BACKGROUND: The purpose of this study was to assess the value of intra-articular fluid injection under pressure, as a technique suggested for temporo-mandibular joint (TMJ) closed-lock treatment, and to determine if there is a persisting lock resolution in time. METHODS: Twelve patients were studied at our centre, with a diagnosis of TMJ closed-lock, not amenable with conventional therapies. All patients underwent a MRI scan, confirming the presence of anteriorly displaced disk. This technique is based on intra-articular injection of anaesthetic (mepivacaine cloridrate) under pressure, using the so called pumping technique, that allows an inferior distraction of the condyle. The study has a six months follow-up. After closed-lock resolution all patients underwent physiotherapy with guided mouth opening, for one month. RESULTS: Mandibular function (maximal mouth opening) increased on average of 20.2 mm after treatment, and of 21.1 mm six months later (p=0.00000; with p<0.005). Pain decreased on average from VAS=6.75 to VAS=0.3 (p=0.00001; with p<0.005). The masticatory efficiency improved from VAS=5.25 to VAS=8.75 (p=0.002; p<0.005). Functional TMJ limitation level is significantly increased (p=0.002; p<0.005). Also, patient's efficacy judgement (mean value 3.58= good) and tolerability judgement (mean value 2.92=good) indicate that this therapy is well accepted. CONCLUSIONS: This technique is easy to perform, well tolerated and does not need specific instruments: it permits the resolution of TMJ closed-lock, decreases the pain and improves masticatory efficiency. All these effects persist in time. Subjects with recent closed-lock have an immediate and complete functional recovery while patients with chronic closed-lock do not.

Adolescent↗

PubMedDate not supplied

Mycobacterium marinum: a case of skin granuloma complicated by tenosynovitis of the extensors.

The authors report the case of a male patient who owned a tropical aquarium and who developed a M. marinum skin infection of the wrist. The clinical findings and microbiological features of the case are described, as are the difficulty in providing a prompt diagnosis, and the need for surgical treatment and the use of antibiotics to treat the infection.

Adult↗

PubMedDate not supplied

[Walled city project: fluoroprophylaxis in the prevention of caries].

The Authors evaluate some parameters relative to the concentration of fluoride in the potable water and in that bottled available in the territory of the Ussl no. 19. The integration of these parameters with the data that regard some life habits (frequency of assumption of the fluoride compresses, beverages of common use) in a target group, underlines the importance of the educational aspects of a preventive program in a community environment aiming to obtain the benefits of such method.

Beverages↗