Assessment of Low-Level Laser Therapy Effects After Extraction of Impacted Lower Third Molar Surgery

Introduction: The aim of this study was to assess the effect of low-level laser therapy (LLLT) on pain, swelling and maximum mouth opening in patients undergoing third molar surgery. Methods: A prospective, randomized double-blind study was undertaken on 44 patients at the Dental School, Ahvaz Jundishapur University of Medical Sciences, in 2015. A low-level laser was randomly applied on one of the two sides after surgery of 15 patients. The experimental side received 18 J/cm2 of energy density, wavelength of 980 nm, and output power of 1.8 W. On the control side, a hand-piece was applied intra-orally, but laser was not activated. In addition, in order to evaluate trismus, 13 patients were treated by unilateral laser therapy and 16 patients did not receive laser therapy at all. The laser was administered intraorally on two points of vestibular and lingual sides at 1 cm from the surgery site, and extraorally at the emergence of the masseter muscle, immediately after surgery, and repeated 24 hours later. The pain, swelling and maximum mouth opening (MMO) were compared between the two groups at 24 hours and a week after surgery. Results: The mean score of pain 24 hours after surgery in the laser therapy group (2.3 ± 3.5) was significantly lower than the mean score of pain in the drug therapy (4.19 ± 3.09) (P = 0.036). Moreover, the mean score of pain at one week after surgery in the laser therapy group (0.13 ± 2.33) was significantly lower than the drug therapy group (1.43 ± 2.45) (P = 0.046). The amount of swelling according to different measurements did not significantly differ between the two groups neither at 24 hours nor at 1 week after surgery. Conclusion: Our findings showed that LLLT was useful in reducing pain and could slightly reduce swelling compared to drug therapy in impacted third molar surgery.

Maximum mouth opening and its correlation with gender, age, height, weight, body mass index, and temporomandibular joint disorders in a Saudi population

Objective: To investigate maximum mouth opening (MMO) and its correlation with gender, age, height, weight, Body Mass Index, and temporomandibular joint disorders in a Saudi population.Methods: This is an observational cross-sectional study of 222 Saudi patients (46% male and 54% female). Patients were clinically examined, and files were accessed to record data. Frequency test was mainly used along with correlation tests.Results: The mean MMO for all subjects was 47.8 ± 6.9 mm. The mean MMO for male subjects was 50.8 ± 7.0 mm, and the mean MMO for female subjects was 45.2 ± 5.7 mm. The mean MMO of male subjects was significantly higher than the mean MMO of female subjects. MMO had a significantly weak positive correlation with height and weight.Conclusion: Male subjects had a significantly higher MMO than female subjects. MMO showed a weak but positive significant correlation with height and weight.

Efficacy of Arthrocentesis and Stabilization Splints in Treatment of Temporomandibular Joint Disc Displacement Disorder Without Reduction: A Systematic Review and Meta-analysis

Background

Temporomandibular joint disc displacement disorders are a group of temporomandibular disorders beside from other inflammatory disorders and growth related disorders of joint. The purpose of this analysis was to evaluate the efficacy of arthrocentesis procedure in comparison with stabilization splints used for disc displacement disorders without reduction.

Materials and Methods

A systematic search was done in electronic databases (PubMed, Cochrane Central, Web of Science). In addition to this hand search of references and grey literatures was done. Qualities of randomized controlled clinical trials were assessed by Cochrane's tool for Systematic Reviews of Interventions and the Newcastle-Ottawa Scale was followed to assess the prospective and retrospective studies. Outcome variables pain (VAS) and maximum mouth opening were assessed by the software review manager 5.03.

Results

A total of five studies were included in the review. Three studies showed greater improvement of symptoms in patients of arthrocentesis group in terms of maximum mouth opening, pain (VAS) value. Two other studies found no significant advantage of arthrocentesis over the other treatment protocol. The meta-analysis resulted in statistically significant difference between outcome variables favouring arthrocentesis group (VAS 1-10) (Mean Difference: 3.10; 95% CI 1.74, 4.45; P ≤ .00001, Mean difference: 2.00; 95% CI 0.29, 3.71; P = 0.02).

Conclusion

Arthrocentesis showed effective result in terms of increase in mouth opening and reduction of pain level compared to stabilization splint and other non-invasive approaches in patients with disc displacement disorders without reduction. Overall, results supported the rationale of using arthrocentesis in patients with disc displacement disorders without reduction.

Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study

BACKGROUND & OBJECTIVES

Oral submucous fibrosis (OSF) is a potentially malignant disorder of the oral cavity leading to reduction in mouth opening. Mouth opening assessment is used as one of the methods to assess the severity of the disease. In this study the normal maximum mouth-opening capacity of an individual is considered in assessing the reduction in mouth opening. This study was done to establish a new clinical staging pattern in OSF and to evaluate the relationship between the proposed staging system and traditional histopathological grading system of OSF.

MATERIALS AND METHODS

The study included 50 clinically diagnosed OSF patients. Normal mouth opening was established by measuring three-finger index (TFI). Existing maximum mouth opening was established by measuring the interincisal distance. Presence of palpable vertical bands was recorded. Histopathological grading was done according to Pindborg and Sirsat. Percentage of reduction in mouth opening (PRMO) was calculated and the mean of PRMO in different clinical and histopathological stages was analysed by fisherman's extract test. A new staging pattern for OSF was proposed from the data.

RESULTS

PRMO was assessed at different clinical stages. A range between 16% and 47% was obtained, and statistically the p value of <0.001 was very highly significant. Similarly, a range between 17% and 45.6% was obtained when PRMO was assessed at different histopathological grading; again the statistical value was very highly significant with a p value of <0.001.

CONCLUSION

With the data obtained from our study, the following clinical staging pattern can be adapted: stage I indicates that the PRMO is <30%, Stage II between 30-45%, and stage III >45%. Hence it may be appropriate to asses the disease severity and stage by assessing the degree of disability (i.e., mouth opening reduction considering the individual normal mouth opening ability). The determination of PRMO may be a useful tool in this direction.

Comparison of Maximum Mouth Opening Following Mandibular Bilateral Sagittal Splitting Ramus osteotomies in Class III Females Using Two Different Osteosynthesis Methods

BACKGROUND

Limitation of mouth opening is a common complaint following orthognathic surgery.

OBJECTIVES

This investigation reports on the progress of maximum incisal opening following orthognathic surgery and compares the impact of two different osteosynthesis methods on mouth opening in female patients with Class III dentofacial deformities.

METHODS

Forty cases of skeletal class III malocclusion were divided into twenty cases treated using the conventional single miniplate osteosynthesis method (P1) and twenty cases using the additional L-shaped miniplate osteosynthesis method (P2). No significant differences in pre-operative clinical status were detected between the P1 and P2 group, and all patients were managed with elastics in the post-operative period. Independent mouth opening exercises were initiated seven days after surgery, and inter-incisal distance was measured as maximum mouth opening (MMO) at 1 week, 2 weeks, and 1, 2, 3, 6 months. Statistical analysis was performed in order to analyse differences in MMO between the P1 and P2 groups (Prism 7 GraphPad software, San Diego, CA). Values of P < .05 were considered to be significant.

RESULTS

MMO significantly increased from 2 weeks after surgery in both groups. The MMO of P2 was significantly larger than that of P1 in all experimental periods after surgery. MMO was statistically improved in P2 at 2 months after surgery, while MMO in P1 was significantly smaller than the pre-operative MMO, even at 6 months post-operative. A minimum MMO of 40 mm was achieved by all patients.

CONCLUSION

L-shaped miniplate osteosynthesis was more useful for early limitation of mandibular opening improvement than conventional single miniplate osteosynthesis.

A Comparative Study of the Effect of Prednisolone and Celecoxib on MMO (Maximum Mouth Opening) and Pain Following Removal of Impacted Mandibular Third Molars

OBJECTIVE

The purpose of this study was to compare the effects of prednisolone and celecoxib on pain and maximum mouth opening (MMO) after surgical removal of mandibular third molars.

METHODS AND MATERIALS

This double-blind clinical study was conducted upon 60 subjects. These patients received 4 tablets of either 100 mg celecocxib or 5 mg prednisolone: one tablet before surgery and the rest for every 8 h post-operation. The subjects were asked to take acetaminophen codeine as rescue dose. Interincisal distance of upper and lower central teeth and pain measurements (according to Visual Analogue Scale) were taken before surgery, 24 h, 48 h and 7 days after surgery.

RESULTS

Average pain intensity in 24 h after surgery in patients receiving celecoxib was 3.6 ± 2.5 with significant difference to the other group (p = 0.041), but in subsequent evaluations prednisolone group reported less pain intensity, but the differences were not significant. MMO in 48 h after surgery was lower in prednisolone group (p = 0.640) and in further evaluations the groups were almost similar. Analyzing the data revealed no significant difference between groups in MMO.

CONCLUSION

According to this study there is no significant difference in the effects of prednisolone or celecoxib upon MMO, while celecoxib had better results for pain relief in 24 h after surgery in comparison to prednisolone.

Mouth opening variables amongst the North Indian population

Background

For the clinician to conveniently perform an extensive oral examination, it is required to have a known normal range of maximum mouth opening (MMO). This study aims to establish a standard for calculating the normal range of mouth opening in the adult population of North India. The results of this research will have clinical implications for the treatment and diagnosis of diseases that affect the mouth opening in adults, either directly or indirectly.

Aim

To evaluate mean mouth opening in North Indian population and establish their correlation with age and gender.

Method

662 adults from North Indian population, 317 males and 345 females in the age range of 18-80 years were evaluated on their consent. Maximum mouth opening was measured using calibrated vernier calliper scale. This study was conducted in the Department of Periodontology, Faculty of Dental Sciences, King George Medical University, Lucknow.

Results

Males exhibited a higher mean MMO of 48.0 mm compared to females, who had a lower mean MMO of 45.1 mm among North Indian population of the country. In the statistical comparison of MMO between males and females within each age group, the results showed no significant differences.

Conclusion

Mouth opening of females is less than males in all age groups and it seems to decrease with age in all age groups in both males and females. The variability of MMO with age appears statistically similar for both genders.

The normal range of maximum mouth opening and its correlation with age, gender, height, and weight in Turkish children

OBJECTIVE

The aim is to measure the maximum mouth opening (MMO) of healthy children between the ages 4 and 18 years.

METHODS

Six hundred seventy-four children between ages 4 and 18 years were included in the study. Individuals with dentofacial anomaly, temporomandibular joint disease, infection, trauma, and rheumatic disease were not included in the study. The MMO of the participants was measured with a vernier caliper. Demographic information such as weight, height, and age was recorded.

RESULTS

The MMO was calculated to be 46.62 mm in boys and 45.96 mm in girls. The MMO value increased with increasing age. However, no difference was observed in terms of gender in the same age group.

CONCLUSION

In this study, normal MMO values between the ages 4 and 18 years were determined. It is to have differences in age group and society-based examinations. For this reason, it is important to know the normal values of each society in terms of age groups.

RANGE OF MOUTH OPENING AMONG THREE MAJOR ETHNIC GROUPS IN NIGERIA

BACKGROUND

Maximum mouth opening (MMO) is an important parameter in the assessment of several clinical situations and its measured value is documented to have racial, gender, age and anthropometric variation.

OBJECTIVE

To determine the maximal mouth opening and its predictors among the different major ethnic groups in Nigeria.

METHODS

Study subjects were 449 adults (232 males, 215 females), age range 18-74 years from the three major ethnic groups in Nigeria. MMO measurements and anthropometric parameters were recorded. Data analysis was done using SPSS Version 22 and variables subjected to univariate analysis to determine association and a linear regression model was performed to determine variables that could predict maximum mouth opening with p-value set at < 0.05.

RESULTS

The overall mean MMO across the ethnic groups was 49.33 ± 7.91mm. Mean MMO for the Yoruba ethnic group, 53.06 ± 6.27 mm was found to be significantly higher than values obtained for Hausa tribe 52.77 ± 8.06 mm and Igbo tribe 47.59 ± 8.61 mm (p=<0.001). Age, weight and height were observed to correlate significantly with MMO. A multivariate linear regression model revealed that age and height were independent predictors of maximum mouth opening across the ethnic groups.

CONCLUSION

There is ethnic variation in MMO among the 3 major ethnic groups in Nigeria with mean MMO values of 53.96 (± 6.27 mm), 52.77 (± 8.06 mm) and 47.59 (± 8.61 mm) for the Yoruba, Hausa and Igbo ethnic groups respectively. Age and height are important predictors of MMO.

Investigation of maximum mouth opening in terms of age, weight, height and body mass index in Turkish adult population

INTRODUCTION

Maximum mouth opening (MMO) is an important finding in the detection of many diseases and conditions.The aim of this study is to determine the relationship of MMO level with age, gender, weight, height, BMI variables in adult individuals.

MATERIALS AND METHODS

A total of 1582 participants, 806 women and 756 men, between the ages of 18-85 were included in the study. MMO, age, gender, weight, height and BMI values of the participants were recorded.

RESULTS

Among the 1582 participants included in the study, the MMO value of men was 44.2 mm, while it was 40.29 mm in women. The MMO value of men was found to be higher than that of women (p < .05). A correlation was observed between MMO and height (p < .05).

CONCLUSIONS

In the study, a correlation was observed between MMO and height. The MMO value was found to be higher in men.