Long-Term Effects of a Single Application of Botulinum Toxin Type A in Temporomandibular Myofascial Pain Patients: A Controlled Clinical Trial.

This study assessed the long-term effects of botulinum toxin type A (BoNT-A) in subjective pain, pain sensibility, and muscle thickness in persistent myofascial temporomandibular-disorder pain (MFP-TMD) patients. Fourteen female subjects with persistent MFP received BoNT-A treatment with different doses (10U-25U for temporalis muscle and 30U-75U for masseter muscle). The treatment was injected bilaterally in the masseter and anterior temporalis muscles in a single session. Clinical measurements included: self-perceived pain (VAS), pain sensibility (PPT), and muscles thickness (ultrasonography). Follow-up occurred 1, 3, 6, and 72 months after treatment for VAS and PPT and 1, 3, and 72 months for ultrasonography. For statistical analysis, the Friedman test with the Bonferroni test for multiple comparisons as a post hoc test was used for non-parametric repeated measures comparisons among the evaluation times. A 5% probability level was considered significant in all tests. VAS values presented a significant decrease throughout the study (p < 0.05). Regarding PPT values, a significant increase was found when comparing baseline data with post-treatment follow-ups (p < 0.05), and even though a significant decrease was found in muscle thickness when baseline values were compared with the 1- and 3-months assessments, no differences were found when compared with the 72 months follow-up (p > 0.05). A single injection of BoNT-A presents long-term effects in reducing pain in persistent MFP-TMD patients, and a reversibility of adverse effects on masticatory-muscle thickness.

Health-related quality of life of institutionalized older adults: Influence of physical, nutritional and self-perceived health status.

INTRODUCTION: Institutionalized older adults have higher risks of diseases and worse health-related quality of life (HRQoL) than noninstitutionalized. OBJECTIVE: To evaluate the influence of physical state, nutritional status and self-perceived general health and oral health on the quality of life of institutionalized older adults in two Brazilian cities. METHODS: A multicenter cross-sectional study was conducted in 17 homes for the aged of two Brazilian cities. Six trained researchers interviewed 344 older adults. The performance of activities of daily living (Katz scale) and frailty status (Fried scale) were applied to evaluate the physical state. The Mini Nutritional Assessment Short-Form (MNA-SF®) and the body composition were used to screening the nutritional status. A hand dynamometer was used to measure the dominant hand grip strength. The 12-Item Short Form Survey for self-perceived health (SF-12) was used to determine the HRQoL. A Likert scale was used to assess the general and oral health self-perception. Multiple Poisson regression model was applied to analyze the data (α = 0.05). RESULTS: The mean (SD) score of the SF-12 was 60.89 (14.50) points. The factors associated with the highest SF-12 score were being able to walk, being nonfrail, being normal nourished, taking fewer medications, having greater dominant hand grip strength and higher self- perceived general health (p < 0.05). CONCLUSION: Better HRQoL in institutionalized older adults was associated with better physical state, nutritional status and self-perceived general health.

Masticatory function in nursing home residents: Correlation with the nutritional status and oral health-related quality of life.

BACKGROUND: Masticatory function of institutionalised elders and its relationship with nutrition and oral health-related quality of life (OHRQoL) are unknown. OBJECTIVES: This multicentre cross-sectional study evaluated the influence of the presence of teeth and dentures on masticatory function (masticatory performance and swallowing threshold) in institutionalised elders. Correlation of masticatory function with nutrition and OHRQoL was also verified. METHODS: Older adults (n = 344; mean age (SD) = 77.70 (9.10)), selected from nursing homes in two Brazilian cities, were classified as edentulous with or without complete dentures (CDs), and partially dentate with or without prosthesis. Masticatory performance was assessed using a two-colour chewing gum. Swallowing threshold was set by the number of chewing cycles performed until swallowing 3.7 g of peanuts. Nutrition was screened by Mini-Nutritional Assessment-Short Form and body composition. OHRQoL was evaluated through Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-14). The Kruskal-Wallis test and Spearman's correlation were used (α = 0.05). RESULTS: Edentulous elders without CDs had lower masticatory performance than those with CDs and partially dentate with or without prosthesis (P < .05). Swallowing threshold of edentulous elders with CDs and partially dentate with prosthesis was greater than edentulous elders without CDs and partially dentate without prosthesis (P < .05). Masticatory function was not correlated with nutrition. Masticatory performance was correlated (P < .05) with GOHAI (r2  = -.154) and swallowing threshold with GOHAI (r2  = .162) and OHIP-14 (r2  = -.146). CONCLUSION: The absence of teeth and dentures negatively affected the masticatory function. Although the masticatory function was not correlated with institutionalised elders' nutrition, their OHRQoL was negatively impacted.

Association of sleep bruxism with oral health-related quality of life and sleep quality.

OBJECTIVES: To compare the oral health-related quality of life (OHRQoL) and sleep quality of subjects with and without sleep bruxism (SB). MATERIALS AND METHODS: Participants of both genders were assigned as bruxers (n = 30, age 21-45 years) and non-bruxers (n = 30, age 24-40 years). SB was clinically diagnosed and confirmed with an electromyography/electrocardiograph portable device (Bruxoff). The OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14). The sleep quality was determined using the Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires. OHIP-14, PSQI, and ESS data were analyzed by one-way ANOVA, considering a significance level of 5%. RESULTS: Bruxers had worse OHRQoL (mean = 16.43) than controls (mean = 4.1), with an effect size (ES) of 1.58. Moreover, SB volunteers showed the highest PSQI scores (mean = 7.07; ES = 0.82) and excessive daytime sleepiness (mean = 10.33; ES = 0.65), compared to non-bruxers (means = 4.7 and 7.8, respectively). CONCLUSIONS: SB may be associated with a negative impact on OHRQoL and sleep quality. CLINICAL RELEVANCE: Determining that SB may have a marked role in OHRQoL and sleep quality is important for dental professionals establish proper multifactorial management, and understand patient-related psychosocial aspects.