orofacial two-point discrimination (2-PD) test result with pain symptoms and psychological factors in patients with Temporomandibular Disorders (TMDs). METHODS: 193 patients with TMDs were included in this study. Patients' demographics, pain intensity, and psychological status were recorded. The 2-PDs in the bilateral temporal, zygomatic, mandibular, and temporomandibular joint (TMJ) regions of the patients were measured. Statistical analyses were conducted to observe the associations between variables. RESULTS: For Pain-related TMDs (PT) patients, Monthly Visual Analogue Scale (VAS-M) and Current Analogue Scale (VAS-C) were correlated with TMJ, zygomatic and temporal 2-PDs. Patients with PT tended to have higher TMJ 2-PDs[Right: ß = 1.827 mm, 95%CI(0.107, 3.548), P = 0.038], zygomatic 2-PDs[Right: ß = 1.696 mm, 95%CI(0.344, 3.048), P = 0.014], temporal 2-PDs[Left: ß = 2.138 mm, 95%CI(0.127, 4.149), P = 0.037; Right: ß = 1.893 mm, 95%CI(0.011, 3.775), P = 0.049]. Associations were also observed between VAS-C and TMJ 2-PDs[Left: ß = 0.780, 95%CI(0.190, 1.370), P = 0.01; Right: ß = 0.885, 95%CI(0.406, 1.364), P = 0.001], Zygomatic 2-PDs[Right: ß = 0.555, 95%CI(0.172, 0.938), P = 0.005]; VAS-M and TMJ 2-PDs[Left: ß = 0.812, 95%CI(0.313, 1.311), P = 0.002; Right: ß = 0.567, 95%CI(0.152, 0.983), P = 0.008], zygomatic 2-PDs[Left: ß = 0.405, 95%CI(0.075, 0.735), P = 0.016; Right: ß = 0.545, 95%CI(0.221, 0.870), P = 0.001], and temporal 2-PDs [Left: ß = 0.741, 95%CI(0.258, 1.224), P = 0.003; Right: ß = 0.519, 95%CI(0.063, 0.975), P = 0.026]. CONCLUSION: TMJ, zygomatic, and temporal 2-PDs were significantly associated with PT and pain intensity. Age, gender and psychological factors were not associated with orofacial 2-PDs. PT patients exhibited weaker tactile acuity compared to Non-PT patients. Further discussion on the underlying mechanism is needed. CLINICAL RELEVANCE: Orofacial tactile acuity of TMDs patients was associated with their pain symptoms, which researchers should take account into when performing 2-PD tests for TMDs patients. The 2-PD test can be considered as a potential tool along with the current procedures for the differentiations of PT and Non-PT.

Development of a new category system for the profile morphology of temporomandibular disorders patients based on cephalograms using cluster analysis.

Objective: This study aims to develop a new category scheme for the profile morphology of temporomandibular disorders (TMDs) based on lateral cephalometric morphology. Methods: Five hundred and one adult patients (91 males and 410 females) with TMD were enrolled in this study. Cluster tendency analysis, principal component analysis and cluster analysis were performed using 36 lateral cephalometric measurements. Classification and regression tree (CART) algorithm was used to construct a binary decision tree based on the clustering results. Results: Twelve principal components were discovered in the TMD patients and were responsible for 91.2% of the variability. Cluster tendency of cephalometric data from TMD patients were confirmed and three subgroups were revealed by cluster analysis: (a) cluster 1: skeletal class I malocclusion; (b) cluster 2: skeletal class I malocclusion with increased facial height; (c) cluster 3: skeletal class II malocclusion with clockwise rotation of the mandible. Besides, CART model was built and the eight key morphological indicators from the decision tree model were convenient for clinical application, with the prediction accuracy up to 85.4%. Conclusion: Our study proposed a novel category system for the profile morphology of TMDs with three subgroups according to the cephalometric morphology, which may supplement the morphological understanding of TMD and benefit the management of the categorical treatment of TMD.

Association between Stigma and Pain in Patients with Temporomandibular Disorders.

Objective: This study aims to explore the association between stigma and pain in patients with temporomandibular disorders (TMDs). Methods: Two hundred and twenty-five patients with TMDs were recruited, and they completed the questionnaires including the Visual Analogue Scale of Pain (VAS), Generalized Anxiety Disorder 7-Item (GAD-7), the Patient Health Questionnaire 9-item (PHQ-9), Jaw Functional Limitation Scale 8-item (JFLS-8), the Stigma Scale for Chronic Illness 8-item (SSCI-8), and other demographic and disease-related information. The total score of SSCI-8 indicated overall stigma, which could be classified into 2 subdomains, felt stigma and enacted stigma, according to their representative items, respectively. Then, the patients were divided into 2 groups in each subdomain of stigma according to their scores: stigma group (score ≥ 1) and no stigma group (score = 0). Results: Patients with overall stigma and enacted stigma presented significantly higher scores in VAS, GAD-7, PHQ-9, and JFLS-8 than those without overall stigma and those without enacted stigma, respectively. Significant differences between patients with and without felt stigma were only observed in GAD-7, PHQ-9, and JFLS-8. Patients with overall stigma and enacted stigma mainly suffered from pain-related TMDs (PTs) and combined TMDs (CTs). Overall stigma and enacted stigma rather than felt stigma were significantly associated with both PTs and CTs. Stigma, including overall stigma, enacted stigma, and felt stigma, was more associated with anxiety and depression and less related to jaw functional limitation of the patients with TMDs. Conclusion: Stigma, specifically enacted stigma, was correlated to pain in patients with TMDs. Stigma was more related to psychological problems than jaw functional limitation.

[Characterization of VOCs Emissions from Caged Broiler House in Winter].

Volatile organic compound (VOCs) emissions from poultry and livestock facilities affect the surrounding environmental quality and human health. However, VOCs emissions from broiler houses have been less characterized, and studies of related dominant odorants, carcinogenic risk, and ozone formation potential are still lacking. To fill this research gap, VOCs pollutants emitted from a broiler house were investigated in this study. The VOCs emission characteristics of the broiler house during three different periods of broiler growth (early, middle, and later) were analyzed using gas chromatography-mass spectrometry. The results showed that 77 types of VOCs were detected, including 16 types of halogenated hydrocarbons, 21 types of alkanes, 5 types of olefins, 12 types of aromatic hydrocarbons, 15 types of oxygenated volatile organic compounds (OVOCs), and 8 types of sulfides. During the entire 42-day growth period, the concentrations of halogenated hydrocarbons, alkanes, olefin, aromatic hydrocarbons, and OVOCs in the broiler house showed few changes. However, with the growth of broilers, the intake of sulfur-containing amino acids and the fecal emission coefficient increased, resulting in the gradual conversion of the VOCs to sulfide. Therefore, emissions of sulfur-containing VOCs increased in the early and middle growth periods. Moreover, the increase in ventilation in the house during the later growth period resulted in a decrease in the sulfur-containing VOCs concentrations. The dominant odorants in the broiler house were naphthalene, ethyl acetate, acetaldehyde, carbon disulfide, dimethyl disulfide, methanethiol, methanethiol, and thiophene. Methanethiol had the highest odorous values, ranging from 2172.4 to 19090.9. Meanwhile, there were acceptable levels of carcinogenic risk in the early and middle growth periods, with a lifetime cancer risk (LCR) of 7.7×10-6 and 4.5×10-6, respectively. The average ozone formation potential (OFP) was (1458.9±787.4) µg·m-3. The results of this study can provide a scientific basis for the monitoring of malodorous substances and formulation of emission reduction strategies in broiler production.