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Min CK, Jung W, Joo S. Enhanced multistage deep learning for diagnosing anterior disc displacement in the temporomandibular joint using MRI. Dentomaxillofac Radiol 2024; 53:488-496. [PMID: 39024472 DOI: 10.1093/dmfr/twae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/21/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVES This study aimed to propose a new method for the automatic diagnosis of anterior disc displacement of the temporomandibular joint (TMJ) using MRI and deep learning. By using a multistage approach, the factors affecting the final result can be easily identified and improved. METHODS This study introduces a multistage automatic diagnostic technique using deep learning. This process involves segmenting the target from MR images, extracting distance parameters, and classifying the diagnosis into 3 classes. MRI exams of 368 TMJs from 204 patients were evaluated for anterior disc displacement. In the first stage, 5 algorithms were used for the semantic segmentation of the disc and condyle. In the second stage, 54 distance parameters were extracted from the segments. In the third stage, a rule-based decision model was developed to link the parameters with the expert diagnosis results. RESULTS In the first stage, DeepLabV3+ showed the best result (95% Hausdorff distance, Dice coefficient, and sensitivity of 6.47 ± 7.22, 0.84 ± 0.07, and 0.84 ± 0.09, respectively). This study used the original MRI exams as input without preprocessing and showed high segmentation performance compared with that of previous studies. In the third stage, the combination of SegNet and a random forest model yielded an accuracy of 0.89 ± 0.06. CONCLUSIONS An algorithm was developed to automatically diagnose TMJ-anterior disc displacement using MRI. Through a multistage approach, this algorithm facilitated the improvement of results and demonstrated high accuracy from more complex inputs. Furthermore, existing radiological knowledge was applied and validated.
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Affiliation(s)
- Chang-Ki Min
- Deparment of Oral and Maxillofacial Radiology, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, 54896, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea
| | - Won Jung
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea
- Department of Oral Medicine, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, 54896, Republic of Korea
| | - Subin Joo
- Department of Medical Robotics, Korea Institute of Machinery & Materials, Daegu 42994, Republic of Korea
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Mahmoud NR, Shehab WI, AlAraby AA, Habaka YF. Efficacy of different low-level laser therapy sessions in the management of masseter muscle trigger points. BMC Oral Health 2024; 24:1125. [PMID: 39327563 PMCID: PMC11428541 DOI: 10.1186/s12903-024-04780-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/20/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Low-level laser therapy (LLLT) is one of the recent treatment modalities for myofascial pain dysfunction syndrome with trigger points. The objective of the present study was to examine the impact of varying LLLT sessions on the treatment of masseter muscle trigger points. METHODS 90 patients diagnosed with orofacial pain and trigger points in the masseter muscle for at least 6 months were selected and divided into 3 groups (n = 30) based on the number of LLLT sessions provided to patients. Patients in Group I received one session/per week, group II received two sessions/per week, and Group III received three sessions/per week. The sessions continued for 4 weeks, evaluations of pain levels, maximum mouth opening (MMO), and quality of life were conducted before and after the procedure at 1, 2, 3, 4, and 8 weeks. RESULTS The pain scores exhibited a highly statistically significant difference among the three groups (p < 0.001) over the 8-week study period. MMO was statistically significantly different between groups at week 4 and week 8. The Oral Health Impact Profile-14 (OHIP-14) score was statistically significant difference between groups at week 8. The time showed a highly significant effect on the study outcomes within each group. CONCLUSION Increased the number of LLLT sessions reduced the pain improved the MMO, and subsequently improved the quality of life. CLINICALTRIALS GOV ID NCT06327204 - retrospectively registered.
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Affiliation(s)
- Nermine Ramadan Mahmoud
- Oral and maxillofacial surgery Department, Faculty of Dentistry, October 6th University, 6th of October City, Giza Governorate, Egypt
| | - Wessam Ibrahim Shehab
- Oral Medicine, Periodontology & Oral Radiology Department, Faculty of Dentistry, October 6th University, 6th of October City, Giza Governorate, Egypt
| | - Amany Ahmed AlAraby
- Oral Medicine, Periodontology & Oral Radiology Department, Faculty of Dentistry, October 6th University, 6th of October City, Giza Governorate, Egypt.
| | - Yasser Fekry Habaka
- Oral and maxillofacial surgery Department, Faculty of Dentistry, October 6th University, 6th of October City, Giza Governorate, Egypt
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Buduru S, Oprea DM, Manziuc MM, Leucuța DC, Almășan O. Effectiveness of Laser Therapy in Treatment of Temporomandibular Joint and Muscle Pain. J Clin Med 2024; 13:5327. [PMID: 39274540 PMCID: PMC11396360 DOI: 10.3390/jcm13175327] [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: 07/22/2024] [Revised: 08/06/2024] [Accepted: 09/08/2024] [Indexed: 09/16/2024] Open
Abstract
Background/Objectives: Temporomandibular joint disorders (TMDs) express a condition derived from a broad spectrum of etiological factors and clinical manifestations. Many treatment options have been developed for TMDs; nevertheless, conservative and non-invasive approaches ought to be prioritized. Laser therapy is an effective treatment for pain management due to its non-invasive nature and capacity for tissue regeneration. This review aimed at bringing an overview of the present evidence regarding the efficiency of laser therapy on myofascial or temporomandibular joint disorders pain. Methods: The search was conducted in four electronic databases: PubMed, Web of Science, Embase, and Scopus, of studies published between January 1997 and January 2023. The following terms have been extensively searched: "laser treatment", pain management", "temporomandibular joint disorders", "masseter muscle pain", "pterygoid muscle pain", and "temporal muscle pain". The inclusion criteria were original papers, available in full text, and written in English. Cohen's Kappa coefficient was used to assess the inter-rater reliability for article selection. The methodological quality was assessed with the Cochrane Risk of Bias tool for randomized controlled trials and the National Heart, Lung, and Blood Institute's quality assessment tool for before-after studies with no control group. Results: Out of 846 identified records, 7 studies were included, of which 5 were randomized controlled trials. The inter-rater reliability for article selection showed an almost perfect agreement (Cohen's Kappa = 0.832, p < 0.001). The protocol of laser application was not standardized; the laser wavelength ranged from 633 to 940 nm, with a power output range from 25 to 1600 mW. The number of sessions varied from 3 to 12, with a frequency of application from 1 time per week to 3 times per week. All studies reported pain reduction after laser therapy. Conclusions: Laser therapy is an efficient method to treat TMDs related to muscle pain. To accomplish the desired results, a standard procedure must be followed; however, the protocol is still not fully designed.
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Affiliation(s)
- Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Denisa Maria Oprea
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Manuela-Maria Manziuc
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Oana Almășan
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
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Mohos V, Harmat M, Kun J, Aczél T, Zsidó BZ, Kitka T, Farkas S, Pintér E, Helyes Z. Topiramate inhibits adjuvant-induced chronic orofacial inflammatory allodynia in the rat. Front Pharmacol 2024; 15:1461355. [PMID: 39221150 PMCID: PMC11361966 DOI: 10.3389/fphar.2024.1461355] [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] [Received: 07/08/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Chronic orofacial pain disorders are common debilitating conditions, affecting the trigeminal system. Its underlying pathophysiological mechanisms are still unclear and the therapy is often unsatisfactory, therefore, preclinical models are crucial to identify the key mediators and novel treatment options. Complete Freund's adjuvant (CFA)-induced orofacial inflammatory allodynia/hyperalgesia is commonly used in rodents, but it has not been validated with currently used drugs. Here we tested the effects of the adjuvant analgesic/antiepileptic voltage-gated Na+ channel blocker complex mechanism of action topiramate in comparison with the gold standard antimigraine serotonin 5-HT1B/D receptor agonist sumatriptan in this model. CFA was injected subcutaneously into the right whisker pad of male Sprague-Dawley rats (250-300 g), then mechanonociceptive threshold values were investigated with von Frey filaments (3, 5, and 7 days after CFA injection). Effects of topiramate (30 mg/kg per os) and sumatriptan (1 mg/kg subcutaneous) on the adjuvant-induced chronic inflammatory orofacial allodynia were investigated 60, 120, and 180 min after the treatments each day. To determine the optimal concentration for drug effect analysis, we tested the effects of two different CFA-concentrations (1 and 0.5 mg/mL) on mechanonociceptive thresholds. Both concentrations of CFA induced a chronic orofacial allodynia in 60% of all rats. Although, higher CFA concentration induced greater allodynia, much more stable threshold reduction was observed with the lower CFA concentration: on day 3 the thresholds decreased from 18.30 g to approximately 11 g (low) and 5 g (high), respectively, however a slight increase was observed in the case of higher CFA concentration (on days 5, 7, and 11). In all investigation days, topiramate showed significant anti-allodynic effect comparing the pre and post drug dose and comparing the vehicle treated to the drug treated groups. Sumatriptan also caused a significant threshold increase compared to pre dose thresholds (day 3) and also showed a slight anti-allodynic effect compared to the vehicle-treated group (day 3 and 5). In the present study CFA-induced chronic orofacial allodynia was reversed by topiramate in rats validating the model with the adjuvant analgesic. Other than establishing a validated orofacial pain-related syndrome model in rats, new ways are opened for the repurposing of topiramate.
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Affiliation(s)
- Violetta Mohos
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Máté Harmat
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Jozsef Kun
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Hungarian Centre for Genomics and Bioinformatics, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- National Laboratory for Drug Research and Development, Budapest, Hungary
| | - Tímea Aczél
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Balázs Zoltán Zsidó
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Kitka
- Uzsoki Cardiovascular Center Ltd., Budapest, Hungary
| | - Sándor Farkas
- Uzsoki Cardiovascular Center Ltd., Budapest, Hungary
| | - Erika Pintér
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- National Laboratory for Drug Research and Development, Budapest, Hungary
- Hungarian Research Network, PTE HUN-REN Chronic Pain Research Group, Budapest, Hungary
- PharmInVivo Ltd., Pécs, Hungary
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- National Laboratory for Drug Research and Development, Budapest, Hungary
- Hungarian Research Network, PTE HUN-REN Chronic Pain Research Group, Budapest, Hungary
- PharmInVivo Ltd., Pécs, Hungary
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Troisi G, Di Giacomo P, Forte G, Langher V, Casagrande M, Di Paolo C. The "Wear and Tear" of the Organism in Temporomandibular Disorders: A Pilot Study Investigating the Effects of Allostatic Load on Heart Rate Variability and Inhibitory Control. J Pers Med 2024; 14:787. [PMID: 39201979 PMCID: PMC11355141 DOI: 10.3390/jpm14080787] [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: 06/12/2024] [Revised: 07/12/2024] [Accepted: 07/22/2024] [Indexed: 09/03/2024] Open
Abstract
Temporomandibular disorders (TMDs) are the most common cause of non-dental chronic pain in the orofacial region and can chronically increase the activity of the allostatic systems. The allostatic overload related to these conditions causes an autonomic dysregulation, reflected by a reduction in heart rate variability (HRV). Nevertheless, chronic pain in these patients could cause more severe health consequences, such as those related to cognitive functioning. Deficits in executive control have been associated with allostatic overload and could negatively affect pain management strategies. This study aimed to investigate the effects of chronic pain on HRV and both motor and cognitive inhibition (assessed with the Go/No-Go and Stroop tasks, respectively) in a sample of 14 patients with TMD and 15 healthy controls. Consistent with our hypothesis and the previous literature, the group with TMD had a lower resting HRV, but no differences were found between the groups in inhibition. Furthermore, the results showed that the effects of HRV on cognitive inhibition can be mediated by pain intensity. Finally, a correlation between age and HRV emerged in patients with TMD but not in healthy controls.
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Affiliation(s)
- Giovanna Troisi
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy
- Department of Experimental Psychology, Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain
| | - Paola Di Giacomo
- Department of Oral and Maxillo-Facial Sciences, Policlinico Umberto I, 00161 Rome, Italy
| | - Giuseppe Forte
- Department of Dynamic, Clinical Psychology and Health Studies, University of Rome “Sapienza”, 00185 Rome, Italy
| | - Viviana Langher
- Department of Dynamic, Clinical Psychology and Health Studies, University of Rome “Sapienza”, 00185 Rome, Italy
| | - Maria Casagrande
- Department of Dynamic, Clinical Psychology and Health Studies, University of Rome “Sapienza”, 00185 Rome, Italy
| | - Carlo Di Paolo
- Department of Oral and Maxillo-Facial Sciences, Policlinico Umberto I, 00161 Rome, Italy
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Di Giacomo P, Forte G, Capogna I, Casagrande M, Di Paolo C. The role of nutraceuticals in the management of temporomandibular disorders. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 0:jcim-2023-0394. [PMID: 38958698 DOI: 10.1515/jcim-2023-0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES Temporomandibular disorders (TMDs) are usually treated with occlusal appliances and supportive treatments such as physical therapy and drugs. Supplements can be included among potential supportive therapies, with the aim of reducing the use of drugs. To evaluate the efficacy of nutraceuticals' short-term treatment in subjects with temporomandibular disorders. METHODS The study started in January 2021 and ended in January 2022. Subjects with temporomandibular disorders and a verbal numeric scale >40 were recruited and randomly assigned to one of the following groups. If waiting to start a therapy, to the nutraceutical group or to the no treatment group, while if already undergoing splint therapy, to nutraceautical+splint group or to splint therapy group. Nutraceutical used was composed by Boswellia Serrata Casperome, Magnesium, Tryptophan and vitamins B2 and D with a posology of one tablet/day before sleep for 40 days. Presence of temporomandibular pain, headache, neck pain and sleep/emotional disorders were assessed at T0 and at T1, after 40 days. ANOVA was performed to compare treatments with nutraceuticals and their respective controls, as for the variables related to painful symptomatology. Chi- Squared was conducted to assess differences in sleep/emotional disorders between groups. The statistical significance was p<0.05. RESULTS The groups using nutraceuticals showed statistically significant improvements over controls for most of the variables analyzed. CONCLUSIONS The use of nutraceutical seems to be a valuable support for TMD therapy in the short term either alone or combined with occlusal splint therapy.
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Affiliation(s)
- Paola Di Giacomo
- Department of Oral and Maxillo-Facial Sciences, 209311 Sapienza University of Rome , Roma, Italy
| | - Giuseppe Forte
- Department of Psychology, 209311 Sapienza University of Rome , Roma, Italy
| | - Irene Capogna
- Department of Oral and Maxillo-Facial Sciences, 209311 Sapienza University of Rome , Roma, Italy
| | - Maria Casagrande
- Department of Psychology, 209311 Sapienza University of Rome , Roma, Italy
| | - Carlo Di Paolo
- Department of Oral and Maxillo-Facial Sciences, 209311 Sapienza University of Rome , Roma, Italy
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van Selms MKA, Lobbezoo F. The reports of specific waking-state oral behaviours, including awake bruxism activities, and psychological distress have a dose-response relationship: A retrospective medical record study. Cranio 2024:1-12. [PMID: 38860447 DOI: 10.1080/08869634.2024.2360865] [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: 06/12/2024]
Abstract
OBJECTIVE To investigate if there are dose-response relationships between self-reported waking-state oral behaviours, including awake bruxism, and three indicators of psychological distress (depression, anxiety, stress). METHODS The study sample consisted of 1,886 patients with function-dependent TMD pain. Relationships between six non-functional and six functional waking-state oral behaviours, scored on a 5-point ordinal scale, and the psychological factors were investigated using ordinal logistic regression. RESULTS Mean age was 42.4 (±15.3) years, 78.7% being female. The odds of reporting the higher categories of non-functional oral behaviours depended on the severity of depression, anxiety, and stress. Most OR coefficients followed a quadratic dose-response distribution, the others increased linearly as the severity of the psychological scales increased. Almost no such associations were found with normal jaw function behaviours. CONCLUSION Within the limitations of this study, it may be concluded that non-functional waking-state oral behaviours, including awake bruxism, and psychological distress have a dose-response relationship, with higher levels of distress being associated with higher reports of oral behaviours.
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Affiliation(s)
- Maurits K A van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Henien M, Zebic L, Mahendran K, Mellor A, Sproat C, Maciag A. The TMD management dilemma. Br Dent J 2024; 236:949-954. [PMID: 38942856 DOI: 10.1038/s41415-024-7506-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 02/21/2024] [Accepted: 03/02/2024] [Indexed: 06/30/2024]
Abstract
As temporomandibular disorders (TMDs) become ever more prevalent in both primary and secondary care settings, successful management is increasingly challenging in both sectors. The authors aim to explore the dilemma of TMD management as the patient journeys through from primary to secondary care and offer educational tools to support practitioners in managing this complex patient cohort, as well as outlining alternative solutions for the delivery of TMD management strategies.
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Affiliation(s)
- Marianne Henien
- Consultant Oral Surgeon, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK.
| | - Lara Zebic
- Specialist Oral Surgeon, Department of Oral Surgery, Birmingham Dental Hospital, UK
| | - Krishantini Mahendran
- Academic Clinical Fellow in Oral Surgery, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK
| | - Amy Mellor
- Speciality Dentist in Oral Surgery, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK
| | - Chris Sproat
- Consultant Oral Surgeon, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK
| | - Anna Maciag
- Consultant Oral Surgeon, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK
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Salbego RS, Conti PCR, Soares FFC, Ferreira DMAO, Herreira-Ferreira M, de Lima-Netto BA, Svensson P, Costa YM, Bonjardim LR. Influence of psychometric and sleep quality features on painful mechanical sensitivity and pain modulation in patients with temporomandibular disorders. Clin Oral Investig 2024; 28:302. [PMID: 38714576 DOI: 10.1007/s00784-024-05699-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/28/2024] [Indexed: 05/10/2024]
Abstract
Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies. OBJECTIVE Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients. MATERIALS AND METHODS A cross-sectional study using secondary data analysis of 77 TMD patients and 101 controls. All participants completed questionnaires characterizing their psychometric profile (anxiety, depression, stress and catastrophizing) and sleep quality, alongside psychophysical tests for painful mechanical sensory (mechanical pain threshold (MPT), pressure pain threshold (PPT), and wind-up ratio (WUR)) and conditioned pain modulation (CPM). Participants were grouped into "High distress" or "Low distress" categories based on psychometric properties and sleep quality using hierarchical cluster and k-means analyses. Multiple linear regression evaluated the influence of TMD, age, and the distress cluster on MPT, WUR, PPT, and CPM in masseter and thenar muscles. Differences were statistically significant when p < 0.05. RESULTS The presence of TMD was the strongest predictor of mechanical painful sensitivity in the trigeminal region (MPT[F(3,174) = 51.902;p < .001;R2 = .463]; TMD presence (β = -.682) / PPT[F(3,174) = 15.573;p < .001;R2 = .198] TMD presence (β = -.452), and extra-trigeminal (MPT[F(3,174) = 35.897;p < .001;R2 = .382] TMD (β = -.647) / CPM [F(3,174) = 4.106;p < .05;R2 = .050] TMD presence (β = .197). Furthermore, neither the high distress group nor the low distress group were able to significantly influence the variation of the values of any of the psychophysical variables evaluated (p > .05). CONCLUSIONS There is not a significant influence of impairment clusters based on psychological variables and sleep quality on painful mechanical sensitivity and pain modulation, regardless of the presence of TMD. CLINICAL RELEVANCE This outcome suggests that psychosocial factors and sleep quality may not play a decisive role in the sensory-discriminative aspect of pain, particularly concerning painful TMD.
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Affiliation(s)
- Rafaela Stocker Salbego
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
| | - Paulo César Rodrigues Conti
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | | | - Matheus Herreira-Ferreira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | | | - Yuri Martins Costa
- Department of Biosciences, Piracicaba School of Dentistry, University of Campinas, Piracicaba, Brazil
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Ramishvili M, Gobadze G, Menabde G, Zurmukhtashvili M, Dugashvili G, Marks L. The influence of COVID-19 on temporo-mandibular disorders. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38637909 DOI: 10.1111/scd.13002] [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: 01/10/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/20/2024]
Abstract
Temporomandibular disorders are multi-factorial conditions affected by psychological, biomechanical, and neuromuscular factors. Stress and anxiety experienced during the pandemic are capable of influencing and aggravating temporomandibular disorders and orofacial pain. The study aimed to analyze whether the coronavirus infection can directly affect these diseases. All participants were asked to complete the Pain Screener and Patients Health Questionnaire and were assigned to Group I: healthy participants and Group 2: participants with existing complaints. In group II participants filled the questionnaires twice the Temporomandibular Disorders Symptom Questionnaire and Graded Chronic Pain Scale. The first time to self-report the severity of chronic pain before COVID-19 (T1 timeline) and the second time- to self-report the level of pain after COVID-19 infection (T2 timeline). Totally 150 participants were included in the study. In group II the difference between T1 and T2 timeline was significant for the level of average pain (p = 0.022) and highest facial pain (p = 0.043); Difference in level of interference of daily activities (p > 0.05), recreational activities (p > 0.05) and ability to work (p > 0.05) was statistically not significant. Graded chronic pain status was the same "Grade I" for T1 and T2 timeline. There was no statistically significant difference in stress level between group I and II.
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Affiliation(s)
- Marika Ramishvili
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Gia Gobadze
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Giorgi Menabde
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | | | | | - Luc Marks
- Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
- Special Care in Dentistry, Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium
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11
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Bousché G, Koutris M, Su N, Verhoeff MC, Lobbezoo F. Predictors of patients' satisfaction after temporomandibular disorder treatment in a referral clinic. J Oral Rehabil 2024; 51:266-277. [PMID: 37727979 DOI: 10.1111/joor.13600] [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: 03/15/2023] [Revised: 04/26/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Evaluating patients' satisfaction after received care for temporomandibular disorders (TMD) pain provides oral health care professionals with knowledge and tools to improve their clinical procedures. However, knowledge on patient characteristics that determine satisfaction with the received care for TMD pain is lacking. OBJECTIVE To identify potential baseline predictors for patients' satisfaction regarding the management of TMD pain upon treatment completion in a referral clinic. METHODS Eligible patients, viz., individuals of ≥16 years of age, with a TMD-pain diagnosis according the diagnostic criteria for TMD (DC/TMD), and who were treated in a referral clinic, were included. As part of their standard care, a set of diagnostic questionnaires was filled in (e.g. TMD-pain screener, graded chronic pain scale (GCPS), etc.). After completion of the received care, patients filled in a custom-made questionnaire based on patient reported experience measures (PREMs) to quantify their satisfaction with their treatment results and received care. To identify potential predictors associated with patients' satisfaction, univariate and multivariate linear regression analyses were used. RESULTS Twenty-seven patients (mean 39.6, SD 15.0) were included in this study. Overall, the patients were satisfied with the treatment results and the received care. Depressive feelings were negatively associated with satisfaction of treatment results (p = .01) and positively associated with satisfaction of received care (p = .01), while pain intensity was negatively associated with satisfaction of the received care. CONCLUSION Depressive feelings are a significant negative predictor of patients' satisfaction with the treatment result for TMD pain, while average pain intensity is a significant negative predictor of patients' satisfaction with the received care.
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Affiliation(s)
- G Bousché
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Koutris
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - N Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M C Verhoeff
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - F Lobbezoo
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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12
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van Selms MKA, Thymi M, Lobbezoo F. Psychological distress and the belief that oral behaviours put a strain on the masticatory system in relation to the self-report of awake bruxism: Four scenarios. J Oral Rehabil 2024; 51:170-180. [PMID: 37026467 DOI: 10.1111/joor.13460] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/09/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND It is assumed that other factors than masticatory muscle activity awareness could drive the self-report of awake bruxism. OBJECTIVES To investigate the extent to which the report of awake bruxism is associated with psychological distress, and with the belief that oral behaviours put a strain on the masticatory system among TMD-pain patients. MATERIALS AND METHODS The study sample consisted of 1830 adult patients with reported function-dependent TMD pain. Awake bruxism was assessed through six items of the Oral Behaviors Checklist. Psychological distress was assessed by means of somatic symptoms, depression and anxiety. Causal attribution belief was measured with the question 'Do you think these behaviours put a strain on your jaws, jaw muscles, and/or teeth?' RESULTS Mean age of all participants was 42.8 (±15.2) years, 78.2% being female. Controlled for sex, positive, yet weak, correlations were found between awake bruxism and somatic symptom severity (rs = 0.258; p < .001), depression (rs = 0.272; p < .001) and anxiety (rs = 0.314; p < .001): patients with the highest scores reported approximately twice as much awake bruxism compared to those with minimal scores. Controlled for age and sex, a positive, moderate correlation was found between awake bruxism and causal attribution belief (rs = 0.538; p < .001). Patients who believed that performing awake oral behaviours put 'very much' a strain on the masticatory system reported four times more awake bruxism than patients who did not believe that these behaviours are harmful. CONCLUSIONS Based on the results and relevant scientific literature, the theoretical background mechanisms of our findings are discussed in four scenarios that are either in favour of the use of self-report of awake bruxism being a representation of masticatory muscle activity awareness, or against it.
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Affiliation(s)
- Maurits K A van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Magdalini Thymi
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Tabrizi R, Shourmaej Y, Pourdanesh F, Shafiei S, Moslemi H. Does lifestyle modification (physical exercise and listening to music) improve symptoms in patients with a temporomandibular disorder? A randomized clinical trial. Natl J Maxillofac Surg 2024; 15:55-58. [PMID: 38690258 PMCID: PMC11057608 DOI: 10.4103/njms.njms_23_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/29/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2024] Open
Abstract
Introduction The aim of the study was to compare pain relief in temporomandibular disorder (TMD) patients with or without lifestyle modification. Materials and Methods This randomized clinical trial was performed on patients with TMD, who did not regularly exercise or listen to music. The participants were allocated into two groups. In the treatment group, the participants were instructed to exercise five times or more per week (30 minutes per session) and listen to the music of their choice five times or more per week (15 minutes per session) for 12 weeks. In the control group, the participants had their usual lifestyle without any modifications. The participants were examined for clicking and crepitus in the joint and maximum mouth opening before and after the intervention. The pain severity was also documented based on a visual analog scale. Results Thirty five patients were studied in each group. Twelve weeks after the intervention, the mean pain severity was 2.70 ± 0.73 in the treatment group and 4.63 ± 0.77 in the control group. The results of data analysis demonstrated a significant difference between the two groups regarding the mean pain severity at 12 weeks after the intervention (P <.001). Conclusions Lifestyle modification through physical exercise and listening to music may reduce pain in TMD patients.
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Affiliation(s)
- Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yasaman Shourmaej
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereydoun Pourdanesh
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervin Shafiei
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Moslemi
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Devassy ER, Mustaffa HG, Kulkarni RS, Kontham RK. Parapharyngeal space carcinoma disguised as temporomandibular joint disorder: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00477-8. [PMID: 37673780 DOI: 10.1016/j.prosdent.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 09/08/2023]
Abstract
Parapharyngeal space neoplasms tend to have a considerable volume by the time of diagnosis because of their deep location in the neck and may have a relatively long progression before becoming symptomatic. Common presenting signs and symptoms of parapharyngeal space neoplasms include swelling in the neck, intraoral mass, dysphagia, dysphonia, heaviness in the ear, otalgia, and rarely, trismus. Some of these signs and symptoms could be mistaken for signs of temporomandibular disorder (TMD). This clinical report presents the incidental discovery of parapharyngeal space carcinoma initially presenting as TMD. A thorough clinical examination of the temporomandibular joints, supported by their magnetic resonance imaging, led to early detection of the neoplasm, thereby improving the patient's post-treatment survival probability.
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Affiliation(s)
- Elna R Devassy
- Postgraduate student, Department of Prosthodontics, Nair Hospital Dental College, Mumbai, India
| | - Hazari G Mustaffa
- Associate Professor, Department of Prosthodontics, Nair Hospital Dental College, Mumbai, India
| | - Rahul S Kulkarni
- Associate Professor, Department of Prosthodontics, Nair Hospital Dental College, Mumbai, India.
| | - Rakeshkumar K Kontham
- Associate Professor, Department of Orthodontics, Nair Hospital Dental College, Mumbai, India
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15
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de Macedo CF, Sonza A, Puel AN, dos Santos AR. Trigger point dry needling increases masseter muscle oxygenation in patients with temporomandibular disorder. J Appl Oral Sci 2023; 31:e20230099. [PMID: 37646716 PMCID: PMC10501752 DOI: 10.1590/1678-7757-2023-0099] [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: 03/17/2023] [Revised: 06/15/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. OBJECTIVE To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. METHODOLOGY Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). RESULTS We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. CONCLUSION These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.
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Affiliation(s)
- Carolina Ferreira de Macedo
- Universidade Federal de Santa CatarinaCentro de Ciências BiológicasDepartamento de Ciências FisiológicasSanta CatarinaBrasilUniversidade Federal de Santa Catarina, Centro de Ciências Biológicas, Departamento de Ciências Fisiológicas, Programa de Pós-Graduação em Neurociências Florianópolis, Laboratório de Neurobiologia da Dor e Inflamação, Santa Catarina, Brasil.
| | - Anelise Sonza
- Universidade do Estado de Santa CatarinaPrograma de Pós-Graduação em FisioterapiaSanta CatarinaBrasilUniversidade do Estado de Santa Catarina (UDESC), Programa de Pós-Graduação em Fisioterapia, Florianópolis, Laboratório de Desenvolvimento e Controle Postural (LADESCOP), Santa Catarina, Brasil.
- Universidade do Estado de Santa CatarinaCentro de Ciências da Saúde e EsporteDepartamento de FisioterapiaSanta CatarinaBrasilUniversidade do Estado de Santa Catarina (UDESC), Centro de Ciências da Saúde e Esporte, Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências do Movimento Humano, Santa Catarina, Brasil.
| | - Alexia Nadine Puel
- Universidade do Estado de Santa CatarinaPrograma de Pós-Graduação em FisioterapiaSanta CatarinaBrasilUniversidade do Estado de Santa Catarina (UDESC), Programa de Pós-Graduação em Fisioterapia, Florianópolis, Laboratório de Desenvolvimento e Controle Postural (LADESCOP), Santa Catarina, Brasil.
| | - Adair Roberto dos Santos
- Universidade Federal de Santa CatarinaCentro de Ciências BiológicasDepartamento de Ciências FisiológicasSanta CatarinaBrasilUniversidade Federal de Santa Catarina, Centro de Ciências Biológicas, Departamento de Ciências Fisiológicas, Programa de Pós-Graduação em Neurociências Florianópolis, Laboratório de Neurobiologia da Dor e Inflamação, Santa Catarina, Brasil.
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Idáñez-Robles AM, Obrero-Gaitán E, Lomas-Vega R, Osuna-Pérez MC, Cortés-Pérez I, Zagalaz-Anula N. Exercise therapy improves pain and mouth opening in temporomandibular disorders: A systematic review with meta-analysis. Clin Rehabil 2023; 37:443-461. [PMID: 36263523 DOI: 10.1177/02692155221133523] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyse the effectiveness of exercise therapy in improving pain and active or passive maximum mouth opening in patients with temporomandibular disorders. DATA SOURCES PubMed Medline, Web of Science, Scopus, CINAHL Complete and Physiotherapy Evidence Database, until April 2022, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. REVIEW METHODS We included randomized controlled trials evaluating the effect of exercise therapy on pain and on active and passive maximum mouth opening in patients with temporomandibular disorders. Effect size was calculated using Cohen's standardized mean difference (SMD) and their 95% confidence interval (95% CI) in a random-effects model. RESULTS A total of 16 studies with 812 participants were included. Exercise therapy is effective in reducing pain (SMD: -0.58; 95% CI: -1.01 to -0.12) and increasing the pain pressure threshold (SMD: 0.45; 95% CI: 0.14-0.76), active and passive maximum mouth opening (SMD: 0.43; 95% CI: 0.14-0.71 and SMD: 0.4; 95% CI: 0.06-0.75, respectively). Subgroup analyses showed more effect of exercise therapy more splints versus splints on pain (SMD: -0.5; 95% CI: -0.73 to -0.26), active and passive maximum mouth opening (SMD: 1.14; 95% CI: 0.22-2.07 and SMD: 0.56; 95% CI: 0.06-1.06, respectively). On pain pressure threshold, exercise therapy was better than physiotherapy approach (manual therapy and electrotherapy) (SMD: 0.48; 95% CI: 0.09-0.87). CONCLUSIONS Therapeutic exercise is an effective therapy to reduce pain and increase pain pressure threshold and active and passive maximum mouth opening in patients with temporomandibular disorders.
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Affiliation(s)
- Ana M Idáñez-Robles
- Servicio de Fisioterapia, Residencia de Mayores "Fuente de la Peña", Dean de la Fuente González, Jaén, Spain
| | - Esteban Obrero-Gaitán
- Physiotherapy Area, 536192Department of Health Sciences, 553090Faculty of Health Sciences, 16747University of Jaén, 16747Campus Las Lagunillas s/n, Jaén, Spain
| | - Rafael Lomas-Vega
- Physiotherapy Area, 536192Department of Health Sciences, 553090Faculty of Health Sciences, 16747University of Jaén, 16747Campus Las Lagunillas s/n, Jaén, Spain
| | - María C Osuna-Pérez
- Physiotherapy Area, 536192Department of Health Sciences, 553090Faculty of Health Sciences, 16747University of Jaén, 16747Campus Las Lagunillas s/n, Jaén, Spain
| | - Irene Cortés-Pérez
- Physiotherapy Area, 536192Department of Health Sciences, 553090Faculty of Health Sciences, 16747University of Jaén, 16747Campus Las Lagunillas s/n, Jaén, Spain
| | - Noelia Zagalaz-Anula
- Physiotherapy Area, 536192Department of Health Sciences, 553090Faculty of Health Sciences, 16747University of Jaén, 16747Campus Las Lagunillas s/n, Jaén, Spain
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Effects of osseous structure based on three-dimensional reconstructive imaging evaluation in the assessment of temporomandibular joint disc position. Clin Oral Investig 2023; 27:1449-1463. [PMID: 36877406 DOI: 10.1007/s00784-023-04936-0] [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: 03/09/2022] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVES This pilot morphological study aimed to investigate the association between anterior disc displacement (ADD) and the status of the mandibular condyle and articular fossa. MATERIALS AND METHODS Thirty-four patients were divided into a normal articular disc position group and an ADD with and without reduction group. Images reconstructed were used to determine multiple group comparisons of these three different types of disc position, and the diagnostic efficacy for the morphological parameters with significant group difference was analyzed to assess. RESULTS The condylar volume (CV), condylar superficial area (CSA), superior joint space (SJS), and medial joint space (MJS) all exhibited obvious changes (P < 0.05). Additionally, they all had a reliable diagnostic accuracy in differentiating between normal disc position and ADD with an AUC value from 0.723 to 0.858. Among them, the CV, SJS, and MJS (P < 0.05) had a significantly positive impact on the groups by analysis of multivariate logistic ordinal regression model. CONCLUSIONS The CV, CSA, SJS, and MJS are significantly associated with different disc displacement types. The condyle in ADD exhibited altered dimensions. These could be promising biometric markers for assessing ADD. CLINICAL RELEVANCE The morphological changes of mandibular condyle and glenoid fossa were significantly influenced by the status of disc displacement, and condyles with disc displacement had three-dimensionally altered condylar dimensions, irrespective of age and sex.
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18
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Poorna T A, Jr L, Ek J, John B, S N, S S. Extracranial schwannoma of the maxillary nerve misdiagnosed as trigeminal neuralgia in an elderly patient with schizophrenia - A diagnostic dilemma. SPECIAL CARE IN DENTISTRY 2023; 43:276-280. [PMID: 35916362 DOI: 10.1111/scd.12763] [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: 04/22/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 11/27/2022]
Abstract
The present paper discusses the diagnostic challenges we faced in a 60-year-old woman with a history of schizophrenia, presenting with left unilateral facial pain for the past three months. Based on the elaborate clinical examination and diagnostic nerve blocks, the patient was diagnosed with trigeminal neuralgia (TN) and non-surgical therapy commenced. Further investigations with magnetic resonance imaging (MRI) and ultrasound-guided fine needle aspiration cytology (FNAC) revealed the presence of an extracranial schwannoma involving a branch of the maxillary nerve. The patient was symptomatically relieved after surgical excision of the benign tumor under general anesthesia. Hence, we emphasize the need for special care and attention in psychiatric patients presenting with orofacial pain.
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Affiliation(s)
| | - Lokesh Jr
- Government Dental College, Kottayam, Kerala, India
| | - Joshna Ek
- Government Dental College, Kottayam, Kerala, India
| | - Bobby John
- Government Dental College, Kottayam, Kerala, India
| | - Neethu S
- Department of General Pathology, Government Medical College, Kottayam, Kerala, India
| | - Shankar S
- Department of General Pathology, Government Medical College, Kottayam, Kerala, India
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da Silva ZA, Melo WWP, Ferreira HHN, Lima RR, Souza-Rodrigues RD. Global Trends and Future Research Directions for Temporomandibular Disorders and Stem Cells. J Funct Biomater 2023; 14:103. [PMID: 36826902 PMCID: PMC9965396 DOI: 10.3390/jfb14020103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/15/2023] Open
Abstract
Temporomandibular disorder (TMD) is an umbrella term used to describe various conditions that affect temporomandibular joints, masticatory muscles, and associated structures. Although the most conservative and least invasive treatment is preferable, more invasive therapies should be employed to refractory patients. Tissue engineering has been presented as a promising therapy. Our study aimed to investigate trends and point out future research directions on TMD and stem cells. A comprehensive search was carried out in the Web of Science Core Collection (WoS-CC) in October 2022. The bibliometric parameters were analyzed through descriptive statistics and graphical mapping. Thus, 125 papers, published between 1992 and 2022 in 65 journals, were selected. The period with the highest number of publications and citations was between 2012 and 2022. China has produced the most publications on the subject. The most frequently used keywords were "cartilage", "temporomandibular joint", "mesenchymal stem cells", and "osteoarthritis". Moreover, the primary type of study was in vivo. It was noticed that using stem cells to improve temporomandibular joint repair and regeneration is a significant subject of investigation. Nonetheless, a greater understanding of the biological interaction and the benefits of using these cells in patients with TMD is required.
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Affiliation(s)
| | | | | | | | - Renata Duarte Souza-Rodrigues
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, Brazil
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20
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Revilla-León M, Agustín-Panadero R, Zeitler JM, Barmak AB, Yilmaz B, Kois JC, Pérez-Barquero JA. Differences in maxillomandibular relationship recorded at centric relation when using a conventional method, four intraoral scanners, and a jaw tracking system: A clinical study. J Prosthet Dent 2023:S0022-3913(22)00795-8. [PMID: 36682896 DOI: 10.1016/j.prosdent.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/21/2023]
Abstract
STATEMENT OF PROBLEM Digital systems including intraoral scanners (IOSs) and optical jaw tracking systems can be used to acquire the maxillomandibular relationship at the centric relation (CR). However, the discrepancy of the maxillomandibular relationship recorded at the CR position when using digital methods remains uncertain. PURPOSE The purpose of this clinical study was to compare the accuracy of the maxillomandibular relationship recorded at the CR position using a conventional procedure, 4 different IOSs, and an optical jaw tracking system. MATERIAL AND METHODS A completely dentate volunteer was selected. A Kois deprogrammer (KD) was fabricated. Six groups were created based on the technique used to obtain diagnostic casts and record the maxillomandibular relationship at the CR position: conventional procedures (CNV group), 4 IOS groups: TRIOS4 (TRIOS4 group), iTero Element 5D (iTero group), i700 wireless (i700 group), Primescan (Primescan group), and a jaw tracking system (Modjaw) (Modjaw group) (n=10). In the CNV group, conventional diagnostic stone casts were obtained. A facebow record was used to mount the maxillary cast on an articulator (Panadent). The KD was used to obtain a CR record for mounting the mandibular cast, and the mounted casts were digitized by using a scanner (T710) to acquire the reference scans. In the TRIOS group, intraoral scans were obtained and duplicated 10 times. The KD was used to obtain a bilateral virtual occlusal record at the CR position. To acquire the specimens of the iTero, i700, and Primescan groups, the procedures in the TRIOS4 group were followed, but with the corresponding IOS. In the Modjaw group, the KD was used to record and export the maxillomandibular relationship at the CR position. Articulated virtual casts of each group were exported. Thirty-six interlandmark linear measurements were computed on both the reference and experimental scans. The distances obtained on the reference scan were used to calculate the discrepancies with the distances obtained on each experimental scan. The data were analyzed by using 1-way ANOVA followed by the pairwise comparison Tukey tests (α=.05). RESULTS The trueness and precision of the maxillomandibular relationship record were significantly affected by the technique used (P<.001). The maxillomandibular relationship trueness values from high to low were iTero (0.14 ±0.09 mm), followed by the Modjaw (0.20 ±0.04 mm) and the TRIOS4 (0.22 ±0.09 mm) groups. However, the iTero, Modjaw, and TRIOS4 groups were not significantly different from each other (P>.05). The i700 group obtained the lowest trueness and precision values (0.40 ±0.22 mm) of all groups tested, followed by the Primescan grop (0.26±0.13 mm); however, the i700 and Primescan groups had significantly lower trueness and precision than only the iTero group (P<.05). CONCLUSIONS The trueness and precision of the maxillomandibular relationship recorded at the CR position were influenced by the different digital techniques tested.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, Scool of Dental Medicine, Tufts University, Boston, MA.
| | - Rubén Agustín-Panadero
- Adjunct Professor, Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | | | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics, Department of Dentistry, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - John C Kois
- Private practice, Kois Center, Seattle, Wash; Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
| | - Jorge Alonso Pérez-Barquero
- Associate Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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De Medeiros Tormes AK, Lemos GA, Da Silva PLP, Forte FDS, De Sousa FB, Araujo DN, Batista AUD. Temporomandibular disorders: knowledge, competency, and attitudes of predoctoral dental students. Cranio 2023; 41:32-40. [PMID: 32866058 DOI: 10.1080/08869634.2020.1812816] [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: 02/07/2023]
Abstract
OBJECTIVE To evaluate knowledge, competency, and attitudes related to temporomandibular disorders (TMD) among predoctoral dental students, and to investigate the curricular organization of contents related to TMD and occlusion. METHODS Predoctoral dental students (n = 147) answered a questionnaire with topics related to TMD. Another questionnaire evaluated the organization of TMD and occlusion courses. RESULTS Contents related to TMD and occlusion were taught in the same course in all dental schools. The students' responses showed low agreement with the current gold standards pertaining to TMD. Most students declared that they did not feel confident to treat patients with TMD (62.6%), were not satisfied with the content pertaining to TMD (55.8%), and considered a lack of clinical practice to be the primary limitation in their training (59.2%). DISCUSSION Students' knowledge of basic concepts related to TMD was limited, highlighting the need for readjustment of the dental curriculum to increase clinical experience.
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Affiliation(s)
| | - George Azevedo Lemos
- Biological and Health Sciences Institute, Federal University of Alagoas, Maceió, Brazil
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Vlăduțu DE, Ionescu M, Mercuț R, Noveri L, Lăzărescu G, Popescu SM, Scrieciu M, Manolea HO, Iacov Crăițoiu MM, Ionescu AG, Mercuț V. Ecological Momentary Assessment of Masseter Muscle Activity in Patients with Bruxism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010581. [PMID: 36612902 PMCID: PMC9819829 DOI: 10.3390/ijerph20010581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 05/31/2023]
Abstract
According to the International Bruxism Consensus, bruxism refers to the activity of the masticatory muscles reflecting contraction disorders, regardless of whether it is during sleep (SB) or an awake (AB) state. The objective of the present study was to evaluate the activity of the masseter muscle by surface electromyographic (sEMG) recordings. This study was performed on 20 participants with self-reported “possible bruxism” (study group) and 20 participants with no self-reported bruxism (control group); all participants underwent an evaluation of the masseter muscle activity using the dia-BRUXO device, which provides numerical parameters regarding sEMG (the total duration and the type of bruxism specific events, the effort made by the masticatory muscles during the recording period, and the personal bruxism index of each participant). Participants from the study group presented more clenching events during AB, three times more frequent than the control group (p = 0.002, Mann−Whitney U test); for SB, the frequency of clenching and grinding events was comparable within the study group, being more frequent than for the control group; the mean value of the effort index was higher for AB (1.177%) than SB (0.470%) and the same for the duration index, with a mean value of 2.788% for AB and 1.054% for SB. All participants from the control group presented reduced values for all acquired parameters. Overall, the personal bruxism index in AB was approximately four times higher for the study group (2.251%) compared to the control group (0.585%) (p < 0.005, Mann−Whitney U test). Similar values were obtained for SB. All participants with “possible bruxism” from the study group presented a higher activity of the masseter muscle, which is specific for bruxism, thus being defined as “definite bruxism”.
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Affiliation(s)
- Diana Elena Vlăduțu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Răzvan Mercuț
- Department of Plastic Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Grigore Lăzărescu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Sanda Mihaela Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Monica Scrieciu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Horia Octavian Manolea
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Alin Gabriel Ionescu
- Department of Medical History, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Veronica Mercuț
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Mitrowska-Guźmińska M, Gębska M, Jonko K, Dalewski B, Pałka Ł, Chęć M, Sobolewska E. Effect of Personality Type on the Occurrence of Temporomandibular Disorders-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:352. [PMID: 36612672 PMCID: PMC9819750 DOI: 10.3390/ijerph20010352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/16/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Personality traits are one of the major factors influencing the behavior and functioning of an individual, and they play a crucial role in the development of psychosomatic disorders and diseases. This paper aimed to evaluate the importance of personality traits in temporomandibular disorder (TMDs) development using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). Moreover, the relationship between personality type and the intensity of dysfunctional changes in the stomatognathic system was assessed using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). MATERIAL AND METHODS The study included a group of 75 adult participants (aged 19-52) with TMD diagnosed according to DC/TMD criteria and a control group of 75 participants without symptoms of dysfunction. The study consisted of a questionnaire and clinical study; the questionnaire included the NEO-FFI psychological questionnaire and a self-authored one. The clinical part consisted of extra- and intraoral dental examinations. RESULTS Participants who clenched their teeth showed a greater degree of conscientiousness than those who did not exhibit this symptom (p = 0.048). Presence of headaches was correlated with greater severity of neuroticism (p = 0.001). Moreover, participants with enamel cracks showed a lower intensity of extraversion (p = 0.039), and those with worn hard dental tissues showed a higher intensity of neuroticism (p = 0.03), a lower intensity of conscientiousness (p = 0.01), and a lower intensity of extroversion (p = 0.046). Acoustic symptoms during mandibular movements were found to be linked with a higher level of neuroticism (p = 0.020), a lower level of extraversion (p = 0.035), and a lower level of conscientiousness, whereas pain upon mandibular movements were linked to a lower level of conscientiousness (p = 0.025). Participants with pain upon palpation of the masticatory muscles showed a lower level of conscientiousness (p = 0.01) compared to those without pain symptoms. Episodes of mandibular blockage or problems with its adduction depend on the intensity of conscientiousness (p = 0.007). Moreover, people from the study group with high levels of neuroticism showed lower protrusion values (p = 0.016). CONCLUSION The intensity of individual personality traits was found to be associated with some TMDs in comparison to healthy controls.
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Affiliation(s)
| | - Magdalena Gębska
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Kinga Jonko
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Bartosz Dalewski
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland
| | | | - Magdalena Chęć
- Institute of Psychology, Department of Clinical Psychology, University of Szczecin, Krakowska 69, 71-017 Szczecin, Poland
| | - Ewa Sobolewska
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland
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Refahee SM, Mahrous AI, Shabaan AA. Clinical efficacy of magnesium sulfate injection in the treatment of masseter muscle trigger points: a randomized clinical study. BMC Oral Health 2022; 22:408. [PMID: 36123724 PMCID: PMC9484239 DOI: 10.1186/s12903-022-02452-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Myofascial pain syndrome with trigger points is the most common cause of nonodontogenic pain. Although injection of the trigger points is the most effective pain reduction treatment, many patients exhibit recurrence after a short period. Therefore, the aim of the current study was to evaluate the clinical efficacy of magnesium sulfate injections in the treatment of the masseter muscle trigger points when compared to saline injections.
Material and method This study randomly (1:1) assigned 180 patients to one of two treatment groups based on whether their trigger points were injected with 2 ml of saline or magnesium sulfate. Pain scores, maximum mouth opening (MMO), and quality of life were measured at the pre-injection and 1, 3, and 6 months post-injection.
Results The pain scores were significantly higher in the saline group during all follow-up assessments, whereas the MMO was significantly higher in the magnesium sulfate group up to 3 months of follow-up (p < 0.001). However, the difference in MMO ceased to be statistically significant after 6 months of follow-up (p = 0.121). Additionally, the patient’s quality of life score was significantly higher in the magnesium sulfate group compared to the saline group (p < 0.001). Conclusion Injection of magnesium sulfate is an effective treatment measure for myofascial trigger points. However, further studies with a proper design addressing the limitations of the current study are necessary. ClinicalTrials: org (ID: NCT04742140) 5/2/2021.
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Affiliation(s)
- Shaimaa Mohsen Refahee
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | - Aliaa Ibrahim Mahrous
- Fixed Prosthodontic Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
| | - Alshaimaa Ahmed Shabaan
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
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Temporomandibular Joint Disk Displacements in Class II Malocclusion and Cervical Spine Alterations: Systematic Review and Report of a Hypodivergent Case with MRI Bone and Soft Tissue Changes. LIFE (BASEL, SWITZERLAND) 2022; 12:life12060908. [PMID: 35743939 PMCID: PMC9229202 DOI: 10.3390/life12060908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/07/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
(1) Background: This study aimed to perform a literature review related to disk displacement (DD) in class II malocclusion or cervical vertebrae position alterations and to report a hypodivergent case with cervical pain and right anterolateral DD with reduction, left anterolateral DD with reduction, and left joint effusion. (2) Methods: A structured electronic search was conducted between March 2022 and April 2022, without time limits, following PRISMA guidelines, in the following databases: PubMed, Scopus, Embase and Cochrane; the terms “disc displacement”, “disk displacement”, “temporomandibular joint”, “class II malocclusion” and “cervical vertebrae” are searched. (3) Results: the following thirteen publications are included in this review: two prospective studies and eleven cross-sectional studies; for evaluating disk position, eight included publications used magnetic resonance imaging (MRI), whilst six studies used lateral cephalogram to determine craniofacial morphology and relationships between the cranial base, vertical skeletal pattern, maxilla and mandible. (4) Conclusions: although the literature still shows contradictory opinions, a relationship between temporomandibular disorders and cervical posture has been shown in the presented case as well as in the literature review.
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Ruiz-Romero V, Toledano-Serrabona J, Gay-Escoda C. Efficacy of the use of chondroitin sulphate and glucosamine for the treatment of temporomandibular joint dysfunction: A systematic review and meta-analysis. Cranio 2022:1-10. [PMID: 35588467 DOI: 10.1080/08869634.2022.2076796] [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: 10/18/2022]
Abstract
OBJECTIVE To evaluate the efficacy of chondroitin sulfate (CS) and glucosamine (GS), the most relevant drugs of "Symptomatic Slow Acting Drug for Osteoarthritis" (SYSADOA), in the functional and symptomatic improvement of temporomandibular dysfunction. Although, controversy exists regarding their benefit. METHODS An electronic search was conducted to retrieve randomized controlled clinical trials (RCTs). The risk of bias assessment was evaluated using the Cochrane Collaboration's tool. Data were meta-analyzed with a random effect model whenever possible. RESULTS Three RCTs were included. Qualitative results showed a decrease in pain, joint noise, and inflammatory biomarkers in synovial fluid and an improvement in maximum mouth opening without significant adverse effects. Meta-analysis showed a significant increase in maximum mouth opening with the use of CS-GS (p = 0.19). No statistically significant differences were found in pain reduction compared to tramadol. CONCLUSION CS-GS is effective and safe in the symptomatic and functional improvement of patients with TMD.
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Affiliation(s)
- Víctor Ruiz-Romero
- Faculty of Medicine and Health Sciences, Dental School, University of Barcelona, Barcelona, Spain
| | - Jorge Toledano-Serrabona
- Faculty of Medicine and Health Sciences, Dental School, University of Barcelona, Barcelona, Spain
- Odontological and Maxillofacial Pathology and Therapeutics Group, IDIBELL (Bellvitge Biomedical Research Institute), Barcelona, Spain
| | - Cosme Gay-Escoda
- Faculty of Medicine and Health Sciences, Dental School, University of Barcelona, Barcelona, Spain
- Odontological and Maxillofacial Pathology and Therapeutics Group, IDIBELL (Bellvitge Biomedical Research Institute), Barcelona, Spain
- Department of Oral Surgery and Implantology, EFHRE International University/FUCSO, Barcelona, Spain
- Oral Surgery, Implantology and Maxillofacial Surgery Department, Teknon Medical Centre, Barcelona, Spain
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Ferreira NDR, Marto CMM, de Oliveira AT, Rodrigues MJ, DosSantos MF. Development of core outcome sets for clinical trials in temporomandibular disorders: A study protocol. PLoS One 2022; 17:e0267722. [PMID: 35482750 PMCID: PMC9049344 DOI: 10.1371/journal.pone.0267722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Temporomandibular Disorder (TMD) is a generic term applied to describe musculoskeletal disorders that affect the temporomandibular joint (TMJ), the masticatory muscles and the related structures. TMD comprises two groups of disorders, namely intra-articular TMD and masticatory muscle disorders. There is still difficulty in establishing the effectiveness of different therapeutic modalities for TMD with robust evidence, despite the large volume of publications in the area. The lack of outcomes standardization may represent a limiting factor in the search for scientific evidence. Objective This study aims to develop a core outcome sets (COS) for clinical trials in intra-articular TMD and masticatory muscle disorders. Methods The protocol for determining the COS-TMD will consist of three phases: 1. Synthesis of TMD Management Intervention Outcomes. The identification of outcomes will be carried out through a systematic review, which will include randomized clinical trials that evaluated the effectiveness of interventions used in TMD management. 2. Through a two-round international Delphi survey, the list of outcomes will be scored by three panels of stakeholders. 3. A representative sample of key stakeholders will be invited to participate in a face-to-face meeting where they can discuss the results of the Delphi survey and determine the final core set. Conclusions The implementation of this protocol will determine the COS-TMD, which will be made available for use in all TMD clinical studies. The use of COS when planning and reporting TMD clinical trials will reduce the risk of publication bias and enable proper comparison of results found by different studies.
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Affiliation(s)
- Natália dos Reis Ferreira
- Faculty of Medicine, Institute for Occlusion and Orofacial Pain, University of Coimbra, Coimbra, Portugal
- Postgraduate Program in Medicine (Radiology), Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Carlos Miguel Machado Marto
- Faculty of Medicine, Institute of Experimental Pathology, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Aleli Tôrres de Oliveira
- Postgraduate Program in Medicine (Radiology), Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Maria João Rodrigues
- Faculty of Medicine, Institute for Occlusion and Orofacial Pain, University of Coimbra, Coimbra, Portugal
| | - Marcos Fabio DosSantos
- Postgraduate Program in Medicine (Radiology), Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Laboratory of Mechanical Properties and Cell Biology (PropBio), Prosthodontics and Materials Sciences Department, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Postgraduate Program in Dentistry (PPGO), School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Postgraduate Program in Translational Neuroscience (PGNET), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- * E-mail: ,
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Chondrotoxic effects of intra-articular injection of local anaesthetics in the rabbit temporomandibular joint. Int J Oral Maxillofac Surg 2022; 51:1337-1344. [PMID: 35120788 DOI: 10.1016/j.ijom.2022.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/01/2021] [Accepted: 01/18/2022] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the chondrotoxic effects of a single-dose intra-articular injection of articaine, lidocaine, and bupivacaine on the rabbit temporomandibular joint (TMJ). Twenty-four rabbits were divided into four groups: control (group 1), articaine (group 2), lidocaine (group 3), and bupivacaine (group 4). Synovial fluid samples and venous blood were taken to evaluate matrix metalloproteinase 3 (MMP-3) levels. One millilitre of local anaesthetic solution was injected in the study groups and saline solution in the control group. The rabbits were euthanized after 4 weeks and the mandibular condyles and articular discs were evaluated. On histological examination, the study group samples had irregular joint surfaces, decreased collagen, and a thinner cartilage layer. Apoptotic cells were evaluated with the TUNEL method. TUNEL-positive apoptotic cell counts were higher in all study groups compared to the control group, and the difference was significant (P < 0.001). The mean preoperative serum MMP-3 level for all groups was 5.71 ± 3.33 ng/mL, while the mean postoperative level was 22.61 ± 6.36 ng/mL; this difference was significant (P < 0.001). A single-dose intra-articular injection of local anaesthetic had apoptotic effects on chondrocytes, leading to degenerative changes in the TMJ articular structures. Articaine was found to have less harmful effects than lidocaine and bupivacaine. Intra-articular injection of local anaesthetics should be limited in the TMJ because of the potential toxic effects.
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Comparison of T2 Weighted, Fat-Suppressed T2 Weighted, and Three-Dimensional (3D) Fast Imaging Employing Steady-State Acquisition (FIESTA-C) Sequences in the Temporomandibular Joint (TMJ) Evaluation. BIOMED RESEARCH INTERNATIONAL 2022; 2021:6032559. [PMID: 34977244 PMCID: PMC8716192 DOI: 10.1155/2021/6032559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/20/2021] [Accepted: 11/29/2021] [Indexed: 12/03/2022]
Abstract
Aim Osteonecrosis can affect the mandibular condyle, and bone marrow edema may be a precursor in osteonecrosis development in temporomandibular disorder (TMD) patients. Early detection of bone marrow changes is crucial for occurring osteonecrosis. The purpose of this study was to compare the diagnostic value of fast spin-echo T2 weighted (FSE-T2W), fat-suppressed T2W (FS-T2W), and three-dimensional (3D) fast imaging employing steady-state acquisition (FIESTA-C) MR sequences for early detection of bone marrow changes as well as TMJ soft tissue alterations. Methods A total of 60 joints with TMD were included in this study using a 1.5T MR machine (Signa HDxt, GE, Milwaukee, USA) using a dual surface TMJ coil. Qualitatively, the images were interpreted by two observers for disk configuration, disk position, joint fluid, and bone marrow changes. Quantitatively, signal intensity ratios (SIR) in the TMJ condyle, retrodiscal tissue, disk, and muscle were also measured using all tested sequences. Kappa coefficients were calculated to assess both intra- and interobserver agreements for each image set. The SIR of each sequence was compared using a one-way ANOVA Bonferroni-Dunn test. Results Overall intraobserver kappa coefficients ranged between 0.35 and 0.88 for joint fluid and between 0.22 and 0.82 for bone marrow changes diagnosis, suggesting high intraobserver agreement for FS-T2W and 3D FIESTA-C sequences than FSE T2W sequence (p < 0.05). 3D FIESTA-C showed higher agreement values for disk configuration and position detection than other sequences. Conclusions 3D FIESTA-C sequences can be used and incorporated into routine MRI protocols for obtaining high-resolution TMJ MR images due to the short acquisition time and 3D nature of the sequence. Additional studies should be done for dynamic TMJ imaging with this sequence.
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Mizuhashi F, Ogura I, Watarai Y, Suzuki T, Mizuhashi R, Oohashi M, Saegusa H. Examination for the factors contribute to joint effusion in patients with internal derangement on temporomandibular joint disorder. JOURNAL OF ORAL AND MAXILLOFACIAL RADIOLOGY 2022. [DOI: 10.4103/jomr.jomr_17_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Khalighi HR, Mortazavi H, Mojahedi SM, Azari-Marhabi S, Parvaie P, Anbari F. The efficacy of low-level diode laser versus laser acupuncture for the treatment of myofascial pain dysfunction syndrome (MPDS). J Dent Anesth Pain Med 2022; 22:19-27. [PMID: 35169617 PMCID: PMC8814725 DOI: 10.17245/jdapm.2022.22.1.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/06/2022] [Accepted: 01/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Hamid Reza Khalighi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mortazavi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Mojahedi
- Department of Laser, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saranaz Azari-Marhabi
- Laser Application in Medical Science Research Center, Shohada Tajrish Hospital, Tajrish Square, Tajrish Street, Tehran, Iran
| | - Parvin Parvaie
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Fahimeh Anbari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Olivencia O, Kaplan K, Dreger M, Veloz M, Kais A, Marlowe K. Postrehabilitation Considerations for Individuals With Temporomandibular Disorders. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Dos Santos Aguiar A, Bataglion C, Felício LR, Azevedo B, Chaves TC. Additional effect of pain neuroscience education to craniocervical manual therapy and exercises for pain intensity and disability in temporomandibular disorders: a study protocol for a randomized controlled trial. Trials 2021; 22:596. [PMID: 34488856 PMCID: PMC8419952 DOI: 10.1186/s13063-021-05532-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 08/11/2021] [Indexed: 12/29/2022] Open
Abstract
Abstract The objective of this study will be to investigate the additional effect of pain neuroscience education program compared to a craniocervical manual therapy and exercises program for pain intensity and disability in patients with temporomandibular disorders (TMD). This study will be a randomized controlled trial comprising a sample of 148 participants. Subjects between 18 and 55 years, both genders, will undergo a screening process to confirm painful TMD by the Research Diagnostic Criteria (RDC/TMD), and then the volunteers will be randomized into two groups (G1: pain neuroscience education + craniocervical manual therapy and exercises vs. G2: craniocervical manual therapy and exercises). The volunteers will be recruited at the dentistry clinic. The intervention will be administered twice a week for 6 weeks by a single therapist lasting 1 h per session. The primary outcome will be pain intensity and disability and the secondary outcomes will be pain self-efficacy, kinesiophobia, and global perceived effect of improvement. The participants will be assessed immediately after the last session and at one- and three-month follow-ups. All statistical analyses will be conducted following intention-to-treat principles, and the treatment effects will be calculated using linear mixed models. The results of this study may contribute to understand the additional effect of pain neuroscience education intervention on TMD patients submitted to manual therapy and exercise. Trial registration ClinicalTrials.gov NCT03926767. Registered on April 29, 2019.
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Affiliation(s)
- Aroldo Dos Santos Aguiar
- Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Cesar Bataglion
- Department of Restorative Dentistry at Ribeirão Preto Dental School (FORP), University of São Paulo-USP, Ribeirão Preto, São Paulo, Brazil
| | - Lilian Ramiro Felício
- Graduate Program of Physical Therapy, Laboratory of Evaluation in Biomechanics and Neurosciences (LABiN), Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Beatriz Azevedo
- Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thaís Cristina Chaves
- Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. .,Department of Health Sciences and Graduate Program on Rehabilitation and Functional Performance, Laboratory of Research on Movement and Pain (LabMovePain), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Jedynak B, Jaworska-Zaremba M, Grzechocińska B, Chmurska M, Janicka J, Kostrzewa-Janicka J. TMD in Females with Menstrual Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7263. [PMID: 34299715 PMCID: PMC8306893 DOI: 10.3390/ijerph18147263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are a common reason for patients to present at dental offices. The majority of people with TMD are women between the age of 20 and 40 years. The purpose of this study was to assess the types and prevalence of temporomandibular disorders in female patients of reproductive age with menstrual disorders. MATERIALS AND METHODS The study involved 65 females of reproductive age (18-40 years, an average of 28.00 ± 6.27 years). The women who qualified for the study were patients of the University Center for Maternal and Newborn's Health hospitalized because of infertility or menstrual cycle disorders. Women with confirmed estrogen metabolism disorders participated in a clinical study with the use of Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). RESULTS In the studied female patients with menstrual disorders, temporomandibular disorders (92.3%) were frequent occurrences. The most common type was intra-articular joint disorders (68%). Other reported complaints included masticatory muscle pain (44.62%), and degenerative joint diseases (12.3%). CONCLUSIONS 1. In women with menstrual disorders, TMD may exist. 2. In women with TMD symptoms, their medical history should be extended to include the diagnosis of female hormone disorders.
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Affiliation(s)
- Bożena Jedynak
- Department of Prosthodontics, Medical University of Warsaw, Binieckiego str 6, 02-097 Warsaw, Poland; (B.J.); (M.J.-Z.)
| | - Marta Jaworska-Zaremba
- Department of Prosthodontics, Medical University of Warsaw, Binieckiego str 6, 02-097 Warsaw, Poland; (B.J.); (M.J.-Z.)
| | - Barbara Grzechocińska
- University Center for Maternal and Newborn’s Health, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland;
| | - Magdalena Chmurska
- Military Institute of Medicine, Szaserow str 128, 04-349 Warsaw, Poland;
| | - Justyna Janicka
- Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland;
| | - Jolanta Kostrzewa-Janicka
- Department of Prosthodontics, Medical University of Warsaw, Binieckiego str 6, 02-097 Warsaw, Poland; (B.J.); (M.J.-Z.)
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Sobral APT, Sobral SDS, Campos TM, Horliana ACRT, Fernandes KPS, Bussadori SK, Motta LJ. Photobiomodulation and myofascial temporomandibular disorder: Systematic review and meta-analysis followed by cost-effectiveness analysis. J Clin Exp Dent 2021; 13:e724-e732. [PMID: 34306537 PMCID: PMC8291152 DOI: 10.4317/jced.58084] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/16/2021] [Indexed: 11/05/2022] Open
Abstract
Background Photobiomodulation (PBM) is a non-invasive and non-pharmacological treatment, which, has shown beneficial results in the treatment of temporomandibular disorders (TMD) related pain. This systematic review and meta-analysis study aimed to evaluate the efficacy of photobiomodulation in the treatment of myofascial pain associated with (TMD by analyzing randomized clinical trials published from 2007 to February 2019. The secondary objective of the study was to perform a cost-effectiveness analysis of TMD treatment with photobiomodulation in patients with myofascial pain. Material and Methods International databases were used: Pubmed, Medline and Web of Science; the initial search raised 316 papers, and only 17 papers met the inclusion criteria for the systematic review (SR). Of these, only 04 papers met the inclusion criteria for meta-analysis: VAS data represented by numerical scores and placebo control group. Results As for the wavelength, the most used value was 780nm (followed by 830nm. The most used treatment time was 4 offered treatments for 4 weeks; followed by 10 sessions. Regarding periodicity, 9 studies used 2 times a week. The meta-analysis showed that laser-treated groups had painful symptoms improvement that was superior to the control group (mean difference 1.49;95% CI = -1.67; -1.32). Laser therapy showed a cost-effectiveness of $1,464.28 by controlled pain intensity and placebo showed $2,866.20 by controlled pain intensity. Conclusions The studies were considered to have moderate quality of evidence. Laser-treated groups had painful symptoms improvement that was superior to the control group and photobiomodulation was more cost-effective than placebo in patients with TMD and myofascial pain. Key words:Temporomandibular disorder, Myofascial pain, Photobiomodulation, Placebo, Cost-effectiveness.
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Affiliation(s)
| | - Sergio-de Sousa Sobral
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil
| | - Thalita-Molinos Campos
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil
| | | | | | - Sandra-Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil
| | - Lara-Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, UNINOVE - São Paulo, Brazil.,Postgraduate Program
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A Decade of Complications Following Total Temporomandibular Joint Reconstruction (TJR) in a Patient with Ehlers-Danlos Syndrome. Another Surgical Misadventure or An Absolute Contraindication for TJR? J Oral Maxillofac Surg 2021; 79:2059.e1-2059.e5. [PMID: 34153263 DOI: 10.1016/j.joms.2021.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 11/21/2022]
Abstract
This report describes an extensive surgical journey for a patient with Ehlers-Danlos syndrome (EDS) who underwent a total temporomandibular joint reconstruction and illustrates an ongoing challenge for oral and maxillofacial surgeons treating patients with connective tissue disorders and managing chronic pain symptoms. The surgical team attempted multiple procedures including 2 failed total temporomandibular joint replacements and a myocutaneous vascularized free flap. This case demonstrates the potential for postoperative complications in patients with Ehlers-Danlos syndrome.
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France K, AlMuzaini AAAY, Mupparapu M. Radiographic Interpretation in Oral Medicine and Hospital Dental Practice. Dent Clin North Am 2021; 65:509-528. [PMID: 34051928 DOI: 10.1016/j.cden.2021.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Oral medicine practice includes the diagnosis and nonsurgical treatment of oral and orofacial diseases and oral manifestations of systemic conditions. Oral medicine specialists in medical and dental settings often require imaging in assessment and treatment of these conditions. This article reviews imaging that may be used in practice, particularly as relevant for facial pain, bone conditions, and salivary gland disease. It reviews imaging that may be considered in a hospital setting for assessment of admitted patients, patient evaluation before surgical procedures, and provision of dentistry in a hospital setting for patients who cannot submit to treatment in an outpatient setting.
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Affiliation(s)
- Katherine France
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | | | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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Alrashdan MS, Shaweesh A, Khasawneh AA, Sannoh MH. The Association between Occlusal Features and Temporomandibular Disorders in Northern Jordan: A Cross-sectional Study. Open Dent J 2021. [DOI: 10.2174/1874210602115010145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
To evaluate the possible correlation between basic occlusal features and the outcomes of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I.
Materials and Methods:
A convenient sample of Northern Jordanians was used in the study. Participants were examined in accordance with DC/TMD protocol. Nine occlusal features represented the independent variables; overjet, overbite, midline deviation, pain-free opening, maximum assisted opening, maximum unassisted opening, lateral excursions and protrusion, in addition to the opening pattern (classified as straight, corrected deviation and uncorrected deviation). DC/TMD diagnostic outcomes and their associated features represented the dependent variables, namely, pain-related TMD, Intra-articular Disorders (IAD), Degenerative Joint Disease (DJD), joint sounds (clicking and crepitus), joint locking and headache attributed to TMD. Binary logistic regression, multinomial logistic regression and Chi-square tests were used for statistical analyses.
Results:
A total of 400 participants represented the study population (mean age = 32.3±12.4 years, males=48%, females=52%). 71 subjects (18%) were diagnosed with pain-related TMD, 52 (13%) with IAD, 6 (1.5%) with DJD and 38 (10%) with headache due to TMD. Gender had a significant correlation with pain-related TMD (p= 0.014, OR= 2.16). Maximum pain free opening had a significant inverse relationship with pain related TMD (p= 0.013, OR=0.94), while midline deviation and corrected deviation mouth opening pattern had a significant correlation with IAD (p= 0.04,0.02, OR= 1.30,2.74, respectively). Overbite, midline deviation and pain free opening were significantly associated with unilateral open/close clicking (p= 0.04,0.05,0.03, OR= 0.77, 1.31, 0.94, respectively).
Conclusion:
There is a minimal clinical significance of the correlation between dental occlusion and TMD.
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Kui A, Buduru S, Labunet A, Balhuc S, Negucioiu M. Vitamin D and Temporomandibular Disorders: What Do We Know So Far? Nutrients 2021; 13:nu13041286. [PMID: 33919716 PMCID: PMC8070666 DOI: 10.3390/nu13041286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 02/07/2023] Open
Abstract
Background and aims. Vitamin D is synthesized in the skin with the aid of ultraviolet-B radiation, playing a variety of roles in the body. Temporomandibular disorders (TMDs) are a group of pathological conditions involving the temporomandibular joints as well as the masticatory muscles and othersurrounding tissues. In the present narrative review, we investigated the potential role of vitamin D in the etiology of temporomandibular disorders in order todetermine whether the current knowledge supports 25-hidroxyvitamin D (25-OHD) supplementation in temporomandibular disorders associated with insufficient or deficient levels of vitamin D. Methods. A literature research was performed in PubMed, Scopus, Science Direct, and Google Scholar databases, and a total of 10 articles were included for analysis. Results.Among the observational studies published to date, investigating the role for vitamin D in the etiology of TMDs, six of them suggest that there is a connection between the two aspects. In this context, patients suffering from TMD, with deficient levels of vitamin D (<30 ng/mL), are most likely to benefit from supplementation, whereas individuals with vitamin D level >50ng/mL probably have little benefit from supplementation.Conclusion.Vitamin D might be a safe, simple, and potentially beneficial way to prevent TMDs or to reduce pain; however, more randomized and placebo-controlled trials are required before any firm conclusions can be drawn.
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Affiliation(s)
- Andreea Kui
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
| | - Smaranda Buduru
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
| | - Anca Labunet
- Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
- Correspondence:
| | - Silvia Balhuc
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
| | - Marius Negucioiu
- Prosthodontics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania; (A.K.); (S.B.); (S.B.); (M.N.)
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Lee HM, Kang DW, Yun PY, Kim IH, Kim YK. Associations between mandibular torus and types of temporomandibular disorders, and the clinical usefulness of temporary splint for checking bruxism. BMC Oral Health 2021; 21:182. [PMID: 33836733 PMCID: PMC8033698 DOI: 10.1186/s12903-021-01550-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/05/2021] [Indexed: 02/08/2023] Open
Abstract
Background Occlusal stress from oral parafunctional habits is one of the causes of temporomandibular disorders (TMD) and mandibular torus (MT). Although some studies have investigated the correlation between TMD and MT, understanding of the relationships between types of TMD and MT is insufficient. Therefore, we conducted this study to investigate the associations between presence of MT and TMD types. Methods This study included 77 patients diagnosed with TMD who first visited our clinic for TMD between March 2019 and July 2020. Among them, 30 (38.9%) had MT, and 54 (70.1%) had oral parafunction. Parafunctional activity during sleep was confirmed using a temporary splint for checking bruxism (TSCB). Results The relationship between prevalence of MT and oral parafunction in TMD patients was not statistically significant (P = 0.131), but the odds ratio was relatively high at 2.267. An analysis of TMD type revealed that Type I, which is classified as myalgia of the masticatory muscles, and MT had a significant association (P = 0.011). We fabricated a TSCB for 27 patients to wear during sleep and confirmed that 23 (85.2%) had nocturnal bruxism. The TSCB results and presence of MT showed a significant relationship (P = 0.047). Conclusion Through the results of this study, clinicians may consider the hyperactivity of masticatory muscles in the presence of MT when treating TMD patients. In addition, TSCB has a great diagnostic value as it can be easily manufactured and be useful for discovering pre-existing oral parafunctions that patients are not aware of.
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Affiliation(s)
- Hee-Min Lee
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Dong-Woo Kang
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Il-Hyung Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea. .,Office of Human Resources Development, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea.
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea. .,School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.
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Herrera-Valencia A, Ruiz-Muñoz M, Martin-Martin J, Cuesta-Vargas A, González-Sánchez M. Effcacy of Manual Therapy in TemporomandibularJoint Disorders and Its Medium-and Long-TermEffects on Pain and Maximum Mouth Opening:A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E3404. [PMID: 33114236 PMCID: PMC7690916 DOI: 10.3390/jcm9113404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/12/2020] [Accepted: 10/20/2020] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to conduct a systematic review of the medium- and long-term efficacy of manual therapy for temporomandibular joint disorders, alone or in combination with therapeutic exercise. Information was compiled from the PubMed, SCOPUS, Cochrane, SciELO and PEDro databases. The inclusion criteria were established: randomized controlled trials only; participants must present any kind of temporomandibular disorder; the treatments must include manual therapy in at least one of the experimental groups; a minimum of 3 months of follow-up; pain must be one of the primary or secondary outcomes; and the article must be available in English, Spanish, Italian, Portuguese or French. Six documents that fulfilled all the criteria were obtained for analysis, two of them considered low quality and four considered high quality. A significant improvement in pain and mouth opening compared to baseline was observed after manual therapy treatment. Manual therapy seems to be an effective treatment for temporomandibular disorders in the medium term, although the effect appears to decrease over time. However, when complemented with therapeutic exercise, these effects can be maintained in the long term. This review underlines the importance of manual therapy and therapeutic exercise for the medium- and long-term treatment of temporomandibular joint disorders in daily practice.
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Affiliation(s)
- Andres Herrera-Valencia
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain; (A.H.-V.); (A.C.-V.); (M.G.-S.)
| | - Maria Ruiz-Muñoz
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain;
| | - Jaime Martin-Martin
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Málaga, 29010 Málaga, Spain
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain; (A.H.-V.); (A.C.-V.); (M.G.-S.)
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain;
- School of Clinical Sciences of the Faculty of Health, Queensland University of Technology, Brisbane QLD 4000, Australia
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain; (A.H.-V.); (A.C.-V.); (M.G.-S.)
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain;
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Owczarek JE, Lion KM, Radwan‐Oczko M. The impact of stress, anxiety and depression on stomatognathic system of physiotherapy and dentistry first-year students. Brain Behav 2020; 10:e01797. [PMID: 32862554 PMCID: PMC7559601 DOI: 10.1002/brb3.1797] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/11/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION It is well proven that psychoemotional factors play causative role in development of many civilization diseases. Psychosocial stress is effecting with development of certain oral parafunctions like teeth grinding, bruxism, or cheeks biting. Eventually, all of those parafunctional activities may cause increase of masticatory muscles tone and provoke its intensification. Literature indicates that students must cope with greater level of stressful situations than the average representative of the society. METHODS The research group comprised Ist-year physiotherapy and dentistry students from University School of Physical Education in Wroclaw and Wroclaw Medical University. The study consisted the following: psychological and health questionnaires, and stomatological examination with masseter muscles' electromyography. RESULTS In intraoral examination, symptoms of parafunctions were more frequently observed in physiotherapy students. The mean tone of masseters was higher also among physiotherapy students. The level of perceived stress was high in both groups, and the experienced borderline and incorrect results in Hospital Anxiety and Depression Scale were more frequently observed in dentistry students. The mean tone of masseter muscle was rising with the level of anxiety in physiotherapy group. Among dentistry, the tendency for rise of masseter muscle tone together with level of anxiety and depression was observed. CONCLUSIONS Physiotherapy and dentistry beginners differ between each other's by prevalence of temporomandibular disorders (TMD) and oral parafunction symptoms. The level of perceived stress is high in both groups. The level of experienced anxiety and depression is higher in dentistry group. In both study groups, there is significant growth and tendency for simultaneous rise of masseter muscle tone accordingly to stress, anxiety, and depression indicators.
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Dietrich L, Rodrigues IVS, Assis Costa MDMD, Carvalho RF, Silva GRD. Acupuncture in Temporomandibular Disorders Painful Symptomatology: An Evidence-Based Case Report. Eur J Dent 2020; 14:692-696. [PMID: 33003235 PMCID: PMC7536091 DOI: 10.1055/s-0040-1716631] [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] [Indexed: 10/28/2022] Open
Abstract
Temporomandibular dysfunction (TMD) is complex and multifactorial. Its etiology involves various factors, such as malocclusion, psychological patterns, parafunctional habits, and the temporomandibular joint anatomy. Symptoms include myofascial pain, joint clicking, mouth opening limitation, headaches, earaches, and neck pain, comprising one of the greatest causes of nondental pain. Acupuncture has been used to treat these conditions by acting locally both in muscle relaxation and pain management as well as reaching physical, mental, and emotional balance. The aim of this study is to present a brief literature review reporting the efficacy of acupuncture on TMDs and a case report in which the painful symptomatology of TMD was treated with a systemic protocol, based on scientific evidence and concepts of traditional Chinese medicine. Acupuncture may be a complementary treatment for TMD, and in this case report, it eliminated the patient's painful symptomatology.
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Affiliation(s)
- Lia Dietrich
- Department of Operative Dentistry and Dental Materials, Biomechanics Research Group, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
- Department of Operative Dentistry and Oral Rehabilitation, Faculty of Dentistry, Faculty of Patos de Minas, Patos de Minas, Brazil
| | - Igor Vinícius Santos Rodrigues
- Department of Operative Dentistry and Dental Materials, Biomechanics Research Group, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Marcelo Dias Moreira de Assis Costa
- Department of Oral Surgery, Faculty of Dentistry, Faculty of Patos de Minas, Patos de Minas, Brazil
- Department of Operative Dentistry and Dental Materials, Biomechanics Research Group, School of Dentistry, CEUMA University/Federal University of Uberlândia, Uberlândia, Brazil
| | - Roberta Furtado Carvalho
- Department of Operative Dentistry and Dental Materials, Biomechanics Research Group, School of Dentistry, CEUMA University/Federal University of Uberlândia, Uberlândia, Brazil
| | - Gisele Rodrigues da Silva
- Department of Operative Dentistry and Dental Materials, Biomechanics Research Group, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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Villavicencio-Espinoza CA, Giacomini MC, Narimatsu MH, Magalhães AC, Atta MT, Wang L. Adapted Three-step Restorative Technique: Recovering Dental Substrate Compromised by Complex Erosive Wear in a Young Patient. Oper Dent 2020; 45:457b-466. [DOI: 10.2341/18-204-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2019] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
This article presents the dental restoration of a young female patient complaining of erosive dental wear using a three-step restorative technique, an alternative approach with some novel adjustments.
SUMMARY
For successful tooth wear treatment, determining the etiological systemic and local factors is the main priority before deciding on effective and long-term preventive and/or therapeutic restorative approaches. In addition to professional intervention, achieving optimal outcomes requires patients to control their diet and/or gastric issues, thus minimizing the wear process. However, continuous wear constitutes the most challenging scenario, mainly when it affects young patients’ dentitions. This article describes the dental restoration of posterior teeth with reestablishment of occlusal vertical dimension before treating the anterior teeth, while educating the patient and providing medical monitoring. The three-step restorative technique seems to be properly applicable in cases of significant dental compromise due mainly to erosive wear and is based on direct procedures, which can assure a reliable and feasible approach.
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Mahmoud NR, Ashour EM. Cervico-facial pain associated with Eagle's syndrome misdiagnosed as cranio-mandibular disorders. A retrospective study. J Craniomaxillofac Surg 2020; 48:1009-1017. [PMID: 32811716 DOI: 10.1016/j.jcms.2020.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/21/2020] [Accepted: 07/25/2020] [Indexed: 11/18/2022] Open
Abstract
AIM OF STUDY a retrospective study was done to assess symptoms correlated with and responsible for the misdiagnosis of Eagle's syndrome with Cranio-Mandibular Disorders. MATERIALS AND METHODS Our study comprised patients suffering from vague craniofacial pain resulting from elongated styloid processes, presented to the outpatient clinic of the oral and maxillofacial surgery department, October 6 University Hospital. The length of styloid processes was measured on 3D-CT X-rays. All our patients were operated by surgical treatment in the form of shortening of the styloid process (styloidectomy) under general anaesthesia and followed up clinically as well as radiographically for 12 months. RESULTS Patients were assessed preoperatively as well as postoperatively throughout the following scheduled regular follow up intervals at 1 week and at 1,3,6 and 12 months postoperatively for the following parameters. VAS pain score gradually decreased from a median of 9, with a minimum of 7 and a maximum of 10 pre-operatively to a median of 1.5, with a minimum of 0 and a maximum of 3 at twelve months. Freidman test revealed a statistically significant difference by time. Maximum unassisted mouth opening was assessed. Mouth opening significantly decreased from 30.23 ± 3.28 pre-operatively to 26.08 ± 2.83 after one week, then gradually increased to reach its highest level (43.56 ± 0.72) at twelve months. CONCLUSION When dealing with cases of vague craniofacial pain, possibility of Eagle syndrome should be considered.
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Affiliation(s)
- Nermine Ramadan Mahmoud
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, October 6 University, Egypt.
| | - Essam Mohamed Ashour
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, October 6 University, Egypt.
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Yin Y, He S, Xu J, You W, Li Q, Long J, Luo L, Kemp GJ, Sweeney JA, Li F, Chen S, Gong Q. The neuro-pathophysiology of temporomandibular disorders-related pain: a systematic review of structural and functional MRI studies. J Headache Pain 2020; 21:78. [PMID: 32560622 PMCID: PMC7304152 DOI: 10.1186/s10194-020-01131-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/25/2020] [Indexed: 02/08/2023] Open
Abstract
Chronic pain surrounding the temporomandibular joints and masticatory muscles is often the primary chief complaint of patients with temporomandibular disorders (TMD) seeking treatment. Yet, the neuro-pathophysiological basis underlying it remains to be clarified. Neuroimaging techniques have provided a deeper understanding of what happens to brain structure and function in TMD patients with chronic pain. Therefore, we performed a systematic review of magnetic resonance imaging (MRI) studies investigating structural and functional brain alterations in TMD patients to further unravel the neurobiological underpinnings of TMD-related pain. Online databases (PubMed, EMBASE, and Web of Science) were searched up to August 3, 2019, as complemented by a hand search in reference lists. A total of 622 papers were initially identified after duplicates removed and 25 studies met inclusion criteria for this review. Notably, the variations of MRI techniques used and study design among included studies preclude a meta-analysis and we discussed the findings qualitatively according to the specific neural system or network the brain regions were involved in. Brain changes were found in pathways responsible for abnormal pain perception, including the classic trigemino-thalamo-cortical system and the lateral and medial pain systems. Dysfunction and maladaptive changes were also identified in the default mode network, the top-down antinociceptive periaqueductal gray-raphe magnus pathway, as well as the motor system. TMD patients displayed altered brain activations in response to both innocuous and painful stimuli compared with healthy controls. Additionally, evidence indicates that splint therapy can alleviate TMD-related symptoms by inducing functional brain changes. In summary, MRI research provides important novel insights into the altered neural manifestations underlying chronic pain in TMD.
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Affiliation(s)
- Yuanyuan Yin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.,State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Shushu He
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jingchen Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Wanfang You
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Qian Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jingyi Long
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Lekai Luo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.,Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China. .,Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
| | - Song Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
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47
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Fernandes BV, Brancher JA, Michels AC, Nagashima S, Johann ACBR, Bóia Ferreira M, da Costa DJ, Rebellato NLB, Klüppel LE, Scariot R, Zielak JC. Immunohistochemical panel of degenerated articular discs from patients with temporomandibular joint osteoarthritis. J Oral Rehabil 2020; 47:1084-1094. [PMID: 32524653 DOI: 10.1111/joor.13034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 05/04/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Temporomandibular joint osteoarthritis (TMJOA) is a progressive degenerative disease caused by imbalance between anabolic and catabolic stimuli. OBJECTIVE The aim of this study was to evaluate histopathological changes, collagen degeneration and the expression of eleven TMJOA biomarkers in articular discs. METHODS Specimens were obtained from eight female patients submitted to discectomy. Discs were divided into anterior band (AB), intermediate zone (IZ) and posterior band (PB) for computerised histomorphometric analyses. Each was assigned a histopathological degeneration score (HDS). Collagen degeneration was assessed with Picrosirius-polarisation method. Biomarkers were evaluated through immunohistochemistry, including IGF-1, OPG, VEGF, TNF-α, FGF-23, IHH, MMP-3, MMP-9, TGF-β1 , BMP-2 and WNT-3. Image processing software was used to calculate average immature collagen ratios and immunostained areas. Spearman rank tests were applied to verify correlations, with significance level of 0.05. RESULTS The HDS showed negative correlation with expression of VEGF in IZ and PB (P < .05) and positive with TNF-α in AB (P < .01). Collagen degeneration correlated with TGF-β1 (P < .05), BMP-2 (P < .01) and IHH (P < .05) immunostained areas in the IZ; TGF-β1, BMP-2 and IHH expression correlated among each other in AB and IZ (P < .05). CONCLUSION Angiogenesis and tissue fragmentation may result from aberrant physiologic responses mediated by VEGF and TNF-α, compromising TMJ discs during OA progression. The expression of TGF-β1, BMP-2 and IHH could be related to collagen degeneration in displaced discs and may participate in TMJOA pathogenesis.
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Affiliation(s)
| | - João A Brancher
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil.,School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Arieli C Michels
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Seigo Nagashima
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Marianna Bóia Ferreira
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil.,School of Biological Sciences, Department of Cell Biology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Delson J da Costa
- School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - Nelson Luis B Rebellato
- School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - Leandro E Klüppel
- School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - Rafaela Scariot
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil.,School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - João C Zielak
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil
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48
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Leissner O, Maulén-Yáñez M, Meeder-Bella W, León-Morales C, Vergara-Bruna E, González-Arriagada WA. Assessment of mandibular kinematics values and its relevance for the diagnosis of temporomandibular joint disorders. J Dent Sci 2020; 16:241-248. [PMID: 33384804 PMCID: PMC7770294 DOI: 10.1016/j.jds.2020.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/16/2020] [Indexed: 11/18/2022] Open
Abstract
Background/purpose Temporomandibular disorders (TMD) are common conditions that involve the temporomandibular joints (TMJs), jaw muscles, or both, and can cause alteration in the mandibular kinematics. The aim of this study was to assess the relationship between mandibular kinematics and temporomandibular joint disorders (TMJD) as a clinical tool for evaluation and diagnosis of these patients. Materials and methods A retrospective study based on the analysis of the clinical findings from patients’ charts was carried out, with a sample size of 476 patients. Statistical analysis was made with chi-square test for qualitative variables and student t-test for quantitative variables. Then, odds ratio with its confidence interval were calculated. A p value < 0.05 was considered statistically significant. Results Most patients were female (80.7%) and between 16 and 25 years old. Disc displacement with reduction (DDwR) and subluxation were associated with increased kinematic parameters, while disc displacement without reduction (DDwoR) and retrodiscitis were associated with decreased kinematic values. A soft end feel was related to osteoarthritis (OA). Structural incompatibility was most prevalent in older patients. Conclusion Mandibular kinematic values are associated with specific temporomandibular joint disorders and could be considered as a useful clinical tool to perform the right diagnosis of TMJD.
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Affiliation(s)
- Oliver Leissner
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Miguel Maulén-Yáñez
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
- Clinic of Temporomandibular Disorders and Orofacial Pain, Department of Dentistry, Gustavo Fricke Hospital, Viña del Mar, Chile
| | - Walther Meeder-Bella
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Camilo León-Morales
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Eduardo Vergara-Bruna
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Wilfredo Alejandro González-Arriagada
- Department of Oral Pathology and Diagnosis, Universidad de Valparaíso, Valparaíso, Chile
- Centro de Investigación en Ciencias Odontológicas y Médicas (CICOM), Universidad de Valparaíso, Valparaíso, Chile
- Corresponding author. Department of Oral Pathology and Diagnosis & Centro de Investigación en Ciencias Odontológicas y Médicas (CICOM), Universidad de Valparaíso, Valparaíso, Chile.
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49
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Jung W, Lee KE, Suh BJ. Influence of psychological factors on the prognosis of temporomandibular disorders pain. J Dent Sci 2020; 16:349-355. [PMID: 33384819 PMCID: PMC7770244 DOI: 10.1016/j.jds.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/03/2020] [Indexed: 10/26/2022] Open
Abstract
Background/purpose The leading symptom of temporomandibular disorders (TMD) is pain, and psychological factors are involved in the persistence of TMD-related pain. Therefore, this study was aimed to analyze the influence of psychological factors on the prognosis of TMD-related pain. Materials and methods The medical records of 486 patients with TMD-related pain were analyzed. Each patient's psychological profile was assessed using the Symptom Checklist-90-Revised (SCL-90-R). Patients were classified into two groups according to a post-treatment numeric rating scale (NRS). Patients with an NRS score of 0 or 1 at the last visit were classified into group G, and those with an NRS score of 2 or greater were classified into group P. Following this, all patients were re-classified into groups N and R according to pain recurrence. Statistical analysis was performed to evaluate differences in the SCL-90-R T scores between the groups. In addition, multiple logistic regression analysis was used to identify psychological factors that affected treatment outcome. Results The patients in groups P and R had higher scores in all subscales of the SCL-90-R than groups G and N, respectively. In particular, somatization (SOM) and psychoticism (PSY) scores showed significant differences between the groups in the treatment outcome. Conclusion A correlation is identified between psychological factors and treatment outcome in patients with TMD-related pain. In particular, patients with elevated SOM and PSY scores are more likely to develop refractory pain, and thus require additional interventions to control this risk.
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Affiliation(s)
- Won Jung
- Department of Oral Medicine, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, South Korea
| | - Kyung-Eun Lee
- Department of Oral Medicine, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, South Korea
| | - Bong-Jik Suh
- Department of Oral Medicine, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, South Korea
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50
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Ananthan S, Kanti V, Zagury JG, Quek SYP, Benoliel R. The effect of the twin block compared with trigger point injections in patients with masticatory myofascial pain: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:222-228. [PMID: 32009005 DOI: 10.1016/j.oooo.2019.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/29/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The twin block, a novel nerve block that blocks the deep temporal and masseteric branches of the trigeminal nerve, has been shown to be effective in the short-term management of masticatory myofascial pain. However, little is known about its effectiveness in long-term management. The objective of this study was to assess the efficacy of the twin block in comparison with trigger point injections for the treatment of masticatory myofascial pain. STUDY DESIGN Forty-eight patients age 18 to 89 years were randomly assigned to the twin block group (n = 23) or the trigger point injection group (n = 25). The final analysis was based on a total number of 40 patients. RESULTS Mean numerical pain intensity at baseline was 6.54 ± 1.90 for the trigger point injection group and 6.47 ± 2.23 for the twin block group. At the 6th month visit, it was 1.85 ± 1.85 for the trigger point injection group and 1.85 ± 1.94 for the twin block group. There were no statistically significant differences in pain intensity between the 2 groups at baseline (P = .64) and at the 6th month follow-up (P = .45). CONCLUSIONS The twin block is effective in the long-term management of masticatory myofascial pain compared with trigger point injections. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03870191.
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Affiliation(s)
- Sowmya Ananthan
- Assistant Professor, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, USA.
| | - Veena Kanti
- Predoctoral Student, University of Colorado School of Dental Medicine, Aurora, CO, USA
| | - Julyana Gomes Zagury
- Adjunct Faculty, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Samuel Y P Quek
- Professor, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Rafael Benoliel
- Professor and Associate Dean for Research, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, USA
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