Intra-oral myofascial therapy for chronic myogenous temporomandibular disorders: a randomized, controlled pilot study

Objectives: Studies investigating the efficacy of intra-oral myofascial therapies (IMT) for chronic temporomandibular disorder (TMD) are rare. The objective of this randomized, controlled pilot study was to compare the effects of IMT and the addition of self-care and education over 6 months on four common TMD outcome measures: inter-incisal opening range, jaw pain at rest, jaw pain upon opening, and jaw pain upon clenching. Participants: Thirty myogenous TMD participants between the ages of 18 and 50 years, experiencing chronic jaw pain of longer than 3-month duration, were recruited for the present study. Intervention: Included patients were randomized into one of three groups: (1) IMT consisting of two treatment interventions per week for 5 weeks; (2) IMT plus 'self-care' involving education and exercises; and (3) wait list control. Main outcome measures: Range of motion findings were measured in millimetres by vernier callipers and pain scores were quantified using an 11-point self-reported graded chronic pain scale. Measurements were taken at baseline, 6 weeks post-treatment, and 6 months post-treatment. Results: The results showed statistically significant differences in resting, opening, and clenching pain and opening range scores (P<0.05) in both treatment groups compared to control at 6 months. No significant differences were observed between the two treatment groups during the course of the trial. Conclusions: This study suggests that IMT alone or with the addition of self-care may be of some benefit in the management of chronic TMD over the short-medium term. A larger scale study over a longer term (1–2 years) may be of further value.8 page(s

Efeito da clorexidina na mucosite induzida por radioterapia em câncer de cabeça e pescoço Effects of chlorhexidine mouthwash on radiation induced mucosistis in head and neck cancer

A radioterapia em pacientes com neoplasias de Cabeça e Pescoço causa alterações na mucosa oral comprometendo a execução terapêutica e o resultado final. OBJETIVO: Avaliar o efeito protetor do gluconato de clorexidina, sobre a mucosa oral, durante o tratamento actínico fracionado e o seu reflexo na qualidade de vida referida pelos pacientes. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram selecionados 21 portadores de câncer de Cabeça e Pescoço alocados em dois grupos: grupo Placebo (n=11, 9H e 2M, idade média 58 anos) água destilada - dois bochechos diários e grupo Medicação (n=10, 7H e 2M, idade média 52 anos) gluconato de clorexidina a 0,12% - dois bochechos diários. Os pacientes foram avaliados semanalmente com exame local para detecção das alterações de mucosa (classificação de acordo com a WHO e Grupo de Terapia por Radiação em Oncologia - graus 0 a IV) e preenchimento de questionário de qualidade de vida ressaltando os aspectos de dor, apetite, paladar e hábitos alimentares. A análise estatística realizada pelo teste exato de Fisher. RESULTADOS: A graduação da mucosite foi mais intensa no grupo Placebo em 6 das 10 semanas de avaliação. A freqüência e intensidade das dores foram piores no grupo Placebo na 4ª semana de radioterapia e a modificação de paladar foi mais intensa nos indivíduos que não usavam o medicamento apenas na 7ª semana. Não foram encontradas diferenças nos outros parâmetros de qualidade de vida. CONCLUSÃO: Podemos concluir que o gluconato de clorexidina não eliminou as lesões de mucosa mas diminuiu, significativamente, os seus efeitos deletérios e intensidade sem apresentar um reflexo persistente na qualidade de vida dos pacientes.<br>The radiotherapy in patients with neoplasias of Head and Neck causes alterations in the oral mucous membrane interfering with the therapeutic execution and the final result. AIM: To evaluate the protective effect of the chlorhexidin on the oral mucous membrane, during the radiotherapy and its reflex in the quality of life referred by patients. STUDY DESIGN: Clinical prospective. MATERIAL AND MATHOD: 21 patients with cancer of Head and Neck were selected and allocated in two groups: group Placebo (n=11, 9 men and 2 women, mean age 58 years) distilled water - two daily mouthwashes and group Medication (n=10, 7 men and 2 women, mean age 52 years) chlorhexidin 0,12% - two daily mouthwashes. The patients were appraised weekly with local exam for detection of the mucous membrane alterations (classification in agreement with WHO and Group of Therapy for Radiation in Oncology - degrees 0 to IV) and completion of questionnaire of life quality emphasizing the pain aspects, appetite, palate and alimentary habits. The statistical analysis accomplished by Fisher's exact test. RESULTS: The graduation of mucositis was more intense in the group Placebo in 6 of the 10 weeks of evaluation. The frequency and intensity of pain were worse in the group Placebo in the 4th week of radiotherapy and the palate modification was more intense in the individuals that didn't use the medicine just in the 7th week. They were not found differences in the other parameters of life quality. CONCLUSIONS: We can conclude that the chlorhexidin didn't eliminate the mucous membrane lesions but decreased, significantly, their harmful effects and intensity without presenting a persistent reflex in the quality of the patients' life

DESA1002 'Continuous City' <Danielle Gardner>

My familiarity of the design process has been extended and I have found this semester to be a rewarding and worthwhile experience where I have been challenged and have begun to have a clearer understanding of the different approaches and techniques used in design and architecture. The exercises have been valuable with ongoing weekly research benefiting us with our independence in following up queries on our own and improving our critical thinking. The experience of presenting in front of a group of people in the design classes is an area that I needed to improve on and something that I have appreciated. At times I have found myself to be nervous and uncomfortable about having to express my opinions although doing this repetitively has enhanced my capabilities and given me confidence. I have enjoyed the experience of seeing a project through from the beginning, starting with the selection of an appropriate site and balancing up the options of orientation, site size, accessibility in order to come to an appropriate resolution. As I have progressed through I have changed my design in accordance with feedback and formed new ideas and concepts that eventuated through this design process