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Borges REA, Mendonça LDRA, Roncalli da Costa Oliveira AG, Dos Santos Calderon P. Development and Validation of the Epidemiological Diagnostic Instrument for Temporomandibular Disorders. J Oral Rehabil 2024. [PMID: 39238186 DOI: 10.1111/joor.13853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 08/09/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are a highly misreported health problem. Its diagnosis is complex and requires the use of valid and reliable instruments. OBJECTIVE To develop and validate the Epidemiological Diagnostic Instrument for TMD (EDI/TMD). METHODS Content validity (CV), response process (RP), construct validity (EFA), reliability (inter and intraobserver consistency), and convergence validity of the EDI/TMD were assessed and compared to the Diagnostic Criteria for TMD (DC/TMD). RESULTS An instrument composed of a 9-question questionnaire and a 12-step clinical protocol was developed. CV analysis reduced the instrument to a 5-question and 7-step clinical protocol (CVI = 0.93). Some instructions were included after the RP. The EFA found three factors: myogenous TMD, arthrogenous TMD, and differential diagnosis. The reliability scores ranged from substantial to excellent. When compared to the DC/TMD, the EDI/TMD total score indicated that this instrument is valid and provides satisfactory diagnostic criteria (Kappa = 0.906; p < 0.001), and can distinguish non-TMD and TMD individuals, with a cut-off point of 4.9 (Sensitivity = 1.0; Specificity = 1.0; AUC = 1.0). For individuals who had both myogenous and arthrogenous TMD, the cut-off point was 14 or higher (Sensitivity = 0.8; Specificity = 1.0; AUC = 0.987). For individuals who had either myogenous TMD (Sensitivity = 1.0; Specificity = 0.88; PPV = 0.89; NPV = 1.0) or arthrogenous TMD (Sensitivity = 0.95; Specificity = 0.87; PPV = 0.83; NPV = 0.96), the cut-off point was between 5 and 13.9, with the highest EFA score being the determinant factor for final diagnosis. CONCLUSION Based on its psychometric properties, the EDI/TMD is a valid and reliable assessment tool that is capable of diagnosing TMD and classifying its subtypes.
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van der Meer HA, van der Wal AC, van Hinte G, Speksnijder CM. Counselling for patients with a temporomandibular disorder: A scoping review and concept analysis. J Oral Rehabil 2024. [PMID: 39225165 DOI: 10.1111/joor.13827] [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: 07/14/2023] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND An integral component of comprehensive temporomandibular disorder (TMD) treatment involves what is commonly referred to in literature as patient counselling or patient education. Despite its importance, a clear definition of the concept is lacking. OBJECTIVES To describe the concept of counselling (i.e. what is it, what should it consist of, and when should it be given) through a concept analysis of the literature. ELIGIBILITY CRITERIA All papers that include a description of counselling or education for TMD are included. SOURCES OF EVIDENCE Literature searches were performed in the electronic databases PubMed, Cinahl, and PsycInfo. CHARTING METHODS A qualitative analysis was done using the principle-based concept analysis approach, where descriptions of counselling from the included papers were analysed by the researchers. RESULTS A total of 71 articles were included. Based on the qualitative analysis of the included articles and descriptions of counselling, the following content themes were identified: (1) general information on TMD; (2) overuse of the masticatory system; (3) posture education; (4) lifestyle and psychosocial factors; (5) exercise- and thermotherapy; and (6) additional information and therapies. CONCLUSIONS A definition and framework of counselling for TMD has been provided, which can be used in the clinic, research, and educational programs.
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Affiliation(s)
- Hedwig A van der Meer
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Orofacial Pain and Disfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit (VU) University Amsterdam, Amsterdam, The Netherlands
- Department of Oral-Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Annemarie C van der Wal
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Orofacial Pain and Disfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit (VU) University Amsterdam, Amsterdam, The Netherlands
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Gerben van Hinte
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caroline M Speksnijder
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Oral-Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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3
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Wei Y, Guo R, Zhao S. The clinical study and multi-factor analysis of temporomandibular joint disorder induced by tooth extraction. Curr Probl Surg 2024; 61:101554. [PMID: 39168539 DOI: 10.1016/j.cpsurg.2024.101554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 08/23/2024]
Affiliation(s)
- Yunpeng Wei
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Ruitong Guo
- Department of Pharmacy, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School,Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Sufeng Zhao
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
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4
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Ozmen EE, Unuvar BS. The effects of dry needling and face yoga on pain, depression, function, and sleep quality in patients with temporomandibular dysfunction. Explore (NY) 2024; 20:102980. [PMID: 38281850 DOI: 10.1016/j.explore.2024.01.006] [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: 11/02/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
CONTEXT Temporomandibular joint dysfunction (TMD) poses significant challenges due to its diverse symptoms and impact on patients' daily lives. OBJECTIVE This study aimed to explore the effectiveness of two innovative interventions, dry needling and face yoga, in managing TMD-related issues such as pain, depression, and sleep quality. DESIGN AND STUDY PARTICIPANTS Ninety patients with TMD symptoms were enrolled in a prospective randomized controlled trial. The patients were divided into three groups: dry needling, face yoga, and a control group. Various assessments, including Visual Analog Scale for pain, Beck Depression Inventory for depression, and Pittsburgh Sleep Quality Index for sleep quality, were conducted before and 6 weeks after the interventions. RESULTS A decrease in pain levels and a statistically significant increase in jaw joint movements (mouth opening, protrusive movement, lateral movements) were observed in the dry needling and face yoga groups after treatment (p <0.05). Additionally, improvements in sleep quality were observed (p <0.05). CONCLUSION Dry needling and face yoga interventions demonstrated efficacy in managing TMD symptoms, including pain relief and improved jaw movement. The findings suggest that these interventions can be valuable additions to the treatment regimen for patients suffering from TMD-related issues. However, further research is warranted to explore the long-term effects and mechanisms underlying these interventions in TMD management.
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Affiliation(s)
- Elif Esra Ozmen
- Department of Oral and Maxillofacial Surgery, Karamanoglu Mehmetbey University, Karaman, Turkiye.
| | - Bayram Sonmez Unuvar
- Faculty of Health Sciences, Department of Audiology, KTO Karatay University, Konya, Turkiye
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Sauvageon L, Savard G, Moussa C, Rochefort GY, Denis F, Fossat C, Renaud M. Dentists and physiotherapists level of collaboration in the treatment of temporomandibular disorders in France. BMC Oral Health 2024; 24:979. [PMID: 39174944 PMCID: PMC11342734 DOI: 10.1186/s12903-024-04768-8] [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: 04/09/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVES Temporomandibular disorders (TMD) affect 10% of the population in France, significantly impacting patient's health and quality of life. The multifactorial etiology of TMD complicates its treatment. Consequently, adopting a multidisciplinary approach that encourages collaboration among healthcare professionals is recommended. Nevertheless, this approach does not seem to occur on a regular basis. The aim of this study was to assess the dentist's treatment support of TMD in the context of the inter-professional collaboration between dental practitioners and physiotherapists. MATERIEL AND METHODS A cross-sectional observational study was conducted based on an online questionnaire from January 15th to April 30th, 2023. The data are collected through Professional Broad, Regional Unions of Health Professional and Healthcare Professional Communities and Territories. RESULTS Of the 420 responses analyzed, the main first-line treatment provided by the dentist was the correction of dental occlusion (84%). The rate of referral to a physiotherapist was 57% and was 75% for second-placed treatment. The main reason for the lack of referral was a lack of awareness of physiotherapy role in the management of TDM. We observed that 70% of dental health practitioners were interested about inter-professional collaboration and the development of postgraduate training. CONCLUSION Given the difficulty of managing TDM, efforts should be made to improve inter professional management. CLINICAL RELEVANCE The implementation of appropriate teaching in initial training seems to be essential to allow dentists to open the range of treatment for TMD with increased knowledge of physiotherapy techniques for an adapted prescription to the patient.
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Affiliation(s)
- Loanne Sauvageon
- University School of Physiotherapy, Orléans University, Orléans, France
| | - Guillaume Savard
- Department of Medicine and Bucco-Dental Surgery, Faculty of Odontology, Tours Hospital, Tours University, Tours, France
- Bioengineering Biomodulation and Imaging of the Orofacial Sphere, 2Bios, Tours University, Tours, 37000, France
- EA75-05 Education, Ethique, Santé, Tours University, Tours, France
| | - Carol Moussa
- Department of Medicine and Bucco-Dental Surgery, Faculty of Odontology, Tours Hospital, Tours University, Tours, France
- Bioengineering Biomodulation and Imaging of the Orofacial Sphere, 2Bios, Tours University, Tours, 37000, France
- EA75-05 Education, Ethique, Santé, Tours University, Tours, France
| | - Gael Y Rochefort
- Department of Medicine and Bucco-Dental Surgery, Faculty of Odontology, Tours Hospital, Tours University, Tours, France
- Bioengineering Biomodulation and Imaging of the Orofacial Sphere, 2Bios, Tours University, Tours, 37000, France
- Tours University, iBrain U1253 INSEM, Tours, France
| | - Frédéric Denis
- Department of Medicine and Bucco-Dental Surgery, Faculty of Odontology, Tours Hospital, Tours University, Tours, France
- EA75-05 Education, Ethique, Santé, Tours University, Tours, France
| | - Cécile Fossat
- University School of Physiotherapy, Orléans University, Orléans, France
- Medical Intensive Care Unit, Orléans Hospital, Orléans, France
| | - Matthieu Renaud
- Department of Medicine and Bucco-Dental Surgery, Faculty of Odontology, Tours Hospital, Tours University, Tours, France.
- Bioengineering Biomodulation and Imaging of the Orofacial Sphere, 2Bios, Tours University, Tours, 37000, France.
- Tours University, N2C U1069 INSERM, Tours, France.
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Zlendić M, Vrbanović E, Trošelj KG, Tomljanović M, Đerfi KV, Alajbeg IZ. Genetic influence on treatment outcomes in patients with pain-related temporomandibular disorders. J Oral Rehabil 2024; 51:1542-1554. [PMID: 38725226 DOI: 10.1111/joor.13730] [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: 10/06/2023] [Revised: 03/28/2024] [Accepted: 04/26/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Single nucleotide polymorphisms (SNPs) may influence pain susceptibility and impact treatment response in pain-related temporomandibular disorders (TMDp). OBJECTIVE Explore the role of COMT (rs4646310, rs6269, rs4818, rs4680) and OPRM1 (rs1799971) genotypes in regulating treatment response. METHODS Sixty TMDp patients (55 females and 5 males), diagnosed with the Diagnostic Criteria for TMD (DC/TMD), underwent standardised treatment (information and education, home physical therapy, occlusal splint) for 6 months. Treatment outcomes included: pain intensity, pain-free mouth opening, jaw functional limitation, depression, and anxiety. Genotyping for COMT and OPRM1 SNPs was performed using DNA from buccal mucosa swabs and TaqMan assays. Statistical analysis was carried out to compare the changes in treatment outcomes and the influence of genotypes on treatment response. RESULTS Significantly less pain reduction was observed in minor allele carriers of rs4646310, and rs4680 compared to dominant homozygous (p < .025). Minor allele carriers of rs1799971 and rs4646310 demonstrated worsening in pain-free mouth opening while dominant homozygous exhibited improvement (p < .025). Significantly less anxiety reduction was observed in minor allele carriers of rs4646310 compared to dominant homozygous (p = .003). Of the all variables assessed in the regression model, carrying a minor allele of rs1799971 predicted a poorer treatment response considering pain-free mouth opening while carrying a minor allele of rs4646310 predicted less pain and less anxiety reduction. CONCLUSION Our findings indicate that certain SNP variants of the COMT and OPRM1 genes were associated with poorer treatment response and may therefore play a significant role in the classification of TMDp patients. Also, assessment of patient genotype could potentially aid in predicting treatment response.
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Affiliation(s)
- Marko Zlendić
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - Ema Vrbanović
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - Koraljka Gall Trošelj
- Division of Molecular Medicine, Laboratory for Epigenomics, Ruđer Bošković Institute, Zagreb, Croatia
| | - Marko Tomljanović
- Division of Molecular Medicine, Laboratory for Epigenomics, Ruđer Bošković Institute, Zagreb, Croatia
| | - Kristina Vuković Đerfi
- Division of Molecular Medicine, Laboratory for Personalized Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Iva Z Alajbeg
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Centre Zagreb, Zagreb, Croatia
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Wang Y, Zhao Y, Xie Q. Visual psychosocial profiling of Chinese temporomandibular disorder pain patients and correlations with somatosensory function. J Oral Rehabil 2024; 51:1401-1412. [PMID: 38661392 DOI: 10.1111/joor.13710] [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: 05/23/2023] [Revised: 03/18/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied. OBJECTIVE The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively. METHODS The Symptom Checklist 90 (SCL-90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age- and gender-matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons. RESULTS 100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001). CONCLUSIONS Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment.
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Affiliation(s)
- Yang Wang
- First Clinical Division and Center for Oral Function Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Yanping Zhao
- Center for TMD and Orofacial Pain, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Qiufei Xie
- Department of Prosthodontics and Center for Oral Function Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
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8
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Shivakumar S, Abdul NS, Jyoti B, Kalburgi V, Cicciù M, Minervini G. Comparative evaluation of cognitive behavioural therapy versus standard treatment in temporomandibular disorders: A systematic review. J Oral Rehabil 2024. [PMID: 39041325 DOI: 10.1111/joor.13792] [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: 07/10/2023] [Revised: 10/19/2023] [Accepted: 06/20/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Temporomandibular disorders (TMDs) are musculoskeletal and neuromuscular conditions affecting the temporomandibular joint and associated structures. Cognitive-behavioural therapy (CBT) has emerged as a potential intervention for TMDs, but its comparative effectiveness against standard treatments remains unclear. This systematic review aimed to evaluate and compare the efficacy of CBT versus standard treatment interventions in managing TMDs. METHODS A comprehensive search was conducted across multiple databases using MeSH keywords and Boolean operators. Inclusion criteria encompassed clinical trials comparing CBT/CBT in combination with standard treatment interventions or a control group in individuals with TMDs. The primary outcome measured was pain. Secondary outcomes such as disability, depression and jaw function were also looked into. Two reviewers independently assessed for the eligibility of the articles and conducted data extraction. Quality assessments were performed using RoB 2.0 for randomised clinical trials. RESULTS The initial search identified 623 articles, of which a total of eight clinical studies met the inclusion criteria and were included in the systematic review. Seven out of eight studies demonstrated improvements in outcomes related to TMD. Pain was significantly decreased in studies that showed a positive outcome. Jaw function, quality of life and psychological well-being were superior among individuals receiving CBT alone or in combination with conventional modalities, as well as hypnotic therapy coupled with CBT-based interventions. The quality of studies assessed showed all articles to be of good quality as per RoB-2 evaluation. CONCLUSION This systematic review highlights the potential benefits of CBT in managing TMDs, suggesting its effectiveness in improving pain outcomes and enhancing overall well-being. The findings indicate that CBT may be a valuable adjunct or alternative to standard treatment interventions for individuals with TMDs. However, further research with larger sample sizes and standardised outcome measures is warranted to establish definitive conclusions regarding the comparative efficacy of CBT versus standard treatments in TMD management.
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Affiliation(s)
- Sahana Shivakumar
- Public Health Dentistry, Peoples College of Dental Sciences and Research Centre Peoples University Bhopal, Bhopal, India
| | - Nishath Sayed Abdul
- Faculty of Oral Pathology, Department of OMFS and Diagnostic Sciences, Riyadh Elm University Riyadh, Riyadh, Saudi Arabia
| | - Bhuvan Jyoti
- Dental Surgeon and Consultant, Oral Medicine and Radiology Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS), Ranchi, India
| | - Veena Kalburgi
- Periodontics, Peoples College of Dental Sciences and Research Centre Peoples University Bhopal, Bhopal, India
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Abdul NS. Data analysis for differentiating temporo mandibular disorders (TMD) pain from tooth pain. Bioinformation 2024; 20:674-677. [PMID: 39131527 PMCID: PMC11312320 DOI: 10.6026/973206300200674] [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: 06/01/2024] [Revised: 06/30/2024] [Accepted: 06/30/2024] [Indexed: 08/13/2024] Open
Abstract
The factors differentiating temporomandibular disorders (TMD) pain from tooth pain is of interest to dentists. Prior to receiving therapy, participants answered the six-question TMD Pain Screener questionnaire. Applying validated Diagnostic Guidelines for TMD (DC/TMD), an orofacial pain specialist and endodontic resident with board certification performed endodontic and TMD examinations. In our study, sensitivity was higher for TMD screener regarding identification of all types of TMDs (0.94 (0.80-0.97), TMD pain not referring to teeth (0.94 (0.76-0.98), TMD pain referring to teeth only (0.94 (0.64-1.00)). TMD Pain Screener questionnaire can be applied in identification of TMDS in patient seeking endodontic therapy.
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Affiliation(s)
- Nishath Sayed Abdul
- Faculty of Oral Pathology, Department of OMFS and Diagnostic Sciences, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
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Maniaci A, Lavalle S, Anzalone R, Lo Giudice A, Cocuzza S, Parisi FM, Torrisi F, Iannella G, Sireci F, Fadda G, Lentini M, Masiello E, La Via L. Oral Health Implications of Obstructive Sleep Apnea: A Literature Review. Biomedicines 2024; 12:1382. [PMID: 39061956 PMCID: PMC11274061 DOI: 10.3390/biomedicines12071382] [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: 04/25/2024] [Revised: 06/03/2024] [Accepted: 06/12/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. While the systemic implications of OSA are well documented, the dental consequences are less frequently discussed yet equally significant. This review aims to elucidate the oral health impacts of OSA, emphasizing the importance of interdisciplinary care. METHODS A comprehensive literature search was conducted across several databases to identify studies examining the relationship between OSA and various oral health parameters. The review included observational studies, clinical trials, and systematic reviews published in English up to January 2024. RESULTS OSA was significantly associated with heightened risks of bruxism, dry mouth, periodontal disease, temporomandibular joint disorders, palatal and dental changes, and alterations in taste sensation. Mouth breathing associated with OSA was a critical factor in exacerbating xerostomia and dental caries. Furthermore, the systemic inflammation induced by OSA appeared to correlate with the severity of periodontal disease. Patients using oral appliance therapy for OSA also showed notable changes in dental occlusion and required ongoing dental monitoring. CONCLUSIONS The findings underscore the bidirectional relationship between OSA and oral health, highlighting the need for dental professionals to be integral participants in the management of OSA. Early dental evaluation and intervention can contribute to the overall health and quality of life of individuals with OSA. The review advocates for the development of clinical guidelines to facilitate the early identification and management of OSA-related oral health issues within dental practice and encourages a collaborative approach to patient care.
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Affiliation(s)
- Antonino Maniaci
- Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (F.T.)
| | - Salvatore Lavalle
- Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (F.T.)
| | - Riccardo Anzalone
- Otorhinolaryngology Section, Biomedicine, Neuroscience and Advanced Diagnostic Department, University of Palermo, 90127 Palermo, Italy; (R.A.); (F.S.)
| | - Antonino Lo Giudice
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy;
| | - Salvatore Cocuzza
- Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia” ENT Section, University of Catania, 95124 Catania, Italy; (S.C.); (F.M.P.)
| | - Federica Maria Parisi
- Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia” ENT Section, University of Catania, 95124 Catania, Italy; (S.C.); (F.M.P.)
| | - Filippo Torrisi
- Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (F.T.)
| | - Giannicola Iannella
- Otorhinolaryngology Department, Sapienza University of Rome, 00161 Rome, Italy;
| | - Federico Sireci
- Otorhinolaryngology Section, Biomedicine, Neuroscience and Advanced Diagnostic Department, University of Palermo, 90127 Palermo, Italy; (R.A.); (F.S.)
| | - Gianluca Fadda
- Department of Otolaryngology, San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, Italy;
| | - Mario Lentini
- ASP Ragusa-Hospital Giovanni Paolo II, 97100 Ragusa, Italy;
| | - Edoardo Masiello
- Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Luigi La Via
- Department of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Policlinico “G.Rodolico-San Marco”, 95123 Catania, Italy;
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Saadat Sarmadi B, Schmidt F, Beuer F, Metin DS, Simeon P, Nicic R, Unkovskiy A. The Effect of Build Angle and Artificial Aging on the Accuracy of SLA- and DLP-Printed Occlusal Devices. Polymers (Basel) 2024; 16:1714. [PMID: 38932064 PMCID: PMC11207952 DOI: 10.3390/polym16121714] [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: 04/14/2024] [Revised: 05/22/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
The aim of this study is to investigate the influence of printing material, build angle, and artificial aging on the accuracy of SLA- and DLP-printed occlusal devices in comparison to each other and to subtractively manufactured devices. A total of 192 occlusal devices were manufactured by one SLA-printing and two DLP-printing methods in 5 different build angles as well as milling. The specimens were scanned and superimposed to their initial CAD data and each other to obtain trueness and precision data values. A second series of scans were performed after the specimens underwent an artificial aging simulation by thermocycling. Again, trueness and precision were investigated, and pre- and post-aging values were compared. A statistically significant influence was found for all main effects: manufacturing method, build angle, and thermocycling, confirmed by two-way ANOVA. Regarding trueness, overall tendency indicated that subtractively manufactured splints were more accurate than the 3D-printed, with mean deviation values around ±0.15 mm, followed by the DLP1 group, with ±0.25 mm at 0 degree build angle. Within the additive manufacturing methods, DLP splints had significantly higher trueness for all build angles compared to SLA, which had the highest mean deviation values, with ±0.32 mm being the truest to the original CAD file. Regarding precision, subtractive manufacturing showed better accuracy than additive manufacturing. The artificial aging demonstrated a significant influence on the dimensional accuracy of only SLA-printed splints.
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Affiliation(s)
- Bardia Saadat Sarmadi
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Dilan Seda Metin
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Philipp Simeon
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Robert Nicic
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow 119146, Russia
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Lau Rui Han S, Xiang J, Zeng XX, Fan PD, Cheng QY, Zhou XM, Ye Z, Xiong X, Wang J. Relationship Between Temporomandibular Joint Effusion, Pain, and Jaw Function Limitation: A 2D and 3D Comparative Study. J Pain Res 2024; 17:2051-2062. [PMID: 38881762 PMCID: PMC11180444 DOI: 10.2147/jpr.s448283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 05/26/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose This study aimed to investigate the relationship between temporomandibular joint (TMJ) effusion and TMJ pain, as well as jaw function limitation in patients via two-dimensional (2D) and three-dimensional (3D) magnetic resonance imaging (MRI) evaluation. Patients and Methods 121 patients diagnosed with temporomandibular disorder (TMD) were included. TMJ effusion was assessed qualitatively using MRI and quantified with 3D Slicer software, then graded accordingly. In addition, a visual analogue scale (VAS) was employed for pain reporting and an 8-item Jaw Functional Limitations Scale (JFLS-8) was utilized to evaluate jaw function limitation. Statistical analyses were performed appropriately for group comparisons and association determination. A probability of p<0.05 was considered statistically significant. Results 2D qualitative and 3D quantitative strategies were in high agreement for TMJ effusion grades (κ = 0.766). No significant associations were found between joint effusion and TMJ pain, nor with disc displacement and JLFS-8 scores. Moreover, the binary logistic regression analysis showed significant association between sex and the presence of TMJ effusion, exhibiting an Odds Ratio of 5.168 for females (p = 0.008). Conclusion 2D qualitative evaluation was as effective as 3D quantitative assessment for TMJ effusion diagnosis. No significant associations were found between TMJ effusion and TMJ pain, disc displacement or jaw function limitation. However, it was suggested that female patients suffering from TMD may be at a risk for TMJ effusion. Further prospective research is needed for validation.
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Affiliation(s)
- Sophie Lau Rui Han
- 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, Sichuan Province, People's Republic of China
| | - Jie Xiang
- 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, Sichuan Province, People's Republic of China
| | - Xiang-Xiang Zeng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Pei-Di 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, Sichuan Province, People's Republic of China
| | - Qiao-Yu 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, Sichuan Province, People's Republic of China
| | - Xue-Man 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, Sichuan Province, People's Republic of China
| | - Zheng Ye
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xin Xiong
- 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, Sichuan Province, People's Republic of China
| | - Jun Wang
- 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, Sichuan Province, People's Republic of China
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Tariq M, Fatima K, Khan SFA, Mahmood W, Mahmood T, Khurshaid S, Khalid M, Khoosa M, Babur MN. Efficacy of massage versus massage with post isometric relaxation in temporomandibular disorders: a randomized controlled trial. BMC Sports Sci Med Rehabil 2024; 16:110. [PMID: 38750518 PMCID: PMC11097573 DOI: 10.1186/s13102-024-00865-x] [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: 12/15/2023] [Accepted: 03/15/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Temporomandibular joint disorder (TMD) is a common condition affecting the masticatory muscles and joint mobility. OBJECTIVES The primary objective was to compare the effects of massage therapy alone and massage therapy combined with post-isometric relaxation exercises in patients with TMD for pain and maximal mouth opening. DESIGN Assessor-blinded randomized controlled trial. SETTING Sir Ganga Ram Hospital, Chaudhry Muhammad Akram Dental Hospital, Lahore Medical and Dental Hospital. SUBJECTS Temporomandibular joint disorder patients. INTERVENTION Group A (n = 23) received conventional treatment including massage and therapeutic exercises consecutively for 2 weeks. Group B (n = 23) received post-isometric relaxation technique along with conventional treatment for consecutive 2 weeks. MAIN MEASURES The main outcome measures were pain and maximal mouth opening. Pain was measured using the Visual Analogue Scale (VAS) and maximal mouth opening (MMO) was measured using the TheraBite Scale. RESULTS Both groups demonstrated significant improvements in pain and MMO scores post-treatment. However, Group B (massage with post-isometric relaxation exercises) showed significantly better outcomes compared to Group A (massage alone). There was a statistically significant difference in post-treatment pain scores (P = 0.000) and MMO scores (P = 0.000) between the two groups. CONCLUSION The results suggest that massage therapy combined with post-isometric relaxation is more effective than massage therapy alone in managing pain and improving mouth opening in TMD patients. The study provides evidence supporting the use of these therapies in TMD management. TRIAL REGISTRY NUMBER NCT05810831. Date of registration/First submission: 15 March 2023.
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Affiliation(s)
- Mahnoor Tariq
- Department of Physical therapy & Rehabilitation Sciences, Faculty of Allied health Sciences, Superior University, Lahore, Pakistan
| | - Kainaat Fatima
- Department of Physical therapy & Rehabilitation Sciences, Faculty of Allied health Sciences, Kainaat Fatima Demonstrator, Superior University, Lahore, Pakistan
| | - Shahzada Faiz Ahmad Khan
- Department of Oral & Maxillofacial Surgery, Azra Naheed Dental College, The Superior University, Lahore, Pakistan
| | - Wajeeha Mahmood
- Department of Physical therapy, University of Health Sciences, Lahore, Pakistan.
| | - Tahir Mahmood
- Department of Physical Therapy, Rashid Latif Khan University [RLKU] Lahore, Lahore, Pakistan
| | - Sarma Khurshaid
- Physical Therapy Department Jinnah Hospital, Lahore, Pakistan
| | | | - Mehrunisa Khoosa
- Physical Therapy Department, Allama Iqbal Teaching Hospital, Dera Ghazi Khan, DGK, Pakistan
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Lee YH, Chung JW. Climate temperature and seasonal influences on the prevalence of temporomandibular disorders in South Korea. Sci Rep 2024; 14:10974. [PMID: 38744911 PMCID: PMC11094084 DOI: 10.1038/s41598-024-61829-2] [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: 12/29/2023] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
This study aimed to explore seasonal variations in temporomandibular disorder (TMD) prevalence in South Korea, utilizing nationwide population-based big data. Data corresponding to the Korean Standard Classification of Diseases code of K07.6, which identifies TMD, were extracted from the Health Insurance Review and Assessment Service online platform for the period from 2010 to 2022. Additionally, we integrated these data with climate temperature records from the Korean Meteorological Administration. We subsequently conducted a statistical analysis of TMD patient data on a monthly and seasonal basis over the past 13 years to assess prevalence. Over the past 13 years, the number of TMD patients in Korea has steadily increased. The prevalence of TMD rose from 0.48% (224,708 out of a total population of 50,515,666) in 2010 to 0.94% (482,241 out of a total population of 51,439,038) in 2022, marking a 1.96-fold increase. Among children under 10 years of age, no significant differences were observed in TMD prevalence between boys and girls. However, a distinct female predominance emerged after the age of 10, with an average female-to-male ratio of 1.51:1. The peak prevalence of TMD occurred in individuals in their 20 s, followed by adolescents in their late 10 s. The majority of TMD patients were concentrated in Seoul and Gyeonggi province, with metropolitan areas accounting for 50% of the total patient count. Seasonally, TMD patient numbers showed no significant increase in winter compared with spring or summer. The temperature difference, defined as the absolute difference between the highest and lowest temperatures for each month, showed a positive correlation with TMD patient counts. A greater temperature difference was associated with higher patient counts. The strongest correlation between temperature differences and TMD patient numbers was observed in winter (r = 0.480, p < 0.01), followed by summer (r = 0.443, p < 0.01), and spring (r = 0.366, p < 0.05). Temperature differences demonstrated a significantly stronger correlation with the increase in the number of TMD patients than absolute climate temperatures. This aspect should be a key consideration when examining seasonal trends in TMD prevalence in South Korea.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, College of Dentistry, Kyung Hee University Dental Hospital, Kyung Hee University, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Jin-Woo Chung
- Department of Oral Medicine and Oral Diagnosis, Seoul National University School of Dentistry, #101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
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15
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Long YF, Zheng YH, Fu YH, Si JR, Yue Y, Liu Y, Xiong X. Pain symptoms are associated with two-point discrimination threshold in patients with temporomandibular disorders. Clin Oral Investig 2024; 28:273. [PMID: 38664277 DOI: 10.1007/s00784-024-05667-6] [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: 11/19/2023] [Accepted: 04/16/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE This study aimed to explore the associations of orofacial two-point discrimination (2-PD) test result with pain symptoms and psychological factors in patients with Temporomandibular Disorders (TMDs). METHODS 193 patients with TMDs were included in this study. Patients' demographics, pain intensity, and psychological status were recorded. The 2-PDs in the bilateral temporal, zygomatic, mandibular, and temporomandibular joint (TMJ) regions of the patients were measured. Statistical analyses were conducted to observe the associations between variables. RESULTS For Pain-related TMDs (PT) patients, Monthly Visual Analogue Scale (VAS-M) and Current Analogue Scale (VAS-C) were correlated with TMJ, zygomatic and temporal 2-PDs. Patients with PT tended to have higher TMJ 2-PDs[Right: β = 1.827 mm, 95%CI(0.107, 3.548), P = 0.038], zygomatic 2-PDs[Right: β = 1.696 mm, 95%CI(0.344, 3.048), P = 0.014], temporal 2-PDs[Left: β = 2.138 mm, 95%CI(0.127, 4.149), P = 0.037; Right: β = 1.893 mm, 95%CI(0.011, 3.775), P = 0.049]. Associations were also observed between VAS-C and TMJ 2-PDs[Left: β = 0.780, 95%CI(0.190, 1.370), P = 0.01; Right: β = 0.885, 95%CI(0.406, 1.364), P = 0.001], Zygomatic 2-PDs[Right: β = 0.555, 95%CI(0.172, 0.938), P = 0.005]; VAS-M and TMJ 2-PDs[Left: β = 0.812, 95%CI(0.313, 1.311), P = 0.002; Right: β = 0.567, 95%CI(0.152, 0.983), P = 0.008], zygomatic 2-PDs[Left: β = 0.405, 95%CI(0.075, 0.735), P = 0.016; Right: β = 0.545, 95%CI(0.221, 0.870), P = 0.001], and temporal 2-PDs [Left: β = 0.741, 95%CI(0.258, 1.224), P = 0.003; Right: β = 0.519, 95%CI(0.063, 0.975), P = 0.026]. CONCLUSION TMJ, zygomatic, and temporal 2-PDs were significantly associated with PT and pain intensity. Age, gender and psychological factors were not associated with orofacial 2-PDs. PT patients exhibited weaker tactile acuity compared to Non-PT patients. Further discussion on the underlying mechanism is needed. CLINICAL RELEVANCE Orofacial tactile acuity of TMDs patients was associated with their pain symptoms, which researchers should take account into when performing 2-PD tests for TMDs patients. The 2-PD test can be considered as a potential tool along with the current procedures for the differentiations of PT and Non-PT.
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Affiliation(s)
- Yi-Fei Long
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yun-Hao Zheng
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yi-Hang Fu
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jia-Rui Si
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yuan Yue
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yang Liu
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xin Xiong
- Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
- Department of Temporomandibular Joint, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
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Saini RS, Ali Abdullah Almoyad M, Binduhayyim RIH, Quadri SA, Gurumurthy V, Bavabeedu SS, Kuruniyan MS, Naseef PP, Mosaddad SA, Heboyan A. The effectiveness of botulinum toxin for temporomandibular disorders: A systematic review and meta-analysis. PLoS One 2024; 19:e0300157. [PMID: 38483856 PMCID: PMC10939295 DOI: 10.1371/journal.pone.0300157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE The current body of research on utilizing botulinum toxin (BTX) to manage temporomandibular disorders (TMDs) has not yet yielded definitive conclusions. The primary objective of this study was to determine the effectiveness of BTX in pain reduction for TMDs compared to placebo and other treatments. The secondary outcomes evaluated were adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. MATERIALS AND METHODS A literature search was performed on PubMed, Dimension Publication, Scopus, and Google Scholar. The RoB 2 tool was used for quality assessment. The mean differences in pain scores were estimated to measure the effect of BTX on pain reduction. For adverse events, the risk ratio for the incidence of side effects was calculated. RESULTS Two hundred and sixty non-duplicate articles were identified; however, only 14 RCTS were included in this review. The total study population included 395 patients. The overall risk of bias showed a low to moderate quality of evidence. Results from 6 studies were reported only narratively; four studies were used for meta-analysis on pain reduction, and five were used for meta-analysis on adverse events. The control used in the meta-analysis was placebo injections. Results of the meta-analysis for pain reduction were statistically insignificant for the BTX group with mean differences at MD = -1.71 (95% CI, -2.87 to -0.5) at one month, -1.53 (95% CI, -2.80 to -0.27) at three months, and -1.33 (95% CI, -2.74 to 0.77) at six months. This showed that BTX treatment was not significantly better than placebo for a reduction in pain scores at 1, 3, and 6 months. Regarding safety, the placebo group showed a relative risk of 1.34 (95%CI, 0.48-6.78) and 1.17 (95%CI, 0.54-3.88) at 1 and 3 months respectively. However, the risks were not statistically significant. There was also no difference in the effectiveness of BTX compared to placebo and other treatments for maximum mouth opening, bruxism events, and maximum occlusal force. CONCLUSION BTX was not associated with better outcomes in terms of pain reduction, adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. More high-quality RCTs are needed to better understand this topic.
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Affiliation(s)
- Ravinder S. Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | | | | | | | | | - Shashit Shetty Bavabeedu
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | | | - Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Del Carmen Villaverde-Rodríguez M, Correa-Rodríguez M, Casas-Barragán A, Tapia-Haro RM, Aguilar-Ferrándiz ME. Orofacial Pain and Risk of Dysphagia in Women With Fibromyalgia: A Cross-Sectional Observational Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:883-892. [PMID: 38118459 DOI: 10.1044/2023_ajslp-23-00193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
OBJECTIVE This study aims to analyze the frequency of dysphagia risk and swallowing-associated quality of life (QoL) in a sample of women with fibromyalgia syndrome (FMS) and examine the potential relationship between risk of dysphagia and chronic orofacial pain (COP) in a sample of women with FMS. METHOD A cross-sectional observational study was conducted in 46 women with FMS. COP was assessed by mouth opening, the orofacial visual analog scale (VAS), and the craniofacial pain and disability inventory (CF-PDI). Risk of dysphagia was assessed using the Eating Assessment Tool (EAT-10) and the volume-viscosity swallowing test (V-VST). Swallowing-associated QoL was determined using the Swallowing Quality of Life (SWAL-QOL) questionnaire. RESULTS Thirty patients were identified as being at risk for dysphagia (65.21%) using the EAT-10 and, according to the SWAL-QOL, 41.30% of patients had alterations in QoL associated with swallowing. The EAT-10 correlated positively with orofacial VAS, CF-PDI-total, CF-PDI-pain and disability, and CF-PDI-jaw-functional status. In relation to SWAL-QOL, negative correlations were observed for orofacial VAS, CF-PDI-total, CF-PDI-pain and disability, and CF-PDI-jaw-functional status. Patients at risk of dysphagia (EAT-10 and V-VST) had significantly higher scores in orofacial VAS (p = .002 and p = .015), CF-PDI-total (p = .006 and p = .014), and CF-PDI-pain and disability (p = .004 and p = .013). CONCLUSIONS In this sample of women with FMS, we identified a high rate of dysphagia risk. Also, a high percentage of these women presented alterations in QoL associated with swallowing. Patients at risk for dysphagia had significantly higher orofacial VAS and CF-PDI-total scores, supporting the relationship between dysphagia risk and COP in FMS. Further research to establish the need for appropriate assessment referrals in clinical practice to determine whether dysphagia is present in this population is needed.
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Affiliation(s)
- María Del Carmen Villaverde-Rodríguez
- PhD Biomedicine Program, Faculty of Health Sciences (Granada), University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
| | - María Correa-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Nursing, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - Antonio Casas-Barragán
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - Rosa María Tapia-Haro
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - María Encarnación Aguilar-Ferrándiz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
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Mathpati SK, Jain G, Mishra V, Singh AK, Mishra R, Yadav BK. Platelet-Rich Plasma in the Management of Temporomandibular Joint Pain in Young Adults With Temporomandibular Disorder. Cureus 2024; 16:e55609. [PMID: 38586782 PMCID: PMC10995649 DOI: 10.7759/cureus.55609] [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: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) encompasses a range of conditions affecting the temporomandibular joint (TMJ) and associated structures, with TMJ pain being a prevalent symptom. Conventional management strategies have limitations, which require the exploration of innovative interventions. Platelet-rich plasma (PRP), known for its regenerative properties, presents a potential therapeutic avenue. This study aims to investigate the effectiveness of PRP in reducing the pain associated with mild TMJ in young adults. METHODOLOGY Participants (n = 128) aged 18 to 35 years with mild TMD were evenly randomized into PRP treatment and placebo control groups. PRP was prepared using a standardized protocol, and intra-articular injections were administered. Placebo injections mimic PRP. Follow-up evaluations were carried out at four and eight weeks after the intervention. RESULTS The study successfully randomized comparable groups, and the PRP treatment group experienced a significant reduction in TMJ pain (visual analog scale [VAS] score: 6.8 ± 1.2 to 2.1 ± 1.0 at eight weeks, P < 0.001). The PRP treatment also increased the largest opening of the mouth (from 38.2 ± 2.5 to 43.5 ± 3.1, P < 0.001) and the number of lateral movements (12.3 ± 1.5 to 14.9 ± 2.0, P < 0.001), while the placebo group had very few changes. Positive patient-reported outcomes on daily activities were observed, with no serious complications reported in either group. CONCLUSIONS This study provides evidence supporting the efficacy of PRP in reducing TMJ pain, improving jaw function, and improving quality of life in young adults with mild TMD. The results underscore the potential of PRP as a minimally invasive intervention for TMJ disorders.
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Affiliation(s)
- Santosh Kumar Mathpati
- Department of Oral and Maxillofacial Surgery, Navodaya Dental College and Hospital, Raichur, IND
| | - Gourav Jain
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Vijay Mishra
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Atul K Singh
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Rahul Mishra
- Department of Pedodontics and Preventive Dentistry, Faculty of Dentistry, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Bipin K Yadav
- Department of Periodontology, Faculty of Dentistry, Uttar Pradesh University of Medical Sciences, Etawah, IND
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Abdel-Gawwad EA, Atito E, Osman M, Emam ANM, Baraka Y, Abdullah AAB, Helal MA. Evaluating the Impact of Various Treatment Modalities on the Chewing Efficiency of Anterior Disc Displacements of Temporomandibular Joint Disorder Cases: A Comparative Study. J Int Soc Prev Community Dent 2024; 14:136-143. [PMID: 38827358 PMCID: PMC11141894 DOI: 10.4103/jispcd.jispcd_151_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 06/04/2024] Open
Abstract
Aim Internal disc displacement of the temporomandibular joint (TMJ) is identified by an anomaly between the condylar-disc assembly, which, in many cases, may lead to discomfort and malfunction of the chewing function. The study's objective was to assess the effects of four distinct treatment approaches on temporomandibular disorder cases with anterior disc displacements focusing on their chewing efficiency. Materials and Methods One hundred participants suffering from reducible TMJ disc displacement were selected for enrollment in the study. Subjects were divided equally into four groups: group I patients were treated with behavioral therapy; group II patients were treated with low-level laser therapy (LLLT); group III patients were treated with anterior repositioning splints; and group IV patients were treated with flat plane splints. Chewing efficiency was assessed utilizing the fractional sieving method and a synthetic food substitute was created using silicon impression material. The statistical analysis encompassed comparisons of chewing efficiency between groups and between baseline and posttreatment within each group, employing analysis of variance (ANOVA) and paired t tests, respectively. Results Using the paired t test, a significant difference in chewing efficiency values as expressed by the median particle size was observed between the baseline and 6-month values in all groups (P < 0.05), except for group I where no significant change was noted over the 6 months (P > 0.05). The one-way ANOVA test revealed a statistically significant difference among groups following therapies (P ˂ 0.05). The post hoc Tukey test was employed for pairwise comparisons and revealed statistically significant variances in the main values of chewing efficiency among all groups at a 95% confidence level (P ˂ 0.05). Conclusion The study's results suggest that occlusal splints and LLLT are more effective in improving chewing efficiency than behavioral interventions.
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Affiliation(s)
| | - Ehap Atito
- Department of Prosthodontics, Faculty of Dentistry, Al-Azhar University (Boys Branch), Cairo, Egypt
| | - Mohammed Osman
- Department of Prosthodontics, Faculty of Dentistry, Al-Azhar University (Boys Branch), Cairo, Egypt
| | - Abdel-Naser M Emam
- Department of Prosthetic Dental Science, College of Dentistry, Najran University, , Saudi Arabia
| | - Yasser Baraka
- Department of Prosthodontics, Faculty of Dentistry, Deraya University, Al-Menia, Egypt
| | | | - Mohamed Ahmed Helal
- Department of Prosthodontics, Faculty of Dentistry, Al-Azhar University (Boys Branch), Cairo, Egypt
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20
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Anita H, Asnely Putri F, Maulina T. The Association Between Orofacial Pain and Depression: A Systematic Review. J Pain Res 2024; 17:785-796. [PMID: 38440413 PMCID: PMC10910975 DOI: 10.2147/jpr.s435219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 02/16/2024] [Indexed: 03/06/2024] Open
Abstract
Background The occurrence of orofacial pain is often accompanied by comorbid conditions such as depression. Even though previous studies suggested a bidirectional correlation between orofacial pain and psychological factors, some studies still provided contradictory results. Objective This systematic review aimed at providing scientific evidence regarding the association between orofacial pain and depression in published literature. Methods The current study is a systematic literature review (PROSPERO registration no. CRD42023438596) that was conducted by reviewing cross-sectional studies that investigated the association between orofacial pain and depression. Article selection was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Articles searching was performed by using three databases, namely PubMed, ScienceDirect, and Scopus using the Boolean operator method. Article screening was carried out by applying the inclusion and exclusion criteria, as well as duplication checking, suitability checking, and compatibility checking. Reviewed articles went through the risk of bias evaluation form from the Joanna Briggs Institute (JBI). Extracted data were analyzed in a qualitative method. Results Twelve studies that were conducted on 5557 participants were included in the final review. After all articles were analyzed, the correlation between orofacial pain and depression was revealed. Most articles revealed a positive correlation between orofacial pain and depression, and the rest showed how orofacial pain patients showed significantly higher depression scores compared to those individuals without orofacial pain. Conclusion The results of this systematic review suggested a correlation between orofacial pain and depression with varying degrees. Incorporating potential depressive symptoms' treatment, when treating orofacial pain patients, should be part of the treatment plan.
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Affiliation(s)
- Hadia Anita
- Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Farah Asnely Putri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Tantry Maulina
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
- Dentistry Department, Faculty of Medical Sciences, Radboud University, Nijmegen, the Netherlands
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21
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da Silva Mira PC, Biagini ACSCF, Gomes MG, Galo R, Corona SAM, Borsatto MC. Laser acupuncture to reduce temporomandibular disorder (TMD) symptoms: systematic review and meta-analysis. Lasers Med Sci 2024; 39:66. [PMID: 38374226 DOI: 10.1007/s10103-024-03999-z] [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: 07/06/2023] [Accepted: 01/19/2024] [Indexed: 02/21/2024]
Abstract
The application of low-level laser therapy (LLLT) to acupuncture points may produce effects similar to that of needle stimulation in patients with temporomandibular disorders (TMD). This systematic review was conducted according to the Cochrane Collaboration guidelines and aimed to address clinical questions using the following strategy: Patient/Problem, Intervention, Comparison, and Outcome (PICO). A comprehensive literature search was performed upto April 26, 2023, across nine electronic databases (BVS, PubMed, Scopus, Embase, Web of Science, ScienceDirect, Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), and Google Scholar) supplemented with gray literature. The risk of bias in randomized and nonrandomized clinical trials was assessed using two tools: risk-of-bias (RoB) 2 and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I). Meta-analysis involved the extraction of mean and standard deviation values for spontaneous pain and mouth opening levels. Seven studies were included in this review, all of which used LLLT. The applied wavelengths ranged from 690 to 810 nm without significant variations in light emission patterns. LLLT demonstrated a significant reduction in instantaneous pain levels (standard mean difference [SMD] = 3.85; 95% confidence interval [CI] = 2.09, 5.62; p < 0.003) and an improvement in instantaneous mouth opening ability (mean difference [SMD] = -7.15; 95% CI = -11.73, -2.58; p < 0.002), with low certainty of evidence. LLLT may alleviate symptoms in patients with TMD; however, caution should be exercised when interpreting the results because of protocol variations among studies and the limited number of studies included in the meta-analysis.
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Affiliation(s)
- Paôla Caroline da Silva Mira
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil.
| | | | - Marília Goulardins Gomes
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Galo
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
| | - Maria Cristina Borsatto
- Department of Pediatric Clinics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP) - Ribeirão Preto, São Paulo, Brazil
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Potewiratnanond P, Vanichanon P, Limpuangthip N. Occlusal splint and combined multiwave locked system laser therapy demonstrated differential patient-reported outcomes and clinical parameters: A randomized controlled trial in patients with temporomandibular disorder. J Oral Rehabil 2024; 51:247-254. [PMID: 37727026 DOI: 10.1111/joor.13593] [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: 02/04/2023] [Revised: 04/18/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE To evaluate the impact of occlusal splint plus laser therapy (OS + LT) compared with OS alone on the patient-reported outcomes and clinical parameters of patients with temporomandibular disorders (TMDs). METHODS Twenty-three patients with TMDs were randomly assigned to two treatment approaches: OS and OS + LT (multiwave locked system). The two outcomes were clinical parameters (mouth-opening distances, number of muscles and TMJs with pain) and patient-reported outcomes (pain score and oral health-related quality of life [OHRQoL] determined using the 14-item oral health impact profile [OHIP-14]). The outcomes were measured at four time points: baseline, 2 weeks, 1 and 3 months after treatment. According to DC/TMD Axis I classification, the participants were diagnosed as having pain only and pain with intraarticular joint disorder. Adjusting for age and sex, the outcome changes were analysed using generalized estimating models at a 5% significance level. RESULTS The pain-free mouth-opening distance of the patients who received OS + LT continuously increased from 2 weeks to 3 months. However, the value was significantly increased at 3 months in patients who received OS alone. The unassisted mouth-opening distance significantly increased after 3 months in both groups. In both treatment approaches, the number of muscles and TMJs with pain, as well as the pain and OHIP-14 scores gradually decreased from baseline to 3 months. CONCLUSIONS The patients who received OS and OS + LT demonstrated better OHRQoL and clinical parameters during 3 months after treatment. An improvement in the pain-free mouth-opening distance at 2 weeks was found only in OS plus LT group; however, this difference may not be clinically significant.
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Affiliation(s)
| | - Phanomporn Vanichanon
- Department of Occlusion, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nareudee Limpuangthip
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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23
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van der Meer HA, Doomen A, Visscher CM, Engelbert RHH, Nijhuis-van der Sanden MWG, Speksnijder CM. The additional value of e-Health for patients with a temporomandibular disorder: a mixed methods study on the perspectives of orofacial physical therapists and patients. Disabil Rehabil Assist Technol 2024; 19:433-445. [PMID: 35960692 DOI: 10.1080/17483107.2022.2094000] [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: 09/14/2021] [Accepted: 06/17/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To assess the experience and perceived added value of an e-Health application during the physical therapy treatment of patients with temporomandibular disorders (TMD). MATERIALS AND METHODS A mixed-methods study including semi-structured interviews was performed with orofacial physical therapists (OPTs) and with TMD patients regarding their experience using an e-Health application, Physitrack. The modified telemedicine satisfaction and usefulness questionnaire and pain intensity score before and after treatment were collected from the patients. RESULTS Ten OPTs, of which nine actively used Physitrack, described that the e-Health application can help to provide personalised care to patients with TMD, due to the satisfying content, user-friendliness, accessibility, efficiency, and ability to motivate patients. Ten patients, of which nine ended up using Physitrack, felt that shared decision-making was very important. These patients were positive towards the application as it was clear, convenient, and efficient, it helped with reassurance and adherence to the exercises and overall increased self-efficacy. This was mostly built on their experience with exercise videos, as this feature was most used. None of the OPTs or patients used all features of Physitrack. The overall satisfaction of Physitrack based on the telemedicine satisfaction and usefulness questionnaire (TSUQ) was 20.5 ± 4.0 and all patients (100%) showed a clinically relevant reduction of TMD pain (more than 2 points and minimally 30% difference). CONCLUSION OPTs and patients with TMD shared the idea that exercise videos are of added value on top of usual physical therapy care for TMD complaints, which could be delivered through e-Health.Implications for RehabilitationPhysical therapists and patients with temporomandibular disorders do not use all features of the e-Health application Physitrack in a clinical setting.Exercise videos were the most often used feature and seen as most valuable by physical therapists and patients.Based on a small number of participants, e-Health applications such as Physitrack may be perceived as a valuable addition to the usual care, though this would need verification by a study designed to evaluate the therapeutic effect (e.g., a randomised clinical trial).
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Affiliation(s)
- Hedwig A van der Meer
- University Medical Center Utrecht, Department of Oral-Maxillofacial Surgery and Special Dental Care, Utrecht University, Utrecht, The Netherlands
- Department of Orofacial Pain and Disfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit (VU) University Amsterdam, Amsterdam, The Netherlands
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation, Amsterdam, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location Meibergdreef 9, The Netherlands
- Radboud University Medical Center, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
| | - Annet Doomen
- Physiotherapy Private Practice 'De Molen', Houten, The Netherlands
- Institute of Movement Studies, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Corine M Visscher
- Department of Orofacial Pain and Disfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit (VU) University Amsterdam, Amsterdam, The Netherlands
| | - Raoul H H Engelbert
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation, Amsterdam, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Location Meibergdreef 9, The Netherlands
| | | | - Caroline M Speksnijder
- University Medical Center Utrecht, Department of Oral-Maxillofacial Surgery and Special Dental Care, Utrecht University, Utrecht, The Netherlands
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Kumar N, Francis M, Sindhu Vk S, Ramachandra V, Anilkumar PV, Fahad Khan M. Efficacy of Injectable Platelet-Rich Fibrin (I-PRF) in Managing Temporomandibular Joint Pain: A Prospective Clinical Study. Cureus 2024; 16:e54367. [PMID: 38500930 PMCID: PMC10945458 DOI: 10.7759/cureus.54367] [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: 12/31/2023] [Accepted: 02/17/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Temporomandibular joint (TMJ) pain is a common condition that can significantly impact an individual's quality of life. Current treatment options often fall short of providing long-lasting relief. So, this prospective clinical study aimed to investigate the efficacy of injectable platelet-rich fibrin (I-PRF) in mitigating TMJ pain. METHODS A total of 68 participants, aged 18-60 years, clinically diagnosed with TMJ pain, were recruited from dental clinics and specialist referrals. Participants were randomly assigned to either the intervention group (I-PRF injections) or the control group (placebo). Primary outcome measures included TMJ pain intensity and jaw function, assessed using the Visual Analog Scale and functional examinations, respectively. Secondary outcomes comprised patient-reported outcomes (PROs) on quality of life and satisfaction. Data were collected at baseline and six, 12, and 24 weeks post intervention. RESULTS Baseline characteristics demonstrated successful randomization, with no significant differences in age, gender, or TMJ pain duration between groups. Post intervention, the intervention group exhibited a significant and sustained reduction in TMJ pain intensity compared to controls (p<0.001). Improvements in jaw function were also notable in the intervention group at all follow-up time points (p<0.001). PROs related to quality of life and satisfaction substantially increased in the intervention group compared to controls (p<0.001). CONCLUSION I-PRF demonstrated significant efficacy in reducing TMJ pain intensity, improving jaw function, and enhancing PROs. These findings support the consideration of I-PRF as a valuable therapeutic intervention for individuals with TMJ pain.
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Affiliation(s)
- Nithin Kumar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Central Asian University, Tashkent, UZB
| | - Mariea Francis
- Department of Oral and Maxillofacial Surgery, Sankalchand Patel University, Visnagar, IND
| | - Sai Sindhu Vk
- Department of Oral and Maxillofacial Surgery, RVS Dental College and Hospital, Coimbatore, IND
| | - Varun Ramachandra
- Department of Oral and Maxillofacial Surgery, Manubhai Patel Dental College, Vadodara, IND
| | - P Vijay Anilkumar
- Department of Oral and Maxillofacial Surgery, GITAM Dental College and Hospital, Visakhapatnam, IND
| | - Mohammad Fahad Khan
- Department of Oral and Maxillofacial Surgery, Chandra Dental College and Hospital, Barabanki, IND
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25
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Zanelatto FB, Vieira WF, Nishijima CM, Zanotto TM, Magalhães SFD, Sartori CR, Parada CA, Tambeli CH. Effect of propranolol on temporomandibular joint pain in repeatedly stressed rats. Eur J Oral Sci 2024; 132:e12957. [PMID: 37908149 DOI: 10.1111/eos.12957] [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: 07/06/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023]
Abstract
Stress substantially increases the risk of developing painful temporomandibular disorders (TMDs) by influencing the release of endogenous catecholamines. Propranolol, an antagonist of β-adrenergic receptors, has shown potential in alleviating TMD-associated pain, particularly when the level of catecholamines is elevated. The aim of this study was to explore whether intra-articular propranolol administration is effective in diminishing temporomandibular joint (TMJ) pain during repeated stress situations. Additionally, we investigated the effect of repeated stress on the expression of genes encoding β-adrenoceptors in the trigeminal ganglion. In the present study, rats were exposed to a stress protocol induced by sound, then to the administration of formalin in the TMJ (to elicit a nociceptive response), followed immediately afterward by different doses of propranolol, after which the analgesic response to propranolol was evaluated. We also assessed the levels of beta-1 and beta-2 adrenergic receptor mRNAs (Adrb1 and Adrb2, respectively) using reverse transcription-quantitative PCR (RT-qPCR). Our findings revealed that propranolol administration reduces formalin-induced TMJ nociception more effectively in stressed rats than in non-stressed rats. Furthermore, repeated stress decreases the expression of the Adrb2 gene within the trigeminal ganglion. The findings of this study are noteworthy as they suggest that individuals with a chronic stress history might find potential benefits from β-blockers in TMD treatment.
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Affiliation(s)
- Fernanda Barchesi Zanelatto
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | | | - Catarine Massucato Nishijima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Tamires Marques Zanotto
- Department of Internal Medicine, School of Medical Science, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Silviane Fernandes de Magalhães
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - César Renato Sartori
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Claudia Herrera Tambeli
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
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Barjandi G, Svedenlöf J, Jasim H, Collin M, Hedenberg-Magnusson B, Christidis N, Ernberg M. Clinical aspects of mastication myalgia-an overview. FRONTIERS IN PAIN RESEARCH 2024; 4:1306475. [PMID: 38264542 PMCID: PMC10803665 DOI: 10.3389/fpain.2023.1306475] [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: 10/03/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Mastication myalgia is the most common cause of non-odontogenic pain in the orofacial region and is often associated with a reduced quality of life. The purpose of this review is to provide an overview of the clinical aspects of myalgia based on available research. The review includes epidemiological, diagnostic, and etiological aspects. In addition, the potential risk factors related to the transition from acute to chronic myalgia are explored and treatment strategies are presented for its management. As a result, this review may increase clinical knowledge about mastication myalgia and clarify strategies regarding prevention, diagnostics, and management to improve prognosis and reduce patient suffering.
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Affiliation(s)
- Golnaz Barjandi
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Johanna Svedenlöf
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Hajer Jasim
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
- Department of Orofacial Pain and Jaw Function, Eastman Institute, Stockholm, Sweden
| | - Malin Collin
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Britt Hedenberg-Magnusson
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
- Department of Orofacial Pain and Jaw Function, Eastman Institute, Stockholm, Sweden
| | - Nikolaos Christidis
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Malin Ernberg
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
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Gupta AK, Gupta R, Tiwari B, Verma K. Effect of a centric stabilization splint on masticatory muscles in patients with temporomandibular disorders: An electromyographic study. J Indian Prosthodont Soc 2024; 24:76-81. [PMID: 38263561 PMCID: PMC10896315 DOI: 10.4103/jips.jips_431_23] [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: 08/30/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024] Open
Abstract
AIM Occlusal splint treatment is commonly used to treat a variety of temporomandibular disorders (TMDs), with efficacy ranging between 70% and 90%. Centric splints are effective in relieving muscular soreness in individuals with TMD. Electromyography (EMG) quantifies muscle activity and can be used as an accessory diagnostic tool to evaluate the efficiency of the splint on the masticatory complex. Electromyography is used for assessing patients with TMD and observing muscle electromyography. TMD patients have altered electromyographic (EMG) masticatory muscle activity because of its change in electrical activity index or because of the compensatory mechanism for the disorder. Therefore, this study serves to evaluate the efficacy of the centric stabilization splint on TMD using EMG. SETTINGS AND DESIGN This cross-sectional study enrolled Ten TMD Patients with TMD, who underwent treatment with centric stabilization splint. MATERIALS AND METHODS The study involved ten young adults with TMD aged 18-45 years who were recruited without regard to sex, religion, caste, or socioeconomic background. The participants were randomized to receive a flat-contact upper stabilization splint and pregelled EMG electrodes to assess the immediate impact of centric splints on TMDs. After 3 months of follow-up, muscle activity and muscle symmetrical activity were measured to assess improvement in the symptoms of TMD. STATISTICAL ANALYSIS USED The Shapiro-Wilk test was used to assess the normality of the variables' distribution using SPSS 26.0. Symmetrical activity and treatment response were investigated using the Wilcoxon signed-rank test. RESULTS It showed an improvement in the temporalis, masseter, and sternocleidomastoid muscles' resting EMG activity. A statistically significant improvement was seen in the EMG activity of the bilateral temporalis, right masseter, right sternocleidomastoid, and left digastric muscles while clenching. The masseter, sternocleidomastoid, and digastric muscles all displayed significantly enhanced symmetrical activity (P < 0.05). CONCLUSIONS This research concludes that a centric stabilizing splint assists in relieving TMD symptoms. There was enhanced masticatory muscle activity both at rest and during function. Furthermore, there was an improvement in symmetrical activity of the masticatory muscles, which improved balance and enhanced the effective functioning of the masticatory complex.
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Affiliation(s)
- Abhishek Kumar Gupta
- Department of Prosthodontics, Crown and Bridge, ESIC Dental College and Hosital, New Delhi, India
| | - Rekha Gupta
- Department of Prosthodontics, Crown and Bridge, ESIC Dental College and Hosital, New Delhi, India
| | - Bhawana Tiwari
- Department of Prosthodontics, Crown and Bridge, ESIC Dental College and Hosital, New Delhi, India
| | - Kirti Verma
- Department of Prosthodontics, Crown and Bridge, ESIC Dental College and Hosital, New Delhi, India
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Benli M, Al-Haj Husain N, Ozcan M. Mechanical and chemical characterization of contemporary occlusal splint materials fabricated with different methods: a systematic review. Clin Oral Investig 2023; 27:7115-7141. [PMID: 37910242 DOI: 10.1007/s00784-023-05360-0] [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: 03/25/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To systematically review studies on various occlusal splint materials and describe their mechanical and chemical properties. METHODS MEDLINE (PubMed), Scopus, and Web of Science searches were conducted for in vitro studies focusing on occlusal splint materials. Two reviewers performed an assessment of the identified studies and data abstraction independently, and this was complimented by an additional hand search. The articles were limited to those in the English language that were published between January 1st, 2012, and December 1st, 2022. RESULTS The initial search yielded 405 search results of which 274 were selected for full-text review following abstract evaluation. 250 articles that did not meet the inclusion criteria were excluded, and the remaining 25 articles (with 1 article identified from the reference lists of included articles) providing mechanical and chemical values were used in this review. Poly methyl methacrylate (PMMA) -based occlusal splint materials showed the highest values in terms of hardness, wear resistance, flexural strength, flexural modulus, e-modulus, and fracture toughness. The material group with the highest water sorption and water solubility was 3D printed (PR) splint materials. In addition, the lowest degree of double bond conversion was also observed in this group of materials. CONCLUSIONS The outcome of this review suggests that mechanically and chemically acceptable properties can be attained with PMMA-based occlusal splint materials using both conventional and digital production methods. PR splint materials should not be considered as the primary choice for long-term treatments due to their low mechanical and chemical properties. CLINICAL RELEVANCE This review provides clinical recommendations for selecting the appropriate material and fabrication method for occlusal splints while taking the patients' needs and the materials´ mechanical and chemical properties into account.
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Affiliation(s)
- Merve Benli
- James B. Edwards College of Dental Medicine, Department of Oral Rehabilitation, Division of Removable Prosthodontics, MUSC, Charleston, USA.
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - Mutlu Ozcan
- Division of Dental Biomaterials, Center for Dental Medicine, Clinic for Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
- Clinic for Chewing Function Disturbances, Center for Dental Medicine, Clinic for Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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Seyhan M, Atalay ES. Is core stability training effective in temporomandibular disorder? A randomized controlled trial. Clin Oral Investig 2023; 27:7237-7246. [PMID: 37924356 DOI: 10.1007/s00784-023-05274-x] [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: 08/20/2022] [Accepted: 09/23/2023] [Indexed: 11/06/2023]
Abstract
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.
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Affiliation(s)
- Merve Seyhan
- Department of Physical Therapy and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Emre Serdar Atalay
- Faculty of Physiotherapy and Rehabilitation, University of Health Sciences Turkey, Emrah Mah, Ankara, Turkey.
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Didier HA, Cappellari AM, Sessa F, Giannì AB, Didier AH, Pavesi MM, Caria MP, Curone M, Tullo V, Di Berardino F, Iacona E, Lilli G, Barozzi S, Aldè M, De Bortoli G, Zanetti D, Arnone F, Bussone G. Somatosensory tinnitus and temporomandibular disorders: A common association. J Oral Rehabil 2023; 50:1181-1184. [PMID: 37335244 DOI: 10.1111/joor.13541] [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: 11/16/2022] [Revised: 02/16/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Although the association between tinnitus and temporo-mandibular disorders (TMD) has been frequently reported, their rate of association in the literature shows a great variability. OBJECTIVE We aimed to investigate the prevalence of TMD in patients with somatosensory tinnitus and, vice versa, the occurrence of somatosensory tinnitus in patients with TMD. METHODS The study included patients with somatosensory tinnitus (audiological group) and patients with TMD (stomatological group), evaluated at the audiologic and stomatologic clinics of the Policlinic Hospital of Milan, Italy. Common causes of tinnitus, such as hearing and neurological disorders, were excluded. A cervicogenic somatic tinnitus was also ruled out. Different TMD symptoms, including joint noise and joint pain, were considered. The collected data were analysed using descriptive statistical methods, and the Pearson's Chi-squared test was performed to study the prevalence of the different symptoms by clinical groups. RESULTS Audiological group included 47 patients with somatosensory tinnitus. Overall, TMD was diagnosed in 46 patients (97.8%), including TMJ noise in 37 (78.7%), clenching in 41 (87.2%) and pain in 7 (14.8%) patients. Stomatological group included 50 patients with TMD, including joint noise in 32 (64.0%), clenching in 28 (56.0%) and TMJ pain in 42 (84.0%) patients. A somatosensory tinnitus was diagnosed in 12 (24.0%) patients. CONCLUSION Our study showed a high prevalence of TMD in patients with tinnitus, as well as a not uncommon occurrence of tinnitus in patients presenting with TMD. The distribution of TMD symptoms, such as joint noise, and joint pain was different between the two groups.
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Affiliation(s)
- H A Didier
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
- Department of Neuroscience, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
- UOC Hospital Pharmacy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Istituto Stomatologico Italiano, Milan, Italy
| | - A M Cappellari
- Department of Neuroscience, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - F Sessa
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - A B Giannì
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - A H Didier
- UOC Hospital Pharmacy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M M Pavesi
- Istituto Stomatologico Italiano, Milan, Italy
| | - M P Caria
- CERISMAS (Research Centre in Health Care Management), Catholic University Milan, Milan, Italy
| | - M Curone
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - V Tullo
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - F Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Iacona
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G Lilli
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - S Barozzi
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - M Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G De Bortoli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - D Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Arnone
- Azienda Ospedaliera Santi Paolo e Carlo, Milan, Italy
| | - G Bussone
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
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Almeida LE. Temporomandibular Disorders and Physiotherapy. J Contemp Dent Pract 2023; 24:723-724. [PMID: 38152901 DOI: 10.5005/jp-journals-10024-3575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Affiliation(s)
- Luis Eduardo Almeida
- Department of Surgical Sciences, School of Dentistry, Marquette University, Milwaukee, Wisconsin, United States of America, Phone: +14142886022, e-mail:
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Jeong KH, Kim ME, Kim HK. Temporomandibular disorders and autonomic dysfunction: Exploring the possible link between the two using a questionnaire survey. Cranio 2023; 41:467-477. [PMID: 33427101 DOI: 10.1080/08869634.2021.1872313] [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: 01/23/2023]
Abstract
OBJECTIVE To assess autonomic function and investigate factors related to its dysfunction in patients with temporomandibular disorders (TMD) from a biopsychosocial perspective. METHODS Seventy-six patients with TMD were investigated by clinical examination and questionnaires concerning biopsychosocial aspects (The Brief Pain Inventory, the Pain Catastrophizing Scale, and the Symptom Checklist-90-Revised) and autonomic dysfunction (The COMPASS 31). RESULTS Seventy-one patients were included in the study. The result of multiple regression analysis showed that four variables (sex, depression, age, and pain interference) were significantly associated with autonomic dysfunction. Increased orthostatic intolerance and bladder dysfunction were observed in females and males, respectively. Younger age was associated with higher orthostatic intolerance, while higher pain interference was associated with higher secretomotor dysfunction and bladder dysfunction. Further, higher depression scores were linked to higher scores in the gastrointestinal subdomain. CONCLUSION Autonomic dysfunction may affect TMD-related pain in the context of a biopsychosocial perspective.
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Affiliation(s)
- Koo Hyun Jeong
- Department of Oral Medicine, College of Dentistry, Dankook University, Cheonan, South Korea
| | - Mee Eun Kim
- Department of Oral Medicine, College of Dentistry, Dankook University, Cheonan, South Korea
| | - Hye Kyoung Kim
- Department of Oral Medicine, College of Dentistry, Dankook University, Cheonan, South Korea
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Hsu GCY. A Novel Burn / Synovectomy Mouse Model for Temporomandibular Joint Osteoarthritis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.07.552340. [PMID: 37609135 PMCID: PMC10441340 DOI: 10.1101/2023.08.07.552340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Temporomandibular Disorders (TMDs) is present in 33% of the U.S. population. Currently available animal models do not faithfully simulate the native disease progression of TMJ OA. The initiation of TMJ OA requires both local trauma and systemic inflammation. In this study, we present a novel mouse model which reproduces these two conditions. This is achieved by a procedure involving both synovectomy (local trauma) and a distant burn injury (systemic inflammation). Its efficacy at inducing TMJ OA was assessed with histomorphology and radiographic evaluation at 1,3, and 9 weeks after the procedure. We found that burn/synovectomy mice demonstrated significantly more degenerative changes in TMJ than uninjured control mice or synovotomy mice. The observed histology in burn/synoectomy mice mimicked native TMJ OA disease progression in a faithful manner. This animal model is invaluable in future research of the mechanism and risk factors of TMJ OA.
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Xu J, Ren H, Zhao S, Li Q, Li C, Bao G, Kang H. Comparative effectiveness of hyaluronic acid, platelet-rich plasma, and platelet-rich fibrin in treating temporomandibular disorders: a systematic review and network meta-analysis. Head Face Med 2023; 19:39. [PMID: 37633896 PMCID: PMC10463486 DOI: 10.1186/s13005-023-00369-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/13/2023] [Indexed: 08/28/2023] Open
Abstract
OBJECTIVE This study aims to compare the efficacy of intra-articular injections of hyaluronic acid (HA), platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) for treating temporomandibular disorders (TMDs) and summarize their mechanisms of action. METHODS Randomized controlled trials (RCTs) published until November 13, 2021, were identified using electronic and manual searches. Each study was evaluated for the risk of bias using the Cochrane risk of bias tool. The studies found via searches were categorized by follow-up time (1, 3, or 6 months). Evidence quality was graded according to the GRADE system. RESULTS Twelve RCTs were included that involved 421 patients with TMD. The network meta-analysis showed that all treatment groups improved compared to the placebo groups in terms of pain and maximal mouth opening (MMO). For pain evaluated via the visual analog scale, PRF exhibited better analgesic effects than PRP or HA after 1 and 3 months. PRP appeared to be more effective than PRF was after 6 months but there were no statistically significant differences between the two. For MMO, the effect of PRP was superior to those of PRF and HA after 1 month. However, after 3 and 6 months, PRF provided more encouraging results in improving MMO. CONCLUSION PRP and PRF exhibited similar short-term efficacy in treating TMD, while PRF was more advantageous in terms of long-term efficacy. Therefore, PRF was recommended for treating TMD.
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Affiliation(s)
- Jingjing Xu
- Key Laboratory of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, 730030, China
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Hui Ren
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Shuwei Zhao
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Qian Li
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Ce Li
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Guangjie Bao
- Key Laboratory of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, 730030, China.
| | - Hong Kang
- Department of Temporomandibular Joint and Occlusion, School/Hospital of Stomatology, Lanzhou University, Lanzhou, 730000, China.
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Xiong X, Gao X, Zhong J, Hu S, Li Y, Zheng Y, Liu Y. Bibliometric Analysis of Research on Temporomandibular Joint and Occlusion from 2000 to 2022. J Pain Res 2023; 16:2847-2860. [PMID: 37605745 PMCID: PMC10440111 DOI: 10.2147/jpr.s418362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/26/2023] [Indexed: 08/23/2023] Open
Abstract
Purpose This study conducted a bibliometric analysis that comprehensively described publications on temporomandibular joint and occlusion from 1 January 2000 to 31 October 2022, aiming to reveal hotspots and predict future research trends. Methods A total of 2985 articles and reviews were retrieved from Web of Science Core Collection (WoSCC). Excel 2019, VOSviewer and CiteSpace software were used for visualizing analysis of research trends, authors, journals, institutions, countries, keywords and cited references. Results Both the annual publication counts and citation times increased significantly. Wang MQ was the most active author. Moreover, Manfredini D and Okeson JP were the most influential two. Journal of Oral Rehabilitation was the core journal. University of Sao Paulo was the most productive institutions. "Temporomandibular disorders" (TMDs), "temporomandibular joint" and "occlusion" were the top 3 keywords with the most frequencies. Keywords and references with burst showed that the causes of TMDs, diagnosis and treatments for TMDs as well as bruxism may be hotspots currently and in the future. Conclusion In this study, the research trends, the most productive and influential authors, journals, institutions, countries, in addition to keywords and cited references with burst in the field of temporomandibular joint and occlusion were revealed by a bibliometric analysis, which could help scholars to understand recent hotspots and future trends.
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Affiliation(s)
- Xin Xiong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Xinlin Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Jiawei Zhong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Shoushan Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Yijun Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Yunhao Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Yang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China
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Shimada A, Ogawa T, Sammour SR, Narihara T, Kinomura S, Koide R, Noma N, Sasaki K. Effectiveness of exercise therapy on pain relief and jaw mobility in patients with pain-related temporomandibular disorders: a systematic review. FRONTIERS IN ORAL HEALTH 2023; 4:1170966. [PMID: 37521175 PMCID: PMC10382173 DOI: 10.3389/froh.2023.1170966] [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: 02/21/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background Orofacial pain conditions are complex disorders that involve biological, social, and psychological factors. Temporomandibular Disorders (TMDs) are one of the most common orofacial pain conditions, and our previous literature review indicated that exercise therapy has shown promise in reducing TMD-related pain. However, more evidence is needed to firmly establish its effectiveness. Objectives This systematic review aims to investigate the effectiveness of exercise therapy on pain relief and jaw mobility in patients with pain-related TMDs. Methods To include randomized controlled trials (RCTs) written in English, a literature search was performed using PubMed, Scopus, Web of Science, Cochrane Library, Ovid, EBM reviews, and Academic Search Complete initially from 4th November 2020 until March 2022. A PICOS for this review was as follows; P: Patients with TMD myalgia or arthralgia, I: Excursion exercise, Stretch exercises, Resistance exercise, or Coordination exercise, C: No treatment or education only. O: Pain intensity and Range of Motion (ROM), S: RCTs. After title screening, a full-text assessment was done to extract data. According to Risk of Bias (RoB) 2.0, risk of bias was assessed in each included paper by 2 reviewers independently. Results A total of 3,388 titles were identified from the electronic database search. After the screening and full-text evaluation, only 5 studies (145 participants) were eligible to be included. Among the exercise modalities, coordination exercise showed a significant effect on pain relief and improvement of joint mobility. Discussion Due to the heterogeneity and small sample size of the included studies, a meta-analysis was not feasible. However, this systematic review suggested that exercise therapy, especially coordinate exercise, can be effective in managing painful TMD conditions. Further research is needed to establish optimal parameters for this patient population, as well as standardization and consistency in terminology and treatment structure.
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Affiliation(s)
- Akiko Shimada
- Department of Oral Health Sciences, Faculty of Health Sciences, Osaka Dental University, Osaka, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Sara Reda Sammour
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Prosthodontic Department, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Taichi Narihara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shiori Kinomura
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Rie Koide
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Noboru Noma
- Department of Oral Medicine, Nihon University School of Dentistry, Tokyo, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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da Silva MT, Silva C, Silva J, Costa M, Gadotti I, Ribeiro K. Effectiveness of Physical Therapy Interventions for Temporomandibular Disorders Associated with Tinnitus: A Systematic Review. J Clin Med 2023; 12:4329. [PMID: 37445364 DOI: 10.3390/jcm12134329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 07/15/2023] Open
Abstract
Temporomandibular disorders (TMDs) refers to different clinical conditions affecting the temporomandibular joints, masticatory muscles, and adjacent structures. Although TMDs signs and symptoms (e.g., pain and limited mouth opening) are common, otological symptoms, such as tinnitus, might also be present. This study aims to summarize the evidence of the effectiveness of physical therapy interventions in individuals with TMDs associated with tinnitus. Randomized controlled trials investigating the effectiveness of physical therapy in individuals of both genders aged 18 or older with TMDs associated with tinnitus were included. The electronic search was performed in the following databases: MEDLINE, EMBASE, CINAHL, PEDro and CENTRAL. A total of four studies were included. All studies showed that physical therapy reduced the intensity of tinnitus, and two trials showed a decrease in the pain intensity caused by TMDs, an increase in the pressure pain thresholds in the masticatory muscles and an improvement of mandibular function. Two studies presented a low risk of bias. Despite a low certainty of the evidence, this review showed that physical therapy reduces the intensity or severity of tinnitus associated with TMDs. Results may support future research on the topic and evidence-based practice by recommending the best physical therapy approach for patients, clinicians, researchers, and health system managers.
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Affiliation(s)
- Marianne Trajano da Silva
- Post-Graduation Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Carlos Silva
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Jade Silva
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Mateus Costa
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Inae Gadotti
- Department of Physical Therapy, Florida International University, Miami, FL 33199, USA
| | - Karyna Ribeiro
- Post-Graduation Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
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Serrano-Muñoz D, Beltran-Alacreu H, Martín-Caro Álvarez D, Fernández-Pérez JJ, Aceituno-Gómez J, Arroyo-Fernández R, Avendaño-Coy J. Effectiveness of Different Electrical Stimulation Modalities for Pain and Masticatory Function in Temporomandibular Disorders: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2023; 24:946-956. [PMID: 36801166 DOI: 10.1016/j.jpain.2023.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/21/2022] [Accepted: 01/20/2023] [Indexed: 02/20/2023]
Abstract
Temporomandibular disorders comprise a set of conditions that include alterations of the temporomandibular joint and masticatory muscles. Although different modalities of electric currents are widely used for treating temporomandibular disorders, previous reviews have suggested these are ineffective. This systematic review and meta-analysis aimed to determine the effectiveness of different electrical stimulation modalities in patients with temporomandibular disorders for reducing musculoskeletal pain, increasing the range of movement, and improving muscle activity. An electronic search was conducted of randomized controlled trials published until March of 2022 that compared the application of an electrical stimulation therapy versus a sham or control group. The main outcome measure was pain intensity. Seven studies were included in the qualitative analysis and in the quantitative analysis (n = 184 subjects). The overall effect of electrical stimulation on pain reduction was statistically superior to sham/control (MD = -1.12 cm; CI 95%: -1.5 to -0.8), showing moderate heterogeneity of results (I2 = 57%, P = .04). The overall effect on range of movement of the joint (MD = 0.97 mm; CI 95%: -0.3 to 2.2) and muscle activity (SMD = -2.9; CI 95%: -8.1 to 2.3) were not significant. Transcutaneous electrical nerve stimulation (TENS) and high-voltage current stimulation reduces pain intensity clinically in people with temporomandibular disorders with a moderate quality of evidence. On the other hand, there is no evidence of the effect of different electrical stimulation modalities on range of movement and muscle activity in people with temporomandibular disorders with a moderate and low quality of evidence respectively. PERSPECTIVE: TENS and high voltage currents are valid options for the control of pain intensity in patients suffering from temporomandibular disorder. Data suggest clinically relevant changes compared to sham. Healthcare professionals should take this into account as it is inexpensive therapy, has no adverse effects and can be self-administered by patients.
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Affiliation(s)
- Diego Serrano-Muñoz
- Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Hector Beltran-Alacreu
- Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain.
| | - David Martín-Caro Álvarez
- Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Juan José Fernández-Pérez
- Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Javier Aceituno-Gómez
- Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Rubén Arroyo-Fernández
- Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Juan Avendaño-Coy
- Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
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Gururaj N, Subramaniyan P, Hasinidevi P, V J. The Role of Supraerupted and Distoverted Maxillary Third Molars in the Treatment of Temporomandibular Disorder: A Randomised Controlled Trial. Cureus 2023; 15:e41158. [PMID: 37525765 PMCID: PMC10387163 DOI: 10.7759/cureus.41158] [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] [Accepted: 06/29/2023] [Indexed: 08/02/2023] Open
Abstract
Objective Temporomandibular disorder (TMD) is a multifactorial disease that is classified into muscular and joint disorders. The etiology of TMD is unknown but it is related to various factors such as bruxism, uncorrected high dental restorations, and occlusal prematurities. This study aims to provide treatment modalities for TMD patients with supraerupted and/or distoverted maxillary third molars that have premature contact with the opposing arch. Methods A total of 430 subjects diagnosed with TMD were included in the study and randomized into study and control groups based on their treatment needs. A detailed case history was taken, and findings of intra and extra oral examination were recorded along with other investigations such as study model analysis, orthopantomogram (OPG), cone-beam computed tomography (CBCT), and MRI. The multiphase treatment included counseling in phase I, extraction in phase II (only for the study group), and oral appliance in the third phase. The final phase involved the restoration of edentulous areas or reduced vertical dimension. Results Extraction of supraerupted and/or distoverted maxillary third molars in the study group during phase II showed a 96% reduction in TMD when compared to the control group who did not undergo extraction. Conclusion TMD is a repetitive motion disorder, and the success of treatment relies on the elimination of causative factors, the type of appliance used, and the establishment of ideal occlusion. This study suggests that the extraction of supraerupted and/or distoverted maxillary third molars is a prerequisite for treating TMD patients.
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Affiliation(s)
- Narayanarao Gururaj
- Oral and Maxillofacial Pathology, CSI College of Dental Sciences and Research, Madurai, IND
| | - Ponniah Subramaniyan
- Oral and Maxillofacial Surgery, Dhanalakshmi Srinivasan Dental College, Perambalur, IND
| | | | - Janani V
- Dentistry, Srinivas Dental Clinic and Oral Care, Madurai, IND
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Militi A, Bonanno M, Calabrò RS. It Is Time for a Multidisciplinary Rehabilitation Approach: A Scoping Review on Stomatognathic Diseases in Neurological Disorders. J Clin Med 2023; 12:jcm12103528. [PMID: 37240633 DOI: 10.3390/jcm12103528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients' swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD.
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Affiliation(s)
- Angela Militi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
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Nattapon R, Aree W, Sompol T, Anchalee V, Chit C, Wongsathit C, Kanokwan T, Mayuree TH, Narawut P. Standardized Centella asiatica (ECa 233) extract decreased pain hypersensitivity development in a male mouse model of chronic inflammatory temporomandibular disorder. Sci Rep 2023; 13:6642. [PMID: 37095163 PMCID: PMC10126003 DOI: 10.1038/s41598-023-33769-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 04/18/2023] [Indexed: 04/26/2023] Open
Abstract
Chronic inflammatory temporomandibular disorder (TMD) pain has a high prevalence, and available nonspecific treatments have adverse side effects. ECa 233, a standardized Centella asiatica extract, is highly anti-inflammatory and safe. We investigated its therapeutic effects by injecting complete Freund's adjuvant (CFA) into right temporomandibular joint of mice and administering either ibuprofen or ECa 233 (30, 100, and 300 mg/kg) for 28 days. Inflammatory and nociceptive markers, bone density, and pain hypersensitivity were examined. CFA decreased ipsilateral bone density, suggesting inflammation localization, which ipsilaterally caused immediate calcitonin gene-related peptide elevation in the trigeminal ganglia (TG) and trigeminal subnucleus caudalis (TNC), followed by late increase of NaV1.7 in TG and of p-CREB and activation of microglia in TNC. Contralaterally, only p-CREB and activated microglia in TNC showed delayed increase. Pain hypersensitivity, which developed early ipsilaterally, but late contralaterally, was reduced by ibuprofen and ECa 233 (30 or 100 mg/kg). However, ibuprofen and only 100-mg/kg ECa 233 effectively mitigated marker elevation. This suggests 30-mg/kg ECa 233 was antinociceptive, whereas 100-mg/kg ECa 233 was both anti-inflammatory and antinociceptive. ECa 233 may be alternatively and safely used for treating chronic inflammatory TMD pain, showing an inverted U-shaped dose-response relationship with maximal effect at 100 mg/kg.
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Affiliation(s)
- Rotpenpian Nattapon
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
- Department of Oral Biology and Occlusion, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Wanasuntronwong Aree
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Tapechum Sompol
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Vattarakorn Anchalee
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Care Chit
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Chindasri Wongsathit
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Tilokskulchai Kanokwan
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | | | - Pakaprot Narawut
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand.
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Raveggi E, Ramieri G, Bosco GF, Zavattero E. Temporomandibular joint arthrocentesis: a single-center experience and review of the literature. Minerva Dent Oral Sci 2023; 72:69-76. [PMID: 37052194 DOI: 10.23736/s2724-6329.22.04653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND The aim of this paper was to report our experience and to review the literature of arthrocentesis focusing on protocols and results. METHODS Arthrocentesis with supplemental hyaluronic acid was performed in patients with TMDs between January 2017 and December 2020 at the Division of Maxillofacial Surgery. The maximum interincisal opening (MIO) and pain score were recorded preoperatively (T0), 2 months postoperatively (T1), and 6 months postoperatively (T2). A literature search was performed to analyze the same parameters in patients with TMDs. Patient demographic, characteristics and treatment protocols used were also recorded. RESULTS This retrospective analysis enrolled 45 patients. Twenty-two patients (20 females, 2 males) with mean age of 37.13 years with internal derangement were included in study group A. Study group B included 23 patients with degenerative joint disease (19 females and 4 males) with mean age of 55.73 years. The outcomes trend of MIO and pain during the follow-up period showed a gradual improvement. Fifty articles meeting the proposed scientific criteria were selected for the literature revision. A range of clinical and procedural variables were analyzed by grouping the studies into two broad categories based on the diagnosis of TMD. CONCLUSIONS Based on our experience and on the basis of the most accredited scientific studies in the literature, intra-articular injections of HA are beneficial for the improvement of the pain and/or functional symptoms of TMDs.
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Affiliation(s)
- Elisa Raveggi
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Giovanni F Bosco
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Emanuele Zavattero
- Division of Maxillofacial Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy -
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Liu S, Fan S, Li G, Cai B, Yao Y, Jin L, Zhang Y, Zhang X, Xu L. Short term effects of a novel combined approach compared with physical therapy alone among older patients with temporomandibular degenerative joint disease: a prospective cohort study. BMC Oral Health 2023; 23:173. [PMID: 36966303 PMCID: PMC10040115 DOI: 10.1186/s12903-023-02848-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 02/28/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND There is a lack of consensus regarding the best treatment option, including physical exercise, available for temporomandibular degenerative joint disease (DJD) that affect the older patients. Herein, we aimed to study and compare the efficacy of a combined approach using injection and home physical exercise with physical therapy alone as well as explored an optimal treatment strategy for older patients with DJD. METHODS We included 213 older patients with DJD treated at our medical centre from June 2020 to June 2021, 64 of whom were selected for analysis. Of these 64 patients, 32 received injections combined with home physical exercise, and the other 32 received physical therapy alone. Propensity score matching was used to ensure that the two groups did not differ significantly in categorical and continuous variables. Measurements included pain intensity, maximum mouth opening, joint crepitus, jaw functional limitation scale (JFLS) scores, treatment times, and treatment durations. Improvement in each measurement was compared between the two groups 2, 4, and 12 weeks after the treatment commenced, as were the final treatment times and durations. RESULTS Pain intensity, maximum mouth opening, and JFLS scores in the two groups improved 2, 4, and 12 weeks after treatment (all p < 0.05). The crepitus ratio improved significantly only in the combined treatment group after 12 weeks. Compared with the physical therapy group, pain while opening the mouth improved after 2, 4, and 12 weeks in the combined treatment group. Furthermore, 2 weeks after treatment, the physical therapy group showed significant improvement in maximal mouth opening compared with the combined treatment group. No significant between-group differences were observed regarding improvement in joint crepitus and JFLS scores at each observation point. The combined treatment group had a significantly lower number of visits than the physical therapy group; however, the treatment duration was longer. CONCLUSION Compared with physical therapy, pain while opening the mouth is significantly improved by the combined treatment within 12 weeks, and the number of required visits is fewer. Physical therapy improves the patients' mouth-opening capabilities in a short time (2 weeks), and the treatment cycle is short.
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Affiliation(s)
- Shasha Liu
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China
| | - Shuai Fan
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guiping Li
- Department of Orthopedics, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China
| | - Bin Cai
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Yao
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China
| | - Lei Jin
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxin Zhang
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinjun Zhang
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China.
- Department of Orthopedics, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China.
| | - Lili Xu
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China.
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Qiao Y, Li J, Yuh C, Ko F, Mercuri LG, Alkhudari J, Pourzal R, Oh CD. Chemokine Regulation in Temporomandibular Joint Disease: A Comprehensive Review. Genes (Basel) 2023; 14:408. [PMID: 36833336 PMCID: PMC9956915 DOI: 10.3390/genes14020408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
Temporomandibular joint disorders (TMDs) are conditions that affect the muscles of mastication and joints that connect the mandible to the base of the skull. Although TMJ disorders are associated with symptoms, the causes are not well proven. Chemokines play an important role in the pathogenesis of TMJ disease by promoting chemotaxis inflammatory cells to destroy the joint synovium, cartilage, subchondral bone, and other structures. Therefore, enhancing our understanding of chemokines is critical for developing appropriate treatment of TMJ. In this review, we discuss chemokines including MCP-1, MIP-1α, MIP-3a, RANTES, IL-8, SDF-1, and fractalkine that are known to be involved in TMJ diseases. In addition, we present novel findings that CCL2 is involved in β-catenin-mediated TMJ osteoarthritis (OA) and potential molecular targets for the development of effective therapies. The effects of common inflammatory factors, IL-1β and TNF-α, on chemotaxis are also described. In conclusion, this review aims to provide a theoretical basis for future chemokine-targeted therapies for TMJ OA.
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Affiliation(s)
- Yusen Qiao
- Department of Orthopedic Surgery, 1st Affiliated Hospital of Soochow University, Suzhou 215005, China
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Jun Li
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA 19107, USA
| | - Catherine Yuh
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Frank Ko
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Louis G. Mercuri
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Bioengineering, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Jad Alkhudari
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Robin Pourzal
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Chun-do Oh
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
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Fang X, Xiong X, Lin J, Wu Y, Xiang J, Wang J. Machine-learning-based detection of degenerative temporomandibular joint diseases using lateral cephalograms. Am J Orthod Dentofacial Orthop 2023; 163:260-271.e5. [PMID: 36710061 DOI: 10.1016/j.ajodo.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Degenerative temporomandibular joint diseases (DJDs) are common diseases in dental practice, characterized by a series of degenerative processes in the temporomandibular joint. Early clinical detection of DJD by dental practitioners can be beneficial to prevent or alleviate the further progression of the disease. This study aimed to develop a cephalogram-based multidimensional nomogram to screen DJD. METHODS A total of 502 patients (170 normal and 332 with DJD) were randomly assigned to a training set (n = 351) or a validation set (n = 151). Thirty-six cephalometric parameters were extracted from the cephalograms to be used as input for a predictive machine-learning algorithm. Multivariable logistic regression was used to construct a combined model for visualization in the form of a nomogram. Receiver operating characteristic curve, calibration testing, and decision curve analyses were conducted to evaluate the performance of the combined model. RESULTS A Ceph score consisting of 22 cephalometric parameters were significantly associated with DJD (P <0.01). A combined model that consisted of Ceph scores and clinical features (including age, gender, limited mouth opening, crepitus, etc.) performed well in the receiver operating characteristic curve (area under the curve, 0.893), calibration test, and decision curve analyses, indicating its potential clinical value. CONCLUSIONS This study constructed and verified a multidimensional nomogram consisting of Ceph scores and clinical features, which may contribute to the clinical screening of DJD in dental practice. Future studies are needed to test the reliability of the model with similar parameters.
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Affiliation(s)
- Xinyi Fang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthodontics, Hospital of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiu Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yange Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jie Xiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Aguiar ADS, Moseley GL, Bataglion C, Azevedo B, Chaves TC. Education-Enhanced Conventional Care versus Conventional Care Alone for Temporomandibular Disorders: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2023; 24:251-263. [PMID: 36220481 DOI: 10.1016/j.jpain.2022.09.012] [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: 06/09/2022] [Revised: 08/29/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022]
Abstract
The objective of this study was to determine the effect of enhancing conventional care for people with chronic painful temporomandibular disorders (TMD) with an individualised contemporary pain science education (PSE) intervention. In this randomized controlled trial, a consecutive sample of 148 participants (18-55 years of age) was randomized into 2 groups: PSE-enhanced conventional care or Conventional care alone. Conventional care involved a 6-week, 12-session manual therapy and exercise program. The PSE enhancement involved 2 sessions of modern PSE, undertaken in the first 2 treatment sessions. Primary outcomes were pain intensity, assessed with a numeric pain rating scale, and disability, assessed with the craniofacial pain and disability inventory, post-treatment. Linear mixed model analyses were used to investigate between-group differences over time. There was a statistically and clinically meaningful effect of PSE enhancement on disability (Mean Difference = 6.1, 95% CI: 3.3-8.8), but not on pain intensity, post-treatment. Secondary analyses suggested clinically meaningful benefit of PSE enhancement on pain and disability ratings at 10-week and 18-week follow-ups, raising the possibility that preceding conventional care with a PSE intervention may result in long-term benefits. PERSPECTIVE: The addition of modern Pain Science Education (PSE) intervention improved disability for people with chronic TMD receiving manual therapy and exercise, but not pain. A mean difference in pain and disability favoring the PSE group at the 10- and 18-week follow-ups, respectively, suggests that PSE addition resulted in longer-lasting effects. Trial registration: NCT03926767. Registered on April 29, 2019. https://clinicaltrials.gov/ct2/show/NCT03926767.
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Affiliation(s)
- Aroldo D S Aguiar
- Ph.D. in Musculoskeletal Rehabilitation, Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - G Lorimer Moseley
- DSc Ph.D, Bradley Distinguished Professor, IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Cesar Bataglion
- Ph.D in Dental Sciences, Professor and Researcher from the Department of Restorative Dentistry at Ribeirão Preto Dental School (FORP), University of São Paulo-USP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Beatriz Azevedo
- Master's Degree in Progress in Musculoskeletal Rehabilitation, Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thaís C Chaves
- Ph.D, Adjunct Professor and Researcher from the Department of Physical Therapy, University Federal of São Carlos, UFSCar, São Carlos, Brazil; Researcher from the Graduate Program on Rehabilitation and Functional Performance, Laboratory of Research on Movement and Pain (LabMovePain), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Accurate Diagnosis and Treatment of Painful Temporomandibular Disorders: A Literature Review Supplemented by Own Clinical Experience. Pain Res Manag 2023; 2023:1002235. [PMID: 36760766 PMCID: PMC9904928 DOI: 10.1155/2023/1002235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/04/2022] [Accepted: 01/21/2023] [Indexed: 02/04/2023]
Abstract
Introduction Temporomandibular disorders (TMD) is a multifactorial group of musculoskeletal disorders often with combined etiologies that demand different treatment plans. While pain is the most common reason why patients decide to seek help, TMD is not always painful. Pain is often described by patients as a headache, prompting patients to seek the help of neurologists, surgeons, and ultimately dentists. Due to the unique characteristics of this anatomical area, appropriate diagnostic tools are needed, as well as therapeutic regimens to alleviate and/or eliminate the pain experienced by patients. Aim of the Study. The aim of this study is to collect and organize information on the diagnosis and treatment of pain in TMD, through a review of the literature supplemented by our own clinical experience. Material and Methods. The study was conducted by searching scientific databases PubMed, Scopus, and Google Scholar for documents published from 2002-2022. The following keywords were used to build the full list of references: TMD, pain, temporomandibular joint (TMJ), TMJ disorders, occlusal splint, relaxing splints, physiotherapy TMD, pharmacology TMD, natural therapy TMD, diagnostic criteria for TMD, and DC/TMD. The literature review included 168 selected manuscripts, the content of which was important for pain diagnosis and clinical treatment of TMD. Results An accurate diagnosis of TMD is the foundation of appropriate treatment. The most commonly described treatments include physiotherapy, occlusal splints therapy, and pharmacological treatment tailored to the type of TMD. Conclusions Based on the literature review and their own experience, the authors concluded that there is no single ideal form of pain therapy for TMD. Treatment of TMD should be based on a thorough diagnostic process, including the DC/TMD examination protocol, psychological evaluation, and cone beam computer tomography (CBCT) imaging. Following the diagnostic process, once a diagnosis is established, a treatment plan can be constructed to address the patient's complaints.
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Jasim H. Topical review - salivary biomarkers in chronic muscle pain. Scand J Pain 2023; 23:3-13. [PMID: 36228098 DOI: 10.1515/sjpain-2022-0112] [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: 08/08/2022] [Accepted: 09/23/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Muscle related temporomandibular disorders (myogenous TMD), one of the most common orofacial pain conditions, is characterized by facial pain and often accompanied by jaw movement limitations. Although the underlying biological mechanisms are still unclear, a cluster of proteins and peptides is assumed to be involved in the pathophysiology. These proteins and peptides may be measured in a simple non-invasive saliva sample. This work investigated whether saliva can be used to sample algogenic substances that can serve as molecular biomarkers for TMD myalgia. METHODS Saliva and blood samples were collected from healthy individuals (n=69) and patients diagnosed with TMD myalgia (n=39) according to the Diagnostic Criteria for TMD. Unstimulated and stimulated whole, parotid, and sublingual saliva were analysed. The protein profiles were investigated using two-dimensional gel electrophoresis followed by identification with liquid chromatography tandem mass spectrometry. Levels of nerve growth factor (NGF), calcitonin gene-related peptide (CGRP), and brain derived neuro-tropic factor (BDNF) were determined using western blotting based technology and multiplex electro-chemiluminescence assay panel. Glutamate, serotonin, and substance p (SP) were determined using commercially available methods. RESULTS Different saliva collection approaches resulted in significant differences in the protein profile as well as in the expression of NGF, BDNF, CGRP, SP, and glutamate. Stimulated whole saliva showed least variability in protein concentration (35%) and was correlated to plasma levels of glutamate. Unlike SP and glutamate, NGF and BDNF expressed a rhythmic variation in salivary expression with higher levels in the morning (p<0.05). Patients with a diagnosis of TMD myalgia had significantly higher levels of salivary glutamate but lower salivary NGF and BDNF compared to controls; in addition, the lower NGF and BDNF levels correlated to psychological dysfunction. The quantitative proteomics data revealed 20 proteins that were significantly altered in patients compared to controls. The identified proteins are involved in metabolic processes, immune response, and stress response. Dissimilarities in protein profile and clinical variables were observed between TMD myalgia and myofascial pain. CONCLUSIONS The work highlights the importance of consistency in saliva collection approaches, including the timing of the collection. It displayed significant changes in pain specific mediators and protein profile in TMD myalgia and furthermore dissimilarities between subclasses indicating different pathophysiology. After extensive validation, potential salivary biomarkers can be combined with clinical features to better understand and diagnose TMD myalgia.
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Affiliation(s)
- Hajer Jasim
- Eastman Institutet, Folktandvården Stockholms Län AB, Stockholm, Sweden
- Division of Oral Diagnostics & Rehabilitation, Department of Dental Medicine, Karolinska Institutet and Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
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Effects of Physiotherapy on Pain and Mouth Opening in Temporomandibular Disorders: An Umbrella and Mapping Systematic Review with Meta-Meta-Analysis. J Clin Med 2023; 12:jcm12030788. [PMID: 36769437 PMCID: PMC9917698 DOI: 10.3390/jcm12030788] [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: 12/20/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
The aim of this meta-meta-analysis was to assess the current evidence regarding the effect of physical therapy (PT) interventions on pain and functional variables in temporomandibular disorders (TMD). We conducted an umbrella systematic review (SR) and four meta-meta-analyses (MMA) and created an evidence map to determine the effectiveness of PT on pain intensity and maximum mouth opening in patients with TMD. The quality of the included SR was assessed with the AMSTAR 2, and the risk of bias with ROBIS. Of the 31 SR included in the umbrella SR, only 10 were included in the MMA. The MMA showed moderate effects for manual therapy and therapeutic exercise, and large effects for low-level laser therapy on improving pain intensity and maximum mouth opening in patients with TMD, with a limited to moderate quality of evidence. The overlapping analyses showed only a slight overlap for all the MMA according to the corrected covered area (range from 0.07 to 0.2), 23.1% to 41.6%. This umbrella SR showed that manual therapy and exercise interventions, as well as low-level laser therapy interventions, are effective in the reduction in pain intensity and improvement of maximum mouth opening in TMD. This article presents a synthesis of the available evidence related to the various physical therapy interventions used in patients presenting with temporomandibular disorders. These results could help clinicians to select the optimal intervention for their patients and to reject those that are less useful.
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Moleirinho-Alves P, Cebola P, Melo X, Simões S, Godinho C. Analysis of Portuguese Physiotherapists' Self-Knowledge on Temporomandibular Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1294. [PMID: 36674049 PMCID: PMC9858732 DOI: 10.3390/ijerph20021294] [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: 12/05/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Physiotherapy is one of the most referenced and effective conservative strategies for treating patients with temporomandibular disorders (TMD). This study aimed to characterize and analyze the self-knowledge of TMD of Portuguese physiotherapists. METHODS an online questionnaire was carried out, and the data collected were descriptively analyzed. RESULTS A total of 338 physiotherapists participated, of which only 142 treated patients with TMD. Seventy-six percent of the physiotherapists reported that they had not received training in the TMD area during the physiotherapy degree course. Only 11% of the physiotherapists reported that treating patients with TMD adequately identified all symptoms of TMD. CONCLUSIONS the present study showed that it is necessary to integrate TMD-related content into the basic training of physiotherapists and promote an increase in evidence-based training.
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Affiliation(s)
- Paula Moleirinho-Alves
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Cuf Tejo Hospital, 1300-352 Lisboa, Portugal
| | | | - Xavier Melo
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Centro Interdisciplinar de Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana Universidade de Lisboa, 1496-751 Oeiras, Portugal
| | - Sérgio Simões
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
| | - Catarina Godinho
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
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