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Analysis of factors influencing the long-term effect of treatment of TMJ pain-dysfunction
CURRENT
LITERATURE Abstracts
The Anatomy and Electrical Activity of the Platysma Muscle. Widmalm S-E. Nemeth PA, Ash Jr MM, et al. J Oral Rehabil 12: 17-22, 1985
Reprint requests to Dr. Wilson: Department of Oral Pathology and Oral Surgery. The University of Adelaide. Adelaide, South Australia 5001.
Dissection of seven cadavers showed varying distributions of the platysma muscle ranging from overlapping of just the anterior-inferior aspect of the masseter to overlapping the major portion of the muscle. The platysma inserted in the anterior-inferior aspect of the mandible as well as intermingled with the lateral fibers of the orbicularis oris. Electrical activity of the platysma muscle at rest and during various mandibular excursions was studied in seven patients using EMG recordings. The results showed that in most cases the platysma was active in the late phase of vertical opening and that the ipsilatera1 platysma was active during lateral-vertical excursion. It was also noted that the platysma was a possibly significant source of artifact when attempting to record EMG activity of the masseter with surface electrodes due to its superficial location and aCtiVitY.--JEFF KENNEY
Effective Short-term Diazepam Prophylaxis in Febrile Convulsions. Knudsen FU. J Pediatr 106:487-490, 1985
Reprint requests to
The efficacy of short-term diazepam prophylaxis for febrile convulsions was evaluated in a prospective. controlled study. Two groups of children were evaluated and randomized after being admitted with their first febrile seizure. One group received prophylaxis with rectally administered diazepam for 18 months whenever the temperature was elevated to 38.5”. while the second group received no prophylaxis but was treated with rectally administered diazepam in the event of new seizures. The short-term prophylaxis afforded effective seizure control. The IS-month recurrence rate was reduced from 39% to 12% and the total number of recurrences from 77 to 23. No adverse effects from the diazepam administration were observed. It should be noted that pediatric patients may be on this protocol when presenting for dental surgical treatment and that in this event full evaluation is required prior to administration of other drugs for seda-
Dr. Widmalm. 1565 Kuehnle St., Ann Arbor,
MI 48103.
Oral Flunitrazepam in the Prevention of Local Anesthetic-induced Convulsions in Mice. Vatashsky E, Beilin B. Aronson HB, et al. Can Anaesth Sot J 31:6, 1984
tion or general
JR.
Analysis of Factors Influencing the Long-term Effect of Treatment of TMJ Pain-dysfunction. Mejersjo C, Carlsson GE. J Oral Rehabil 2:289-297, 1984 A study of 154 females who had TMJ dysfunction was performed approximately seven years following treatment. The various types of treatment were not described. The influence of factors such as diagnosis, age, general health, occlusal disharmonies, den&ion, and social environment on the effectiveness of treatment was analyzed. Three main diagnostic classifications were used: mandibular pain-dysfunction; osteoarthrosis of the TMJ; and TMJ clicking without manifestation of pain or dysfunction. Data were obtained by a questionnaire and thorough examination. Amnestic and clinical dysfunction indices were developed along with maximal mouth-opening measurements for pre- and posttreatment phases for each of the three diagnostic groups. It was found that patients who had TMJ osteoarthrosis had no more symptoms of dysfunction at follow up than those who had only neuromuscular problems. Poor general health was found to have a negative influence on both immediate and longterm response to treatment of TMJ pain. Little correlation was found between occlusal disharmony and dysfunction. It was also noted that pain on mandibular movement seemed to correlate objectively with TMJ pain and “facial” pain seemed to correlate clinically with muscle pain. It was also found that decreased molar/premolar support due to tooth loss could be correlated with impaired TMJ fUtICtiOn.-MtCHAEL E. MILLER
Reprint requests to Dr. Vatashsky: Department of Anesthesia. Mt. Scopus, Jerusalem.
RINGGOLD.
Reprints requests to Dr. Knudsen: Department of Pediatrics, Glostrup University Hospital. DK-2600 Glostrup. Denmark.
The efficacy of oral flunitrazepam in reducing the CNS toxicity of lidocaine and bupivacaine was studied in mice. The two local anesthetics were injected intraperitoneally 45 minutes after pretreatment of mice with flunitrazepam, 0.065-0.25 mglkg. Pretreatment with flunitrazepam reduced or prevented convulsions and mortality induced by lidocaine in strengths of 106-209 mg/kg. The same results were found with bupivacaine in strengths of 58-90 mgi kg. The doses of flunitrazepam did not produce measurable sedation. These findings support the results of previous studies of this kind and indicate that flunitrazepam could be useful for the oral premeditation of patients undergoing extensive oral surgery.-RONALD SHAMASKIN Hadassah University Hospital, 24035, Jerusalem 91240 Israel.
anesthesia.-CHARLES
POB
Surgicel: Its Fate Following Implantation. Pierce AM. Wiebkin OW, Wilson DE J Oral Path01 13:661-670. 1984 A study was undertaken to investigate the biologic mechanisms for removal or degradation of Surgicela, an alledgedly absorbable hemostatic agent consisting of oxidized regenerated cellulose. The time necessary for absorption of Surgicel components from the implantation site and the mechanism its removal were studied both in vitro and in vivo after implantation into chest wall muscles of rats. Histochemical analysis indicated that Surgicel contains at least two active components: a readily soluble uranic acid component lost from implants and degraded extracellularly or systemically cleared within 18 hours and a fibrous residue component still evident in the implantation site at 48 hours and postulated to require macrophage phagocytosis for subsequent clearance.-
Reprint request to Dr. Mejersjo: Department of Stomatognathic Physiology, Faculty of Odontology, University of GBteborg, Box 33070, S-400 33 GBteborg, Sweden.
LARRY R. MEADOR
740
LITERATURE Abstracts
The Anatomy and Electrical Activity of the Platysma Muscle. Widmalm S-E. Nemeth PA, Ash Jr MM, et al. J Oral Rehabil 12: 17-22, 1985
Reprint requests to Dr. Wilson: Department of Oral Pathology and Oral Surgery. The University of Adelaide. Adelaide, South Australia 5001.
Dissection of seven cadavers showed varying distributions of the platysma muscle ranging from overlapping of just the anterior-inferior aspect of the masseter to overlapping the major portion of the muscle. The platysma inserted in the anterior-inferior aspect of the mandible as well as intermingled with the lateral fibers of the orbicularis oris. Electrical activity of the platysma muscle at rest and during various mandibular excursions was studied in seven patients using EMG recordings. The results showed that in most cases the platysma was active in the late phase of vertical opening and that the ipsilatera1 platysma was active during lateral-vertical excursion. It was also noted that the platysma was a possibly significant source of artifact when attempting to record EMG activity of the masseter with surface electrodes due to its superficial location and aCtiVitY.--JEFF KENNEY
Effective Short-term Diazepam Prophylaxis in Febrile Convulsions. Knudsen FU. J Pediatr 106:487-490, 1985
Reprint requests to
The efficacy of short-term diazepam prophylaxis for febrile convulsions was evaluated in a prospective. controlled study. Two groups of children were evaluated and randomized after being admitted with their first febrile seizure. One group received prophylaxis with rectally administered diazepam for 18 months whenever the temperature was elevated to 38.5”. while the second group received no prophylaxis but was treated with rectally administered diazepam in the event of new seizures. The short-term prophylaxis afforded effective seizure control. The IS-month recurrence rate was reduced from 39% to 12% and the total number of recurrences from 77 to 23. No adverse effects from the diazepam administration were observed. It should be noted that pediatric patients may be on this protocol when presenting for dental surgical treatment and that in this event full evaluation is required prior to administration of other drugs for seda-
Dr. Widmalm. 1565 Kuehnle St., Ann Arbor,
MI 48103.
Oral Flunitrazepam in the Prevention of Local Anesthetic-induced Convulsions in Mice. Vatashsky E, Beilin B. Aronson HB, et al. Can Anaesth Sot J 31:6, 1984
tion or general
JR.
Analysis of Factors Influencing the Long-term Effect of Treatment of TMJ Pain-dysfunction. Mejersjo C, Carlsson GE. J Oral Rehabil 2:289-297, 1984 A study of 154 females who had TMJ dysfunction was performed approximately seven years following treatment. The various types of treatment were not described. The influence of factors such as diagnosis, age, general health, occlusal disharmonies, den&ion, and social environment on the effectiveness of treatment was analyzed. Three main diagnostic classifications were used: mandibular pain-dysfunction; osteoarthrosis of the TMJ; and TMJ clicking without manifestation of pain or dysfunction. Data were obtained by a questionnaire and thorough examination. Amnestic and clinical dysfunction indices were developed along with maximal mouth-opening measurements for pre- and posttreatment phases for each of the three diagnostic groups. It was found that patients who had TMJ osteoarthrosis had no more symptoms of dysfunction at follow up than those who had only neuromuscular problems. Poor general health was found to have a negative influence on both immediate and longterm response to treatment of TMJ pain. Little correlation was found between occlusal disharmony and dysfunction. It was also noted that pain on mandibular movement seemed to correlate objectively with TMJ pain and “facial” pain seemed to correlate clinically with muscle pain. It was also found that decreased molar/premolar support due to tooth loss could be correlated with impaired TMJ fUtICtiOn.-MtCHAEL E. MILLER
Reprint requests to Dr. Vatashsky: Department of Anesthesia. Mt. Scopus, Jerusalem.
RINGGOLD.
Reprints requests to Dr. Knudsen: Department of Pediatrics, Glostrup University Hospital. DK-2600 Glostrup. Denmark.
The efficacy of oral flunitrazepam in reducing the CNS toxicity of lidocaine and bupivacaine was studied in mice. The two local anesthetics were injected intraperitoneally 45 minutes after pretreatment of mice with flunitrazepam, 0.065-0.25 mglkg. Pretreatment with flunitrazepam reduced or prevented convulsions and mortality induced by lidocaine in strengths of 106-209 mg/kg. The same results were found with bupivacaine in strengths of 58-90 mgi kg. The doses of flunitrazepam did not produce measurable sedation. These findings support the results of previous studies of this kind and indicate that flunitrazepam could be useful for the oral premeditation of patients undergoing extensive oral surgery.-RONALD SHAMASKIN Hadassah University Hospital, 24035, Jerusalem 91240 Israel.
anesthesia.-CHARLES
POB
Surgicel: Its Fate Following Implantation. Pierce AM. Wiebkin OW, Wilson DE J Oral Path01 13:661-670. 1984 A study was undertaken to investigate the biologic mechanisms for removal or degradation of Surgicela, an alledgedly absorbable hemostatic agent consisting of oxidized regenerated cellulose. The time necessary for absorption of Surgicel components from the implantation site and the mechanism its removal were studied both in vitro and in vivo after implantation into chest wall muscles of rats. Histochemical analysis indicated that Surgicel contains at least two active components: a readily soluble uranic acid component lost from implants and degraded extracellularly or systemically cleared within 18 hours and a fibrous residue component still evident in the implantation site at 48 hours and postulated to require macrophage phagocytosis for subsequent clearance.-
Reprint request to Dr. Mejersjo: Department of Stomatognathic Physiology, Faculty of Odontology, University of GBteborg, Box 33070, S-400 33 GBteborg, Sweden.
LARRY R. MEADOR
740