Analysis of the reliability of the Italian version of the Oral Behaviours Checklist and the relationship between oral behaviours and trait anxiety in healthy individuals.

BACKGROUND: The Oral Behaviours Checklist (OBC) is a valid 21-item instrument quantifying the self-reported frequency of oral behaviours. An Italian version (OBC-It) has been released recently. Anxiety and oral behaviours are known to be associated in individuals with oro-facial pain due to temporomandibular disorders (TMD). However, information about this relationship in pain-free individuals is still limited. OBJECTIVES: The aim of this study was to test the reliability of the OBC-It and its reduced version (OBC-It 6), focusing on tooth clenching-related wake-time oral behaviours, and the effect of patient instructions on reliability. A second aim was to test the association between trait anxiety and oral behaviours in pain-free individuals. METHODS: Two hundred and eighty-two TMD-free students, divided into 2 groups (Group A, n = 139, mean age ± SD = 22.6 ± 5.4 years; Group B, n = 143, 23.7 ± 4.2 years), filled in the State-Trait Anxiety Inventory and the OBC-It. Group B received instructions about the OBC-It, while Group A did not. After 2 weeks, both groups filled in the OBC-It again. However, Group B was further divided into 2 subgroups, B1 and B2 . The first received the same instructions again, while B2 did not. RESULTS: The test-retest reliability of the OBC-It (A: ICC = .87; B1 : ICC = .94; B2 : ICC = .95) and OBC-It 6 (A: ICC = .85; B1 : ICC = .89; B2 : ICC = .93) was excellent in all groups. Trait anxiety was weakly associated with OBC-It only in women (R2  = .043, P = .021). CONCLUSIONS: The OBC-It is a reliable tool but further subjects' instructions might be needed. Trait anxiety has a limited effect on oral behaviours in TMD-free subjects.

Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine.

Patients with masticatory muscle pain and migraine typically report that the intensity of pain fluctuates over time and is affected by weather changes. Weather variables, such as ambient temperature and humidity, may vary significantly depending on whether the individual is outdoor or indoor. It is, therefore, important to assess these variables at the individual level using portable monitors, during everyday life. This study aimed to determine and compare the temporal patterns of pain in individuals affected with facial and head pain and to investigate its relation with weather changes. Eleven patients (27·3 ± 7·4 years) with chronic masticatory muscle pain (MP) and twenty (33·1 ± 8·7 years) with migraine headache (MH) were asked to report their current pain level on a visual analogue scale (VAS) every hour over fourteen consecutive days. The VAS scores were collected using portable data-loggers, which were also used to record temperature, atmospheric pressure and relative humidity. VAS scores varied markedly over time in both groups. Pain VAS scores fluctuate less in the MP group than in the MH group, but their mean, minimum and maximum values were higher than those of migraine patients (all P < 0·05). Pain scores <2 cm were more common in the MH than in the MP group (P < 0·001). Perceived intensity of pain was negatively associated with atmospheric pressure in the MP group and positively associated with temperature and atmospheric in the MH group. Our results reveal that patients with masticatory muscle pain and patients with migraine present typical temporal pain patterns that are influenced in a different way by weather changes.

Oral fingolimod reduces glutamate-mediated intracortical excitability in relapsing-remitting multiple sclerosis.

OBJECTIVE: Fingolimod is an effective disease modifying therapy for multiple sclerosis (MS). Beyond its main action on peripheral lymphocytes, several noteworthy side effects have been demonstrated in vitro, among which modulation of neural excitability. Our aim was to explore cortical excitability in vivo in patients treated with fingolimod 0.5mg/day. METHODS: Paired-pulse TMS was applied on the left primary motor cortex in 13 patients affected by relapsing-remitting MS, the day before the first dose of fingolimod (T0) and 60days later (T1). Resting motor threshold, baseline motor evoked potentials, short interval intracortical inhibition (at 1, 3, 5ms) and intracortical facilitation (at 7, 9, 11 and 13ms) were estimated at T0 and T1. RESULTS: Intracortical facilitation was reduced at T1, without any changes in short interval intracortical inhibition. CONCLUSIONS: Fingolimod selectively reduced intracortical facilitation, which is mainly mediated by glutamate. SIGNIFICANCE: This is the first in vivo confirmation of the effects of fingolimod on glutamatergic drive in treated humans. Our results suggest a novel neuromodulatory activity of fingolimod with potential effect on glutamate-mediated excitotoxicity in vivo, as already seen in animal models.

[Epidemiologic study of patients with craniomandibular disorders. Report of data and clinical findings]. / Studio epidemiologico su un gruppo di pazienti con disordini craniomandibolari. Analisi dei dati e delle caratteristiche cliniche.

BACKGROUND: The purpose of this retrospective study was to identify the subjective and objective characteristics of a population referred to a clinic for diagnosis and treatment of orofacial pain and/or temporomandibular disorders. METHODS: Beginning in 1993, 825 patients, consecutively referred to the University of Naples Federico II , were examined and their records entered into a database. These data were collected by trained clinicians. Diagnostic subgroups were identified following the Research Diagnostic Criteria for temporomandibular disorders (RDC). RESULTS: Seventy-nine percent of patients were female, the mean age of the sample was 31.3+/-13 years (range: 5 to 74 years), most of patients were between 15 and 39 years of age. Based on diagnostic subgroups, patients were divided into: patients affected with myogenous pain (59%), arthrogenous pain (13%), arthrogenous and myogenous pain (16%) and fibromyalgia (4%). Sixty-three percent of the sample reported recent headaches, 53% reported parafunction, and 28% reported a previous trauma. Eighty-one percent reported spontaneous pain, which was chronic in 83% of them. The majority of patients (78%) presented a relatively high cultural BACKGROUND. CONCLUSIONS: These data appear to agree with other epidemiologic studies and depict the TMD treatment-seeking population as a predominantly female population during child-bearing years with multiple chronic pain complaints.

Mandibular rest position and electrical activity of the masticatory muscles.

STATEMENT OF PROBLEM: The determination of a correct vertical dimension of occlusion is a critical procedure in clinical dentistry. PURPOSE: The objectives of this study were to analyze the relation between mandibular rest position and electrical activity of masticatory muscles and to compare clinical and electromyographic rest position in subjects with different vertical facial morphologic features. MATERIAL AND METHODS: Clinical rest position and electromyographic rest position were investigated in 40 subjects. Electromyographic rest position ranged from 0.4 to 12.7 mm (average 7.7 +/- 2.7 mm). Clinical rest position ranged from 0.1 to 4.4 mm (average 1.4 +/- 1.1 mm). The average difference between electromyographic rest position and clinical rest position was 6.3 +/- 2.5 mm (range 0.3 to 10.3 mm). Sixteen subjects were selected according to the Frankfort mandibular plane angle and separated in two groups having a mandibular plane angle > or = 28 degrees. RESULTS: Rest position was significantly greater (p < 0.05) in the low-angle group (2 +/- 1.3 mm) than in the high angle group (0.8 +/- 0.8 mm). Electromyographic rest position did not differ between subjects with different facial morphologic features (8.1 +/- 1.7 mm low-angle group; 7.6 +/- 4.1 mm high angle group). By varying the vertical dimension millimeter by millimeter, masseter and anterior temporal electromyographic activity demonstrated a considerable decrease over an interocclusal distance of 3 to 4 mm. Further mandibular opening up to 18 mm corresponded to small changes in postural activity. CONCLUSION: This study suggests that a jaw posture with a few millimeters of interocclusal distance involves a great reduction of masticatory muscle activity.