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Aim: The prevalence of temporomandibular disorders (TMD) is higher among women than men, indicating a multifactorial role for gender-related differences in the etiology of TMD: physiological hormonal differences, inflammatory response to stress, and sociocultural differences in response to pain. The aim of this study was to draw a biobehavioral picture of the TMD patient based on Research Diagnostic Criteria for TMD (RDC/TM) Axis II diagnosis and analysis of gender-related differences., Methods: Between January 2006 and January 2008, 362 subjects were consecutively enrolled from patients who presented at the Clinic for Temporomandibular Disorders, School of Dental Medicine, University of Pavia, because of orofacial pain, limitation or joint sounds on mandibular movement. Of the 362 subjects evaluated, 308 met the inclusion criteria., Results: The average age of the study population was 41 years; the female: male ratio was 4:1. When stratified according to chronic pain intensity grade and gender, 26% of the women had grade I, 36.4% grade II, 17% grade III, and 9.7% grade IV; 34.4% of the men had grade I, 32.8% grade II, 6.5% grade III, and 3.3% grade IV. Depression was moderate in 35 women and in 6 men and severe in 138 women and in 24 men; somatization was moderate in 59 women and in 20 men and severe in 143 women and in 19 men., Conclusions: Gender-related differences may be considered risk factors for TMD; psychological characteristics, including somatization, depression, and anxiety related to gender, appear to have a significant impact on the prevalence of TMD.

In the international scientific literature, MRI is reported to identify anterior cruciate ligament tears with high diagnostic accuracy (80-95%). In this prospective analysis, 274 MR examinations of the knee were performed to develop a method to measure even slight sagittal dislocation of the tibia relative to the femur as a predictor of an anterior cruciate ligament tear. Ninety-eight patients presented a healthy anterior cruciate ligament and were therefore considered as a control group. In 92 cases, a complete tear of the anterior cruciate ligament was observed; in 78 cases the injury was partial and in 6 cases the posterior cruciate ligament was injured. Our results had arthroscopic, surgical or clinical confirmation in all cases. The measurements were carried out on an MR image of the sagittal midplane of the knee and served to calculate a ratio (Y/X) which quantifies the degree of possible tibial dislocation. The results served to establish a range for classifying the status of the anterior cruciate ligament in three categories: 1) undamaged ligaments (Y/X < 3), 2) interstitial injury (2.2 < Y/X < 3) and 3) complete tear (Y/X < 2.2). This simple and easy-to-apply method should be considered complementary to conventional MR examinations. The results are extremely useful in the analysis of acute injuries where other radiologic and symptomatologic techniques are not completely reliable.

The authors discuss the outcomes of therapy for CMDs and present a clinical case reporting an alternative method for the treatment of disc displacement. The orthopaedic therapy for CMDs is based on the use of interocclusal splints. Two kind of splints are prescribed to patients with CMDs: stabilization or repositioning splint. The former is used for a conservative treatment, the latter for irreversible treatment. In view of the poor long-term success of repositioning therapy, the cost of subsequent dental treatment, and the great potential for iatrogenic occlusal and muscular problems, the authors believe that the initial treatment approaches should be, in any case, conservative, reversible, and non invasive. The authors prescribe to their patients the repositioning splint for use either part-time or full time use. Part-time use is effective for preventing disc displacement without reduction. If used full time, once joint noises, pain, and displacement are decreased, the appliance should be adjusted to/or replaced with a stabilization appliance to allow posterior positioning of the mandible into a more physiologically stable position. The authors present a clinical case, a 27 yo female with disc displacement with reduction was treated with stabilization splint. After 6 weeks of therapy she returned reporting a temporary closed lock and sharp pain in the left TMJ. An anterior repositioning splint was fabricated in order to position the mandible forward. After 10 weeks of this treatment the patient reported absence of joint/muscle symptoms and of joint noise.(ABSTRACT TRUNCATED AT 250 WORDS)

A total of 41 patients affected with recurrent subluxations or dislocations of the patella treated with different surgical methods between 1972 and 1981 were examined. Radiographic and clinical monitoring according to Crosby-Insall in 35 patients ranges from 10 to 20 years, with the following results: excellent: 17%; good: 69%; fair: 14%; poor: 0; recurrent dislocations or subluxations: 0.

After a brief introduction, the authors experience on 71 capsular-ligamentous traumatic lesions of the acromion-clavicular articulation is reported. Statistical considerations are made and clinical results, obtained after three years from conservative treatment (all lesions were lifting in Allmann's standards), are exposed.

The Authors have considered one year's traumatological activity in the G. Pini Institute's S.T.U. by drawing some statistical results. The data refer to the traumas ambulatorium-treated and to all those which required hospitalization during 1979. The total of the traumas surveyed in 1979 is 33335 of which 1812 required urgent hospitalization (5.44%). Previous statistics show 6679 patients in 1961 and 3209 in 1956. We can realize how these figures have increased in a few years (and in this abstract the different kinds of traumas are also highlighted) without any adjustment to the existing structures and equipment which are completely insufficient.