Orofacial Region Research Articles

Inhibition of Nociception in a Preclinical Episodic Migraine Model by Dietary Supplementation of Grape Seed Extract Involves Activation of Endocannabinoid Receptors.

Migraine is associated with peripheral and central sensitization of the trigeminal system and dysfunction of descending pain modulation pathways. Recently, dietary inclusion of grape seed extract (GSE) was shown to inhibit mechanical nociception in a preclinical model of chronic temporomandibular joint disorder, a condition often comorbid with migraine, with the antinociceptive effect mediated, in part, by activation of 5-HT3/7 and GABAB receptors. This study further investigated the mechanisms by which GSE inhibits mechanical nociception in a preclinical model of episodic migraine. Hyperalgesic priming of female and male Sprague Dawley rats was induced by three consecutive daily two-hour episodes of restraint stress. Seven days after the final restraint stress, rats were exposed to pungent odors from an oil extract that contains the compound umbellulone, which stimulates CGRP release and induces migraine-like pain. Some animals received dietary supplementation of GSE in their drinking water beginning one week prior to restraint stress. Changes in mechanical sensitivity in the orofacial region and hindpaw were determined using von Frey filaments. To investigate the role of the endocannabinoid receptors in the effect of GSE, some animals were injected intracisternally with the CB1 antagonist AM 251 or the CB2 antagonist AM 630 prior to odor inhalation. Changes in CGRP expression in the spinal trigeminal nucleus (STN) in response to stress, odor and GSE supplementation were studied using immunohistochemistry. Exposure of stress-primed animals to the odor caused a significant increase in the average number of withdrawal responses to mechanical stimulation in both the orofacial region and hindpaw, and the effect was significantly suppressed by daily supplementation with GSE. The anti-nociceptive effect of GSE was inhibited by intracisternal administration of antagonists of CB1 and CB2 receptors. GSE supplementation inhibited odor-mediated stimulation of CGRP expression in the STN in sensitized animals. These results demonstrate that GSE supplementation inhibits trigeminal pain signaling in an injury-free model of migraine-like pain via activation of endocannabinoid receptors and repression of CGRP expression centrally. Hence, we propose that GSE may be beneficial as a complementary migraine therapeutic.

Pannexin 1 role in the trigeminal ganglion in infraorbital nerve injury-induced mechanical allodynia.

The detailed pathological mechanism of orofacial neuropathic pain remains unknown. We aimed to examine the pannexin 1 (Panx1) signaling in the trigeminal ganglion (TG) involvement in infraorbital nerve injury (IONI)-induced orofacial neuropathic pain. Mechanical head-withdrawal threshold (MHWT) was measured in IONI-treated rats receiving intra-TG Panx1 inhibitor or metabotropic glutamate receptor 5 (mGluR5) antagonist administration and MHWTs in naive rats receiving intra-TG mGluR5 agonist administration post-IONI. Glutamate and Panx1 in the TG were measured post-IONI. Panx1, mGluR5, and glutamine synthetase expression in TG were immunohistochemically identified, and changes in the number of mGluR5-P2X3 -expressed TG neurons were examined. MHWT was significantly decreased post-IONI, and this decrease was reversed by Panx1 inhibition or mGluR5 antagonism. mGluR5 agonism induced a decrease in the MHWT. IONI increased extracellular glutamate in TG. Panx1 was expressed in satellite glial cells and TG neurons, and intra-TG mGluR5 antagonism decreased the number of mGluR5 and P2X3 positive TG neurons post-IONI. IONI facilitates glutamate release via Panx1 that activates mGluR5 which was expressed in the nociceptive TG neurons innervating the orofacial region. In turn, P2X3 receptor-expressed TG neurons are enhanced via mGluR5signaling, resulting in orofacial neuropathic pain.

Treatment of papillomatous lesions in a patient with Goltz syndrome—A case report

AbstractBackgroundGoltz syndrome, also known as focal dermal hypoplasia (FDH), is a rare genetic disorder that affects ectodermal and mesodermal tissues. The purpose of this study is to report the treatment of papillomatous lesions in the orofacial region of a patient with Goltz syndrome.Case descriptionA 31‐year‐old male patient was attended at Dental School of Federal University of Goiás with the chief complaint of discomfort during speaking and eating, due to the presence of a papillomatous lesion at the labial commissure. During the physical examination, syndrome characteristics were found, such as unilateral anophthalmia; atrophic cutaneous lesions of different intensities of pigmentation, mostly on the arms and neck; sparse hair; ectrodactyly, being the right hand was shaped like a ‘lobster claw’; and body asymmetry. In addition, papillomatous lesions at the right labial commissure and on the dorsum of the tongue were noted, which were subsequently removed with surgical laser. The microscopic diagnosis of the lesions was a squamous papilloma.ConclusionThe proposed surgical treatment was well succeeded, and the rarity of the present case also having Goltz syndrome is an uncommon condition in males.

Susceptibility of craniofacial ciliopathies to oral cancer-A proposed research

The Ciliary disorders are a group of clinically and genetically overlapping disorders, manifesting as syndromes, whose patho-physiology arises due to defective ciliary function including its organelles. These are antenna-like organelles are present in the apical surface of numerous cell types in a variety of tissues and organs, in humans, currently under research in medico genetic field.1 During organogenesis, although the neural crest receives a significant amount of attention, craniofacial tissue has more patterning information present when compared to other tissues of the body.2 Newer studies have further indicated the importance of ciliary epithelia as a source of patterning information for the tissues in or-facial region. In this article, we propose a research in patients with craniofacial ciliopathies linking to origin of cancers in oro-facial region.

Foreign Bodies in Soft and Hard Tissues of Oral Cavity: A Report of three Cases

Encountering foreign bodies in orofacial region is a rare entity. Children are usually more prone to such accidents especially in anterior region with open pulp chambers or root canals. Frequently these foreign bodies are embedded in the oral cavity either due to iatrogenic reasons or traumatically producing various types of reactions ranging from pain to abscess and fistula. Most common foreign bodies noted in the oral cavity include amalgam obturating materials broken instruments needles pins paper clips beads pencil tips etc. Case history clinical evaluation and radiographic investigations play a key role in accurate diagnosis and treatment planning. This paper presents three uncommon cases of embedded foreign bodies in oral cavity in adult patients. The foreign particles presented here included broken bur piece stapler pin and a piece of steel wire.

Direct Mechanical Stimulation Mediates Cell-to-Cell Interactions in Cultured Trigeminal Ganglion Cells.

Trigeminal neuralgia occurs in the orofacial region, characteristically causing pain that feels like a transient electric shock. Some histopathological studies have reported that trigeminal neuralgia is caused by mechanical compression of the demyelinated trigeminal nerve; the pathophysiological mechanism behind this phenomenon remains to be clarified, however. Cell-cell interactions have also been reported to be involved in the development and modulation of some types of neuropathic pain. The purpose of this study was to investigate the potential contribution of cell-cell interactions to trigeminal neuralgia by measuring intracellular free Ca2+ concentrations ([Ca2+]i) in primary cultured trigeminal ganglion (TG) cells. Direct mechanical stimulation of TG cells induced an increase in [Ca2+]i in both neuronal and non-neuronal cells, such as glial cells. Moreover, this increase was stimulus intensity-dependent and non-desensitizing. Direct mechanical stimulation increased [Ca2+]i in neighboring cells as well, and this increase was inhibited by application of carbamazepine. These results indicate that direct mechanical stimulation affects Ca2+ signaling. Trigeminal ganglion cells establish intercellular networks between themselves, suggesting that this is involved in the development and generation of trigeminal neuralgia.

Management of orofacial arrow injuries at Nigerian tertiary health care hospital: A report of 30 cases

Background: Arrow injuries are still common presentations at various medical facilities across the Northern region of Nigeria.Objective: This study evaluated various degree of orofacial arrow injuries presented and managed at Federal Medical Centre, Nguru, North eastern Nigeria.Methods: A retrospective analysis of thirty patients with orofacial arrow injuries who presented and were managed over a period of four years was carried out. The information collated included patients’ personal profile, circumstances of injury, presentation, treatment and complications. The data analysis was done using IBM SPSS version 20.0.Results: Thirty cases of orofacial arrow injuries in patients whose ages ranged from 10 to 70 years were evaluated and managed. The mean age of the patients was 50.70 years. All patients were males, mostly farmers and herders, and are rural dwellers. The arrows were shot following misunderstanding between these herders and farmers Among the age groups recorded, the highest frequency was found between the ages of 41-50 years. Out of the 30 patients, 8(26.67%) had arrow injuries outside the orofacial region. 23 patients had arrow in-situ on presentation and the others had a part of their arrows extracted mostly by themselves prior to presentation. Conclusion: Orofacial arrow injuries has become a common finding at primary and secondary health care centers and hospitals in the North eastern region of Nigeria. In this study, we evaluated 30 cases with various degree of orofacial arrow injuries presented and managed at Federal Medical Centre, Nguru, North eastern Nigeria.

Pediatric dentist alert: Child maltreatment

Introduction: Child maltreatment is an important public health problem; the timely detection of signs and symptoms of abuse in the orofacial region places the pediatric dentist in a strategic situation, with the capacity to recognize, register and report suspicious cases. Objective: To review the literature on oral lesions related to child abuse and the role of the pediatric dentist in the dental office. Methodology: A search was carried out in the MEDLINE/PubMed databases from 2016 to 2020, using the keywords:

The incidence and pattern of non-odontogenic orofacial pain conditions at a tertiary hospital in Tanzania

Introduction and aim. Non-odontogenic orofacial pain (NOFP) is a result of pathology, or injury to the structures in the orofacial region including the muscles, temporomandibular joint, neurovascular structures, and glands. This multi-diverse aetiopathogenesis poses a challenge in the diagnosis and management of NOPF. To determine the incidence and trend of various non-odontogenic orofacial pain conditions at a tertiary hospital in Tanzania. Material and methods. This cross-sectional study was conducted at the Muhimbili National Hospital (MNH) for 6 months. The information gathered included socio-demographic characteristics of participants, characteristics of pain, and cause of pain. Pain intensity was assessed using the Visual Analogue Scale (VAS). Results. The incidence of NOFP was 3.3%. The male to female ratio was 1.7:1 and the mean age of patients was 44.2 ± 17.4 years. The mean intensity of the pain using the VAS was 47.27 ± 5.66. Most (36.7%) patients experienced sharp pain. The common causes of NOFP were trauma (43.3%) and malignant lesions (38.3%). A statistically significant association between the age and sex of the patients and the causes of non-odontogenic pain was observed (p < 0.05). Conclusion. The incidence of non-odontogenic orofacial pain is low. Trauma and malignant conditions were the leading causes of NOFP.

Efficacy of Combined Administration of Cinnamon and Curcumin on Acute Orofacial Inflammatory Pain Enhanced by Xerostomia

Objectives: Orofacial pain can be caused by xerostomia, dental procedures, infections, and functional disorders in various areas, and it can greatly deteriorate patients’ quality of life. Thus, the present study aimed to investigate the efficacy of natural products in minimizing the side effects of synthetic drugs. Methods: In an experimental model of 4-DAMP-induced xerostomia, formalin was injected to induce inflammatory pain in the orofacial region, and the effects of oral administration of curcumin and cinnamon on pain behavioral response were observed. Results: In the experimental group with xerostomia, the pain response was prominent, which was suppressed in a concentration-dependent manner upon curcumin and cinnamon administration. Conclusions: Curcumin and cinnamon may be useful natural products for relieving the inflammatory orofacial pain caused by xerostomia.

MYOGRAPHY TECHNIQUE IN INVESTIGATING OROFACIAL MUSCULES IN HEARING-IMPAIRED PATIENTS (LITERATURE REVIEW)

This article briefly reviews the literature describing the application of electoromyography technique to investigate the muscles of the orofacial region. Muscle characteristics are an indicator of complex functional relationships of the dentofacial system. Disorders of muscle function lead to morphological changes in the normal structure of the teeth and bones of the maxillofacial area, as well as exacerbate existing bite pathologies. Today, the electromyography is considered as the latest, objective, and informative method of functional diagnostics of the dentofacial system. This study is an evidence-based method for diagnosis and evaluation of the treatment outcomes in orthodontics, and guarantees an unbiased and objective analysis of the functional state of the patient's maxillofacial apparatus at different stages: from diagnosis to treatment and after its completion. Interference electromyography, a non-invasive technique, is known as the most commonly applied in various fields of dentistry. In orthodontics, interference electromyography is used to control the remodelling of the coordination relationships between the temporal and masticatory muscles in the treatment of malocclusion. In orthodontics, the mandibular levators are of great importance, especially the masticatory muscle, the temporal muscle, the medial pterygoid muscle, and the lateral pterygoid muscle. The sublingual muscle also plays an important role in determining facial morphology. This muscle is responsible for stretching the tongue. Facial muscles, such as the orbicularis oris muscle, are also very important in orthodontics. In patients with hearing deprivation not all the muscles work, only some facial muscles function during speech. The scientific literature presents quite a few studies on the function of the facial and masticatory muscles in orthodontic patients with hearing deprivation, both in children and adults, indicating a greater activity of the masticatory muscles in such patients. However, there is no single scientific conception about the work of the orbicular oris muscle.

Evaluation of the Association of Oral Stereognosis with Malocclusion in Children.

Aim and objectiveTo evaluate the association between oral stereognosis with malocclusion in children.Materials and methodsStereognostic investigation was made with a set of seven different geometric configurations (circle, square, triangle, star, clover, diamond, and heart shapes) cut out from fresh, raw carrots using preformed iron molds. Any five of the seven geometric forms were randomly placed inside the mouth on the dorsum of the tongue by the investigator with the subject's eyes closed. A minimum of three shapes correctly identified out of the five offered to each child was considered as an indicator of the adequate stereognostic ability of that particular child.ResultsAmong the children under Index of Orthodontic Treatment Needs (IOTN) grade I group, 82.4% of children came under the positive response group. Among IOTN grades II, III, and IV, the percentages of children with positive responses were 72.1%, 58.1%, and 18.8%, respectively. There is a statistically significant (p < 0.001) decrease in positive response with increasing IOTN grades.ConclusionThe observations from the present study show that there is altered oral sensory perception in children graded as with malocclusion according to the index used and belonging to the age group selected in the study.Clinical significanceSensory and motor components of the orofacial region, like any other part of the human body, are inseparable in their structure and function, the association between orofacial growth and development and sensory maturation cannot be overlooked.How to cite this articleJanardhanan R, Soman A, George S, et al. Evaluation of the Association of Oral Stereognosis with Malocclusion in Children. Int J Clin Pediatr Dent 2021;14(S-1):S18–S21.

Customized protocol for psychological management of a patient with residual maxillofacial defects

: Maxillofacial surgeons and Prosthodontist deal with rehabilitation of defects of orofacial region but understanding the mental attitude of patients is often ignored or neglected. Success of any prosthesis relies on patient’s compliance and motivation to adjust and cope up with irreversible loss. Evaluation of psychological distress and management of the same is of utmost importance. Literature is deficit with an elaborate systematic classification system to evaluate the impact of maxillofacial defect on the psychological status of patients and role of therapy on improvement post-rehabilitation.: Am of this study is to propose a customized comprehensive protocol for evaluation of psychological status using ICD-11 classification system before and after maxillofacial prosthetic intervention and impact of psychological management tools on the same.: Ten patients with maxillofacial defects reporting for prosthetic rehabilitation were selected. Psychological evaluation tool, ICD-11 classification system was applied pre and post rehabilitation by two independent observers. Customized psychological management protocol was formulated and implemented to note the impact on overall improvement in psychological status of the patient.: Patients with severe personality trait showed varied levels of improvement ranging from no change to mild. Five patients with moderate personality trait showed improvement and change in personality trait to mild on implementation of psychological tools. Statistical evaluation could not be done due to multitude of subjective variables.: ICD-11 can be used as a successful tool for psychological evaluation of patients. Necessary intervention at every level in form of family support, support groups, psychological therapeutic modalities and therapies can improve status of the patient. A well-structured management protocol helps in early recognition of psychological distress and systematic management of the same to improve clinical outcome of the rehabilitation procedure.: Patients with maxillofacial defects experience a progressive cycle of loss and grief. This diminishes their ability to adjust to stress and acceptability towards maxillofacial prosthetic rehabilitation procedure. Assessment of psychological alteration using a standardized classification system and utilization of therapeutic modalities to deal with the same helps in successful rehabilitation and restoration of patient in the society as a whole.

Involvement of Different Nerve Branches in Trigeminal Neuralgia on Right and Left Sides- A Retrospective Study

One of the most common symptoms in the orofacial region is pain. Trigeminal neuralgia is characterized by pain affecting the trigeminal nerve and its related areas of distribution and is known to have significant impact on the quality of life. Misdiagnosis of trigeminal neuralgia has been reported by dentists in several previous studies in the literature. With this rationale, the aim of the present study is to determine the most commonly involved nerve branch and the side affected in trigeminal neuralgia patients. The present retrospective study involved 72 patients diagnosed with trigeminal neuralgia who reported from October 2013 to October 2014. Data regarding the age of onset, gender, side of involvement was analyzed from their clinical records. Out of the 72 patients, males were 42(58.3%) and females were 30(41.7%). In our study, a total of 56 % (i.e., 40) patients showed involvement on the right and 44% (i.e., 32) (i.e, 32) patients on the left side of the face. In this retrospective study, ophthalmic branch (V1) was affected only in 3 patients. Mandibular nerve (V3) alone was involved in 24 patients. Involvement of all the three divisions V1, V2 and V3 was seen in 16(22.3%) of patients. Clinical similarities of trigeminal neuralgia that have an impact on different populations were demonstrated in this study. Detailed history and proper identification of involved nerve branch play an important role in the diagnostic accuracy and treatment satisfaction. Most involved branch in our study was the mandibular (V3) branch and the most affected side was the right side. Correlation of systemic factors with trigeminal neuralgia can be attempted in future research.

The effects of altered BMP4 signaling in first branchial-arch-derived murine embryonic orofacial tissues

The first branchial arch (BA1), which is derived from cranial neural crest (CNC) cells, gives rise to various orofacial tissues. Cre mice are widely used for the determination of CNC and exploration of gene functions in orofacial development. However, there is a lack of Cre mice specifically marked BA1’s cells. Pax2-Cre allele was previously generated and has been widely used in the field of inner ear development. Here, by compounding Pax2-Cre and R26R-mTmG mice, we found a specific expression pattern of Pax2+ cells that marked BA1’s mesenchymal cells and the BA1-derivatives. Compared to Pax2-Cre; R26R-mTmG allele, GFP+ cells were abundantly found both in BA1 and second branchial arch in Wnt1-Cre;R26R-mTmG mice. As BMP4 signaling is required for orofacial development, we over-activated Bmp4 by using Pax2-Cre; pMes-BMP4 strain. Interestingly, our results showed bilateral hyperplasia between the upper and lower teeth. We also compare the phenotypes of Wnt1-Cre; pMes-BMP4 and Pax2-Cre; pMes-BMP4 strains and found severe deformation of molar buds, palate, and maxilla-mandibular bony structures in Wnt1-Cre; pMes-BMP4 mice; however, the morphology of these orofacial organs were comparable between controls and Pax2-Cre; pMes-BMP4 mice except for bilateral hyperplastic tissues. We further explore the properties of the hyperplastic tissue and found it is not derived from Runx2+ cells but expresses Msx1, and probably caused by abnormal cell proliferation and altered expression pattern of p-Smad1/5/8. In sum, our findings suggest altering BMP4 signaling in BA1-specific cell lineage may lead to unique phenotypes in orofacial regions, further hinting that Pax2-Cre mice could be a new model for genetic manipulation of BA1-derived organogenesis in the orofacial region.

Substance P/ Neurokinin-1 Receptor, Trigeminal Ganglion, Latency, and Coronavirus Infection-Is There Any Link?

Novel Severe Acute Respiratory Syndrome-Corona Virus-2 infection (SARS-CoV-2) is an acute respiratory and infectious disease. This perspective aims to provide a basic understanding of the inflammation caused by SARS-CoV-2 and its relation to the trigeminal ganglion (TG). The virus enters through the mucous membranes of the orofacial region and reaches the TG, where it resides and takes control of its peptides including Substance P (SP). SP is the main neuropeptide, neuromodulator, and neuro-hormone of TG, associated with nociception and inflammation under noxious stimulus. SP release is triggered and, consequently, affects the immune cells and blood vessels to release the mediators for inflammation. Hence, cytokine storm is initiated and causes respiratory distress, bronchoconstriction, and death in complicated cases. Neurokinin-1 Receptor (NK-1R) is the receptor for SP and its antagonists, along with glucocorticoids, may be used to alleviate the symptoms and treat this infection by blocking this nociceptive pathway. SP seems to be the main culprit involved in the triggering of inflammatory pathways in SARS-CoV-2 infection. It may have a direct association with cardio-respiratory rhythm, sleep-wake cycle, nociception, and ventilatory responses and regulates many important physiological and pathological functions. Its over-secretion should be blocked by NK-1R antagonist. However, experimental work leading to clinical trials are mandatory for further confirmation. Here, it is further proposed that there is a possibility of latency in SARS-CoV-2 virus infection if it is acting through TG, which is the main site for other viruses that become latent.

Myotonometric comparison of sternocleidomastoideus and masseter muscles in multiple sclerosis patients with swallowing problem and healthy individuals

BackgroundDysphagia occurring in the oral and pharyngeal phases of swallowing in MS patients may be caused by changes in muscles' viscoelasticity. The aim of this study was to compare the muscles' (sternocloideomastoideus and masseter) viscoelasticity properties by myotonometer between MS patients and healthy individuals. MethodsThis study design was a cross-sectional, non-interventional study. Ten healthy individuals were allocated to the control group, eleven MS patients without swallowing problems were allocated to the without swallowing group, ten MS patients with swallowing problems were allocated to the swallowing group. Disability was evaluated using the Expanded Disability Status Scale (EDSS), swallowing problem was assessed with Dysphagia in Multiple Sclerosis (DYMUS) scale, and to measure the viscoelastic parameters (tone, stiffness, elasticity) of sternocloideomastoideus (SCM) and masseter muscles bilaterally, MyotonPro® was used. The comparison between the groups was performed using the Kruskal-Wallis H test. ResultsIt was observed that there was no difference in terms of viscoelastic properties of the masseter muscle in groups (p > 0.05). There was no difference between the groups in terms of the elasticity of the SCM muscle (p > 0.05). However, the tonus and stiffness of the SCM on the left side of the MS patients were higher than in other groups (p = 0.050, p = 0.005). ConclusionThe increment level of tone and stiffness of SCM muscle is related to swallowing problems in patients with MS. Due to swallowing problems in MS, the orofacial and neck region's muscles' viscoelastic properties may change in time and may be affected by phases of swallowing problems.

Occurrence of the Elongated Styloid Process on Digital Panoramic Radiographs in the Riyadh Population.

Background Patients with an elongated styloid process might present with dysphagia and pain in the cervicofacial region. These patients could be misdiagnosed as other orofacial pathologies. Aim The present study attempted to assess the prevalence of the elongated styloid process on digital panoramic radiographs in the Riyadh population. Materials and Methods The present prospective randomized study was conducted on the panoramic digital radiographs of 300 randomly selected patients visiting a private dental hospital to identify any elongation of the styloid process. Only the radiographs without any magnification errors were considered. The styloid process length was measured using the Sidexis measuring tool and entered in an Excel spreadsheet with other demographic data. A length beyond 30 mm was considered styloid process elongation. The data were subjected to statistical analysis. Results The symptoms of styloid process elongation were higher among females (78.6%), and this difference was statistically significant (χ2 = 7.182; P=0.007). No statistically significant association was observed between styloid process elongation and symptoms between different age groups. Females exhibited a significant longer mean length of the styloid process than males. The present study exhibited a 27.3% prevalence for the elongation and calcification of the styloid process. Conclusion Given the significant prevalence of the elongated styloid process in our study, we recommend it to be considered as one of the differential diagnosis for pain or discomfort in the orofacial region.

Spatiotemporal Expression and Functional Analysis of miRNA-22 in the Developing Secondary Palate.

Normal development of the embryonic orofacial region requires precise spatiotemporal coordination between numerous genes. MicroRNAs represent small, single-stranded, non-coding molecules that regulate gene expression. This study examines the role of microRNA-22 (miR-22) in murine orofacial ontogeny. Spatiotemporal and differential expression of miR-22 (mmu-miR-22-3p) within the developing secondary palate was determined by in situ hybridization and quantitative real-time PCR, respectively. Bioinformatic approaches were used to predict potential mRNA targets of miR-22 and analyze their association with cellular functions indispensable for normal orofacial ontogeny. An in vitro palate organ culture system was used to assess the role of miR-22 in secondary palate development. There was a progressive increase in miR-22 expression from GD12.5 to GD14.5 in palatal processes. On GD12.5 and GD13.5, miR-22 was expressed in the future oral, nasal, and medial edge epithelia. On GD14.5, miR-22 expression was observed in the residual midline epithelial seam (MES), the nasal epithelium and the mesenchyme, but not in the oral epithelium. Inhibition of miR-22 activity in palate organ cultures resulted in failure of MES removal. Bioinformatic analyses revealed potential mRNA targets of miR-22 that may play significant roles in regulating apoptosis, migration, and/or convergence/extrusion, developmental processes that modulate MES removal during palatogenesis. Results from the current study suggest a key role for miR-22 in the removal of the MES during palatogenesis and that miR-22 may represent a potential contributor to the etiology of cleft palate.

Effect of Low-level Laser on LI4 Acupoint in Pain Reduction during Local Anesthesia in Children.

BackgroundPain is a multidimensional construct that involves sensory, emotional, and cognitive processes. It is an essential component of child behavior guidance. The injection of a local anesthetic agent during pediatric dental treatment is one of the most painful and distressing procedures performed, stimulation of acupoint LI4 provides an analgesic effect in the orofacial region, thus decreasing the pain during injection.Aims and objectivesTo compare and evaluate the effect of low-level laser on LI4 acupoint and surface-acting 20% benzocaine gel during local anesthesia.Materials and methodsChildren of age-group between 5 years and 9 years receiving bilateral local anesthesia were scheduled for dental treatment. Split-mouth cross-over study was planned and was divided into two groups, receiving low-level laser acupuncture on LI4 acupoint with placebo as a moist cotton swab in the first visit and 20% benzocaine gel with placebo as low-level laser acupuncture off mode in second visit and vice versa. Pain intensity was evaluated using the sound eye motor scale as subjective scale, Wong–Bakers pain rating scale. Pulse rate was measured before, during, and after the procedure using a pulse oximeter.ResultsThe average heart rate, Wong–Bakers pain rating scale, and Sound Eye Motor scale were significantly lower in the group having low-level laser when compared with the group having placebo low-level laser therapy.ConclusionThe low-level laser can be used to control pain during local anesthesia in children.How to cite this articleSandhyarani B, Pawar RR, Patil AT, et al. Effect of Low-level Laser on LI4 Acupoint in Pain Reduction during Local Anesthesia in Children. Int J Clin Pediatr Dent 2021;14(4):462–466.