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Vivacqua A, Fan K, Gürtler A, Thieringer FM, Berg BI. An Algorithm for Jaw Pain among Divers. J Clin Med 2024; 13:3167. [PMID: 38892877 PMCID: PMC11173261 DOI: 10.3390/jcm13113167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/15/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Temporomandibular disease (TMD) is commonly seen, and divers also experience pain in the temporomandibular joint (TMJ) or masticatory muscles. This article aims to provide a tool for diving physicians or medical professionals involved in diving medicine since jaw pain among divers is a pertinent subject and can be challenging to evaluate without some background in dentistry or maxillofacial surgery. Method: A basic algorithm was developed to provide a tool to differentiate jaw pains experienced by divers. Three brief case studies were developed, and five diving physicians were tasked with diagnosing the cases using the algorithm. Additionally, simple exercises and massage techniques that can benefit patients with TMD, particularly immediately after diving, are outlined. Results: All five diving physicians successfully diagnosed the cases using the algorithm. However, three of them were unable to diagnose the first case (disc luxation) without consulting the algorithm. Nevertheless, all physicians acknowledged the utility of the algorithm. Conclusions: Jaw pain in divers can stem from diverse causes, but effective treatment options exist. Our study findings provide valuable insights to assist diving physicians in making accurate diagnoses and guiding appropriate patient management, which may include referrals to specialists such as dentists, maxillofacial surgeons, or orthodontists.
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Affiliation(s)
- Angelo Vivacqua
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (F.M.T.)
| | - Kathleen Fan
- Oral and Maxillofacial Surgery Department, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | | | - Florian M. Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (F.M.T.)
- Faculty of Medicine, University Hospital Basel, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University Basel, 4001 Basel, Switzerland
| | - Britt-Isabelle Berg
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (F.M.T.)
- Faculty of Medicine, University Hospital Basel, 4031 Basel, Switzerland
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Nemani SM, Chidambaranathan AS, Muthukumar B, Srinivasan S. Evaluation of the effect of different kinds of treatment modalities for temporomandibular joint pain and its relevance to chronic cervical pain: A randomized controlled trial. J Indian Prosthodont Soc 2024; 24:128-135. [PMID: 38650337 PMCID: PMC11129811 DOI: 10.4103/jips.jips_468_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 04/25/2024] Open
Abstract
AIM The aim of this study was to evaluate the effect of different treatment modalities for temporomandibular joint (TMJ) pain and their relevance to chronic cervical pain after 12 months. SETTINGS AND DESIGN This was a randomized controlled trial. MATERIALS AND METHODS Forty-eight participants with chronic cervical and TMJ pain were selected using research diagnostic criteria and randomized into four groups (n = 12), which included control, soft splints, transcutaneous electrical nerve stimulation (TENS), and low-level laser (LLL). The cervical and TMJ pain was recorded using visual analog scale (VAS) scores at baseline, 3 months, 6 months, and 12 months. Occlusal equilibration was done for all groups except for the control. STATISTICAL ANALYSIS USED The mean pain scores were statistically analyzed using one-way analysis of variance and posthoc test. RESULTS The mean VAS scores in TMJ pain patients between the four groups at baseline and at final follow-up were 7.27 ± 1.29 in Group 1, 7.53 ± 0.70 in Group 2, 7.76 ± 0.80 in Group 3, and 7.61 ± 0.61 in Group 4. The mean difference between Groups 1 and 3, Groups 1 and 4, and Groups 2 and 3 was statistically significant (P < 0.00). Pearson correlation test yielded a mild and negative correlation between TMJ and cervical pain. CONCLUSION TENS and LLL were found to be equally effective in reducing pain in the jaw joint region, followed by soft splints, and there was no correlation between TMJ and cervical pain.
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Affiliation(s)
- Sai Madhuri Nemani
- Department of Prosthodontics, SRM Dental College, Ramapuram, Tamil Nadu, India
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Odzimek M, Brola W. Occurrence of Cervical Spine Pain and Its Intensity in Young People with Temporomandibular Disorders. J Clin Med 2024; 13:1941. [PMID: 38610705 PMCID: PMC11012664 DOI: 10.3390/jcm13071941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The main aim of this cross-sectional study was to compare the occurrence and severity of cervical spine pain in young adults diagnosed with TMDs with a healthy control group (without TMDs). Methods: The study was conducted from June to July 2023. Inclusion criteria were age (18-30 years), cervical spine pain (for at least 1 month), and consent to participate in the study. The study was conducted based on RDC/TMD protocol, an original questionnaire, and a physiotherapeutic examination focused on detecting TMDs. The cervical pain level was assessed using the Visual Analogue Scale (VAS). Thus, a total of 95 subjects were registered for the trials, 51 people (53.7%) constituted the control group (without TMDs), while 44 (46.3%) people constituted the study group (with TMDs). Results: The mean age of people participating in the study was 22.2 ± 2.2 years in the study group and 22.5 ± 3.1 years in the control group. The largest group was people aged 21-25 (n = 51 people, 53.7%). Patients from the study group more often experienced pain in the stomatognathic system during palpation (both in the muscle, joint, and musculoskeletal groups) and had reduced mobility of the temporomandibular joints in every movement (p < 0.001). People from the study group were also characterized by less mobility of the cervical spine (p < 0.05), apart from extension movement (p > 0.05). The analysis showed that of the 95 people participating in the study, 85.4% reported problems in the cervical spine area (n = 81), of which almost all people in the study group struggled with this problem (n = 43, 97.7%). It was found that cervical spine pain was significantly more common in people with TMDs (p < 0.05, chi2 = 10.118, df = 1, rc = 0.31). The level of pain was significantly higher in people from the study group (p < 0.001, chi2 = 45.765, df = 4, rc = 0.57). Conclusions: Our research has shown that the occurrence of cervical spine pain is more common in the group of young people with temporomandibular disorders (TMDs). In young people, this problem is rarely recognized and properly treated.
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Affiliation(s)
- Martyna Odzimek
- Doctoral School, The Jan Kochanowski University, Żeromskiego 5, 25-369 Kielce, Poland
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Al. IX Wieków Kielc 19A, 25-516 Kielce, Poland;
| | - Waldemar Brola
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Al. IX Wieków Kielc 19A, 25-516 Kielce, Poland;
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Gençosmanoğlu H, Ünlüer NÖ, Akın ME, Demir P, Aydın G. An investigation of biomechanics, muscle performance, and disability level of craniocervical region of individuals with temporomandibular disorder. Cranio 2024; 42:232-242. [PMID: 34128775 DOI: 10.1080/08869634.2021.1938854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate biomechanics, muscle performance, and disability of the craniocervical region in temporomandibular disorder (TMD) patients and compare them with controls. METHODS Craniocervical posture was evaluated using lateral photography and radiography. Range of motion, muscle performance, disability, and TMD severity were assessed using an inclinometer, Functional Strength Testing of Cervical Spine, Neck Disability Index, and Fonseca Anamnestic Index, respectively. RESULTS Compared to the control group, the TMD group demonstrated higher cervical flexion angle (p=0.005) and neck disability (p<0.001) as well as lower cervical extension (p=0.040), right cervical rotation (p=0.005), left cervical rotation (p<0.001), and tragus-C7-horizontal (p=0.048) angles, and reduced muscle performances (p≤0.001). Most patients had higher than normal craniocervical angle (p<0.001). Muscle performance in each cervical motion (p<0.005) and disability (p<0.001) were associated with TMD severity in the TMD group. CONCLUSION Biomechanics, muscle performance, and disability of craniocervical region were altered in the TMD group.
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Affiliation(s)
- Harun Gençosmanoğlu
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Avrasya University, Trabzon, Turkey
| | - Nezehat Özgül Ünlüer
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Mustafa Emre Akın
- Department of Radiology, Yenimahalle Training & Research Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Pervin Demir
- Department of Biostatistics & Medical Informatics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
| | - Gülümser Aydın
- Department of Physical Medicine & Rehabilitation, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
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Naderi Y, Karami E, Chamani G, Amizadeh M, Rad M, Shabani M. Temporomandibular treatments are significantly efficient in improving otologic symptoms. BMC Oral Health 2023; 23:913. [PMID: 37996839 PMCID: PMC10666408 DOI: 10.1186/s12903-023-03627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient's parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs.
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Affiliation(s)
- Yeganeh Naderi
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Elaheh Karami
- Department of Oral Medicine and Orofacial Pain, Kerman School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Goli Chamani
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Scandinavian Center for Orofacial Neuroscience (SCON), Karolinska Institute, Huddinge, Sweden.
| | - Maryam Amizadeh
- Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Rad
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, 76198-13159, Iran.
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Shaffer SM, Naze GS. Evaluation and management of temporomandibular disorders. Part 2: an orthopaedic physical therapy update on examination and clinical reasoning. J Man Manip Ther 2023; 31:143-152. [PMID: 36171740 PMCID: PMC10288906 DOI: 10.1080/10669817.2022.2124617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Temporomandibular (TM) disorders afflict many people globally and, despite the presence of existing peer-reviewed material that assists conservative orthopedic providers, recent advances in knowledge indicate that updated resources are required for students, clinicians, and educators. This two-part series builds off previously published material to present newer supplementary information that can be useful during the evaluation and management processes. Content in Part 1 of this series includes a discussion about the factors that have been shown to contribute to TM disorders, an updated perspective of relevant pain science, a discussion of self-report outcome measures, and various different topics related to the examination of patients with TM disorders. Part 2 addresses information related to the temporomandibular joint disc, joint hypermobility, oral splints, and clinical reasoning. In combination with other available publications, this two-part series provides clinicians an opportunity to improve their delivery of effective and efficient clinical services for people diagnosed with TM disorders.
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Affiliation(s)
- Stephen M. Shaffer
- Department of Rehabilitation Sciences, College of Education, Nursing, and Health Professions, University of Hartford, West Hartford, CT, USA
| | - Garrett S. Naze
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
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Lee IS, Kim SY. Effectiveness of manual therapy and cervical spine stretching exercises on pain and disability in myofascial temporomandibular disorders accompanied by headaches: a single-center cohort study. BMC Sports Sci Med Rehabil 2023; 15:39. [PMID: 36959659 PMCID: PMC10035158 DOI: 10.1186/s13102-023-00644-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/11/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Previous studies have demonstrated a relationship between headaches and temporomandibular disorders (TMDs). Moreover, recent studies have shown functional, anatomical, and neurological associations between the temporomandibular joint (TMJ) and upper cervical spine. This study aimed to investigate the effectiveness of manual therapy and cervical spine stretching exercises for pain and disability in patients with myofascial TMDs accompanied by headaches. METHODS Thirty-four patients recruited from Gyeryong Hospital with headaches and diagnosed with TMDs were randomly assigned to the experimental (n = 17) and control (n = 17) groups. Headache impact was assessed using the Korean Headache Impact Test-6. Masseter myofascial pain was measured using the visual analog scale, and TMJ pressure pain threshold levels were evaluated using an algometer. Neck pain intensity was assessed using the numerical rating scale. Once per week for 10 weeks, the experimental group received cervical spine-focused manual therapy and stretching exercises alongside conservative physical therapy, and the control group received conservative physical therapy alone. Patients were evaluated at baseline and 5 and 10 weeks post-intervention. RESULTS After the intervention, the experimental group exhibited significant reductions in the cervical kyphotic angle, Korean Headache Impact Assessment score, neck pain intensity, TMJ pain pressure threshold, Neck Disability Index score, and Jaw Functional Limitation Scale level compared with the control group (p < 0.01). CONCLUSION Manual therapy and stretching exercises could help resolve TMDs accompanied by headaches through biomechanical changes in the cervical spine. These findings may guide protocols and clinical trials involving manual therapy that align morphological structures.
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Affiliation(s)
- In-Su Lee
- Department of Physical Therapy, Graduate School, Daejeon University, Daejeon, Republic of Korea
| | - Suhn-Yeop Kim
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
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Cephalometric assessment regarding craniocervical posture in orthodontic patients. Sci Rep 2022; 12:21729. [PMID: 36526718 PMCID: PMC9758121 DOI: 10.1038/s41598-022-26243-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
A major factor that contributes to dental malocclusions is represented by the positioning of the mandible. Considering the existing interconnections between the craniocervical and craniomandibular systems it is interesting to assess how changes in one system can influence the other, thus establishing a pattern in terms of certain cephalometric landmarks that orthodontists could consider when diagnosing and evaluating an orthodontic case. Therefore, the aim of this study was to investigate the connections between cervical posture, head position, hyoid bone position in orthodontic patients with different skeletal patterns. 45 lateral cephalometric radiographs were analyzed. Skeletal class and vertical growth were the main elements that were considered when classifying patients. Craniofacial and Cervical landmarks were determined on the cephalograms, from which lines and angles resulted which were considered relevant in our study. Correlations between cephalometric variables of the patients were determined. there were some statistically significant changes identified concerning craniocervical posture and hyoid bone position between the patients in the following parameters: H-Rgn, OPT/HOR, CVT/HOR, OPT/SN, CVT/SN, H-SN. The results obtained allowed us to conclude that there were some differences at the skeletal level of the sample of patients studied. The findings are indicating that there is a close relationship between, mandible position, cervical- and head posture and the hyoid bone. The information obtained in this study could help to better understand the development of malocclusions, and to improve the orthodontic diagnostic and treatment plan.
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Crăciun MD, Geman O, Leuciuc FV, Holubiac IŞ, Gheorghiţă D, Filip F. Effectiveness of Physiotherapy in the Treatment of Temporomandibular Joint Dysfunction and the Relationship with Cervical Spine. Biomedicines 2022; 10:biomedicines10112962. [PMID: 36428529 PMCID: PMC9687864 DOI: 10.3390/biomedicines10112962] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Temporomandibular dysfunctions are a heterogeneous group of conditions involving the temporomandibular joints (TMJs) and periarticular musculoskeletal structures. This study aimed to evaluate the effectiveness of a physiotherapy program for TMJ dysfunctions and the relationship with cervical spine. The study design was a non-randomized clinical trial with two parallel treatment groups: 33 subjects in the experimental group that underwent conservative drug treatment and physiotherapy treatment, and 31 subjects in the control group that underwent only conservative drug treatment. The participants were examined at baseline and re-examined after 3 months. In this study there was a higher incidence of female subjects. After 3 months of treatment of the TMJs and cervical spine, pain decreased in both groups (p = 0001). Muscle testing at the cervical spine and temporomandibular level showed a decrease in pain and muscles spasms. The average percentage values of the Neck Disability Index (NDI) and the Jaw Functional Limitation Scale 8 (JFLS 8) decreased significantly in both groups, but especially in the experimental group (p = 0.001). Physiotherapy treatments could maintain the functional state at the temporomandibular and cervical levels, thus contributing to increasing the quality of daily life.
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Affiliation(s)
- Maria Daniela Crăciun
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
- Correspondence: (M.D.C.); (O.G.)
| | - Oana Geman
- Neuroaesthetics Laboratory, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
- Correspondence: (M.D.C.); (O.G.)
| | - Florin Valentin Leuciuc
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Iulian Ştefan Holubiac
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Daniela Gheorghiţă
- Dentist’s Office Omnis Dental, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Florin Filip
- County Hospital of Suceava, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
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Sanchla AD, Shrivastav S, Bharti L, Kamble R. Comparative Evaluation and Correlation of Pain Pattern in Neck Musculature Observed in Mild, Moderate, and Severe Temporomandibular Joint Disorder Cases as Compared to Non-temporomandibular Joint Disorder Cases. Cureus 2022; 14:e30099. [PMID: 36381943 PMCID: PMC9642967 DOI: 10.7759/cureus.30099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Temporomandibular disorder (TMD) is a broad term used to describe several interlinked disorders affecting the temporomandibular joint (TMJ), muscles of the craniofacial region, and associated structures, all of which have common symptoms such as pain and reduced jaw opening. Along with these, extra-craniofacial symptoms may also be present, which need to be assessed for early diagnosis of TMD. Considering the extra-craniofacial symptoms of TMD, this observational study aimed to evaluate the severity of pain in the neck musculature of patients with TMD and correlate it with the severity of the disorder. Material and methods A total of 44 patients were included in the study who were graded for severity of TMD based on the amnestic and dysfunctional components of the Helkimo index separately. The pain was evaluated bilaterally in five groups of neck muscles in all cases using manual palpation. The severity of pain in these neck muscles was then correlated with the severity of both subjective and objective symptoms of TMD and compared with patients without TMD. Results The Chi-square test revealed a statistically significant association between the severity of pain in all five groups of neck muscles and the severity of TMD. The severity of pain increased with the increasing severity of TMD, with a total of 59.09% of TMD patients presenting with varying degrees of pain in the neck musculature and a p-value of 0.0001% which was significant. Negligible pain in the neck musculature was present in patients without TMD. Conclusion Based on the results, it was observed that the severity of TMD directly correlated with pain in various groups of neck muscles. 59.09% of patients with TMD reported varying degrees of pain in the neck musculature. The severity and distribution of pain in the neck muscles increased with the increasing severity of TMD.
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Chiou-Tan FY. Musculoskeletal mimics of cervical radiculopathy. Muscle Nerve 2022; 66:6-14. [PMID: 35466429 DOI: 10.1002/mus.27553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 11/10/2022]
Abstract
Musculoskeletal mimics of cervical radiculopathy will be explored in this AANEM monograph. A review of the literature and textbooks was conducted. Musculoskeletal cervical radiculopathy mimics include: (1) head/neck pain, such as neck tension, cervicogenic headache, and temporomandibular disorder; (2) referred pain from shoulder pathology, such as rotator cuff tears/impingement; (3) elbow region abnormalities, including medial/lateral epicondylitis; (4) wrist/hand conditions, such as DeQuervain's tenosynovitis and intersection syndrome; (5) muscle connective tissue disorders, including myofascial trigger points; (6) conditions that have decreased range of motion, including frozen shoulder and rounded shoulders with tight pectoral/scalene muscles; (7) conditions with joint hyperlaxity and instability, as seen in post-stroke shoulder subluxation; (8) vascular conditions, such as thoracic outlet syndrome; and (9) autonomic controlled soft tissue changes associated with complex regional pain syndrome. Formulating a differential diagnosis and recognizing mimics of cervical radiculopathy can decrease the time between symptom onset and diagnosis/treatment plan.
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Affiliation(s)
- Faye Y Chiou-Tan
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.,Harris Health System, Electrodiagnostic Laboratory, Smith Clinic/Ben Taub Hospital, Houston, Texas, USA
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Botros J, Gornitsky M, Samim F, der Khatchadourian Z, Velly AM. Back and neck pain: A comparison between acute and chronic pain-related Temporomandibular Disorders. Can J Pain 2022; 6:112-120. [PMID: 35799959 PMCID: PMC9255212 DOI: 10.1080/24740527.2022.2067032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/04/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022]
Abstract
Background Temporomandibular disorders (TMDs) are common and cause persistent pain. Comorbidities are associated with TMDs and can affect the effectiveness of their treatments. The literature is lacking enough evidence on the difference between acute and chronic pain, particularly in TMDs. Investigating this difference could highlight potential risk factors for the transition from acute to chronic pain-related TMDs. Aim To compare the likelihood of back and neck pain (BP, NP) between acute and chronic pain-related TMDs (AP-TMD, CP-TMD) as defined by pain duration and pain-related disability.. Methods Participants with AP-TMDs (≤3 months) and CP-TMDs (>3 months) were recruited according to the diagnostic criteria and research diagnostic criteria of TMD. BP and NP were assessed using a self-reported checklist. CP-TMDs defined by disability (chronic disability) and depression and anxiety symptoms were assessed using validated instruments. Logistic regression analyses were employed. Results This study enrolled 487 adults with AP-TMD (n = 118) and CP-TMD (n = 369). Relative to AP-TMD, participants with CP-TMD had twice the odds of reporting NP (odds ratio [OR] = 2.17, 95% CI 1.27-3.71) but not BP (OR = 0.96, 95% CI 0.57-1.64). Participants with chronic disability were twice as likely to report NP (OR = 1.95, 95% CI 1.20-3.17) but not BP (OR = 1.13, 95% CI 0.69-1.82) compared to those without. All analyses were adjusted for age, sex, and anxiety and depression symptoms. Conclusions Within the limitations of this study, results suggest that central dysregulation or trigeminocervical convergence mechanisms are implicated in the process of pain-related TMD chronification and highlight the relevance of considering disability when defining CP-TMDs.
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Affiliation(s)
- Jack Botros
- Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Mervyn Gornitsky
- Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Firoozeh Samim
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Department of Dentistry, Montreal General Hospital, Montreal, Quebec, Canada
| | - Zovinar der Khatchadourian
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal, Quebec, Canada
| | - Ana Miriam Velly
- Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal, Quebec, Canada
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Prodoehl J, Kraus S, Buros Stein A. Predicting the number of physical therapy visits and patient satisfaction in individuals with temporomandibular disorder: A cohort study. J Oral Rehabil 2021; 49:22-36. [PMID: 34674278 DOI: 10.1111/joor.13272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/21/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) can be challenging to manage for clinicians and patients alike. It is unclear which factors are associated with prolonging conservative care and patient dissatisfaction with treatment outcomes. OBJECTIVES To examine factors collected during a physical therapy (PT) evaluation in a cohort of individuals with TMD to determine factors associated with an increased number of PT visits and reduced patient satisfaction. METHODS Records of 511 patients referred to PT over 18 months were reviewed to extract 27 variables to develop a predictive model. Outcomes were patient satisfaction following PT and number of PT visits. Linear and zero inflated negative binomial regressions were used, and a multivariate regression model was built for both outcomes. RESULTS Two factors were associated with both lower patient satisfaction and an increased number of PT visits: higher patient rated functional neck disability and a greater number of healthcare professionals seen. Other factors associated with patient satisfaction were duration of symptoms, subluxation, and referral from an oral surgeon. Only patient rated functional neck disability score was a significant predictive factor in the multivariate model. Factors associated with number of PT visits were gender, educational level, time between initial visit and discharge, number of pain areas, bruxism, biopsychosocial factors, dizziness, pain rating, and presence of neck pain. In the multivariate model, gender, number of healthcare professionals seen, and resting pain rating were significant predictors of number of PT visits. CONCLUSION Considering key factors on initial evaluation, specifically functional neck disability and the number of prior healthcare professionals seen before starting PT, can help to predict a higher number of PT visits and reduced patient satisfaction with outcomes.
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Affiliation(s)
- Janey Prodoehl
- Physical Therapy Program, Midwestern University, Downers Grove, Illinois, USA
| | - Steven Kraus
- Horizon Physical Therapy LLC, Atlanta, Georgia, USA
| | - Amy Buros Stein
- Office of Research and Sponsored Programs, Midwestern University, Glendale, Arizona, USA
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Impact of Cervical Spine Rehabilitation on Temporomandibular Joint Functioning in Patients with Idiopathic Neck Pain. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6886373. [PMID: 34660797 PMCID: PMC8516540 DOI: 10.1155/2021/6886373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022]
Abstract
Objective The aim of this study was to assess the effectiveness of a 3-week rehabilitation programme focusing only on the cervical region, pain intensity, range of motion in the cervical spine, head posture, and temporomandibular joint (TMJ) functioning in subjects with idiopathic neck pain who did not report TMJ pain. Design A parallel group trial with follow-up. Methods The study included 60 participants divided into 2 groups: experimental: n = 25, 27-57 years old, experiencing idiopathic neck pain and who underwent a 3-week rehabilitation programme, and the control, n = 35, 27-47 years, who were cervical pain-free. At baseline and after 3 weeks of treatment in the experimental group and with a 3-week time interval in the control group, pain intensity, head posture in the sagittal plane, range of motion in the cervical spine, and TMJ functioning were evaluated. Results After 3 weeks of rehabilitation, there was a significant decrease in pain intensity, improved range of motion of the cervical spine and head posture, and improved clinical condition of TMJ in participants with idiopathic neck pain who did not report TMJ pain. Conclusion The study suggested that idiopathic neck pain is associated with limited range of motion in the cervical spine, incorrect head posture, and TMJ dysfunction. Our data suggests that therapy focusing only on the cervical region may improve the clinical condition of the TMJ in subjects with idiopathic neck pain who do not report TMJ pain. These observations could be helpful in physiotherapeutic treatment of neck and craniofacial area dysfunctions. This trial is registered with ISRCTN Registry ISRCTN14511735.
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Kanhachon W, Boonprakob Y. Modified-Active Release Therapy in Patients with Scapulocostal Syndrome and Masticatory Myofascial Pain: A Stratified-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8533. [PMID: 34444281 PMCID: PMC8392135 DOI: 10.3390/ijerph18168533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/01/2021] [Accepted: 08/09/2021] [Indexed: 01/12/2023]
Abstract
Modified-active release therapy (mART) was developed to treat patients experiencing upper quarter pain. The objective of the study was to determine the effectiveness of the mART in treating pain, promoting function, and measuring emotions in patients with scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP). A stratified-randomized controlled trial was employed in 38 participants separated into two groups. All participants underwent the same series visual analog scale (VAS), pressure pain threshold (PPT), mouth opening (MO), maximum mouth opening (MMO), craniovertebral angle (CV-angle), and pain catastrophizing scale Thai version (PCS-Thai-version) at the baseline. The mART group underwent the mART program three times a week for 4 weeks with a hot pack and an educational briefing while the control group received only a hot pack and the educational briefing. After treatment, both groups showed significant improvement (p < 0.05) in all parameters except MO, MMO, and CV-angle. When comparing outcomes between the groups, the mART group showed a statistically significant greater number of improvements than did the control group. In conclusion, the mART program can improve pain experienced by patients with SCS and MMP and it can be used as an adjuvant technique with conservative treatment.
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Affiliation(s)
- Wilawan Kanhachon
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand;
- Research Institute for Human High Performance and Health Promotion, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Yodchai Boonprakob
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand;
- Research Institute for Human High Performance and Health Promotion, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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16
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Balthazard P, Hasler V, Goldman D, Grondin F. Association of cervical spine signs and symptoms with temporomandibular disorders in adults: a systematic review protocol. JBI Evid Synth 2021; 18:1334-1340. [PMID: 32813383 DOI: 10.11124/jbisrir-d-19-00107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The objective of this systematic review is to assess the evidence of association of cervical spine signs and symptoms with temporomandibular disorders (TMD). This will help to lend credence to mechanisms supporting the association in order to improve care strategies for this condition. INTRODUCTION The association of cervical spine impairments (in relation to neck posture, cervical spine mobility, muscle tenderness, muscle activity, and neck disability) with TMD has been widely discussed in the literature. Clarification of this relationship is important for health professionals to better assess and treat TMD. INCLUSION CRITERIA Eligible studies will include participants aged 18 years and over, with a diagnosis of TMD from the Research and Diagnostic Criteria for Temporomandibular Disorders or a revised version. Exclusion criteria will be participants with previous temporomandibular joint surgery, history of trauma or fracture in the temporomandibular joint or the craniomandibular system; serious comorbid conditions such as cancer, rheumatic disease, and neurological problems; primary cervical spine disorders such as disc herniation or spinal degenerative changes; or systemic disease such as ankylosing spondylitis. METHODS The search for articles will be conducted in the databases PubMed, PEDro, CINAHL, Web of Science, and Embase, without language or time restrictions. Two independent reviewers will review the title, abstract, and full texts of identified studies; select studies against the inclusion criteria; assess the methodological quality of eligible studies using critical appraisal tools; and perform data extraction. Relevant quantitative data will be pooled with statistical meta-analysis, when possible. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019123698.
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Affiliation(s)
- Pierre Balthazard
- Department of Physiotherapy, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence
| | - Véronique Hasler
- Department of Physiotherapy, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence
| | | | - Francis Grondin
- Laboratoire IRISSE, Université de La Réunion, Tampon, France
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The influence of cervical spine rehabilitation on bioelectrical activity (sEMG) of cervical and masticatory system muscles. PLoS One 2021; 16:e0250746. [PMID: 33901247 PMCID: PMC8075221 DOI: 10.1371/journal.pone.0250746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/09/2021] [Indexed: 01/13/2023] Open
Abstract
Background Coexistence of temporomandibular joint discomfort along with cervical spine disorders is quite common, and is associated with many limitations and adverse symptoms for the patient. Both diagnostics and treatment of these ailments are difficult, and in many cases, the effects of therapy are not satisfactory. This study assessed the impact of a 3-week neck-only rehabilitation programme without direct intervention in the craniofacial area on the bioelectric activity of both the cervical spine and muscles in the craniofacial area among patients with idiopathic neck pain who do not report TMJ pain. Design A parallel group trial with follow-up; Setting: Rehabilitation Clinic. Methods Twenty five patients experiencing idiopathic neck pain underwent the 3-week rehabilitation programme. Thirty five age-matched subjects with no cervical spine and temporomandibular joint (TMJ) dysfunctions were control group. At baseline and after 3 weeks the cervical and craniofacial area muscles’ bioelectrical activity (sEMG) was evaluated. Results In the experimental group during cervical flexion, a significant decrease of sEMG amplitude was noted in the right (mean 25.1 μV; 95% CI: 21.5–28.6 vs mean 16.8 μV; 95% CI: 13.8–19.7) and left (mean 25.9 μV; 95% CI: 21.7–30.0 vs mean 17.2 μV; 95% CI: 13.6–20.7) Sternocleidomastoid as well as a significant increase in sEMG amplitude of the right (mean 11.1 μV; 95% CI: 7.9–14.2 vs mean 15.7 μV; 95% CI: 12.1–19.2) and left (mean 15.3 μV; 95% CI: 11.9–18.6 vs mean 20.2 μV; 95% CI: 15.7–24.2) Upper Trapezius muscles. In the experimental group, after therapy right and left Sternocleidomastoid, Temporalis Anterior and Masseter muscles presented lower fatigue levels. Conclusions Three weeks of rehabilitation without any therapeutic intervention in temporomandibular joint significantly decreased the bioelectrical activity of the neck and craniofacial muscles while improving the muscle pattern of coactivation in participants with idiopathic neck pain who do not report temporomandibular joint pain. These observations could be helpful in the physiotherapeutic treatment of neck and craniofacial area dysfunctions. Trial registration ID ISRCTN14511735—retrospectively registered.
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Paço M, Duarte JA, Pinho T. Orthodontic Treatment and Craniocervical Posture in Patients with Temporomandibular Disorders: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3295. [PMID: 33806739 PMCID: PMC8004626 DOI: 10.3390/ijerph18063295] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/18/2021] [Indexed: 12/15/2022]
Abstract
Orthodontic treatment acts through the application of forces and/or by stimulating and redirecting the functional forces within the craniofacial complex. Considering the interrelationship between craniomandibular and craniocervical systems, this intervention may alter craniocervical posture. Thus, our aim is to (a) compare craniocervical posture, hyoid bone position, and craniofacial morphology before, after, and also in the contention phase at least one year after the orthodontic treatment, in patients with temporomandibular disorders and (b) to verify whether the presence of condylar displacement, the skeletal class, or the facial biotype interferes with the abovementioned outcomes. To do so an observational, analytical, longitudinal, and retrospective design study was carried out. A non-probabilistic convenience sampling method was applied. The sample consisted of clinical records of patients diagnosed with temporomandibular disorders in order to compare pre-orthodontic treatment with post-orthodontic treatment (n = 42) and contention phase data (n = 26). A cephalometric analysis of several variables was performed. The p-value was set as 0.05. When the pre- and post-orthodontic treatment data were analyzed, there were statistically significant changes in variables concerning craniocervical posture (CV angle, C0-C1, and AA-PNS) and also concerning hyoid bone position (C3-Rgn). When pre- and post-orthodontic treatment and contention phase data were analyzed the variables concerning craniocervical posture (C0-C1, CVT/Ver, NSL/OPT, NSL/CVT, NSL/Ver; OPT/CVT, OPT/Ver) and facial biotype had statistically significant changes. This allowed us to conclude that in the sample studied, there were significant differences regarding hyoid bone position (pre- versus post-orthodontic treatment) and craniocervical posture (pre- versus post-orthodontic versus contention), with the craniocervical posture being prone to return to basal values. The presence of condylar displacement was found to significantly increase the H-H1 distance in the three moments of evaluation. Facial biotype was found to significantly increase the NSL/Ver angle on hypodivergent compared to hyperdivergent in the contention phase.
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Affiliation(s)
- Maria Paço
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, 4585-116 Gandra-Paredes, Portugal;
| | - José Alberto Duarte
- CIAFEL, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - Teresa Pinho
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, 4585-116 Gandra-Paredes, Portugal;
- IBMC—Inst. Biologia Molecular e Celular, i3S—Inst. Inovação e Investigação em Saúde, Universidade do Porto, 4585-116 Porto, Portugal
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Cuenca-Martínez F, Herranz-Gómez A, Madroñero-Miguel B, Reina-Varona Á, La Touche R, Angulo-Díaz-Parreño S, Pardo-Montero J, del Corral T, López-de-Uralde-Villanueva I. Craniocervical and Cervical Spine Features of Patients with Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Observational Studies. J Clin Med 2020; 9:E2806. [PMID: 32872670 PMCID: PMC7565821 DOI: 10.3390/jcm9092806] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 01/22/2023] Open
Abstract
To assess neck disability with respect to jaw disability, craniocervical position, cervical alignment, and sensorimotor impairments in patients with temporomandibular disorders (TMD), a systematic review and meta-analysis of observational studies trials were conducted. The meta-analysis showed statistically significant differences in the association between neck disability and jaw disability (standardized mean difference (SMD), 0.72 (0.56-0.82)). However, results showed no significant differences for cervical alignment (SMD, 0.02 (-0.31-0.36)) or for the craniocervical position (SMD, -0.09 (-0.27-0.09)). There was moderate evidence for lower pressure pain thresholds (PPT) and for limited cervical range of motion (ROM). There was limited evidence for equal values for maximal strength between the patients with TMD and controls. There was also limited evidence for reduced cervical endurance and conflicting evidence for abnormal electromyographic (EMG) activity and motor control in TMD patients. Results showed a clinically relevant association between cervical and mandibular disability in patients with TMD. Regarding sensory-motor alterations, the most conclusive findings were observed in the reduction of PPT and cervical ROM, with moderate evidence of their presence in the patients with TMD. Lastly, the evidence on impaired motor control and cervical EMG activity in patients with TMD was conflicting.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
| | - Aida Herranz-Gómez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Beatriz Madroñero-Miguel
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Álvaro Reina-Varona
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Facultad de Medicina, Universidad CEU San Pablo, 28003 Madrid, Spain
| | - Joaquín Pardo-Montero
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain
| | - Tamara del Corral
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
| | - Ibai López-de-Uralde-Villanueva
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
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van der Wal A, Michiels S, Van de Heyning P, Braem M, Visscher CM, Topsakal V, Gilles A, Jacquemin L, Van Rompaey V, De Hertogh W. Treatment of Somatosensory Tinnitus: A Randomized Controlled Trial Studying the Effect of Orofacial Treatment as Part of a Multidisciplinary Program. J Clin Med 2020; 9:jcm9030705. [PMID: 32150992 PMCID: PMC7141361 DOI: 10.3390/jcm9030705] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Tinnitus, or ringing in the ears, is a perception of sound in the absence of overt acoustic stimulation. In some cases, tinnitus can be influenced by temporomandibular somatosensory input, then called temporomandibular somatosensory tinnitus (TST). It is, however, not entirely known if orofacial treatment can decrease tinnitus severity. The purpose of this study was to evaluate the effect of orofacial treatment on tinnitus complaints in patients with TST. Methods: Adult patients with TST were included, and all patients received information and advice about tinnitus and conservative orofacial treatment consisting of physical therapy, and, in case of grinding, occlusal splints were applied. Included patients were randomly assigned to an early start group and a delayed start group according to our delayed treatment design. Results: In total, 40 patients were included in each group. The treatment effect on tinnitus severity was investigated using the tinnitus questionnaire (TQ) and Tinnitus Functional Index (TFI). Regarding the TQ score, no clinically relevant reductions were observed, and no significant differences in the decrease were observed between the early start group and delayed start group. Contrarily, a significantly higher percentage of patients showed a decrease in the TQ degree in the early start group compared to the delayed start group (30.0% versus 2.8%, p = 0.006). The TFI score did show a significantly greater and clinically relevant reduction in the early start group compared to the delayed start group (p = 0.042). Conclusion: A multidisciplinary non-invasive orofacial treatment was able to reduce tinnitus severity in patients with temporomandibular related somatosensory tinnitus.
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Affiliation(s)
- Annemarie van der Wal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium; (S.M.); (W.D.H.)
- Department of Otorhinolaryngology, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.V.d.H.); (V.T.); (A.G.); (L.J.); (V.V.R.)
- Correspondence: ; Tel.: +32-3-265-89-44
| | - Sarah Michiels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium; (S.M.); (W.D.H.)
- Department of Otorhinolaryngology, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.V.d.H.); (V.T.); (A.G.); (L.J.); (V.V.R.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.V.d.H.); (V.T.); (A.G.); (L.J.); (V.V.R.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, 2610 Edegem, Belgium
| | - Marc Braem
- Lab Dental Materials, University of Antwerp, 2610 Edegem, Belgium;
- Special Care Dentistry, University Hospital Antwerp, 2610 Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Corine M. Visscher
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Research Institute MOVE Amsterdam, 1012WX Amsterdam, The Netherlands;
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.V.d.H.); (V.T.); (A.G.); (L.J.); (V.V.R.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.V.d.H.); (V.T.); (A.G.); (L.J.); (V.V.R.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.V.d.H.); (V.T.); (A.G.); (L.J.); (V.V.R.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.V.d.H.); (V.T.); (A.G.); (L.J.); (V.V.R.)
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Edegem, Belgium; (S.M.); (W.D.H.)
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Kim D, Ko SG, Lee EK, Jung B. The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study. BMC Musculoskelet Disord 2019; 20:631. [PMID: 31884949 PMCID: PMC6935481 DOI: 10.1186/s12891-019-3003-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/12/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. Therefore, this study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data. METHODS A total of 12,375 TMD patients from the Korean National Health Insurance Review and Assessment database were analyzed. Controls were selected using propensity score-matching. The McNemar test, chi-square test, and paired t-test were used to compare the prevalence and severity of spinal pain between cases and matched controls. Logistic regression and linear regression models were used to analyze factors affecting the prevalence and severity of spinal pain in patients with TMD. RESULTS The annual period prevalence of TMD was 1.1%. The prevalence was higher in younger individuals than in individuals of other ages and was higher in women than in men. The medical expenditure for TMD per person was $86. Among TMD patients, 2.5% underwent surgical procedures and 0.3% were hospitalized. The prevalence of spinal pain in patients with TMD was 48%, whereas that in the control group was 34%. Increased severity of TMD was associated with an increased probability of spinal pain. The medical expenditure, mean number of visits, and lengths of treatment for spinal pain were greater for patients with TMD than for controls ($136 vs. $81, 4.8 days vs. 2.7 days, 5.5 days vs. 3.3 days). Higher TMD grade was associated with greater differences in average medical expenditure, number of visits, and lengths of treatment for spinal pain between cases and controls. Additionally, for women, living in a rural area and having an older age and more severe TMD were associated with a greater probability of spinal pain and higher medical expenditure related to spinal pain. CONCLUSION A strong association was observed between the presence of TMD and the presence of spinal pain. The association became stronger as the severity of TMD increased, indicating a positive correlation between the severity of TMD and spinal pain.
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Affiliation(s)
- Doori Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Graduate School, Khyung Hee University, Hoegi-dong, Dongdaemun-gu, Seoul, 02453, Republic of Korea
| | - Eun-Kyoung Lee
- Department of Preventive Medicine, College of Korean Medicine, Graduate School, Khyung Hee University, Hoegi-dong, Dongdaemun-gu, Seoul, 02453, Republic of Korea. .,Research Department, Research Institute of Korean Medicine Policy, 91, Heojun-ro, Gangseo-gu, Seoul, 07525, Republic of Korea.
| | - Boyoung Jung
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
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Ghodrati M, Mosallanezhad Z, Shati M, Noroozi M, Moghadam AN, Rostami M, Nourbakhsh MR. Adding Temporomandibular joint treatments to routine physiotherapy for patients with non-specific chronic neck pain: A randomized clinical study. J Bodyw Mov Ther 2019; 24:202-212. [PMID: 32507146 DOI: 10.1016/j.jbmt.2019.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/12/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Neck Pain can be related to the disorders of other adjacent areas such as the Temporomandibular Joint (TMJ). This study aimed to investigate whether there is value in adding TMJ treatments to routine physiotherapy in patients with non-specific chronic neck pain compared with a control group. METHODS A randomized, single-blind, clinical study desined including two groups of patients. Group A (20 people) received routine physiotherapy for neck pain and group B (20 people) received TMJ manual therapy plus exercise therapy in addition to routine physiotherapy for neck pain. The Treatment program included six sessions for two days a week over a period of 21 days. Assessments were performed during the first session, in the last session and one month after treatment as a follow-up. Outcome measures included neck range of motion (ROM), neck disability index (NDI) and visual analogue scale (VAS). Before starting the study, the reliability of methods for measuring neck ROM was evaluated. RESULTS Participants were 21 women and 19 men. Initially, a pilot study was carried out on the 40 volunteers to assess the reliability of the measurement methods, and the results were acceptable. With both the control group and the intervention group, the indexes showed significant improvement (p < 0.001), although the intervention group showed more improvement (p < 0.001). CONCLUSION This result means adding treatments of TMJ to routine neck physiotherapy can magnify the effect of the intervention, a significant change still in evidence at follow up. Moreover, given the clinically important differences, our results for VAS and NDI were acceptable.
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Affiliation(s)
- Maryam Ghodrati
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
| | - Zahra Mosallanezhad
- Department of Physical Therapy and Research Center of Aging, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran.
| | - Mohsen Shati
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mehdi Noroozi
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Afsun Nodehi Moghadam
- Department of Physical Therapy and Research Center of Aging, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Mohamad Rostami
- Department of Physical Therapy and Research Center of Aging, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
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Ferreira MP, Waisberg CB, Conti PCR, Bevilaqua‐Grossi D. Mobility of the upper cervical spine and muscle performance of the deep flexors in women with temporomandibular disorders. J Oral Rehabil 2019; 46:1177-1184. [DOI: 10.1111/joor.12858] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/18/2019] [Accepted: 06/28/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Michele P. Ferreira
- Department of Healthy Science, Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - César B. Waisberg
- Department of Prosthodontics, Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Paulo César R. Conti
- Department of Prosthodontics, Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Débora Bevilaqua‐Grossi
- Department of Healthy Science, Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
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Liu X, Zhang C, Liu Q, Zhou K, Yin N, Zhang H, Shi M, Liu X, Wang M. Dental malocclusion stimulates neuromuscular circuits associated with temporomandibular disorders. Eur J Oral Sci 2018; 126:466-475. [DOI: 10.1111/eos.12579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Xin Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases; Department of Oral Anatomy and Physiology; School of Stomatology; The Fourth Military Medical University; Xi'an China
- Department of Stomatology; The 456th Hospital of People's Liberation Army; Jinan China
| | - Chunkui Zhang
- Department of Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre; The Fourth Military Medical University; Xi'an China
| | - Qian Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases; Department of Oral Anatomy and Physiology; School of Stomatology; The Fourth Military Medical University; Xi'an China
| | - Kaixiang Zhou
- Department of Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre; The Fourth Military Medical University; Xi'an China
| | - Nannan Yin
- Department of Stomatology; The 456th Hospital of People's Liberation Army; Jinan China
| | - Hongyun Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases; Department of Oral Anatomy and Physiology; School of Stomatology; The Fourth Military Medical University; Xi'an China
| | - Minghong Shi
- School of Stomatology; The Third Affiliated Hospital of Xinxiang Medical University; Xinxiang China
| | - Xiaodong Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases; Department of Oral Anatomy and Physiology; School of Stomatology; The Fourth Military Medical University; Xi'an China
| | - Meiqing Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases; Department of Oral Anatomy and Physiology; School of Stomatology; The Fourth Military Medical University; Xi'an China
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Maciel L, Landim F, Vasconcelos B. Otological findings and other symptoms related to temporomandibular disorders in young people. Br J Oral Maxillofac Surg 2018; 56:739-743. [DOI: 10.1016/j.bjoms.2018.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/06/2018] [Indexed: 11/29/2022]
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Coskun Benlidayi I, Guzel R, Tatli U, Salimov F, Keceli O. The relationship between neck pain and cervical alignment in patients with temporomandibular disorders. Cranio 2018; 38:174-179. [DOI: 10.1080/08869634.2018.1498181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ilke Coskun Benlidayi
- Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Rengin Guzel
- Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Ufuk Tatli
- Department of Maxillofacial Surgery, Cukurova University Faculty of Dentistry, Adana, Turkey
| | - Fariz Salimov
- Department of Maxillofacial Surgery, Cukurova University Faculty of Dentistry, Adana, Turkey
| | - Onur Keceli
- Department of Maxillofacial Surgery, Cukurova University Faculty of Dentistry, Adana, Turkey
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Giannakopoulos NN, Schindler HJ, Hellmann D. Co-contraction behaviour of masticatory and neck muscles during tooth grinding. J Oral Rehabil 2018; 45:504-511. [PMID: 29761534 DOI: 10.1111/joor.12646] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2018] [Indexed: 12/19/2022]
Abstract
The objective of this study was to analyse the co-contraction behaviour of jaw and neck muscles during force-controlled experimental grinding in the supine position. Twelve symptom-free subjects were enrolled in the experimental study. Electromyographic (EMG) activity of semispinalis capitis, splenius capitis and levator scapulae muscles was recorded bilaterally with intramuscular fine-wire electrodes, whereas that of sternocleidomastoideus, infrahyoidal, suprahyoidal, masseter and anterior temporalis muscles were registered with surface electrodes. EMG and force measurements were performed during tasks simulating tooth grinding on custom-made intraoral metal splints. The mean EMG activity normalised by maximum voluntary contraction (% MVC) of each of the neck muscles studied during grinding was analysed and compared with previous data from jaw clenching at identical force (100 N) and (supine) position. The occurrence of low-level, long-lasting tonic activation (LLTA) of motor units was also documented. The mean three-dimensional force vector of the grinding forces was 106 ± 74 N. In the frontal plane, the incline to the midsagittal plane ranged between 10° and 15°. In the midsagittal plane, the incline to the frontal plane was negligibly small. Posterior neck muscle activity during grinding ranged between 4.5% and 12% MVC and during clenching with 100 N between 1.8% and 9.9% MVC. Masticatory muscle activity during grinding ranged between 17% and 21% MVC for contralateral masseter and ipsilateral temporalis and between 4% and 6.5% for ipsilateral masseter and contralateral temporalis. LLTA had an average duration of 195 ± 10 seconds. The findings from this study do not support pathophysiological muscle chain theories postulating simple biomechanical coupling of neck and jaw muscles. Co-contractions of neck and masticatory muscles may instead occur as a result of complex neurophysiological interactions.
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Affiliation(s)
| | - H J Schindler
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | - D Hellmann
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
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28
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Spinal high-velocity low-amplitude manipulation with exercise in women with chronic temporomandibular disorders. MANUELLE MEDIZIN 2018. [DOI: 10.1007/s00337-018-0406-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Affiliation(s)
- John E Mitakides
- a Private Practice , Beavercreek , OH , USA.,b Member, Medical Board of the Ehlers-Danlos Society.,c Staff of The Ehlers-Danlos Society Center for EDS Research & Clinical Care at The Greater Baltimore Medical Center , Towson , MD , USA.,d The Kettering Medical Center , Dayton , OH , USA.,e The Children's Medical Center , Cincinnati , OH , USA
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Eberhard L, Terebesi S, Giannakopoulos NN, Hellmann D, Schindler HJ, Schmitter M, Pfau D. Quantitative sensory response of the SCM muscle on sustained low level activation simulating co-contractions during bruxing. Arch Oral Biol 2017; 86:87-93. [PMID: 29202311 DOI: 10.1016/j.archoralbio.2017.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/20/2017] [Accepted: 09/24/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Bruxism is discussed as an etiological factor in the pathogenesis of orofacial and cervical pain. As the sternocleidomastoid muscle (SCM) is co-activated during clenching, our aim was to investigate, whether the muscle loading leads to peripheral or central sensitizations. DESIGN In twenty-one healthy female volunteers, somatosensory profiles of the SCM were recorded according to the test battery of the German Research Network on Neuropathic Pain (DFNS) prior to and after an isometric muscle exercise. QST comprised thermal and mechanical stimuli. A submaximal activation of the SCM (15% MVC) was kept for 10min in sitting position. In separate test sessions one month apart, one sham and one verum experiment were conducted in randomized order. During the muscle loading, the parameters cold detection threshold (CDT), mechanical pain sensitivity (MPS) and pressure pain treshold (PPT) were tested and experimental pain recorded by visual analogoue scales (VAS). All test sessions were performed during the follicular phase of the menstrual cycle (day 5), to avoid effects on pain perception. Data were analyzed with Repeated Measures ANOVA (SPSS 22.0) RESULTS: No significant changes were found during or after (sham) loading except for stimulus-response-function (SR, P=0.01) and PPT (P=0.02) in the sham test. No effect was observed in the verum experiment (P=0.12 up to 1.0). CONCLUSION Prolonged low level contraction of the SCM does not evoke painful sensitization. In contrast, submaximal muscle activation seems to have a protective effect corresponding to a training effect preventing sensitization.
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Affiliation(s)
- Lydia Eberhard
- Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
| | - Sophia Terebesi
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | | | - Daniel Hellmann
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | | | - Marc Schmitter
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | - Doreen Pfau
- Department of Neurophysiology, Center of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Jagdhari BS, Mukta M, Saket AG, Golhar AV. Therapeutic Evaluation of Cervical Dysfunction in Patients with Myofascial Pain Dysfunction Syndrome: A Prospective Study. J Contemp Dent Pract 2017; 18:601-606. [PMID: 28713116 DOI: 10.5005/jp-journals-10024-2092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study was to find out the therapeutic correlation between cervical dysfunction and myofascial pain dysfunction syndrome (MPDS). MATERIALS AND METHODS The study included 46 patients out of which 23 had MPDS with cervical pain (group I), and 23 patients had only MPDS (group II). Detailed history and examination of the patients were carried out, and the factors taken into consideration were pain and tenderness of muscles of mastication and neck muscles, maximum comfortable mouth opening, and cervical range of motion. All the patients were randomly divided and advised physical exercises, light amplification by stimulated emission of radiation (LASER) therapy, and the combination of both exercise and LASER. Patients were assessed for the relief of signs and symptoms of myofascial pain and cervical pain posttreatment, every month for 2 months. RESULTS Both the groups showed a similar response to all the different treatment modalities. In group I, the patients also had relief in their cervical pain although the treatment was directed for MPDS. Patients from both the groups who were advised LASER and combination of both exercise and LASER showed better response in terms of reduction in visual analog scale, number of tender muscles, and increased maximum comfortable mouth opening posttreatment and during the follow-up, as compared with the patients who were advised only exercise. CONCLUSION Patients having cervical pain showed significant improvement comparable with patients having no cervical pain. Hence, the conclusion drawn was that there is a positive interrelationship between MPDS and cervical (neck) pain; MPDS may act as a catalyst for precipitating cervical pain. CLINICAL SIGNIFICANCE Cervical pain showed significant improvement to physiotherapy in the form of exercise, LASER, and combination treatment, though the effective modality was LASER and combination of exercise and LASER therapy.
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Affiliation(s)
- B Smriti Jagdhari
- Department of Oral Medicine and Radiology, Vidya Shikshan Prasarak Mandals Dental College & Research Center, C/O Dr. Anil Golhar, 256 Ramdaspeth, Nagpur, Maharashtra, India, Phone: +919766640600, e-mail:
| | - Motwani Mukta
- Department of Oral Medicine and Radiology, Vidya Shikshan Prasarak Mandals Dental College & Research Center, Nagpur Maharashtra, India
| | - A Golhar Saket
- Department of Orthopedics, NKP Salve Institute of Medical Sciences & Research Center, Nagpur, Maharashtra, India
| | - Anil V Golhar
- Department of Orthopedics, NKP Salve Institute of Medical Sciences & Research Center, Nagpur, Maharashtra, India
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Ballenberger N, von Piekartz H, Danzeisen M, Hall T. Patterns of cervical and masticatory impairment in subgroups of people with temporomandibular disorders–an explorative approach based on factor analysis. Cranio 2017; 36:74-84. [DOI: 10.1080/08869634.2017.1297904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Nikolaus Ballenberger
- Department of Physiotherapy and Rehabilitation, University of Applied Science, Osnabrück, Germany
| | - Harry von Piekartz
- Department of Physiotherapy and Rehabilitation, University of Applied Science, Osnabrück, Germany
| | - Mira Danzeisen
- Department of Physiotherapy and Rehabilitation, University of Applied Science, Osnabrück, Germany
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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Mitakides J, Tinkle BT. Oral and mandibular manifestations in the Ehlers-Danlos syndromes. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2017; 175:220-225. [PMID: 28192626 DOI: 10.1002/ajmg.c.31541] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The Ehlers-Danlos syndromes (EDS) are hereditary disorders that affect the connective tissue and collagen structures in the body. Several types of EDS have been identified. Oral and mandibular structures, which include oral soft tissue, dentition, facial and head pain, and the functioning of the temporomandibular joint (TMJ), are variably affected in the various types of EDS. These various manifestations of EDS have been noted for many years, but newer diagnostic techniques and studies are shedding additional light on the challenges faced by EDS patients in the area of oral and mandibular disorders. Further, the impact of temporomandibular disorder (TMD) on musculoskeletal dysfunction and vice versa, make this an important feature to recognize. Oral and mandibular hypermobility of the TMJ with associated consequences of EDS are noted. These features, diagnostic parameters and treatment procedures are presented. © 2017 Wiley Periodicals, Inc.
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Greenbaum T, Dvir Z, Reiter S, Winocur E. Cervical flexion-rotation test and physiological range of motion - A comparative study of patients with myogenic temporomandibular disorder versus healthy subjects. Musculoskelet Sci Pract 2017. [PMID: 28637604 DOI: 10.1016/j.msksp.2016.11.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Temporomandibular Disorders (TMD) refer to several common clinical disorders which involve the masticatory muscles, the temporomandibular joint (TMJ) and the adjacent structures. Although neck signs and symptoms are found with higher prevalence in TMD patients compared to the overall population, whether limitation of cervical mobility is an additional positive finding in this cohort is still an open question. OBJECTIVE To compare the physiological cervical range of motion (CROM) and the extent of rotation during cervical flexion (flexion-rotation test, FRT) in people with TMD (muscular origin) and healthy control subjects. METHOD The range of motion of the neck and FRT was measured in 20 women with myogenic TMD and 20 age matched healthy controls. RESULTS Women with myogenic TMD had significantly lower FRT scores compared to their matched healthy women. No difference was found between groups in CROM in any of the planes of movement. The FRT was positive (less than 32°) in 90% of the TMD participants versus 5% in the healthy control but the findings were not correlated with TMD severity. CONCLUSION The results point out a potential involvement of the upper cervical joints (c1-c2) in women with myogenic TMD.
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Affiliation(s)
- Tzvika Greenbaum
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Zeevi Dvir
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Shoshana Reiter
- Department of Oral Pathology & Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel
| | - Ephraim Winocur
- Department of Oral Rehabilitation, Charge of, TMD & Orofacial Pain Clinic, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel
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Osseous osteoarthritic-like changes and joint mobility of the temporomandibular joints and upper cervical spine: is there a relation? Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:273-279. [DOI: 10.1016/j.oooo.2016.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 10/03/2016] [Accepted: 10/29/2016] [Indexed: 12/27/2022]
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High-density EMG Reveals Novel Evidence of Altered Masseter Muscle Activity During Symmetrical and Asymmetrical Bilateral Jaw Clenching Tasks in People With Chronic Nonspecific Neck Pain. Clin J Pain 2017; 33:148-159. [DOI: 10.1097/ajp.0000000000000381] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Calixtre LB, Grüninger BLDS, Haik MN, Alburquerque-Sendín F, Oliveira AB. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test. J Appl Oral Sci 2016; 24:188-97. [PMID: 27383698 PMCID: PMC5022215 DOI: 10.1590/1678-775720150240] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 03/09/2016] [Indexed: 11/24/2022] Open
Abstract
Objective To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder (TMD). Material and Methods: Single-group pre-post test, with baseline comparison. Subjects Twelve women (22.08±2.23 years) with myofascial pain and mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. Outcome measures Subjects were evaluated three times: twice before (baseline phase) and once after intervention. Self-reported pain, jaw function [according to the Mandibular Functional Impairment Questionnaire (MFIQ)], pain-free maximum mouth opening (MMO), and pressure pain thresholds (PPTs) of both masseter and temporalis muscles were obtained. Baseline and post-intervention differences were investigated, and effect size was estimated through Cohen’s d coefficient. Results Jaw function improved 7 points on the scale after the intervention (P=0.019), and self-reported pain was significantly reduced (P=0.009). Pain-free MMO varied from 32.3±8.8 mm to 38±8.8 mm and showed significant improvement (P=0.017) with moderate effect size when compared to the baseline phase. PPT also increased with moderate effect size, and subjects had the baseline values changed from 1.23±0.2 kg/cm2 to 1.4±0.2 kg/cm2 in the left masseter (P=0.03), from 1.31±0.28 kg/cm2 to 1.51±0.2 kg/cm2 in the right masseter (P>0.05), from 1.32±0.2 kg/cm2 to 1.46±0.2 kg/cm2 in the left temporalis (P=0.047), and from 1.4±0.2 kg/cm2 to 1.67±0.3 kg/cm2 in the right temporalis (P=0.06). Conclusions The protocol caused significant changes in pain-free MMO, self-reported pain, and functionality of the stomatognathic system in subjects with myofascial TMD, regardless of joint involvement. Even though these differences are statistically significant, their clinical relevance is still questionable.
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Affiliation(s)
- Letícia Bojikian Calixtre
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Cinesiologia Clínica e Ocupacional, São Carlos, SP, Brasil
| | - Bruno Leonardo da Silva Grüninger
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Cinesiologia Clínica e Ocupacional, São Carlos, SP, Brasil
| | - Melina Nevoeiro Haik
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Avaliação e Intervenção do Complexo do Ombro, São Carlos, SP, Brasil
| | - Francisco Alburquerque-Sendín
- - Universidad de Salamanca, Departamento de Enfermería y Fisioterapia; Instituto de Investigación Biomédica de Salamanca, Salamanca,España
| | - Ana Beatriz Oliveira
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Cinesiologia Clínica e Ocupacional, São Carlos, SP, Brasil
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von Piekartz H, Pudelko A, Danzeisen M, Hall T, Ballenberger N. Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study. ACTA ACUST UNITED AC 2016; 26:208-215. [PMID: 27744136 DOI: 10.1016/j.math.2016.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 08/10/2016] [Accepted: 09/05/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. OBJECTIVES To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects. DESIGN Cross-sectional survey. METHOD Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae. RESULTS According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache. CONCLUSION These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor.
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Affiliation(s)
- Harry von Piekartz
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany.
| | - Ani Pudelko
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany
| | - Mira Danzeisen
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany
| | - Toby Hall
- School of Physiotherapy and Curtin Health Innovation Research, Curtin University, P.O. Box U1987, Perth, WA 6845, Australia
| | - Nikolaus Ballenberger
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany
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Liljeström MR, Le Bell Y, Anttila P, Aromaa M, Jämsä T, Metsähonkala L, Helenius H, Viander S, Jäppilä E, Alanen P, Sillanpää M. Headache Children with Temporomandibular Disorders have Several Types of Pain and other Symptoms. Cephalalgia 2016; 25:1054-60. [PMID: 16232157 DOI: 10.1111/j.1468-2982.2005.00957.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim was to investigate the association between temporomandibular disorders (TMD) and overall muscle tenderness, depressive symptoms, sleep difficulties, headache frequency and related symptoms in children with primary headache in comparison with controls. Based on an unselected population sample of 1135 Finnish schoolchildren classified according to the type of headache at age 12, altogether 297 children aged 13-14 from different headache groups and healthy controls were randomly selected for an interview and clinical examinations. Children with migraine had more TMD signs than children with nonmigrainous headaches or healthy controls. High TMD total scores were associated with palpation tenderness in other parts of the body and with frequent headache attacks. We conclude that children with overall headache, migraine in particular, and high total TMD scores showed an increased overall tenderness to muscle palpation and multiply manifested hypersensitivity pain.
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Affiliation(s)
- M-R Liljeström
- Institute of Dentistry, University of Turku, Turku, Finland.
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Häggman-Henrikson B, Lampa E, Marklund S, Wänman A. Pain and Disability in the Jaw and Neck Region following Whiplash Trauma. J Dent Res 2016; 95:1155-60. [PMID: 27307051 DOI: 10.1177/0022034516653598] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The relationship between whiplash trauma and chronic orofacial pain is unclear, especially with regard to the time elapsed from trauma to development of orofacial pain. The aim was to analyze prevalence of jaw pain and disability, as well as the relationship between pain and disability in the jaw and neck regions in the early nonchronic stage after whiplash trauma. In this case-control study, 70 individuals (40 women, 30 men, mean age 35.5 y) who visited an emergency department with neck pain following a car accident were examined within 3 wk of trauma (group 1) and compared with 70 individuals (42 women, 28 men, mean age 33.8 y), who declined to attend a clinical examination but agreed to fill in questionnaires (group 2). The 2 case groups were compared with a matched control group of 70 individuals (42 women, 28 men, mean age 37.6 y) without a history of neck trauma. All participants completed questionnaires regarding jaw pain and dysfunction, rating pain intensity in jaw and neck regions on the Numerical Rating Scale, the Neck Disability Index, and Jaw Disability Checklist. Compared with controls, individuals with a recent whiplash trauma reported more jaw pain and dysfunction. Furthermore, there was a moderate positive correlation between jaw and neck pain ratings for group 1 (r = 0.61, P < 0.0001) and group 2 (r = 0.59, P < 0.0001). In the logistic regression analysis, cases showed higher odds ratios (range, 6.1 to 40.8) for jaw and neck pain and disability compared with controls. Taken together, the results show that individuals with a recent whiplash trauma report more jaw pain and disability compared with controls without a history of neck trauma. Furthermore, the correlation between jaw and neck pain intensity implies that intensity of neck pain in the acute stage after whiplash trauma might be a possible risk factor also for development of chronic orofacial pain.
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Affiliation(s)
- B Häggman-Henrikson
- Clinical Oral Physiology, Umeå University, Umeå, Sweden Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
| | - E Lampa
- Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - S Marklund
- Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - A Wänman
- Clinical Oral Physiology, Umeå University, Umeå, Sweden
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Carvalho GF, Chaves TC, Florencio LL, Dach F, Bigal ME, Bevilaqua-Grossi D. Reduced thermal threshold in patients with Temporomandibular Disorders. J Oral Rehabil 2016; 43:401-8. [DOI: 10.1111/joor.12386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2016] [Indexed: 11/30/2022]
Affiliation(s)
- G. F. Carvalho
- Department of Biomechanics; Medicine and Locomotor Apparatus Rehabilitation - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - T. C. Chaves
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - L. L. Florencio
- Department of Biomechanics; Medicine and Locomotor Apparatus Rehabilitation - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - F. Dach
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - M. E. Bigal
- Migraine & Headache Clinical Development; Global Branded R&D; Pennsylvania PA USA
| | - D. Bevilaqua-Grossi
- Department of Biomechanics; Medicine and Locomotor Apparatus Rehabilitation - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
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Kim TY, Shin JS, Lee J, Lee YJ, Kim MR, Ahn YJ, Park KB, Hwang DS, Ha IH. Gender Difference in Associations between Chronic Temporomandibular Disorders and General Quality of Life in Koreans: A Cross-Sectional Study. PLoS One 2015; 10:e0145002. [PMID: 26673219 PMCID: PMC4686021 DOI: 10.1371/journal.pone.0145002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 11/25/2015] [Indexed: 11/25/2022] Open
Abstract
Background Chronic temporomandibular disorder (TMD) is known to have strong correlations with psychological factors and to display gender disparity. However, while chronic TMD is known to affect quality of life, large-scale studies investigating the influence on quality of life by gender are scarce. Methods This cross-sectional study assessed the data of 17,198 participants aged ≥19 years who completed chronic TMD and EuroQol-5 Dimension sections in the 4th Korean National Health and Nutrition Examination Survey (2007–2009). We adjusted for covariates (health behavior, sociodemographic factors) in regression analysis for complex sampling design to calculate regression coefficients and 95% CIs for gender difference in the association between chronic TMD and quality of life. We also evaluated which covariates of somatic health, mental health, health behavior, and sociodemographic factors weakened the relationship between TMD and EQ-5D. Results Prevalence of chronic TMD was 1.6% (men 1.3%, women 1.8%), and chronic TMD persisted to negatively impact quality of life even after adjusting for confounding variables. Low sociodemographic factors and health behavior had a negative effect on quality of life. Somatic health and mental health were most affected by chronic TMD. As for quality of life, women were affected to a greater extent than men by TMD. Women were more affected by osteoarthritis and general mental health (stress, depressive symptoms, and thoughts of suicide), and men by employment. Conclusions These results imply that chronic diseases and psychological factors are important in chronic TMD, and that there may be physiological and pathological gender differences in TMD.
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Affiliation(s)
- Tae-Yoon Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Me-riong Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yong-jun Ahn
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Ki Byung Park
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Deok-Sang Hwang
- Department of Korean Medicine Obstetrics & Gynecology, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
- * E-mail:
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Calixtre LB, Moreira RFC, Franchini GH, Alburquerque-Sendín F, Oliveira AB. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil 2015; 42:847-61. [PMID: 26059857 DOI: 10.1111/joor.12321] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 01/24/2023]
Abstract
There is a lack of knowledge about the effectiveness of manual therapy (MT) on subjects with temporomandibular disorders (TMD). The aim of this systematic review is to synthetise evidence regarding the isolated effect of MT in improving maximum mouth opening (MMO) and pain in subjects with signs and symptoms of TMD. MEDLINE(®) , Cochrane, Web of Science, SciELO and EMBASE(™) electronic databases were consulted, searching for randomised controlled trials applying MT for TMD compared to other intervention, no intervention or placebo. Two authors independently extracted data, PEDro scale was used to assess risk of bias, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) was applied to synthetise overall quality of the body of evidence. Treatment effect size was calculated for pain, MMO and pressure pain threshold (PPT). Eight trials were included, seven of high methodological quality. Myofascial release and massage techniques applied on the masticatory muscles are more effective than control (low to moderate evidence) but as effective as toxin botulinum injections (moderate evidence). Upper cervical spine thrust manipulation or mobilisation techniques are more effective than control (low to high evidence), while thoracic manipulations are not. There is moderate-to-high evidence that MT techniques protocols are effective. The methodological heterogeneity across trials protocols frequently contributed to decrease quality of evidence. In conclusion, there is widely varying evidence that MT improves pain, MMO and PPT in subjects with TMD signs and symptoms, depending on the technique. Further studies should consider using standardised evaluations and better study designs to strengthen clinical relevance.
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Affiliation(s)
- L B Calixtre
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - R F C Moreira
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - G H Franchini
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | | | - A B Oliveira
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
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Neck disability is associated with masticatory myofascial pain and regional muscle sensitivity. Arch Oral Biol 2015; 60:745-52. [DOI: 10.1016/j.archoralbio.2015.02.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 11/25/2014] [Accepted: 02/10/2015] [Indexed: 01/03/2023]
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Kietrys DM, Palombaro KM, Mannheimer JS. Dry needling for management of pain in the upper quarter and craniofacial region. Curr Pain Headache Rep 2015; 18:437. [PMID: 24912453 DOI: 10.1007/s11916-014-0437-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Dry needling is a therapeutic intervention that has been growing in popularity. It is primarily used with patients that have pain of myofascial origin. This review provides background about dry needling, myofascial pain, and craniofacial pain. We summarize the evidence regarding the effectiveness of dry needling. For patients with upper quarter myofascial pain, a 2013 systematic review and meta-analysis of 12 randomized controlled studies reported that dry needling is effective in reducing pain (especially immediately after treatment) in patients with upper quarter pain. There have been fewer studies of patients with craniofacial pain and myofascial pain in other regions, but most of these studies report findings to suggest the dry needling may be helpful in reducing pain and improving other pain related variables such as the pain pressure threshold. More rigorous randomized controlled trials are clearly needed to more fully elucidate the effectiveness of dry needling.
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Affiliation(s)
- David M Kietrys
- Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, School of Health Related Professions, Stratford, NJ, USA,
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46
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Jaw dysfunction is associated with neck disability and muscle tenderness in subjects with and without chronic temporomandibular disorders. BIOMED RESEARCH INTERNATIONAL 2015; 2015:512792. [PMID: 25883963 PMCID: PMC4391655 DOI: 10.1155/2015/512792] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/26/2014] [Accepted: 10/27/2014] [Indexed: 12/21/2022]
Abstract
Purpose. Tender points in the neck are common in patients with temporomandibular
disorders (TMD). However, the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with TMD still needs further investigation.
This study investigated the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with and without chronic TMD.
Participants. Forty females between 19 and 49 years old were included in this study. There were 20 healthy controls and 20
subjects who had chronic TMD and neck disability. Methods. Subjects completed the neck disability index and the limitations of daily functions in TMD questionnaires.
Tenderness of the masticatory and cervical muscles was measured using an algometer.
Results. The correlation between jaw disability and neck disability was significantly high (r = 0.915, P < 0.05). The correlation between level of muscle tenderness in the masticatory
and cervical muscles with jaw dysfunction and neck disability showed fair to moderate correlations (r = 0.32–0.65). Conclusion. High levels of muscle tenderness in upper trapezius
and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high
levels of neck disability correlated with high levels of jaw disability.
These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD.
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Ringhof S, Stein T, Potthast W, Schindler HJ, Hellmann D. Force-controlled biting alters postural control in bipedal and unipedal stance. J Oral Rehabil 2014; 42:173-84. [PMID: 25354425 DOI: 10.1111/joor.12247] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2014] [Indexed: 01/01/2023]
Abstract
Human posture is characterised by inherent body sway which forces the sensory and motor systems to counter the destabilising oscillations. Although the potential of biting to increase postural stability has recently been reported, the mechanisms by which the craniomandibular system (CMS) and the motor systems for human postural control are functionally coupled are not yet fully understood. The purpose of our study was, therefore, to investigate the effect of submaximum biting on postural stability and on the kinematics of the trunk and head. Twelve healthy young adults performed force-controlled biting (FB) and non-biting (NB) during bipedal narrow stance and single-leg stance. Postural stability was quantified on the basis of centre of pressure (COP) displacements, detected by use of a force platform. Trunk and head kinematics were investigated by biomechanical motion analysis, and bite forces were measured using a hydrostatic system. The results revealed that FB significantly improved postural control in terms of reduced COP displacements, providing additional evidence for the functional coupling of the CMS and human posture. Our study also showed, for the first time, that reductions in the sway of the COP were accompanied by reduced trunk and head oscillations, which might be attributable to enhanced trunk stiffness during FB. This physiological response to isometric activation of the masticatory muscles raises questions about the potential of oral motor activity as a strategy to reduce the risk of falls among the elderly or among patients with compromised postural control.
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Affiliation(s)
- S Ringhof
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
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Kraus SL. Characteristics of 511 patients with temporomandibular disorders referred for physical therapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:432-9. [DOI: 10.1016/j.oooo.2014.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/01/2014] [Accepted: 06/17/2014] [Indexed: 10/25/2022]
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Santander H, Zúñiga C, Miralles R, Valenzuela S, Santander MC, Gutiérrez MF, Córdova R. The effect of a mandibular advancement appliance on cervical lordosis in patients with TMD and cervical pain. Cranio 2014; 32:275-82. [PMID: 25252766 DOI: 10.1179/0886963414z.00000000038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIMS A preliminary study to compare cervical lordosis by means of cervical cephalometric analysis, before and after six months of continuous mandibular advancement appliance (MAA) use, and to show how physical therapy posture re-education would improve the cervical lordosis angle. METHODOLOGY Twenty-two female patients with temporomandibular disorders (TMD) and cervical pain with lordosis <20° were included. Patients had to have a muscle pain history for at least six months, and with an intensity ⩾6, measured by means of a visual analog scale (a horizontal 0-10 numeric rating scale with 0 labeled as 'no pain' and 10 as 'worst imaginable pain'). Patients had to present the angle formed by the posterior tangents to C2 and C7 of equal or less than 20°. Cephalometric and clinical diagnostics were performed initially (baseline) and at the end of the study period (six months). During the third month with MAA treatment, a physical therapist evaluated the postural deficit and performed a program of postural re-education. Angular and linear dimension data presented a normal distribution (P>0·05; Shapiro Wilk Test), so the paired comparison of the cephalometric measurements was made by t-test for dependent samples. RESULTS Angle 1 (OPT/7CVT); angle 3 (CVT/EVT) and angle 4 (2CL/7CL) showed a significant increase in the cervical lordosis. Angle 2 (MGP/OP), angle 5 (HOR/CVT) and the distances C0-C2 and Pt-VER, presented no significant changes. CONCLUSIONS The increase in cervical lordosis implies that six months of continuous MAA use, together with a program of postural re-education, promotes the homeostasis of the craniocervical system.
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Grondin F, Hall T, Laurentjoye M, Ella B. Upper cervical range of motion is impaired in patients with temporomandibular disorders. Cranio 2014; 33:91-9. [PMID: 25919749 DOI: 10.1179/0886963414z.00000000053] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIMS Clinicians increasingly suggest assessment and treatment of the cervical spine in patients with temporomandibular dysfunction (TMD); however, few studies have investigated upper cervical spine mobility in people who suffer from TMD. The purpose of this study was to investigate whether patients with TMD pain (with or without headache) present with upper cervical spine impairment when compared with asymptomatic subjects. METHODOLOGY A single blind examiner evaluated cervical range of motion (ROM) measures including axial rotation during the flexion-rotation test (FRT) and sagittal plane ROM. Twenty asymptomatic subjects were compared with 37 subjects with pain attributed to TMD, confirmed by the Revised Research Diagnostic Criteria. Subjects with TMD were divided according to the presence of headache (26 without headache TMDNHA, 11 with headache TMDHA). One-way analysis of variance and planned orthogonal comparisons were used to determine differences in cervical mobility between groups. All subjects with TMD were positive on the FRT with restricted ROM, while none were in the control group. RESULTS The analysis of variance revealed significant differences between groups for the FRT F(2,54) = 57.96, P<0.001) and for sagittal ROM [F(2,54) = 5.69, P = 0.006]. Findings show that the TMDHA group had less axial rotation than group TMDNHA, and both TMD groups had less ROM than controls. For sagittal ROM, the only difference was between group TMDHA and controls. CONCLUSIONS Subjects with TMD had signs of upper cervical spine movement impairment, greater in those with headache. Only subjects with TMD and headache had impairment of cervical spine sagittal plane mobility. This study provides evidence for the importance of examination of upper cervical mobility determined by the FRT in patients who suffer from TMD.
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