Placas estabilizadoras: avaliação de sua eficácia no tratamento das disfunções temporomandibulares

A placa estabilizadora é o mais difundido método de tratamento das disfunções têmporo-mandibulares. A Ressonância Magnética (RM) é o exame mais indicado para a visualização dos componentes da Articulação têmporo-mandibular (ATM). Quarenta pacientes com sinais e sintomas de disfunções têmporo-mandibulares foram tratados com as placas estabilizadoras por um período médio de 12 meses, com controles periódicos quinzenais. Após a estabilização do quadro clínico foram realizados ajustes oclusais e a avaliação por meio da RM. Concluímos que os melhores resultados dessa modalidade de tratamento são relacionados à melhora total (70%) ou parcial (22,5%) da sintomatologia dolorosa e ao restabelecimento da função do complexo crânio-mandibular. A RM permitiu avaliar e concluir que as placas possibilitam condições para que o organismo possa criar meios resistentes às disfunções da articulação têmporo-mandibular por meio da eliminação de vários fatores etiológicos. E que após o tratamento, os pacientes podem conviver com os deslocamentos do disco, alguns com maior, outros com menor tolerância.Occlusal stabilization appliances or splints are the most widely employed method for treatment of temporomandibular disorders (TMD). Magnetic Resonance Imaging (MRI) is the most indicated imaging modality to evaluate the components of the temporomandibular joint (TMJ). Forty patients with signs and symptoms of temporomandibular disorders were treated with splints for a mean period of 12 months, comprising regular semimonthly follow-ups. After stabilization of the clinical status, occlusal adjustments and MRI evaluation were performed. It was concluded that the success of this kind of treatment are related to the total (70%) or partial improvement (22.5%) of painful symptomatology and to the functional reestablishment of the craniomandibular complex. The MRI allowed evaluation and also the conclusion that the splints provide conditions for the organism to develop means to resist to the temporomandibular disorders by means of elimination of several etiologic factors. Moreover, after treatment the patients are able to cope with disc displacements with larger or smaller tolerance

Evaluation of inferior alveolar nerve regeneration by bifocal distraction osteogenesis with retrograde transportation of horseradish peroxidase in dogs

Background: Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing segmental mandibular defects. However, there are few reports regarding the occurrence of inferior alveolar nerve regeneration during the process of distraction. Previously, we reported inferior alveolar nerve regeneration after distraction, and evaluated the regenerated nerve using histological and electrophysiological methods. In the present study, we investigated axons regenerated by bifocal distraction osteogenesis using retrograde transportation of horseradish peroxidase in the mandibles of dogs to determine their type and function. Methods and Findings: Using a bifocal distraction osteogenesis method, we produced a 10-mm mandibular defect, including a nerve defect, in 11 dogs and distracted using a transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by retrograde transportation of HRP in all dogs at 3 and 6 months after the first operation. At 3 and 6 months, HRP-labeled neurons were observed in the trigeminal ganglion. The number of HRP-labeled neurons in each section increased, while the cell body diameter of HRP-labeled neurons was reduced over time. Conclusions: We found that the inferior alveolar nerve after bifocal distraction osteogenesis successfully recovered until peripheral tissue began to function. Although our research is still at the stage of animal experiments, it is considered that it will be possible to apply this method in the future to humans who have the mandibular defects. © 2014 Shogen et al.Evaluation of Inferior Alveolar Nerve Regeneration by Bifocal Distraction Osteogenesis with Retrograde Transportation of Horseradish Peroxidase in Dogs. Shogen Y, Isomura ET, Kogo M. PLOS ONE 2014. 9(4) e94365. doi:10.1371/journal.pone.009436

General Factors and Dental-Related Risk Factors for Postoperative Pneumonia or Infectious Complications: A Retrospective Study

Numerous studies report that perioperative oral care decreases the frequency of postoperative pneumonia or infection. However, no studies have analyzed the specific impact of oral infection sources on the postoperative course, and the criteria for preoperative dental care differ among institutions. This study aimed to analyze the factors and dental conditions present in patients with postoperative pneumonia and infection. Our results suggest that general factors related to postoperative pneumonia, including thoracic surgery, sex (male > female), the presence or absence of perioperative oral management, smoking history, and operation time, were identified, but there were no dental-related risk factors associated with it. However, the only general factor related to postoperative infectious complications was operation time, and the only dental-related risk factor was periodontal pocket (4 mm or higher). These results suggest that oral management immediately before surgery is sufficient to prevent postoperative pneumonia, but that moderate periodontal disease must be eliminated to prevent postoperative infectious complication, which requires periodontal treatment not only immediately before surgery, but also on a daily basis.Isomura E.T., Fujimoto Y., Matsukawa M., et al. General Factors and Dental-Related Risk Factors for Postoperative Pneumonia or Infectious Complications: A Retrospective Study. Journal of Clinical Medicine 12, 3529 (2023); https://doi.org/10.3390/jcm12103529

Young Age, Female Sex, and No Comorbidities Are Risk Factors for Adverse Reactions after the Third Dose of BNT162b2 COVID-19 Vaccine against SARS-CoV-2: A Prospective Cohort Study in Japan

Background: This study compared the adverse events (AEs) of the second and third doses of BNT162b2, as well as investigated the impact of vaccine recipients’ background and vaccination interval on the AEs of the third dose. Methods: We conducted a questionnaire survey of AEs among health care workers at Osaka University Dental Hospital. Chi-square tests were performed to compare AEs to the administration of second and third vaccine doses. Logistic regression analyses were conducted to identify factors influencing the presence of AEs using age, sex, comorbidities, and the vaccination interval. Spearman’s rank correlation coefficient was calculated to investigate the correlation between age, vaccination interval, and severity of each AE. Results: The third dose of BNT162b2 was associated with significantly more frequent or milder AEs than the second dose. Logistic regression analyses detected significant differences in six items of AEs by age, three by sex, two by comorbidities, and zero by vaccination interval. Consistently, the risk of AEs was greater among younger persons, females, and those without comorbidities. Significant negative correlations were detected between age and vaccination interval, and between age and the severity of most AEs. Conclusions: Young, female, and having no comorbidities are risk factors for AEs after the third dose of BNT162b2, while vaccination interval is not.Urakawa R., Isomura E.T., Matsunaga K., et al. Young Age, Female Sex, and No Comorbidities Are Risk Factors for Adverse Reactions after the Third Dose of BNT162b2 COVID-19 Vaccine against SARS-CoV-2: A Prospective Cohort Study in Japan. Vaccines, 10, 8, 1357. https://doi.org/https://doi.org/10.3390/vaccines10081357

Establishment of a new rehabilitation program using masticatory training food for jaw deformity patients

Background/purpose: Patients with jaw deformities may show a reduction in masticatory function as a result of postoperative hypofunction. This study aimed to establish a novel rehabilitation program using a commercially available masticatory training food for patients with jaw deformities after orthognathic surgery. Materials and methods: Nine patients with mandibular prognathism (the training group: n = 5, and the non-training group: n = 4) and 6 control participants with normal occlusion were included in this study. For the rehabilitation program with masticatory exercise, patients were instructed to chew the training food once a day for 60 days starting from 10 days after the surgery. The effects of the rehabilitation program were assessed by determining the maximum bite force (MBF) and the masticatory performance (MP). Clinical assessments were performed just before orthognathic surgery (Pre) and at 10 days (T0), 1 month (T1), 2 months (T2), and 3 months (T3) after surgery. Results: Compared with the non-training group, the training group showed a trend toward greater recovery amount of MBF from Pre to T3, and a significantly greater recovery amount in MP (p < 0.05) from Pre to T3. When the time-series change of MP was evaluated in both groups from T0 to T3, a significant difference was observed in the interaction terms (p = 0.03). This result indicates that the effectiveness of the training may be demonstrated by following the postoperative course further. Conclusion: The rehabilitation using this training food may become a useful method for postoperative hypofunction in patients with jaw deformities

Breast spindle cell carcinoma

Spindle cell carcinoma (SpCC) of the breast is quite a rare modality classified to the metaplastic carcinoma of the breast. Regarding its biological behavior and the prognosis of the patients with this rare tumor, it has been remaining controversial. We herein report an 88 year-old woman who had a huge bleeding tumor on the right breast. She was a high-aged woman with low activities of daily life, even with some suspicion of distant organ metastasis. While the tumor proved to drastically bleed due to the tumor disintegration, a right simple mastectomy was performed. According to the histopathologic examinations, sarcomatoid spindle cells with severe atypia were observed. By an immunohistochemical examination, the tumor had proved to express neither estrogen receptor, progesterone receptor nor HER2 receptor. Moreover an immunohistochemical expression of AE1/3 and CAM5.2, defining an epithelial neoplasm were observed in addition to an expression of vimentin. From these findings, this bleeding tumor was diagnosed as spindle cell carcinoma of the breast

Metastasis to the finger of oral floor squamous cell carcinoma: A case report

When cetuximab is used, diagnosing finger metastasis can be difficult due to the side effects of paronychia and color changes of nails. Finger metastasis may be a marker of multiple metastasis; therefore, it can lead to a poor prognosis

Evaluation of sites of velopharyngeal structure augmentation in dogs for improvement of velopharyngeal insufficiency

Background Velopharyngeal structure augmentation methods are used as alternatives to velopharyngeal plasty. Anatomic sites of implantation/injection vary widely due to a lack of standardized criteria. Here, we experimentally investigated optimal sites of velopharyngeal structure augmentation via saline injection in dogs as they naturally exhibit velopharyngeal insufficiency (VPI). Methods Velopharyngeal structure augmentation was performed on 10 beagles (age range: 20–24 months; weight range: 9–12 kg). Saline containing 1/80,000 epinephrine was injected intraorally in 1-mL increments into the nasal mucosa of the soft palate (n = 4), posterior pharyngeal wall (n = 3), or bilateral pharyngeal walls (n = 3) of each dog. Nasal air leakage was measured under rebreathing until velopharyngeal closure was achieved; the measurement was performed using flow meter sensors on both nasal apertures, and the oral cavity was filled with alginate impression material to prevent oral air leakage. Results Pre-injection, the dogs exhibited an average of 0.455 L/s air leakage from the nasal cavity. The dogs with saline injected into the nasal mucosa of the soft palate achieved steady augmentation, and nasal air leakage disappeared under rebreathing following 6-mL saline injection. Conversely, nasal air leakage remained in the dogs with saline injected in the posterior pharyngeal wall or bilateral pharyngeal walls. Conclusions During VPI treatment in dogs, augmentation was most effective at the nasal mucosa of the soft palate. Improvement in nasal air leakage was highly dependent on the saline injection volume. Although velopharyngeal structures vary between dogs and humans, velopharyngeal closure style is similar. Thus, our results may aid in the treatment of VPI patients.Evaluation of sites of velopharyngeal structure augmentation in dogs for improvement of velopharyngeal insufficiency. Isomura ET, Nakagawa K, Matsukawa M, Mitsui R, Kogo M. PLOS ONE. 2019. 14(2) e0212752. doi:10.1371/journal.pone.021275