Mouth Opening Research Articles

Intramuscular Botulinum Toxin as an Adjunct to Arthrocentesis with Viscosupplementation in Temporomandibular Disorders: A Proof-of-Concept Case-Control Investigation.

The reduction in joint load is a potential beneficial factor in managing osteoarthritis of the temporomandibular joint (TMJ). This paper aims to compare the effectiveness of the intramuscular injection of botulinum toxin (BTX-A) as an adjunct to TMJ arthrocentesis plus viscosupplementation with arthrocentesis plus viscosupplementation alone in the management of TMJ osteoarthritis. A pilot clinical retrospective study examined TMJ osteoarthritis treatments. Patients were divided into two groups: Group A received BTX-A injections and arthrocentesis with viscosupplementation, while Group B received only arthrocentesis with viscosupplementation. The study assessed outcomes based on mouth opening (MO), pain at rest (PR), pain at mastication (PF), and masticatory efficiency (ME) at various time points (baseline (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4)) up to 2 months after treatment. The study included two groups, each with five patients. Group A received five weekly sessions of arthrocentesis plus viscosupplementation and a single BTX-A injection during the first arthrocentesis appointment. Group B underwent the five-session protocol of arthrocentesis plus viscosupplementation alone. MO, PF, PR, and ME improved quickly in T2 in both groups, but the improvement was of greater importance over the following weeks and lasted longer in Group A. Arthrocentesis with viscosupplementation associated with BTX-A was found to be more effective than arthrocentesis alone in improving clinical outcomes. This suggests that patients with TMJ osteoarthritis and myofascial pain may benefit from reduced muscle tone and joint load.

Analyzing effects on anterior open bite in twins by PLS-SEM and sobel test

ObjectiveThis study aimed to assess the different pathways between predictor factors such as zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding related to anterior open bite (AOB) in twins.MethodsThe study was conducted in monozygotic (MZ) and dizygotic (DZ) twin children aged 3–15 years. AOB, atypical swallowing, mouth breathing, feeding type, duration of bottle use, and mouth opening status during sleep were recorded during oral examination. Partial least squares structural equation model (PLS-SEM) and sobel tests were performed to assess the total and indirect effects among the variables on AOB.ResultsA total of 404 children (29.2% MZ;70.8% DZ) participated in this study. The effect of zygosity on mouth breathing in the PLS-SEM model was statistically significant. Conversely, it was determined that mouth breathing effected that atypical swallowing (p = 0.001). Atypical swallowing triggered AOB (p = 0.001). The atypical swallowing has a mediation effect between AOB and mouth breathing (p = 0.020). Mouth breathing causes atypical swallowing and therefore indirectly increases the likelihood of AOB. While breastfeeding decreases AOB incidence (p = 0.023), bottle feeding increases AOB incidence (p = 0.046). The sobel tests show that the fully mediator variable feature of mouth breathing is statistically significant in the negative relation between zygosity and atypical swallowing.ConclusionThe PLS-SEM model showed that mouth breathing triggers atypical swallowing and atypical swallowing triggers AOB. As a result of this chain of relationships, an indirect effect of zygosity on AOB was observed. According to sobel tests, zygosity has an indirect effect on atypical swallowing through mouth breathing, while mouth breathing has a positive indirect effect on AOB through atypical swallowing.Clinical relevanceThis study identified the relationships between different factors and the presence of AOB. The findings of this study demonstrate in detail the relationships between AOB and zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding. Brestfeeding has a reducing effect on the frequency of AOB. Among the nutritional forms, breastfeeding ensures the proper development of the stomatognathic system by working the oro-facial muscles.

The recycling potential of fibre reinforced concrete with 4D Dramix® fibres: Experimental analysis and model verification

This experimental study aims to advance sustainable construction practices by exploring the recycling potential of steel fibre reinforced concrete with 4D Dramix® fibres from the company Bekaert. In this research steel fibres from reinforced concrete specimens with varying fibre quantities of two 4D Dramix® fibre types, more precisely, the 55/50 BG and 65/50 BG fibres are recycled. A jaw crusher at the recycling company AC Materials (Flanders, Belgium) and an impact crusher at the research and development company CTP (Wallonia, Belgium) are employed to optimize the quantity and quality of the recycled fibres. Subsequently, the recycled steel fibres are reintegrated into fresh concrete mixes. The recycling process of the fibres results in a general decrease of the residual tensile strength capacity for the concrete mixtures with recycled fibres (RSFRC) compared to those with new fibres (NSFRC), and the deviation increases with increasing crack mouth opening displacement (CMOD). It was found that fibres recovered by the impact crushing process are (generally) shorter than those obtained from the jaw crusher, which results in a fibre reinforced concrete (FRC) with a somewhat lower post-cracking tensile strength. Nevertheless, most recycled fibres retain 75 % of their original capacity, considering the mean residual tensile strength of the FRC mixtures. Consequently, current findings show promising results for the recycling potential of steel fibres and the residual strength behaviour of RSFRC compared to NSFRC. Additionally, this study highlights the potential for an improved constitutive tensile model for FRC mixtures, where the design parameters ka and kc can be estimated based on the fR3k/fR1k-ratio.

Effects of different treatments for obstructive sleep apnea on temporomandibular joint: a randomized clinical trial

BackgroundIn recent years, obstructive sleep apnea (OSA) has been increasingly recognized as a significant health concern. No previous studies assessed the effect of recommended treatment modalities of patients with OSA on the temporomandibular joint (TMJ). The current study aimed to evaluate the effect of different treatment modalities of OSA, such as continuous positive airway pressure (CPAP), mandibular advancement device (MAD), and oral myofunctional therapy (OMT) on subjective symptoms, clinical, and radiographic signs of temporomandibular disorders.Patients & MethodsThis hospital-based prospective randomized controlled clinical trial study was approved by the institutional review board and formal patient consent, 39 OSA patients, ranging in age from 19 to 56 after confirmation with full night Polysomnography (PSG) with healthy TMJ confirmed clinically and radiographically with magnetic resonance imaging (MRI) were randomly allocated into three treatment groups. Group 1: 13 patients were managed with CPAP after titration, group 2: 13 patients were managed with digitally fabricated MAD, and group 3: 13 patients were managed with OMT. The following parameters were evaluated before and 3 months after the intervention. Pain using a visual analogue scale (VAS), maximum inter-incisal opening (MIO), lateral movements, and clicking sound of TMJ. MRI was done before and 3 months after the intervention.ResultsOut of the 83 patients enrolled, 39 patients completed the treatment. There were no statistically significant differences in lateral jaw movements or clicking, and no significant difference in MRI findings between the three studied groups before and after the intervention. The OMT group showed a statistically significant difference in pain (p = 0.001), and MIO (p = 0.043) where patients experienced mild pain and slight limitation in mouth opening after 3 months of follow-up in comparison to MAD and CPAP groups.ConclusionCPAP and MAD are better for preserving the health of TMJ in the treatment of OSA patients. While OMT showed mild pain and slight limitation of MIO (that is still within the normal range of mouth opening) compared to CPAP and MAD.Trial registrationThe study was listed on www.clinicaltrials.gov with registration number (NCT05510882) on 22/08/2022.

On comparison of fracture energy measured for six hot mix asphalt composite mixtures using force–load line displacement and force–crack mouth opening displacement curves at intermediate temperatures and different loading rates

AbstractThere are two methods for determining the fracture energy (Gf) of hot mix asphalt (HMA) composites at intermediate temperatures: (i) load–crack mouth opening displacement (CMOD) and (ii) load–load line displacement (LLD) curves. The effects of these two methods on the Gf values of different HMA mixtures are investigated at different loading rates and temperatures. A large number of semicircular bend (SCB) specimens were tested under mode I at different temperatures of 5°C, 15°C, and 25°C and loading rates of 1, 5, 10, and 50 mm/min. The three‐dimensional (3D) fracture energy surface plots obtained from the tests revealed that both temperature and loading rate have noticeable effects on the fracture energy, such that Gf values generally increased by increasing the loading rate and reducing the temperature. Also, the Gf values measured by the LLD method were higher than those by the CMOD method for lower temperatures and lower loading rates (i.e., below 10 mm/min). For the higher loading rates, the Gf values determined by the CMOD method were higher than those by the LLD method. Furthermore, the HMA type had meaningful influences on the variations of Gf at different temperatures and loading rates.

Impact of acute therapeutic toxicities on anxiety during radiotherapy among Chinese patients with newly diagnosed nonmetastatic head and neck cancer: A cross-sectional study.

147 Background: Head and neck cancer (HNC) poses a significant threat to both psychological and physical health. This study aimed to depict the anxiety status of Chinese newly diagnosed nonmetastatic HNC patients during radiotherapy (RT) and to examine predictors of anxiety symptoms. Methods: Newly diagnosed nonmetastatic HNC patients who received RT at the Radiation Therapy Center of Sun Yat-sen University Cancer Center from August 23,2023 to August 24,2023 were recruited into this study. Using Zung Self-Rating Anxiety Scale (Zung SAS) to screen anxiety. Twenty-four common acute therapeutic toxicities (18 patient-reported and 6 clinician-rated) were assessed according to European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck 35 (EORTC QLQ-HN35) and Common Terminology Criteria for Adverse Events, fifth version (CTCAE V5.0). Chi-square ( χ2) test and multivariate binary logistic regression stepwise forward selection: likelihood ratio (LR) method were applied to identify factors associated with anxiety. Results: A total of 457 patients were included ultimately. Up to 29.10% of the patients showed varying degrees of anxiety and the average SAS standardized score was 45.66 ± 8.83. Chi-square test manifested that sex, annual household income, fatigue, anorexia, nausea, vomit, pain, dysphagia, sense problems (smell and taste), speech problems, trouble in social eating, trouble in social contact, sexual frustration, teeth problems, difficulty in opening mouth, xerostomia, sticky saliva, coughing, feeling ill, use of analgesics, use of nutritional supplements and weight loss were related to anxiety ( p < 0.05). But multivariate logistic regression only demonstrated fatigue (OR = 3.696, 95% CI = 2.096-6.519), speech problems (OR = 3.247, 95% CI = 1.554-6.783), sexual frustration (OR = 2.029, 95% CI = 1.232-3.341), nausea (OR = 3.075, 95% CI = 1.807-5.234), feeling ill (OR = 2.283, 95% CI = 1.215-4.291), use of nutritional supplements (OR = 1.930, 95% CI = 1.136-3.280) and difficulty in opening mouth (OR = 3.007, 95% CI = 1.081-8.363) as independent predictive factors of anxiety. Conclusions: The Chinese newly diagnosed nonmetastatic HNC patients suffered greatly from anxiety during RT. This study identified the predictive contribution of sociodemographic and clinical characteristics and 24 common acute therapeutic toxicities to the vulnerability to anxiety, which can provide evidence and reference for medical staff to carry out psychological intervention.

Predictors of paediatric difficult intubation according to the experience of a university hospital in a low- and middle-income country: A prospective observational study.

Difficult airway management is one of the main challenges in paediatric anaesthesia, particularly in low- and middle-income countries. The aim of this study was to investigate the main predictors of difficult paediatric intubation. In this observational study, we included all children aged less than five years undergoing intra-abdominal surgery with endotracheal intubation. Patients were divided into two groups according to the incidence of difficult intubation. Then, we investigated predictors for difficult paediatric intubation. We included 217 children, and difficult intubation was observed in 10% of them. Predictors were as follows: Mallampati III-IV class (adjusted odds ratio = 2.21; 95% confidence interval = 1.1-6.4), limited mouth opening (adjusted odds ratio = 2.4; 95% confidence interval = 1.8-3.5), facial dysmorphia (adjusted odds ratio = 2.6; 95% confidence interval = 1.32-7.4) and anaesthesia without muscle relaxant (adjusted odds ratio = 1.8; 95% confidence interval = 1.0-5.1) or without opioids during crash inductions (adjusted odds ratio = 1.7; 95% confidence interval = 1.01-4.8). Facial dysmorphia and limited mouth opening were predictors of difficult intubation in children. Furthermore, it seems that Mallampati class and anaesthesia technique may also predict challenging intubation, which may guide us to change our perioperative practice.

A habitually open mouth posture leads to less affect strength during joy in childhood

AimCompared with children without orofacial disorders, children with a habitual lack of mouth closure and mouth breathing show less frequent and reduced or absent facial expressions. The facial feedback hypothesis states that affective sensation is enhanced by mimic involvement. In this randomized cross-sectional study with and without orofacially disordered children, we investigated the effect of lack of mouth closure on the strength of emotions related to joy, sadness and fear in children. We aimed to determine whether kindergarten and primary school-age children with a lack of mouth closure are less emotionally involved.Materials and MethodWe used facial feedback as an indicator to measure affect intensity in children with and without orofacial disorders. For this purpose, we modified the experimental design of Strack et al. (Strack et al. in J Pers Soc Psychol 54:768–777, 1988), in which the subjects were asked to hold a pencil exclusively with their teeth (experimental group 1, “joy”), with their lips (experimental group 2, “sadness” and “fear”) or with their nondominant hand (control group). Instead of cartoons, ten medium-funny animal pictures were presented individually in a predefined order to be judged on a Likert scale. The allocation to the groups was implemented using a randomized procedure, independent of the diagnosis, age and sex of the children. The only exclusion criteria were the presence of surgical scars in the orofacial area and cerebral palsy.ResultsA total of 414 children aged 4 to 17 years were studied for facial feedback, with orofacial disorders such as open mouth posture, tongue thrust, myofunctional disorder, craniomandibular dysfunction (CMD) and speech motor disorders diagnosed in 223 subjects. The significance tests showed that in all age groups, children with orofacial disorders rated the joke content of the animal pictures significantly lower than did children without orofacial disorders (4- to 6-year-olds: p value = 0.01, T value = 2.33, confidence = 99%; 7- to 8-year-olds: p value = 0, T value = 4.98, 100% confidence; 9- to 17-year-olds: p value = 0, T value = 2.87, 100% confidence). This finding indicates that children with a lack of mouth closure and other orofacial disorders not only express less pleasure with the help of facial expressions but also feel less pleasure. Moreover, the experimental setup used in this work, which has been modified for children, can be used to test facial feedback in young subjects.ConclusionIn our study, we focused on the interplay between physical and emotional development in children. If left untreated, children with a lack of oral closure may not only show deviations in the orofacial area later on, but also in their emotionality. We endeavored to highlight the importance of treating children with orofacial disorders at an early age.

Factors predicting the use of the backward upward rightward pressure maneuver in thyroid surgery: a single-center retrospective cohort study

BackgroundThe purpose of this study was to evaluate the predictability of utilizing the backward upward rightward pressure (BURP) maneuver and the efficacy of related tests in patients with a challenging airway and a Mallampati score of 2 or higher who underwent scheduled elective thyroid surgery.MethodsPatient files were scanned for 300 adult patients who had undergone thyroid surgery under general anesthesia. The information included their medical history of thyroid disease, previous thyroid surgery, and evaluation tests for difficult intubation such as Mallampati score, maximum mouth opening, ease of intubation, thyroid goitre grade, and whether the BURP maneuver was performed. Patients who had a history of difficult intubation or a Cormack Lehane score less than 2 were excluded. Additionally, the patients were divided into two groups: one group underwent the BURP maneuver (n = 78) and the other did not (n = 56).ResultsStatistically significant differences in the maximum mouth openings and thyroid goitre grade were observed between the groups according to the preoperative evaluation. Furthermore, significant differences were noted between the groups in terms of the ease of intubation, intubation time, Cormack–Lehane score, and number of intubation attempts.ConclusionThere may be a correlation between the maximum mouth opening and thyroid goitre grade in predicting the use of the BURP maneuver. It is important to keep in mind, however, that difficult intubation may occur in some uncommon types of goiter, such as retrosternal goiter, even if the thyroid gland size is small. Therefore, it may be useful to consider performing the BURP maneuver.

Efficacy of High-intensity laser therapy in patients with temporomandibular joint disorders: A systematic review and meta-analysis.

This study aimed to assess the effects of High-intensity laser therapy (HILT) on individuals suffering from temporomandibular joint disorders (TMDs). A search was conducted across six electronic databases for randomized controlled trials (RCTs) focusing on HILT for TMDs: PubMed, Scopus, Web of Science, ScienceDirect, EBSCOhost, Cochrane Library, the PEDro database and Google Scholar (last updated on July 18, 2024). Eligible studies were chosen by independent reviewers, and their quality was assessed with the Cochrane risk of bias tool (RoB). The main outcome was pain intensity (VAS), with secondary outcomes including mouth opening (mm), disability (JFLS-20), and quality of life (OHIP-14). A meta-analysis was conducted to assess the pooled effect by calculating mean differences (MD) for these variables (95% confidence level). The heterogeneity of the meta-analyses was explored using the I2 statistic. Three studies met the selection criteria and were included in the meta-analysis. The main RoB was the blinding of participant and treaters. Statistically significant differences (p < 0.05) in favor of HILT were observed for VAS and maximum mouth opening. The pooled effect showed an MD of -14.8mm (95% CI:-27.1,-2.5) for pain intensity and 3.7mm (95% CI:0.9,6.5) for mouth opening, changes that were assessed as clinically important. According to GRADE, the evidence was rated as important, and the certainty was moderate due to the heterogeneity between studies. A sensitivity analysis was not performed to address heterogeneity, primarily due to the limited availability of RCTs. HILT has been found effective in short-term pain relief and improvement of jaw opening in TMDs, potentially enhancing quality of life by facilitating activities such as chewing, jaw mobility, and communication. However, further research is needed to confirm its long-term effectiveness. Combining HILT with interventions such as occlusal splints or therapeutic exercises could potentially enhance its effects, leveraging the existing evidence supporting these treatments. It is important to note that the high RoB associated with the lack of blinding of participants and treaters may influence data collection, compromising the internal validity of findings in some studies.

Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study.

The aim of the present study was to estimate the salivary copper levels in oral submucous fibrosis (OSMF) condition. A total of 60 individuals of which an equal number of 30 each in normal healthy control group as well as in clinically and histopathologically (the biopsy was done once after the clinical confirmation of OSMF in the patient) confirmed patients of OSMF were included in the study group. Total of 51 males and 9 females were considered for the present study and the age distribution of these groups ranged from a minimum of 21 years to a maximum of 74 years. Unstimulated whole saliva was collected from the patient followed by the conventional biopsy practice. The collected saliva was then subjected for the analysis of copper levels. Trace element copper was estimated by using Digital Semiautomatic Analyzer with the help of copper kit. The clinical mouth opening of OSMF was estimated. Analysis of variance (ANOVA) and Tukey HSD post hoc test was used analyze the data wherein the participants were grouped into age ranges of 20-30, 31-40, 41-50, and >60 years. The mean salivary copper level among OSMF and control groups with respect to age in 20-30 years was 55.98 ± 15.50 and 30.87 ± 7.70, in 31-40 years was 63.96 ± 21.13 and 32.95 ± 4.56, in 41-50 years was 50.11 ± 6.83 and 30.46 ± 3.28, and >60 years was 45.65 and 13.67 µg/dL, respectively. The mean salivary copper levels among OSMF and Control groups with respect to males were 55.60 ± 15.27 and 31.18 ± 6.97 and among females were 67.0 ± 24.25 and 30.06 ± 5.77 µg/dL, respectively. The mean salivary copper levels with histopathological grades in very early stage was 47.18 ± 5.73, in early stage was 49.22 ± 7.65, in moderately advanced was 73.53 ± 10.62 and in OSMF with mild dysplasia was 79.98 ± 16.27 µg/dL, respectively. The mean salivary copper levels in individuals with clinical mouth opening more than 35 mm was 45.65 ± 6.57, in 25-35 mm was 48.94 ± 21.60, in 15-25 mm was 70.54 ± 3.52 and in less than 15 mm was 81.50 ± 16.66, respectively. The present study concluded that salivary trace element levels could be used as potential diagnostic and prognostic markers in patients with OSMF. Trace elements are involved in many different physiological and metabolic processes in humans, either directly or indirectly. Copper is involved in vital biochemical activities like different redox and free radical formation and in maintaining cellular proton homeostasis. It is also associated with the processing of oxygen and a component of arecanut in all forms, which is implicated in the etiology of OSMF. How to cite this article: Gupta R, Jayanti I, Das A, et al. Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study. J Contemp Dent Pract 2024;25(5):498-502.

Treatment of temporomandibular joint internal derangement using MESNA injection

IntroductionThe development of temporomandibular disorders specifically emphasizes the biochemical changes occurring in the synovial fluid at different stages of temporomandibular joint disease. Research has indicated that inflammation may be a primary reason behind the pain and dysfunction in temporomandibular joint diseases. Since its clearance several years ago, MESNA (sodium 2-mercaptoethanesulfonate) has been used in various formulations as a mucolytic drug in the respiratory domain. It operates by disrupting the disulfide bonds present between polypeptide chains within mucus. MESNA exhibits minimal tissue distribution, with the material being swiftly and thoroughly eliminated via the kidneys.ObjectivesTo assess the efficacy of injecting MESNA directly into the Temporomandibular Joint to treat internal derangement.Materials and methodsA randomized clinical trial was conducted on sixty patients who exhibited non-responsiveness to conventional treatment and were diagnosed with TMJ anterior disc displacement with reduction. The patients were chosen from the outpatient clinic of the Oral and Maxillofacial Surgery Department at Tanta University Faculty of Dentistry. Two equal groups of patients were randomly assigned to each other. Group I (Mesna group) received intra-articular injection with MESNA solution. Group II (Standard group) received arthrocentesis with lactated ringer solution followed by injection of Hyaluronic Acid (HA). The data was gathered by functional examinations such as maximum interincisal opening (MIO) and clicking. A Visual Analogue Scale (VAS) assessed pain severity before and after treatments.ResultsBoth MESNA and HA showed significant improvement up to six months of the follow-up compared to preoperative status, as evidenced by better mouth opening, lateral excursion, lower clicking, and reduced pain score in patients with TMDs. MESNA showed significant improvement during follow-up compared to HA.ConclusionCompared to HA, MESNA showed a more noticeable improvement during the follow-up period.

Which of the autologous blood products administered simultaneously with arthrocentesis is more effective in terms of clinical outcomes?

This study aimed to determine which of the autologous blood products administered simultaneously with arthrocentesis is more effective on clinical outcomes in patients with temporomandibular joint disorder. The study included 116 patients who underwent arthrocentesis alone, i-PRF (injectable- Platelet Rich Fibrin) with arthrocentesis, and PRP (Platelet Rich Plasma) with arthrocentesis. A total of 35 patients underwent arthrocentesis (Group A), 47 patients underwent arthrocentesis with i-PRF (Group APRF) and 34 patients underwent arthrocentesis with PRP (Group APRP). All patients received local anaesthesia before the procedure, and then the upper joint cavity was irrigated with approximately 100 mL of saline solution. Subsequently, patients in Group APRF and Group APRP were administered 2 ml of autologous blood product. All patients' pain and maximum mouth opening values were compared statistically at each time point: before the procedure, 1 week, 1 month, 3 months, and 6 months after the procedure. The results demonstrated no significant difference among the groups in terms of pain. Nevertheless, in terms of maximum mouth opening, superior outcomes were observed in the early postoperative period in the PRP group, while superior outcomes were observed in the late postoperative period in the i-PRF group.

Preventing radiation-induced dysphagia and trismus in head and neck cancer-A randomized controlled trial.

Radiation-induced dysphagia and restricted mouth opening are common problems among patients with head and neck cancer. The aim of the present randomized controlled trial was to determine if an exercise protocol could prevent swallowing and mouth opening impairment. Eighty-nine participants were randomly assigned to either an active group performing preventive swallowing and mouth opening exercises (n = 45) or to a control group (n = 44). Outcome measures were collected at baseline before radiotherapy and approximately 1-month post-treatment. Primary endpoints were changes in swallowing function according to the Penetration Aspiration Scale and mouth opening ability measured in millimeters. Intention-to-treat analysis was used. Swallowing function and mouth opening deteriorated in both groups, with no statistically significant positive effect of the protocol detected at follow-up. Among patients who completed >75% of exercises, there was a trend toward better outcomes. Preventive exercises did not improve short-term swallowing function and mouth opening after radiotherapy.

Triad of temporomandibular joint ankylosis, micrognathia, and obstructive sleep apnoea: a systematic review of surgical management

Complex functional issues arising from temporomandibular joint (TMJ) ankylosis are associated with abnormal mandibular growth secondary to the condylar-glenoid fossa and its surrounding structures. These include severe limited mouth opening, micrognathia, mandibular asymmetry, and obstructive sleep apnoea (OSA), which necessitate effective treatment to allow optimum functional rehabilitation. This article aims to present a comprehensive systematic review of the surgical strategy for patients who present with a triad of TMJ ankylosis, micrognathia and OSA via a literature search of PubMed, Google Scholar, and Scopus following PRISMA guidelines. The outcomes of interest were difference in maximum mouth opening, incidence of reankylosis, amount of mandibular advancement, posterior airway space, preoperative and postoperative apnoea/hypopnoea index, and arterial oxygen saturation, as well as changes in other cephalometric or polysomnographic variables. Thirty four studies involving 360 patients were included. Surgical interventions included distraction osteogenesis (DO), release of TMJ ankylosis and mandibular advancement, simultaneous arthroplasty and DO, pre-athroplasty DO, and post-arthroplasty DO. Most studies reported functional post-intervention mouth opening, with reankylosis reported in four. Mandibular advancement was between 6 mm and 34 mm. All studies reported improvement in the various polysomnographic variables measured. In conclusion, the systematic review was conducted based on a low level of literature evidence. Even though various surgical strategies were reported, effective case-specific management of TMJ ankylosis with micrognathia and OSA requires comprehensive assessment and careful consideration of surgical options that promote mandibular advancement and airway improvement.

Edema and Trismus Assessment After Applying Kinesiotape With the Web Strip Technique Compared With Cryotherapy: A Randomized Clinical Trial.

Extraction of impacted third molars is one of the most common oral surgeries performed in the dental clinic, which is often accompanied by many complications such as edema and trismus. Many methods have been used to alleviate these complications, such as drugs or physical therapy. Kinesiotape (KT) has recently spread as a popular physical method for eliminating complications after surgical extraction of lower third molars after its long-term use in sports medicine and injuries of the musculoskeletal system. The current study aimed to study the effect of using KT (Kinesio® Holding Corporation, Albuquerque, NM, USA) on both edema and trismus after impacted third molar extraction. This study was designed as a randomized controlled clinical trial using the split-mouth technique and included 25 patients with radiographically symmetrical lower third molars from patients. All surgical extractions were performed by a single surgeon under sterile conditions according to the standard surgical protocol after that one group applied KT and the other group applied cryotherapy. Edema and trismus were measured in the first five days. Data was collected and analyzed by SPSS software (IBM Corp., Armonk, NY, USA). The mean change in the total linear facial measurements in the experimental group (Kinesio Group) was 12.32 mm three days after surgery, and then this value decreased to 6.80 mm, while the average increase in the control group (Cryo Group) was 17.00 mm after three days, then the value decreased to 9.68 mm five days after surgery. Regarding the changes in the amount of maximum mouth opening after surgery, the results were similar between the Kinesio Group and the Cryo Group, as there were no significant differences between the two groups (P<0.05). This study concluded that KT was superior to cryotherapy when studying edema. The current study also concluded that the mouth opening was similar between the two study groups.

SAPHO syndrome in the mandible: A 17-patient-based experience

SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) syndrome is a rare inflammatory bone disorder with a remarkably low incidence. The condition's impact on the mandible is exceptionally uncommon, often resulting in a high rate of misdiagnosis and an extended duration of illness. The objective of this study was to assess patients with SAPHO syndrome in the mandible in across various stages and to dissect their distinctive features, aiming to provide future clinical experience for the disease.Methods: A retrospective analysis was performed on a cohort of 17 patients diagnosed with SAPHO syndrome affecting the mandible at the Second Affiliated Hospital of Zhejiang University from January 2020 to March 2023. Data including clinical presentations, imaging characteristics, and laboratory results were collected.Results: The median age at disease onset was 25, with a diagnostic interval of 26 months. Notably, seven individuals were prepubescent (under the age of 14). Seven patients (41.18 %) exhibited polyostotic involvement, while eight patients (47.06 %) presented with dermatological manifestations either concurrently with or subsequent to the osseous lesions. Condyle involvement was identified in six patients (35.29 %), and bilateral mandibular affection was noted in an equivalent number. The majority of patients (sixteen patients, 94.12 %) reported symptomatic relief following treatment with nonsteroidal anti-inflammatory drugs (NSAIDs). Glucocorticoids were instrumental in managing severe pain and extreme limitations in mouth opening. For patients with refractory disease, tumor necrosis factor-alpha (TNF-α) inhibitors, Janus kinase (JAK) inhibitors and bisphosphonates were employed. Ultimately, effective pain management was achieved in the entire cohort.Conclusion: The diagnosis of SAPHO syndrome involving the mandible is exclusionary. It is important to improve diagnostic accuracy among oral and maxillofacial surgeons (OMFS), dentists, and rheumatologists to avoid unnecessary surgery and tooth extraction. TNF-α inhibitors, JAK inhibitors and bisphosphonates are recommended as third-line drugs.

Effect of Jiedu Huayu decoction on oral mucosal Axin and β-catenin expression in oral submucosal fibrosis model rats.

To investigate the protective effect of the Chinese herbal formula of Jiedu Huayu decoction (, JHD) on oral mucosa of rats with oral submucosal fibrosis (OSF) and its potential mechanism of action. Sprague-Dawley male OSF model rats were constructed by injection of betaine and topical rubbing and were randomly grouped and administered by gavage for 4 weeks. Mouth opening and buccal mucosa scores interleukin levels and the expression of Axin and β-catenin proteins or genes were measured before and after drug administration. After treatment with JHD the buccal mucosal lesions of rats were significantly reduced Axin protein and mRNA expression were significantly increased β-catenin protein and mRNA expression were significantly decreased interleukin-1β and interleukin-6 levels were decreased and interleukin-10 levels were increased. The mechanism of action of JHD can effectively alleviate the pathological damage of buccal mucosa in OSF rats which may be related to the promotion of Axin expression and inhibition of β-catenin expression.

Acoustic sensors to detect the rate of cow vocalization in a complex farm environment

Acoustic technologies provide a method to investigate cow vocalization. This study demonstrated that collar attached acoustic sensors can determine vocalization from continuous acoustic recordings of cows under grazing conditions. In this study a total of 4843 vocalizations from 10 cows were observed over 3 days. Algorithms were developed to differentiate cow vocalization from other farm noises and the F1-statistic for the vocalization classification model was 95 % for the test dataset. Models for the rate of vocalization per cow (R2 = 0.99), average vocalization duration per cow (R2 = 0.83), and the coefficient of variation (CV) of duration of vocalization per cow (R2 = 0.73) in the validation dataset demonstrate that it is feasible to determine vocalization traits that provide information on the state of the animal. There was also significant between-cow variation in the vocalization traits examined in this study, with a rate of vocalization per cow that ranged from 20 to 584 events day−1, an average duration of vocalization per cow that ranged from 1.0 to 1.4 s, a CV of duration of vocalization per cow that ranged from 0.28 to 0.42. The transition probabilities between vocalization type (closed, mixed, open mouth) were also calculated for each cow and there was a 1.3–14-fold between-cow variation in the transition probabilities. The total number of vocalizations per hour interval was highly variable and ranged from zero to 250 vocalizations, depending on cow and time of day. The cows largely vocalized at similar times of the day, although we demonstrated that the technology could identify cows that differ in their pattern of vocalization relative to the herd and relative to their vocalization patterns on previous days. These models can be used to investigate the role of management and environmental factors on cow vocalization, and to develop technologies that respond to cow vocalization behaviour.

Does transcriptome of freshly hatched fish larvae describe past or predict future developmental trajectory?

Transcriptomic analysis of freshly hatched fish larvae offers insights into phenotype development, yet it remains uncertain whether it reflects parental influence or predicts individual growth. This research scrutinizes the transcriptome of 16 Eurasian perch (Perca fluviatilis) larval families (at mouth opening stage, coinciding in this species with hatching) alongside pre- and post-hatching zootechnical traits. Despite consistent fertilization rates, significant variations in embryonic development and larval performance highlight diverse phenotypes studied. It enabled us to bring our attention to the fact that transcriptome of larvae at mouth opening stage can serve as a window into both the parental contributions and the future performance of the larvae. Our analysis shed light on ribosome biogenesis, neurogenesis, and the cell cycle, as important processes shaping early larval performance. Additionally, we propose a set of predictive, validated gene markers associated with further larval performance and key aquaculture traits, such as selenoo (associated with cannibalism), trim16 (fulton's condition factor), slc15a1 (specific growth factor), and cipc (final weight). This study delves into the descriptive and predictive nature of the transcriptomic portrait of newly hatched larvae, paving the way to comprehend the intricate developmental pathways from fertilization towards juvenile stage.