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Uta D, Ishibashi N, Tao S, Sawahata M, Kume T. Photobiomodulation inhibits neuronal firing in the superficial but not deep layer of a rat spinal dorsal horn. Biochem Biophys Res Commun 2024; 710:149873. [PMID: 38583230 DOI: 10.1016/j.bbrc.2024.149873] [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: 03/05/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Abstract
Photobiomodulation (PBM) has attracted attention as a treatment for chronic pain. Previous studies have reported that PBM of the sciatic nerve inhibits neuronal firing in the superficial layers (lamina I-II) of the spinal dorsal horn of rats, which is evoked by mechanical stimulation that corresponds to noxious stimuli. However, the effects of PBM on the deep layers (lamina III-IV) of the spinal dorsal horn, which receive inputs from innocuous stimuli, remain poorly understood. In this study, we examined the effect of PBM of the sciatic nerve on firing in the deep layers of the spinal dorsal horn evoked by mechanical stimulation. Before and after PBM, mechanical stimulation was administered to the cutaneous receptive field using 0.6-26.0 g von Frey filaments (vFFs), and vFF-evoked firing in the deep layers of the spinal dorsal horn was recorded. The vFF-evoked firing frequencies were not altered after the PBM for any of the vFFs. The inhibition rate for 26.0 g vFF-evoked firing was approximately 13 % in the deep layers and 70 % in the superficial layers. This suggests that PBM selectively inhibits the transmission of pain information without affecting the sense of touch. PBM has the potential to alleviate pain while preserving the sense of touch.
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Affiliation(s)
- Daisuke Uta
- Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, University of Toyama, Toyama, 930-0194, Japan.
| | - Naoya Ishibashi
- Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, 930-0194, Japan; Biomedical Engineering Laboratories, Teijin Institute for Bio-Medical Research, Teijin Pharma Ltd., Tokyo, 191-8512, Japan
| | - Shinichi Tao
- Biomedical Engineering Laboratories, Teijin Institute for Bio-Medical Research, Teijin Pharma Ltd., Tokyo, 191-8512, Japan
| | - Masahito Sawahata
- Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, University of Toyama, Toyama, 930-0194, Japan
| | - Toshiaki Kume
- Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, University of Toyama, Toyama, 930-0194, Japan
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Mauro G, Verdecchia A, Suárez-Fernández C, Nocini R, Mauro E, Zerman N. Temporomandibular Disorders Management-What's New? A Scoping Review. Dent J (Basel) 2024; 12:157. [PMID: 38920858 PMCID: PMC11202583 DOI: 10.3390/dj12060157] [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: 04/12/2024] [Revised: 05/13/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Temporomandibular disorders include various conditions that impact the masticatory system, affecting its structure, function, or physiology. Clinicians face a complex array of therapeutic options when treating this group of diseases, emphasizing the importance of evaluating the current evidence to guide decisions in patient care. The main objective of this article is to conduct a scoping review on the available treatment approaches to manage temporomandibular disorders (TMDs). An extensive search of the literature was performed on Scopus, Pubmed, Embase, and Web of Science. Systematic reviews published in the last 5 years were considered. Out of the 2183 publications identified, 109 studies were included in this review. Among them, 39 articles focused on the non-invasive approach, while 120 delved into the minimally invasive approach, and 15 explored the surgical approach. Non-invasive or conservative approaches like cognitive-behavioral therapy, physical therapy, and acupuncture offer effective pain management and functional improvements in TMDs. Emerging treatments offer promising alternatives for treating these disorders. Surgery should be reserved for severe cases, with conservative therapies used in conjunction with invasive procedures for optimal patient outcomes.
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Affiliation(s)
- Giovanni Mauro
- Department of Medicine and Surgery, Dental Clinic, University of Parma, 43125 Parma, Italy;
| | - Alessio Verdecchia
- Department of Surgical Sciences, Postgraduate School in Orthodontics, University of Cagliari, 09124 Cagliari, Italy
| | - Carlota Suárez-Fernández
- Department of Surgery and Medical-Surgical Specialities, School of Medicine and Health Sciences, University of Oviedo, 33003 Oviedo, Spain;
| | - Riccardo Nocini
- Department of Surgical Science, Dentistry, Pediatrics and Gynecology, University of Verona, 37134 Verona, Italy;
| | - Enrico Mauro
- Faculty of Medicine, University of Milano, 20122 Milano, Italy;
| | - Nicoletta Zerman
- Department of Surgical Science, Dentistry, Pediatrics and Gynecology, University of Verona, 37134 Verona, Italy;
- Pediatric Dentistry and Oral Hygiene Unit, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy
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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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Al-Moraissi EA, Almaweri AA, Al-Tairi NH, Alkhutari AS, Grillo R, Christidis N. Treatments for painful temporomandibular disc displacement with reduction: a network meta-analysis of randomized clinical trials. Int J Oral Maxillofac Surg 2024; 53:45-56. [PMID: 37802670 DOI: 10.1016/j.ijom.2023.09.006] [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: 04/05/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
There is currently no consensus on the best treatment for painful temporomandibular disc displacement with reduction (DDwR), and no network meta-analysis of randomized clinical trials (RCTs) comparing all types of treatment for this condition has been conducted. The objective of this study was to compare and rank all treatments for DDwR, including conservative treatments, occlusal splints, low-level laser therapy (LLLT), manual therapy, no treatment (control), arthrocentesis (Arthro) alone, Arthro plus intra-articular injection of platelet-rich plasma (Arthro-PRP) or hyaluronic acid (Arthro-HA), and Arthro plus occlusal splint. Predictor variables were pain intensity and maximum mouth opening (MMO). The mean difference with 95% confidence interval was estimated using Stata software. The GRADE system was used to assess the certainty of the evidence. Twenty RCTs reporting 1107 patients were identified in the literature search; 980 of these patients were included in the network meta-analysis. Direct meta-analysis showed that Arthro-PRP significantly reduced pain intensity compared to Arthro alone, while occlusal splint and manual therapy were superior to conservative treatment (all very low quality evidence). Arthro with intra-articular injection of PRP/HA ranked as the most effective treatment in terms of pain reduction, whereas LLLT ranked the best choice for increasing MMO for patients with DDwR. However, it is important to note that the evidence for the superiority of these treatments is generally of very low quality. Therefore, further high-quality research is needed to confirm these findings and provide more reliable recommendations for the treatment of DDwR.
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Affiliation(s)
- E A Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen.
| | - A A Almaweri
- Department of Oral Medicine, Thamar University, Thamar, Yemen
| | - N H Al-Tairi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen
| | - A S Alkhutari
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen
| | - R Grillo
- Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - N Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Farshidfar N, Farzinnia G, Samiraninezhad N, Assar S, Firoozi P, Rezazadeh F, Hakimiha N. The Effect of Photobiomodulation on Temporomandibular Pain and Functions in Patients With Temporomandibular Disorders: An Updated Systematic Review of the Current Randomized Controlled Trials. J Lasers Med Sci 2023; 14:e24. [PMID: 37744015 PMCID: PMC10517581 DOI: 10.34172/jlms.2023.24] [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: 02/25/2023] [Accepted: 05/27/2023] [Indexed: 09/26/2023]
Abstract
Introduction: Temporomandibular disorders (TMDs) are the most prevalent non-dental origin orofacial pain conditions affecting the temporomandibular joints (TMJs) and/or orofacial muscles. Photobiomodulation therapy (PBMT) is a conservative way to improve function and reduce symptoms in TMD patients. This systematic review was conducted to update evidence about the effects of PBMT on pain intensity, TMJ movements, electromyography (EMG) activity, pressure pain threshold (PPT), and TMJ sound in patients with TMDs. Methods: A systematic literature search was conducted in Web of Science, PubMed/Medline, and Scopus databases using appropriate keywords and specific strategies from January 2000 to September 2022. Data extraction was done based on the inclusion/exclusion criteria. Results: A total of 40 studies were included. All included studies except one provided information on pain intensity; 27 studies showed a reduction in pain intensity in PBMT groups compared to control groups. Seven out of 15 studies, which reported maximum mouth opening (MMO), showed a greater MMO in PBMT groups than in placebo groups. In addition, the figures for passive maximum mouth opening (PMMO) and active maximum mouth opening (AMMO) in all the studies reporting PMMO and AMMO were higher in PBMT groups. In eight out of ten studies, lateral movement (LM) was greater in PBMT groups. Moreover, in three studies out of four, protrusive movement (PM) was reported to be greater in the PBMT group. Four out of nine studies showed a greater PPT in the PBMT group. Reduced TMJ sounds in the PBMT group were reported in two out of five studies. In addition, in most studies, no difference in EMG activity was detected between the two groups. Conclusion: This updated systematic review showed the promising effects of PBMT on the alleviation of pain and improvement in MMO. Using the infrared diode laser with a wavelength ranging between 780-980 nm, an energy density of<100 J/ cm2, and an output power of≤500 mW for at least six sessions of treatment seems to be a promising option for treating mentioned TMDs signs and symptoms based on the previously reported findings.
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Affiliation(s)
- Nima Farshidfar
- Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnoush Farzinnia
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sahar Assar
- Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Parsa Firoozi
- School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fahimeh Rezazadeh
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Hakimiha
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhang Y, Qian Y, Huo K, Liu J, Huang X, Bao J. Efficacy of laser therapy for temporomandibular disorders: A systematic review and meta-analysis. Complement Ther Med 2023; 74:102945. [PMID: 36997006 DOI: 10.1016/j.ctim.2023.102945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the efficacy of laser therapy in temporomandibular disorders (TMD). METHODS Randomized controlled trials (RCTs) in regard to this issue were searched in electronic databases. Three investigators independently screened the eligible studies, and the quality of the included studies was assessed according to the risk of bias tool recommended by the Cochrane handbook. The primary outcome measure was the degree of pain, reported on a visual analog scale (VAS), and the secondary outcome measures were TMJ function, including maximum active vertical opening (MAVO), maximum passive vertical opening (MPVO), left and right lateral movement (LLE, RLE). Pooled effect sizes were calculated using random effects models and 95% confidence interval (95% CI). RESULTS A total of 28 randomized controlled trials were included. Laser therapy had a more significant effect in terms of VAS (SMD=﹣1.88; 95% CI=﹣2.46 to﹣1.30; P<0.00001; I2 =93%), MAVO (MD = 4.90; 95% CI= 3.29 to 6.50; P < 0.00001; I2 =72%), MPVO (MD=5.82; 95% CI= 4.62 to 7.01; P<0.00001; I2 =40%) and RLE (MD = 0.73; 95% CI= 0.23 to 1.22; P = 0.004; I2 = 0%) as compared to placebo group. However, there was no significant difference in LLE between two groups (MD= 0.35; 95% CI=﹣0.31 to 1.01; P=0.30; I2 =0%). CONCLUSIONS Laser therapy can effectively reduce pain but have small effect on improving mandibular movement of TMD patients. More well-designed RCTs with large sample sizes are needed for further validation. And these studies should report detailed laser parameters and provide complete outcome measure data. PROSPERO CRD42022349719.
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Affiliation(s)
- Yan Zhang
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Yingqiu Qian
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Kangxin Huo
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Jingxin Liu
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China
| | - Xi Huang
- Department of Stomatology, First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Jie Bao
- School of Physical Education and Sports Science, Soochow University, Suzhou, China; Sport Rehabilitation Center of Soochow University, Suzhou, China; Children's Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Ningbo, China.
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Li Q, Hou Y, Cao P, Bi R, Zhu S. Near-Infrared Light-Activated Mesoporous Polydopamine for Temporomandibular Joint Osteoarthritis Combined Photothermal-Chemo Therapy. Int J Mol Sci 2023; 24:ijms24109055. [PMID: 37240401 DOI: 10.3390/ijms24109055] [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: 03/29/2023] [Revised: 05/04/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
The treatments generally employed for temporomandibular joint osteoarthritis (TMJOA) involve physical therapy and chemotherapy, etc., whose therapeutic efficacies are impaired by the side effects and suboptimal stimulus responsiveness. Although the intra-articular drug delivery system (DDS) has shown effectiveness in addressing osteoarthritis, there is currently little reported research regarding the use of stimuli-responsive DDS in managing TMJOA. Herein, we prepared a novel near-infrared (NIR) light-sensitive DDS (DS-TD/MPDA) by using mesoporous polydopamine nanospheres (MPDA) as NIR responders and drug carriers; diclofenac sodium (DS) as the anti-inflammatory medication; and 1-tetradecanol (TD) with a phase-inversion temperature of 39 °C as the drug administrator. Upon exposure to 808 nm NIR laser, DS-TD/MPDA could raise the temperature up to the melting point of TD through photothermal conversion, and intelligently trigger DS release. The resultant nanospheres exhibited an excellent photothermal effect and effectively controlled the release of DS through laser irradiation to accommodate the multifunctional therapeutic effect. More importantly, the biological evaluation of DS-TD/MPDA for TMJOA treatment was also performed for the first time. The experiments' results demonstrated that DS-TD/MPDA displayed a good biocompatibility in vitro and in vivo during metabolism. After injection into the TMJ of rats afflicted with TMJOA induced by unilateral anterior crossbite for 14 days, DS-TD/MPDA could alleviate the deterioration of TMJ cartilage, thus ameliorating osteoarthritis. Therefore, DS-TD/MPDA could be a promising candidate for photothermal-chemotherapy for TMJOA.
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Affiliation(s)
- Qianli Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Hou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Pinyin Cao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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El-Shaheed NH, Mostafa AZH, Aboelez MA. Efficacy of stabilisation splint and low-level laser therapy for patients with chronic closed lock from non-reducible displaced temporo-mandibular joint discs: A parallel randomised clinical trial. J Oral Rehabil 2023; 50:177-193. [PMID: 36564950 DOI: 10.1111/joor.13405] [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: 09/16/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Stabilisation splint therapy (SST) and low-level laser therapy (LLLT) are effective-invasive treatment for temporo-mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo-mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown. OBJECTIVES The aim of this study was to assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR. METHODS This parallel randomised clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software. RESULTS Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non-significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II. CONCLUSION All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases, but the combined SST and LLLT group seems to provide the best and quickest improvement. CLINICAL TRIAL REGISTRATION NUMBER NCT05548894.
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Application of photobiomodulation for chronic pain-related TMD on pain points versus pre-established points: Randomized clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2023; 238:112612. [PMID: 36459910 DOI: 10.1016/j.jphotobiol.2022.112612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Photobiomodulation therapy (PTB) is a therapeutic possibility for temporomandibular disorders (TMD), but its effectiveness and protocols for use remain controversial. This study is a RCT that compared the effectiveness of PTB on pain points of the masticatory muscles and TMJs, located through palpation versus application of pre-established points in women with painful TMD, diagnosis by DC/TMD (Diagnostic Criteria for Temporomandibular Disorders - Brazilian Portuguese version). Therefore, a total sample of 54 women, aged between 18 and 60 years, was investigated. Volunteers were randomly randomized and PTB was applied in four different groups with a dose of 4 J and 6 J divided into pre-established application points (PE - G1) and pain points (PD - G2) - Groups 4PE, 4PD, 6PE and 6PD. Four laser applications were performed with a wavelength of 780 nm, one session per week, totaling one month of therapy. The following assessments were performed: DC/TMD, Brief Pain Inventory (BPI), McGill Questionnaire - Short Version (SF-MPQ) and Pain Intensity, Visual Analogue Scale (VAS). Friedman's test was used for within-group comparisons, while the Mann-Whitney test was used for between-group comparisons (p < 0.05). According to the results, laser application on pain points (G2) was more effective. McGill's results showed that regardless of dose, the pain point application group had better outcomes (p = 0.004). Pain intensity evaluation (last days) also showed that application at the pain points was more effective regardless of dose (p = 0.0002). Medians and interquartile deviations showed overall that PTB was more effective at pain points, with a trend towards better outcomes at the 6 J dose. Therefore, it can be concluded that in women with chronic painful TMD, the application of PTB at pain points is more effective than the application at pre-established points. Therefore, individualized PTB protocols are proposed, based on examination palpation of the masticatory structures.
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Turosz N, Chęcińska K, Chęciński M, Kamińska M, Nowak Z, Sikora M, Chlubek D. A Scoping Review of the Use of Pioglitazone in the Treatment of Temporo-Mandibular Joint Arthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416518. [PMID: 36554400 PMCID: PMC9779153 DOI: 10.3390/ijerph192416518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 05/27/2023]
Abstract
Thiazolidinediones (TZDs) are a group of diabetes medications currently being investigated for anti-arthritis effectiveness, one of which is pioglitazone. The purpose of this scoping review is to evaluate the potential use of pioglitazone in the treatment of temporomandibular joint (TMJ) arthritis. The criteria of eligibility were studies with the diagnosis of arthritis and pioglitazone treatment with a change in any inflammation index as an outcome. Of the 1169 records initially identified following the selection process, two animal studies and four clinical studies were included in the review. Improvements from the baseline were observed in each treatment group for each inflammation indicator. The results of the animal studies on the temporomandibular joints and on patients with rheumatoid and psoriatic arthritis indicate that the drug in question may have potential to treat arthritis, including within the temporomandibular joint.
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Affiliation(s)
- Natalia Turosz
- Ortomania, Bartosza Głowackiego 6/1, 30-085 Kraków, Poland
| | - Kamila Chęcińska
- Department of Glass Technology and Amorphous Coatings, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Mickiewicza 30, 30-059 Kraków, Poland
| | - Maciej Chęciński
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland
| | - Monika Kamińska
- Collegium Medicum, Jan Kochanowski University, aleja IX Wieków Kielc 19A, 25-317 Kielce, Poland
| | - Zuzanna Nowak
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq.2, 41-800 Zabrze, Poland
| | - Maciej Sikora
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, Wojska Polskiego 51, 25-375 Kielce, Poland
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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Ferrillo M, Nucci L, Giudice A, Calafiore D, Marotta N, Minervini G, d'Apuzzo F, Ammendolia A, Perillo L, de Sire A. Efficacy of conservative approaches on pain relief in patients with temporomandibular joint disorders: a systematic review with network meta-analysis. Cranio 2022:1-17. [PMID: 36148997 DOI: 10.1080/08869634.2022.2126079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this systematic review with meta-analysis was to evaluate the efficacy of conservative interventions in pain relief in patients with intracapsular temporomandibular disorders (TMD). METHODS PubMed, Scopus, and Web of Science were systematically searched until January 1st, 2022 to identify randomized controlled trials (RCTs) presenting patients with diagnosis of intracapsular TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), conservative approaches as interventions, and pain intensity as outcome. RESULTS Out of 3372 papers, 13 RCTs were included, with 844 study participants. Most of them (n = 7) investigated the efficacy of splint appliance. Meta-analysis revealed that rehabilitative interventions had a significant overall effect size of 0.75 [0.17, 1.34], reporting splint appliance and laser therapy as significantly effective treatments. CONCLUSION Findings of this systematic review with network meta-analysis suggested that conservative approaches might be effective in pain relief of intracapsular TMD patients.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Ludovica Nucci
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Amerigo Giudice
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Minervini
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fabrizia d'Apuzzo
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Letizia Perillo
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Ansar AS, Munna K, Iqbal A, Mohammad F, Naved A, Shamimul H. Prognostic criteria for the management of temporomandibular disorders using arthrocentesis with normal saline and arthrocentesis with normal saline and platelet-rich plasma. J Med Life 2022; 15:698-704. [PMID: 35815075 PMCID: PMC9262257 DOI: 10.25122/jml-2021-0240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022] Open
Abstract
Temporomandibular joint disorders (TMDs) are ailments affecting the jaws and allied structures, resulting in many pathologies (TMJ hypermobility, internal disc derangement, bone changes, degenerative disorders, and ankylosis). Pain, clicking or crepitus, restricted range of motion, deranged jaw function, and deflected or deviated mouth opening and closing are the commonly observed manifestations in TMDs. Internal derangement refers to an aberrant relation of the articular disc to the condyle and fossa, respectively. Conventional therapies highlight the role of non-invasive conservative treatment strategies, namely joint unloading, anti-inflammatory drugs, and physiotherapy. Current literature has emphasized the use of corticosteroids and platelet-rich plasma (PRP) as treatment strategies in TMDs. This study aimed to evaluate whether intra-articular injection of PRP after normal saline lavage in TMJ minimizes the symptoms of TMDs, as compared to injection of normal saline. Thirty patients with TMD according to research diagnostic criteria (RDC) were selected. One group received arthrocentesis with normal saline, and the other group received arthrocentesis with PRP injection. The patients were assessed for pain, maximum inter-incisal mouth opening, bite force, and TMJ sounds. TMDs treated by PRP injection had slightly better results. More studies are required to substantiate the outcome. Injections of PRP were more effective in reducing the symptoms than arthrocentesis with normal saline.
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Affiliation(s)
- Ahmad Syed Ansar
- Department of Oral and Maxillofacial Surgery, Jamia Millia Islamia Central University, New Delhi, India
| | - Khan Munna
- Department of Electrical Engineering, Faculty of Engineering and Technology, Jamia Millia Islamia Central University, New Delhi, India
| | - Asif Iqbal
- Department of Electrical Engineering, Vivekananda Global University, Rajasthan, India
| | - Faisal Mohammad
- Department of Oral and Maxillofacial Surgery, Jamia Millia Islamia Central University, New Delhi, India
| | - Alam Naved
- Department of Computer Sciences, Jamia Hamdard, New Delhi, India
| | - Hasan Shamimul
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia Central University, New Delhi, India
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Argueta-Figueroa L, Flores-Mejía LA, Ávila-Curiel BX, Flores-Ferreyra BI, Torres-Rosas R. Nonpharmacological Interventions for Pain in Patients with Temporomandibular Joint Disorders: A Systematic Review. Eur J Dent 2022; 16:500-513. [PMID: 35259762 PMCID: PMC9507562 DOI: 10.1055/s-0041-1740220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This systematic review aimed to compare the efficacy of nonpharmacological therapies for painful temporomandibular joint disorders. The protocol was registered on International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020171364). The search was performed on the electronic databases PubMed, Google Scholar, Clinical Trials, and Web of Science. The eligibility criteria were randomized controlled trials in patients diagnosed with painful temporomandibular joint disorders comparing the pain relief between conventional treatment and nonpharmacological therapies such as acupuncture, physiotherapy, low-level laser, and massage. Fourteen articles were included in this review. At the overall bias of the studies included, 71.42% exhibited some concerns and 28.57% had high risk. The efficacy of nonpharmacological interventions was found to be moderate in the short term and variable in the long term for pain reduction in patients with temporomandibular joint disorders. The evidence pointed out that acupuncture, laser therapy, and physiotherapy are potentially useful interventions for pain relief in patients with temporomandibular joint disorders. However, there is a lack of consistency and short-term follow-up in the studies to determine the lasting of such effect.
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Affiliation(s)
- Liliana Argueta-Figueroa
- CONACyT - Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca, Oaxaca, México
| | | | - Beatriz Xóchitl Ávila-Curiel
- Laboratorio de Medicina Complementaria, Centro de Estudios en Ciencias de la Salud y la Enfermedad, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca Oaxaca, México
| | | | - Rafael Torres-Rosas
- Laboratorio de Medicina Complementaria, Centro de Estudios en Ciencias de la Salud y la Enfermedad, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca Oaxaca, México
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Moaddabi A, Abbasi F, Moaddabi A, Beithardan G, Asnaashari M, Rezaei S. Comparing the Effects of Low-Level Laser Therapy with Ibuprofen in Improving Myofascial Pain Dysfunction Syndrome. DENTAL HYPOTHESES 2021. [DOI: 10.4103/denthyp.denthyp_112_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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