Relationship between cervical spine and skeletal class II in subjects with and without temporomandibular disorders

AIM. To assess changes of cranio-cervical structure and of hyoid bone position in skeletal Class II subjects with and without Temporomandibular disorders (TMD). MATERIAL AND METHODS. The cephalometric analysis of 59 subjects with skeletal Class II were evaluated and compared. The measurements considerated were: ANB as parameter of Class II and C0-C1 distance, C1-C2 distance, cranio-cervical angle and hyoid bone position for the cervical spine analysis. Patients were divided into two subgroups: patients with TMD (group A) and patients without TMD (group B). TMD were evaluated with the Diagnostic Criteria for TMD (DC/TMD). Descriptive statistics and Pearson and Spearman correlation analysis, with p-value <0,005, were performed. RESULTS. C0-C1 and C1-C2 distance values and hyoid bone position resulted within normal range in the majority of patients examined. Cranio-cervical angle was alterated in 33 patients. The reduction of this angle with the increase of the ANB value resulted statistically significant in the group A, according to Pearson correlation index. No other data was statistically significant. CONCLUSIONS. Significant relationship between skeletal Class II and cervical spine cannot be highlighted. The alteration of cranio-cervical angle seems to be mildly present, with backward counterclockwise rotation of the head upon the neck in the sample (group A and B). The presence of TMDs as key factor in changes of neck posture could explain the different result between the two groups about relationship between ANB and cranio-cervical angle. This result should be further analyzed in order to better understand if cervical spine changes could be related to mandibular postural ones in the cranio-cervical space or to temporomandibular joints retropositioning, more recognizable in Class II with TMD, which could determine functional changes in other structures of this unit; neck posture also could be the result of a compensatory/ antalgic mechanism in response to TM

Functional implications of minor mandibular asymmetry: clinical and digital research on a sample of healthy patients

OBJECTIVE.The aim of the study is to evaluate the influence that the mandibular asymmetry could have towards the other components of the Stomathognatic system and to further related structures from a functional point of view. MATERIALS and METHODS. A sample of 18 young asymmetric patients, in healthy status, was investigated with clinical evaluation and questionnaires and digital devices such as Electromiography, Stabilometry, T-scan and Formetric. Descriptive and quantitative statistical analysis were performed. RESULTS. ASIM electromyography index was significant only in a short percentage of the sample. Hypertonia of temporalis muscle in the same side of mandibular deviation and the cross-activation of the contralateral masseter were present. The data of the stabilometric platform showed that only 33% of patients had a load discrepancy between right and left side. All patients presented similar and limited postural anomalies during the Formetric examination. No significant results emerged from statistics . CONCLUSIONS. From the emerging data, mandibular asymmetry does not seem to be considered a potential risk factor for the development of functional anomalies both in the stomatognatic system and in the postural one. The only issue that should be considered is the condylar retrusion of the mandibular shortest side that is a possible destabilizing factor of the TMJ condyle-disc coordination

Functional implications of minor mandibular asymmetry: clinical and digital research on a sample of healthy patients

OBJECTIVE.The aim of the study is to evaluate the influence that the mandibular asymmetry could have towards the other components of the Stomathognatic system and to further related structures from a functional point of view. MATERIALS and METHODS. A sample of 18 young asymmetric patients, in healthy status, was investigated with clinical evaluation and questionnaires and digital devices such as Electromiography, Stabilometry, T-scan and Formetric. Descriptive and quantitative statistical analysis were performed. RESULTS. ASIM electromyography index was significant only in a short percentage of the sample. Hypertonia of temporalis muscle in the same side of mandibular deviation and the cross-activation of the contralateral masseter were present. The data of the stabilometric platform showed that only 33% of patients had a load discrepancy between right and left side. All patients presented similar and limited postural anomalies during the Formetric examination. No significant results emerged from statistics . CONCLUSIONS. From the emerging data, mandibular asymmetry does not seem to be considered a potential risk factor for the development of functional anomalies both in the stomatognatic system and in the postural one. The only issue that should be considered is the condylar retrusion of the mandibular shortest side that is a possible destabilizing factor of the TMJ condyle-disc coordination

Personalized medicine of monoclonal antibodies in inflammatory bowel disease: pharmacogenetics, therapeutic drug monitoring and beyond

The pharmacotherapy of inflammatory bowel diseases (Crohn’s disease and ulcerative colitis) has experienced significant progress with the advent of monoclonal antibodies (mABs). As therapeutic proteins, mABs display peculiar pharmacokinetic characteristics that differentiate them from chemical drugs, such as aminosalicylates, antimetabolites (i.e., azathioprine, 6-mercaptopurine, and methotrexate), and immunosuppressants (corticosteroids and cyclosporine). However, clinical trials have demonstrated that biologic agents may suffer from a pharmacokinetic variability that could influence the desired clinical outcome, beyond primary resistance phenomena. Therefore, therapeutic drug monitoring (TDM) protocols have been elaborated and applied to adaptation drug doses according to the desired plasma concentrations of mABs. This activity is aimed at maximizing the beneficial effects of mABs while sparing patients from toxicities. However, some aspects of TDM are still under discussion, including time-changing therapeutic ranges, proactive and reactive approaches, the performance and availability of instrumental platforms, the widely varying individual characteristics of patients, the severity of the disease, and the coadministration of immunomodulatory drugs. Facing these issues, personalized medicine in IBD may benefit from a combined approach, made by TDM protocols and pharmacogenetic analyses in a timeline that necessarily considers the frailty of patients, the chronic administration of drugs, and the possible worsening of the disease. Therefore, the present review presents and discusses the activities of TDM protocols using mABs in light of the most recent results, with special attention on the integration of other actions aimed at exploiting the most effective and safe therapeutic effects of drugs prescribed in IBD patients

Digital evaluation of occlusal forces: comparison between healthy subjects and TMD patients

ABSTRACT Aim: Continuous technological innovation has provided the clinicians to access to a computerized device that can analyse the different characteristics of occlusal contacts. The purpose of this research was to use this device to study the occlusal forces comparing healthy subjects and TMD patients. Materials and Methods: The study was conducted by following specific criteria to select participants, the sample was divided into two homogeneous groups: control group (CG) comprising healthy subjects, and dysfunctional group (DG) comprising TMD patients. The occlusal force analysis was performed using the computerized system T-Scan III V 5.20 T. The data were analysed with statistical methods. Results: The most significant differences emerged between the groups in the average occlusal load distribution and in the location of the centre of occlusal forces (COF). In particular, compared with the CG and the functional standard, reductions in the molar field forces on the second and first molars of 27% and 6.9%, respectively, were observed in the DG. The COF was located in the most forward position in TMD patients compared with healthy subjects. Conclusions: Although the differences in the distribution of the occlusal forces and the location of the occlusal centre of gravity were significant, the relationship between occlusal contacts and TMD remains to be fully clarified. Further research is needed to investigate whether studying occlusal force distributions in both healthy subjects and TMD patients

Electric field effects on the dynamics of bubble detachment from an inclined surface

An experimental apparatus to study bubble detachment from an inclined surface under the action of electric forces is described. It consists of a container filled with FC72 at room temperature and pressure where a train of gas bubbles is injected from an orifice. An electrostatic field can be imposed around the bubble, while the cell can be tilted from 0 to 90°. It is possible to study interface growth with the aid of high-speed cinematography. Since the interface is asymmetrical, a mirror system allowed to acquire, in the same frame, two images at 90° of the bubble. Different inclinations, injection rates and voltages were tested in order to couple the effects of shear gravity and electric field. Curvature and contact angles have been derived with appropriate interpolation methods of the profile. Force balances on the bubble were checked, finding an electric force, which, at first pulls the bubbles from the orifice, then pushes it against the surface. The motion of the center of gravity confirms this behaviour. A power balance has been developed to determine the energy contributions, revealing that surface growth incorporates both the effects of inlet power and electric field

Local vibratory stimulation for temporomandibular disorder myofascial pain treatment: a randomised, double-blind, placebo-controlled preliminary study

Several methods are currently used to manage pain related to temporomandibular disorder (TMD).Vibratory stimulation is applied as a pain treatment for several musculoskeletal disorders, but it has not yet been studied in-depth for TMD symptoms. The aim of this study is to analyse the effectiveness of at-home local vibration therapy (LVT) for the management of TMDs-related myofascial pain.Methods. Fifty-four TMD patients (43 F, 11 M) with an average age of 40.7 (age range: 29-54 yr.) were randomly subdivided into two groups. The study group (AG) received 1 week of at-home LVT treatment with the NOVAFON Pro Sk2/2: 50/100 Hz, bilaterally applied to the pain area for 16 minutes daily. The placebo group (IG) followed the same protocol using inactive devices. Temporomandibular jointpain (TMJ), muscular pain (MM), and headache (HA) were assessed. Pain was evaluated using the visual analogue scale (VAS) before (T0) and after therapy (T1). Statistical analysis and Student's t-tests were applied (statistical significance for P&lt;0.05). Results. AG patients reported decreased average values for all types of pain considered between T0 and T1, with a statistically significant difference for TMJ pain (P&lt;0.05), MM pain, and HA (P&lt;0.001). IG patients reported a no statistically significant decrease in the average values of MM pain and an increase in the average valuesof TMJ pain and HA. Conclusion. The study supports the use of local vibration therapy in the control of TMD-related TMJ pain, local muscular pain, and headache

Topological susceptibility and string tension in CP(N-1) models

We investigate the features of ${\rm CP}^{N-1}$ models concerning confinement and topology. In order to study the approach to the large-$N$ asymptotic regime, we determine the topological susceptibility and the string tension for a wide range of values of $N$, in particular $N=4,10,21,41$. Quantitative agreement with the large-$N$ predictions is found for the ${\rm CP}^{20}$ and the ${\rm CP}^{40}$ models. Problems related to the measure of the topological susceptibility and the string tension on the lattice are discussed.Comment: Talk presented at the Lattice '92 Conference, Amsterdam. 6 pages, sorry, no figures included, if required we can send them by mai

The SU(2) Confining Vacuum as a Dual Superconductor

We investigate the dual superconductivity hypothesis in pure SU(2) lattice gauge theory. We find evidence of the dual Meissner effect both in the maximally Abelian gauge and without gauge fixing. We also obtain a rather good extimation of the string tension using the value of the London penetration length.Comment: 4 pages, uuencoded compressed (using GNU's gzip) tar file containing 1 LaTeX2e file, 5 encapsulated Postscript figures, and espcrc2.sty. Contribution to Lattice 9

Okada Purifying Therapy in combination with duloxetine vs. duloxetine alone in patients with TMD and fibromyalgia: a randomized clinical study

Abstract Objectives This randomized study was aimed at evaluating the additional analgesic effect of Okada Purifying Therapy (OPT) when administered in combination with duloxetine in patients with Temporomandibular Disorders (TMDs) and Fibromyalgia (FM). Methods Patients with TMDs visited at Department of Oral and Maxillofacial Sciences, Sapienza University of Rome who were diagnosed with FM were selected for the study. The final sample was composed of 31 patients: 15 patients were treated only with duloxetine (Group I) and 16 patients underwent also OPT treatment (Group II), for eight weeks. Craniomandibular index, total tenderness score, Brief Pain Inventory Modified Short Form, Fibromyalgia Impact Questionnaire, Beck Depression Inventory and State and Trait Anxiety Inventory-1 were assessed at the beginning (T0), during the course (T1) and after therapy (T2). Descriptive and inferential statistics were performed. Results In all the data analyzed, both groups showed an improvement in particular between T0 and T1. No statistically significant differences were observed between the two groups during the trial, except for the interaction between treatment and time as to the ability of walking at the BPI-I (F=7.57, p=0.002). No side effects due to the duloxetine were recorded in group II compared to group I. Conclusion The additional complementary treatment (OPT) did not appear to give the patients with TMDs and FM any further benefit but it might improve pharmacological tolerability of the traditional medication