Effect of high voltage electrical stimulation in temporomandibular disorders: a randomized controlled trial.

OBJECTIVE: To examine the effects of high voltage electrical stimulation (HVES) on pain intensity, maximum mouth opening (MMO), cervical mobility, head position, pressure pain thresholds (PPTs), bite force, joint sounds, and jaw muscle strength in individuals with temporomandibular disorders (TMDs). METHODS: Thirty-four individuals with TMDs were randomly divided into the exercise group (EG) (n = 17) and the HVES group (HG) (n = 17). For 4 weeks, EG received exercise therapy alone, while HG received HVES (12 sessions in total, 3 days a week to anterior temporalis and masseter) in conjunction with exercise. RESULTS: After the treatment, in both groups, pain intensity significantly decreased (p < .001); MMO (7.27 mm in HG and 3.61 mm in EG), cervical mobility, head position, PPTs, bite force, and jaw muscle strength significantly increased (p = .043 to < .001). Joint sounds significantly decreased in the HG (p = .008). Left bite force (p = .040) and left medial pterygoid PPT (p = .013) increased more in EG. The change in left bite force in EG over time was significant (p = .040; ηp2 = .126). The effect sizes of treatments were medium to large (from .527 to 1.602) for the evaluated parameters. CONCLUSION: Although exercise alone was effective in many parameters evaluated, additional application of HVES provided further improvement for pain, MMO, cervical mobility, PPTs, jaw muscle strength and joint sounds. HVES can be routinely used in clinics for individuals with TMDs.

Psychometric properties of the Fonseca Anamnestic Index (FAI) for temporomandibular disorders: Turkish version, responsiveness, reliability, and validity study.

PURPOSE: Many assessment tools have been proposed for use in clinical practice and research on individuals with temporomandibular disorders (TMD). It aimed to translate the Fonseca Anamnestic Index into Turkish (FAI/T) and examine the responsiveness, reliability and validity of the FAI/T in this study. MATERIALS AND METHODS: Two hundred forty-nine individuals (207 female/42 male) with TMD were included in this study according to the RDC/TMD (muscle disorders, disc displacement, arthralgia and mixed disorders (muscle disorders and disc displacement)). Reliability was evaluated with test-retest reliability, internal consistency, and reproducibility. Validity was assessed with structural validity, construct validity, content validity, and face validity. In addition, responsiveness and floor and ceiling effects were also examined. RESULTS: The ICC value (0.906) and Cronbach's α (0.951) of the (FAI/T) were excellent. Following Explarotary Factor Analysis, two factors were extracted, accounting for 51.859% of the total variation. Structural validity, construct validity, content validity, and face validity analyses proved the validity of the FAI/T. The responsiveness analysis showed that the Turkish FAI and its subscales were able to detect change over time. CONCLUSIONS: The FAI/T has shown excellent reliability and good validity. The FAI/T can assess the symptoms of Turkish-speaking persons with TMD.Clinical Trials registration number: NCT04274985.

Turkish version of Fonseca Anamnestic Index has been translated into Turkish from English version.Turkish version of Fonseca Anamnestic Index has excellent reliability and good validity.The Turkish version of the Fonseca Anamnestic Index and its subscales are able to detect change over time.Turkish clinicians and researchers could easily use the Turkish version of the Fonseca Anamnestic Index to assess the Turkish population with temporomandibular disorders.

Cross-cultural adaptation, reliability, and validity of the Turkish version of the Craniofacial Pain and Disability Inventory (CF-PDI/T) for individuals with temporomandibular disorders.

PURPOSE: To translate the Craniofacial Pain and Disability Inventory into Turkish (CF-PDI/T) and to examine its reliability and validity. MATERIALS AND METHODS: Cultural adaptation of CF-PDI/T was conducted according to international standards. The psychometric analyses included reliability by internal consistency (Cronbach's alpha) and test/retest reliability (intraclass correlation coefficient, ICC); structural validity was evaluated with exploratory factor analysis (EFA), confirmatory factor analysis (CFA); and construct validity was investigated by matching (a priori hypotheses) the CF-PDI/T with the Numeric Rating Scale (NRS), Headache Impact Test-6 (HIT-6), Tampa Scale for Kinesiophobia for Temporomandibular Disorders-12 (TSK-TMD-12), Pain Catastrophizing Scale (PCS), Neck Disability Index (NDI), Fonseca Anamnestic Index (FAI), and Jaw Functional Limitation Scale-20 (JFLS-20). Correlations ranging from low to high were expected. RESULTS: CF-PDI/T showed excellent test-retest reliability (ICC = 0.971), excellent internal consistency (Cronbach's α = 0.985), and low to high correlation with NRS, HIT-6, TSK-TMD, PCS, NDI, FAI, and JFLS-20. Following EFA, three factors ("pain and psychosocial limitation", "jaw functional status", and "frequency comorbidities and disability") were extracted, accounting for 55.028% of the total variation. CONCLUSIONS: The CF-PDI/T is a reliable and valid instrument to assess the symptoms and disability in the Turkish population with temporomandibular disorders. Clinical trial registration number: NCT03837587.Implications for rehabilitationThe Spanish version of the Craniofacial Pain and Disability Inventory is a highly reliable and good valid outcome measure to evaluate disability and treatment outcomes for individuals with temporomandibular disorders (TMDs).We suggest the Turkish version of the Craniofacial Pain and Disability Inventory (CF-PDI/T) be used in the Turkish population to indicate small changes in the severity of disorder of individuals with TMDs until a normal quality of life is achieved.The CF-PDI/T can be used with high reliability and validity by experienced and inexperienced dentists and physiotherapists.

Analysis of Confidence Levels and Application Success Rates in Simulator-Based Dental Anesthesia Education Among Undergraduate Dental Students.

PURPOSE: We investigated the confidence levels of undergraduate dental students who used dental anesthesia simulators and patient reports of undergraduate dental students' confidence levels in delivering anesthesia injections, in comparison with undergraduate dental students who did not use dental anesthesia simulators. We also investigated application success rates. MATERIALS AND METHODS: The study was carried out in the dental anesthesia simulator laboratory and in the faculty clinics of the Faculty of Dentistry of Ankara University. One-hundred volunteer undergraduate dental students who had completed the third year of the 5-year undergraduate education program and who had not performed local anesthesia on a patient participated in the study. Seventy and 30 undergraduate dental students did and did not receive training on dental anesthesia simulators, respectively, before performing procedures on patients. Using a questionnaire, undergraduate dental students conducted a self-assessment of preparedness and confidence, educators assessed the application success rates, and patients evaluated the undergraduate dental students' confidence levels. RESULTS: Patients reported that the undergraduate dental students trained using the simulators were more confident. The self-reported confidence and success rates in providing anesthesia did not differ significantly as per the use of dental anesthesia simulators. CONCLUSIONS: Although use of simulators did not enhance self-reported confidence, patients reported that undergraduate dental students who used the simulators were more confident and reassuring. Use of simulators did not increase the undergraduate dental students' self-reported confidence or preparedness. However, we recommend using such simulators to overcome the ethical and moral issues associated with other teaching methods.

Effect of locally applied bFGF on implant stability: biomechanical evaluation of 2 different implant surfaces in rabbits.

OBJECTIVES: The aim of this study was to evaluate the implant stability with the addition of local application of basic fibroblast growth factor (bFGF) during the osseointegration of 2 different dental implant surfaces using rabbit tibia model. MATERIALS AND METHODS: Fifty-six dental implants, 28 of hydrophilic surface (SLActive) and 28 of hydrophobic surface (OsseoSpeed), were placed in 14 mature New Zealand rabbits. The rabbits each received both SLActive and OsseoSpeed implants per tibia, and bFGF was applied locally on 1 randomly selected tibia. Half of the subjects were killed at the fourth week of healing period, and the other half were killed at the twelfth week. Stabilization was assessed using resonance frequency analysis (RFA) and removal torque value (RTV). RESULTS: The local application of bFGF was found to enhance osseointegration, especially at the fourth week of healing period after application (P = 0.046). RFAs and RTVs were found to be higher in bFGF-treated implant with hydrophilic surfaces when compared with both bFGF-treated hydrophobic implants and nontreated hydrophilic controls. CONCLUSION: Local application of bFGF seems to increase the stabilization values in implants with hydrophilic surfaces and those with hydrophobic surfaces.

Postoperative analgesia in impacted third molar surgery: the role of preoperative diclofenac sodium, paracetamol and lornoxicam.

OBJECTIVE: The aim of this study was to compare the postoperative analgesic effects of preoperative intravenous (i.v.) paracetamol, diclofenac sodium and lornoxicam (nonsteroidal anti-inflammatory drugs). SUBJECTS AND METHODS: Sixty patients with impacted third molar who underwent surgical removal were randomly allocated into three groups: group P (n = 20), group D (n = 20) and group L (n = 20). Group P received preoperatively 1 g paracetamol i.v., group D 75 mg diclofenac sodium i.m. and group L 8 mg lornoxicam i.v. Postoperative pain intensity, additional consumption of analgesics postoperatively and postoperative complications were compared among groups. RESULTS: The groups were comparable for pain scores (p > 0.05). Maximum pain scores were recorded in postoperative 4th h in all groups (group L 22, 14-44 mm; group P 24, 13-43 mm; group D 14, 10-24 mm, p = 0.117). Patients experienced high satisfaction scores which were comparable among groups (group L 85, 75-100 mm; group P 87, 70-95 mm; group D 84, 77-98 mm, p = 0.457). CONCLUSION: Preoperative intramuscular diclofenac, intravenous paracetamol and lornoxicam effectively decreased the pain scores. The patients were satisfied with the three postoperative pain management regimens.

Preoperative diclofenac sodium and tramadol for pain relief after bimaxillary osteotomy.

PURPOSE: The aim of this study was to compare the postoperative analgesic affects of preoperative use of a synthetic opioid tramadol and a nonsteroidal anti-inflammatory drug diclofenac sodium for postoperative pain, with placebo, in patients undergoing bimaxillary osteotomy. PATIENTS AND METHODS: Thirty-six orthognathic surgery patients who underwent both Le Fort I osteotomy in the maxilla and bilateral sagittal split ramus osteotomy in the mandible as bimaxillary osteotomy were randomly allocated into 3 groups via sealed envelope technique. Group T (n = 12), group D (n = 12), and group P (n = 12) received preoperative 50 mg tramadol intramuscularly, 75 mg diclofenac sodium intramuscularly, and saline, respectively. Postoperative pain intensity (visual analog scale, verbal pain score), postoperative opioid consumption with intravenous patient-controlled analgesia, hemodynamic variables, and postoperative complications were compared among the 3 groups. RESULTS: The median number of patient-controlled analgesia demands (n) in group P (34, 28-39) was higher than other groups (group D 14, 11-13; group T 19, 12-25; P = .001). Total tramadol consumption was higher in group P (330 mg, 290-390) compared with group D (260 mg, 190-340; P = .046) and group T (270 mg, 200-330; P = .034). The 3 groups were comparable for the area under the hemodynamic variables time curves. The area under the visual analog scale and verbal pain score curves were lower in group D and group T compared with group P, however, there was no significant difference between group T and group D. CONCLUSIONS: Preoperative diclofenac or tramadol, compared with placebo, effectively decreases postoperative opioid consumption via intravenous patient-controlled analgesia.

Intravascular papillary endothelial hyperplasia and osteoma: a case report of an individual with 2 different pathologies.

Intravascular papillary endothelial hyperplasia (IPEH) is an unusual, benign, non-neoplastic, vascular lesion characterized histologically by papillary fronds lined by proliferating endothelium. Osteoma is a benign osteogenic lesion characterized by proliferation of compact or cancellous bone. Osteoma of the maxillary sinus is an uncommon lesion. The purpose of this report is to present a case with 2 different lesions (intravascular papillary endothelial hyperplasia and osteoma) occurring at the same time in 1 patient that may or may not be related to each other and to stress the value of diagnostic imaging.

Role of fine needle aspiration cytology in the preoperative presumptive diagnosis of ameloblastoma.

OBJECTIVE: To determine the role of fine needle aspiration cytology (FNAC) on the preoperative presumptive diagnosis of ameloblastoma. STUDY DESIGN: Sixty-three patients, diagnosed preoperatively and postoperatively with ameloblastoma, were evaluated between 1990 and 2003. The patients were classified according to whether they were diagnosed with ameloblastoma preoperatively or postoperatively, on histologic examination. RESULTS: The accuracy rate for ameloblastoma was 0.95% for all biopsy methods, while the incisional biopsy rate was 75.00%. Concerning clinical diagnosis, ameloblastoma was mistaken mostly (56.41%) for odontogenic cysts (22 of 39). CONCLUSION: FNAC should be utilized more commonly on intraosseous and soft tissue lesions in the oral and maxillofacial regions, to obtain sufficient material. It is convenient, inexpensive and noninvasive as compared with other biopsy methods.

The effects of articaine hydrochloride on wound healing: an experimental study.

PURPOSE: The aim of the study was to examine the effect of articaine hydrochloride (AH) on the healing of surgical wounds and to compare healing with that of lidocaine. MATERIALS AND METHODS: Forty rats were used in this study. The rats were randomly separated into 4 groups. Three groups were given 2% lidocaine, 4% AH, or injectable saline, and the fourth was a control group. Skin specimens underwent the breaking strength test (BST) and histologic examination at 1 week after the surgical procedure. The skin specimens of the rats were subjected to a pulling force of 10 mm/min across the incision line. The strength value at the moment of breaking in the tissue was expressed in Newtons. Histologic examination was performed as well, and wound healing was graded. RESULTS: Both the histologic grade and BST values in the lidocaine and AH groups were significantly lower than those of the control and saline groups (P <.01). Similarly, the histologic and BST values of the AH and lidocaine groups were statistically significant (P <.05, P <.001). Some necrotic regions were observed at the incision region in 2 samples from the AH group. CONCLUSION: The results of the study showed that AH is as safe a local anesthetic agent as lidocaine from the standpoint of wound response.

Peripheral osteoma of the oral and maxillofacial region: a study of 35 new cases.

PURPOSE: The purpose of this article was to present 35 new cases of peripheral osteoma of the oral and maxillofacial region with an analysis of the literature. PATIENTS AND METHODS: We performed a search of our files for the past 5 years for peripheral osteoma of the oral and maxillofacial region. The criteria used to diagnose osteoma included the radiographic and histologic features. RESULTS: The 35 patients, which included 23 males (65%) and 12 females (35%), ranged in age from 14 to 58 years, with a mean age of 29.4 years. Most of the osteomas were located in frontal bone (28.57%), mandible (22.85%), and maxilla (14.28%). CONCLUSION: Peripheral osteomas of the jaw bones are uncommon, and accordingly, patients with osteoma should be evaluated for Gardner's syndrome. In addition, it is appropriate to provide both clinical and radiographic follow-up after surgical excision of a peripheral osteoma.