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Son J, Kim ES, Lee YJ, Lee NW, Ha IH. Minimum clinically important difference and substantial clinical benefit in patients with chronic temporomandibular disorders. J Oral Rehabil 2024; 51:1468-1474. [PMID: 38706163 DOI: 10.1111/joor.13717] [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: 12/07/2023] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Research on temporomandibular disorder (TMD) responsiveness is scarce and limited regarding patients' representativeness. OBJECTIVE(S) This study aimed to estimate minimum clinically important difference (MCID) and substantial clinical benefit (SCB) among a large and diverse patient population regarding sex and age. METHODS In this study, 162 patients participated from five hospitals. MCID and SCB in pain, functional disability and quality of life were examined with anchor-based methods. Patients' global impression of change was used as the anchor. Area under the curve (AUC) values were determined for testing accuracy. Changes from baseline and coefficient of variation by responsiveness status were calculated to explain the results of accuracy. RESULTS SCB was estimated to be 2.18 for the numeric rating scale (NRS) for pain (AUC: 0.80 [95% CI: 0.72-0.88]) in all patients and 2.50 in women (AUC: 0.81 [95% CI: 0.71-0.89]). The estimated SCB of NRS for discomfort (1.50) and Jaw Functional Limitation Scale for mastication (1.35) had wide CIs for AUCs. Likewise, the estimated MCIDs of NRS for pain (0.80) and NRS for discomfort (1.50) had wide CIs for AUCs. Among non-responders who did not achieve the MCID of NRS for pain, the coefficient of variation was very high for all outcomes other than the NRS for pain. CONCLUSION This study investigated the responsiveness of patients with TMD using a large and diverse patient sample. SCB in pain decrease can be used to assess the responsiveness of patients with TMD. Composite outcomes should be developed to estimate MCID.
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Affiliation(s)
- Jaemin Son
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Eun-San Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Nam-Woo Lee
- Department of Korean Rehabilitation Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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Oliveira-Souza AISD, Sales LRDV, Coutinho ADDF, Armijo Olivo S, de Oliveira DA. Oral health quality of life is associated to jaw function and depression in patients with myogenous temporomandibular dysfunction. Cranio 2023; 41:518-528. [PMID: 33616020 DOI: 10.1080/08869634.2021.1885893] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine which factors influence and better differentiate between good and poor oral health-related quality of life (OHRQoL) in patients with myogenous TMD and which cut-off could predict a good/poor OHRQoL. METHODS Fifty-eight women with myogenous TMD were included. Factors of interest were collected (i.e., demographic variables, depression symptoms (Symptom Checklist-90 R (RDC/TMD)), pain intensity (Visual Analog Scale), jaw function (Mandibular Functional Limitation Questionnaire), and OHRQoL (Oral Health Impact Profile-14). A multivariable regression model, logistic regression, and receiver operating curve (ROC) analyses were conducted. RESULTS Depression symptoms (β = 0.139) and jaw function (β = 0.478) were significantly associated with OHRQoL in the multivariable model. The best model to discriminate between good/poor OHRQoL included only jaw function (AUC = 0.90), with the best cut-off of 17 points (sensitivity: 0.93; specificity: 0.79). CONCLUSION Depression symptoms and jaw function were significantly associated with OHRQoL. The best model and cut-off to discriminate good/poor OHRQoL included only jaw function.
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Affiliation(s)
| | | | | | - Susan Armijo Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences - Hochschule Osnabrück, Osnabrück, Germany. Faculty of Rehabilitation Medicine/Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Şahin D, Kaya Mutlu E, Şakar O, Ateş G, İnan Ş, Taşkıran H. The effect of the ischaemic compression technique on pain and functionality in temporomandibular disorders: A randomised clinical trial. J Oral Rehabil 2021; 48:531-541. [PMID: 33411952 DOI: 10.1111/joor.13145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Interventions addressing pain and impaired functionality in individuals with temporomandibular disorders (TMDs) are needed. OBJECTIVE To compare the effects of 4 weeks of exercise combined with ischaemic compression and exercise alone in patients with TMDs. METHODS Fifty patients who were diagnosed with TMDs were randomised into Group 1 (exercise combined with ischaemic compression technique) (n = 25) or Group 2 (exercise alone) (n = 25). Both groups performed 4 weeks of Rocabado's exercise and 3 weeks of postural exercise, while Group 1 received ischaemic compression to the masseter muscle for a total of 3 sessions in addition to exercise. A ruler was used to assess range of motion (ROM) (painless mouth opening (PMO), maximum mouth opening, maximum assisted mouth opening (MAMO), left lateral movement and right lateral movement), the visual analogue scale and graded chronic pain scale were used to assess pain, an algometer was used to determine the pain pressure threshold (PPT), and the 8-item jaw functional limitation scale was used to assess, functionality. The assessments were performed at baseline, at week 1 and at week 4. RESULTS The participants in Group 1 exhibited larger PMO (F = 5.26, P = .02) and MAMO values (F = 6.71, P = .01) than did the patients in Group 2 at week 1. The effect size was small for MAMO (ES = 0.27) and moderate for PMO (ES = 0.51). However, there were no significant differences in any other outcomes between groups at week 1 or 4. CONCLUSION In summary, this randomised controlled trial indicates that exercise combined with ICT and exercise alone have similar effects on ROM, pain, the PPT and functionality in patients with TMDs.
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Affiliation(s)
- Duygu Şahin
- Division of Physiotheraphy and Rehabilitation, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey
| | - Ebru Kaya Mutlu
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Olcay Şakar
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Gökçen Ateş
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Şebnem İnan
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Hanifegül Taşkıran
- Division of Physiotheraphy and Rehabilitation, Faculty of Health Sciences, Istanbul Aydin University, İstanbul, Turkey
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Dinsdale A, Liang Z, Thomas L, Treleaven J. Are jaw range of motion, muscle function and proprioception impaired in adults with persistent temporomandibular disorders? A systematic review and meta‐analysis. J Oral Rehabil 2020; 47:1448-1478. [DOI: 10.1111/joor.13090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/22/2020] [Accepted: 08/25/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Alana Dinsdale
- School of Health and Rehabilitation Sciences The University of Queensland St Lucia QLD Australia
| | - Zhiqi Liang
- School of Health and Rehabilitation Sciences The University of Queensland St Lucia QLD Australia
| | - Lucy Thomas
- School of Health and Rehabilitation Sciences The University of Queensland St Lucia QLD Australia
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences The University of Queensland St Lucia QLD Australia
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Herpich CM, Gomes CAFDP, Dibai-Filho AV, Politti F, Souza CDS, Biasotto-Gonzalez DA. Correlation Between Severity of Temporomandibular Disorder, Pain Intensity, and Pressure Pain Threshold. J Manipulative Physiol Ther 2018; 41:47-51. [DOI: 10.1016/j.jmpt.2017.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/10/2017] [Accepted: 08/23/2017] [Indexed: 11/15/2022]
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Tosato JDP, Caria PHF, Gomes CAFDP, Berzin F, Politti F, Gonzalez TDO, Biasotto-Gonzalez DA. Correlation of stress and muscle activity of patients with different degrees of temporomandibular disorder. J Phys Ther Sci 2015; 27:1227-31. [PMID: 25995595 PMCID: PMC4434016 DOI: 10.1589/jpts.27.1227] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/25/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Temporomandibular disorder is one of the many different adverse health
conditions that can be triggered by stress. Therefore, a biopsychosocial model has been
proposed to characterize the multifactorial nature of temporomandibular disorder. The aim
of the present study was investigate the correlation of salivary cortisol levels with the
activities of the masseter and anterior temporal muscles of patients with different
degrees of temporomandibular disorder. [Subjects and Methods] Forty-nine women between 18
and 40 years of age with a diagnosis of myogenous temporomandibular disorder based on the
Research Diagnostic Criteria for temporomandibular disorders were evaluated using the
Fonseca Index to determine the degree of the disorder. Salivary cortisol levels were
determined and surface electromyography was used to evaluate electrical activity in the
masticatory muscles. [Results] Positive correlations were found among the degree of
temporomandibular disorder, electromyographic activity and salivary cortisol: as women
with more severe temporomandibular disorder had greater electrical activity in the muscles
analyzed, especially the anterior temporal muscle, and higher levels of cortisol.
[Conclusion] Muscle activity was greater among individuals with severe temporomandibular
disorder and positive correlations were found among electromyographic activity, salivary
cortisol and the degree of temporomandibular disorder severity.
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Affiliation(s)
| | | | | | - Fausto Berzin
- Department of Morphology, Piracicaba Dental School, State University of Campinas, Brazil
| | - Fabiano Politti
- Department of Rehabilitation Sciences, University Nove de Julho, Brazil
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Gomes CAFDP, El Hage Y, Amaral AP, Politti F, Biasotto-Gonzalez DA. Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial. Chiropr Man Therap 2014; 22:43. [PMID: 25512839 PMCID: PMC4266206 DOI: 10.1186/s12998-014-0043-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 11/03/2014] [Indexed: 11/10/2022] Open
Abstract
Introduction Temporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in the perpetuation of TMD. The aim of the present study was to investigate the effects of massage therapy, conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism. Methods Sixty individuals with severe TMD and sleep bruxism were randomly distributed into four treatment groups: 1) massage group, 2) conventional occlusal splint group, 3) massage + conventional occlusal splint group and 4) silicone occlusal splint group. Block randomization was employed and sealed opaque envelopes were used to conceal the allocation. Groups 2, 3 and 4 wore an occlusal splint for four weeks. Groups 1 and 3 received three weekly massage sessions for four weeks. All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index. The Wilcoxon test was used to compare the effects of the different treatments and repeated-measures ANOVA was used to determine the intensity of TMD. Results The inter-group analysis of variance revealed no statistically significant differences in median frequency among the groups prior to treatment. In the intra-group analysis, no statistically significant differences were found between pre-treatment and post-treatment evaluations in any of the groups. Group 3 demonstrated a greater improvement in the intensity of TMD in comparison to the other groups. Conclusion Massage therapy and the use of an occlusal splint had no significant influence on electromyographic activity of the masseter or anterior temporal muscles. However, the combination of therapies led to a reduction in the intensity of signs and symptoms among individuals with severe TMD and sleep bruxism. Trial registration This study is registered in August, 2014 in the ClinicalTrials.gov (NCT01874041). Electronic supplementary material The online version of this article (doi:10.1186/s12998-014-0043-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cid André Fidelis de Paula Gomes
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil ; Department of Physical Therapy, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil
| | - Yasmin El Hage
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil ; Department of Physical Therapy, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil
| | - Ana Paula Amaral
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil
| | - Fabiano Politti
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil ; Department of Physical Therapy, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil
| | - Daniela Aparecida Biasotto-Gonzalez
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil ; Department of Physical Therapy, Universidade Nove de Julho (UNINOVE), Av. Dr. Adolfo Pinto,109, Água Branca, 05001-100 São Paulo, SP Brazil
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