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Montemurro N, Trilli I, Bordea IR, Ferrara E, Francesco MD, Caccamo F, Malcangi G, Rapone B. Are Whiplash-Associated Disorders and Temporomandibular Disorders in a Trauma Related Cause and Effect Relationship? A Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1482. [PMID: 37629772 PMCID: PMC10456620 DOI: 10.3390/medicina59081482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Background: Whiplash is associated with a wide variety of clinical manifestations, including headache, neck pain, cervical rigidity, shoulder and back pain, paresthesia, vertigo, and temporomandibular disorders (TMDs). Previous studies reported that TMDs are more common in individuals with chronic whiplash-associated disorders (WAD) than in the general population; however, the pathophysiology and mechanism of this relationship are still not well understood. Methods: A PubMed and Ovid EMBASE review was performed to identify all studies addressing the trauma related cause and effect relationship between WAD and TMDs from January 2003 to March 2023. Results: After screening for eligibility and inclusion criteria, a total of 16 articles met the selection criteria. The various included studies discussed different aspects of the association between WDA and TMDs, including changes in the coordination and amplitude of jaw opening, the severity of the associated symptoms/signs in cases of WAD, the degree of fatigue and psychological stress, difficulty in feeding, cervical and myofascial pain, changes in the MRI signal at various muscle points, muscle tenderness, and quality of life. Conclusions: In this review, we summarized the clinical evidence of any trauma related cause and effect relationship between whiplash and TMDs. An accurate screening of the previous literature showed that, in conclusion, the relationship between whiplash and TMDs is still unclear.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy;
| | - Irma Trilli
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, 400012 Cluj-Napoca, Romania
| | - Elisabetta Ferrara
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio, 66100 Chieti, Italy;
| | - Maurizio De Francesco
- Department of Neurosciences, Institute of Clinical Dentistry, University of Padua, 35128 Padua, Italy;
| | | | - Giuseppina Malcangi
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Biagio Rapone
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
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Alghadir AH, Zafar H, Ahmed Iqbal Z, Anwer S, Iqbal A. Effect of static and dynamic jaw positions on postural stability among people with blindness. Brain Behav 2022; 12:e2645. [PMID: 35916391 PMCID: PMC9480900 DOI: 10.1002/brb3.2645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/10/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND In comparison with the people with normal sight, the mean center of gravity (COG) velocity is significantly higher among blind people. A strong relationship has been shown between jaw and neck sensorimotor and postural control. The purpose of this study was to determine the effect of different static and dynamic jaw positions on postural stability among subjects with blindness. METHODS Postural stability was measured as COG velocity in 39 blind subjects under the following five conditions: resting jaw (natural jaw position with no instructions, control), open jaw (teeth of both jaws slightly apart), clenched jaw (teeth tightly closed across each other), chewing (a standard bolus of gum at the natural palace), and tongue position (positioned behind the upper incisors) while standing on firm and foam surfaces. RESULTS The mean COG velocity while standing on the firm surface during resting, open jaw position, clenched jaw position, chewing, and tongue positions were 0.54, 0.50, 0.44, 0.59, and 0.46 deg/s, respectively. The mean COG velocity while standing on the foam surface during resting, open jaw position, clenched jaw position, chewing, and tongue positions were 1.42, 1.23, 1.10, 1.14, and 1.06 deg/s, respectively. Compared to the firm surface, the COG velocity was significantly higher on the foam surface in all five conditions (p < .001). In the comparison between the conditions, there were no significant differences in either the firm or foam surface in all five conditions (p > .05). CONCLUSION People with blindness behave in the same way as sighted subjects on firm and foam surfaces. However, changes in static and dynamic jaw positions do not affect postural stability among them.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Hamayun Zafar
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zaheen Ahmed Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Shahnawaz Anwer
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Ginszt M, Szkutnik J, Zieliński G, Bakalczuk M, Stodółkiewicz M, Litko-Rola M, Ginszt A, Rahnama M, Majcher P. Cervical Myofascial Pain Is Associated with an Imbalance of Masticatory Muscle Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031577. [PMID: 35162600 PMCID: PMC8834744 DOI: 10.3390/ijerph19031577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to assess the relationship between the occurrence of cervical myofascial pain with active myofascial trigger points (MTrPs) within the upper trapezius muscle and the electromyographic asymmetry index (AsI) of masticatory muscles: temporalis anterior (TA), superficial part of the masseter muscle (MM), and anterior belly of the digastric muscle (DA). The study group comprised 100 subjects (80 women and 20 men) aged 18 to 30 years (mean 23 ± 2.6 years) reporting pain in the neck muscles, diagnosed with myofascial pain with active MTrPs only within the upper trapezius muscle. The control group comprised 60 healthy, pain-free subjects (42 women and 18 men) aged 20 to 30 years (mean 22.8 ± 2.6 years) without MTrPs in the upper trapezius muscle. The palpation measurement, based on the diagnostic criteria of Travell and Simons, was used to diagnose active MTrPs. The masticatory muscle activity was recorded using an 8-channel device for surface electromyography—BioEMG IIITM. Significant differences in electromyographic patterns between the group with MTrPs in the right side of upper trapezius muscle and the control group were observed within resting activity for the AsI TA (MTrPs: 8.64 vs. controls: −3.22; p = 0.001) and AsI MM (MTrPs: 7.05 vs. controls: −2.09; p = 0.018). Controls presented different electromyographic patterns during maximum voluntary clenching with cotton rolls between teeth within masseter muscle compared to the MTrPs group (MTrPs: 9.27 vs. controls: −0.43 vs. p = 0.041). Participants with MTrPs in the left side of upper trapezius muscle presented predomination of left-sided electromyographic patterns at rest within temporalis anterior in comparison to controls (MTrPs: −19.22 vs. controls: −3.22; p = 0.001). MTrPs within the trapezius muscle may be related to asymmetry within the masticatory muscle activity, suggesting that the presence of myofascial pain within the cervical muscles plays a role in the imbalance of the stomatognathic system. A unilateral active MTrPs within the trapezius muscle may increase the sEMG activity on the same side of the temporalis anterior and masseter muscles.
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Affiliation(s)
- Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (A.G.); (P.M.)
- Correspondence:
| | - Jacek Szkutnik
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Magdalena Bakalczuk
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Małgorzata Stodółkiewicz
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Monika Litko-Rola
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Apolinary Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (A.G.); (P.M.)
| | - Mansur Rahnama
- Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Piotr Majcher
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (A.G.); (P.M.)
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Österlund C, Nilsson E, Hellström F, Häger CK, Häggman-Henrikson B. Jaw-neck movement integration in 6-year-old children differs from that of adults. J Oral Rehabil 2019; 47:27-35. [PMID: 31357241 DOI: 10.1111/joor.12865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 07/03/2019] [Accepted: 07/18/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children. OBJECTIVES To determine the movement integration between the jaw and neck during jaw motor tasks in 6-year-olds, whether there is a difference between children and adults. METHODS Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6-year-olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening-closing and self-paced gum chewing. Jaw and neck movement amplitudes, intra-individual variation in movement amplitude, ratio between neck-jaw movement amplitudes and movement cycle time were analysed. Differences between children and adults were evaluated with Mann-Whitney U test for independent samples. RESULTS Compared to adults, 6-year-old children showed larger neck movement amplitudes (P = .008) during chewing, higher intra-individual variability in amplitudes of jaw (P = .008) and neck (P = .001) movements, higher ratio between neck-jaw movement amplitudes for jaw opening-closing (P = .026) and chewing (P = .003), and longer jaw movement cycle time (P ≤ .0001) during the jaw opening-closing task. CONCLUSION Despite integrated jaw-neck movements in 6-year-old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw-neck motor behaviour. The well-integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well-controlled longitudinal studies to map this development in order to provide appropriate age-related clinical treatment for functional disorders.
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Affiliation(s)
- Catharina Österlund
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Evelina Nilsson
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Fredrik Hellström
- Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Birgitta Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden
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Eriksson PO, Zafar H, Backén M. Instant reduction in postural sway during quiet standing by intraoral dental appliance in patients with Whiplash associated Disorders and non-trauma neck pain. Arch Oral Biol 2018; 97:109-115. [PMID: 30384151 DOI: 10.1016/j.archoralbio.2018.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study tested the hypothesis that modulation of jaw sensorimotor control by intraoral dental appliance can reduce postural sway during quiet standing and hence improve standing balance, in patients with whiplash associated disorders (WAD) and non-trauma neck pain. DESIGN Postural sway during quiet standing with feet together was examined in 54 WAD patients (40 females) and 10 non-trauma patients (8 females) using wireless 3D movement recording technique. Recordings were performed alternating without and with intraoral dental appliance, and with closed eyes and open eyes, respectively. In this protocol the participants served as their own controls. A reference group of 30 healthy subjects (17 females) was also recorded. Each recording lasted 120 s, followed by 3-5 min of rest. Speed, acceleration and perimeter of postural sway area were documented. RESULTS In the patients, but not in the healthy group, the intraoral dental appliance instantly and significantly reduced standing postural sway in recordings with closed and open eyes. CONCLUSIONS The prompt reduction in standing postural sway from intervention by intraoral dental appliance i.e. improved standing balance, suggests a potent effect on the postural control system by modulation of the jaw sensorimotor system, probably involving reflex transmission. The result opens for new insight into mechanisms behind postural control and the pathophysiology of balance disorders, and adds to the knowledge on plasticity of the nervous system. It may help developing new procedures for assessment and management of impaired balance in WAD and non-trauma neck pain patients.
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Affiliation(s)
- Per-Olof Eriksson
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Hamayun Zafar
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; Rehabilitation Research Chair, King Saud University, Riyadh, Saudi Arabia.
| | - Mattias Backén
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Informatics, County Council of Västerbotten, Umeå, Sweden
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Lee YH, Lee KM, Auh QS, Hong JP. Magnetic Resonance Imaging-Based Prediction of the Relationship between Whiplash Injury and Temporomandibular Disorders. Front Neurol 2018; 8:725. [PMID: 29375466 PMCID: PMC5767220 DOI: 10.3389/fneur.2017.00725] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 12/14/2017] [Indexed: 01/03/2023] Open
Abstract
Purpose Whiplash injury can cause internal derangement of the temporomandibular joint (TMJ) and lead to temporomandibular disorders (TMDs). Our aim was to evaluate whether the initial clinical findings in TMD patients with whiplash injury are correlated with their magnetic resonance imaging (MRI) characteristics. Materials and methods This case–control study involved 219 patients (135 women, 84 men; mean age: 37.84 years) who visited our orofacial pain clinic with TMD; TMD was diagnosed using the diagnostic criteria for TMD Axis I. Patients were categorized into three groups based on the presence and type of macrotrauma: in the “wTMD” group, patients had suffered whiplash injury; patients in the “pTMD” group had post-traumatic TMD; the “iTMD” group comprised patients who had presented with TMD symptoms and had sustained no macrotrauma. We investigated the presence of disk displacement, effusion, disk deformity, and condylar degeneration, and changes in the lateral pterygoid muscle (LPM). To evaluate the severity of TMD pain and objectively analyze symptoms, we used a visual analog scale (VAS), palpation index (PI), neck PI, dysfunction index, and craniomandibular index (CMI). Results The VAS scores, and the severity indexes of the TMD including PI, neck PI, and CMI were highest in the wTMD patients. Atrophy of the LPM was most commonly seen in the wTMD group, as was disk deformity. In wTMD patients only, VAS score was significantly correlated with stress; it was correlated with headache in wTMD and iTMD patients. The clinical symptoms of TMD were not correlated with MRI findings in the wTMD group. However, alterations in the LPM were strongly correlated with disk displacement. Conclusion If clinicians recognize alterations in the LPM and disk displacement in the TMJ, they will better understand the clinical symptoms and pathophysiology of TMD with whiplash injury. Whiplash injury may lead to TMD via different mechanisms from other macrotraumas.
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Affiliation(s)
- Yeon-Hee Lee
- Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Seoul, South Korea
| | - Kyung Mi Lee
- Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Q-Schick Auh
- Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Seoul, South Korea
| | - Jyung-Pyo Hong
- Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Seoul, South Korea
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Häggman-Henrikson B, Nordh E, Zafar H, Eriksson PO. Head Immobilization can Impair Jaw Function. J Dent Res 2016; 85:1001-5. [PMID: 17062739 DOI: 10.1177/154405910608501105] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Findings that jaw-opening/-closing relies on both mandibular and head movements suggest that jaw and neck muscles are jointly activated in jaw function. This study tested the hypothesis that rhythmic jaw activities involve an active repositioning of the head, and that head fixation can impair jaw function. Concomitant mandibular and head-neck movements were recorded during rhythmic jaw activities in 12 healthy adults, with and without fixation of the head. In four participants, the movement recording was combined with simultaneous registration of myoelectric activity in jaw and neck muscles. The results showed neck muscle activity during jaw opening with and without head fixation. Notably, head fixation led to reduced mandibular movements and shorter duration of jaw-opening/-closing cycles. The findings suggest recruitment of neck muscles in jaw activities, and that head fixation can impair jaw function. The results underline the jaw and neck neuromuscular relationship in jaw function.
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Affiliation(s)
- B Häggman-Henrikson
- Department of Odontology, Clinical Oral Physiology, Umeå University, S-901 87, Umeå, Sweden
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Leung MY, Lo J, Leung YY. Accuracy of Different Modalities to Record Natural Head Position in 3 Dimensions: A Systematic Review. J Oral Maxillofac Surg 2016; 74:2261-2284. [PMID: 27235181 DOI: 10.1016/j.joms.2016.04.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/18/2016] [Accepted: 04/18/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Three-dimensional (3D) images are taken with positioning devices to ensure a patient's stability, which, however, place the patient's head into a random orientation. Reorientation of images to the natural head position (NHP) is necessary for appropriate assessment of dentofacial deformities before any surgical planning. The aim of this study was to review the literature systematically to identify and evaluate the various modalities available to record the NHP in 3 dimensions and to compare their accuracy. MATERIALS AND METHODS A systematic literature search of the PubMed, Cochrane Library and Embase databases, with no limitations on publication time or language, was performed in July 2015. The search and evaluations of articles were performed in 4 rounds. The methodologies, accuracies, advantages, and limitations of various modalities to record NHP were examined. RESULTS Eight articles were included in the final review. Six modalities to record NHP were identified, namely 1) stereophotogrammetry, 2) facial markings along laser lines, 3) clinical photographs and the pose from orthography and scaling with iterations (POSIT) algorithm, 4) digital orientation sensing, 5) handheld 3D camera measuring system, and 6) laser scanning. Digital orientation sensing had good accuracy, with mean angular differences from the reference within 1° (0.07 ± 0.49° and 0.12 ± 0.54°, respectively). Laser scanning was shown to be comparable to digital orientation sensing. The method involving clinical photographs and the POSIT algorithm was reported to have good accuracy, with mean angular differences for pitch, roll, and yaw within 1° (-0.17 ± 0.50°). Stereophotogrammetry was reported to have the highest reliability, with mean angular deviations in pitch, roll, and yaw for active and passive stereophotogrammetric devices within 0.1° (0.004771 ± 0.045645° and 0.007572 ± 0.079088°, respectively). CONCLUSIONS This systematic review showed that recording the NHP in 3 dimensions with a digital orientation sensor has good accuracy. Laser scanning was found to have comparable accuracy to digital orientation sensing, but routine clinical use was limited by its high cost and low portability. Stereophotogrammetry and the method using a single clinical photograph and the POSIT algorithm were potential alternatives. Nevertheless, clinical trials are needed to verify their applications in patients. Preferably, digital orientation sensor should be used as a reference for comparison with new proposed methods of recording the NHP in future research.
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Affiliation(s)
- Ming Yin Leung
- Resident, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - John Lo
- Honorary Associate Professor, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Yiu Yan Leung
- Clinical Assistant Professor, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Chronic Neck Pain and Cervico-Craniofacial Pain Patients Express Similar Levels of Neck Pain-Related Disability, Pain Catastrophizing, and Cervical Range of Motion. PAIN RESEARCH AND TREATMENT 2016; 2016:7296032. [PMID: 27119020 PMCID: PMC4828545 DOI: 10.1155/2016/7296032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/01/2016] [Accepted: 03/15/2016] [Indexed: 11/29/2022]
Abstract
Background. Neck pain (NP) is strongly associated with cervico-craniofacial pain (CCFP). The primary aim of the present study was to compare the neck pain-related disability, pain catastrophizing, and cervical and mandibular ROM between patients with chronic mechanical NP and patients with CCFP, as well as asymptomatic subjects. Methods. A total of 64 participants formed three groups. All participants underwent a clinical examination evaluating the cervical range of motion and maximum mouth opening, neck disability index (NDI), and psychological factor of Pain Catastrophizing Scale (PCS). Results. There were no statistically significant differences between patients with NP and CCFP for NDI and PCS (P > 0.05). One- way ANOVA revealed significant differences for all ROM measurements. The post hoc analysis showed no statistically significant differences in cervical extension and rotation between the two patient groups (P > 0.05). The Pearson correlation analysis shows a moderate positive association between NDI and the PCS for the group of patients with NP and CCFP. Conclusion. The CCFP and NP patient groups have similar neck disability levels and limitation in cervical ROM in extension and rotation. Both groups had positively correlated the NDI with the PCS.
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10
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Alghadir AH, Zafar H, Iqbal ZA. Effect of tongue position on postural stability during quiet standing in healthy young males. Somatosens Mot Res 2015; 32:183-6. [DOI: 10.3109/08990220.2015.1043120] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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La Touche R, Paris-Alemany A, Gil-Martínez A, Pardo-Montero J, Angulo-Díaz-Parreño S, Fernández-Carnero J. Masticatory sensory-motor changes after an experimental chewing test influenced by pain catastrophizing and neck-pain-related disability in patients with headache attributed to temporomandibular disorders. J Headache Pain 2015; 16:20. [PMID: 25902781 PMCID: PMC4385233 DOI: 10.1186/s10194-015-0500-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/04/2015] [Indexed: 01/03/2023] Open
Abstract
Background Recent research has shown a relationship of craniomandibular disability with neck-pain-related disability has been shown. However, there is still insufficient information demonstrating the influence of neck pain and disability in the sensory-motor activity in patients with headache attributed to temporomandibular disorders (TMD). The purpose of this study was to investigate the influence of neck-pain-related disability on masticatory sensory-motor variables. Methods An experimental case–control study investigated 83 patients with headache attributed to TMD and 39 healthy controls. Patients were grouped according to their scores on the neck disability index (NDI) (mild and moderate neck disability). Initial assessment included the pain catastrophizing scale and the Headache Impact Test-6. The protocol consisted of baseline measurements of pressure pain thresholds (PPT) and pain-free maximum mouth opening (MMO). Individuals were asked to perform the provocation chewing test, and measurements were taken immediately after and 24 hours later. During the test, patients were assessed for subjective feelings of fatigue (VAFS) and pain intensity. Results VAFS was higher at 6 minutes (mean 51.7; 95% CI: 50.15-53.26) and 24 hours after (21.08; 95% CI: 18.6-23.5) for the group showing moderate neck disability compared with the mild neck disability group (6 minutes, 44.16; 95% CI 42.65-45.67/ 24 hours after, 14.3; 95% CI: 11.9-16.7) and the control group. The analysis shows a decrease in the pain-free MMO only in the group of moderate disability 24 hours after the test. PPTs of the trigeminal region decreased immediately in all groups, whereas at 24 hours, a decrease was observed in only the groups of patients. PPTs of the cervical region decreased in only the group with moderate neck disability 24 hours after the test. The strongest negative correlation was found between pain-free MMO immediately after the test and NDI in both the mild (r = −0.49) and moderate (r = −0.54) neck disability groups. VAFS was predicted by catastrophizing, explaining 17% of the variance in the moderate neck disability group and 12% in the mild neck disability group. Conclusion Neck-pain-related disability and pain catastrophizing have an influence on the sensory-motor variables evaluated in patients with headache attributed to TMD.
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Affiliation(s)
- Roy La Touche
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Alba Paris-Alemany
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Alfonso Gil-Martínez
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Joaquín Pardo-Montero
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Faculty of Medicine, Universidad San Pablo CEU, Madrid, Spain.
| | - Josué Fernández-Carnero
- Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain. .,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
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12
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Alghadir A, Zafar H, Whitney SL, Iqbal Z. Effect of chewing on postural stability during quiet standing in healthy young males. Somatosens Mot Res 2014; 32:72-6. [DOI: 10.3109/08990220.2014.969837] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Häggman-Henrikson B, Rezvani M, List T. Prevalence of whiplash trauma in TMD patients: a systematic review. J Oral Rehabil 2013; 41:59-68. [DOI: 10.1111/joor.12123] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- B. Häggman-Henrikson
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
| | - M. Rezvani
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
| | - T. List
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
- Department of Rehabilitation Medicine; Skåne University Hospital; Lund Sweden
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14
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Häggman-Henrikson B, Lampa E, Nordh E. Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders. Int J Oral Sci 2013; 5:150-4. [PMID: 23867844 PMCID: PMC3967328 DOI: 10.1038/ijos.2013.42] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 06/08/2013] [Indexed: 11/09/2022] Open
Abstract
There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders (WADs) with both a qualitative method and quantitative sensory testing (QST). Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women. Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits. Seven test sites in the facial skin (overlying each trigeminal branch bilaterally, and the midpoint of the chin) were examined. The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds. For the WAD patients, the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy, whereas QST systematically showed significantly higher detection thresholds (i.e., decreased sensitivity) for both cold and warm stimuli. For the individuals who were assessed as having increased sensitivity in the qualitative assessment, the QST displayed either normal or higher thresholds, i.e., decreased sensitivity. The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method. The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.
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15
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Häggman-Henrikson B, Nordh E, Eriksson PO. Increased sternocleidomastoid, but not trapezius, muscle activity in response to increased chewing load. Eur J Oral Sci 2013; 121:443-9. [DOI: 10.1111/eos.12066] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Erik Nordh
- Department of Clinical Neurosciences; Clinical Neurophysiology; Umeå University; Umeå; Sweden
| | - Per-Olof Eriksson
- Department of Odontology; Clinical Oral Physiology; Umeå University; Umeå; Sweden
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16
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Davis CG. Mechanisms of chronic pain from whiplash injury. J Forensic Leg Med 2012; 20:74-85. [PMID: 23357391 DOI: 10.1016/j.jflm.2012.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 05/03/2012] [Accepted: 05/30/2012] [Indexed: 10/28/2022]
Abstract
This article is to provide insights into the mechanisms underlying chronic pain from whiplash injury. Studies show that injury produces plasticity changes of different neuronal structures that are responsible for amplification of nociception and exaggerated pain responses. There is consistent evidence for hypersensitivity of the central nervous system to sensory stimulation in chronic pain after whiplash injury. Tissue damage, detected or not by the available diagnostic methods, is probably the main determinant of central hypersensitivity. Different mechanisms underlie and co-exist in the chronic whiplash condition. Spinal cord hyperexcitability in patients with chronic pain after whiplash injury can cause exaggerated pain following low intensity nociceptive or innocuous peripheral stimulation. Spinal hypersensitivity may explain pain in the absence of detectable tissue damage. Whiplash is a heterogeneous condition with some individuals showing features suggestive of neuropathic pain. A predominantly neuropathic pain component is related to a higher pain/disability level.
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17
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Santamato A, Panza F, Di Venere D, Solfrizzi V, Frisardi V, Ranieri M, Fiore P. Effectiveness of botulinum toxin type A treatment of neck pain related to nocturnal bruxism: a case report. J Chiropr Med 2011; 9:132-7. [PMID: 22027036 DOI: 10.1016/j.jcm.2010.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 03/18/2010] [Accepted: 04/28/2010] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This case report describes a patient with nocturnal bruxism and related neck pain treated with botulinum toxin type A (BTX-A). CLINICAL FEATURES The patient was a 27-year-old man with nocturnal bruxism and difficulty in active mouth opening and chewing and neck pain at rest. His numeric pain score was 7 of 10. Surface electromyography of the temporalis and masseter muscles showed typical signs of hyperactivity, characterized by compound muscle action potential amplitude alterations. INTERVENTION AND OUTCOME After clinical evaluation, he was treated with BTX-A to reduce masseter and temporalis muscle hyperactivity. After 3 days of treatment with BTX-A, with each masseter muscle injected with a dose of about 40 mouse units with a dilution of 1 mL and with temporal muscle bilaterally injected with 25 mouse units with the same dilution, a decrease in bruxism symptoms was reported. Neck pain also decreased after the first treatment (visual analog scale of 2/10) and then resolved completely. After 4 weeks, electromyography showed the reduction of muscle hyperactivity with a decrease in the amplitude of the motor action potential. The same reduction in signs and symptoms was still present at assessment 3 months posttreatment. CONCLUSION These findings suggest that BTX-A may be a therapeutic option for the treatment of bruxism and related disorders.
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Affiliation(s)
- Andrea Santamato
- Assistant Professor, Department of Physical Medicine and Rehabilitation-"OORR," University of Foggia, Foggia, Italy
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18
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Benoliel R, Svensson P, Heir GM, Sirois D, Zakrzewska J, Oke-Nwosu J, Torres SR, Greenberg MS, Klasser GD, Katz J, Eliav E. Persistent orofacial muscle pain. Oral Dis 2011; 17 Suppl 1:23-41. [PMID: 21382137 DOI: 10.1111/j.1601-0825.2011.01790.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The pathophysiology of persistent orofacial myalgia has been the centre of much controversy. In this article we suggest a novel descriptive term; 'persistent orofacial muscle pain' (POMP) and review current evidence that supports the hypothesis that the induction of POMP involves the interplay between a peripheral nociceptive source in muscle, a faulty central nervous system component and decreased coping ability. In this context it is widely accepted that a complex interaction of variable intrinsic and extrinsic factors act to induce POMP and dysfunction.
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Affiliation(s)
- R Benoliel
- Department of Oral Medicine, The Faculty of Dentistry, Hebrew University-Hadassah, Jerusalem, Israel.
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19
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SFORZA C, ROSATI R, De MENEZES M, MUSTO F, TOMA M. EMG analysis of trapezius and masticatory muscles: experimental protocol and data reproducibility. J Oral Rehabil 2011; 38:648-54. [DOI: 10.1111/j.1365-2842.2011.02208.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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20
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Kalezic N, Noborisaka Y, Nakata M, Crenshaw AG, Karlsson S, Lyskov E, Eriksson PO. Cardiovascular and muscle activity during chewing in whiplash-associated disorders (WAD). Arch Oral Biol 2010; 55:447-53. [DOI: 10.1016/j.archoralbio.2010.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 03/17/2010] [Accepted: 03/18/2010] [Indexed: 11/15/2022]
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21
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Severinsson Y, Bunketorp O, Wenneberg B. Jaw symptoms and signs and the connection to cranial cervical symptoms and post-traumatic stress during the first year after a whiplash trauma. Disabil Rehabil 2010; 32:1987-98. [DOI: 10.3109/09638281003797323] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Ries LGK, Bérzin F. Analysis of the postural stability in individuals with or without signs and symptoms of temporomandibular disorder. Braz Oral Res 2009; 22:378-83. [PMID: 19148396 DOI: 10.1590/s1806-83242008000400016] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Accepted: 09/06/2007] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate the stability and the distribution of weight of individuals with TMD (Temporomandibular Disorder) when placed in an orthostatic position. Forty female volunteers, participating in this study, were distributed into a control and a TMD group. Clinical examinations of the craniomandibular system and of the neck were performed. Postural stability was evaluated using a stabilographic platform. Through this system, the sway index (SI), the maximum medial-lateral distance (MMLD), the maximum anterior-posterior distance (MAPD) and the medial-lateral symmetry (MLS) could be determined. Tests were performed in the mandibular rest position and during isometric and isotonic contraction. The variables were analyzed through repeated measures ANOVA. The level of significance was p < 0.05. The results of this study indicate that individuals with TMD present more pain in the cervical region (p < 0.05). The group with TMD showed a significant reduction in SI (p < 0.05), MMLD (p < 0.05) and MLS (p < 0.01). Individuals with TMD presented greater postural asymmetry, and cervical pain demonstrated a potential link with an increase in postural stability.
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Affiliation(s)
- Lilian Gerdi Kittel Ries
- Department of Prevention, Assessment and Rehabilitation, Santa Catarina State Development University, Florianópolis, Brazil.
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23
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Ramirez L, Ballesteros L, Sandoval G. Topical review: Temporomandibular disorders in an integral otic symptom model. Int J Audiol 2009; 47:215-27. [DOI: 10.1080/14992020701843137] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Ramirez L, Ballesteros L, Sandoval G. Topical review: Temporomandibular disorders in an integral otic symptom model. Int J Audiol 2009. [DOI: https://doi.org/10.1080/14992020701843137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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25
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Desmons S, Graux F, Atassi M, Libersa P, Dupas PH. The lateral pterygoid muscle, a heterogeneous unit implicated in temporomandibular disorder: a literature review. Cranio 2007; 25:283-91. [PMID: 17983128 DOI: 10.1179/crn.2007.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Based on its anatomical relationships, the lateral pterygoid muscle is strongly linked with the temporomandibular joint (TMJ). It plays a major role in mastication. Embryological, histological, and anatomical knowledge define the lateral pterygoid muscle as a single muscle with a penniform structure. The various results of electromyographic (EMG) studies describe a complex physiology with a chronological contraction of the layers during the masticatory cycle. The sequential contraction of the layers of the lateral pterygoid muscle is the result of a selective neuronal activation induced by the masticatory Central Pattern Generator (mCPG). This neurophysiological theory highlights the essential role of the reticular formation in oral motor control. The sensitivity of those neurological structures to chronic emotional stress is one of the possible explanations for the appearance of oral parafunctions accompanied by a modification of pain perception and a disorganized muscular activation, determining factors in temporomandibular disorders.
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26
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Eriksson PO, Häggman-Henrikson B, Zafar H. Jaw–neck dysfunction in whiplash-associated disorders. Arch Oral Biol 2007; 52:404-8. [PMID: 17274944 DOI: 10.1016/j.archoralbio.2006.12.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2006] [Revised: 12/20/2006] [Accepted: 12/21/2006] [Indexed: 11/26/2022]
Abstract
This paper reports data from recent studies on integrative jaw-neck motor control in healthy subjects and disturbed jaw-neck behaviour in whiplash-associated disorders (WAD). The results show that neck function is an integral part of natural jaw behaviour, and that neck injury can impair jaw function and therefore disturb eating behaviour. We also show preliminary results from implementation of a new approach for rehabilitation of jaw-neck dysfunction and pain in WAD.
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Affiliation(s)
- Per-Olof Eriksson
- Muscle & Motor Control and MotoRehab Laboratory, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
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27
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Ferrario VF, Tartaglia GM, Luraghi FE, Sforza C. The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders. MANUAL THERAPY 2006; 12:372-9. [PMID: 16973402 DOI: 10.1016/j.math.2006.07.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2005] [Revised: 03/06/2006] [Accepted: 07/03/2006] [Indexed: 02/02/2023]
Abstract
The aim of this study was to assess the electromyographic characteristics of the masticatory muscles (masseter and temporalis) of patients with either "temporomandibular joint disorder" or "neck pain". Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 38 patients aged 21-67 years who had either (a) temporomandibular joint disorder (24 patients); (b) "neck pain" (13 patients). Ninety-five control, healthy subjects were also examined. During clenching, standardized total muscle activities (electromyographic potentials over time) were significantly different in the three groups: 75 microV/microVs% in the temporomandibular joint disorder patients, 124 microV/microVs% in the neck pain patients, and 95 microV/microVs% in the control subjects (analysis of variance, P<0.001). The temporomandibular joint disorder patients also had significantly (P<0.001) more asymmetric muscle potentials (78%) than either neck pain patients (87%) or control subjects (92%). A linear discriminant function analysis allowed a significant separation between the two patient groups, with a single patient error of 18.2%. Surface electromyographic analysis during clenching allowed to differentiate between patients with a temporomandibular joint disorder and patients with a neck pain problem.
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Affiliation(s)
- Virgilio F Ferrario
- Dipartimento di Morfologia Umana, Via Mangiagalli 31, I-20133 Milano, Italy.
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28
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Lobbezoo F, van Selms MKA, Naeije M. Masticatory muscle pain and disordered jaw motor behaviour: Literature review over the past decade. Arch Oral Biol 2006; 51:713-20. [PMID: 16674911 DOI: 10.1016/j.archoralbio.2006.03.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2005] [Revised: 03/17/2006] [Accepted: 03/23/2006] [Indexed: 11/28/2022]
Abstract
The clinically important relationship between masticatory muscle pain (MMP) and disordered jaw motor behaviour is subject of this concise, evidence-based review of the literature that was published during the past 10 years. Mainly based on studies that used some sort of experimental MMP (e.g., the intramuscular injection of noxious substances like hypertonic saline), it was concluded that MMP has pronounced effects on jaw motor functions like maximal clenching and mastication. The pain-related modulation of oral reflexes further illustrated the effects of MMP on masticatory motor control. Protecting the painful muscle tissues against further damage and allowing for time to heal the damaged tissues by immobilization of the masticatory system seem to be the key outcomes of these effects. Further, MMP was shown to influence the cervical motor system, which may partly explain the mechanism behind the frequently observed co-occurrence of pain in the neck and the jaw. Finally, it was concluded that, even though the evidence is not yet conclusive, also remote pain (non-MMP) can modulate jaw motor behaviour, which indicates the involvement of central mechanisms in this modulation.
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Affiliation(s)
- Frank Lobbezoo
- Department of Oral Function, Section of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands.
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29
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Hellström F, Roatta S, Thunberg J, Passatore M, Djupsjöbacka M. Responses of muscle spindles in feline dorsal neck muscles to electrical stimulation of the cervical sympathetic nerve. Exp Brain Res 2005; 165:328-42. [PMID: 15883803 DOI: 10.1007/s00221-005-2309-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2005] [Accepted: 02/08/2005] [Indexed: 10/25/2022]
Abstract
Previous studies performed in jaw muscles of rabbits and rats have demonstrated that sympathetic outflow may affect the activity of muscle spindle afferents (MSAs). The resulting impairment of MSA information has been suggested to be involved in the genesis and spread of chronic muscle pain. The present study was designed to investigate sympathetic influences on muscle spindles in feline trapezius and splenius muscles (TrSp), as these muscles are commonly affected by chronic pain in humans. Experiments were carried out in cats anesthetized with alpha-chloralose. The effect of electrical stimulation (10 Hz for 90 s or 3 Hz for 5 min) of the peripheral stump of the cervical sympathetic nerve (CSN) was investigated on the discharge of TrSp MSAs (units classified as Ia-like and II-like) and on their responses to sinusoidal stretching of these muscles. In some of the experiments, the local microcirculation of the muscles was monitored by laser Doppler flowmetry. In total, 46 MSAs were recorded. Stimulation of the CSN at 10 Hz powerfully depressed the mean discharge rate of the majority of the tested MSAs (73%) and also affected the sensitivity of MSAs to sinusoidal changes of muscle length, which were evaluated in terms of amplitude and phase of the sinusoidal fitting of unitary activity. The amplitude was significantly reduced in Ia-like units and variably affected in II-like units, while in general the phase was affected little and not changed significantly in either group. The discharge of a smaller percentage of tested units was also modulated by 3-Hz CSN stimulation. Blockade of the neuromuscular junctions by pancuronium did not induce any changes in MSA responses to CSN stimulation, showing that these responses were not secondary to changes in extrafusal or fusimotor activity. Further data showed that the sympathetically induced modulation of MSA discharge was not secondary to the concomitant reduction of muscle blood flow induced by the stimulation. Hence, changes in sympathetic outflow can modulate the afferent signals from muscle spindles through an action exerted directly on the spindles, independent of changes in blood flow. It is suggested that such an action may be one of the mechanisms mediating the onset of chronic muscle pain in these muscles in humans.
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Affiliation(s)
- F Hellström
- Centre for Musculoskeletal Research, Gävle University, Umeå, Sweden
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30
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Ferrario VF, Sforza C, Lovecchio N, Mian F. Quantification of translational and gliding components in human temporomandibular joint during mouth opening. Arch Oral Biol 2005; 50:507-15. [PMID: 15777532 DOI: 10.1016/j.archoralbio.2004.10.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2004] [Accepted: 10/06/2004] [Indexed: 12/01/2022]
Abstract
OBJECTIVE In humans, the opening movement of the mouth requires a complex combination of rotation in the lower temporomandibular joint compartment and of translation in the upper compartment. The aim of the current study was to quantitatively assess the percentage contribution of rotation and translation movements of the mandible at maximum mouth opening in normal, healthy individuals. DESIGN Free, habitual movements of mouth opening were recorded in 12 men and 15 women aged 19-30 years using an optoelectronic three-dimensional motion analyser. All subjects had a sound, complete, permanent dentitions with Angle Class I jaw relationships, without cast restorations or cuspal coverage, TMJ or craniocervical disorders. For each subject, the mandibular movements at the interincisor point (occlusal plane) were reconstructed, and, using suitable mathematical algorithms, divided into their rotation and gliding components. The relative contribution of the two components to the total movement was calculated for each frame of motion. In particular, the situation at maximum opening was assessed. RESULTS At maximum mouth opening, on average, men had significantly larger displacement of the mandibular interincisor point (56 mm versus 46 mm) and angle of rotation (34 degrees versus 32 degrees), than women. The percentage of mandibular movement explained by rotation at maximum mouth opening (77%) was not influenced by sex. The degree of rotation was significantly related to the displacement of the interincisor point: in women r2 = 87%, in men, r2 = 45%. CONCLUSIONS Overall, in normal subjects with a healthy stomatognathic apparatus, mouth opening was more determined by mandibular rotation than by translation.
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Affiliation(s)
- Virgilio F Ferrario
- Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Functional Anatomy Research Center (FARC), Dipartimento di Morfologia Umana, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Milano, MI, Italy.
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