Association Between Articular Eminence Structure and Joint Spaces in Temporomandibular Joints with Anterior Disc Displacement.

BACKGROUND AND AIMS: The association among the joint spaces, articular eminence morphology, and disc displacement is not well documented in the literature. This study aims to evaluate and compare the joint spaces and the articular eminence structure (eminence height [Eh] and inclination [Ei]) using cone-beam computed tomography (CBCT) of temporomandibular joints (TMJs) with anterior disc displacements and joints with normal disc position. METHODS: The study groups consisted of 75 TMJs of 39 patients. The disc status of TMJs was diagnosed with magnetic resonance imaging, and the measurements were performed on CBCT. Three groups, that is, normal disc position (NDP) group, anterior disc displacement with reduction (ADDWR) group, and anterior disc displacement without reduction (ADDWoR) group, were established. Anterior, superior, posterior joint spaces (AJS, SJS, and PJS, respectively), articular Eh, and articular Ei were measured. Statistical Package for the Social Sciences version 22 was used for statistical analysis. Shapiro-Wilk test was used to check the normality of data. Intergroup comparisons of categorical variables were assessed with Fisher-Freeman-Halton test. For comparison of continuous variables parameters, Mann-Whitney U test and Kruskal-Wallis test were used. Statistical significance level was determined as P < 0.05. RESULTS: Significant differences were not found in intergroup comparisons for PJS. However, the difference between groups was found to be significant for AJS, SJS, Eh, and Ei. Intergroup comparisons were performed for these parameters. No significant difference was found between the NDP group and the ADDWR group for AJS, SJS, Eh, and EI. The mean AJS, SJS, Eh, and Ei values in ADDWoR were found to be significantly lower compared to the corresponding values in both NDP and ADDWR groups. CONCLUSION: Decreased AJS and SJS when TMJ is evaluated with CBCT may be an indicator of ADDWoR. Authors suggest that narrowed articular Ei and reduced articular Eh can be one of the predisposing factors for anterior disc displacement.

Does preventive single dose of intravenous dexketoprofen reduce pain and swelling after orthognathic surgery? A prospective, randomized, double blind clinical trial.

BACKGROUND: The purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery. MATERIAL AND METHODS: The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test. RESULTS: The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p<0,05). There was no statistically significant difference between the groups in terms of swelling (p>0,05). CONCLUSIONS: Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery.

Effect of occlusal splint on interleukin 6, malondialdehyde and 8-hydroxydeoxyguanosine levels in the synovial fluid of patients with temporomandibular disorders.

The actual role of splint therapy in preventing excessive loading of the temporomandibular joint (TMJ) is still debated. Lower intra-articular pressure levels have been measured in patients wearing occlusal splints, which may also reduce oxidative stress in the articular spaces. The aim of this study was to determine whether splint therapy reduces oxidative stress and inflammation in TMJ internal derangement patients by measuring interleukin 6 (IL-6), malondialdehyde (MDA), and 8-hydroxydeoxyguanosine (8-OHdG) levels in the synovial fluid (SF). Twenty-four patients with a temporomandibular disorder (TMD) were included in the study. TMJ SF samples were obtained prior to arthrocentesis. Twelve patients used a 2-mm hard acrylic, maxillary stabilization-type splint for 3 months after arthrocentesis. Twelve patients had no treatment after the SF aspiration. Second SF samples were obtained from all patients at 3 months post arthrocentesis. IL-6, MDA, and 8-OHdG levels in the samples were evaluated. All patients showed a significant symptomatic improvement after treatment (P < 0.005). No statistical correlation was found between the two groups concerning pre-treatment and 3-month SF levels of MDA, 8-OHdG, and IL-6. Although splint therapy was found to be successful in eliminating clinical symptoms of TMD, the results showed no beneficial effect on inflammation and oxidative stress markers in the synovial fluid.

Vertical ridge augmentation using guided bone regeneration procedure and dental pulp derived mesenchymal stem cells with simultaneous dental implant placement: A histologic study in a sheep model.

OBJECTIVES: To determine the effects of bone graft and dental pulp derived mesenchymal stem cells (DPMSCs) implantation with simultaneous dental implant placement on osteointegration, newly formed bone and vertical bone height histologically and histomorphometrically in a sheep model. MATERIAL AND METHODS: A total of 48 implants were divided into three groups. In Group I (n = 16), no material was placed around the implants. In Group II (n = 16), particulate deproteinized bovine bone graft (DBBG) was placed around the implant and in Group III (n = 16), 2 × 106 DPMSCs were placed around the implant with DBBG. All implants were covered with a 20 × 30 mm collagen membrane and the edges of the membrane were fixed with mini screws. The animals were sacrificed 3 and 6 weeks after surgery. Histologic and histomorphometric assessments were performed. RESULTS: The area of newly formed bone in Groups I, II, and III were calculated as percentage 2.15 ± 0.22, 11.88 ± 0.77, and 14.50 ± 0.67 respectively after 3 weeks and 3.33 ± 0.37, 18.45 ± 0.33, and 29 ± 1.07 after 6 weeks, respectively (P < 0.05). Three weeks after dental implant placement, the vertical bone length was 0.17 ± 0.02 mm in Group I, 0.89 ± 0.068 mm in Group II and 0.96 ± 0.05 mm in Group III. After 6 weeks, these values were 0.28 ± 0.03 mm, 1.34 ± 0.08 mm, and 1.49 ± 0.08 mm, respectively. There was no significant difference between Groups II and III at 3 and 6 weeks in terms of vertical bone length. CONCLUSION: Bone graft and DPMSCs application with dental implant have beneficial effects on newly formed bone and vertical bone height in this experimental sheep model.

Comparison of the analgesic effects of pulse radiofrequency and cryoablation in rabbits with mental nerve neuropathic pain.

PURPOSE: After mental nerve injury, several sensory disorders may occur. The alterations in sensation may differ from mild paresthesia to complete anesthesia, or neuropathic pain. Neuropathic pain is a difficult clinical condition to manage. The aim of this study was to compare the analgesic effects of pulsed radiofrequency (PRF) and cryoablation in an experimental mental nerve neuropathic pain model in rabbits. MATERIALS AND METHODS: Fifteen rabbits were divided into three groups. One-third to one-half of the mental nerve was ligated with 4-0 silk sutures. In Group 1, a nonconducting PRF electrode was placed on the mental nerve for 6 min, whereas the mental nerve was exposed to PRF in Group 2. In Group 3, the cryoablation was processed. The responses to thermal and mechanical stimuli were measured at the 1st, 2nd, 3rd, and 4th weeks. RESULTS: There were no statistically significant differences among the groups for thermal withdrawal latency to heat stimulation in any weeks (P > 0.05). However, a significant difference was found between the groups (P < 0.05) in the 3rd and 4th weeks for mechanical withdrawal latency values. CONCLUSIONS: Both PRF and cryoablation therapies are successful in the treatment of experimentally induced mental nerve neuropathic pain in rabbits.