Association between experience of stressful life events and muscle-related temporomandibular disorders in patients seeking free treatment in a dental hospital.

OBJECTIVES: Psychological factors are known to play an important role in the etiology and maintenance of temporomandibular disorders. Since there have been very few studies on this issue in Asian countries, the study was aimed to investigate the relationship between various stressful life events and temporomandibular disorders in patients seeking free treatment in a Dental Hospital, Bangladesh. MATERIALS AND METHODS: Five hundred and twenty Bangladeshi adults (370 males and 150 females; mean age, 30.9 +/- 8.2 years) participated in this study. The subjects were given a questionnaire to evaluate their stress status in the last 12 months. The Research Diagnostic Criteria for TMD (RDC/TMD) was used as TMD diagnostic system by three standardized examiners. Two hundred and thirty-six patients were RDC/TMD-defined TMD-positive and were subsequently classified into 7 groups: group I, myofacial pain only; group II, disk displacement only; group III, joint pain only; group IV, myofacial pain and disc displacement; group V, myofacial pain and joint pain; group VI, disc displacement and joint pain; and group VII, myofacial pain, disk displacement and joint pain. Two hundred and eighty-four subjects were RDC/TMD-defined TMD-negative subjects (controls). Adjusted odds ratios were calculated by multiple logistic regression analysis. RESULTS: Logistic regression analysis revealed that patients diagnosed with myofacial pain (group I) and a combination of myofacial and joint pain (group V) had significantly higher levels of financial and job stress than did the controls. Self-health-related stress and stress related to a spouse or deaths of a relative were also identified as predisposing factors for myofacial pain (group I). CONCLUSION: This study suggests that myofacial pain is more common in individuals with various types of psychological stress. When treating patients with facial pain, dentists should consider the possible presence of psychological factors.

A study of attached and oriented human periodontal ligament cells to periodontally diseased cementum and dentin after demineralizing with neutral and low pH etching solution.

BACKGROUND: This study aimed to evaluate quantitatively the migrated, attached, and oriented human periodontal ligament cells (HPLC) to periodontally diseased cementum and dentin after demineralization with low and neutral pH etching solution. METHODS: Human teeth, extracted due to periodontal diseases, were scaled and root planed so that cementum remained on one longitudinal half of the root and dentin was exposed on the other half. Forty root slices of 200 microm thickness, obtained from the mid-third of these roots, were divided into four groups: group 1, demineralized with a saturated solution of citric acid (pH 1.20); group 2, with 24% EDTA (pH 7.04); group 3, with tetracycline HCl 100 mg/ml (pH 2.00); and group 4, only scaled and root planed (control). Root slices were placed over the confluent HPLC in 35 mm culture dishes and incubated. Phase contrast microscopic photographs of attached and oriented refractile HPLC to root surfaces were taken at days 1, 3, and 7. Quantitative analysis of attached and oriented HPLC from these photographs was done using special software. RESULTS: The results showed no significant difference in the attachment and orientation index of HPLC to cementum compared to dentin in any method of demineralization at each time point (P >0.05), although there was a significantly higher cell attachment and orientation index to demineralized dentin with EDTA and citric acid than to non-etched dentin and to all 3 demineralized cementum surfaces compared to non-etched cementum (P<0.05). CONCLUSIONS: EDTA and citric acid demineralization may enhance HPLC attachment and orientation to the root surface, and it is not always necessary to remove excessive cementum when the demineralizing procedure is used.

Effect of recombinant human platelet-derived growth factor-BB and bone morphogenetic protein-2 application to demineralized dentin on early periodontal ligament cell response.

The purpose of this study is to investigate the early responses of human periodontal ligament cells attached to recombinant human platelet-derived growth factor-BB and bone morphogenetic protein-2 applied EDTA-demineralized dentin. One hundred and seventy-four root-planed flat dentin blocks were prepared from the mid-third of periodontally diseased human tooth roots. After demineralization with 24% EDTA (pH 7.02) 120 dentin blocks were treated with 0.5 and 1 microgram/ml rhPDGF-BB, 1 and 3 micrograms/ml rhBMP-2 and only MEM as control (24/group). Human periodontal ligament cells (HPLC) were seeded on these dentin surfaces and incubated. The alkaline phosphatase (ALP) activity and protein concentration of the attached cell were assessed at d 2, 4 and 7. Fifty-four dentin blocks were seeded with HPLC after application of 1 microgram/ml rhPDGF-BB, 3 micrograms/ml rhBMP-2 and MEM (18/group) and then incubated. At d 2, 4 and 7, the attached cells were stained and counted under light microscope. The results showed a significant increase of protein concentration and cell number in PDGF-BB treated groups than control (p < 0.05, p < 0.01) but not the ALP activity, and a significant increase of ALP activity was observed in BMP-2 treated groups than control (p < 0.05) but protein concentration and cell number remained almost the same over time. Thus, rhPDGF-BB and rhBMP-2 application to EDTA demineralized dentin surfaces promote the early human periodontal ligament cell responses by increasing cell proliferation and differentiation, respectively, which would ultimately enhance periodontal regeneration.

Blood lead levels and anemia in lead exposed workers.

The effects of lead on haematological parameters were studied in 51 occupationally exposed individuals comprising of 27 lead furnace workers, 24 lead pellet handlers and 20 healthy age and service matched controls. Blood lead levels were estimated by atomic absorption spectrometer AAS-180-80 and haematological parameters by Technicon H.1 system. The lead furnace workers had highest blood lead levels (median 71.20 ug/dl, range 21.2-171.10 ug/dl) and low Hb (median 106 g/l, range 73-144 g/l) as compared to healthy subjects (median lead levels 29.80 ug/dl, range 10.20-54.10 ug/dl and Hb median 135 g/l, range 101-153 g/l). The workers handling pellets had moderately increased blood lead levels (median 45.50 ug/dl, range 8.50-130.6 ug/l) and low Hb (median 114 g/l, range 74-158 g/l). The furnace exposed workers had higher blood lead levels and low Hb compared to the lead pellet handlers. TRBC, Hct, MCV, MCH and MCHC did not reveal any significant difference in all groups. It is concluded that chronic lead exposure causes normocytic normochromic anaemia and shows a dose response relationship between lead levels and severity of anemia.