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Rangel M, Ferreira MV, dos Santos MTBR, da Silva CBG, Romano MM, Guaré RO. Temporomandibular disorder in individuals with spinal cord injuries. J Spinal Cord Med 2024; 47:270-276. [PMID: 35349395 PMCID: PMC10885762 DOI: 10.1080/10790268.2022.2046421] [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: 10/18/2022] Open
Abstract
OBJECTIVE This study evaluated Temporomandibular Disorder (TMD) in individuals with Spinal Cord Injuries (SCI) compared to individuals without physical disabilities. DESIGN Cross-sectional. SETTING International Fair of Technologies in Rehabilitation and Accessibility (REATECH) and School of Dentistry at the University of São Paulo (USP), Brazil. PARTICIPANTS In total, 19 patients with SCI and 19 patients without SCI (36.9 ± 11.4 years old) were examined by a calibrated examiner. METHODS using the following parameters: cervical spine mobility, palpation of muscle groups of the head and neck, functional manipulation of the lateral and medial pterygoids, and joint palpation (Diagnostic Criteria). The pattern and amplitude of mandibular movements were determined during screening using the Helkimo index. STATISTICAL ANALYSES Student's t-test, chi-square, Fisher's exact and Shapiro-Wilk test were used. RESULTS The groups did not differ in the presence of noise, pain, temporomandibular joint palpation, locking, dislocation, jaw pain, muscle sensitivity, or in pain, mobility of the cervical spine and functional manipulation. With respect to the jaw mobility index, the groups differed in range of movement (P = 0.020) and maximum right lateral movement (P = 0.007), with the worst values in the SCI group. The groups also differed in relation to lateral flexion in cervical mobility, in which the group without SCI presented better results (P = 0.046). CONCLUSION The Spinal Cord Injuries group showed higher levels of TMD in terms of range of movement, lateral flexion, and maximum right lateral movement, than the individuals without physical disabilities, demonstrating a clinical significance between cervical and mandibular disability in this group.
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Affiliation(s)
- Mayara Rangel
- Graduate Program in Dentistry, Cruzeiro do Sul University - UNICSUL, São Paulo, Brazil
| | | | | | | | | | - Renata Oliveira Guaré
- Graduate Program in Dentistry, Cruzeiro do Sul University - UNICSUL, São Paulo, Brazil
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Masticatory Function in Individuals with Temporomandibular Disorders: A Systematic Review and Meta-Analysis. Life (Basel) 2023; 13:life13020472. [PMID: 36836829 PMCID: PMC9963498 DOI: 10.3390/life13020472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/12/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol in the PubMed, Cochrane Library, LILACS, EBSCO, Scielo, between 2012 and 2022. The methodological quality was assessed by using the Newcastle-Ottawa Study Quality Assessment Scale. Mean differences and 95% confidence intervals were calculated and combined in meta-analyses. A total of 1202 participants were included in this systematic review (690 with TMD; 512 without TMD), with 22 articles being included in the qualitative analysis. Only three studies enabled the comparative analysis of the results. Ten articles showed a high methodological quality and a low risk of bias, and twelve had a low methodological quality and an increased risk of bias. The meta-analysis showed that the differences between the intervention and control groups were not statistically significant for the percentage overlapping coefficient of the anterior temporal muscle, for the masseter, and for the torque coefficient. The parameters analyzed with the compound technique for chewing showed altered mandibular functions in individuals with TMD. With the EMG method, it was possible to suggest that TMD in adult individuals causes compensatory muscle behaviors, and several changes in the masticatory function were found.
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Dinsdale A, Liang Z, Thomas L, Treleaven J. Is jaw muscle activity impaired in adults with persistent temporomandibular disorders? A systematic review and meta-analysis. J Oral Rehabil 2021; 48:487-516. [PMID: 33369753 DOI: 10.1111/joor.13139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022]
Abstract
Understanding jaw muscle activity changes in temporomandibular disorders (TMD) is crucial to guide clinical management. The nature of these changes is currently unclear. Explore changes in jaw muscle activity in TMD. Electronic databases (PubMed, EMBASE, CINAHL, Scopus, Web of Science, Cochrane) and bibliographies were searched from inception to 9 July 2020 for eligible studies, including grey literature. Case-control and interventional studies reporting time-domain and frequency-domain electromyographic measures of jaw muscle activity in TMD and control groups were included. SIGN checklist for case-control studies was used to evaluate risk of bias. Results were pooled for meta-analysis using random-effects model. Confidence in cumulative evidence was established using American Academy of Neurology guidelines. Forty-five studies were included. Most were rated moderate risk of bias. Activity of four muscles (masseter, temporalis, lateral pterygoid, suprahyoids) was assessed across six domains (resting, clenching, chewing, swallowing, concentrating, resisted mandibular movements), with partial meta-analysis scope. Masseter and temporalis activity were significantly higher at rest (P = .05, P < .0001), but lower during brief maximal clenching (P = .005, P = .04) in TMD vs controls. Insufficient data precluded meta-analysis of remaining outcomes and subgroup analysis. Confidence in cumulative evidence ranged from moderate to very low. Changes in jaw muscle activity exist in TMD, which are both task-specific and muscle-specific. It remains unclear whether jaw muscle activity changes vary between TMD subgroups. Muscle function should be considered in clinical management of TMD. Insufficient subgroup data highlight future direction for research.
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Affiliation(s)
| | - Zhiqi Liang
- The University of Queensland, St Lucia, QLD, Australia
| | - Lucy Thomas
- The University of Queensland, St Lucia, QLD, Australia
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Cho GH, Lee Y. Analysis of Masticatory Muscle Activity Based on Presence of Temporomandibular Joint Disorders. Med Sci Monit 2020; 26:e921337. [PMID: 32153300 PMCID: PMC7083083 DOI: 10.12659/msm.921337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background This study was conducted to analyze the activity of masticatory muscles depending on the presence of temporomandibular joint disorders (TMD) when foods of various hardness are masticated. Material/Methods We enrolled 20 subjects (13 men and 7 women) who met our selection criteria, and they were divided into 3 groups (the Disorder Group, the Malalignment Group, and the Control Group) based on surveys and screening inspection. The average of reference voluntary contraction (RVC) was used to measure masticatory muscle activity. Using surface electromyography (SEMG) for each group during masticatory activity, the activities of the masseter muscle and temporalis muscle were measured based on the hardness of 3 different foods (soft, sticky, and hard). Results Characteristics of these 3 groups prior to the experiment were identical, and subsequent findings were as follows: First, when masticating sticky food, the Disorder Group and Malalignment Group showed significant differences from the Control Group in activities of the masseter muscle and temporalis muscle (p<0.05). Second, when masticating hard food, the Malalignment Group and Control Group showed significant differences from the Disorder Group in the masseter muscle and temporalis muscle activities (p<0.05). Based on these findings, the study showed that malalignment affects movement of the temporomandibular joint during mastication of sticky food, and the temporomandibular joint movement was affected by the presence of pain during mastication of hard food. Conclusions Our results provide basic data useful in the diagnosis of temporomandibular joint disorder, as well as guiding future studies on this topic.
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Affiliation(s)
- Gi-Hoon Cho
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, South Korea
| | - Yongwoo Lee
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, South Korea
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Nunes AM, Lopes PRR, Bittencourt MAV, Araújo RPCD. Association between severity of the temporomandibular disorder, neck pain, and mandibular function impairment. REVISTA CEFAC 2020. [DOI: 10.1590/1982-0216/202022217418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Purpose: to investigate the possible association between the severity of the temporomandibular disorder, cervical pain, and mandibular function impairment. Methods: is a cross-sectional, descriptive study, conducted with 32 individuals with temporomandibular disorder, categorized by degree of severity, according to the Fonseca Index. Using the diagnosis criteria for temporomandibular disorder, the likely etiological factors for the disorder were established, as well as the intensity of the functional disability, resulting from cervical pain and of the mandibular impairment. The data obtained were statistically treated, adopting the significance level of 5%. Results: the mean age was 33.8 years, 90.6% being females. As for the degree of disorder, 56.3% presented severe TMD, followed by 28.1% showing a moderate one. The myogenic etiology was present in 93.7% of the patients. Cervical pain was present in 90.6% of them, of which, 59.4% presented a mild disability, and 25%, a moderate one. Considering the mandibular function, 46.9% of the patients presented a low, 40.6%, a moderate, and 12.5%, a severe impairment. There was a statistically significant association between cervical pain and mandibular function (p = 0.011). However, although there was an increase in cervical disability and in mandibular impairment as the severity of the TMD also increased, these associations were not statistically significant (p = 0.178 and p = 0.102, respectively). Conclusion: it can be stated that there is a higher prevalence of severe TMD and of myogenic origin, and that cervical pain influences, directly, the mandibular function, which is not necessarily related to the severity of the temporomandibular alteration. Likewise, such severity does not present a relationship to mandibular function impairment either.
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Ferreira MC, Porto de Toledo I, Dutra KL, Stefani FM, Porporatti AL, Flores-Mir C, De Luca Canto G. Association between chewing dysfunctions and temporomandibular disorders: A systematic review. J Oral Rehabil 2018; 45:819-835. [DOI: 10.1111/joor.12681] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. C. Ferreira
- Department of Speech Language Pathology; Federal University of Santa Catarina; Florianópolis Brazil
| | - I. Porto de Toledo
- Health Sciences Faculty; University of Brasilia; Brasilia Brazil
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
| | - K. L. Dutra
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
| | - F. M. Stefani
- Department of Speech Language Pathology; Federal University of Santa Catarina; Florianópolis Brazil
| | - A. L. Porporatti
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
| | - C. Flores-Mir
- Department of Dentistry; Faculty of Medicine and Dentistry; University of Alberta; Edmonton AB Canada
| | - G. De Luca Canto
- Department of Dentistry; Brazilian Centre for Evidence-Based Research; Federal University of Santa Catarina; Florianópolis Brazil
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Alencar NAD, Fernandes ABN, Souza MMGD, Luiz RR, Fonseca-Gonçalves A, Maia LC. Lifestyle and oral facial disorders associated with sleep bruxism in children. Cranio 2016; 35:168-174. [DOI: 10.1080/08869634.2016.1196865] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Nashalie Andrade de Alencar
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro, Brazil
| | - Alline Birra Nolasco Fernandes
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro, Brazil
| | - Margareth Maria Gomes de Souza
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro, Brazil
| | - Ronir Raggio Luiz
- Institute of Public Health Studies, Universidade Federal do Rio de Janeiro , Rio de Janeiro, Brazil
| | - Andréa Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro, Brazil
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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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Cooper BC. Temporomandibular disorders: A position paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). Cranio 2012; 29:237-44. [PMID: 22586834 DOI: 10.1179/crn.2011.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
PURPOSE Two principal schools of thought regarding the etiology and optimal treatment of temporomandibular disorders exist; one physical/functional, the other biopsychosocial. This position paper establishes the scientific basis for the physical/functional. THE ICCMO POSITION: Temporomandibular disorders (TMD) comprise a group of musculoskeletal disorders, affecting alterations in the structure and/or function of the temporomandibular joints (TMJ), masticatory muscles, dentition and supporting structures. The initial TMD diagnosis is based on history, clinical examination and imaging, if indicated. Diagnosis is greatly enhanced with physiologic measurement devices, providing objective measurements of the functional status of the masticatory system: TMJs, muscles and dental occlusion. The American Alliance of TMD organizations represent thousands of clinicians involved in the treatment of TMD. The ten basic principles of the Alliance include the following statement: Dental occlusion may have a significant role in TMD; as a cause, precipitant and/or perpetuating factor. Therefore, it can be stated that the overwhelming majority of dentists treating TMD believe dental occlusion plays a major role in predisposition, precipitation and perpetuation. While our membership believes that occlusal treatments most frequently resolve TMD, it is recognized that TMD can be multi faceted and may exist with co-morbid physical or emotional factors that may require therapy by appropriate providers. The International College of Cranio-Mandibular Orthopedics (ICCMO), composed of academic and clinical dentists, believes that TMD has a primary physical/functional basis. Initial conservative and reversible TMD treatment employing a therapeutic neuromuscular orthosis that incorporates relaxed, healthy masticatory muscle function and a stable occlusion is most often successful. This is accomplished using objective measurement technologies and ultra low frequency transcutaneous electrical neural stimulation (TENS). CONCLUSION Extensive literature substantiates the scientific validity of the physical/functional basis of TMD, efficacy of measurement devices and TENS and their use as aids in diagnosis and in establishing a therapeutic neuromuscular dental occlusion. CLINICAL IMPLICATIONS A scientifically valid basis for TMD diagnosis and treatment is presented aiding in therapy.
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Affiliation(s)
- Barry C Cooper
- Division of Translational Oral Biology, State University of New York (SUNY) Stony Brook School of Dental Medicine, USA.
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Cavalcanti RF, Studart LM, Kosminsky M, de Goes PSA. Validation of the multimedia version of the RDC/TMD axis II questionnaire in Portuguese. J Appl Oral Sci 2010; 18:231-6. [PMID: 20856999 PMCID: PMC5349054 DOI: 10.1590/s1678-77572010000300006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Accepted: 03/19/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of the study was to validate the multimedia version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II Questionnaire in Portuguese language. MATERIAL AND METHODS The sample comprised 30 patients with signs and symptoms of temporomandibular disorders (TMD), evaluated at the Orofacial Pain Control Center of the Dental School of the University of Pernambuco, Brazil, between April and June 2006. Data collection was performed using the following instruments: Simplified Anamnestic Index (SAI) and RDC/TMD Axis II written version and multimedia version. The validation process consisted of analyzing the internal consistency of the scales. Concurrent and convergent validity were evaluated by the Spearman's rank correlation. In addition, test and analysis of reproducibility by the Kappa weighted statistical test and Spearman's rank correlation test were performed. RESULTS The multimedia version of the RDC/TMD Axis II questionnaire in Portuguese was considered consistent (Crombrach alpha = 0.94), reproducible (Spearman 0.670 to 0.913, p<0.01) and valid (p<0.01). CONCLUSION The questionnaire showed valid and reproducible results, and represents an instrument of practical application in epidemiological studies of TMD in the Brazilian population.
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