A study of Association of Mast Cell Count in Different Grades of Oral Squamous Cell Carcinoma

Background: Mast cells(MC) are cells of the immune cells which can secrete a variety of molecules. Many studies suggest that mast cells may either promote tumour growth in some types of cancer or may act in an opposite manner in other tumour types. Aim: To evaluate the association of mast cells in the different grades of Oral Squamous Cell Carcinoma(OSCC). Material and methods: Fifteen diagnosed cases each of well, moderate and poorly differentiated OSCC were identified from the institutional archival material. Two slides each were made of 5 μm thickness and stained with Hematoxylin and eosin and 1% Toluidine blue stain. Each section was evaluated for mast cells in peritumoural, intratumoural locations and at the invasive front of the tumour. The results obtained were subjected to statistical evaluation by an SPSS version 19 using Chi square test, Anova and Post hoc Tuckey tests. Results: An inverse relation was observed between MC count with grade of the tumour with maximum MC located in the peritumoural area followed by the invasive front and the least in the intra tumoural areas. Conclusion: The results of the present study suggest that a decrease in MC count is associated with an advanced histologic grade of OSCC and hence a poorer prognosis, thus favouring the protective role of mast cells in OSCC.Keywords: Mast cells, Oral squamous cell carcinoma, Histological gradin

Self-management programmes in temporomandibular disorders: results from an international Delphi process

Self-management (SM) programmes are commonly used for initial treatment of patients with temporomandibular disorders (TMD). The programmes described in the literature, however, vary widely with no consistency in terminology used, components of care or their definitions. The aims of this study were therefore to construct an operationalised definition of self-management appropriate for the treatment of patients with TMD, identify the components of that self-management currently being used and create sufficiently clear and non-overlapping standardised definitions for each of those components. A four-round Delphi process with eleven international experts in the field of TMD was conducted to achieve these aims. In the first round, the participants agreed upon six principal concepts of self-management. In the remaining three rounds, consensus was achieved upon the definition and the six components of self-management. The main components identified and agreed upon by the participants to constitute the core of a SM programme for TMD were as follows: education; jaw exercises; massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. This Delphi process has established the principal concepts of self-management, and a standardised definition has been agreed with the following components for use in clinical practice: education; self-exercise; self-massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. The consensus-derived concepts, definitions and components of SM offer a starting point for further research to advance the evidence base for, and clinical utility of, TMD SM

Craniofacial Pain and Jaw-muscle Activity during Sleep

This study compared the jaw-muscle electromyographic (EMG) activity during sleep in patients with craniofacial pain (n = 63) or no painful conditions (n = 52) and between patients with tension-type headache (TTH: n = 30) and healthy control individuals (n = 30). All participants used a portable single-channel EMG device (Medotech A/S) for four nights. There was no significant difference in EMG activity between craniofacial pain (24.5 ± 17.9 events/hr) and no painful conditions (19.7 ± 14.5), or between TTH (20.8 ± 15.0) and healthy control individuals (15.2 ± 11.6, p >.050). There were positive correlations between EMG activity and number of painful muscles (r = 0.188; p = 0.044), characteristic pain intensity (r = 0.187; p = 0.046), McGill Pain Questionnaire (r = 0.251; p = 0.008), and depression scores (r = 0.291; p = 0.002). Patients with painful conditions had significantly higher night-to-night variability compared with pain-free individuals (p < 0.050). This short-term observational study suggests that there are no major differences between patients with different craniofacial pain conditions and pain-free individuals in terms of jaw-muscle EMG activity recorded with a single-channel EMG device during sleep. However, some associations may exist between the level of EMG activity and various parameters of craniofacial pain. Longitudinal studies are warranted to further explore the relationship between sleep bruxism and craniofacial pain

Orofacial quantitative sensory testing:Current evidence and future perspectives

BACKGROUND AND OBJECTIVE: Orofacial quantitative sensory testing (QST) is an increasingly valuable psychophysical tool for evaluating neurosensory disorders of the orofacial region. Here, we aimed to evaluate the current evidence regarding this testing method and to discuss its future clinical potential. DATA TREATMENT: We conducted a literature search in Medline, Embase and Scopus for English-language articles published between 1990 and 2019. The utilized search terms included QST, quantitative, sensory testing and neurosensory, which were combined using the AND operator with the terms facial, orofacial, trigeminal, intraoral and oral. RESULTS: Our findings highlighted many methods for conducting QST-including method of levels, method of limits and mapping. Potential stimuli also vary, and can include mechanical or thermal stimulation, vibration or pinprick stimuli. Orofacial QST may be helpful in revealing disease pathways and can be used for patient stratification to validate the use of neurosensory profile-specific treatment options. QST is reportedly reliable in longitudinal studies and is thus a candidate for measuring changes over time. One disadvantage of QST is the substantial time required; however, further methodological refinements and the combination of partial aspects of the full QST battery with other tests and imaging methods should result in improvement. CONCLUSIONS: Overall, orofacial QST is a reliable testing method for diagnosing pathological neurosensory conditions and assessing normal neurosensory function. Despite the remaining challenges that hinder the use of QST for everyday clinical decisions and clinical trials, we expect that future improvements will allow its implementation in routine practice