In this thesis, several techniques were combined to optimize, evaluate and characterize craniofacial development in Xenopus, with additional focus on understanding the alterations made during maturation in the craniofacial region and the cartilage. Three important techniques used were: confocal microscopy in conjunction with Acridine Orange (AO) labeling, Alcian Blue (AB) labeling, and geometric morphometric analysis. I found that facial width increased across all techniques used to evaluate it. Included within this focus was the study of the development of the ceratohyal (CH) cartilage, which supported the mouth and snout. This was also found to increase width wise, in unison with facial and orofacial growth. This data may suggest a link between the face, mouth and CH growth, in which the developing cartilage elongates and widens causing the increase seen in the width and distension of the mouth.

Neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system". In contrast to physiological pain that warns of noxious stimuli likely to result in tissue damage, neuropathic pain serves no protective function. Examples of neuropathic pain states include postherpetic neuralgia (shingles) and phantom limb / stump pain. This pain state also exists in the orofacial region, with the possibility of several variants including atypical odontalgia and burning mouth syndrome. There is a paucity of information on the prevalence of neuropathic pain in the orofacial region. One study assessed patients following endodontic treatment and found that approximately 3 to 6percent of patients reported persistent pain. Patients predisposed to the condition atypical odontalgia (phantom tooth pain) include those suffering from recurrent cluster or migraine headaches. Biochemical and neurobiological processes leading to a neuropathic pain state are complex and involve peripheral sensitisation, and neuronal plasticity of the central and peripheral nervous systems. Subsequent associated pathophysiology includes regional muscle spasm, sympathetic hyperfunction, and centralisation of pain. The relevant clinical features of neuropathic pain are: (i) precipitating factors such as trauma or disease (infection), (ii) pain that is frequently described as having burning, paroxysmal, and lancinating or sharp qualities, and (iii) physical examination may indicate hyperalgesia, allodynia and sympathetic hyperfunction. The typical patient complains of persistent, severe pain, yet there are no clearly identifiable clinical or radiographic abnormalities. Often, due to the chronicity of the problem, afflicted patients exhibit significant distress and are poor pain historians, thus complicating the clinician's task of obtaining a detailed and relevant clinical and psychosocial history. An appropriate analgetic blockade test for intraoral sites of neuropathic pain is mucosal application of topical anaesthetics. Other, more specific, tests include placebo controlled lignocaine infusions for assessing neuropathic pain, and placebo controlled phentolamine infusions for sympathetically maintained pain. The treatment and management of neuropathic pain is multidisciplinary. Medication rationalisation utilises first-line antineuropathic drugs including tricyclic antidepressants, and possibly an anticonvulsant. Topical applications of capsaicin to the gingivae and oral mucosa are a simple and effective treatment. Neuropathic pain responds poorly to opioid medication. Psychological assessment is often crucial in developing strategies for pain management. Psychological variables include distress, depression, expectations of treatment, motivation to improve, and background environmental factors. To enable a greater understanding of neuropathic pain, thereby leading to improved treatments, high-performance liquid chromatography-mass spectrometry is one analytical technique that has the potential to contribute to our knowledge base. This technique allows drugs and endogenous substances to be assayed from one sample in a relatively short time. The technique can identify, confirm, and measure the concentrations of multiple analytes from a single sample.

For pain research, the orofacial region is unique in a number of ways. The region has complex local anatomy, including substantial sensory innervation from neural pathways, and muscles of facial expression that convey important information concerning pain intensity and associated psychological traits. Although chronic orofacial pain conditions appear prevalent, useful documentation on pain intensity ratings using well established instruments is sparse. In particular, two conditions, atypical facial pain and atypical odontalgia, are poorly understood in aetiology so that definitive treatment modalities are severely limited. The region's local biofluid, saliva, has been used to diagnose various local and systemic disease states, and to quantitate drug concentrations. However, recent studies indicate that saliva also contains some of the same peptides, e.g. bradykinin, that are involved in pain mechanisms. It may be that pharmacological-pharmacokinetic studies of these peptides could shed more information on thesignificance of their presence in saliva. This thesis consists of four major sections. Section 1 comprises of three clinical studies investigating orofacial pain. Section 2 deals with clinical laboratory studies of saliva. Section 3 is concerned with the development of chromatographic methods to assay bradykinin and its pharmacokinetics in saliva. Section 4 uses chromatography for the identification of novel salivary peptides. This thesis, then, presents clinical studies of orofacial pain and pharmacological investigations of saliva as the local biofluid.

The orofacial area stands apart from other body systems in that it possesses a unique performance anatomy whereby oral musculature inserts directly into the underlying cutaneous skin, allowing for the generation of complex three-dimensional deformations of the orofacial system. This anatomical substrate provides for the tight temporal synchrony between self-generated cutaneous somatosensation and oromotor control during functional behaviors in this region and provides the necessary feedback needed to learn and maintain skilled orofacial behaviors. The Directions into Velocity of Articulators (DIVA) model highlights the importance of the bidirectional relationship between sensation and production in the orofacial region in children learning speech. This relationship has not been as well-established in the adult orofacial system. The purpose of this observational study was to begin assessing the perception-action relationship in healthy adults and to describe how this relationship may be altered as a function of healthy aging. This study was designed to determine the correspondence between orofacial cutaneous perception using vibrotactile detection thresholds (VDT) and low-level static and dynamic force control tasks in three representative age cohorts. Correlational relationships among measures of somatosensory capacity and low-level skilled orofacial force control were determined for 60 adults (19-84 years). Significant correlational relationships were identified using non-parametric Spearman’s correlations with an alpha at 0.1 between the 5 Hz test probe and several 0.5 N low-level force control assessments in the static and slow ramp-and-hold condition. These findings indicate that as vibrotactile detection thresholds increase (labial sensation decreases), ability to maintain a low-level force endpoint decreases. Group data was analyzed using non-parametric Kruskal-Wallis tests and identified significant differences between the 5 Hz test frequency probe and various 0.5 N skilled force assessments for group variables such as age, pure tone hearing assessments, sex, speech usage and smoking history. Future studies will begin the processing of modeling this complex multivariate relationship in healthy individuals before moving to a disordered population.

Neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system". In contrast to physiological pain that warns of noxious stimuli likely to result in tissue damage, neuropathic pain serves no protective function. Examples of neuropathic pain states include postherpetic neuralgia (shingles) and phantom limb / stump pain. This pain state also exists in the orofacial region, with the possibility of several variants including atypical odontalgia and burning mouth syndrome. There is a paucity of information on the prevalence of neuropathic pain in the orofacial region. One study assessed patients following endodontic treatment and found that approximately 3 to 6percent of patients reported persistent pain. Patients predisposed to the condition atypical odontalgia (phantom tooth pain) include those suffering from recurrent cluster or migraine headaches. Biochemical and neurobiological processes leading to a neuropathic pain state are complex and involve peripheral sensitisation, and neuronal plasticity of the central and peripheral nervous systems. Subsequent associated pathophysiology includes regional muscle spasm, sympathetic hyperfunction, and centralisation of pain. The relevant clinical features of neuropathic pain are: (i) precipitating factors such as trauma or disease (infection), (ii) pain that is frequently described as having burning, paroxysmal, and lancinating or sharp qualities, and (iii) physical examination may indicate hyperalgesia, allodynia and sympathetic hyperfunction. The typical patient complains of persistent, severe pain, yet there are no clearly identifiable clinical or radiographic abnormalities. Often, due to the chronicity of the problem, afflicted patients exhibit significant distress and are poor pain historians, thus complicating the clinician's task of obtaining a detailed and relevant clinical and psychosocial history. An appropriate analgetic blockade test for intraoral sites of neuropathic pain is mucosal application of topical anaesthetics. Other, more specific, tests include placebo controlled lignocaine infusions for assessing neuropathic pain, and placebo controlled phentolamine infusions for sympathetically maintained pain. The treatment and management of neuropathic pain is multidisciplinary. Medication rationalisation utilises first-line antineuropathic drugs including tricyclic antidepressants, and possibly an anticonvulsant. Topical applications of capsaicin to the gingivae and oral mucosa are a simple and effective treatment. Neuropathic pain responds poorly to opioid medication. Psychological assessment is often crucial in developing strategies for pain management. Psychological variables include distress, depression, expectations of treatment, motivation to improve, and background environmental factors. To enable a greater understanding of neuropathic pain, thereby leading to improved treatments, high-performance liquid chromatography-mass spectrometry is one analytical technique that has the potential to contribute to our knowledge base. This technique allows drugs and endogenous substances to be assayed from one sample in a relatively short time. The technique can identify, confirm, and measure the concentrations of multiple analytes from a single sample.

For pain research, the orofacial region is unique in a number of ways. The region has complex local anatomy, including substantial sensory innervation from neural pathways, and muscles of facial expression that convey important information concerning pain intensity and associated psychological traits. Although chronic orofacial pain conditions appear prevalent, useful documentation on pain intensity ratings using well established instruments is sparse. In particular, two conditions, atypical facial pain and atypical odontalgia, are poorly understood in aetiology so that definitive treatment modalities are severely limited. The region's local biofluid, saliva, has been used to diagnose various local and systemic disease states, and to quantitate drug concentrations. However, recent studies indicate that saliva also contains some of the same peptides, e.g. bradykinin, that are involved in pain mechanisms. It may be that pharmacological-pharmacokinetic studies of these peptides could shed more information on thesignificance of their presence in saliva. This thesis consists of four major sections. Section 1 comprises of three clinical studies investigating orofacial pain. Section 2 deals with clinical laboratory studies of saliva. Section 3 is concerned with the development of chromatographic methods to assay bradykinin and its pharmacokinetics in saliva. Section 4 uses chromatography for the identification of novel salivary peptides. This thesis, then, presents clinical studies of orofacial pain and pharmacological investigations of saliva as the local biofluid.

Thesis (Ph. D. in Psychology)--University of Wisconsin--Milwaukee, 1996. / Vita. Photocopy (positive) University Microfilms No. 97-17147. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 61-69).

Thesis (Ph. D. in Psychology)--University of Wisconsin--Milwaukee, 1996. / Vita. Photocopy (positive) University Microfilms No. 97-17147. Includes bibliographical references (leaves 61-69).

Submitted by Hiolanda Rêgo (hiolandarego@gmail.com) on 2016-03-09T12:06:31Z No. of bitstreams: 1 Dissertação_Med_ Mayra Carvalho Oliveira.pdf: 3709155 bytes, checksum: 6ea431b1bf49bab4869630071a814266 (MD5) / Approved for entry into archive by Delba Rosa (delba@ufba.br) on 2016-04-19T15:25:53Z (GMT) No. of bitstreams: 1 Dissertação_Med_ Mayra Carvalho Oliveira.pdf: 3709155 bytes, checksum: 6ea431b1bf49bab4869630071a814266 (MD5) / Made available in DSpace on 2016-04-19T15:25:53Z (GMT). No. of bitstreams: 1 Dissertação_Med_ Mayra Carvalho Oliveira.pdf: 3709155 bytes, checksum: 6ea431b1bf49bab4869630071a814266 (MD5) / FAPESB / Introdução: a asma grave, controlada ou não controlada, somados aos sintomas da rinite alérgica e à respiração oronasal, podem estar associadas à presença de alterações miofuncionais do sistema estomatognático. Objetivo: descrever os achados da avaliação miofuncional orofacial em pacientes com asma grave. Materiais e métodos: Estudo descritivo do tipo corte transversal, comparando asma grave controlada e não controlada. Os 160 participantes selecionados responderam questionários (sócio demográfico e ACQ 6) e realizaram avaliação espirométrica e miofuncional fonoaudiológica. Resultados: asma grave controlada esteve presente em 126 (78,8%) pacientes e não controlada em 34 (21,2%); padrão de respiração oronasal 121 vs 32 (96% vs 94,1%; p<0,641); problemas de voz 87 vs 25 (71% vs 76%; p<0,666); palato duro largo e alto 62 vs 16 (49,2% vs 47,1%; p<0,849); úvula alongada 105 vs 26 (83,3% vs 76,6%; p<0,451); estado de conservação da arcada dentária médio ou ruim 121 vs 34 (96% vs 100%; p<0,585); mastigação habitual com amassamento de língua 123 vs 33 (100% vs 100%; p<0,156); mastigação habitual muito rápida 115 vs 32 (93,5% vs 94,1%; p<0,685); mastigação habitual muito pouco 118 vs 33 (96% vs 94,1%; p<0,585); mastigação habitual fazendo ruídos 118 vs 32 (96% vs 94,1%; p<1,000); deglutição com projeção anterior de língua 121 vs 33 (96% vs 100%; p<0,788); deglutição com contração periorbicular 121 vs 33 (96% vs 100%; p<0,621); deglutição com contração de mento 122 vs 32 (99,2% vs 94,1%; p<0,379); deglutição com movimento anterior de cabeça 123 vs 32 (100% vs 94,1%; p<1,000); se sobram alimentos após deglutir 120 vs 32 (97,5% vs 94,1%; p<0,618). Conclusões: os pacientes com asma grave não controlada 16 apresentaram maior frequência quanto às alterações do sistema estomatognático (músculos e estruturas), quando comparados com os pacientes com asma controlada; pacientes com asma grave apresentaram elevada frequência de respiração oronasal, alterações em arcada dentária e alterações de voz; pacientes com asma grave apresentaram alterações do sistema estomatognático (funções de respiração, mastigação e deglutição), sendo que aqueles que tinham asma não controlada, essa frequência foi maior.

Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2015-04-14T01:40:41Z No. of bitstreams: 1 Lilian Anabel Becerra de Oliveira.pdf: 1118276 bytes, checksum: e347b846e5c6489acb044ed68d6bed22 (MD5) / Made available in DSpace on 2015-04-14T01:40:41Z (GMT). No. of bitstreams: 1 Lilian Anabel Becerra de Oliveira.pdf: 1118276 bytes, checksum: e347b846e5c6489acb044ed68d6bed22 (MD5) Previous issue date: 2013 / A neuromodulação através da estimulação elétrica transcraniana com corrente continua (ETCC) tem sido usada para o controle da dor, mas pouco se sabe sobre seu uso associado a outras formas de terapia em síndromes dolorosas. Este trabalho teve como objetivo avaliar o efeito da ETCC associada à exercícios no controle da disfunção temporomandibular crônica. Método: Todos os participantes foram avaliados pelos Critérios Diagnósticos de Investigação para Disfunção Temporomandibular (RDC∕DTM). A avaliação da dor foi feita pela escala visual analógica (EVA) e pela medida do limiar da dor a pressão na articulação temporomandibular (ATM) e músculos cervicais. A qualidade de vida foi avaliada pelo questionário WHOQOL-brief. Todos os indivíduos foram randomicamente assignados a: ETCC+exercícios ou ETCC simulada+exercícios. Protocolo de tratamento: cinco sessões consecutivas de ETCC com duração de 20 minutos, intensidade de 2 mA., mais dez sessões de exercícios orofaciais e cervicais. Resultados: 32 indivíduos participaram com idade entre 18 a 40 anos (media de 24,7±6,8 anos). Houve diferença estatisticamente significante na intensidade da dor EVA (p<0,01) no grupo ETCC+ exercícios com uma redução de 78% na intensidade da dor no mesmo grupo e de 55% no grupo ETCC simulada+ exercícios. Os pacientes mostraram redução significativa (p<0,001) na dor à pressão dos músculos cervicais e na região anterior e posterior do côndilo mandibular porem sem diferenças entre grupos. O mesmo aconteceu em relação aos domínios físico e psicológico da qualidade de vida. 47% do grupo ETCC ativa e 37.5% do grupo ETCC simulada aumentaram a abertura bucal acima de 5mm. EVA foi avaliada cinco meses após o tratamento, resultados iniciais foram parcialmente mantidos com diminuição da dor de 68,2% no grupo ETCC+ exercícios e 65% no grupo ETCC simulada+ exercícios. Conclusão: Este estudo sugere que a ETCC associada a exercícios oferece resultados a curto e médio prazo quando comparado a exercícios e ETCC simulada para o tratamento de dor crônica proveniente de desordens temporomandibulares em adultos jovens.