The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study

Clinical effect of digitalized designed and 3D-printed repositioning splints in the treatment of anterior displacement of temporomandibular joint disc

OBJECTIVE

To compare the treatment effectiveness of digitized and 3D-printed repositioning splints with that of conventional repositioning splints in the treatment of anterior displacement of the temporomandibular joint disc.

METHODS

This retrospective study included 96 patients with disc displacement of the anterior temporomandibular joint. They were treated with either digitally designed and 3D-printed repositioning splints or traditional splints and followed up for at least six months. Changes in signs and symptoms such as pain and mouth opening before and after treatment were recorded to evaluate treatment outcomes.

RESULTS

During the first month of treatment, both the digitally designed and 3D-printed repositioning splint groups (Group B) and the traditional repositioning splint group (Group A) showed significant increases in mouth opening, with increases of 4.93 ± 3.06 mm and 4.07 ± 4.69 mm, respectively, and there was no significant difference between the two groups. Both groups had a significant reduction in visual analog scale (VAS) pain scores, with Group B showing a greater reduction of 1.946 ± 1.113 compared to 1.488 ± 0.978 in Group A (P < 0.05). By the sixth month, Group B's mouth opening further improved to 38.65 ± 3.22 mm (P < 0.05), while Group A's mouth opening did not significantly improve. Regarding pain, Group A's VAS score decreased by 0.463 ± 0.778 after one month, and Group B's score decreased by 0.455 ± 0.715; both groups showed significant reductions, but there was no significant difference between the two groups.

CONCLUSION

Compared with traditional repositioning splints, digitally designed and 3D-printed repositioning splints are more effective at reducing patient pain and improving mouth opening. 3D-printed repositioning splints are an effective treatment method for temporomandibular joint disc displacement and have significant potential for widespread clinical application.

Occurrence of Cervical Spine Pain and Its Intensity in Young People with Temporomandibular Disorders

Background: The main aim of this cross-sectional study was to compare the occurrence and severity of cervical spine pain in young adults diagnosed with TMDs with a healthy control group (without TMDs). Methods: The study was conducted from June to July 2023. Inclusion criteria were age (18-30 years), cervical spine pain (for at least 1 month), and consent to participate in the study. The study was conducted based on RDC/TMD protocol, an original questionnaire, and a physiotherapeutic examination focused on detecting TMDs. The cervical pain level was assessed using the Visual Analogue Scale (VAS). Thus, a total of 95 subjects were registered for the trials, 51 people (53.7%) constituted the control group (without TMDs), while 44 (46.3%) people constituted the study group (with TMDs). Results: The mean age of people participating in the study was 22.2 ± 2.2 years in the study group and 22.5 ± 3.1 years in the control group. The largest group was people aged 21-25 (n = 51 people, 53.7%). Patients from the study group more often experienced pain in the stomatognathic system during palpation (both in the muscle, joint, and musculoskeletal groups) and had reduced mobility of the temporomandibular joints in every movement (p < 0.001). People from the study group were also characterized by less mobility of the cervical spine (p < 0.05), apart from extension movement (p > 0.05). The analysis showed that of the 95 people participating in the study, 85.4% reported problems in the cervical spine area (n = 81), of which almost all people in the study group struggled with this problem (n = 43, 97.7%). It was found that cervical spine pain was significantly more common in people with TMDs (p < 0.05, chi2 = 10.118, df = 1, rc = 0.31). The level of pain was significantly higher in people from the study group (p < 0.001, chi2 = 45.765, df = 4, rc = 0.57). Conclusions: Our research has shown that the occurrence of cervical spine pain is more common in the group of young people with temporomandibular disorders (TMDs). In young people, this problem is rarely recognized and properly treated.

Is core stability training effective in temporomandibular disorder? A randomized controlled trial

OBJECTIVES

This study investigated the effect of core stability training on pain, function, quality of life, and posture in individuals with temporomandibular disorder.

MATERIALS AND METHODS

Participants were divided into the following: the core stability group and the control group. For pain assessment, the Graded Chronic Pain Scale 2.0; for function, the 20-item Jaw Functional Limitation Scale (JFLS-20); for oral health-related quality of life, Oral Health Impact Profile-14 (OHIP-14); and for posture assessment, the New York Scale were used. Rocabado exercises were applied to the control group. Additionally, spinal stabilization exercises were applied for the core stability group for 6 weeks.

RESULTS

Both types of exercise contribute positively to the quality of life associated with oral health. Rocabado exercise provided a significant change in Chronic Pain Intensity and Disability Score.

CONCLUSION

Rocabado exercise and core stability training, implemented with Rocabado, provide significant changes in pain values. When evaluated in terms of function, no significant difference was found in both exercise programs.

CLINICAL RELEVANCE

Core stability training with Rocabado provides significant changes.

CLINICAL TRIAL REGISTRATION NUMBER

NCT04755621.

Treating Parafunctional Habits for Alleviating Temporomandibular Disorder and Lower Back Pain: A Phase II Clinical Trial

Objectives: Temporomandibular disorders (TMDs) include a series of signs and symptoms in the temporomandibular joints (TMJ) and muscles of mastication, which are associated with or caused by parafunctional habits. Many of these patients also suffer from lumbar pains. This study aimed to evaluate the effectiveness of treating parafunctional habits in alleviating symptoms of TMD and lower back pain. Materials and Methods: This phase II clinical trial was conducted on 136 patients suffering from TMDs and lumbar pain, who consented to participate in this study. They were provided with instructions on how to discontinue their parafunctional habits including clenching and bruxism. The Helkimo and Rolland Morris questionnaires were used to assess TMD and lower back pain, respectively. Data were statistically analyzed using paired Student's t-test, Wilcoxon, Mann-Whitney, and Spearman correlation tests, with the significance level set at P<0.05. Results: The mean severity score of TMD significantly decreased after the intervention. Following treatment of TMD, the mean severity score of lumbar pain decreased from 8 to 2 (P=0.0001). Conclusion: Based on our findings, it appears that the elimination of parafunctional habits improves TMD and lumbar pain.

Relationship between hospital specialization and health outcomes in patients with nonsurgical spinal joint disease in South Korea: A nationwide evidence-based study using national health insurance data

ABSTRACT

Previous studies on hospital specialization in spinal joint disease have been limited to patients requiring surgical treatment. The lack of similar research on the nonsurgical spinal joint disease in specialized hospitals provides limited information to hospital executives.To analyze the relationship between hospital specialization and health outcomes (length of stay and medical expenses) with a focus on nonsurgical spinal joint diseases.The data of 56,516 patients, which were obtained from the 2018 National Inpatient Sample, provided by the Health Insurance Review and Assessment Service, were utilized. The study focused on inpatients with nonsurgical spinal joint disease and used a generalized linear mixed model with specialization status as the independent variable. Hospital specialization was measured using the Inner Herfindahl-Hirschman Index (IHI). The IHI (value ≤1) was calculated as the proportion of hospital discharges accounted for by each service category out of the hospital's total discharges. Patient and hospital characteristics were the control variables, and the mean length of hospital stay and medical expenses were the dependent variables.The majority of the patients with the nonsurgical spinal joint disease were female. More than half of all patients were middle-aged (40-64 years old). The majority did not undergo surgery and had mild disease, with Charlson Comorbidity Index score ≤1. The mean inpatient expense was 1265.22 USD per patient, and the mean length of stay was 9.2 days. The specialization status of a hospital had a negative correlation with the length of stay, as well as with medical expenses. An increase in specialization status, that is, IHI, was associated with a decrease in medical expenses and the length of stay, after adjusting for patient and hospital characteristics.Hospital specialization had a positive effect on hospital efficiency. The results of this study could inform decision-making by hospital executives and specialty hospital-related medical policymakers.