The effects of chronic pain on oral health related quality of life in patients with anterior disc displacement with reduction

AIM

The aim of this study was to evaluate the effects of chronic pain on oral health related quality of life (oral QoL) in patients with anterior disc displacement with reduction (DDwR).

MATERIAL AND METHODS

Thirty-seven patients who had disc displacement with reduction (DDwR, F/M: 23/14, median age: 29, range: 23-49) were selected. These patients had chronic pain and had not been undergoing any treatment protocols for the previous six months. Age- and gender-matched healthy subjects healthy control, F/M: 23/14, mean age: 33.0 +/- 15.7 years) were used as a control group. Data were collected by means of a clinical examination and a questionnaire about pain status which included a jaw disability checklist RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders). Pain status was scored between 0 (no pain) and 10 (poor pain status) by the patients. Oral health related quality of life (oral QoL) over the previous six months was evaluated by an oral health impact profile-14 (OHIP-14) questionnaire.

RESULTS

OHIP-14 score was significantly higher in patients with DDwR (median:17, min-max:6-39) than healthy controls (9, 0-18) (p = 0.000). The median duration of orofacial pain was 12 (range 7-120) months. Statistically significant correlations were observed between OHIP-14 score and the worst pain intensity in the past six months (7, 0-10) (r = 0.5 p = 0.007) and average pain intensity in the past six months (5.5, 1-10) (r = 0.4 p = 0.018). In addition, an increase in OHIP-14 score was observed in patients experiencing difficulty in smiling/laughing, cleaning their teeth or face, swallowing or talking, according to the jaw disability checklist (p = 0.042, p = 0.001, p = 0.023 and p = 0.007, respectively).

CONCLUSION

Poor oral QoL was related to chronic pain and limitations in jaw function in patients with DDwR.

A composite index for determining the impact of oral ulcer activity in Behcet's disease and recurrent aphthous stomatitis

BACKGROUND

Although number, frequency and healing time of oral ulcers and pain are generally used for clinical practice and studies in Behcet's disease (BD) and recurrent aphthous stomatitis (RAS), no standardized activity index is currently present to monitor clinical manifestations associated with oral ulcers. The aim of this study was to develop a standardized composite index (CI) to assess oral ulcer activity in BD and RAS.

METHODS

In this cross-sectional study, 121 patients with BD and 45 patients with RAS were included. Sixty-five percentage of BD and 68.9% of RAS patients were in active stage during the previous 3 months. The developed CI included the presence of oral ulcers, ulcer-related pain and functional status and was evaluated in patients with both active and inactive disease for content validity.

RESULTS

Composite index score was observed to be higher in active patients with RAS (6.94 + or - 2.19) compared with active BD patients (6.01 + or - 2.04) (P = 0.04). The number of oral ulcers and healing time of oral ulcers were significantly higher in RAS compared with BD (P = 0.018, P = 0.001 respectively). CI score correlated with the number of oral ulcers in both BD and RAS (P = 0.000, P = 0.002 respectively). CI score was '0' for inactive patients without oral ulcer in BD and RAS.

CONCLUSIONS

The presented CI as an oral ulcer activity index seems to be a reliable and suitable tool for evaluating the clinical impact and disease-specific problems in BD and RAS.

Gold weight with single hole versus multiple holes--experimental study in rabbits

Lagophtalmia can be a serious complication of facial paralysis. Gold weight application to the upper eyelid is one of the most popular and practical conventional techniques. However, displacement or extrusion are commonly encountered complications. In order to minimize these complications, we modified the original design of the gold weight. Our hypothesis is that gold weight with multiple holes resists displacement and resultant extrusion via extensive fibrous tissue formation through the holes. Twelve New Zealand rabbits were used for this experiment. 2 x 1 cm and 1.8 g ellipsoid golden weights with single and multiple holes were compared. They were placed subcutaneously, to the dorsal surface of the rabbit ears and no suturing was performed. Golden weights with single holes were introduced to the left ear while the golden weights with multiple holes were placed to the right ear. The rates and degree of extrusion and displacement were evaluated in the second and third weeks macroscopically and microscopically. Results were compared by Chi-square and Mann-Whitney U tests. Statistically better outcomes were achieved by golden weights with multiple holes versus single hole (p<0.0034).

A primitive neuroectodermal tumor on the face: case report

In 1918, Stout defined the lesion in which small round cells originating from the ulnar nerve formed a rosette as neuroepithelioma. It was claimed that this tumor originated from neuroectodermis and was different from the classical neuroblastoma. The term primitive neuroectodermal tumor (PNET) involves a group of tumors of the soft tissue originating from neural crest and resulting from the brain, spinal cord and branches of the sympathetic nervous system. Extracranial primitive neuroectodermal tumors originate from neural crest cells outside the sympathetic and central nervous system. PNET also has some distinctive histological, immunohistochemical and ultrastructural features. It is usually encountered in children and young adults; most frequently located in thoracopulmonary region (Askin's tumor). The second most commonly involved body part is the extremities. It is very rarely located on the face. PNET is an aggressive tumor. In fact, the disease has a rapid progression, causes local or distant metastases and 50% of the patients die within two years of the presentation. It is treated with aggressive surgery as well as chemotherapy and radiotherapy. In this report, we presented a case of PNET located on the right cheek with multiple distant metastases. Clinicians should be on alert when treating facial tumors, not to skip PNET, which is a very aggressive one.