Effectiveness of Electrophysical Modalities in the Management of Temporomandibular Joint Disorders: A Review.

This review was conducted by three investigators to assess the scientific evidence and eff ectiveness of various electro physical modalities in the treatment of temporomandibular joint (TMJ) disorders. This review was conducted by three investigators. The databases of PubMed, Science direct, Cochrane clinical trials register (June 1994-Jan 2013) were electronically searched for the key terms TMJ disorders with low-level laser therapy (LLLT), iontophoresis, phonophoresis, therapeutic ultrasound, transcutaneous electric nerve stimulation, microcurrent electrical nerve stimulation. The retrieved titles were thoroughly evaluated, and full text was obtained. Based on the inclusion and exclusion criteria the selected studies were assessed for the quality evidence of the trails using the Grade Pro 3.6 version software and summary of finding table was generated. Of 1544 titles, 28 full text publications, which were eligible for this review were included, and 15 randomized placebo controlled trials that were fulfilling the set criteria. Out of 15 studies 10 are performed on LLLT, 2 on iontophoresis, 1 on pulsed radiofrequency energy, 1 on cathodal high voltage electric stimulation and 1 on laser acupuncture. LLLT is the extensively practiced electrophysical treatment modality with the moderate quality of evidence. Electrophysical modalities are helpful as adjuvant in the treatment of TMJ symptoms. However, there are no evidences to conclude that a single electrophysical modality is beneficial over the other in the temporomandibular disorders management.

Colposcopy: Gynecological vision in viewing oral lesions.

Context: The diagnosis of malignant and potentially malignant epithelial lesions of the oral mucosa cannot be based solely on clinical fi ndings. The histologic evaluation of a representative biopsy specimen thus becomes necessary. The site for biopsy however is always a subjective choice that sometimes raises doubts about its representativeness. So far, no simple and reliable method is available for the selection of the most appropriate area for biopsy. Colposcopy is helpful in the selection of these sites of epithelial dysplasia depending upon the vascular patterns. Aims: This study was planned to assess the role of Colposcopic examination in the selection of biopsy site in patients with varying grades of oral epithelial dysplasia at various sites. Settings and Design: One hundred and eighty patients between the ages of 30 and 60 years clinically diagnosed with leukoplakia and carcinoma buccal mucosa were included in the study. Materials and Methods: For each of the subjects, a thorough clinical examination followed by Colposcopic assessment was carried out for the selection of biopsy site from the involved mucosa. The histopathological fi ndings were then compared in the two cases and results analyzed. Statistical Analysis Used: The statistical analysis was performed using a paired t-test. Results: In our study, sensitivity and specifi city for the selection of biopsy site by Colposcopic examination was found to be higher for leukoplakia than for carcinoma buccal mucosa. Conclusions: It was concluded that Colposcopic examination was found to be signifi cant in the selection of biopsy site for leukoplakia while clinical criterion was found to be more appropriate for carcinoma buccal mucosa cases.

Low Intensity Laser Therapy in Disc Derangement Disorders of Temporomandibular Joint: A Review Article / Terapia con Láser de Baja Intensidad en Trastornos de Alteración Discal de la Articulación Temporomandibular: Un Artículo de Revisión

Temporomandibular disorders embrace a number of clinical conditions that involves the masticatory musculature, temporomandibular joint (TMJ) and associated structures. The most frequent cause of TMJ disorders are disc derangement disorders which involve progressive slipping or displacement of articular disc. Various conservative treatment strategies for disc derangement disorders includes pharmacologic therapy, psychological counselling, treatment of parafunctional habits, use of occlusal splints and acupuncture which gives short term relief only. Recently, a non traumatic introduction to dentistry can be represented by low level laser therapy or soft laser therapy. It has proved to be an effective treatment modality in management of disc derangement disorders through its analgesic and anti- inflammatory effect. Therefore, the goal of this review article is to explore the use of low level laser therapy as an emerging trend in the management of disc derangement disorders of TMJ.

Los trastornos temporomandibulares abarcan una serie de condiciones clínicas que involucran la musculatura masticatoria, la articulación temporomandibular (ATM) y estructuras asociadas. La causa más frecuente de trastornos de la ATM es la alteración discal que implica el deslizamiento o desplazamiento progresivo del disco articular. Diversas estrategias de tratamiento conservador para los trastornos de alteración discal incluyen el tratamiento farmacológico, la terapia psicológica, el tratamiento de los hábitos parafuncionales, uso de férulas oclusales y acupuntura, que solamente dan un alivio a corto plazo. Recientemente, una introducción no traumática para la odontología puede ser representada por la terapia con láser de baja frecuencia o terapia de láser blando. Esta ha demostrado ser una modalidad de tratamiento eficaz en el manejo de los trastornos de alteración discal a través de su efecto analgésico y antiinflamatorio. El objetivo de este artículo es explorar el uso de la terapia con láser de baja frecuencia como una tendencia emergente en el tratamiento de los trastornos de alteración del disco de la ATM.

Oro-facial manifestations in myotonic syndrome / Manifestações bucais na síndrome miotônica

Objective: To present a case of myotonic syndrome in a 35-year-old male patient and to review anddiscuss the literature. Discussion and conclusion: The myotonic syndrome is a steadily progressive,familial, distal myopathy with associated weakness of the muscles of face, jaw, neck and elevators of theeyelids, a tendency for myotonic persistence of contraction in the affected parts and testicular atrophy.The patient was referred to the Department with complaint of recurrent temporomandibular joint dislocation,presenting with the characteristic oro-facial manifestations of myotonic syndrome.

Objetivo: Apresentar um caso de síndrome miotônica em um paciente adulto, 35 anos, sexo masculino, bem comorever e discutir a literatura pertinente. Discussão e conclusão: A síndrome miotônica é uma miopatia distal deprogressão contínua, familiar, e associada à fraqueza dos músculos da face, mandíbula, pescoço e músculos elevadoresdas pálpebras, com tendência de persistência de contratura miotônica nas partes afetadas, bem como atrofi a testicular.O paciente se apresentou ao departamento com queixa de deslocamento recorrente da articulação temporomandibular,apresentando as características de manifestações orofaciais de síndrome miotônica.

Cleidocranial dysplasia with spina bifida: a case report / Displasia cleido-craniana com espinha bífida: relato de caso

OBJECTIVE: To present and discuss a case of a rare disease in a 35 year old otherwise healthy maleIndian in origin reported to the Department of Oral Medicine and Radiology of the Dental College andResearch Institute, Bangalore, India. DISCUSSION: The cleidocranial dysplasia is a rare disease whichcan occur either spontaneously (40%) or by an autosomal dominant inheritance. The dentists are, mostof the times, the first professionals who patients look for to solve their problem, since there is a delayin the eruption and /or absence of permanent teeth. In the present case multiple missing teeth was thereason for patient’s visit to odontologist. CONCLUSION: An early diagnosis allows proper orientationfor the treatment, offering a better life quality for the patient.

OBJETIVO: Apresentar e discutir um caso de doença rara em paciente masculino, de 35 anos de idade, sadio, demodo geral, de origem indiana, que foi encaminhado ao Departamento de Medicina Bucal e Radiologia da Escola deOdontologia e Instituto de Pesquisa, Bangalore, Índia. DISCUSSÃO: A displasia cleidocraniana é uma doença raraque pode ocorrer espontaneamente (40%) ou por herança autossômica dominante. O cirurgião-dentista é, na maioriadas vezes, o primeiro profissional que o paciente procura para solução de seu problema, uma vez que há demora na erupção e/ou ausências de dentes permanentes. No presente caso, múltiplos dentes ausentes foram a razão para opaciente visitar o dentista. CONCLUSÃO: O diagnóstico precoce permite a orientação adequada para o tratamento,visando melhor qualidade de vida ao paciente.

Radiation-induced spindle cell sarcoma: A rare case report.

Ionizing radiation has been known to induce malignant transformation in human beings. Radiation-induced sarcomas are a late sequel of radiation therapy. Most sarcomas have been reported to occur after exposure to a radiation dose of 55 Gray (Gy) and above, with a dose ranging from 16 to 112 Gys. Spindle cell sarcomas, arising after radiotherapy given to treat the carcinoma of head and neck region is a very uncommon sequel. This is a rare case report of spindle cell sarcoma of left maxilla, in a 24-year-old male, occurring as a late complication of radiotherapy with Cobalt-60 given for the treatment of retinoblastoma of the left eye 21 years back.