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Zhu Y, Zheng F, Gong Y, Zhu J, Yin D, Liu Y. Effect of occlusal contact on TMJ loading during occlusion: An in silico study. Comput Biol Med 2024; 178:108725. [PMID: 38878405 DOI: 10.1016/j.compbiomed.2024.108725] [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: 11/08/2023] [Revised: 05/08/2024] [Accepted: 06/07/2024] [Indexed: 07/24/2024]
Abstract
Alterations in occlusal features may have significant consequences, ranging from dental aesthetics to health issues. Temporomandibular joint disorders (TMDs) are often associated with joint overload, and the correlation between occlusal features and TMDs has been thoroughly discussed. In current work, we introduced a novel stomatognathic model that aligns well with in vivo experimental measurements, specifically designed to decouple the impact of occlusal contact and periodontal ligament (PDL) negative feedback on temporomandibular joint (TMJ) loading. Utilizing an in-silico approach, the simulation analysis included six symmetric occlusal contact scenarios. Furthermore, a biomechanical lever model was employed to clarify the mechanical mechanism and investigate the multi-factorial effects of TMJ overload. These findings indicate that anterior shifts in the occlusal centre lead to increased TMJ loading, particularly in occlusal contact cases with anteroposterior changes. Considering the symmetrical distribution of occlusal contact, mediolateral alterations had a more modest effect on TMJ loading. Additionally, potential negative feedback activated by principal strain of periodontal could not only alleviate joint load but also diminish occlusal force. These investigations enhance our understanding of the intricate interactions between masticatory muscles, occlusal forces, and joint contact forces, thereby providing motivation for future comprehensive studies on TMJ biomechanical overload.
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Affiliation(s)
- Yunfan Zhu
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Fangjie Zheng
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Yanji Gong
- State Key Laboratory of Oral Disease, National Center for Stomatology &National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jinyi Zhu
- State Key Laboratory of Oral Disease, National Center for Stomatology &National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Deqiang Yin
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China.
| | - Yang Liu
- State Key Laboratory of Oral Disease, National Center for Stomatology &National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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Alowaimer HA, Al Shutwi SS, Alsaegh MK, Alruwaili OM, Alrashed AR, AlQahtani SH, Batais MS. Comparative Efficacy of Non-Invasive Therapies in Temporomandibular Joint Dysfunction: A Systematic Review. Cureus 2024; 16:e56713. [PMID: 38646388 PMCID: PMC11032691 DOI: 10.7759/cureus.56713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Temporomandibular disorder (TMD) is a multifaceted disorder impacting the temporomandibular joint (TMJ), causing substantial discomfort and functional limitations. This systematic review aims to comprehensively assess the effectiveness of non-invasive treatment modalities for TMJ dysfunction, prioritizing a definitive protocol to ensure patient safety and enhance quality of life. Employing the PRISMA guidelines, we meticulously analyzed 20 studies from a pool of 1,417 articles sourced from databases such as PubMed, Google Scholar, ScienceDirect, and Medline. These studies underscore the multifarious nature of TMD and the varied responses to treatments such as physical therapy, laser therapy, ultrasound and electrical stimulation, splint therapy, injections, and arthrocentesis. Notably, the review highlights the paramount importance of precise diagnosis, often through surface electromyography, followed by a tailored treatment approach integrating manual therapy, counseling, and splint therapy. The systematic analysis revealed that while certain treatments such as transcutaneous electrical nerve stimulation and low-level laser therapy showed limited efficacy, combination therapies, especially those involving manual therapy, counseling, and splint therapy, demonstrated substantial improvement in reducing pain, depression, and anxiety. The findings advocate for a non-invasive, patient-centric approach, emphasizing education and symptom management before considering more invasive procedures such as injections and arthrocentesis. The review identifies the need for more comprehensive, longitudinal studies to establish a standardized, evidence-based treatment protocol for TMJ dysfunction, aiming to improve patient outcomes holistically.
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Brighenti N, Battaglino A, Sinatti P, Abuín-Porras V, Sánchez Romero EA, Pedersini P, Villafañe JH. Effects of an Interdisciplinary Approach in the Management of Temporomandibular Disorders: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2777. [PMID: 36833474 PMCID: PMC9956386 DOI: 10.3390/ijerph20042777] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 05/27/2023]
Abstract
Temporomandibular disorders (TMD) is an umbrella term that encompasses many musculoskeletal problems that include the masticatory muscles, the temporomandibular joint, and other associated structures. TMD can be divided into two large groups: those that affect the musculature and those that affect the joint. The treatment of TMD requires the combined skills of physiotherapists and dentists, as well as sometimes psychologists and other medical specialists. This study aims to examine the effectiveness of the interdisciplinary approach using physiotherapy and dental techniques on pain in patients with temporomandibular disorders (TMDs). This is a Scoping Review of studies investigating the effects of combined therapy on patients with TMD. PRISMA guidelines were followed during this review's design, search, and reporting stages. The search was carried out in the MEDLINE, CINHAL, and EMBASE databases. A total of 1031 studies were detected and analyzed by performing the proposed searches in the detailed databases. After removing duplicates and analyzing the titles and abstracts of the remaining articles, six studies were ultimately selected for this review. All the included studies showed a positive effect on pain decreasing after a combined intervention. The interdisciplinary approach characterized by the combination of manual therapy and splint or electrotherapy can positively influence the perceived symptoms; positively decrease pain; and reduce disability, occlusal impairments, and perception of change.
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Affiliation(s)
- Nicolò Brighenti
- Scuola di Medicina, Dipartimento di Scienze della Salute, Università degli Studi del Piemonte Orientale, 28100 Novara, Italy
| | | | - Pierluigi Sinatti
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Vanesa Abuín-Porras
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Eleuterio A. Sánchez Romero
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Physiotherapy Department, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 La Orotava, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Tenerife, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
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Gałczyńska-Rusin M, Pobudek-Radzikowska M, Prylińska-Czyżewska A, Maciejewska-Szaniec Z, Gawriołek K, Strużycka I, Czajka-Jakubowska A. Comparison of the Effects of Myotherapy in Patients with Myofascial Pain with and without Self-Reported Sleep Bruxism Using The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I Questionnaire. Med Sci Monit 2021; 27:e934917. [PMID: 34848675 PMCID: PMC8647457 DOI: 10.12659/msm.934917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background This study aimed to compare the effects of myotherapy using sublingual relaxation splints and stretching exercises in 110 patients with myofascial pain with and without self-reported sleep bruxism using The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I Questionnaire. Material/Methods The study involved 110 patients with myofascial pain. The diagnosis was based on the RDC/TMD questionnaire. The number of painful muscle sites (PMS) and the range of maximum mouth opening (MMO) were assessed 2 times – at the first visit and after 3 months. Then, the influence of possible bruxism on the treatment was assessed. Results The mean age of the patients was 26.8 years (SD 5.4); 89% of the subjects were women; and 60.9% of the patients reported bruxism. Each patient was instructed to perform muscle stretching at the first visit and after 1 week all patients received a sublingual relaxation splint. The number of PMS decreased and the range of MMO increased in both groups after a period of 3 months of treatment (P<0.05). Significant differences were observed in the obtained treatment effects between the patients with and without possible bruxism. Conclusions This study evaluated the effectiveness of the sublingual relaxation splint and stretching exercises in patients with myofascial pain. Patients at a single center in Poland who reported myofascial pain that was not associated with self-reported sleep bruxism had a significantly better response to myotherapy when compared to patients with self-reported sleep bruxism.
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Affiliation(s)
| | | | | | | | - Krzystof Gawriołek
- Dempartment of Temporomandibular Disorders, University of Medical Sciences, Poznań, Poland
| | - Izabela Strużycka
- Department of Comprehensive Dentistry, Medical University of Warsaw, Warsaw, Poland
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Şahin D, Kaya Mutlu E, Şakar O, Ateş G, İnan Ş, Taşkıran H. The effect of the ischaemic compression technique on pain and functionality in temporomandibular disorders: A randomised clinical trial. J Oral Rehabil 2021; 48:531-541. [PMID: 33411952 DOI: 10.1111/joor.13145] [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: 11/18/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Interventions addressing pain and impaired functionality in individuals with temporomandibular disorders (TMDs) are needed. OBJECTIVE To compare the effects of 4 weeks of exercise combined with ischaemic compression and exercise alone in patients with TMDs. METHODS Fifty patients who were diagnosed with TMDs were randomised into Group 1 (exercise combined with ischaemic compression technique) (n = 25) or Group 2 (exercise alone) (n = 25). Both groups performed 4 weeks of Rocabado's exercise and 3 weeks of postural exercise, while Group 1 received ischaemic compression to the masseter muscle for a total of 3 sessions in addition to exercise. A ruler was used to assess range of motion (ROM) (painless mouth opening (PMO), maximum mouth opening, maximum assisted mouth opening (MAMO), left lateral movement and right lateral movement), the visual analogue scale and graded chronic pain scale were used to assess pain, an algometer was used to determine the pain pressure threshold (PPT), and the 8-item jaw functional limitation scale was used to assess, functionality. The assessments were performed at baseline, at week 1 and at week 4. RESULTS The participants in Group 1 exhibited larger PMO (F = 5.26, P = .02) and MAMO values (F = 6.71, P = .01) than did the patients in Group 2 at week 1. The effect size was small for MAMO (ES = 0.27) and moderate for PMO (ES = 0.51). However, there were no significant differences in any other outcomes between groups at week 1 or 4. CONCLUSION In summary, this randomised controlled trial indicates that exercise combined with ICT and exercise alone have similar effects on ROM, pain, the PPT and functionality in patients with TMDs.
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Affiliation(s)
- Duygu Şahin
- Division of Physiotheraphy and Rehabilitation, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey
| | - Ebru Kaya Mutlu
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Olcay Şakar
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Gökçen Ateş
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Şebnem İnan
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Hanifegül Taşkıran
- Division of Physiotheraphy and Rehabilitation, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey
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Eliassen M, Hjortsjö C, Olsen-Bergem H, Bjørnland T. Self-exercise programmes and occlusal splints in the treatment of TMD-related myalgia-Evidence-based medicine? J Oral Rehabil 2019; 46:1088-1094. [PMID: 31286551 DOI: 10.1111/joor.12856] [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: 01/24/2019] [Revised: 05/22/2019] [Accepted: 07/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The low-cost and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, stretching exercises, manual therapy, acrylic splints and cognitive behavioural therapy. OBJECTIVE The aim of this study was to evaluate the evidence behind the use of self-exercising programmes and occlusal splints in the treatment of myofascial pain. METHODS We conducted a thorough search of five databases, using four cardinal search terms in combination with twelve supporting terms. We also assessed the evidence quality, using GRADEpro software. RESULTS The search resulted in 4967 individual studies. 18 studies met the inclusion criteria and were re-evaluated. CONCLUSION The selected studies were in favour of a self-care or an occlusal splint treatment of myalgia. However, a GRADE assessment showed that 14 of the 18 selected studies had low or very low evidence quality. Studies also showed weaknesses with regard to nomenclature and reproducibility. Hence, it is our professional opinion that the evidence level for prescribing self-exercises and occlusal splints in the treatment of myalgia is low.
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Affiliation(s)
- Morten Eliassen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Carl Hjortsjö
- Department of Prosthetic Dentistry and Oral Function, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Heming Olsen-Bergem
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tore Bjørnland
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Correlations between the Helkimo indices and the maximal mandibular excursion capacities of patients with temporomandibular joint disorders. J Bodyw Mov Ther 2019; 23:148-152. [DOI: 10.1016/j.jbmt.2017.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/28/2017] [Accepted: 12/06/2017] [Indexed: 11/23/2022]
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Dubova LV, Stupnikov AA, Kriheli NI, Tsalikova NA, Melnik AS. [Diagnostic criteria for the transition from occlusal splints to non-removable orthopedic appliances in patients with TMJ dysfunction with disc disorders]. STOMATOLOGIIA 2019; 98:65-70. [PMID: 31322598 DOI: 10.17116/stomat20199803165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The aim of the study was to elaborate Diagnostic criteria for the transition from occlusal splints to non-removable orthopedic appliances in patients with TMJ dysfunction with disc disorders. The study involved 95 patients with the clinics of TMJ dysfunction. An examination included electrovibrography and computerized electromyography in order to assess diagnostic value of the methods. Electrovibrography is a method based on arthrophonography, which makes it possible to obtain data on intraarticular noise in the TMJ. Computerized electromyography provides an objective assessment of the bioelectrical activity of the masticatory muscles in occlusive disorders, changes in the height of the lower facial area, and their relationship with the development of musculo-articular dysfunction of the TMJ and allows monitoring the effectiveness of orthopedic treatment. Within the normal function of the jaws the graphic trajectories of mandibular movements are within the limits of norm, and in the case of a violation of the TMP function, the graphic and linear indices are significantly different from the normal values.
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Affiliation(s)
- L V Dubova
- Moscow State Medical and Dental University, Moscow, Russia
| | - A A Stupnikov
- Moscow State Medical and Dental University, Moscow, Russia
| | - N I Kriheli
- Moscow State Medical and Dental University, Moscow, Russia
| | - N A Tsalikova
- Moscow State Medical and Dental University, Moscow, Russia
| | - A S Melnik
- Moscow State Medical and Dental University, Moscow, Russia
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Adly MS, Adly AS, Adly AS. Assessment of early orthodontic treatment on functional shifts by telemonitoring mandibular movements using a smart phone. J Telemed Telecare 2018; 26:150-160. [PMID: 30373447 DOI: 10.1177/1357633x18800876] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction To assess effect of orthodontic treatment on anterior or lateral functional shift in mixed dentition stage by telemonitoring mandibular movements in four-dimensions using a novel objective method that can assist in orthodontics and other dental specialties without the need of expensive, bulky or complicated equipment. Methods A sample of 60 patients was divided into two groups. Group I included 30 patients with normal occlusion and TMJ functions. Group II included 30 patients that were diagnosed with an abnormal path of closure in antero-posterior or transverse directions due to disharmony between centric occlusion and centric relation. The latter group was orthodontically treated and mandibular movements were measured before, during, directly after orthodontic treatment, and one year after treatment using our proposed method. To evaluate validity and reliability of our method, it was compared with two methods, a commercially available mandibular scanner, and a low-cost graphical method that utilizes a sheet of wax and a stylus. Results It was found that the overall differences between opening and closing curves of our proposed method and the other two methods were small and negligible (p > 0.05). Discussion It was found that our proposed method is offering a reasonably accurate, simple and rapid way to telemonitor the mandible movements in four-dimensions using the rear/front camera of any smart-phone.
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Affiliation(s)
- Mahmoud Sedky Adly
- Faculty of Oral and Dental Medicine, Orthodontics and Dentofacial Orthopedics, Bioinformatics, Cairo University, Egypt
| | - Aya Sedky Adly
- Faculty of Computers and Information, Computer Science, Helwan University, Egypt
| | - Afnan Sedky Adly
- Kasr El Aini Medical School, Laser Applications in Physical Medicine, Physical Therapy for Cardiovascular-Respiratory Disorders and Geriatrics, Cairo University, Egypt
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Giro G, Policastro VB, Scavassin PM, Leite ARP, Mendoza Marin DO, Gonçalves DADG, Compagnoni MA, Pero AC. Mandibular kinesiographic pattern of women with chronic TMD after management with educational and self-care therapies: A double-blind, randomized clinical trial. J Prosthet Dent 2016; 116:749-755. [PMID: 27236596 DOI: 10.1016/j.prosdent.2016.03.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Limited mandibular movements are one of the most important signs of temporomandibular disorders (TMDs) and may cause functional difficulties. PURPOSE The purpose of this double-blind, randomized clinical trial was to evaluate the effect of treatment with only educational or education associated with self-care therapies on the pattern of mandibular movements of women with chronic painful TMDs. MATERIAL AND METHODS Forty-two women were selected and randomly divided into 3 groups, control group (CG, n=13), education group (EG, n=16), and education and self-care group (ESG, n=13), according to the sequence of treatment they received. A kinesiograph device recorded mandibular movements during maximum mouth opening and mastication at baseline (T0) and at 30-day (T1) and 60-day (T2) follow-up. Kinesiographic data were statistically analyzed using 1-way ANOVA, followed by the Bonferroni test for multiple comparisons of means (α=.05). RESULTS The ESG group demonstrated an improvement in the maximum vertical opening (MVO= 5.1 ±3.4 mm; P=.012) and anteroposterior mandibular movement (MAM) during maximum opening (7.4 ±9.5; P=.019), significantly higher than that of the EG (MVO=1.8 ±3.5 mm; MAM=0.8 ±5.0 mm) and the CG (MVO=0.9 ±3.8 mm; MAM=0.8 ±4.4 mm) after 30 days of follow-up. Moreover, at T1, vertical mandibular movement during mastication was significantly higher in the ESG group (17.4 ±1.7 mm) than in the EG group (15.0 ±2.8, P=.027). No significant differences were found between the women who received treatment with educational and self-care therapies for 60 days and the women who received this treatment for 30 days. CONCLUSIONS In the short-term, education and self-care treatment positively influenced the mandibular movement pattern of women with chronic painful TMDs.
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Affiliation(s)
- Gabriela Giro
- Doctoral student, Department of Dental Materials and Prosthodontics, São Paulo State University, Araraquara Dental School, São Paulo, Brazil
| | - Vivian Barnabé Policastro
- Graduate student, Department of Dental Materials and Prosthodontics, São Paulo State University, Araraquara Dental School, São Paulo, Brazil
| | - Priscila Mattos Scavassin
- Graduate student, Department of Dental Materials and Prosthodontics, São Paulo State University, Araraquara Dental School, São Paulo, Brazil
| | - Andressa Rosa Perin Leite
- Doctoral student, Department of Dental Materials and Prosthodontics, São Paulo State University, Araraquara Dental School, São Paulo, Brazil
| | - Danny Omar Mendoza Marin
- Doctoral student, Department of Dental Materials and Prosthodontics, São Paulo State University, Araraquara Dental School, São Paulo, Brazil
| | | | - Marco Antonio Compagnoni
- Full Professor, Department of Dental Materials and Prosthodontics, São Paulo State University, Araraquara Dental School, São Paulo, Brazil
| | - Ana Carolina Pero
- Assistant Professor, Department of Dental Materials and Prosthodontics, São Paulo State University, Araraquara Dental School, São Paulo, Brazil.
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