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Singh BP, Singh N, Jayaraman S, Kirubakaran R, Joseph S, Muthu MS, Jivnani H, Hua F. Occlusal interventions for managing temporomandibular disorders. Cochrane Database Syst Rev 2024; 9:CD012850. [PMID: 39282765 PMCID: PMC11403706 DOI: 10.1002/14651858.cd012850.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2024]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are conditions related to the musculoskeletal structure of the temporomandibular joint, which may lead to muscle or joint pain and other health issues. TMD may present in muscles only (myogenous), joints only (arthrogenous), or both (mixed), and may affect one side or both sides of the face. Myogenous TMD may present with or without limited mouth opening. Arthrogenous TMD may present as disc displacement with or without reduction ('reduction' meaning the articular disc resumes its normal position when the jaw is moving). Occlusal interventions change the occlusal relationship of maxillary and mandibular teeth to improve the alignment of the tooth contact, with the aim of relieving pain, and improving psychosocial functioning and quality of life. Occlusal interventions include splints and adjustments. Occlusal splints are specially designed mouth guards; they are generally classified as stabilisation, reflex or repositioning splints. Occlusal adjustment is the grinding down of teeth to improve occlusion. OBJECTIVES To assess the effects of occlusal interventions in people diagnosed with temporomandibular disorders (TMD), compared to other interventions or no treatment, on joint pain, muscle pain at rest and when chewing, quality of life, discomfort, and recurrence. SEARCH METHODS Cochrane Oral Health's Information Specialist searched following sources up to 9 August 2022: Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via Ovid, Embase via Ovid, and two trials registers. SELECTION CRITERIA We included randomised controlled trials (RCTs) of occlusal interventions (splints or adjustment) for managing TMD compared with no treatment, placebo, occlusal splint with a different mechanism of action, or other active treatments. DATA COLLECTION AND ANALYSIS We adopted standard Cochrane methods to select studies, extract and analyse data, assess the risk of bias in the studies, and judge the certainty of the evidence. We reported outcomes as short term (three months or less) or long term (more than three months). MAIN RESULTS We included 57 studies (2846 participants) that compared occlusal splints with no treatment, placebo, or another treatment. Most of the studies evaluated full hard stabilisation splint (FHSS) as the occlusal splint. We judged only one study to be at low risk of bias. Our key outcomes of interest were self-reported joint pain when chewing, muscle pain at rest and when chewing, discomfort, severity and frequency of joint noise, and recurrence rate. The duration of the studies ranged from 5 weeks to 84 months. The key results presented below were measured between 4.4 weeks and 4 months. It is important to note that we have very low certainty in the evidence for all comparisons and outcomes assessed. There may be little to no difference in self-reported joint pain when chewing between occlusal splint (FHSS) and placebo (non-occlusal splint) (RR 1.88, 95% CI 0.94 to 3.75; 1 study, 60 participants with mixed TMD), or pharmacological therapy (diclofenac) (RR 2.10, 95% CI 0.83 to 5.30; 1 study, 29 participants with osteoarthritis), but the evidence is very uncertain. Occlusal splint (FHSS) may reduce muscle pain when chewing compared to no treatment (MD -1.97, 95% CI -2.37 to -1.57; 1 study, 84 participants with disc displacement without reduction), but may have little to no effect when compared to physical therapy (low-level laser) (RR 0.17, 95% CI 0.02 to 1.26; 1 study, 40 participants) or acupuncture (with needles) (MD 0.10, 95% CI -0.80 to 1.00, 1 study, 40 participants) in people with myofascial pain TMD, but the evidence is very uncertain. There may be little to no difference in muscle pain at rest when occlusal splint (FHSS) is compared to no treatment (MD -11.63, 95% CI -29.37 to 6.11; 1 study, 37 participants) or physical therapy (physiotherapy) (MD -0.19, 95% CI -1.25 to 0.87; 1 study, 72 participants) in myofascial pain TMD, but the evidence is very uncertain. There may be little to no difference in severity of joint noise when occlusal splint (FHSS) is compared to no treatment, but the evidence is very uncertain (MD -0.58, 95% CI -7.09 to 5.93; 1 study, 20 participants). When FHSS is compared to physical therapy (specifically, orofacial myofunctional therapy), physical therapy may reduce severity of joint noise, but the evidence is very uncertain (MD 5.92, 95% CI 0.18 to 11.66; 1 study, 20 participants with mixed TMD). There may be little to no difference in frequency of joint noise when occlusal splint (FHSS) is compared to placebo (non-occlusal splint) (RR 1.18, 95% CI 0.63 to 2.20; 1 study, 60 myofascial pain TMD participants), occlusal splint with a different mechanism of action (RR 0.80, 95% CI 0.07 to 9.18; 1 study, 9 participants with disc displacement with reduction), or physical therapy (jaw exercise) (RR 1.50, 95% CI 0.32 to 6.94; 1 study, 18 participants with myofascial pain TMD), but the evidence is very uncertain. Discomfort and recurrence rate were not reported in any study. We judged the certainty of the evidence to be very low for all outcomes in all comparisons due to limitations in study design and imprecision. AUTHORS' CONCLUSIONS This review included 57 RCTs with 2846 participants, but the final results are inconclusive, so the research questions remain unanswered. Occlusal splints of the FHSS type may reduce muscle pain when chewing compared to no treatment, but the evidence is very uncertain. Orofacial myofunctional therapy may reduce severity of joint noise compared to occlusal splint (FHSS), but the evidence is very uncertain. For all other comparisons and outcomes, there may be little or no difference between groups, although the evidence is also very uncertain for these findings. Overall, we found insufficient evidence to reach conclusions regarding the effectiveness of occlusal interventions for managing symptoms of TMD, despite the available studies including almost 3000 participants. To make a useful contribution to the debate about the best way to treat TMD, any further research must be well-designed, with enough participants to reach the optimal information size for meaningful results; it requires recruitment from primary care, consensus around key outcomes and measures, and, ideally, long-term follow-up of three to five years, plus inclusion of a cost-effectiveness component.
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Affiliation(s)
- Balendra P Singh
- Cochrane India-King George's Medical University, Lucknow affiliate, King George's Medical University, Lucknow, India
| | - Nishi Singh
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Srinivasan Jayaraman
- Department of Prosthodontics, Faculty of Dentistry, Al Baha University, Al Baha, Saudi Arabia
| | | | - Suja Joseph
- Prosthodontics, Pushpagiri Dental College (Christian Charitable Institution), Thiruvala, India
| | - M S Muthu
- Centre for Early Childhood Caries Research (CECCRe), Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Hemant Jivnani
- Sadguru Dental Care and Implant Clinic, 103, Hari Leela Building, opposite Bal Bhavan, Kilvani Naka Road, Silvassa, India
| | - Fang Hua
- Hubei-MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Mohamad N, de Oliveira-Souza AIS, de Castro-Carletti EM, Müggenborg F, Dennett L, McNeely ML, Armijo-Olivo S. The effectiveness of different types of acupuncture to reduce symptoms and disability for patients with orofacial pain. A systematic review and meta-analysis. Disabil Rehabil 2024:1-17. [PMID: 38357796 DOI: 10.1080/09638288.2024.2310766] [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: 03/04/2023] [Accepted: 01/20/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE To determine the effectiveness of different types of acupuncture in reducing pain, improving maximum mouth opening and jaw functions in adults with orofacial pain. METHODS Six databases were searched until 15 June 2023. The Cochrane risk of bias tool and GRADE were employed to evaluate bias and overall evidence certainty. RESULTS Among 52 studies, 86.5% (n = 45) exhibited high risk of bias. Common acupoints, including Hegu LI 4, Jiache ST 6, and Xiaguan ST 7, were used primarily for patients with temporomandibular disorder [TMDs]. Meta-analyses indicated that acupuncture significantly reduced pain intensity in individuals with myogenous TMD (MD = 26.02 mm, I2=89%, p = 0.05), reduced tenderness in the medial pterygoid muscle (standardised mean differences [SMD] = 1.72, I2 = 0%, p < 0.00001) and jaw dysfunction (SMD = 1.62, I2 = 88%, p = 0.010) in mixed TMD when compared to sham/no treatment. However, the overall certainty of the evidence was very low for all outcomes as evaluated by GRADE. CONCLUSION The overall results in this review should be interpreted with caution as there was a high risk of bias across the majority of randomized controlled trial (RCTs), and the overall certainty of the evidence was very low. Therefore, future studies with high-quality RCTs are warranted evaluating the use of acupuncture in patients with orofacial pain.
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Affiliation(s)
- Norazlin Mohamad
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Faculty of Health Sciences, Centre of Physiotherapy, Universiti Teknologi MARA, Puncak Alam Campus, Puncak Alam, Selangor, Malaysia
| | - Ana Izabela Sobral de Oliveira-Souza
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Pernambuco, Brazil
| | - Ester Moreira de Castro-Carletti
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
- Post Graduate Program in Human Movement Sciences, Methodist University of Piracicaba - UNIMEP, Piracicaba, Brazil
| | - Frauke Müggenborg
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
| | - Liz Dennett
- Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Susan Armijo-Olivo
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabrück, Germany
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Zheng Y, Zhou X, Huang Y, Lu J, Cheng Q, Fan P, Xiong X. Low income is associated with impaired jaw function via anxiety and depression in patients with temporomandibular disorders. J Oral Rehabil 2023; 50:1373-1381. [PMID: 37641469 DOI: 10.1111/joor.13579] [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: 04/13/2023] [Revised: 05/06/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The association between jaw function and income in patients with temporomandibular disorders (TMDs) remain unclear. The aim of this study was to explore this association and its relationship with anxiety and depression. SUBJECTS AND METHODS A total of 451 TMD patients, including 361 males and 90 females, participated in this study. The sociodemographic information of patients and their questionnaires including the Generalised Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire 9-item (PHQ-9), and Jaw Functional Limitation Scale-8 (JFLS-8) were collected. Patients were divided into the high-income and low-income groups based on a household per capita income of 6000 RMB per month. Multiple regression and mediation analysis were used to explore the association between variables. The bootstrap method was applied to estimate confidence intervals (CIs). RESULTS Higher JFLS-8 scores were significantly correlated with higher GAD-7 scores (r = 0.361, p < .001), PHQ-9 scores (r = 0.339, p < .001). Females and patients with low income had statistically higher JFLS-8 scores (p < .01, p < .001). Mediation analysis with 10 000 bootstrap simulations revealed a significant direct association between JFLS-8 scores and income (-2.920, 95% CI [-4.757, -1.044], p = .002). A significant indirect association of JFLS-8 scores with income via GAD-7 scores and PHQ-9 scores was also observed (-0.889, 95% CI [-1.728, -0.164], p = .025), accounting for 23.3% of the total association. CONCLUSIONS Low income is associated with impaired jaw function via anxiety and depression in patients with TMD. Clinicians may need to pay more attention to the psychological status of low-income TMD patients in clinical practice.
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Affiliation(s)
- Yunhao Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Temporomandibular joint, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xueman Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Huang
- Psychology Research Institute, Research departments, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Jinjin Lu
- Academy of Future Education, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Qiaoyu Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peidi Fan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Temporomandibular joint, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Hirsch C, Schierz O, Körner A, Kiess W, Biemann R, Schrock A, Türp JC. Sex hormones associated with temporomandibular pain on palpation in male adolescents-Results of the epidemiologic LIFE child study. J Oral Rehabil 2023; 50:972-979. [PMID: 37277983 DOI: 10.1111/joor.13530] [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: 02/28/2022] [Revised: 04/18/2023] [Accepted: 05/29/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aimed to investigate whether the sex steroid precursor hormone dehydroepiandrosterone sulphate (DHEA-S), sex hormone-binding globulin (SHBG) and testosterone (TT) are associated with temporomandibular (TM) pain on palpation in male adolescents. METHODS Out of the LIFE Child study dataset containing 1022 children and adolescents aged 10-18 years (496 males, 48.5%), we used a subsample of 273 male adolescents (mean age: 13.8 ± 2.3 years) in advanced pubertal development (PD) to analyse the association between hormones and TM pain. The Tanner scale was applied to describe the stage of PD. Pain on palpation of the temporalis and masseter muscles and the TM joints (palpation pain) was assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum levels of sex hormones (DHEA-S, SHBG and TT) were determined using standardised laboratory analyses. Free TT was estimated from the ratio between TT and SHBG (free androgen index[FAI]). We calculated the risk of perceived positive palpation pain for male participants as a function of hormone levels (DHEA-S, FAI) taking into account age and body mass index (BMI). RESULTS Among more developed (Tanner stage 4-5) male adolescents, 22.7% (n = 62) reported palpation pain in the TM region. In these participants, FAI levels were approximately half that of individuals without such pain (p < .01). DHEA-S levels were about 30% lower in the pain group (p < .01). In multivariable regression analyses, the odds ratio (OR) for pain on palpation decreased to 0.75 (95% confidence interval [CI]: 0.57-0.98) per 10 units of FAI level compared to those without pain, after controlling for the effects of age and adjusted BMI. We observed the same effect for this subgroup per unit of DHEA-S serum level (OR = 0.71; 95% CI: 0.53-0.94). CONCLUSION At subclinical lower levels of serum free TT and DHEA-S, male adolescents are more likely to report pain on standardised palpation of the masticatory muscles and/or TM joints. This finding supports the hypothesis that sex hormones may influence pain reporting.
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Affiliation(s)
- Christian Hirsch
- Clinic of Pediatric and Preventive Dentistry, University of Leipzig, Leipzig, Germany
| | - Oliver Schierz
- Department of Prosthetic Dentistry and Materials Science, University of Leipzig, Leipzig, Germany
| | - Antje Körner
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Ronald Biemann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Annett Schrock
- Department of Prosthetic Dentistry and Materials Science, University of Leipzig, Leipzig, Germany
| | - Jens Christoph Türp
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Moxley B, Stevens W, Sneed J, Pearl C. Novel Diagnostic and Therapeutic Approaches to Temporomandibular Dysfunction: A Narrative Review. Life (Basel) 2023; 13:1808. [PMID: 37763212 PMCID: PMC10533154 DOI: 10.3390/life13091808] [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: 07/20/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Temporomandibular dysfunction (TMD) is a burgeoning area of study within the dental field. TMD is caused by abnormalities in the temporomandibular joint or muscles of mastication and can lead to pain, loss of function, and other complications. As this area of patient care receives increased focus, the ability to accurately diagnose TMD becomes paramount. The aim of this review is to summarize novel diagnostic and therapeutic techniques that have been proposed within the last approximately 3 years in order to inform readers of the cutting-edge advances in the field of TMD diagnosis and management, while also analyzing the clinical relevance of each study. A PubMed search was completed on 1 March 2023, using MeSH terms related to TMD diagnosis and treatment. The search yielded seven articles that pertained to the aim of this review article. The main findings from each study are summarized in this review article. These novel methods of diagnosing and treating TMD may improve our ability to assess and treat patients suffering from TMD.
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Affiliation(s)
- Brendan Moxley
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (W.S.); (J.S.)
| | - William Stevens
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (W.S.); (J.S.)
| | - Joel Sneed
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (W.S.); (J.S.)
| | - Craig Pearl
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA;
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Vieira LS, Pestana PRM, Miranda JP, Soares LA, Silva F, Alcantara MA, Oliveira VC. The Efficacy of Manual Therapy Approaches on Pain, Maximum Mouth Opening and Disability in Temporomandibular Disorders: A Systematic Review of Randomised Controlled Trials. Life (Basel) 2023; 13:292. [PMID: 36836649 PMCID: PMC9967117 DOI: 10.3390/life13020292] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
Temporomandibular disorder (TMD) is a common condition disabling people and bringing up costs. The aim of this study was to investigate the effects of manual therapy on pain intensity, maximum mouth opening (MMO) and disability. Searches were conducted in six databases for randomised controlled trials (RCTs). Selection of trials, data extraction and methodological quality assessment were conducted by two reviewers with discrepancies resolved by a third reviewer. Estimates were presented as mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). Quality of the evidence was assessed using the GRADE approach. Twenty trials met the eligibility criteria and were included. For pain intensity, high and moderate quality evidence demonstrated the additional effects of manual therapy at short- (95% CI -2.12 to -0.82 points) and long-term (95% CI -2.17 to -0.40 points) on the 0-10 points scale. For MMO, moderate to high quality evidence was found in favour of manual therapy alone (95% CI 0.01 to 7.30 mm) and its additional effects (95% CI 1.58 to 3.58 mm) at short- and long-term (95% CI 1.22 to 8.40 mm). Moderate quality evidence demonstrated an additional effect of manual therapy for disability (95% CI = -0.87 to -0.14). Evidence supports manual therapy as effective for TMD.
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Affiliation(s)
- Leonardo Sette Vieira
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, Brazil
| | - Priscylla Ruany Mendes Pestana
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, Brazil
| | - Júlio Pascoal Miranda
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, Brazil
| | - Luana Aparecida Soares
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, Brazil
| | - Fabiana Silva
- Cirklo Health Education, Barão de Ubá, Porto Alegre 90450-090, Brazil
| | - Marcus Alessandro Alcantara
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, Brazil
| | - Vinicius Cunha Oliveira
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, Brazil
- Postgraduate Program in Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, Brazil
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Freiwald HC, Schwarzbach NP, Wolowski A. Impact of sports on temporomandibular dysfunction: a comparison of competitive and recreational female athletes as well as female non-athletes. Clin Oral Investig 2022; 26:5313-5323. [PMID: 35484356 PMCID: PMC9381453 DOI: 10.1007/s00784-022-04499-6] [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: 10/05/2021] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
Objectives The present study was conducted to investigate the correlation between (competitive) sports and the occurrence of temporomandibular dysfunctions (TMD) by comparing the prevalences in competitive, recreational, and non-athletic women. Materials and methods A total of 138 women between the ages of 18 and 45 were interviewed about symptoms of TMD by means of a questionnaire. Based on their athletic performance level, the participating women were classified as competitive athletes, recreational athletes, or non-athletes (each group n = 46). Results Symptoms of TMD were notably less frequent in competitive female athletes (52.2%) than in recreational female athletes (63.0%) and female non-athletes (60.9%). With increasing training load, the prevalence of TMD decreased in both the competitive and recreational female athlete groups. Conclusions Athletic activity in general seems to have a positive effect on the occurrence of TMD. Competitive female athletes appear less likely to suffer from symptoms of TMD than recreational athletes and non-athletes. One possible explanation for this could be the better supervision by qualified trainers and physiotherapists in competitive sports. Clinical relevance Patients should be motivated to engage in sports as a protective measure against symptoms of TMD. However, it is important to ensure that they are properly instructed by experienced personnel in order to avoid unphysiological strain and negative consequences.
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Affiliation(s)
- Hannah Charlotte Freiwald
- Poliklinik für Prothetische Zahnmedizin und Biomaterialien, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1/W30, 48149, Munster, Germany
| | - Nico Peter Schwarzbach
- Poliklinik für Prothetische Zahnmedizin und Biomaterialien, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1/W30, 48149, Munster, Germany
| | - Anne Wolowski
- Poliklinik für Prothetische Zahnmedizin und Biomaterialien, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1/W30, 48149, Munster, Germany.
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Jung SY, Kim E, Kim K, Cho J, Lee YJ, Ha I. Treatment for temporomandibular disorders in South Korea: a 9‐year trend using cluster analysis. J Oral Rehabil 2022; 49:691-700. [DOI: 10.1111/joor.13333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/13/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sung Yub Jung
- Jaseng Hospital of Korean Medicine 536 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
| | - Eun‐San Kim
- Jaseng Spine and Joint Research Institute Jaseng Medical Foundation 3F, 538 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
| | - Koh‐Woon Kim
- Department of Korean Rehabilitation Medicine College of Korean Medicine Kyung Hee University Seoul Republic of Korea
| | - Jae‐Heung Cho
- Department of Korean Rehabilitation Medicine College of Korean Medicine Kyung Hee University Seoul Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute Jaseng Medical Foundation 3F, 538 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
| | - In‐Hyuk Ha
- Jaseng Spine and Joint Research Institute Jaseng Medical Foundation 3F, 538 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
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de Sire A, Marotta N, Ferrillo M, Agostini F, Sconza C, Lippi L, Respizzi S, Giudice A, Invernizzi M, Ammendolia A. Oxygen-Ozone Therapy for Reducing Pro-Inflammatory Cytokines Serum Levels in Musculoskeletal and Temporomandibular Disorders: A Comprehensive Review. Int J Mol Sci 2022; 23:ijms23052528. [PMID: 35269681 PMCID: PMC8910188 DOI: 10.3390/ijms23052528] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 02/07/2023] Open
Abstract
To date, the application of oxygen-ozone (O2O3) therapy has significantly increased in the common clinical practice in several pathological conditions. However, beyond the favorable clinical effects, the biochemical effects of O2O3 are still far from being understood. This comprehensive review aimed at investigating the state of the art about the effects of O2O3 therapy on pro-inflammatory cytokines serum levels as a modulator of oxidative stress in patients with musculoskeletal and temporomandibular disorders (TMD). The efficacy of O2O3 therapy could be related to the moderate oxidative stress modulation produced by the interaction of ozone with biological components. More in detail, O2O3 therapy is widely used as an adjuvant therapeutic option in several pathological conditions characterized by chronic inflammatory processes and immune overactivation. In this context, most musculoskeletal and temporomandibular disorders (TMD) share these two pathophysiological processes. Despite the paucity of in vivo studies, this comprehensive review suggests that O2O3 therapy might reduce serum levels of interleukin 6 in patients with TMD, low back pain, knee osteoarthritis and rheumatic diseases with a concrete and measurable interaction with the inflammatory pathway. However, to date, further studies are needed to clarify the effects of this promising therapy on inflammatory mediators and their clinical implications.
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Affiliation(s)
- Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (A.A.)
- Correspondence: ; Tel.: +39-0961712819
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (A.A.)
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (M.F.); (A.G.)
| | - Francesco Agostini
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy;
| | - Cristiano Sconza
- IRCCS Humanitas Research Center, Via Manzoni 56, 20089 Rozzano, Italy; (C.S.); (S.R.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
| | - Stefano Respizzi
- IRCCS Humanitas Research Center, Via Manzoni 56, 20089 Rozzano, Italy; (C.S.); (S.R.)
| | - Amerigo Giudice
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (M.F.); (A.G.)
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (A.A.)
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Gębska M, Kołodziej Ł, Dalewski B, Pałka Ł, Sobolewska E. The Influence of the COVID-19 Pandemic on the Stress Levels and Occurrence of Stomatoghnatic System Disorders (SSDs) among Physiotherapy Students in Poland. J Clin Med 2021; 10:3872. [PMID: 34501318 PMCID: PMC8432109 DOI: 10.3390/jcm10173872] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study is a quantitative analysis examining the impact of the COVID-19 pandemic on the occurrence of stress and stomatognathic system disorders (SSDs) among students of physiotherapy. OBJECTIVE To assess stress severity, strategies of coping with stress and the presence of type D personality among physiotherapy students including those with symptoms of stomatognathic system disorders. MATERIAL AND METHODS The research was conducted from October to December 2020 on a sample of 188 students of physiotherapy. The data were collected using a survey form related to the occurrence of SS disorders symptoms and standardized psychological questionnaires, such as the Perceived Stress Scale (PSS)-10, Mini-Cope, and the type-D Scale (DS14), developed for the purpose of this study. RESULTS Women experiencing at least one of the SS disorder-related symptoms were characterized by a significantly higher level of stress and a type D personality (p < 0.05). Among men, these differences were not statistically significant (p > 0.05). On the basis of the strategies of coping with stress, i.e., positive self-reevaluation, discharging and blaming oneself, and taking psychoactive substances, it is possible to predict the intensity of stress during the pandemic in the group of the examined students. Among the reported symptoms of SS, headache was a significant predictor of stress, which was accompanied by an increase in the intensity of stress by nearly 0.2 measurement points. Students with higher levels of stress showed more symptoms of type D personality, and those with more severe symptoms of SS showed higher levels of stress. CONCLUSIONS People prone to stress and having type D personality traits should be assessed for the presence of SS disorders.
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Affiliation(s)
- Magdalena Gębska
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.G.); (Ł.K.)
| | - Łukasz Kołodziej
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.G.); (Ł.K.)
| | - Bartosz Dalewski
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.D.); (E.S.)
| | | | - Ewa Sobolewska
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.D.); (E.S.)
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