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Sàbado-Bundó H, Sánchez-Garcés M, Camps-Font O, Gay-Escoda C. Intraarticular injections of hyaluronic acid in arthrocentesis and arthroscopy as a treatment of temporomandibular joint disorders: A systematic review. Cranio 2024; 42:122-131. [PMID: 34027829 DOI: 10.1080/08869634.2021.1925029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the benefits of hyaluronic acid intraarticular injection (HA IAI), in conjunction with minimally invasive surgery (arthrocentesis or arthroscopy), as a therapeutic option for temporomandibular joint disorders. METHODS An electronic search in PubMed, Cochrane Library, and Scopus databases was conducted in order to answer the following PICOS question: "In clinical trials with patients treated with arthroscopy or arthrocentesis, did the subsequent use of HA IAI provide a better control of postoperative pain and temporomandibular joint function compared to those patients who did not receive it?" RESULTS Following PRISMA criteria, six randomized controlled clinical trials were selected. HA IAI showed significant differences in terms of pain reduction in three of them and improvement of mandibular function in two, compared to the control group. CONCLUSION Based on scientific evidence, the level of recommendation found regarding this type of intervention is type B (recommendation based on inconsistent or limited-quality patient-oriented evidence).
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Affiliation(s)
- Helena Sàbado-Bundó
- Department of Oral Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - MaÁngeles Sánchez-Garcés
- Master's Degree Program in Oral Surgery and Implantology, University of Barcelona, Barcelona, Spain
- Researcher of the IDIBELL Institute, Barcelona, Spain
| | - Octavi Camps-Font
- Department of Oral Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Researcher of the IDIBELL Institute, Barcelona, Spain
| | - Cosme Gay-Escoda
- Oral and Maxillofacial Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Oral Surgery and Implantology, FUCSO, Implantology and Maxillofacial Surgery Department, EFHRE International University, Teknon Medical Center, Barcelona, Spain
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Calil BC, da Cunha DV, Vieira MF, de Oliveira Andrade A, Furtado DA, Bellomo Junior DP, Pereira AA. Identification of arthropathy and myopathy of the temporomandibular syndrome by biomechanical facial features. Biomed Eng Online 2020; 19:22. [PMID: 32295597 PMCID: PMC7161015 DOI: 10.1186/s12938-020-00764-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 04/01/2020] [Indexed: 02/04/2023] Open
Abstract
Background Temporomandibular disorders (TMDs) are pathological conditions affecting the temporomandibular joint and/or masticatory muscles. The current diagnosis of TMDs is complex and multi-factorial, including questionnaires, medical testing and the use of diagnostic methods, such as computed tomography and magnetic resonance imaging. The evaluation, like the mandibular range of motion, needs the experience of the professional in the field and as such, there is a probability of human error when diagnosing TMD. The aim of this study is therefore to develop a method with infrared cameras, using the maximum range of motion of the jaw and four types of classifiers to help professionals to classify the pathologies of the temporomandibular joint (TMJ) and related muscles in a quantitative way, thus helping to diagnose and follow up on TMD. Methods Forty individuals were evaluated and diagnosed using the diagnostic criteria for temporomandibular disorders (DC/TMD) scale, and divided into three groups: 20 healthy individuals (control group CG), 10 individuals with myopathies (MG), 10 individuals with arthropathies (AG). A quantitative assessment was carried out by motion capture. The TMJ movement was captured with camera tracking markers mounted on the face and jaw of each individual. Data was exported and analyzed using a custom-made software. The data was used to identify and place each participant into one of three classes using the K-nearest neighbor (KNN), Random Forest, Naïve Bayes and Support Vector Machine algorithms. Results Significant precision and accuracy (over 90%) was reached by KNN when classifying the three groups. The other methods tested presented lower values of sensitivity and specificity. Conclusion The quantitative TMD classification method proposed herein has significant precision and accuracy over the DC/TMD standards. However, this should not be used as a standalone tool but as an auxiliary method for diagnostic TMDs.
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Affiliation(s)
- Bruno Coelho Calil
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil.
| | - Danilo Vieira da Cunha
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goias, Av. Esperanca, s/n, Campus Samambaia, Goiania, GO, 74690-900, Brazil
| | - Adriano de Oliveira Andrade
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Daniel Antônio Furtado
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Douglas Peres Bellomo Junior
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Adriano Alves Pereira
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
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GIRO G, MARIN DOM, SILVA MDDD, GONÇALVES DADG, PERO AC. Effect of educational and self-care therapies on masticatory performance of women with painful temporomandibular disorder. REVISTA DE ODONTOLOGIA DA UNESP 2018. [DOI: 10.1590/1807-2577.04718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Temporomandibular disorders (TMD) can compromise masticatory performance due to the presence of pain, muscular dysfunction and limitation of mandibular movements. Substantial improvements in TMD pain can be achieved through therapeutic approaches including education and self-care. Objective The aim of the present study was to investigate the impact of these treatment modalities in the masticatory performance of women with painful TMD. Material and method Fifty-two women were randomly divided into three groups: Control Group (CG); Education Group (received education about TMD) (EG); Self-Care and Education Group (received education about TMD and instructions self-care therapies) (SEG). The education instructions about TMD and self-care therapies were transmitted through a video and printed illustrative material. The masticatory performance was evaluated through the sieves method with natural tested foods in the evaluation periods: baseline evaluation, 30 days after and 60 days of follow-up. Data were analyzed and used with a one-way ANOVA parametric test for mean comparison of CG, EG and SEG groups (α = 0.05). Result The masticatory performance of the participants was similar, irrespective of the proposed treatments, at baseline (p=.604), 30 days (p=.450) and 60 days (p=.669). Conclusions The results indicated that treatment with educational and self-care therapies over a period of 60 days had no impact on the masticatory performance of women with painful TMD.
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Choi KH, Kwon OS, Jerng UM, Lee SM, Kim LH, Jung J. Development of electromyographic indicators for the diagnosis of temporomandibular disorders: a protocol for an assessor-blinded cross-sectional study. Integr Med Res 2017; 6:97-104. [PMID: 28462150 PMCID: PMC5395685 DOI: 10.1016/j.imr.2017.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/14/2016] [Accepted: 01/09/2017] [Indexed: 11/04/2022] Open
Abstract
Background Noninvasive and easy-to-use surface electromyography (EMG) is frequently utilized for the diagnosis of temporomandibular disorders (TMDs). However, few EMG parameters that consider TMDs in addition to the cranio-cervical-mandibular system have been regarded as important in traditional Korean medicine. Methods This clinical trial will be conducted as an assessor-blinded cross-sectional study. The participants will be classified based on the Diagnostic Criteria for TMDs Symptom Questionnaire (DC/TMD SQ) and 30 TMD patients and 30 healthy controls will be enrolled. The primary outcome will be the percentage overlapping coefficient (POC; %) in the masseter and sternocleidomastoid muscles between the patient group and healthy control group in clenching and cervical side flexion. The secondary outcomes include the score from temporomandibular joint-related questionnaires, the difference in the absolute values of EMG for the healthy group and TMD group before/after wearing intraoral appliances, and the change in the location of the temporomandibular joint as determined by X-ray imaging and 3D face photography. Discussion This study will provide information about the objective diagnostic method for TMD using surface EMG and will verify the effectiveness of surface EMG in diagnosing TMD. Furthermore, the method or device for diagnosis TMD will improve the expansion of treatment area to TMD by accumulating evidence for the efficacy of TKM treatment.
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Affiliation(s)
- Kwang-Ho Choi
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - O Sang Kwon
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Ui Min Jerng
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea.,Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - So Min Lee
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Lak-Hyung Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea.,Department of Neuropsychiatry, Woosuk University Oriental Medicine Hospital, Jeonju, Korea
| | - Jeeyoun Jung
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
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[Statistical tests in medical research: traditional methods vs. multivariate NPC permutation tests]. Urologia 2015; 82:130-6. [PMID: 25907894 DOI: 10.5301/uro.5000117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2015] [Indexed: 11/20/2022]
Abstract
Statistical tests in medical research: traditional methods vs. multivariate npc permutation tests.Within medical research, a useful statistical tool is based on hypotheses testing in terms of the so-called null, that is the treatment has no effect, and alternative hypotheses, that is the treatment has some effects. By controlling the risks of wrong decisions, empirical data are used in order to possibly reject the null hypotheses in favour of the alternative, so that demonstrating the efficacy of a treatment of interest. The multivariate permutation tests, based on the nonparametric combination - NPC method, provide an innovative, robust and effective hypotheses testing solution to many real problems that are commonly encountered in medical research when multiple end-points are observed. This paper discusses the various approaches to hypothesis testing and the main advantages of NPC tests, which consist in the fact that they require much less stringent assumptions than traditional statistical tests. Moreover, the related results may be extended to the reference population even in case of selection-bias, that is non-random sampling. In this work, we review and discuss some basic testing procedures along with the theoretical and practical relevance of NPC tests showing their effectiveness in medical research. Within the non-parametric methods, NPC tests represent the current "frontier" of statistical research, but already widely available in the practice of analysis of clinical data.
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Cooper BC, Adib F. An assessment of the usefulness of Kinesiograph as an aid in the diagnosis of TMD: a review of Manfredini et al.'s studies. Cranio 2014; 33:46-66. [PMID: 25115950 DOI: 10.1179/2151090314y.0000000010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIM Performing a literature review of publications by Dr. Manfredini et al. related to their temporomandibular joint (TMJ) injection therapy outcome with conclusions on the clinical utility of computerized measurement devices used in the management of temporomandibular disorders (TMDs). In addition, reviewing their published opinion on an occlusion: TMD versus a biopsychosocial paradigm for TMD. Manfredini et al. authored an article published in the Journal of the American Dental Association (JADA) 2013, "An Assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders," the most recent of 12 articles. In all studies, subjects received TMJ injections with an objective measurement outcome criterion; increased maximum mouth opening (MMO) and subjective symptom improvement of pain and chewing function. In the 2013 JADA article, the Mandibular Kinesiograph, referred to as KG, measured MMO before and after therapy. In 11 prior articles, all subject groups with limited mouth opening exhibited very significant increased MMO post-treatment, documenting treatment success using the same 2013 protocol. The 2013 study showed a 1·1 mm improved MMO, described as insignificant. The authors did not critique or explain the aberrant, skewed 2013 outcome data contrasted with their prior studies, which showed overwhelmingly significant increased MMO. Instead, they concluded that the MMO recording device was clinically useless. This motivated a literature review of the authors' TMD publications. CONCLUSION The publications by Manfredini et al. recognized proponents of the psychosocial model of TMD, including the 2013 article, appear to be part of a campaign denying an occlusion: TMD relationship and disparaging the specific computerized measurement devices and the dentists using them in the management of their TMD patients using neuromuscular occlusion dental treatment.
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Jankelson RR. Sensitivity/Specificity: Straw Men, Red Herrings, and Dental Politics. Cranio 2014; 31:156-8. [DOI: 10.1179/crn.2013.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Manfredini D, Cocilovo F, Stellini E, Favero L, Guarda-Nardini L. Surface Electromyography Findings in Unilateral Myofascial Pain Patients: Comparison of Painful vs Non Painful Sides. PAIN MEDICINE 2013; 14:1848-53. [DOI: 10.1111/pme.12159] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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