Five new polymorphs and one hydrated form of 2-thiobarbituric acid have been isolated and characterised by solid-state methods. In both the crystalline form II and in the hydrate form, the 2-thiobarbituric molecules are present in the enol form, whereas only the keto isomer is present in crystalline forms I (reported in 1967 by Calas and Martinex), III, V and VI. In form IV, on the other hand, a 50:50 ordered mixture of enol/keto molecules is present. All new forms have been characterised by single-crystal X-ray diffraction, 1D and 2D ((1)H, (13)C, and (15)N) solid-state NMR spectroscopy, Raman spectroscopy and X-ray powder diffraction at variable temperature. It has been possible to induce keto-enol conversion between the forms by mechanical methods. The role of hydrogen-bond interactions in determining the relative stability of the polymorphs and as a driving force in the conversions has been ascertained. To the best of the authors' knowledge, the 2-thiobarbituric family of crystal forms represents the richest collection of examples of tautomeric polymorphism so far reported in the literature.

This is an author version of the contribution published on:Questa è la versione dell 'autore dell'opera: J Oral Maxillofac Surg. 2014 Oct;72(10):1890-7. doi: 10.1016/j.joms.2014 AbstractPurpose: The surgical removal of mandibular third molars is frequently accompanied by significant post-surgical sequelae, and different protocols have been described to improve such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. Methods:A single-centre, randomized, split-mouth study was performed using a consecutive series of unrelated healthy Caucasian patients, attending the Oral Surgery Unit of the University of Turin, for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on one side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling and the duration of surgical time; secondary outcomes were sex, age and possible adverse events. Anova or paired t-test were used as appropriate to test any significant differences at baseline according to each treatment subgroups and categorical variables were analysed by χ2 test.Results: The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with the piezosurgery was significantly lower than that experienced after bur (conventional) removal, reaching a statistical difference after 4 days (P=0.043). The clinical value of orofacial swelling at 7th day, normalized to baseline, was lower in the piezosurgery group (P<0.005).The average time of surgery was significantly lower in the bur than piezosurgery group (P<0.05).Three patients having bur removal experienced short-term complications (two dry sockets and one temporary paraesthesia): both totally resolved by 4 weeks. Conclusions:To date, this prospective investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal, also comparing surgeons with different 3 degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and reduce post-operative pain and swelling.

To evaluate in patients with different types of facial pain the association between muscle tenderness and a set of characteristics, 649 consecutive outpatients with facial myogenous pain (MP), TMJ disorder, neuropathic pain (NP) and facial pain disorder (FPD) (DSM-IV) were enrolled. For each patient a psychological assessment on the Axis 1 of the DSM-IV and standardized palpation of pericranial and cervical muscles were carried out. A pericranial muscle tenderness score (PTS), a cervical muscle tenderness score (CTS) and a cumulative tenderness score (CUM, range 0-6) were calculated. Univariate analyses (one-way analysis of variance or chi(2) test) indicated that both age- and sex-distribution, tenderness scores and prevalence of psychiatric disorders markedly differed between groups. The prevalence of depression was highest in FPD patients (44.9%). Both muscle tenderness scores (either PTS or CTS) and prevalence of anxiety were higher in patients with MP than in those with TMJ or NP. To assess associations between CUM score and patients' demographic and clinical characteristics an ordered logit model was fit and interactions between psychiatric disorders and diagnostic groups were tested. The analysis showed that, regardless of the diagnostic group, anxiety and depression independently increase the likelihood of having one point higher muscle tenderness score (OR=1.55, 95% CI: 1.13-2.12 and OR=1.56, 95% CI: 1.10-2.21, respectively). A careful screening for the presence of an underlying psychiatric disorder, either anxiety or depression, should be part of the clinical evaluation in patients suffering from facial pain.

To assess in patients with migraine and tension type headache, both episodic and chronic, the extent to which muscle tenderness may relate to anxiety and depression, 459 patients with Episodic Migraine (EM, 125), Chronic Migraine (CM, 97), Episodic Tension Type Headache (ETTH, 82), Chronic Tension Type Headache (CTTH, 83), and EM+ETTH (72) were enrolled. For each patient, a psychological assessment on the Axis 1 of the DSM-IV and muscle palpation of pericranial and cervical muscles were carried out. A Pericranial Muscle Tenderness Score (PTS) and a Cervical Muscle Tenderness Score (CTS) were calculated (range 0-3). Logistic and linear regression analyses were employed to assess relations between muscle tenderness, the demographic variables and psychiatric disorders in the different patient groups. Odds ratio for 'male gender' was higher in groups with tension type headache. Only EM patients showed a positive association with increasing age. Anxiety and depression were significantly associated to CM. A significant negative correlation of PTS and CTS was observed in EM patients. In relation to male gender, the PTS was significantly lower in EM, ETTH and CTTH; CTS was significantly lower in EM, CM, and CTTH. Anxiety and, even more, anxiety and depression combined were positively associated to higher PTS and CTS in EM patients. Anxiety and depression were also positively associated to higher CTS in patients with EM+ETTH. In CTTH patients, PTS only was positively associated to anxiety and depression. We conclude that in patients with EM, the presence of anxiety or anxiety and depression combined considerably increases the level of muscle tenderness in the head and, even more, in the neck, and might facilitate the evolution into CM.

This study was an 8-month controlled trial to evaluate the effectiveness of a workplace educational and physical programme in reducing headache and neck and shoulder pain. Central registry office employees (n = 192; study group) and 192 peripheral registry office and central tax office employees (controls) in the city of Turin, Italy were given diaries for the daily recording of pain episodes. After 2 months, the study group only began the educational and physical programme. The primary end-point was the change in frequency of headache and neck and shoulder pain expressed as the number of days per month with pain, and as the proportion of subjects with a >or= 50% reduction of frequency (responder rate). The number of days of analgesic drug consumption was also recorded. Diaries completed for the whole 8 months were available for 169 subjects in the study group and 175 controls. The baseline frequency of headache (days per month) was 5.87 and 6.30 in the study group and in controls; frequency of neck and shoulder pain was 7.12 and 7.79, respectively. Mean treatment effects [days per month, 95% confidence interval (CI)] on comparing the last 2 months vs. baseline were: headache frequency -2.45 (-3.48, -1.43); frequency of neck pain -2.62 (-4.09, -1.16); responder rates (odds ratio, 95% CI) 5.51 (2.75, 11) for headache, 3.10 (1.65, 5.81) for neck and shoulder pain, and 3.08 (1.06, 8.90) for days with analgesic drug consumption. The study suggests that an educational and physical programme reduces headache and neck and shoulder pain in a working community.