Mouth Opening Research Articles

Experimental Study on Fracture Properties of Self-Compacting Concrete Containing Red Mud Waste and Different Steel Fiber Types

This study aims to investigate the effect of integrating red mud (RM) waste and different types of steel fibers on the fracture toughness characteristics of self-compacting concrete (SCC). A total of 24 specimens consisting of notched SCC beams with various steel fibers (measuring 100 × 100 × 500 mm) are subjected to a three-point bending test. This study examines five various fiber types characterized by varying shapes and aspect ratios. These fiber types include the hook-end fiber with lengths of 60 and 30 mm, the long straight fiber with lengths of 21 and 13 mm, and the flat-end fiber. Six concrete mixtures, each incorporating fibers with 1% of the volume percentage, are examined. RM is used at a replacement rate of 20% of the mass of cement. Another objective of the study is to analyze the mechanical and fresh characteristics of concrete. The findings indicate that the incorporation of steel fiber has an adverse effect on the fresh concrete characteristics of SCC. The presence of steel fiber results in enhanced mechanical properties, peak loads, and deflection at the point of failure, in addition to an increase in the crack mouth opening displacement. The fracture toughness of SCC mixtures is also influenced by the presence of steel fiber.

Clinical outcomes of patients with unilateral internal derangement of the temporomandibular joint following arthrocentesis and stabilization splint therapy

BackgroundThe management of internal derangement (ID) of the TMJ is challenging because of multiple etiologic factors and varying degrees of severity. The aim of this study was to evaluate the clinical outcomes of patients with unilateral ID treated with arthrocentesis and stabilization splint therapy during a 6-month period.MethodsA total of 105 patients (87 females, 18 males) with unilateral ID were included in this study. Patients were divided into unilateral anterior disc displacement with reduction (ADDwR) and unilateral anterior disc displacement without reduction (ADDwoR). Patients with ADDwoR were subdivided according to the erosive bone changes. Objective parameters on mandibular movement and subjective parameters on pain were obtained and assessed.Their clinical outcomes before and after arthrocentesis and stabilization splint therapy were compared with the chi-square, Fisher’s exact test, paired t-test, or Wilcoxon singed-rank test.ResultsAll objective parameters of unilateral ID patients significantly increased at the 6-month follow-up. The differences in mean visual analog scale (VAS) pain scores were statistically significant in all subjective variables (p < 0.01). In joints with ADDwoR, preoperative maximal mouth opening, and maximal protrusive movement in both groups, with erosive and non-erosive changes were significantly increased after 6 months (p < 0.01). However, right and left maximal lateral movement increased after treatment in both groups but without significant differences. All VAS pain scores on jaw movement and palpation of associated muscles showed a significant decrease regardless of erosive changes.ConclusionsThe combination of arthrocentesis and subsequent stabilization splint therapy was shown to be highly effective in pain reduction and improvement of mandibular movements in both unilateral ADDwR and ADDwoR, as well as in cases with both erosive and non-erosive bony changes associated with unilateral ADDwoR.

Fracture mechanical properties and interfacial characteristics of engineered cementitious composites containing coarse aggregate

Engineered cementitious composites (ECC) have significantly high deformability, but their application in the field of engineered crack prevention is severely limited by their high shrinkage and high cost. To address this issue, a safer and more economical ECC was designed in this paper by adding coarse aggregate (CA) into the ECC matrix (i.e., ECC-CA). Then, experimental studies on the fracture properties of ECC-CA were carried out from both macroscopic and microscopic perspectives, by considering four CA mass contents and three CA particle sizes. The results show that ECC-CA maintains good mechanical properties and deformation capacity as ECC. Its crack mouth opening displacement corresponding to the largest particle size (13–17 mm) and the largest mass content (30 %) is equivalent to 47.8 % of that of ECC, which is about 40 times higher than that of conventional concrete. Further, the interfacial transition zone characteristics between each phase medium and matrix were analyzed in ECC-CA for the purpose of clarifying the crack initiation and evolution trends, elucidating the influence of CA on the fracture mechanism of ECC-CA (i.e., fiber cage effect) based on both macroscopic performance and microscopic characteristics.

Different temperature regimes during gastrulation and neurulation influence developmental larval plasticity and survival at mouth opening in longfin yellowtail (Seriola rivoliana)

ABSTRACT We investigated if different temperature regimes during embryogenesis could influence the morphology, the occurrence of oedema, energy reserves, and survival in Seriola rivoliana larvae at mouth opening. Eggs were incubated at six constant (20, 22, 24, 26, 28, 30 °C) and two oscillating (21⇄29 °C) temperatures: decreasing starting (DS) and increasing starting (IS), which resulted in two opposite temperature fluctuating waves: gastrulation and neurulation. Total body length, head length and height were significantly influenced by temperature. Oscillation temperatures reduced major and severe oedema incidence. Mouth gape size was neither influenced by temperature nor by oedema condition. Larvae in DS had the lowest survival (36%) and grew as larvae at 20–24 °C. In contrast, IS showed the highest survival (76%) with larval size similar to 26–28 °C. Constant 28 °C had the lowest survival (48%), which resembled the increase up to 29 °C in DS during neurulation. In contrast, 22–26 °C had higher survivals (55–61%), which resembled the decrease down to 21 °C in IS during neurulation. Larvae at 20 °C and DS had the highest lipids consumption, which suggested detrimental effects on metabolism during gastrulation. Gastrulation and neurulation were likely critical survival and growth-developmental plasticity periods in this species.

162 Outcomes Following Surgical Management of Temporomandibular Disorder in a Specialist Setting

Abstract Introduction Temporomandibular joint (TMJ) dysfunction is an increasingly prevalent condition affecting 31% of adults and 11% of children/adolescents. Initial management is usually conservative with physiotherapy, diet modification, analgesics, and education. 5-10% of patients require surgical treatment. TMJ arthroscopies allows minimally invasive surgery for joints with early degenerative changes. The purpose is to provide symptomatic relief and improve function. Aim To evaluate clinical outcomes 3 months post TMJ surgery. Method Retrospective data was collected from the notes of all patients who underwent procedures between February 2019 and August 2023. Data collected included pain/diet scores, mouth opening, Wilkes staging, clinical diagnosis and the use of intra-articular Platelet Rich Plasma or steroid injections. Results 147 procedures were undertaken. The average age was 43 with an 83.0% female predominance. Overall, 1 arthroplasty, 1 eminectomy, 11 total joint replacements and 134 arthroscopies with/without arthrocentesis were performed with positive results. Mouth opening scores increasing from an average of 27.4mm to 29.5mm, diet scores from 5.8 to 7.5 and pain scores reducing from 7.1 to 4.4. At the 3 month follow up, 53 patients were planned for further monitoring, 32 discharged, 9 listed for a further arthroscopy and 15 for a TMJ replacement. Conclusions Surgical management provides good outcomes and Level 2 arthroscopy is an essential tool in the armamentarium. Development of an integrated physiotherapy pathway as well as educational leaflets has been vital. Educational Leaflets improved patient experience with re-audit results showing positive outcomes. Involvement of clinical psychologists is required for a multidisciplinary approach.

Evaluation of masticatory muscle function in the treatment dynamics of patients with myofascial pain syndrome

Relevance. Myofascial pain syndrome (MPS) often progresses to a chronic form that is challenging to treat with established methods. This issue is well known to dentists and frequently leads to frustration despite significant efforts to advance knowledge in the fields of etiopathogenesis, diagnosis, and therapy. Most treatment protocols focus on normalizing physiological parameters, such as restoring masticatory function, achieving stable occlusal relationships, alleviating pain, and enhancing the psychological well-being of these patients. Therefore, the need for non-invasive diagnostics to assess functional activity and monitor the condition of masticatory muscles during treatment is crucial. This study aims to address this need.Materials and methods. The examination and treatment of 64 patients with myofascial pain syndrome were conducted in two stages—clinical and electromyographic. During the clinical examination, tenderness of the masticatory muscles during palpation and the degree of mouth opening were assessed. The electromyographic research was also conducted in two stages. The first stage assessed the average amplitude and total biopotential of the masticatory and temporal muscles on both the right and left sides. The second stage evaluated the symmetry index of the masticatory muscles, as well as torsion and masseter indices. The first group received conventional treatment combined with laser therapy, while the second group received ozone therapy and kinesiology taping in addition to the conventional therapy.Results. In the short-term observations over 14 days, both groups achieved positive results. However, patients undergoing ozone therapy and kinesiology taping showed statistically significant improvements in their parameters by the third day of observation compared to their baseline values.Conclusion. For diagnosing this pathology, it is advisable to incorporate electromyography into the examination protocol to allow non-invasive evaluation of the functional activity of the masticatory muscles. For treating myofascial pain syndrome, minimally invasive methods with anti-inflammatory, analgesic, and muscle relaxant effects are recommended. While all treatment methods yielded favorable results, ozone therapy combined with kinesiology taping effectively eliminated both subjective and objective symptoms in this patient category.

Kinematic performance of a novel temporomandibular joint replacement prosthesis under bite-force conditions in dogs and cats.

To evaluate the kinematics and stability of the temporomandibular joint (TMJ) of cats and dogs with and without a TMJ replacement (TMJR) prosthesis under simulated bite forces and mouth opening. Sixteen cadaver skulls from domestic cats (n = 8) and medium- to large-breed dogs (n = 8). Intact TMJs were tested. Following condylectomy and coronoidectomy, the skulls were fitted with a TMJR prosthesis unilaterally and retested. Prosthesis was similarly implanted in the contralateral TMJ in 4 cats and 4 dogs before retesting. Left and right bite motions were evaluated before bite contact to peak bite force (200 N in dogs, 63 N in cats). Mouth opening motion was recorded. Mandibular displacement under load was evaluated in 3 orthogonal planes. Maximal displacement was compared between TMJR groups and native TMJ. Prosthesis-bone motion of the temporal and mandibular components was evaluated during simulated bites and mouth opening. TMJR resulted in joint motion not demonstrably different from the native TMJ, with the ability to fully open and close the mouth and with minimal laterotrusion. The TMJR prosthesis demonstrated similar stability after unilateral and bilateral replacement during bite force and with an open mouth. Mean implant-bone motion during bite simulations for the temporal and mandibular TMJR components was ≤ 60 µm in cats and ≤ 30 µm in dogs. A novel TMJR can be implanted and allows normal jaw motion. Joint stability is maintained after TMJR implantation in the TMJ of dogs and cats TMJ that is devoid of muscular support.

Vascular Leiomyoma of oral cavity: A case report in young male patient

Abstract Vascular Leiomyoma of the oral cavity is an uncommon benign soft tissue neoplasia arising from the tunica media of the smooth muscle cells. We reported a rare case of Vascular Leiomyoma involving the retromolar trigone area of a young man. A 24-year-old male presented with a slowly growing mass in the retromolar area, which was associated with pain and difficulty in opening of mouth and eating and drinking. A punch biopsy was taken and sent for histopathological examination which revealed a benign angiomatous lesion. The mass was excised, and the adjoining area was curetted. Histopathological examination confirmed the diagnosis of Vascular Leiomyoma. The immunohistochemistry of cells shows: alpha-smooth muscle (+); vimentin (+), Desmin, actin (+), and S100 (−). Angioleiomyomas are benign lesions, but malignant transformation is a possibility so careful histologic inspection is necessary to distinguish these lesions from their malignant counterpart.

Effects of botulinum toxin type A in patients with painful temporomandibular joint disorders: a systematic review and meta-analysis.

To assess the therapeutic efficacy of botulinum toxin type A (BTX-A) for managing myofascial pain related to temporomandibular disorders (TMDs). This study was conducted according to the PRISMA 2020 statement guidelines. The PubMed, Embase, and Cochrane Library databases were searched. Only randomized controlled trials were included. The primary outcome was a pain score on the visual analog scale, and the secondary outcomes were maximum mouth opening and adverse effects. The Cochrane risk of bias tool was used to assess risk bias. A meta-analysis of studies with the same interventions, controls, assessment methods, and follow-up durations was performed. A total of 519 studies were retrieved, of which 20 randomized controlled trials were included in the qualitative analysis and six were included in the meta-analysis. The results showed that, compared with placebo, BTX-A injection was more effective at relieving myofascial pain, and its effect was similar to that of conventional methods. However, there was no difference in maximum mouth opening between the two groups. After the study assessment with the RoB 2.0 tool, six studies showed a low risk of bias, 13 studies showed some concerns regarding the reported results, and only one study showed a high risk of bias. Adverse effects of BTX-A injection were observed in four studies. In conclusion, BTX-A is effective at relieving pain in TMD patients but does not improve mouth opening. To minimize adverse effects, we recommend a low dose of BTX-A for TMD patients who do not experience complete pain relief from conservative treatments.

Use of Video Laryngoscope during Intubation in Patients with Non Difficult Airway

Endotracheal intubation using laryngoscope which is an important skill required for all anesthesiologist in day to day practice is considered as gold standard for airway management. Various methods can be used for endotracheal intubation of which direct laryngoscopy is most commonly used and video laryngoscopy is an alternative. The success rate of tracheal intubation in cases of difficult airways has increased dramatically with the use of video laryngoscopes and improvements in the degree of glottic exposure. Hence this study aims to evaluate the laryngoscopic view, ease of intubation and haemodynamic changes during intubation using video laryngoscope in patients with non difficult airway. This interventional study was conducted in fifty nine patients of ASA I or II, ≥18 yrs of age with Mallampati grade I or II, mouth opening &gt;3 cms, thyromental distance &gt;6.5 cms of either sex planned for elective surgery under general anesthesia. General anesthesia was induced with similar doses for all the patients and intubated using video laryngoscope. Cormack-Lehane grade, intubation time, number of attempts for intubation and haemodynamic parameters were recorded. In this study, all patients had grade I type of laryngeal view during laryngoscopy and the mean time required for intubation was 18.93±7.08 sec. Out of 59 patients, 58 (98.3%) were intubated in single attempt and there was no significant haemodynamic changes during laryngoscopy with video laryngoscope. Hence, the result of this study concluded that endotracheal intubation using video laryngoscope provides good laryngoscopic view, better intubating condition for the ease of intubation without significant haemodynamic changes, thus considering worth for intubation of non difficult airway.

Successful Anesthesia Management in Landau–Kleffner Syndrome Undergoing Laparoscopic Surgery: A Case Report

Abstract Landau–Kleffner syndrome (LKS), also known as acquired epileptic aphasia, is a childhood disease associated with acquired aphasia and epileptiform abnormalities on the electroencephalographic. We report the uneventful anesthesia management of a 17-year-old female patient with LKS syndrome. Her vital signs and laboratory results were normal, and plasma levels of valproic acid (73.6 µg/mL) were within therapeutic limits. She had mild micrognathia, short thyromental distance, and normal neck movements and mouth opening. An intravenous induction was performed with 100 mg lidocaine, 100 µg fentanyl, 200 mg propofol, and 60 mg rocuronium intravenously. After preoxygenation with 80% O2 for 3 min, she was intubated without complications with a number 7.5 mm endotracheal tube connected to a ventilator. Anesthesia maintenance was provided with 2.2% sevoflurane and 50% oxygen–50% air mixture, 0.01–0.05 μg/kg/min infusion of remifentanil. The target partial pressure of carbon dioxide was 30–35 mm Hg. Care was taken to ensure that intra-abdominal pressure did not exceed 14 mm Hg. Spontaneous breathing returned in 5 min after discontinuation of sevoflurane. She was extubated after following commands and transferred to the post-anesthesia care unit. It is unknown whether general anesthesia has a short- or long-term effect on patients with LKS. Since epileptic seizures are essential in patients with LKS, the correct selection of anesthetic agents is significant. In addition, hypoxemia, hypercarbia, hypocapnia, high positive end-expiratory pressure, and acidosis should all be avoided as they may trigger seizure activity.

Enhancing the Properties of Steel Fiber Self-Compacting NaOH-Based Geopolymer Concrete with the Addition of Metakaolin

There is a demand for innovative construction materials that offer enhanced mechanical characteristics while also being cost-effective and environmentally friendly. This paper examines the fresh properties and mechanical properties of geopolymerized self-compacting concrete (SCC) reinforced with steel fibers, containing 0–100% metakaolin (MK) by mass, as an eco-friendly substitute for Portland cement. SCC combinations included one or more waste cementitious materials (WCMs), such as metakaolin (MK), NaOH as an alkaline activity, and double-hook end steel fibers. For every NaOH geopolymer SCC blend, the mechanical characteristics (compressive strength, splitting tensile strength, flexural strength), as well as the new properties (lump flow, V-Funnel, L-box test), were read up. The findings indicate that combining metakaolin and steel fibers reduces the flowability of NaOH-based geopolymer SCC. On the other hand, incorporating MK and steel fibers enhances the compressive and flexural strength of NaOH-based geopolymer SCC with 25% metakaolin and 0.3% steel fiber. In contrast to the fiber-reinforced NaOH-based geopolymer SCC samples, which could transfer a sizable load even when the crack mouth opening deflection rose at flexural strength, the fiber-free SCC samples showed a brittle and abrupt fracture. The findings showed that the addition of NaOH as an alkaline activator, MK, and steel fiber had a negative impact on the fresh state properties; however, their combined use greatly enhanced the bond strength and flexural performance of the NaOH geopolymer SCC specimens. Doi: 10.28991/CEJ-2024-010-07-011 Full Text: PDF

Assessment of Temporomandibular Joint Disorders: Retrospective Study of Clinical Presentations.

This retrospective research aimed to assess the clinical presentations and management strategies for "temporomandibular joint (TMJ)" disorders. Medical records of patients diagnosed with TMJ disorders between 2017 and 2022 were retrospectively analyzed. Data collected included demographic information, clinical symptoms, radiographic findings, treatment modalities, and treatment outcomes. Statistical analysis was performed to examine associations between variables and treatment outcomes. A total of 150 patients were included in the research, with a mean age of 42.5 years. The most common presenting symptoms were pain (80.0%), limited mouth opening (60.0%), and clicking/popping sounds (40.0%). Muscle tenderness (53.3%) and jaw deviation (20.0%) were also observed. Treatment modalities encompassed pharmacotherapy, physical therapy, occlusal splints, and surgical interventions. Statistical analysis revealed significant associations between certain demographic characteristics and clinical presentations. This research provides valuable insights into the clinical presentations and management strategies for TMJ disorders. Pain, limited mouth opening, clicking/popping sounds, muscle tenderness, and jaw deviation were among the common symptoms observed. A multi-disciplinary approach involving various healthcare professionals is essential to optimize patient outcomes and improve quality of life for individuals affected by TMJ disorders.

Treatment of myofascial pain and dysfunction using botulinum toxin A: a prospective study

Abstract Purpose We prospectively assessed the effects of botulinum toxin type-A (BTX-A) on primary and secondary outcomes in a population of refractory myofascial pain and dysfunction patients when conservative management had proven ineffective. Methods In this study, 26 patients with masticatory myofascial pain, who were refractory to conservative management, were enrolled prospectively to evaluate responses following the injection of botulinum toxin-A (BTX-A). Masseter muscles were injected with 30 units BTX-A and 20 units into the temporalis muscles. Pain, tenderness to palpation, and oral function were evaluated subjectively using a visual analog scale (VAS). Objective outcomes of maximal mouth opening (MMO) and reduction in total facial width after injection with BTX-A were measured. Participants were reassessed at 1-week, 1, 3, and 6-month intervals. A linear mixed-effect model was employed to assess the level of correlation (dependence) among different outcomes. Results Administration of BTX-A had a significant strong positive correlation with the reduction of pain (Phi = 0.641, P &lt; 0.0005); significant strong positive correlation with increase in oral function (Phi = 0.738, P &lt; 0.0015); significant strong positive correlation with increase in maximal mouth opening (Phi = 0.645, P &lt; 0.0085); significant strong positive correlation with tenderness to palpation (Phi = 0.510, P &lt; 0.0011); and significant strong positive correlation with reduction in facial width (Phi = 0.565, P &lt; 0.0001). Conclusion The results from this study demonstrate that BTX-A administration may provide a safe and effective means to treat myofascial pain from hyperfunctioning masticatory muscles. It is not recommended to replace first-line treatment but may provide relief from chronic facial pain if properly administered in patients where standard conservative management has been unsuccessful.

DIFFICULT MASK VENTILATION IN OBESE PATIENTS: ANALYSIS OF PREDICTIVE FACTOR

American Society of Anesthesiologists (ASA), DMV is defined as the clinical situation. developing when it not possible for the anesthesiologist to provide adequate ventilation because of one or more of the following problems: inadequate mask seal, excessive gas lead or excessive resistance to the ingress or egress of gas. Materials and Methods:-This is a prospective randomised observational study in patients with morbid obesity (n = 90body mass index[BMI] &gt;30 kg/m2. Patients were preoperatively assessed for age, height, weight, BMI,modified Mallampati test results,mouth opening [inter- incisor gap (cm)], thyromental distance (cm), sternomental distance (cm), mandibular protrusion,mandibular length (ML), neck circumference (NC) by anesthesiologist. Mask ventilation was graded according to four point Han scale. Conclusion:In conclusion, male sex, snoring history, NC ≥43 cm, ML ≥9 cm and NC/TMD &lt;5 cm were correlated with DMV in obese patients.According to the current investigation the three predictive factors are strongly associated.In the present study we demonstrated that (a)age &gt;49 years, (B)Neck circumference &gt;43cm,and (C) and short neck are strongly associated with DMV in obese patients.

The Efficacy of Ketorolac Buccal Infiltration Following Surgical Removal of The Impacted Mandibular Third Molar on Postoperative Pain and Trismus

Surgical extraction of the mandibular third molars are widely carried out in dental practice. The procedure is associated with postoperative complications such as pain and trismus. Objective: The study aimed to assess ketorolac's analgesic and anti-inflammatory efficacy after surgical extraction of the mandibular third molar. Methods: The study was designed as a double-blinded, randomized prospective clinical study in which 44 patients who required surgical removal of an impacted mandibular third molar were included. They were randomly distributed into two groups (the study and the control/placebo groups), with 22 patients in each group. Immediately after the last stitch, the study group received 30mg/1 ml of ketorolac, while the control group received 1 ml of normal saline at the buccal mucosa near the extraction site of both groups. The mouth openings of the patients were recorded preoperatively, and on the 2nd and 7th postoperative days, a comparison between the two groups was made. The pain level was assessed postoperatively using the numeric rating scale. Results: The comparison between the two groups by pain score showed that there was a statistically significant difference (P = 0.001) in postoperative pain between the study and control groups at all times after the operation. Regarding the trismus, there was no significant difference (p&gt;0.05) between both groups on the 2nd and 7th postoperative days. Conclusion: Ketorolac buccal infiltration is effective for postoperative pain following third molar surgery but has no significant effect on trismus.

Coupled effects of UV radiation and freeze–thaw cycles on the fracture behavior of asphalt concrete

The Qinghai-Tibet Plateau in China is characterized by extreme climate conditions, including intense ultraviolet (UV) radiation, frequent freeze–thaw cycles (FTCs), and significant temperature fluctuations. These conditions contribute to severe cracking in asphalt pavements. This study aims to investigate the impact of coupled damage from UV radiation and FTCs on the fracture behavior of asphalt concrete. To simulate the coupled environmental damage (CED) experienced by asphalt pavement in the field, an alternating two-factor laboratory procedure was developed. This procedure reflects the climatic conditions of the Qinghai-Tibet Plateau. The semi-circular bending test, combined with digital image correlation technology, was employed to evaluate the effects of temperature and CED cycles on fracture-related parameters of asphalt concrete. These parameters include the load–displacement curve, fracture toughness, and fracture energy. Fracture behavioral characteristics such as horizontal strain, crack length, crack propagation path, and crack mouth opening displacement were also analyzed. The results indicate that coupled damage from UV radiation and FTCs significantly weakened the fracture resistance of asphalt concrete. Compared with other fracture-related indicators, the most significant reduction observed was the fracture energy of 68.1%. The two environmental factors exhibited a mutually reinforcing effect on the fracture properties of asphalt concrete, with low temperatures further intensifying their influence. CED cycles delayed the initiation of cracks in asphalt concrete but accelerated crack propagation. This led to a reduction in time to failure by up to 57.6% and a maximum reduction in horizontal strain of 24%. Additionally, the cracking propagation path of asphalt concrete became more linear with increased crack mouth opening displacement. Future research should focus on the evolution of damage accumulation in asphalt concrete under CED cycles, with the goal of establishing predictive models for long-term service life.

Effectiveness of mHealth intervention for trismus exercise in patients with head and neck cancer undergoing proton and heavy ion therapy: a randomized control trial.

This study aimed to compare the effects of a mobile health intervention based on social cognitive theory with standard care on maximal mouth opening, exercise compliance, and self-efficacy in patients receiving proton and heavy ion therapy for head and neck cancer. This open-label, parallel-group, randomized, superiority trial involved a self-developed "Health Enjoy System" intervention. We assessed maximal mouth opening, exercise compliance, and self-efficacy at baseline (T0), post-treatment (T1), and at 1 month (T2) and 3 months (T3) after radiotherapy. Generalized estimating equations were used to analyze differences between the groups over time, with results reported as P values and 95% confidence intervals (CIs). The study included 44 participants. At T3, the intervention group showed a 6 mm greater increase in maximal interincisal opening than the control group (mean difference = 6.0, 95% CI = 2.4 to 9.5, P = 0.001). There was also a significant difference in exercise compliance between the groups (mean difference = 31.7, 95% CI = 4.6 to 58.8, P = 0.022). However, no significant difference in self-efficacy was found between the groups. This study demonstrated that an mHealth intervention incorporating behavior change theory could effectively enhance or maintain maximal mouth opening in patients undergoing proton and heavy ion therapy for head and neck cancer in China. This approach provides valuable support during and after treatment. ChiCTR: ChiCTR2300067550. Registered 11 Jan 2023.

Does Piroxicam have an Added Benefit on Arthrocentesis in the Management of Internal Derangement in Female Patients?: A Randomized Clinical Trial

Background: Arthrocentesis is an accepted treatment modality for internal derangement. Piroxicam is an NSAID that can be injected into the TMJ. Purpose: The primary objective of this study was to improve mouth opening, and the secondary objective was to decrease TMD-associated pain. Methods: A randomized controlled trial (RCT) was performed on patients suffering from anterior disk displacement with reduction. Patients were divided into 2 groups: a study in which patients underwent arthrocentesis followed by an injection of 20 mg of piroxicam. Independent and paired sample t-tests were used to assess mouth opening. The χ2 test was used to assess the pain data; the P value was fixed at 0.05. Results: Twenty female patients were included in the current study. To ensure that covariables did not affect the study results, an intergroup assessment using Student’s t-test for unassisted mouth opening without pain preoperatively showed that the maximum unassisted opening without pain was 20.8±3.9 mm in the control group, and the average maximum unassisted opening without pain was 19.7±1.1 mm in the case study group. The unassisted mouth opening in the control group was 30.9±3.4 mm and 31.8±3.6 mm, respectively, and there was no significant difference (P=0.6, 95% CI: −2.5 to 4.32). There was no significant difference in pain between the study and control groups (P=0.3). Conclusion and Recommendation: Based on the results of the present study, arthrocentesis using piroxicam does not have any benefit over conventional arthrocentesis.

Validity and reliability of the Turkish Version of the Oral Behaviors Checklist.

The aim of this study was to investigate the validity and reliability of the Turkish version of the Oral Behavior Checklist (OBC-TR). The study included 223 patients with temporomandibular disorders (TMDs) and 94 individuals without TMD. Face and content validity were analyzed. Structural (with confirmatory factor analysis [CFA]), convergent (with pain intensity, Fonseca Anamnestic Index [FAI], Hospital Anxiety and Depression Scale [HADS], and Oral Health Impact Profile [OHIP-14]), divergent (with active pain-free maximum mouth opening [MMO]), and discriminant validity were investigated to evaluate the construct validity. Cronbach's alpha for internal consistency and the intraclass correlation coefficient (ICC) for test-retest reliability were computed. Face and content validity were satisfactory. The CFA has verified the structural validity of the OBC-TR. Strong associations between the OBC-TR score and pain intensity (r = 0.88), FAI (r = 0.90), HADS (r = 0.82-0.86), and OHIP-14 (r = 0.83) scores, and MMO (r = -0.85) verified the convergent and divergent validity of the OBC-TR. Concerning discriminant validity, the OBC-TR discriminated between patients with TMD and individuals without TMD (p < 0.05). Internal consistency (Cronbach's alpha = 0.89) and test-retest reliability (ICC = 0.91) were satisfactory. The OBC-TR is a valid and reliable instrument to measure the frequency of oral parafunctional behaviors in Turkish-speaking patients with TMD.