Orofacial Region Research Articles

The effect of oral administration of monosodium glutamate on orofacial pain response and the estimated number of trigeminal ganglion sensory neurons of male Wistar rats

Monosodium glutamate (MSG) is a worldwide flavor enhancer. The excessive glutamate concentration in nerve tissue induces the death of nerve cells, known as excitotoxicity. In the orofacial region, the nerve cells’ death affects pain perception such as mechanical hyperalgesia and allodynia. The aim of the present study was to examine the pain response modification and the estimated total number of trigeminal ganglion sensory neurons after sub chronic oral administration of MSG. Twenty eight male Wistar rats, aged 6-8 weeks (100-150 grams) were divided into 4 groups: Control (2 mL NaCl 0.9%); 1 mg/gWB MSG; 2 mg/gWB MSG; 4 mg/gWB MSG groups. Daily oral administration of MSG was given for 30 days. The control group received NaCl per oral for the same period. The pin prick and air puff test were performed on days 1-2, days 41-42 and days 55-56. The number of trigeminal ganglion sensory neurons were estimated by the unbiased stereology method, using the approach of numerical density and organ volume reference. The results showed that the sub chronic oral administration of MSG does not modify either the orofacial pain response or the estimated total number of trigeminal ganglion sensory neurons. .

Approach to feeding problems in babies with cleft lip and/or palate

Cleft lip and/or palate is one of the most common craniofacial congenital anomalies and is most common in the orofacial region. The incidence of this congenital anomaly in newborn babies is around 15%. Although the pathogenesis of these congenital malformations is not fully known, there is evidence that both dietary and genetic fac- tors play a role, and this evidence is increasing day by day. Children with cleft lip and/or palate may be malnourished after birth due to nutritional difficulties. Children with these deformities are often impaired in growth compared to healthy children. A multidisciplinary approach is mandatory for the evaluation of these babies. Feeding newborns with cleft lip and/or palate in the beginning is a major concern for parents. Nutritional interventions such as breastfeeding, modified bottles and/or nipple, occlu- sive pads and maternal counseling and support are needed, so this article aims to review some nutritional issues and adaptations in this regard.

Interdisciplinary approach in the diagnosis and treatment of orofacial granulomatosis

Orofacial granulomatosis (OFG) is an uncommon disease and represents an idiopathic, nonnecrotizing granulomatous lesion of soft tissue in the orofacial region. Medical history is very important in the diagnosis of OFG as medical condition such as Crohn's disease can also present an extraintestinal manifestation of OFG. Exclusion of other entities such as sarcoidosis, myocardial infections, foreign body reactions, and biopsy helps establish a correct diagnosis. The term idiopathic OFG is used in cases with unknown etiology. This case report describes idiopathic OFG in a 35-year-old female patient with persistent upper lip swelling and gingival enlargement. Management with intralesional acetonide 20 mg/ml, twice week for 3 weeks and gingivectomy, resulted in significant remission without recurrence after a 6-month follow-up.

A systematic review and meta-analysis of failure to take history as a barrier of reporting child abuse by dentists in private and state clinics

Since the symptoms of child abuse and neglect often manifest in the orofacial region, the dental team has a key role in identifying children subjected to abuse. This study was aimed to explore the prevalence of failure to take history as a barrier to reporting child abuse by dentist around the world. In this systematic review and meta-analysis, PubMed, Embase, Scopus, Google Scholar, ProQuest, Cochrane, and ISI databases were searched for the cross-sectional articles in English languages on barriers to reporting child abuse and lack of knowledge about referral procedures by dentists since 1985 using Medical Subject Headings (MeSH). The full-texts of all included articles were obtained and assessed for quality according to Newcastle-Ottawa Scale adapted for cross-sectional studies. The qualified articles were then studied thoroughly and results were extracted. Data were analyzed by Comprehensive Meta-Analysis software using meta-analysis and random effects model. Heterogeneity was determined by Q-test and I-square index. A total of 17 articles were included in the meta-analysis. The prevalence of lack of knowledge about referral procedures as a barrier was determined according to the meta-analysis of the number of relevant articles and was (55%, confidence interval: 0.48, 0.62). The analysis of various studies revealed lack of information about referral procedures as an important barrier to report child abuse by dentists.

Impact of orofacial pain on the quality of life of students

Introduction. The aim of the study was to determine the prevalence of orofacial pain in students and the impact of pain on their quality of life and everyday professional obligations. Material and Methods. A cross-sectional study included 319 respondents of both genders. Two questionnaires were used in this study; one that we specifically designed to detect orofacial pain among students and the Oral Impacts on Daily Performance questionnaire. Results. Of the total number of examinees, 101 (32%) reported that they had previously experienced pain in the orofacial region. Using the logistic regression analysis, we found that gender was an important predictor of pain and that female students had a 1.8 times higher risk for developing pain (p < 0.05). The highest prevalence of pain in our subjects was in the temporal region (7%; confidence interval 4%; 9%) and the region around the eye (6%; confidence interval 4%; 9%). Namely, in 65 (64.4%) students who had pain in the orofacial region, it had an impact on the quality of life and daily activities. The most prominent was the impact of the orofacial pain on the performance of their activities at the faculty. Orofacial pain has a significant impact on the psychosocial sphere, emotional and social contacts (12.3%; 14.1%). The temporomandibular joint pain and the pain when opening the mouth showed the least impact on the quality of life (p < 0.05). Conclusion. Orofacial pain is a condition that affects daily activities of students at the faculty, as well as their emotional and social life.

Chronic Pain in the Orofacial Region Treated Successfully with Intravenous Ketamine: A Report of Three Cases

Chronic Pain in the Orofacial Region Treated Successfully with Intravenous Ketamine: A Report of Three Cases

Mucormycosis of the bones of the facial skull, nasal cavity and par anasal sinuses in patients with COVID19

Abstract Currently, the relevance of the issues of diagnosis and treatment of invasive fungal diseases has increased significantly due to the pandemic of a new coronavirus infection COVID-19 and the massive use of corticosteroids for the treatment. The key success factors in the outcome of invasive fungal diseases are early diagnosis and treatment, including the applying of an adequate systemic antifungal therapy and surgical treatment. Extensive areas of mycotic lesions of the facial bones and paranasal sinuses are lifethreatening conditions due to anatomical proximity to brain structures and a high risk of dissemination of I invasive fungal diseases with a fatal outcome. The objective of this work was to study the risk factors, possible pathogenesis, diagnosis and treatment strategy of invasive fungal diseases of the orofacial region in convalescents of COVID-19. We present case-series data on six patients in the clinics of maxillofacial surgery and otorhinolaryngology of the Pavlov First Saint Petersburg State Medical University over the period of 2021–2022. Predisposing factors, clinical and radiological symptoms, features of diagnosis, therapy and surgical strategy were analyzed. The presented observations confirm the relevance and danger of complications after a COVID-19 in the form of the development of invasive fungal diseases with damage to the maxillofacial region caused by mucormycetes and Aspergillus spp., as well as importance of early diagnosis and treatment.

Exacerbation of chronic myofascial pain during COVID-19

ObjectiveThe COVID-19 pandemic-related restrictions on the public have led to changes in occupation status and societal behavior which may be linked with adverse effects on mental health. We hypothesized that elevated personal stress induced by COVID-19 may underlie pain exacerbation among individuals with chronic myofascial pain. MethodsComprehensive myofascial pain questionnaire among 319 patients registered in our pain clinic. In total, 78 patients with TMD-associated pain responded and 113 patients with pain in other orofacial regions responded. ResultsPatients with chronic TMD pain reported a higher self-rated stress level, which correlated with significantly increased pain intensity, and analgesic consumption. In contrast, patients experiencing non-TMD pain did not report of any increase pain, regardless of their stress levels. ConclusionSignificant correlation between self-perceived psychosocial stress levels and chronic myofascial pain exacerbation. Patients may benefit from early education and conservative intervention, and avoid uncontrolled increases in consumption of pain relief medication.

Oro-facial-digital syndrome type I: a case report with novel features.

ABSTRACTOro-facial-digital syndrome is a group of rare heterogeneous hereditary disorders characterized by abnormalities of the oral cavity, face and digits, along with varying degrees of mental retardation. Currently, Oro-facial-digital syndrome has been classified into 14 types and two additional unclassified variants have been proposed. Amongst the various variants described, Oro-facial-digital syndrome type I is the most common. We report an interesting subclinical sporadic case of Oro-facial-digital syndrome type I in a 21-year-old female patient. Interestingly, our patient presented with a few novel hitherto unreported clinical findings like midline pits in the philtrum area and a hamartomatous proliferation of tissue in the anterior maxillary alveolar gingival region. This case report highlights the importance of prudent histopathological-clinical correlation, which can direct the flow of clinical investigations leading to the detection and diagnosis of unsuspected conditions as learned in this case. We would also like to emphasize that comprehensive examination of new born for structural abnormalities of the orofacial region is crucial to early diagnosis of syndromes and subsequent referral for further evaluation and management.

Prevalence of temporomandibular disorder and possible associated factors in a sample of older adults: population-based cross-sectional study

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorders (TMD) are a group of conditions characterized by changes in the movements and function of the orofacial region and one of main reported symptoms is pain. As it has been increasingly described among different age groups, this study aimed to evaluate the presence of symptoms of TMD and their possible associated factors in older people from a city in southern Brazil. METHODS: A cross-sectional household-based study using a per cluster sampling strategy was performed including 282 older adults aged ≥60 years in the city of Veranopolis/RS. A clinical oral examination and a structured questionnaire were applied. TMD symptoms were evaluated with Fonseca Anamnestic Index (FAI) questionnaire and divided into those “without TMD” and “with TMD” (the later including those reporting mild, moderate and severe TMD symptoms). Associations were performed by the chi-square or Mann-Whitney tests based on frequency distribution. Bi and multivariate analyses were performed using Poisson regression with robust variation to verify associations. RESULTS: Prevalence among older adults that reported symptoms of TMD was 30.5% (n=86). In the final multivariate model, female older adults presented higher prevalence ratio (PR) for symptoms of TMD, presenting 62.8% (p=0.040) higher PR to at least mild symptoms of TMD when compared to older adult men. Number of teeth, need for dental prosthesis or other demographic variables were not associated with symptoms of TMD. CONCLUSION: The results demonstrated a prevalence of TMD symptoms in the seniors of approximately 30%, which was most associated with females. Despite its relevance in public health strategies focused on older adults, these findings should be interpreted with caution due to their observational and cross-sectional nature.

RARES CLINICAL ENTITY - IDIOPATHIC OROFACIAL GRANULOMATOSIS

Orofacial granulomatosis (OFG), a noncaseating granulomatous inflammation is a rare disorder affecting the orofacial region which is clinically characterized by diffuse, nontender, soft to firm enlargement involving lip, tongue, gingiva, buccal mucosa, floor of the mouth and other intra-oral sites. The term Idiopathic Orofacial granulomatosis refers to conditions restricted to the oral region without any identifiable systemic granulomatous diseases. Though certain food and food additives, dental materials and various microbiological agents may be possible etiological agents, the definite cause has yet to be identified. The exact antigen inducing the immunological reaction differs in individuals. Evidence for the role of genetic predisposition to the disease is sporadic. Delayed type of hypersensitivity reaction appears to play a significant role. Early diagnosis and management prevent the systemic complications. Multidisciplinary approaches are evolved to achieve periodontal esthetics. This case report entails the overview of enlargement of lip and gingiva in a 28year old female of 2 years duration without any identifiable etiology and was treated by gingivectomy. KEYWORDS: Orofacial granulomatosis [OFG], Gingival enlargement, Corticosteroid therapy

Prevalence of orofacial Pain among working adults - A Retrospective Study

Orofacial pain can be defined as a discipline of dentistry that deals with the diagnosis and management of different types of pain pertaining to the orofacial region such as the trigeminal neuralgia, atypical facial pain, postherpetic neuralgia, etc. The aim of the current study is to determine the prevalence of Orofacial Pain among working adults. The retrospective study involved the analysis of the case sheets of the patients with orofacial pain in the stipulated time frame and assessment based on the following parameters: age, gender, the type of orofacial pain, working status—statistical analysis calculated by chi-square test. A p-value <0.05 was considered significant. The prevalence of orofacial pain was 0.08% with a female - to - the male ratio of 1.06: 1 and working adults to non-working adults ratio of 1.36: 1. Trigeminal neuralgia shows a male-female ratio of 1.18: 1 and higher prevalence of Atypical facial pain in females (15.15%). According to our study, it can be concluded that orofacial pain was more prevalent in females. The prevalence of Trigeminal Neuralgia was higher in males and Atypical facial pain was the most prevalent type in females.

Prevalence of odontogenic cysts in patients visiting a tertiary Dental Care Hospital in North India- An 8 year experience

Aims and Objectives: The present study aims at evaluation of age, sex and site of occurrence related prevalence of Radicular cyst, Dentigerous cyst, Odontogenic keratocyst (OKC), Lateral Periodontal cyst, Residual cyst, Adult Gingival cyst, Calcifying odontogenic cysts. Materials and Methods: During 8 year period (From 2010 to 2017), 1000 patients with cystic lesions of the jaws were analysed. All patients underwent clinical examination and plain film radiography (panoramic, periapical, and occlusal views). Some of them were referred for CBCT or computed tomography (CT) with a multiplanar reconstruction program (MPR). Age, sex, type of cyst and location were recorded in designed performa. The treatment modalities used for the management of cysts are marsupialization, enucleation, enucleation with bone grafting or resection under local or general anaesthesia depending on the case. Results: Radicular cyst(45.2%) is most common cyst followed by dentigerous cyst(23.2%),Odontogenic keratocyst (13.4%), lateral periodontal cyst(8.9%), residual cyst(4.5%),Calcifying odontogenic cyst (4.4%) followed by the least common occurring adult gingival cyst (1.1%). The mandibular posterior region (41.3%) is most predilected site of occurrence of cysts in orofacial region however maxillary anterior region (17.7%) is least predilected site of occurrence. Conclusion: The radicular cyst is most common cyst of oral cavity while adult gingival cyst is least common cyst. Keywords: Cyst, Jaw bone, Prevalence, Odontogenic, Nonodontogenic.

Dermatomyositis: what the oral healthcare provider must know

Dermatomyositis (DM) is an autoimmune condition characterized by skin rashes and progressive muscle weakness. It is classified under the idiopathic inflammatory myopathies (IIM) and can affect children as well as adults. A heightened incidence of malignancy in adults with DM has laid greater focus on its early diagnosis, treatment, and monitoring. In recent years, a greater understanding of the pathogenesis of the disease, its diagnostic criteria and management has improved the quality of life in affected individuals. The orofacial region presents with many manifestations of the disorder, sometimes even the initial presenting signs. This review presents an update on the disease process, its pathogenesis, diagnostic criteria, orofacial manifestations, medical management and dental considerations for patients with DM. The updated knowledge about DM is crucial for oral health care providers to plan and execute oral health care in a coordinated manner.

Occurrence and patterns of orofacial injury in CrossFit practitioners.

CrossFit is an activity that can provide positive influences on body composition and physical fitness. However, the occurrence or pattern of possible injuries, especially in the orofacial region, has not yet been studied. The aim of this study was to investigate the occurrence and patterns of orofacial injuries in CrossFit practitioners. This was a cross-sectional study carried out using an online questionnaire on the Google Forms platform. The volunteers were self-selected men and women who practice CrossFit and reside in Brazilian municipalities. The online survey was conducted during April 2020 and comprised 12 questions. The data were analyzed, categorized, and presented as percentages. These were 65 (27.8%) participants who reported having suffered at least one episode of orofacial trauma and they were more prevalent during training sessions 58 (89.2%). Among the regions with the highest frequency of injuries, the head 23 (21%), mental protuberance 22 (19.6%), upper lip 19 (16.9%), and maxillary teeth 14 (12.5%) were the most cited. The prevalence of injuries in the head region indicates a potential concern. Preference should be given to making mouthguards for the maxillary teeth, as they are significantly more affected by trauma during CrossFit when compared to the mandibular teeth.

Biomechanical Analysis of a Custom-Made Mouthguard Reinforced With Different Elastic Modulus Laminates During a Simulated Maxillofacial Trauma.

There is a lack of data regarding the influence of different laminates for mouthguard reinforcement in the mechanical response during an impact in the orofacial region. The aim of this study was to verify the influence of the laminate framework on the stresses and strains of the anterior teeth and displacement of ethylene-vinyl acetate (EVA) custom-made mouthguards during a simulated impact. The null hypotheses was that the different laminates reinforcement would present the similar effect in maxillary structures, regardless the elastic modulus. A finite element model of human maxillary central incisors with an antagonist contact was used. A linear quasi-static analysis was used to simulate the force exerted during an impact. A total of 5 different layers were simulated inside the mouthguard at the labial portion according to the Elastic Modulus 1 MPa (Extremely flexible), 9 GPa (Low modulus reinforcement), 18 GPa (Without reinforcement), 50 GPa (Flexible alloy), 100 GPa (Titanium alloy) and 200 GPa (Hard material). The results were evaluated by means of Maximum Principal Stress (in the tooth and bone), Microstrain (periodontal ligament) and Displacement (mouthguard) criteria. The elastic modulus of the material inside the MG influenced the stress distribution on the enamel buccal face. However, it did not affect the bone tissue stress, periodontal ligament strain or root dentin tissue stress. Conclusion: The use of reinforcement inside the custom-made mouthguard can modify the stress generated in the enamel buccal surface without improvement to the root dentin, periodontal ligament or bone tissue.

Impacts of missing upper anterior teeth on daily living

Aesthetics and function of the orofacial region are very important aspects of human life which may be affected by tooth loss and impact on the quality of life. The aim of this study was to identify the effects of anterior tooth loss on patients' quality of life and satisfaction with their dentition. Fifty partially edentulous patients with missing anterior teeth and 50 control subjects who had no missing teeth were recruited into the study. The control subjects matched the patients by age, gender, and level of education. A Dental Impact on Daily Living questionnaire was used to assess dental impacts on daily living and satisfaction with the dentition. Tooth loss has a definite measurable impact on patients' daily living and satisfaction with their appearance, pain levels, oral comfort, general performance, and eating capacities (p = 0.000). Age and level of education had no effect on patients' total satisfaction with their dentition and daily living. However, females were less satisfied with appearance, general performance and eating (p = 0.003, 0.005 and 0.007 respectively) than males. There were significant correlations between the number of missing anterior teeth and patients' total satisfaction (p = 0.028) and patients satisfaction with appearance, oral comfort, general performance, and eating dimensions (p = 0.001, 0.048, 0.011 and 0.009 respectively). Tooth loss has definitive impact on patients' satisfaction with their dentition regardless of personal factors such as age, gender and level of education. The higher the number of missing teeth the lower the levels of satisfaction with the dentition and daily living.

ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ

Bu çalışmanın amacı fasiyal şişliği olan hastaların selülit ve apse teşhisinde klinik muayene ve buna yardımcı bir tanı aracı olan ultrasonografi ile elde edilen bulguları incelemek ve hastaların biyokimyasal bulguları ile karşılaştırmaktır. Kliniğimize fasiyal şişlikle başvuran 34 hastadan, panoramik radyografi alınarak etken diş belirlenip kaydedildi. Enfeksiyon safhaları sonografik olarak selülit, preapse ve apse safhası olmak üzere 3 grupta, yüksek çözünürlüklü ultrasonografi cihazı kullanılarak sınıflandırıldı. Hemoglobin, hematokrit, trombositler, beyaz kan hücresi, diferansiyel sayımlar ve yüzdeler ADVIA 2120 Hematoloji Sistemi kullanılarak belirlendi. Çalışmamızda yer alan 34 bireyden 19’u kadın (%56) ve 15’i erkekti (%44). Apse veya selülit şikâyeti ile hasteneye en yoğun başvuruların 0-10 (%35.3) yaş aralığında olduğu bulundu. Apse ile selülit gruplarının biyokimyasal bulguları karşılaştırıldığında hs-CRP, WBC ve nötrofil sayımı değerlerinin ortalamalarının apse grubunda selülit grubundan daha düşük bulundu. WBC değerleri apse grubunda; 10.18±2.31 mm3, selülit grubunda 11.95±3.48 mm3 bulundu. hs-CRP değerleri apse grubunda 38.22 mg/L (min:3.14-max:118), selülit grubunda 72.21 mg/L (min:3.17-max:159.17) bulundu. Nötrofil değerleri apse grubunda; 6.57±2.12 mm3, selülit grubunda 9.4±3.93 mm3 olarak bulundu. Her üç parametrenin selülite göre daha lokal bir klinik cevap olan apsede düşük olması klinik bulgular ile uyumludur. Yirmi altı apse vakasının on dördü (% 53.84) mandibular posterior diş kaynaklıydı. Orofasiyal bölge enfeksiyonu şikâyeti ile hastanede yatan hastalar için tekrarlanan takip muayenelerinde USG yararlı bir teknik olabilir.

Photodynamic therapy and Acyclovir in the treatment of recurrent herpes labialis: A controlled randomized clinical trial.

Herpes Simplex Virus Type 1 (HSV-1) is one of the most widespread infections that can effect the orofacial region. Recurrent infection is considered a life-long oral health problem, leading to pain, discomfort, and social restriction due to esthetic features when active. Effective therapies are needed. This study aimed to compare photodynamic therapy (PDT), Topical Acyclovir (AC), and the association of both in the healing process and self-reported symptomologies of HSV-1 recurrences. Patients were randomly assigned into 3 groups (n = 25): PDT (low-power laser, 660 nm, 40 mW, 120 J/cm2, 4.8 J, 120 s per point) and methylene blue (0.005 %) as photosensitizer; AC (5%); PDT + AC.Data concerning lesion size, healing time, and self-reported healing parameters, such as pain, tingling, and edema were taken every day up to complete healing for all studied groups. There was no significant difference in healing time and pain between groups. AC group showed a significant minor reduction of the lesion compared to the AC-PDT group on day 1. Regarding edema and tingling, the comparison of treatments showed a statistical difference only on day 1, where PDT showed better results. With all the limitations of this study, it can be concluded that only on day 1 PDT showed positive effects in the treatment of herpes lesions in comparison to AC.

Accuracy of fine needle aspiration cytology in the preoperative diagnosis of malignant non-odontogenic tumors of the orofacial region.

This study aims to determine the association between preoperative cytopathological diagnosis and the histopathological diagnosis of orofacial non-odontogenic tumors. It is also, to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in the preoperative diagnosis of orofacial malignant non-odontogenic tumors in a Nigerian population. A 9-month prospective study in which preoperative FNAC followed by open biopsy for confirmatory histopathological evaluation was performed for consenting patients with orofacial swellings. Patients histopathologically diagnosed as non-odontogenic tumors were selected for the study. There were 40 (83.3%) histopathologically diagnosed non-odontogenic tumors. The female to male ratio was 1.7:1 and the patients' mean age was 36 + 21.9 years. The mandible (n = 4, 10.0%) and the preauricular area (n = 4, 10.0%) were the most common sites affected. The cytopathological diagnosis showed 28 (70.0%) of the lesions were malignant, 7 (17.5%) were benign neoplasms and 5 (12.5%) were reactive/inflammatory swellings. The histopathological diagnosis was predominantly malignant (n = 29, 72.5%), consisting mostly of non-Hodgkin's lymphoma (n = 12, 30.0%). There was significant association (P = .000) between cytopathological diagnosis and histopathological diagnosis of the malignant orofacial non-odontogenic tumors. The sensitivity of FNAC to detect malignant orofacial nonodontogenic tumors was 93.1%, the specificity was 90.9%, the positive predictive value was 96.4%, the negative predictive values was 83.3% and the accuracy was 92.5%. The accuracy of FNAC in the diagnosis of orofacial malignant non-odontogenic orofacial tumors is high and hence recommended as a routine preoperative diagnostic tool.