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PubMed2005

[Cognitive-behavioral therapy in the burning mouth syndrome--a new approach].

OBJECTIVE: The aim of this study is to present a new approach of burning mouth syndrome treatment by cognitive and behavioral therapy. METHODS: Cognitive and behavioral therapy in a patient with severe and resistant burning mouth syndrome. RESULTS: Disappearing of the oral pain of the burning mouth syndrome. CONCLUSION: After a review of the literature, we propose the treatment of burning mouth syndrome by cognitive and behavioral therapy.

Aged↗
PubMed1996

Hardness and shock absorption of silicone rubber for mouth guards.

Silicone rubbers have general properties that make them suitable for the fabrication of custom-made mouth guards. This study evaluated the shock absorption properties and Shore A hardness of several silicone rubbers and derived products, compared their values with those of materials commonly used for the manufacture of mouth guards, and correlated the shock absorption and transmission abilities of these different materials with their Shore hardness. Silicone rubbers absorb shock better than the materials currently used for custom-made mouth guards. In addition, to adapt mouth guards to particular sports, the properties of the silicone rubbers can be appropriately modified by the addition of oils or glass fiber reinforcement. Statistical analysis of hardness values and transmitted forces for the 27 materials tested indicates that the maximum transmitted force increases with hardness. However, this relationship is not linear, and departure from linearity is greatest for minimal and maximal hardness values.

Absorption↗
PubMed2002

Instrumented indentation characterisation of mouth-guard materials.

OBJECTIVES: The aim of the study was to investigate the mechanical properties and energy absorption behavior of mouth-guard materials. Interpretation of indentation force-displacement data has been used to determine these properties. METHODS: An ultra micro-indentation system (UMIS) was used to determine near surface properties of mouth-guard materials with nanometer and micro-Newton displacement and force resolution. The measurement procedure was conducted with a small spherical steel indenter (R=500 microm), with impressions that were equally spaced (250 microm). Measurements of force-displacement response of surfaces at maximum forces of 10, 40 or 50 mN, 10 indentations were made at each of these forces. Tests were undertaken in two different modes to determine the mechanical properties, namely: (a) continuous load to the maximum force and then unload, (b) multiple loading and partially unloading sequence to the maximum load. RESULTS: The force-displacement results were analysed to determine the elastic modulus and contact pressure versus depth of penetration as well as the energy loss. Energy absorption for each material was determined from the ratio of the hysteresis energy loss to the total energy at maximum load and ranged from 10 to 24% among different mouth-guard materials. Energy absorption ratio, elastic modulus and contact pressure were significantly different between different materials with same thickness (FC, GC and C3) (p<0.01) and significantly different between materials with different thickness (C1 and C3) (p<0.01). SIGNIFICANCE: The present approach provides a simple and efficient method to readily measure the elastic-plastic (hysteretic) response of mouth-guard materials. The indentation technique lends itself to investigate the influence of ageing, heat treatment, sterilisation, moisture etc in a simple systematic manner.

Absorption↗
PubMed1997

Impairments and compensation in mouth and limb use in free feeding after unilateral dopamine depletions in a rat analog of human Parkinson's disease.

Rats depleted unilaterally of dopamine (DA) with the neurotoxin 6-hydroxydopamine (6-OHDA) have contralateral sensorimotor deficits. These include pronounced impairments in using the contralateral limbs (bad limbs) for skilled movements in tests of reaching and bar pressing. There has been no systematic examination of the changes that take place in movements of spontaneous food handling. This was the purpose of the present study. Rats were filmed as they picked up and ate pieces of angel hair pasta (Capelli d'Angelo), a food item that challenges the rats to use delicate and bilaterally coordinated limb and paw movements. Control rats picked up the food with their incisors, transferred it to their paws, and manipulated it using a variety of bilaterally coordinated limb and paw movements. The DA-depleted rats were impaired in both their mouth and paw movements. They seemed unable to use their teeth to grasp the food and so used their tongue. They did not use the bad side of their mouth to chew and relied upon the good side of their mouth. The bad paw was impaired in grasping the food, grasped only with a whole paw grip, did not make manipulatory movements, and did not open to release the food or open to regain support once the food was eaten. Although the rats improved over a 30-day recovery period, much of the improvement was due to compensatory adjustments. That unilateral DA-depletion results in profound contralateral impairments of the mouth and limb with improvements due mainly to compensatory adjustments confirms a role for dopaminergic systems in motor control. Additionally, the behavioral tests described here could provide important adjuncts for assessing therapies in this animal analog of human Parkinson's disease.

Animals↗
PubMed2003

Artificial mouth model systems and their contribution to caries research: a review.

The complexity of the oral environment, and ethical problems associated with studies of oral diseases in humans inevitably directed the attention to development of laboratory models, that simulate the human oral microcosm. These developments and in particular the in vitro 'artificial mouth' systems have progressed from simple and basic apparatus devised by Magitot and Miller at the end of 19th century to the currently available, highly sophisticated, computer-controlled, multi-station artificial mouth systems. These advances have metamorphosed from the early studies devised primarily to investigate factors affecting the carious process to the present designs that evaluate growth, pathogenicity, metabolism and mineralization of dental plaque under highly controlled conditions. The modern 'artificial mouth systems' can evaluate microbial interactions in simulated dental plaque and similar biofilms and monitor their physical, chemical, biological and molecular features to a very high degree of accuracy. We review and trace here the historical aspects and developments leading to the currently available artificial mouth systems and discuss their contribution to the study of oral flora, especially related to many variants of dental caries.

Biofilms↗
PubMed2003

Striatal dopamine D1 and D2 receptors in burning mouth syndrome.

Animal studies have indicated that the nigrostriatal dopaminergic system is involved in central pain modulation. In a recent positron emission tomography (PET) study, we demonstrated presynaptic dysfunction of the nigrostriatal dopaminergic pathway in burning mouth syndrome, which is a chronic pain state. The objective of the present study was to examine striatal dopamine D1 and D2 receptors in these patients. We used 11C-NNC 756 and 11C-raclopride to study D1 and D2 receptor binding in a PET study in ten burning mouth patients and 11 healthy controls. Patients underwent a structured psychiatric evaluation and an electrophysiological test for the excitability of the blink reflex. The striatal uptake of 11C-NNC 756 did not differ between patients and controls. In a voxel-level analysis, the uptake of 11C-raclopride was statistically significantly higher in the left putamen in burning mouth patients (corrected P-value 0.038 at cluster-level). In the region of interest analysis, the D1/D2 ratio was 7.7% lower in the right putamen (0.64+/-0.04 vs. 0.69+/-0.04, P=0.01) and 6.4 % lower in the left putamen (0.65+/-0.05 vs. 0.70+/-0.05, P=0.05) when compared to controls. Increased 11C-raclopride uptake and the subsequent decrease in the D1/D2 ratio may indicate a decline in endogenous dopamine levels in the putamen in burning mouth patients.

Adult↗
PubMed2002

Electromyographic analysis of trapezius and sternocleidomastoideus muscles during nasal and oral inspiration in nasal- and mouth-breathing children.

The purpose of this study was to evaluate sternocleidomastoideus (SCM) and trapezius (superior fibers) muscle activity patterns in mouth-breathing children, and to compare them with nasal-breathing children. Forty-six children, of both sexes, ranging from 8 to 12 years old, were evaluated through electromyography. The selected children were divided into two groups; Group I, was made up of 26 mouth-breathing children and Group II of 20 nasal-breathing children. Electromyographic recordings were obtained through surface electrodes in the SCM and trapezius muscles, bilaterally, during oral and nasal inspiration. Root-mean-square (RMS) data expressed in microvolts (microV), were analyzed using the Kruskall-Wallis statistical test. From the results obtained, we concluded that there was a significant difference in the muscle activity between the groups, with higher activity during nasal inspiration in the mouth-breathing group. During oral inspiration, there was no significant difference between groups. Within the groups, only the mouth-breathing group showed higher activity during nasal inspiration.

Action Potentials↗
PubMed1999

Detectability of anterior displacement of the articular disk in the temporomandibular joint on helical computed tomography: the value of open mouth position.

OBJECTIVE: The purpose of this study was to establish the diagnostic reliability of anterior displacement of the articular disk in the temporomandibular joint on helical computed tomography. STUDY DESIGN: Ninety-four consecutive patients were examined through use of both computed tomography and magnetic resonance imaging. On axial computed tomography, anterior disk displacement was defined as the presence of an area of soft tissue density that was semilunar in shape and located in front of the mandibular condyle. RESULTS: With magnetic resonance imaging taken as the diagnostic gold standard in evaluation of articular disk position, the sensitivity, specificity, and accuracy for computed tomography were 91%, 100%, and 97%, respectively, in the closed mouth position and 96%, 99%, and 98%, respectively, in the open mouth position. CONCLUSIONS: The detectability on axial helical computed tomography of anterior displacement of the articular disk in the temporomandibular joint in the open mouth position was almost equal to that on magnetic resonance imaging. It is recommended that the open mouth position be added when helical computed tomography is used to evaluate patients with temporomandibular joint disease.

Absorptiometry, Photon↗
PubMed2003

The influence of gel strength on aroma release from pectin gels in a model mouth and in vivo, monitored with proton-transfer-reaction mass spectrometry.

The course of events from taking a food into the mouth to the perception of the food's flavor involves many steps, from dilution with saliva, mastication, and transportation of the compounds to the olfactory epithelium to transformation into signals that go to the brain. In addition, there are also the effects of the food's structure and properties. In this study, a proton-transfer-reaction mass spectrometer (PTR-MS) was used to investigate how four pectin-containing systems with different structures and strengths affected the release of aroma compounds in a model mouth and in the nose of an assessor. Both the model mouth and the in-nose measurements showed that the strength and structure of pectin-containing systems are important with regard to the quantity of aroma compounds that are released. Mastication and saliva were also shown to have a large influence on how much of the aroma compound is released from the mouth to the nose.

Chemical Phenomena↗
PubMed2000

HLA class II typing of whole genome amplified mouth swab DNA.

Postal collection of mouth swabs provides a cheap and convenient means of DNA sampling but hitherto has not provided sufficient genetic material for HLA typing by polymerase chain reaction using sequence-specific primers (PCR-SSP). This study examined the feasibility of collecting mouth swabs from a test population by post, amplifying the DNA by whole genome amplification and genotyping for selected HLA class II alleles. We optimised a strategy for whole genome amplification or primer extension preamplification using a random 15 base pair primer which resulted in a 1,000-fold increase in DNA template. The amplified DNA was of sufficient quality for analysis of selected HLA Class II alleles by PCR-SSP and PCR using sequence-specific oligonucleotide probes. To test the reliability of our data, blood DNA from 30 individuals in 10 families, previously tested for all DRB1 alleles in a routine diagnostic laboratory, was then tested in our laboratory for DRB1 *03 and *04 following whole genome amplification. Further whole genome amplified product from another 10 families was tested for DRB1 *03, *04 in our laboratory and then tested for all DRB1 alleles in a routine diagnostic laboratory. One repeat typing was required to achieve 100% concordance between laboratories. Amplification of whole genome amplified DNA by PCR-SSP was then extended successfully to low-resolution HLA DRB1, DQA1, DQB1 and DPB1 typing. Mouth swab collection by post, followed by whole genome amplification of DNA provides an effective strategy for genetic analysis of large cohorts. We have optimised conditions for HLA class II typing on whole genome amplified DNA collected by mouth swab, but this method could potentially be applied to low concentrations of DNA from other sources.

Adult↗
PubMed2001

The burden of mouth cancer in Latin America and the Caribbean: epidemiologic issues.

The incidence rates of mouth cancer vary from low to high among the countries of Latin America and the Caribbean. This review will examine incidence and mortality rates according to risk factors for the disease. Studies of local populations are reviewed and common patterns established. Although the incidence rate of mouth cancer is decreasing in some countries, a large increase is observed in southern South America. This trend will probably be maintained over the next few decades. Specific risk factors have been identified: high tobacco smoking and alcohol drinking prevalence, high intake of charcoal-grilled red meat, and mate drinking. The increase in tobacco smoking among females will have a strong impact on the incidence of mouth cancer in the future. In some Latin American and Caribbean countries, lay educational information on cancer is scant. The importance of improving information systems on cancer and the development of tobacco smoking and alcohol control programs are stressed. The training of health practitioners in the early detection and treatment of mouth lesions is a public health goal that could improve survival, but the difficulties encountered by people from the lowest socioeconomic strata in obtaining access to primary health care could hinder this objective. Semin Oncol 28:158-168.

Caribbean Region↗
PubMed2000

[New possibilities in the diagnosis and documentation using 3D power doppler ultrasound with carcinoma of the floor of the mouth as illustration].

AIM: To evaluate a novel 3D power Doppler ultrasound-technique (3D PDUS) in the diagnosis and documentation of tumours of the floor of the mouth. METHOD: 22 patients with tumours of the floor of the mouth (2 T1-, 5 T2-, 6 T3- and 9 T4-carcinomas) prospectively underwent conventional grey-scale ultrasound combined with power Doppler ultrasound and 3D PDUS (3-Scape). All examinations were performed with the "Sonoline Elegra Advanced" in combination with a 7.5 MHz transducer. Two independent observers compared the results regarding clear tumour margins, midline crossing, infiltration of the mylohyoid muscle, infrahyoidal tumour, contact to the mandible, contact to major vessels (such as the lingual, submental and/or facial artery), intra- and peritumoural vascularisation and judged the value of the 3D reconstruction method for documentation purpose. RESULTS: All parameters relevant for therapy could be gathered from the 3D data (agreement: 98.2%) almost without loss of information; results of both observers were identical (kappa value: 1.0). In the comparison to conventional ultrasound, 3D PDUS also allows for the reconstruction of axial images of the floor of the mouth similar to CT-images, and a 3D image of tumour vascularisation can be obtained. Acquisition and reconstruction of the 3D data only takes a couple of minutes. CONCLUSIONS: "3-Scape" is a novel easy-to-perform method allowing the complete acquisition of 3D data of the entire floor of the mouth, and providing the possibility to digitally store and/or transfer examination results without loss of information. Reconstruction of ultrasound-images in any desirable plane and/or as a 3D presentation is possible. Thus, in the future, additional software will facilitate the determination of the volume and the degree of vascularisation of tumours.

Adult↗
PubMed2005

Experimental measurements of particle deposition in three proximal lung bifurcation models with an idealized mouth-throat.

In this paper, particle deposition in three idealized proximal lung bifurcation models with an idealized mouth-throat were investigated experimentally. These bifurcation models included (1) a small symmetric bifurcation, (2) an intermediate asymmetric bifurcation, and (3) a large symmetric bifurcation. An idealized mouth-throat geometry (the "Alberta geometry") was used as the inlet to these bifurcation models. Monodisperse aerosol particles of DEHS (di-2-ethylhexyl-sebecate) oil with mass median diameters in the range of 2.5-7.5 microm were employed at steady flow rates of 30-90 L/min. Particle deposition measurements were conducted by gravimetry. The results show that particle deposition in the mouth-throat and trachea accounts for the major portion of total deposition in the entire models used, and particle deposition fraction in the proximal lung bifurcations is lower compared with that deposited in the regions upstream (the mouth-throat and the trachea). Total particle deposition efficiency increases with increasing either inertial parameter or Stokes number. Total particle deposition varies appreciably from model to model. The laryngeal jet is the key factor dominating particle deposition within the trachea. An effect of Reynolds number on particle deposition efficiency in the trachea is observed. In addition, particle deposition in the bifurcation region is influenced little by the upstream flow condition, and therefore the effect of the laryngeal jet on deposition seemingly does not propagate to the bifurcations downstream.

Administration, Inhalation↗
PubMed2006

A dry powder inhaler with reduced mouth-throat deposition.

A novel, compact, and highly efficient dry powder inhaler (DPI) with low mouth-throat deposition is described. The performance of this DPI was evaluated by measuring both (1) the total aerosol deposition in and distal to an idealized mouth-throat cast and (2) the fine particle fraction (FPF) using a standard Mark II Anderson impactor. Ultraviolet (UV) spectroscopy techniques were used in the aerosol deposition measurements. Two inhalation aerosol powders, namely budesonide (extracted from a Pulmicort/Turbuhaler multi-dose device, 200 microg/dose) and ciprofloxacin + lipid + lactose (in-house), were dispersed by the DPI at a steady inhalation flow rate of 60 L/min. The newly developed DPI had a total aerosol delivery distal to the mouth-throat cast of 50.5% +/- 3.04% and 69.7% +/- 1.5% for the budesonide and ciprofloxacin + lipid + lactose aerosols, respectively. This is a significant improvement over the Turbuhaler original device delivery of 34.5% +/- 5.2%, particularly considering that in vitro mouth-throat deposition dropped from 27.5% +/- 5.4% with the budesonide Turbuhaler to 11.0% +/- 3.5% with the present inhaler. The different lung deliveries from the same inhaler for the two formulations above also confirm that the overall performance of an inhaler is optimizable via powder formulations.

Administration, Inhalation↗
PubMed2005

Reduction in mouth opening with semi-rigid cervical collars.

BACKGROUND: Reduced mouth opening may be a major contributing factor to the deterioration in the view obtained at laryngoscopy when a semi-rigid cervical collar is in place. We set out to assess the degree to which mouth opening is restricted by a cervical collar. METHODS: We measured maximal inter-incisor distance in 52 volunteers. It was measured again after application of each of three appropriately sized semi-rigid cervical collars (Stifneck, Miami J, and Philadelphia). RESULTS: Inter-incisor distance was significantly reduced by the application of a cervical collar [No collar 41 (7) mm-mean (SD); Stifneck 26 (8) P<0.0001; Miami J 29 (9) P<0.0001; Philadelphia 29 (9) P<0.0001]. There was a wide and unpredictable variation between subjects in the reduction in mouth opening and a significant proportion had an inter-incisor distance of 20 mm or less (Stifneck, 25%; Miami J, 21%; Philadelphia, 21%). CONCLUSIONS: Application of a semi-rigid cervical collar can significantly reduce mouth opening. This could hinder definitive airway placement. Our results support removing the anterior portion of the collar before attempts at tracheal intubation.

Anthropometry↗
PubMed1975

Mouth lesions in iron-deficient anemia: relationship to Candida albicans in saliva and to impairment of lymphocyte transformation.

The atrophic glossitis and angular chilosis in patients with iron-deficient anemia are associated with infection of the mouth by Candida albicans. Saliva from these patients contained more Candida and supported the growth of Candida better than did saliva from a control group. The possibility that growth of Candida may be due to impaired lymphocyte function was investigated by measuring transformation of lymphocytes stimulated with phytohemagglutinin. Transformation was depressed in iron-deficient subjects and returned to normal after correction of their iron status. The lymphocyte count in the peripheral blood was also depressed and corrected by additional iron. Impaired lymphocyte function did not explain the mouth lesions and growth of Candida in saliva since lymphocyte transformation was equally depressed in patients with and without mouth lesions. A local factor, such as an effect of lack of iron on the resident vacterial flora of the mouth, may be important.

Adolescent↗
PubMed2001

The effect of swallowing or rinsing alcohol solution on the mouth alcohol effect and slope detection of the intoxilyzer 5000.

Nine female and 21 male alcohol-free subjects introduced 10 mL of diluted gin (20% v/v alcohol) into their mouths under two conditions. The subjects either rinsed the alcohol for 10 s and then expectorated or immediately swallowed. They then provided breath samples into an Intoxilyzer 5000 at 5 and 10 min postadministration for both conditions. The mean Intoxilyzer results plus or minus one standard deviation (n = 30) were 0.091+/-0.051; 0.036+/-0.027; 0.014+/-0.011, and 0.004+/-0.006 g/210 L for 5 min after rinsing, 5 min after swallowing, 10 min after rinsing, and 10 min after swallowing, respectively. The percentages of times that mouth alcohol was correctly detected by the Intoxilyzer 5000 were 90%, 66%, 62% and 30% for these conditions, respectively. Ten minutes after the introduction of alcohol into the mouth, 63% of the Intoxilyzer results were > 0.010 g/210L after rinsing compared with only 7% after swallowing. The mouth alcohol effect is greater for rinsing than for swallowing alcohol.

Alcoholic Intoxication↗
PubMed2005

Evaluation of food-pollen cross-reactivity by nose-mouth cross-challenge in pollinosis with oral allergy syndrome.

BACKGROUND: Oral allergy syndrome (OAS) is often associated with pollen-induced rhinitis, and there are preferential associations between causative substances. If OAS and rhinitis are both immunoglobulin (Ig)E-mediated and there are cross-reacting proteins, it is expected that similar reactions can be elicited in the nose and mouth. In order to test this hypothesis we performed a series of 'cross-challenges' with foods and pollens in both the nose and the mouth. METHODS: Nine patients with ascertained OAS due to vegetables and rhinitis due to pollens were studied. On the first day a nasal challenge with pollen extracts and an oral challenge with fresh food was carried out. After a week, washout nasal challenge with food and an oral challenge with pollens were performed. Immediate symptoms, mucosal tryptase and soluble eosinophil cationic protein (ECP) were assessed after each challenge. RESULTS: The administration of pollen into the nose and food into the mouth elicited symptoms as expected, but the cross-challenge had no clinical effect. In parallel, tryptase and ECP increased after nasal challenge with pollens, whereas foods did not elicit a measurable response. CONCLUSION: The cross-reactivity between foods and pollens, when evaluated at the shock organ, was not clinically evident. This data can be explained with a low concentration of cross-reagent epitopes in pollen extracts and food homogenized because of degradation. The different behaviour upon challenge suggests that different immunological mechanisms may act in the nose and mouth.

Adolescent↗