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One possible cause of the reported positive treatment effect by low-power laser exposure in muscle pain conditions could be that it increases the local microcirculation. The aim of this study was therefore to investigate the immediate effects on masseter muscle blood flow by low-power laser exposure in patients with chronic orofacial pain of muscular origin in comparison to healthy individuals. Twelve patients with myofascial pain of orofacial muscles and 12 age and gender matched healthy individuals participated in the study. Before laser exposure the subjects were examined clinically and the patients scored their current pain intensity from the most tender masseter muscle. Intramuscular laser-Doppler flowmetry was performed unilaterally in the most tender point (patients) or in a standardized point (healthy subjects) of the masseter muscle. The muscle was first exposed with a Gallium-Aluminum-Arsenide laser (active laser) or placebo laser for 2 min in a randomized and double-blind manner. After another 8 min the muscle was treated with the other laser for 2 min and the LDF recording continued for 8 min. Finally, the patients again assessed the pain intensity. Data were analyzed blindly by one of the authors not participating in data collection. The pain intensity was not affected by laser exposure. The blood flow did not change significantly in the patients, but increased after active laser exposure and decreased after placebo exposure in the healthy individuals. The difference between active laser and placebo was significant. In conclusion, the results of this study do not support an effect of low-power laser exposure on masseter muscle microcirculation in patients with chronic orofacial pain of muscular origin.

Forty-four subjects, who at the age of 4 years had been treated for unilateral forced cross-bite by grinding or by maxillary arch expansion, were 16-19 years later followed-up by means of a questionnaire about their present condition with regard to temporomandibular disorders (TMD). Twenty-two of them had received only early treatment (early questionnaire group) and 22 had received late treatment (late questionnaire group). Fourteen of the subjects who received late treatment also received early treatment. Twenty-nine of the subjects were also examined clinically. Eighteen of these had only received early treatment at 4 years of age (early clinical group), whereas 11 of them also received later treatment in the mixed or permanent dentition because of relapse (late clinical group). No significant differences were found between the early and late groups with regard to signs and symptoms of TMD. Most of the young adults who had undergone orthodontic treatment had well-functioning masticatory systems, and severe TMD signs and symptoms were rare. The results of this study suggest that relapse of early orthodontic treatment and further need of treatment does not influence the later status of subjective symptoms or clinical signs of TMD in young adults.

Twenty-nine subjects, 20 years old on average and all treated at 4 years of age for unilateral forced posterior dento-alveolar cross-bite by grinding or by expansion of the upper dental arch, were clinically examined to evaluate the long-term effects of their treatment. The frequency of successful treatment-indicated as stable correction of the cross-bite-by means of only 1 treatment sequence was 59%; by grinding, 57%; and by expansion, 60%. The 18 subjects that had only been treated at the age of 4 years formed the 'early group' in our study. Eleven of our subjects had been retreated later in the mixed or permanent dentition because of a relapse of the unilateral forced posterior cross-bite and formed the 'late group'. A significantly higher frequency of mouth breathing, breathing obstacles, and snoring was found in this group. According to our clinical investigation, 2 of the subjects in our cohort still had a unilateral forced posterior cross-bite. Our findings regarding masticatory performance, bite force, and endurance showed no significant differences between the initial cross-bite and the healthy sides or between the early and the late group subjects, which showed that the masticatory function of the treated subjects was symmetrical. Grinding and expansion treatments seem to display similar success rates in the long-term regarding correction of unilateral posterior forced cross-bite.

Sudden sensorineural hearingloss (SSH) usually affects one ear and leads to life long deafness in some cases. There are many theories about the origin of the condition but the etiology and pathophysiology are still unknown. However, tinnitus and vertigo frequently occur in patients with SSH, but are also frequent symptoms reported by patients with temporomandibular disorders (TMD). We hypothesized that TMD symptoms and signs are frequent in SSH patients. The objective of this study was therefore to investigate the presence of TMD symptoms and signs in SSH patients compared with healthy individuals. The groups, matched by gender and age, consisted each of 9 females and 6 males. Both groups answered a questionnaire about TMD symptoms and a clinical examination which included maximum voluntary mouth opening, temporomandibular joint sounds, tenderness to digital palpation of the TMJs and selected masticatory muscles, intermaxillary relations and dental occlusion was performed. The SSH patients reported significantly higher rates of pain in the head and face region and pain during mandibular movements as well as of aural symptoms compared with the control group. There was also a statistically significant difference between the groups in the number of masticatory muscles tender to digital palpation, as well as in some occlusal variables. In conclusion, this study shows that self-reported symptoms and clinical signs of TMD are more frequent in patients with SSH than in healthy controls.

The aim of the study was to investigate the presence of symptoms and signs of temporomandibular disorders (TMD) in patients with tinnitus and to evaluate the effect of TMD treatment on tinnitus in a long-term perspective in comparison with a control group of patients on a waiting list.One-hundred-and-twenty patients with tinnitus were subjected to a clinical examination of the masticatory system and whether they had co-existing TMD to TMD treatment. Ninety-six patients had TMD, most frequently localized myalgia. Seventy-three of these completed the treatment and responded to a questionnaire 2 years later. Fifty patients with tinnitus who were on the waiting list served as a control group.Eighty percent of the patients had signs of TMD, most commonly myofascial pain. Forty-three percent of the patients reported that their tinnitus was improved at the 2-year follow-up, 39% that it was unchanged, and 17% that it was impaired compared to before the treatment. Twelve percent of the subjects in the control group reported that their tinnitus was improved compared to 2 years previously, 32% that it was unchanged, and 56% that it was impaired. The difference between groups was significant (chi(2): p0.001).The results of this study showed that TMD symptoms and signs are frequent in patients with tinnitus and that TMD treatment has a good effect on tinnitus in a long-term perspective, especially in patients with fluctuating tinnitus.

Twenty-seven gold crowns, removed from patients with problems such as diffuse pain and metallic taste, have been examined. The gold crowns were made of an ordinary casting gold alloy, type III. The crowns were built on amalgam cores or big amalgam fillings. Eight of these crowns had cracks beginning at the cervical margin and propagating occlusally. The crowns were examined in a scanning electron microscope equipped with an energy-dispersive detector. The study showed that the cracks propagated along the grain boundaries within the gold alloy. In the cracks corrosion products usually found on amalgam were identified. The cracks could be due to intercrystalline stress corrosion or overloading.