Study reveals target for drug development for temporomandibular joint disorder (TMJD) - a chronic jaw pain disorder

Main Category: Dentistry
Also Included In: Pain / Anesthetics
Article Date: 05 Aug 2013 - 1:00 PDT

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Study reveals target for drug development for temporomandibular joint disorder (TMJD) - a chronic jaw pain disorder

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Temporomandibular joint disorder (TMJD) is the most common form of oral or facial pain, affecting over 10 million Americans. The chronic disorder can cause severe pain often associated with chewing or biting down, and lacks effective treatments.

In a study in mice, researchers at Duke Medicine identified a protein that is critical to TMJD pain, and could be a promising target for developing treatments for the disorder. Their findings are published in the August issue of the journal PAIN.

Aside from cases related to trauma, little is known about the root cause of TMJD. The researchers focused on TRPV4, an ion channel protein that allows calcium to rapidly enter cells, and its role ininflammation and pain associated with TMJD.

"TRPV4 is widely expressed in sensory neurons found in the trigeminal ganglion, which is responsible for all sensations of the head, face and their associated structures, such as teeth, the tongue and temporomandibular joint," said senior study author Wolfgang Liedtke, M.D., PhD, associate professor of neurology and neurobiology at Duke. "This pattern and the fact that TRPV4 has been found to be involved in response to mechanical stimulation made it a logical target to explore."

The researchers studied both normal mice and mice genetically engineered without the Trpv4 gene (which produces TRPV4 channel protein). They created inflammation in the temporomandibular joints of the mice, and then measured bite force exerted by the mice to assess jaw inflammation and pain, similar to how TMJD pain is gauged in human patients. Given that biting can be painful for those with TMJD, bite force lessens the more it hurts.

The mice without the Trpv4 gene had a smaller reduction in bite force - biting with almost full force - suggesting that they had less pain. In normal mice there was more TRPV4 expressed in trigeminal sensory neurons when inflammation was induced. The increase in TRPV4 corresponded with a greater reduction in bite force.

The researchers also administered a compound to normal mice that blocked TRPV4, and found that inhibiting TRPV4 also led to smaller reductions in bite force, similar to the effects of the mice engineered without the Trpv4 gene.

Surprisingly, the researchers found comparable bone erosion and inflammation in the jaw tissue across all mice, regardless whether the mice had TRPV4 or not.

"Remarkably, the damage is the same but not the pain," Liedtke said. "The mice that had the most TRPV4 appeared to have the most pain, but they all had similar evidence of temporomandibular joint inflammation and bone erosion in the jawbone as a consequence of the inflammation."

The results suggest that TRPV4 and its expression in trigeminal sensory neurons contribute to TMJD pain in mice. Given the lack of effective treatments for this chronic pain disorder, TRPV4 may be an attractive target for developing new therapies.

Stem cells in the gingiva may have important medical applications in the future

Main Category: Dentistry
Also Included In: Stem Cell Research;  Immune System / Vaccines
Article Date: 07 Aug 2013 - 1:00 PDT

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Stem cells in the gingiva may have important medical applications in the future

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Stem cells found in mouth tissue can not only become other types of cells but can also relieve inflammatory disease, according to a new Ostrow School of Dentistry of USC study in the Journal of Dental Research.

The cells featured in the study are gingival mesenchymal stem cells (GMSC), which are found in the gingiva, or gum tissue, within the mouth. GMSC, like other stem cells, have the ability to develop into different types of cells as well as affect the immune system.

"Gingiva is very unique in our body," says Professor Songtao Shi, the study's senior author. "It has much less inflammatory reaction and heals much faster when compared to skin."

Previously, the developmental origins and abilities of GMSC hadn't been fully illustrated. This study shows that there are two types of GMSC: those that arise from the mesoderm layer of cells during embryonic development (M-GMSC) and those that come from cranial neural crest cells (N-GMSC). The cranial neural crest cells develop into many important structures of the head and face, and 90 percent of the gingival stem cells were found to be N-GMSC.

The two types of stem cells vary dramatically in their abilities. N-GMSC were not only easier to change into other types of cells, including neural and cartilage-producing cells; they also had much more of a healing effect on inflammatory disease than their counterparts. When the N-GMSC were transplanted into mice with dextrate sulfate sodium-induced colitis - an inflamed condition of the colon - the inflammation was significantly reduced.

The study indicates that the stem cells in the gingiva - obtained via a simple biopsy of the gums - may have important medical applications in the future.

"We will further work on dissecting the details of the gingiva stem cells, especially their notable immunoregulatory property," says first author Xingtian Xu, specialized lab technician at the Ostrow School of Dentistry Center for Craniofacial Molecular Biology.

"Through the study of this unique oral tissue, we want to shed the light on the translational applications for improving skin wound healing and reducing scar formation."

Results from large international clinical trials provide dentists and patients with a new level of confidence in dental implants

Main Category: Dentistry
Article Date: 08 Aug 2013 - 2:00 PDT

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Results from large international clinical trials provide dentists and patients with a new level of confidence in dental implants

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Results from two of the largest international clinical studies performed to date with dental implants have just been published and demonstrate excellent clinical performance. Together, the studies have evaluated more than one thousand Straumann Bone Level implants in Europe, the US and Australia. The scope of these studies is particularly remarkable in view of the fact that most dental implant companies do not conduct clinical trials because they want to cut costs and do not have the capabilities.

The studies are also remarkable in that they both reported very high implant survival rates of more than 98% with practically no bone loss around the implants. The findings are considerably better than values reported in a comprehensive review of previously published studies with other implants[1]. The new studies add to the wealth of strong clinical evidence backing the Straumann dental implant system and thus provide very good reasons for patients and dentists to insist on Straumann implants rather than undocumented alternatives.

The benchmark in clinical research

The first study was a randomized controlled clinical trial (RCT) at 11 clinical centers in Europe, USA and Australia[2]. RCTs are the benchmark in clinical research because they offer the highest level of clinical evidence. However, few are performed with dental implants and very rarely on such a large scale.

This RCT has evaluated 106 patients each treated with one implant and followed for three years. The investigators compared the outcomes of two different approaches - the first involving two surgical steps, in which the implant is covered with gum tissue ('submerged') during healing, and the second involving just a single step, in which part of the implant is left exposed ('transmucosal') thus saving a second surgical operation. The most impressive highlight reported was the fact that only a single implant was lost, yielding 3-year implant-survival rates of 98.1% and 100% for the transmucosal and submerged groups respectively.

Because bone loss around implants has been documented as a common undesirable effect of implant treatment[3], this study looked carefully at bone level changes. It showed that bone level was impressively stable over 3 years after implant placement, with mean decreases of less than 0.7 mm and 0.6 mm in the submerged and transmucosal groups respectively. These values are well below the data presented in previous studies with other implants. An analysis of published data showed that only three implant systems achieved mean marginal bone loss below 1 mm over a period of 5 years[1].

Excellent results also achieved in everyday practice

While RCTs demonstrate that products or treatments work well, they are usually conducted by specialists in selected and strictly controlled populations. This study was performed by dental practices and University clinics that are highly specialized in dental implantology, which raises the question of whether its excellent results can be reproduced in daily dental practice. To answer this, a large study using the same implant was conducted in Europe and the US, in which the dentists had to follow the product guidelines but were able to use the implant as they would in normal daily practice. The strength of this type of investigation, which is known as 'non-interventional study' (NIS), is that it documents real-life situations, in which indications, patients and conditions all vary widely.

In this study[4], a total of 908 implants were evaluated in 538 patients at more than a hundred dental practices in six countries, revealing an implant survival rate of 98.5% after one year (the risk of failure is highest in the first year after implant placement5). Besides the very high survival rates, the bone level remained very stable in the majority of cases. The investigators therefore concluded that treatment with Straumann Bone Level Implants yielded very successful outcomes in 'real life' conditions.

Results impress further when viewed in the context of other published data

The survival rates reported in both studies are higher than those documented in the literature. The most recent analysis of published data on other implants showed an overall implant survival rate of 95.5% one year after implant placement[5], in contrast to the 98.5% achieved in this NIS in daily dental practice conditions.

The latest dental news on April Fool's Day!

As is known to all, April Fool's Day is the 1st of April, the day on which people traditionally play tricks on each other.  I guess some of us would be fooled on such special day! As for me, I played jokes on my friends this morning! To my surprise, they believed me without question! Lol, because of these, I found it’s not funny at all! Meanwhile, it’s the first day this month! Which means the new beginning for all of us!

Despite of the April Fool’s Day itself, I want to share something refers to the dental news! At the 35th International Dental Show (IDS) in Cologne (12 - 16 March 2013), Hu-Friedy, leading manufacturer of dental instruments will present numerous product innovations for the fields of periodontology, diagnostic, composite restoration, dental surgery, orthodontics and instrumental management solutions. For Hu-Friedy, it is a matter of course that the comfort of the treating dental professional and the patient as well as higher precision and working efficiency are the focus of all instrument solutions. At the IDS, Hu-Friedy will present its entire product range, including numerous innovative instrument solutions. The International Dental Show (IDS), which takes place every two years, is the world?s leading trade fair for the dental sector, as the products presented reflect the entire global dental market. Decision-makers from the dental profession, the dental technician trade, the dental retail trade and the dental industry, as well as appliances and technologies attend it for experiencing the latest developments.

Well, the news above comes from the dentalnews recently! Another one: Mar. 18, 2013 — Microbes from the human mouth are telling Oak Ridge National Laboratory scientists something about periodontitis and more after they cracked the genetic code of bacteria linked to the condition. "So far, no one has been able to isolate and cultivate this type of bacterium," said Podar, who noted that there are bugs in our mouth that we have no clue about and, until now, this was one of them. "The genetic information obtained by sequencing one single cell may offer researchers a key to 'domesticating' these organisms and studying them in the laboratory." We should pay more attention on this problem! Don’t let the unnecessary diease s happen on us someday!

In the end, thanks for the introduction about International Dental Show on dental news! Any suggestions appreciated! Best recommended: http://www.zetadental.com.au/

Arrange the time for oral health each week!

Dear friends, good afternoon, what’s the weather in your place? It’s sunny in my city now! that’s not the most significant, because tomorrow is the weekend! I love the weekends after graduation, I plan to see a dentist with my best friend! My friend told me that the details for life is inevitable! Especially for the oral health! Sometimes we will neglect the important thing, for example, we would have a toothache when we got a cold! Is it not significant? I don’t think so!

Well, before I see a doctor, I searched for the related information on the internet this morning! Good oral health involves more than just brushing. To keep your teeth and mouth healthy for a lifetime of use, there are steps that you should follow. Here's what you should consider:

Meanwhile, Talk with your dentist, other oral health care specialist, or hygienist about any special conditions in your mouth and any ways in which your medical/health conditions affect your teeth or oral health. For example, cancer treatments, pregnancy, heart diseases, diabetes, dental appliances (dentures, braces) can all impact your oral health and may necessitate a change in the care of your mouth and/or teeth. Be sure to tell your dentist if you have experienced a change in your general health or in any medications you are taking since your last dental visit.

Thanks again for the recommendation above! Have a nice time at weekend! Arrange the time for oral health each week!

The inevitable part for us-oral health!

What a cool spring in 2013, the sunshine outside is comfortable for us to enjoy the whole day! I believe that most of us have a special feeling for this season! It made me think of the spring outing! It seems that I did not have such wonderful acativity after graduation! Those days were unforgettable! We are always busy working for our future, is it really the era of money talks?

Last week I paid a visit to my friend at hospital, she suffered the operation, I mean the oral health! You know, oral health now gets more and more important! If we don’t develop a good habbit into this, we will get the pain for a long time! Meanwhile, what I want to say is the opsigenes, somebody tell me that Paracetamol for pain relief after surgical removal of lower wisdom teeth!

Paracetamol has been commonly used for the relief of postoperative pain following oral surgery. In this review we investigated the optimal dose of paracetamol and the optimal time for drug administration to provide pain relief, taking into account the side effects of different doses of the drug. This will inform dentists and their patients of the best strategy for pain relief after the surgical removal of wisdom teeth. To assess the beneficial and harmful effects of paracetamol for pain relief after surgical removal of lower wisdom teeth, compared to placebo, at different doses and administered postoperatively.

The result like this: Twenty-one trials met the inclusion criteria. A total of 2048 patients were initially enrolled in the trials (1148 received paracetamol, and 892 the placebo) and of these 1968 (96%) were included in the meta-analysis (1133 received paracetamol, and 835 the placebo). Paracetamol provided a statistically significant benefit when compared with placebo for pain relief and pain intensity at both 4 and 6 hours. Most studies were found to have moderate risk of bias, with poorly reported allocation concealment being the main problem. Risk ratio values for pain relief at 4 hours 2.85 (95% confidence interval (CI) 1.89 to 4.29), and at 6 hours 3.32 (95% CI 1.88 to 5.87). A statistically significant benefit was also found between up to 1000 mg and 1000 mg doses, the higher the dose giving greater benefit for each measure at both time points. There was no statistically significant difference between the number of patients who reported adverse events, overall this being 19% in the paracetamol group and 16% in the placebo group.

Finally we got the conclusion: Paracetamol is a safe, effective drug for the treatment of postoperative pain following the surgical removal of lower wisdom teeth. From the introduction above, it’s persuasive for all of us that who care about the wisdom teeth! In my eyes, most of us would experience that one day! Then knowing more details about oral health is essential! It’s the inevitable part for us!

When talked about the latest dental news!

Before I open this conversation about the latest dental news, I would like to share something refers to our life with you all here! The country developed well with time went by, people get accoustomed to the pressure from the life, such as the marriage, carrar, study and so on! Well, we can say that we all want to have a nice and wonderful life in 21st century, right?

However, when we have a nice life, we are busy with different triffles and promotions! We forgot to care about our health, for example, teeth problems. In fact, we should have a physical examination every year! We ought to be resonsible for ourselves! Then in my eyes, know more information about the teeth is necessary, because it belongs to our body, what a silly conversation!

Well, let’s get back to the topic today, the latest dental news and the dental equipment. A common test used to determine mercury exposure from dental amalgam fillings may significantly overestimate the amount of the toxic metal released from fillings, according to University of Michigan researchers. Scientists agree that dental amalgam fillings slowly release mercury vapor into the mouth. But both the amount of mercury released and the question of whether this exposure presents a significant health risk remain controversial.

Public health studies often make the assumption that mercury in urine (which is composed mostly of inorganic mercury) can be used to estimate exposure to mercury vapor from amalgam fillings. These same studies often use mercury in hair (which is composed mostly of organic mercury) to estimate exposure to organic mercury from a person's diet.

I am not sure whether this infoamtion is the truth or not, I just know everything has two sides, the advantage and disadvantage! While it’s better to know every details! Here: "These results challenge the common assumption that mercury in urine is entirely derived from inhaled mercury vapor," said Laura Sherman, a postdoctoral research fellow in the Department of Earth and Environmental Sciences and lead author of a paper in the journal Environmental Science & Technology. A final version of the paper has been published online. Since these scientisets began to discuss, which means that these pronlems worth our attention!

In the end, what I want to share with you is the zeta dental, probably it’s weird for you to read this recommendation, I can’t say that I know it 100%, while it helps me a lot, I got the perfect items from zeta dental last month! Thanks for your attention! Meanwhile, any suggestions appreciated!