The aim of this study was to survey the current state of the temporomandibular joint disorder treatment in our clinic and to confirm the therapeutic outcomes. The subjects in this study were recruited from among the patients with temporomandibular disorders who attended the Temporomandibular Disorder Special Clinic, Department of Oral Surgery, Hitachi Yokohama Hospital during one year period from February 2007 to January 2008. A total of 100 consecutive outpatients diagnosed with temporomandibular disorders were selected for the study. Pain intensity and the degree to which daily function was limited before and after treatment were evaluated using the Visual Analogue Scale (VAS) . The Beck Depression Inventory-II (BDI-II) score was evaluated simultaneously, and the correlation with changes in symptom was evaluated. The median (25th, 75th percentiles) of pain intensity (VAS value) before treated was 45 (25.0, 65.0) and the degree of limitation of daily function (VAS value) was 15 (0.0, 50.0) . The median (25th, 75th percentiles) of pain intensity at 4 weeks after was 10 (0.0, 30.0), and significantly lower than that before treatment (p= 0.000) . The degree of limitation of daily function was 0 (0.0, 10.0), also significantly lower than that before treatment (p = 0.000) . The BDI-II score decreased from 8 (2.0, 11.8) before treatment to 5 (2.0, 11.0 p = 0.024) and showed no significant correlation with the improvement in outcomes by primary treatment for temporomandibular disorders.
The periodontal ligament (PDL) is a fibrous connective tissue that exists in the cementum and the alveolar bone. Periodontitis is a chronic inflammatory disease that is caused by a bacterial infection in the periodontal region. This infection increases the production of inflammatory cytokines and causes the destruction of periodontal tissue. High mobility group box 1 (HMGB1) is a nuclear nonhiston DNA-binding protein that is present in many eukaryotic cells. HMGB1 is released actively from macrophages and monocytes stimulated by lipopolysaccharide or tumor necrosis factor-a and passively from damaged cells and necrotic cells. Extracellular HMGB1 signals through a specialized receptor for advanced glycation end products (RAGE), toll-like receptor 2 (TLR2), and toll-like receptor 4 (TLR4) . According to a recent report, HMGB1 is of concern in periodontitis. The purpose of this study was to examine the effect of HMGBI in PDL cells. To investigate RAGE, TLR2 and TLR4 mRNA in PDL cells, reverse transcript-polymerase chain reaction experiments were performed. PDL cells were stimulated with HMGB1, with or without anti-RAGE, TLR2 and TLR4 antibodies. IL-6 and IL-ll production was measured using an enzyme-linked immunosorbent assay, and mRNA expression was quantified by real-time PCR. PDL cells expressed RAGE, TLR2 and TLR4 mRNA. Production and mRNA expression of IL-6 and IL-11 were augmented in PDL cells stimulated with HMGB1. In addition, they were also suppressed by anti-RAGE, TLR2 and TLR4 antibodies. In conclusion, PDL cells produce IL-6 and IL-11 in response to HMGB1 via RAGE, TLR2 and TLR4.
Lymphoepithelial cysts occur mainly in the lateral cervical region, but rarely in the parotid gland. We report three cases of lymphoepithelial cysts arising in the parotid gland. These patients presented with a mass in the pre-auricular or infra-auricular region. All masses were mobile and non-tender. The lesions were removed by superficial partial parotidectomy. A definite diagnosis could not be made at initial evaluation, including clinical findings, ultrasound sonography, computed tomography, magnetic resonance imaging, nor radioisotope scintigraphy. Final diagnoses were made by histopathologic evaluation of the excised specimen. In these three cases, histopathologic examination of the mass showed a cystic lesion to be lined by stratified squamous or cuboidal epithelium that was surrounded by a lymphoid tissue with lymphoid follicles, leading to a histopathological diagnosis of lymphoepithelial cyst. The postoperative course was uneventful, and there has been no evidence of recurrence in any of the three cases reported. A review of 52 cases of lymphoepithelial cyst arising in the parotid gland reported in Japanese literature was also made together with the three cases of lymphoepithelial cyst arising in the parotid gland reported here. The results of this review were considered clinical presentation and histopathogenesis of the three cases of lymphoepithelial cyst arising in the parotid gland reported here.