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Zhao K, JI S, Jiang H, Qian Y, Zhang W. Exploring the gut microbiota's effect on temporomandibular joint disorder: a two-sample Mendelian randomization analysis. Front Cell Infect Microbiol 2024; 14:1361373. [PMID: 39188419 PMCID: PMC11345233 DOI: 10.3389/fcimb.2024.1361373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 07/19/2024] [Indexed: 08/28/2024] Open
Abstract
Background Temporomandibular joint disorders (TMD) are highly prevalent among people. Numerous investigations have revealed the impact of gut microbiota in many diseases. However, the causal relationship between Temporomandibular joint disorders and gut microbiota remains unclear. Methods Genome-Wide Association Studies (GWAS) refer to the identification of sequence variations, namely single nucleotide polymorphisms (SNPs), existing across the entire human genome. GWAS data were collected on gut microbiota and TMD. Then, instrumental variables were screened through F-values and removal of linkage disequilibrium. These SNPs underwent mendelian analysis using five mathematical models. Sensitivity analysis was conducted to further verify the stability of the results. Pathogenic factors of TMD mediate the causal relationship between gut microbiota and TMD were explored through a two-step Mendelian randomization analysis. Finally, reverse mendelian analysis was conducted to account for potential reverse effects. Results The analysis of the data in this article suggests that some gut microbiota, including Coprobacter, Ruminococcus torques group, Catenibacterium, Lachnospiraceae, Turicibacter, Victivallis, MollicutesRF9, Methanobacteriales, Methanobacteriaceae, FamilyXI, Methanobacteria were identified as risk factors, while Peptococcaceae provides protection for TMD. Conclusion The research reveals the relation of gut microbiota in TMD. These findings provide insights into the underlying mechanisms and suggest potential therapeutic strategy.
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Affiliation(s)
- Kai Zhao
- Department of Stomatology, The Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China
| | - Shuaiqi JI
- Fujian Key Laboratory of Oral Diseases and Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Han Jiang
- Department of Stomatology, The Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China
| | - Yunzhu Qian
- Department of Stomatology, The Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China
| | - Weibing Zhang
- Department of Stomatology, The Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China
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Abstract
Temporomandibular disorders (TMDs) and headache disorders are highly prevalent in the population. TMDs can present headache symptoms as a secondary headache and, in addition, be comorbid with primary headache disorders. This overlap has significant clinical implications for which it is essential for the physician to be aware, and they should screen for the potential presence of TMDs in a headache patient. Bruxism is a parafunctional behavior also prevalent in the population which has a role in TMDs and may influence headache symptomatology, but it is still necessary to clarify this relationship.
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Affiliation(s)
- Marcela Romero-Reyes
- Brotman Facial Pain Clinic, University of Maryland, School of Dentistry; Department of Neural and Pain Sciences, University of Maryland, Baltimore, School of Dentistry, 650 West Baltimore Street, Room 8253, Baltimore, MD 21201, USA.
| | - Jennifer P Bassiur
- Center for Oral, Facial & Head Pain, College of Dental Medicine, Columbia University Medical Center; Division of Oral & Maxillofacial Surgery, 620 West 168th Street, P & S Box 20, New York, NY 10032, USA
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Al-Hadad SA, Ahmed MMS, Zhao Y, Wang L, Hu W, Li C, Chen X, Alhammadi MS. Skeletal, dentoalveolar and soft tissue changes after stabilization splint treatment for patients with temporomandibular joint disorders. BMC Oral Health 2024; 24:479. [PMID: 38643111 PMCID: PMC11032605 DOI: 10.1186/s12903-024-04260-3] [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: 12/30/2023] [Accepted: 04/15/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) is a grouping of heterogeneous disorders with multifactorial origins. Stabilization splints (SS) have demonstrated an acceptable treatment effect in TMD. The possible changes at the skeletal, dental, and soft tissue levels need to be addressed to evaluate the benefit/risk ratio of this therapeutic procedure. Accordingly, this study aimed to three‑dimensionally evaluate skeletal, dentoalveolar and soft tissue changes after SS treatment for patients with TMD. METHODS This retrospective study included 74 adult patients with myofascial and/or intra-articular disorders (25 males and 49 females), with an average age of 22.88 ± 4.8 years, who underwent SS treatment. Pre- and post-treatment Cone beam computed tomography were analysed using Invivo 6.0.3 software. The primary outcome was the vertical skeletal and dentoalveolar changes, while the secondary outcomes were the anteroposterior skeletal, dentoalveolar and soft tissue changes. Paired t-test and Wilcoxon rank sum test were used for statistical analyses. RESULTS For the primary outcome; skeletally, there was a significant increase in mandibular plane inclination (difference: 0.82°±1.37), decrease facial height ratio (difference: 0.45%±1.07) and at the dentoalveolar level, the inclination of the functional (FOP-SN, FOP-FH) and bisecting (BOP-SN, BOP-FH) occlusal planes exhibited a significant increase too (difference: 0.38 ± 1.43°, 0.49 ± 1.62°, 0.44 ± 1.29° and 0.41 ± 1.17°, respectively) and also a decrease in the overbite (difference: -0.54 ± 0.83). For the secondary outcomes; there was a significant decrease in mandibular position (SNB) (difference: 1.60 ± 1.36°) and increase in the overjet (difference: 0.93 ± 1.04, p < 0.001) and a significant lower lip retrusion (difference: 0.33 ± 1.01 mm p < 0.01), was observed too. CONCLUSIONS SS therapy resulted in significant vertical skeletal and dentoalveolar changes that were manifested mainly by facial height ratio, mandibular and occlusal plane changes, and to a lesser extent, significant anteroposterior skeletal, dentoalveolar, and soft tissue changes in the form of mandibular position, increased overjet and a more retrusive lower lip. These changes should be considered during patients' selection prior to initiating SS therapy.
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Affiliation(s)
- Saba Ahmed Al-Hadad
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, IBB, Republic of Yemen
| | - Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Lu Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Wanqing Hu
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Chushen Li
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
| | - Maged Sultan Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Zhang X, Gao W, Zhou J, Dai H, Xiang X, Xu J. Low-intensity pulsed ultrasound in the treatment of masticatory myositis and temporomandibular joint synovitis: A clinical trial. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101632. [PMID: 37703917 DOI: 10.1016/j.jormas.2023.101632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Low-intensity pulsed ultrasound (LIPUS) is a non-invasive physical stimulation application for the therapy of articular cartilage injury. This study aimed to explore the therapeutic effects of low-intensity pulsed ultrasound in treating masticatory myositis and synovitis in temporomandibular joint disorders and to establish an evaluation system to evaluate the clinical efficacy. METHODS TMD patients who met the inclusion criteria in the temporomandibular joint clinic of the affiliated Stomatological Hospital of Chongqing Medical University from April 3, 2021, to December 2021 were selected. Before the start and after 7 days of LIPUS treatment, the Fricton temporomandibular joint disorder index, Visual Analog Scale (VAS), and Pressure Difference of Precision Manometer (PD) were measured. A paired t-test was used to compare the values of the Fricton index, VAS, and PD before and after treatment in each group. One-way ANOVA analysis of variance was used to compare the differences between groups. RESULTS After one week of LIPUS treatment, the PI, DI and CMI of the Fricton index in the masticatory myositis (PI: P < 0.001; CMI: P < 0.001; DI: P = 0.2641, ns) and the synovitis group (DI: P < 0.001; CMI: P < 0.001, PI: P = 0.9729, ns) significantly decreased. The VAS of the masticatory myositis group and the synovitis group were significantly reduced (P < 0.001). The PD between the affected and healthy sides of the masticatory myositis group and the synovitis group was significantly reduced (P < 0.001), and the reduction was more evident in the M group. CONCLUSIONS LIPUS is effective in pain relief in patients with masticatory myositis and joint synovitis, meanwhile, masticatory myositis was more sensitive to LIPUS. A new comprehensive clinical efficacy evaluation system which includes PV, FI, and VAS was created to better 2 diagnose masticatory myositis and joint synovitis.
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Affiliation(s)
- Xiaoqing Zhang
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China; Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Wentong Gao
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China; Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jianping Zhou
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China; Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hongwei Dai
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China; Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xuerong Xiang
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China; Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Jie Xu
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China; Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Martínez‐Álvarez O, Wojtovicz E, Luís De la Hoz J, Mesa J, Armijo‐Olivo S. Effectiveness of intraoral splints in the treatment of migraine and tension-type headache: A systematic review. Clin Exp Dent Res 2023; 9:1180-1190. [PMID: 37680032 PMCID: PMC10728529 DOI: 10.1002/cre2.779] [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: 12/11/2022] [Revised: 07/15/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES The main objective of this systematic review was to assess the effectiveness of intraoral splints in treating migraine and tension-type headaches. MATERIAL AND METHODS The article search was conducted within seven electronic databases (Medline, PubMed, Embase, CINAHL PLUS with full text, Cochrane Library Trials, Web of Science, and Scopus) with no date limits or language restrictions up to June 12, 2022. Strict inclusion and exclusion criteria were set for article selection. At the same time as data extraction, each study's risk of bias (RoB) was evaluated using the Cochrane tool to assess their RoB. Subsequently, the Cochrane Grading of Recommendations Assessment Development and Evaluation was used to evaluate the certainty of the evidence. RESULTS Four controlled clinical trials were included. These trials were heterogeneous in terms of (1) diagnosis, (2) design of the intraoral splints, and (3) tools for reporting the results, which made it difficult to compile the data as well as evaluate its quality. Trials reported a reduction in the frequency of headache and pain intensity when using intraoral splints; however, this therapy was not superior to medications. CONCLUSIONS The evidence is very low for the use of oral splints as a therapeutic alternative to medication in the treatment of migraine and/or tension-type headache.
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Affiliation(s)
| | | | | | | | - Susan Armijo‐Olivo
- Faculty of Business and Social SciencesUniversity of Applied SciencesOsnabrückGermany
- Department of Physical Therapy, Faculty of Rehabilitation MedicineUniversity of AlbertaEdmontonAlbertaCanada
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Romero-Reyes M, Klasser G, Akerman S. An Update on Temporomandibular Disorders (TMDs) and Headache. Curr Neurol Neurosci Rep 2023; 23:561-570. [PMID: 37581857 DOI: 10.1007/s11910-023-01291-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW To provide an overview and highlight recent updates in temporomandibular disorders (TMDs) and their comorbidity with headache disorders regarding pathophysiology and management. RECENT FINDINGS In the last decade, there have been great advancements in the understanding of TMDs and their relationship with neurovascular pains such as headaches. Understanding of TMDs is necessary for the context of its comorbidity with primary headache disorders. The literature regarding management of these comorbidities is scarce but points to combination therapy including pharmacological and non-pharmacological approaches to optimize management. The use of CGRP receptor-targeted monoclonal antibodies or CGRP receptor antagonists should be explored for the management of chronic TMDs. It could also be used as a novel monotherapy or in combination with non-pharmacological approaches for TMDs' comorbidity with headache, particularly migraine. Research is needed to support evidence-based management protocols. A team involving neurology (headache medicine) and dentistry (orofacial pain) is critical for optimal management.
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Affiliation(s)
- Marcela Romero-Reyes
- Brotman Facial Pain Clinic, School of Dentistry, University of Maryland, Baltimore, MD, USA.
- Department of Pain and Neural Sciences, School of Dentistry, University of Maryland, 650 W. Baltimore St, 8th floor, Baltimore, MD, 21201, USA.
| | - Gary Klasser
- Department of Diagnostic Sciences, Louisiana State University Health Sciences Center, School of Dentistry, New Orleans, LA, USA
| | - Simon Akerman
- Department of Pain and Neural Sciences, School of Dentistry, University of Maryland, 650 W. Baltimore St, 8th floor, Baltimore, MD, 21201, USA
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Chęciński M, Chęcińska K, Turosz N, Brzozowska A, Chlubek D, Sikora M. Current Clinical Research Directions on Temporomandibular Joint Intra-Articular Injections: A Mapping Review. J Clin Med 2023; 12:4655. [PMID: 37510770 PMCID: PMC10380303 DOI: 10.3390/jcm12144655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/27/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
This mapping review aims to identify and discuss current research directions on intracavitary temporomandibular joints (TMJs) injections. The inclusion criteria allowed studies published in the last full six years, based on patients diagnosed with temporomandibular joint disorders (TMDs), treated by TMJ intra-articular injections. Medical databases covered by the Association for Computing Machinery, Bielefeld Academic Search Engine, PubMed, and Elsevier Scopus engines were searched. The results were visualized with tables, charts, and diagrams. Of the 2712 records identified following the selection process, 152 reports were qualified for review. From January 2017, viscosupplementation with hyaluronic acid (HA) was the best-documented injectable administered into TMJ cavities. However, a significant growing trend was observed in the number of primary studies on centrifuged blood preparations administrations that surpassed the previously leading HA from 2021.
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Affiliation(s)
- Maciej Chęciński
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Cracow, Poland
| | - Kamila Chęcińska
- Department of Glass Technology and Amorphous Coatings, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Mickiewicza 30, 30-059 Cracow, Poland
| | - Natalia Turosz
- Institute of Public Health, Jagiellonian University Medical College, Skawińska 8, 31-066 Cracow, Poland
| | - Anita Brzozowska
- Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Maciej Sikora
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, Wojska Polskiego 51, 25-375 Kielce, Poland
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Dibello V, Lozupone M, Sardone R, Ballini A, Lafornara D, Dibello A, Vertucci V, Santarcangelo F, Maiorano G, Stallone R, Petruzzi M, Daniele A, Solfrizzi V, Panza F. Temporomandibular Disorders as Contributors to Primary Headaches: A Systematic Review. J Oral Facial Pain Headache 2023; 37:91-100. [PMID: 37389836 PMCID: PMC10627196 DOI: 10.11607/ofph.3345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
AIMS To systematically review the literature assessing associations between TMDs and primary headaches. METHODS Using validated clinical criteria, studies on TMDs and primary headaches published up to January 10, 2023 were identified using six electronic databases. This review adhered to the PRISMA 2020 guidelines and 27-item checklist and is registered on PROSPERO (CRD42021256391). Risk of bias was evaluated using the National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies. RESULTS Two independent investigators rated 7,697 records against the primary endpoint and found 8 records meeting the eligibility requirements. Migraine was found to be the most common primary headache related to TMDs (61.5%), followed by episodic tension-type headache (ETTH; 38.5%). A moderate association was found for mixed TMDs with migraine and ETTH, with a large sample size and multiple studies included (n = 8). A very low-quality association was found for myalgia-related TMDs with migraine and ETTH (included studies, n = 2). CONCLUSION The association between TMDs and primary headaches is of great interest given the possible effectiveness of TMD management in reducing headache intensity/frequency in patients with TMDs and headache comorbidity. A moderate association was found for mixed TMDs with primary headaches, in particular migraine and ETTH. However, owing to the overall moderate certainty of evidence of the present findings, further longitudinal studies with larger samples investigating possible associated factors and using accurate TMD and headache category assignment are needed.
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Influence of Soft Stabilization Splint on Electromyographic Patterns in Masticatory and Neck Muscles in Healthy Women. J Clin Med 2023; 12:jcm12062318. [PMID: 36983318 PMCID: PMC10056613 DOI: 10.3390/jcm12062318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
This study investigates the influence of soft stabilization splints on electromyographic patterns in masticatory and neck muscles in healthy women. A total of 70 healthy women were qualified for the research. The resting and clenching electromyographic patterns of the temporalis (TA), masseter (MM), digastric (DA), and sternocleidomastoid (SCM) muscles were measured using the BioEMG III™ apparatus. The interaction between splint application and resting muscle activity affected the results in all examined muscles except the temporalis muscle. A large effect size was observed in masseter (2.19 µV vs. 5.18 µV; p = 0.00; ES = 1.00) and digastric (1.89 µV vs. 3.17 µV; p = 0.00; ES = 1.00) both-sided RMS activity. Significant differences between the two conditions were observed in all Functional Clenching Indices (FCI) for MM, SDM, and DA muscles. All FCI values for the MM and DA muscles were significantly lower with than without the splint. We observed an increase in all activity indices due to splint application, which suggests a masseter muscle advantage during measurement. The soft stabilization splint influenced resting and functional activity in the MM, SDM, and DA muscles. During tooth clenching, a soft stabilization splint changed the involvement proportions of the temporalis and masseter muscles, transferring the main activity to the masseter muscles. Using a soft stabilization splint did not affect the symmetry of the electromyographic activity of the masticatory and neck muscles.
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Almăşan O, Hedeşiu M, Leucu£a DC, Buduru S, Dinu C. Oral splints in the management of nociceptive pain and migraines: A scoping review. Exp Ther Med 2023; 25:28. [PMID: 36561612 PMCID: PMC9748760 DOI: 10.3892/etm.2022.11727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
Temporomandibular disorders (TMDs) are characterized by numerous pain manifestations. Their treatment often involves the use of an oral splint. Recent research has found a relationship between migraines, nociceptive pain and TMDs. The aim of the present study was to perform a scoping review of studies in order to evaluate the effectiveness of the various types of oral splint in the treatment of migraine or nociceptive pain. Publications were retrieved from seven databases (PubMed, Web of Science, EMBASE, Scopus, ProQuest, SpringerLink and Ovid). Out of the 15 included publications, three studies were before and after studies, with no control group, whereas the other twelve studies were clinical trials, among which two publications were crossover studies. A clear, single distinction of pain was difficult to describe. Therefore, numerous publications focused on a combination of various types of pains, including myofascial, temporomandibular joint, headaches and migraine-like symptoms, all of which mimicked TMD pain. Overall, six studies used the stabilization splint (SS), three explored the comparison between the SS and the nociceptive trigeminal inhibition splint (NTIS) and two the NTIS. The majority of publications reported a positive outcome of splint therapy. Regarding the type of oral splint usage, the most commonly used one was the SS, followed by the NTIS. The definition and assessment of pain were heterogenous in the identified articles. The findings of the current study showed that occlusal splints may help with pain management, and that effective treatment of TMD-related pain at an early stage can enhance the quality of life of patients.
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Affiliation(s)
- Oana Almăşan
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Mihaela Hedeşiu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucu£a
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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Albagieh H, Alomran I, Binakresh A, Alhatarisha N, Almeteb M, Khalaf Y, Alqublan A, Alqahatany M. Occlusal splints-types and effectiveness in temporomandibular disorder management. Saudi Dent J 2023; 35:70-79. [PMID: 36817028 PMCID: PMC9931504 DOI: 10.1016/j.sdentj.2022.12.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Background Occlusal splints are routinely used in dental offices to diagnose and treat abnormalities of the masticatory system. There are different occlusal splints, each of which can address various conditions. They may treat individuals with temporomandibular disorders (TMDs) and bruxism or be used for occlusal stabilization and dentition wear reduction. Methods The literature in the National Library of Medicine's Medline Database was reviewed using the Mesh terms 'occlusal splints' AND 'Temporomandibular Disorders. Conclusion Occlusal splints can treat a wide variety of TMDs. They can treat bruxism, headaches, postural imbalances related to TMDs, and decreased vertical dimension of occlusion (VDO). However, there is no clear evidence that occlusal splints are superior to physiotherapy in treating TMDs. In the long-term follow-up, they were equally effective as other therapies.
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Affiliation(s)
- Hamad Albagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,Corresponding author at: College of Dentistry, Building 23, 2nd Floor, Office# 2B 19, Saudi Arabia.
| | - Ibrahim Alomran
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Meteb Almeteb
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Yousef Khalaf
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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ALMASAN O, ROMAN RA, BUDURU S. An Unusual Case of Temporomandibular Joint Disorder Resembling Migraine. MAEDICA 2022; 17:985-989. [PMID: 36818250 PMCID: PMC9923078 DOI: 10.26574/maedica.2022.17.4.985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
This article presents the case of a 32-year-old woman with two distinct temporomandibular joint pathologies: right temporomandibular joint arthralgia, headache, disc displacement with reduction and intermittent locking, and limited opening, whereas the left temporomandibular joint was showing arthralgia and subluxation. A neurologist was regularly consulted and treated the patient for migraine. A detailed clinical assessment was used in the therapeutic approach. Cone beam computed tomography (CBCT) was used in the paraclinical assessment to evaluate the temporomandibular joint (TMJ); CBCT imaging revealed condylar bone changes that were not correlated with the clinical symptoms. To alleviate TMJ symptoms, the treatment plan included anti-inflammatory drugs, physiotherapy and an occlusal splint with lateral guiding ramps. After three months of anti-inflammatory medication, physiotherapy and splint wear, an improvement in the migraine symptoms and enhanced life quality was reported. The variation in pathology between the right and left joints and the extended history of temporomandibular disorder onset with no definitive diagnosis or therapy make this case unique.
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Affiliation(s)
- Oana ALMASAN
- Prosthetic Dentistry and Dental Materials Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Raluca Ancuta ROMAN
- Maxillofacial Surgery and Radiology Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400429 Cluj-Napoca, Romania
| | - Smaranda BUDURU
- Prosthetic Dentistry and Dental Materials Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
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Javed F, Ahmed HB, Zafar MS, Shaikh MS, Rossouw PE, Michelogiannakis D, Alstergren P. "Testosterone decreases temporomandibular joint nociception"- A systematic review of studies on animal models. Arch Oral Biol 2022; 139:105430. [PMID: 35461068 DOI: 10.1016/j.archoralbio.2022.105430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/17/2022] [Accepted: 04/10/2022] [Indexed: 12/09/2022]
Abstract
OBJECTIVE The aim of the present systematic review was to assess the effect of testosterone on temporomandibular joint (TMJ) nociception. DESIGN A systematic review of pertinent indexed literature was performed. The focused question addressed was "Is there a connection between testosterone and TMJ nociception?" Original studies were included. In-vitro and ex-vivo studies, case-reports/series, letters to the Editor and commentaries were not sought. Indexed databases were searched without time and language restrictions up to and including September 2021 using different free text key words: testosterone OR "male sex hormones" OR "gonadal hormones" AND "temporomandibular joint" OR "temporomandibular dysfunction" AND nociception AND males. The literature search was performed in accordance with the preferred reporting outcomes of systematic reviews and meta-analysis guidelines. The risk of bias (RoB) was assessed using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool. RESULTS Out of the 406 studies identified, seven studies on animal-models were included. All studies were performed in rats with age and weight ranging between 21 and 90 days and 200-300 g, respectively. Testosterone was administered in concentrations ranging between 1 and 10 mg/Kg. Results from all studies showed that testosterone administration in gonadectomized male rats reduces induced TMJ nociception. The RoB was high in 3 and unclear in 4 studies. CONCLUSION Testosterone offers protection against TMJ nociception in male rats; however, from a clinical perspective, potential contribution of testosterone therapy towards the management of TMD remains indeterminate.
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Affiliation(s)
- Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY 14620, United States.
| | | | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | - Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi 75510, Pakistan
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY 14620, United States
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY 14620, United States
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö, Sweden; Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden; Specialized Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
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The Role of Pain Inflexibility and Acceptance among Headache and Temporomandibular Disorders Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137974. [PMID: 35805650 PMCID: PMC9265370 DOI: 10.3390/ijerph19137974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023]
Abstract
Temporomandibular disorders (TMD) and headache are complex. This study aims to assess the association between TMD, headache, and psychological dimensions such as psychological inflexibility and pain acceptance. The sample consisted of 120 participants following a non-probabilistic convenience sampling strategy through a direct invitation to the patients attending our facilities and their relatives (n = 61 diagnosed with headache, n = 34 diagnosed with TMD-headache, n = 25 control group). Diagnostic Criteria for Temporomandibular Disorders (DC-TMD), International Classification of Headache Disorders (ICHD-3 beta version), Chronic Pain Acceptance Questionnaire (CPAQ-8), and Psychological Inflexibility in Pain Scale (PIPS) were used as assessment tools. One-way ANOVA, multiple regression analysis (MRA), and the Johnson-Neyman approach were run by IBM SPSS, version 27 (IBM® Company, Chicago, IL, USA). The significance level was 0.05. One third of our sample presented with headache with TMD. Females were predominant. Males with headache, no systemic disease, less pain severity but higher frequency, living longer with the disease and having sensitive changes, showed higher pain acceptance. When headache occurs with TMD, women with higher education, no headache family history, less pain, and no motor changes showed higher pain acceptance. Patients with both conditions are more liable to have chronic pain and pain inflexibility. Pain intensity and willingness explain 50% of the psychological inflexibility in the headache group. In our sample, individuals suffering from both conditions show greater pain inflexibility, implicating more vivid suffering experiences, leading to altered daily decisions and actions. However, further studies are needed to highlight this possible association.
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Pitak-Arnnop P, Mutirangura W, Neff A. TMDs for ENTs - Some more details from non-ENTs. Am J Otolaryngol 2022; 43:103414. [PMID: 35279285 DOI: 10.1016/j.amjoto.2022.103414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/08/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Poramate Pitak-Arnnop
- Attending, Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany.
| | - Wantanee Mutirangura
- Associate Professor, Department of Occlusion and Accredited Training Center for Dental Occlusion and Orofacial Pain, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Andreas Neff
- Head Professor and Chairman, Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany; Specialist for Functional Diagnostics and Therapy of the TMJ (DGFDT), Head of the TMJ Section of the Strasbourg Osteosynthesis Research Group (S.O.R.G), Guideline Coordinator of TMJ Surgery of the German Association for Oral-Maxillofacial Surgeons (DGMKG), Immediate Past President of the European Society of TMJ Surgeons (ESTMJS)
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Dadjoo S, Michelogiannakis D, Rossouw PE, Javed F. Potential adjunct therapies for the management of temporomandibular disorders: An evidence-based review. Cranio 2022:1-11. [PMID: 35156534 DOI: 10.1080/08869634.2022.2036437] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim was to review the role of adjuvant therapies that may potentially contribute toward the management of temporomandibular disorders (TMD). METHODS The addressed focused question was, "Are there any adjuvant therapies that may contribute toward the management of TMD?". Indexed databases were searched up to June 2021. The eligibility criteria were the following: (a) original clinical studies and (b) randomized controlled clinical trials (RCTs). RESULTS Adjuvant therapies were comprised of acupuncture, manual therapy, jaw exercises, dietary modifications, botulinum toxin therapy, and photobiomodulation. Short-term follow-up results from each of these RCTs showed beneficial effects in terms of pain reduction and improvements in jaw movement among patients with TMD. There are no long-term follow-up results in this regard. CONCLUSION The most effective adjunct treatment for managing TMD remains unknown, primarily due to a lack of sufficient scientific evidence.
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Affiliation(s)
- Shaahin Dadjoo
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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