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Salloum K, Karkoutly M, Haddad I, Nassar JA. Effectiveness of Ultrasound Therapy, TheraBite Device, Masticatory Muscle Exercises, and Stabilization Splint for the Treatment of Masticatory Myofascial Pain: A Randomized Controlled Trial. Clin Exp Dent Res 2024; 10:e921. [PMID: 38923288 PMCID: PMC11194472 DOI: 10.1002/cre2.921] [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: 02/19/2024] [Revised: 05/11/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a particular type of temporomandibular joint disorder. Research findings comparing various treatment approaches are scarce and controversial. Therefore, this study aimed to compare the effectiveness of ultrasound therapy, stabilization splint, TheraBite device, and masticatory muscle exercises in reducing pain intensity and improving mandibular mobility in patients with MPS. METHODS It was a single-blind, randomized, parallel-group, active-controlled trial that took place between April 2023 and October 2023 at the Department of Fixed Prosthodontics, Damascus University. Patients older than 18 years old with myofascial pain accompanied by limited jaw opening and pain lasting for at least 6 months were included. Eighty patients were randomly assigned into four groups using online randomization software: ultrasound therapy, stabilization splint, TheraBite device, and masticatory muscle exercises. Only outcome assessors were masked to treatment allocation. The exercise regimen was the exercise program for patients with TMD. The following primary outcome measures were considered at the baseline (t0), at the first (t1), second (t2), and fourth (t3) week of treatment, and at the second (t4) and fifth (t5) month of follow-up: pain intensity using the visual analogue scale, maximum interincisal opening, right lateral movement, and left lateral movement measured in millimeters. RESULTS The pain level changed from severe to mild at t3 in ultrasound therapy, stabilization splint, and TheraBite device groups. In the masticatory muscle exercises group, it changed to moderate, with a significant difference between ultrasound therapy (p = 0.012) and stabilization splint (p = 0.013) groups. In addition, the mandibular mobility continued to improve at the subsequent follow-up periods (t4 and t5). CONCLUSIONS All therapies are equally effective after 5-month follow-up. However, ultrasound therapy and stabilization splints have the benefit of achieving rapid improvement. TRIAL REGISTRATION ISRCTN20833186.
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Affiliation(s)
- Kenaz Salloum
- Department of Fixed ProsthodonticsDamascus UniversitySyriaSyrian Arab Republic
| | - Mawia Karkoutly
- Department of Pediatric DentistryDamascus UniversitySyriaSyrian Arab Republic
| | - Ibrahim Haddad
- Department of BiologyDamascus UniversitySyriaSyrian Arab Republic
| | - Jihad Abou Nassar
- Department of Fixed ProsthodonticsDamascus UniversitySyriaSyrian Arab Republic
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Prabhakar V, Rajvikram N, Ramachandran U, Saravanan R, Ponsekar AA, Thomas DC. Knowledge and awareness about temporomandibular disorder among dentists in India: Questionnaire study and review. J Indian Prosthodont Soc 2024; 24:284-291. [PMID: 38946513 DOI: 10.4103/jips.jips_573_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/15/2024] [Indexed: 07/02/2024] Open
Abstract
AIM Temporomandibular disorders (TMD) comprise ailments involving the jaw joint (temporomandibular joint) and its associated anatomical structures. The complexity involved in TMD is primarily due to its broad spectrum of conditions, clinical signs and symptoms variability, and multifactorial etiology. Considering the above, the present study was performed to help understand the prevailing knowledge and awareness of TMD among Indian dentists in the context of the new specialty "orofacial pain". SETTINGS AND DESIGN Questinnaire study and review. MATERIALS AND METHODS The questionnaire was distributed using a web-based portal nationwide among Indian dentists. Dentists were invited to participate, clearly stating that the intent and purpose of the questionnaire was to record the existing knowledge and awareness concerning temporomandibular disorders among Indian dentists. The questionnaire was segregated into three sections: pathogenesis, diagnosis, and management of TMDs. The questions were recorded using a Likert three-point scale (1=agree; 2=disagree; 3=not aware). 310 dentists participated in the survey, among which 105 were general dentists (BDS [Bachelor of Dental Surgery] graduates), and 205 were dentists with specialist training (MDS [Masters of Dental Surgery] graduates). STATISTICAL ANALYSIS USED The results obtained from the study participants was used to calculate the percentage and frequency, following which tabulations were made based on graduate type and clinical experience. The values obtained from all three sections were recorded, and the responses were analysed using Pearson's Chi-Square test with statistical significance kept at P < 0.05. RESULTS Results of the study disclosed that only 58.1% of general dentists and 46.8% of specialists were confident in handling temporomandibular disorder patients. Splint therapy was the preferred treatment modality for general dentists, whereas dentists with specialist training preferred occlusal rehabilitation. CONCLUSION The results of the current survey indicate that Indian dentists lack sufficient training in dental schools on all three sections and face difficulty diagnosing and treating TMDs.
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Affiliation(s)
- Vaishnavi Prabhakar
- Department of Dental Sciences, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India
| | - N Rajvikram
- Department of Orthodontics and Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Umamaheshwari Ramachandran
- Department of Department of Orthodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - R Saravanan
- Department of Orthodontics and Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Davis C Thomas
- Centre for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA
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Prado IM, Lamenha-Lins R, Ribeiro-Lages MB, Maia LC, Serra-Negra JM. A global bibliometric analysis on the relationship between tinnitus and temporomandibular disorders. J Oral Rehabil 2024; 51:1081-1090. [PMID: 38449443 DOI: 10.1111/joor.13679] [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: 06/11/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND AND OBJECTIVES This global bibliometric review aimed to investigate trends in publications relating to tinnitus and TMD. METHODS A search was performed in eight databases (June/2022), by independent researchers with relevant keywords about tinnitus and TMD, without restriction of date or language. Original research or case report/series evaluating prevalence, association and risk related to tinnitus and TMD were included. Independent examiners selected studies by title and abstract and performed data extraction. Data about publication and researchers, study population, objective, study design and diagnostic criteria for tinnitus and TMD were exported to VintagePoint® for bibliometric analyses. Data about the direct association between tinnitus and TMD were extracted. RESULTS One hundred and seventeen articles from 25 countries were included, most observational (68.4%) and evaluating association (N = 60; 44.8%). Among the 60 studies of association, 22 (36.6%) presented results of a direct association between the presence/absence of tinnitus and the presence/absence of TMD. Brazil (19.5%) and the United States (12.7%) were the countries with the most publications, and Dentistry (48.6%) was the main publication area. A growth in publications in Dentistry was observed in the past 30 years and in the past 10 years in Medicine. Half of the studies included the elderly population (50.2%). The main diagnostic criterion for both tinnitus (37.8%) and TMD (28%) was general questionnaires and/or self-report. CONCLUSION There is a growing trend in publications relating to tinnitus and TMD, especially in Dentistry, with a predominance of observational and association studies in the elderly population using questionnaires and/or self-report. More research with robust diagnostic methods and other study designs should be encouraged in the future.
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Affiliation(s)
- Ivana Meyer Prado
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renata Lamenha-Lins
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Batista Ribeiro-Lages
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Júnia Maria Serra-Negra
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Kliangkaeo W, Tangpothitham S, Mitrirattanakul S, Wachiralarpphaithoon C. The effect of different pain characteristics on jaw functional limitations in patients with temporomandibular disorders. J Oral Rehabil 2024; 51:998-1004. [PMID: 38450596 DOI: 10.1111/joor.13674] [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: 04/25/2023] [Revised: 10/27/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Patients with painful temporomandibular disorders (TMD) more often experience jaw functional limitations. The study of jaw functional limitations should be primarily focused on painful TMD. OBJECTIVES The impact of TMD pain characteristics (source, chronicity and intensity) on jaw functional limitations were evaluated using Jaw Functional Limitation Scale (JFLS). METHODS This cross-sectional study reviewed the dental records and self-report questionnaires of patients with painful TMD. The pain source, chronicity and intensity were evaluated to study the TMD pain characteristics. The jaw functional limitations were analysed using the Thai version of the JFLS. RESULTS A total of 176 patients with painful TMD were included in this study. The jaw functional limitations were affected only by pain intensity. Patients with TMD with severe pain intensity had significantly higher jaw functional limitations than those with mild-to-moderate pain intensity (p < .05). A significant association was observed between pain intensity and jaw functional limitations (p < .05). Mastication was highly restricted by pain intensity (odd ratio = 1.39, 95% confidence interval = 1.16-1.67). CONCLUSION The present study found a significant effect of TMD pain intensity on jaw functional limitations. Patients with severe TMD pain intensity were more likely to experience jaw functional limitations, particularly mastication limitation. Management focusing on reduction of pain intensity may improve jaw functions in patients with TMD.
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Affiliation(s)
- Watcharee Kliangkaeo
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Sakarin Tangpothitham
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Ferrillo M, Marotta N, Viola P, Chiarella G, Fortunato L, Ammendolia A, Giudice A, de Sire A. Efficacy of rehabilitative therapies on otologic symptoms in patients with temporomandibular disorders: A systematic review of randomised controlled trials. J Oral Rehabil 2024. [PMID: 38685701 DOI: 10.1111/joor.13716] [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: 11/11/2023] [Revised: 02/28/2024] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The term temporomandibular disorder (TMD) indicates a set of musculoskeletal conditions involving temporomandibular joint (TMJ), masticatory musculature, and related anatomical structures. Pain is the most common clinical manifestation of TMD, and the auditory system might be involved and affected, through tinnitus, dizziness, otalgia and ear fullness sensation. OBJECTIVES The aim of this systematic review of randomised controlled trails (RCTs) was to evaluate the efficacy of rehabilitative approaches on otologic symptoms in patients with TMD. METHODS PubMed, Scopus and Web of Science were systematically searched from the inception until 8th October 2023 to identify RCTs presenting participants with a diagnosis of TMD associated with otologic signs and symptoms, rehabilitative approaches as interventions, and modification of the otological symptoms as outcome. RESULTS Out of 931 papers suitable for title/abstract screening, 627 articles were assessed for eligibility. Five studies were included reporting the efficacy of occlusal splint therapy, low-level laser therapies, and physical therapy in patients diagnosed whit secondary otalgia or tinnitus associated with TMD. No RCTs evaluating other otologic symptoms, ear fullness, dizziness or vertigo were found. CONCLUSIONS Results of this systematic review suggested that rehabilitative approaches might be effective in improving secondary otalgia and tinnitus in TMD patients. Thus, further RCTs with a higher level of evidence and more representative samples should be conducted to better understand the effects of TMD therapy on otologic complains.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Pasquale Viola
- Audiology Unit, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Chiarella
- Audiology Unit, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Leonzio Fortunato
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Antonio Ammendolia
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Amerigo Giudice
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Alessandro de Sire
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Al-Hadad SA, Ahmed MMS, Zhao Y, Wang L, Hu W, Li C, Chen X, Alhammadi MS. Skeletal, dentoalveolar and soft tissue changes after stabilization splint treatment for patients with temporomandibular joint disorders. BMC Oral Health 2024; 24:479. [PMID: 38643111 PMCID: PMC11032605 DOI: 10.1186/s12903-024-04260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/15/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) is a grouping of heterogeneous disorders with multifactorial origins. Stabilization splints (SS) have demonstrated an acceptable treatment effect in TMD. The possible changes at the skeletal, dental, and soft tissue levels need to be addressed to evaluate the benefit/risk ratio of this therapeutic procedure. Accordingly, this study aimed to three‑dimensionally evaluate skeletal, dentoalveolar and soft tissue changes after SS treatment for patients with TMD. METHODS This retrospective study included 74 adult patients with myofascial and/or intra-articular disorders (25 males and 49 females), with an average age of 22.88 ± 4.8 years, who underwent SS treatment. Pre- and post-treatment Cone beam computed tomography were analysed using Invivo 6.0.3 software. The primary outcome was the vertical skeletal and dentoalveolar changes, while the secondary outcomes were the anteroposterior skeletal, dentoalveolar and soft tissue changes. Paired t-test and Wilcoxon rank sum test were used for statistical analyses. RESULTS For the primary outcome; skeletally, there was a significant increase in mandibular plane inclination (difference: 0.82°±1.37), decrease facial height ratio (difference: 0.45%±1.07) and at the dentoalveolar level, the inclination of the functional (FOP-SN, FOP-FH) and bisecting (BOP-SN, BOP-FH) occlusal planes exhibited a significant increase too (difference: 0.38 ± 1.43°, 0.49 ± 1.62°, 0.44 ± 1.29° and 0.41 ± 1.17°, respectively) and also a decrease in the overbite (difference: -0.54 ± 0.83). For the secondary outcomes; there was a significant decrease in mandibular position (SNB) (difference: 1.60 ± 1.36°) and increase in the overjet (difference: 0.93 ± 1.04, p < 0.001) and a significant lower lip retrusion (difference: 0.33 ± 1.01 mm p < 0.01), was observed too. CONCLUSIONS SS therapy resulted in significant vertical skeletal and dentoalveolar changes that were manifested mainly by facial height ratio, mandibular and occlusal plane changes, and to a lesser extent, significant anteroposterior skeletal, dentoalveolar, and soft tissue changes in the form of mandibular position, increased overjet and a more retrusive lower lip. These changes should be considered during patients' selection prior to initiating SS therapy.
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Affiliation(s)
- Saba Ahmed Al-Hadad
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, IBB, Republic of Yemen
| | - Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Lu Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Wanqing Hu
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Chushen Li
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
| | - Maged Sultan Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Wollenburg M, Wolowski A. Impact of professional, recreational and nonsinging on temporomandibular disorders - a comparative study based on a self-assessment questionnaire. Head Face Med 2024; 20:19. [PMID: 38515168 PMCID: PMC10956313 DOI: 10.1186/s13005-024-00419-z] [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: 09/29/2023] [Accepted: 02/18/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND This study investigates the relationship between professional and recreational singing on temporomandibular disorders (TMDs) in women compared to a nonsinging control group. METHODS A total of 288 female subjects between the ages of 18 and 45 participated in the self-assessment questionnaire including demographic data, as well as questions on vocal practice and TMDs symptoms. Depending on the singing time per week, the (non)vocalists were assigned to the groups professional (n = 96), recreational (n = 96) and nonsingers (n = 96). RESULTS The TMDs prevalence in professional singers (42%) was higher than that in recreational singers (31%) and noticeably higher than that in nonsingers (25%). The Fisher-Freeman-Halton exact test showed that the differences between the groups were not noticeable (p = .053) but could be formulated as tendencies. The professionals suffered much more from restricted jaw movement (p = .004; OR = 2.718; 95% CI = 1.409-5.242), temporomandibular joint sounds (p < .009; OR = 2.267; 95% CI = 1.264-4.064) and temporomandibular pain (p = .010; OR = 2.333; 95% CI = 1.264-4.308) than nonsingers. CONCLUSIONS Singing might have an enhancing effect on the appearance of TMDs. In particular, professional singers suffered more from self-reported TMDs than recreational singers and nonsingers. In addition to the high level of physical workload if participating in professional singing, the psychosocial impact should be investigated more in further studies. No new treatment strategies resulted from this study, as the etiological significance of singing is still unclear. Knowledge about risk factors for multifactorial TMDs can help practitioners and patients prevent and treat TMDs.
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Affiliation(s)
- Maja Wollenburg
- Department of Prosthodontics, University Hospital Münster, Albert-Schweitzer-Campus 1/W30, Münster, 48149, Germany.
| | - Anne Wolowski
- Department of Prosthodontics, University Hospital Münster, Albert-Schweitzer-Campus 1/W30, Münster, 48149, Germany
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Alowaimer HA, Al Shutwi SS, Alsaegh MK, Alruwaili OM, Alrashed AR, AlQahtani SH, Batais MS. Comparative Efficacy of Non-Invasive Therapies in Temporomandibular Joint Dysfunction: A Systematic Review. Cureus 2024; 16:e56713. [PMID: 38646388 PMCID: PMC11032691 DOI: 10.7759/cureus.56713] [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: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Temporomandibular disorder (TMD) is a multifaceted disorder impacting the temporomandibular joint (TMJ), causing substantial discomfort and functional limitations. This systematic review aims to comprehensively assess the effectiveness of non-invasive treatment modalities for TMJ dysfunction, prioritizing a definitive protocol to ensure patient safety and enhance quality of life. Employing the PRISMA guidelines, we meticulously analyzed 20 studies from a pool of 1,417 articles sourced from databases such as PubMed, Google Scholar, ScienceDirect, and Medline. These studies underscore the multifarious nature of TMD and the varied responses to treatments such as physical therapy, laser therapy, ultrasound and electrical stimulation, splint therapy, injections, and arthrocentesis. Notably, the review highlights the paramount importance of precise diagnosis, often through surface electromyography, followed by a tailored treatment approach integrating manual therapy, counseling, and splint therapy. The systematic analysis revealed that while certain treatments such as transcutaneous electrical nerve stimulation and low-level laser therapy showed limited efficacy, combination therapies, especially those involving manual therapy, counseling, and splint therapy, demonstrated substantial improvement in reducing pain, depression, and anxiety. The findings advocate for a non-invasive, patient-centric approach, emphasizing education and symptom management before considering more invasive procedures such as injections and arthrocentesis. The review identifies the need for more comprehensive, longitudinal studies to establish a standardized, evidence-based treatment protocol for TMJ dysfunction, aiming to improve patient outcomes holistically.
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Prott LS, Spitznagel FA, Hugger A, Langner R, Gierthmühlen PC, Gierthmühlen M. Transcutaneous auricular vagus nerve stimulation for the treatment of myoarthropatic symptoms in patients with craniomandibular dysfunction - a protocol for a randomized and controlled pilot trial. Pilot Feasibility Stud 2024; 10:27. [PMID: 38331976 PMCID: PMC10851508 DOI: 10.1186/s40814-024-01447-x] [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: 05/11/2023] [Accepted: 01/12/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are a collective term for pain and dysfunction of the masticatory muscles and the temporomandibular joints. The most common types of TMD are pain-related, which may impact the psychological behavior and quality of life. Currently, the most popular methods for the treatment of TMD patients are occlusal splint therapy, often in combination with physical- and/or pharmacotherapy. However, due to the complexity of etiology, the treatment of chronic TMD remains a challenge. Recently, CE-certified systems for non-invasive VNS (transcutaneous auricular vagus nerve stimulation, taVNS) have become available and show positive effects in the treatment of chronic pain conditions, like migraine or fibromyalgia, with which TMD shares similarities. Therefore, it is the main purpose of the study to evaluate the feasibility of daily taVNS against chronic TMD and to assess whether there is an improvement in pain severity, quality of life, and kinetic parameters. METHODS This study is designed as a single-blinded, double-arm randomized controlled trial (RCT) in a 1:1 allocation ratio. Twenty adult patients with chronical TMD symptoms will be enrolled and randomized to stimulation or sham group. In the stimulation group, taVNS is performed on the left tragus (25 Hz, pulse width 250 µs, 28 s on/32 s off, 4 h/day). The sham group will receive no stimulation via a non-functional identical-looking electrode. Validated questionnaire data and clinical parameters will be collected at the beginning of the study and after 4 and 8 weeks. The compliance of a daily taVNS of patients with chronical TMD will be evaluated via a smartphone app recording daily stimulation time and average intensity. Additionally, the treatment impact on pain severity and quality of life will be assessed with different questionnaires, and the effect on the mandibular mobility and muscle activity will be analyzed. DISCUSSION This is the first clinical trial to assess the feasibility of taVNS in patients with chronic TMD symptoms. If taVNS improves the symptoms of TMD, it will be a significant gain in quality of life for these chronic pain patients. The results of this pilot study will help to determine the feasibility of a large-scale RCT. TRIAL REGISTRATION This study has been registered in the DRKS database (DRKS00029724).
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Affiliation(s)
- Lea S Prott
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany.
| | - Frank A Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
| | - Alfons Hugger
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
| | - Robert Langner
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, 52425, Germany
| | - Petra C Gierthmühlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
| | - Mortimer Gierthmühlen
- Department of Neurosurgery, University Medical Center Knappschaftskrankenhaus Bochum, In Der Schornau 23-25, Bochum, 44892, Germany
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Sun X, Feng Y, Jiao Y, Liu W. Fully digital workflow for the fabrication of occlusal stabilization splints based on individual mandibular movement. J Dent 2024; 141:104826. [PMID: 38157975 DOI: 10.1016/j.jdent.2023.104826] [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: 12/14/2022] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE This study was conducted to present a completely digital workflow for the fabrication of occlusal stabilization splints using CAD/CAM systems and a digital face bow based on optical sensor technology. METHODS Digital scans of the maxillary and mandibular arches of 20 volunteers were obtained using an intraoral scanner. Jaw relation and mandibular movements were recorded with a digital face bow via optical sensors. The virtual increase of the vertical dimension of occlusion (VDO) was then performed, after which computer-aided design (CAD) of the occlusal stabilization splints was carried out. The corresponding splints were then manufactured using digitally controlled technology. RESULTS A completely digital workflow for the manufacturing of occlusal stabilization splints was found to be clinically feasible. The corresponding data analysis revealed high congruence between virtual and physical occlusal contacts on the occlusal splint. Moreover, the appropriate guidance of the anterior teeth area was easily obtainable, and the time for adjusting the occlusion was less. CONCLUSIONS This study demonstrated that the fabrication of occlusal stabilization splints using a fully digital workflow is feasible. Compared to traditional impression-based manufacturing, several advantages of digital manufacturing include easy accessibility, time-efficient manufacturing, high-level accuracy in splint quality, and potential to manufacture duplicate splints. CLINICAL SIGNIFICANCE The proposed fully digital approach may help young dentists fabricating stable occlusal splints with beneficial curative effects. Meanwhile, it could also improve the production efficiency of stable occlusal splints, saving time for both doctors and patients while reducing labor costs.
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Affiliation(s)
- Xinrong Sun
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yue Feng
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yi Jiao
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Weicai Liu
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China.
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Alam MK, Zaman MU, Alqhtani NR, Alqahtani AS, Alqahtani F, Cicciù M, Minervini G. Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. J Oral Rehabil 2024; 51:416-426. [PMID: 37731276 DOI: 10.1111/joor.13589] [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: 07/29/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent. METHODS Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias. RESULTS Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.
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Affiliation(s)
- Mohammad Khursheed Alam
- Preventive Dentistry Department, College of Dentistry, Jouf University, Skaka, Saudi Arabia
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Mahmud Uz Zaman
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Al-kharj, Saudi Arabia
| | - Nasser Raqe Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Al-kharj, Saudi Arabia
| | - Abdullah Saad Alqahtani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Al-kharj, Saudi Arabia
| | - Fawaz Alqahtani
- Department of Prosthodontics, School of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - 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, Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Lekaviciute R, Kriauciunas A. Relationship Between Occlusal Factors and Temporomandibular Disorders: A Systematic Literature Review. Cureus 2024; 16:e54130. [PMID: 38487145 PMCID: PMC10939299 DOI: 10.7759/cureus.54130] [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: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Temporomandibular disorders (TMD) originate from various components within the temporomandibular joint (TMJ), causing an impact on the masticatory muscles, the joint itself, and associated structures. They are a widely prevalent issue across the world. According to epidemiological research, up to 50% of adults in the population have TMD-related symptoms. The objective of this work was to analyze the existing scientific literature regarding the association between malocclusion classes, bruxism, and tooth loss in relation to the etiology of TMD. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 analysis protocol. For the development of the question focus, the population, intervention, control, and outcomes (PICO) study design protocol was used. The question in focus according to the PICO format was: "Do malocclusion, tooth loss, and bruxism contribute to temporomandibular disorders?". The review was performed with articles from PubMed, Web of Science, and Google Scholar databases according to the specified inclusion and exclusion criteria. The included articles were not older than five years. The risk of bias was assessed in the included studies by using the Cochrane Risk-of-bias 2 (RoB-2) tool. Out of a total of 32 results received, 21 articles were chosen according to the established criteria after conducting a review and analysis of their full texts. The article search sequence was presented in the PRISMA 2020 flow diagram, and the outcomes of the chosen articles were presented. The literature results revealed a relationship between occlusion and the development of TMD. The influence of occlusal factors on the TMJ was explained by an examination of joint anatomy and symptoms related to TMD. This study revealed variations in TMJ factors across different malocclusion classes. Additionally, it was observed that the occurrence and attributes of TMD are influenced by the number of tooth loss quadrants and the frequency of missing teeth. Furthermore, a correlation was found between bruxism and the symptoms of TMD, including myofascial pain, disc displacement, arthralgia, and muscle disorders. This literature review provides comprehensive information on the relationship between malocclusion classes, bruxism, tooth loss, and TMDs. This prompts healthcare professionals to prioritize patients' occlusal assessment and TMJ condition.
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Affiliation(s)
- Roberta Lekaviciute
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Albertas Kriauciunas
- Faculty of Odontology, Clinic of Dental and Maxillofacial Orthopaedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
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13
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Sun R, Zhang S, Si J, Zhang L, Yang H, Ye Z, Xiong X. Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population. J Pain Res 2024; 17:431-439. [PMID: 38328021 PMCID: PMC10848921 DOI: 10.2147/jpr.s449377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
Background Studies have reported correlations between various oral behaviors and painful temporomandibular disorders (TMD), yet comprehensive research on the independent effects of each oral behavior within the general population remains sparse. Objective This cross-sectional study aimed to investigate the association between painful TMD (PT) and various oral behaviors in general population. Methods A questionnaire survey was conducted with participants to collect data encompassing demographic characteristics, eight specific oral behaviors, and the 5 major TMD symptoms(5Ts) checklist. Participants were categorized into PT and non-PT (NPT) groups based on their responses to the 5Ts checklist. Those reporting TMJ/facial pain or headaches were assigned to the PT group, while all other participants constituted the NPT group. Both univariate and multivariate logistic regression analyses were employed to evaluate the association between individual oral behavior and the presence of PT, controlling for demographic confounders including age, sex, systemic diseases, and dental treatments history. Results A total of 441 valid questionnaires were received, including 156 males and 285 females. The prevalence of PT was identified to be 33.33%, with 61.00% of participants engaging in one or more types of oral behaviors. Each oral behavior was more frequently reported in the PT group compared to the NPT group. The univariate logistic regression analysis identified positive correlations between all eight oral behaviors and PT. In the multivariate logistic regression analysis, these associations persisted after adjustment for demographic confounders including age, sex, history of systemic diseases and dental treatments (P<0.01). The behaviors most strongly associated with PT were "Hold or jut jaw forward/to the side" (OR:4.478), "Hold, tighten or tense muscles without clench" (OR:3.343) and "Hold jaw in rigid or tense position" (OR:3.209). Conclusion The presence of oral behaviors has significant association with PT. Individuals exhibiting multiple oral behaviors are more likely to experience PT. Additional studies are needed to clarify the effects of reducing oral behaviors on pain-related symptoms.
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Affiliation(s)
- Ruonan Sun
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Shuyuan Zhang
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jiarui Si
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Liming Zhang
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Haolun Yang
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Zheng Ye
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xin Xiong
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
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Liu CG, Yap AU, Fu KY, Lei J. The "5Ts" screening tool: Enhancements and threshold values for effective TMD identification. Oral Dis 2024. [PMID: 38287488 DOI: 10.1111/odi.14877] [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: 11/12/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE This study aimed to enhance the quintessential "five temporomandibular disorder (TMD) symptoms" (5Ts) screener by incorporating frequency options and distinguishing between TMJ and muscle pain. The diagnostic accuracy along with cut-off points for the effective identification of TMDs was also established. METHODS Participants, aged ≥18 years, were recruited from a university-based hospital. After completing surveys encompassing demographic data and the enhanced 5Ts (with frequency options [5Ts-F] and differentiation of TMJ/muscle pain [6Ts-F]), protocolized interviews and clinical examinations were performed following DC/TMD. The diagnostic accuracy and best cut-off points were determined with the area under the receiver operating characteristic curves (AUCs). RESULTS 324 participants were recruited (mean age 30.0 ± 11.4 years). Among these, 86.4% had TMDs. 5Ts exhibited high diagnostic accuracy for detecting all TMDs (AUC = 0.92) with sensitivity/specificity values of 83.9%/88.6%. Both 5Ts-F and 6Ts-F had slightly better accuracy (AUCs = 0.95/0.96), comparable sensitivity, and superior specificity (97.7%) compared to 5Ts. The best cut-off points were 1.5 for 5Ts and 2.5 for 5Ts-F/6Ts-F. CONCLUSIONS Although all three TMD screeners presented high diagnostic accuracy, 5Ts-F/6Ts-F had notably improved specificity. 5Ts scores of >1.5 and 5Ts-F/6Ts-F scores of >2.5 are to be applied for screening the presence of TMDs.
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Affiliation(s)
- C G Liu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - A U Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- Department of Dentistry, Ng Teng Fong General Hospital, and Faculty of Dentistry, National University Health System, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
| | - K Y Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - J Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
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15
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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:S1550-8307(24)00006-5. [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] [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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Minervini G, Marrapodi MM, Tirupathi S, Afnan L, Ronsivalle V, Cervino G, Cicciù M. Prevalence of temporomandibular disorders (TMD) in bleeding disorders: A systematic review with meta-analysis. J Oral Rehabil 2023; 50:1535-1543. [PMID: 37644699 DOI: 10.1111/joor.13572] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Haemophilia A, B and von Willebrand disease are the most common bleeding disorders. There is an increased tendency of spontaneous bleeding into joints resulting in intra-articular infection. It is believed that Temporomandibular Joint (TMJ) can be affected in a similar manner which can further lead to limited mouth opening and ankylosis. The association between bleeding disorders (BD) and development of temporomandibular disorders (TMD) is poorly understood. This systematic review intends to evaluate the association of TMD in individuals with inherited bleeding disorders as compared to healthy controls. METHODS PubMed, Ovid SP and Google Scholar were searched for articles published between the times of inception to 1 May 2023. All the articles were subjected to Population, Exposure, Comparison and Outcome model (PECO) based on which inclusion and exclusion criteria were applied. Participants (P) is children, adults or adolescents; Exposure (E) is children, adults or adolescents with a diagnosis of Haemophilia or bleeding disorder (BD); Comparator (C) is age and gender-matched healthy controls who do not have Haemophilia or bleeding disorder; Outcome (O) is prevalence of any signs or symptoms (clinical, radiographic) that is suggestive of temporomandibular disorder (TMD). Studies showing the prevalence of TMD are included for qualitative analysis. Only the studies which provided data of the prevalence of TMD in both the groups (BD and healthy controls) were included in the quantitative analysis. TMD diagnosis can be by clinical signs and symptoms, radiographic criteria, Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or any other imaging criteria (MRI). We have set the exclusion criteria as articles without a control group, diagnostic sensitivity studies, case reports and systematic reviews and narrative reviews. The software Review Manager version 5.4 (Cochrane Collaboration) was used to perform the pooled analysis. We measured the risk ratio (RR) between the two groups (BD and healthy controls) for the outcome TMD. RESULTS A total of seven studies are included for qualitative analysis of data. The age of the population (BD and control) in the included studies ranged between 2 and 57 years. The prevalence of TMD in individual studies varied from 2% to 77%, and controls in the individual studies varied from 2% to 14%. Among the included studies, only clinical signs, symptoms and history were taken into consideration in four studies. Four studies were included for meta-analysis, the pooled result of the four studies suggests there is no significant difference in the prevalence of TMD in BD and control group (p value = .11, RR 2.19; 95% CI [0.84, 5.73]). CONCLUSION This systematic review and meta-analysis elicits no association between bleeding disorders and increased prevalence of TMD.
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Affiliation(s)
- Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Sunnypriyatham Tirupathi
- Department of Pediatric and Preventive Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Lamea Afnan
- Department of Public Health Dentistry, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India, Maharashtra, India
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, Italy
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Sadrzadeh‐Afshar M, Salari B, shobeiri A, HafeziMotlagh K. Investigating the effect of obsessive-compulsive disorder on clinical symptoms of temporomandibular joint disorders. Clin Exp Dent Res 2023; 9:1191-1199. [PMID: 37840225 PMCID: PMC10728531 DOI: 10.1002/cre2.798] [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: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES Temporomandibular disorders (TMD) are a group of clinical conditions involving muscles of mastication, temporomandibular joint (TMJ), and related structures or both. TMD is characterized by facial pain in TMJ and muscles of mastication, limitation or deviation of jaw movement, and TMJ sounds during jaw movement and function. The highest risk of TMD prevalence is between 18 and 24 years, and a relationship is between chronic TMD and psychological disorders such as stress and depression. The knowledge of the function of this joint and those with TMD symptoms when visiting the dentist will help to provide an ideal treatment plan for the patient. Therefore, if the therapist is familiar with the various etiological factors of this disorder, he will provide better treatment, especially if the simultaneous effect of psychological factors such as stress and obsessive-compulsive disorder (OCD) along with occlusal factors such as posterior cross-bite, overjet, and overbite is measured, it can be a valuable guide for clinicians. METHODS AND MATERIALS In this study, 385 patients were examined by DASS42 and Maudsley's test and classified into normal, with stress, and stress plus OCD groups. TMJ was examined for each of them by the TMD-RDC test. The presence or absence of TMD was noted in their file. RESULTS The prevalence of TMD was 20.7% in the normal group, 30.70% in the stress group, and 44.68% in the stress and OCD group. After analyzing the data by SPSS 24 and performing analysis of variance and Duncan tests, no significant difference was found between the probability of TMD in normal and stressed groups, but the stress and OCD group has a higher chance of TMD. CONCLUSION Although the co-occurrence of stress and OCD is associated with the prevalence of TMD, it cannot be considered a cause of TMD.
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Affiliation(s)
| | - Behzad Salari
- Orthodontics Department, Faculty of Dentistry, Tehran Medical SciencesIslamic Azad UniversityTehranIran
| | - Ali shobeiri
- Department of Oral and Maxillofacial Medicine, Faculty of DentistryAJA University of Medical SciencesTehranIran
| | - Kimia HafeziMotlagh
- Department of Oral Medicine, School of DentistryTehran University of Medical SciencesTehranIran
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Khachatryan Z, Hambartsoumian T, Tatintsyan L, Burnazyan S, Hakobyan G. Efficacy of the transcutaneous electrostimulation in treatment dysfunctions of the TMJ associated with occlusion distortions. BMC Oral Health 2023; 23:937. [PMID: 38017420 PMCID: PMC10683287 DOI: 10.1186/s12903-023-03662-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: 06/29/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The study evaluation of the effectiveness the method of electrostimulation in treatment TMJ associated with occlusion disorders with the use of a patches by the company "Aganyan''. METHODS The study included 54 patients with temporomandibular dysfunction syndrome who had previously undergone endodontic dental treatment. In patients temporomandibular disorders (TMD) determined on the basis of Diagnostic criteria for temporomandibular disorders(DC/TMD).All patients had occlusion disorders due to errors after dental filling restoration. To diagnose the TMJ, a CT scan was used. The complex therapy also included therapy and with the use of a patches by the company "Aganyan''. The wearable patch includes a flexible substrate, a binder an adhesive layer, with an electrode foil attached to it. Patients applied one patch behind each TMJ. The patches were applied for eight hours every third day for three months. All the patients were given full-fledged endodontic treatment and restoration of the crown part, taking into account anatomical features. RESULTS The dynamics of the complex treatment of patients diagnosed with TMJ dysfunction syndrome showed that after treatment, the clinical symptoms gradually decreased and disappeared at the end of treatment. CT scan a year after treatment showed a normal ratio of TMJ elements. Сomplex treatment was effective in 87% of patients, after 3-5 months gradually decreased pain, noise in the joints, restriction of opening and closing of the mouth disappeared. Patients recovered their chewing functions, psycho-emotional state. CONCLUSION The results of the studies revealed a positive effects for the complex treatment dysfunctions syndrome TMJ the using the patches by the company "Aganyan" through electrical stimulation with low intensity.
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Affiliation(s)
- Zhanna Khachatryan
- Dept. of Therapeutic Stomatology, Yerevan State Medical University after M. Heratsi, Dental Clinic Pail, Yerevan, Armenia
| | - Tsovinar Hambartsoumian
- Dept. of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Lyudmila Tatintsyan
- MC ArtMed, Yerevan, Armenia
- Dept. of Therapeutic Stomatology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Seda Burnazyan
- Dept. Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, 0028 Kievyan str. 10 ap. 65, Yerevan, Armenia
| | - Gagik Hakobyan
- Dept. Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, 0028 Kievyan str. 10 ap. 65, Yerevan, Armenia.
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Ali HA, Hadi HA. Can the Autogenous Nanofat Injection Improve the Symptoms of Patients With Temporomandibular Joint Internal Derangement? A Prospective Observational Clinical Study. J Craniofac Surg 2023:00001665-990000000-01190. [PMID: 37955518 DOI: 10.1097/scs.0000000000009820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/29/2023] [Indexed: 11/14/2023] Open
Abstract
Since nanofat is considered one of the richest sources of adipose-derived stem cells with an increased need for new biological approaches for managing temporomandibular joint internal derangement (TMJ-ID) symptoms that impair a patient's lifestyle, this study evaluated the effectiveness of autogenous nanofat intra-articular injection in managing ID symptoms regarding pain, mouth opening, and joint sound. Furthermore, to assess the consequences and complications of this procedure, 20 patients with 38 TMJs with varying stages of Wilkes classification were included in the study. All involved patients were previously diagnosed with ID depending on a clinical and radiographical basis and had no previous response to conservative management for at least 4 to 6 months. Evaluation of the ID in the preoperative phase, as well as 2 weeks, 1 month, 3 months, and 6 months postoperatively. An evaluation was done depending on pain assessment using a visual analog scale (VAS), measuring maximum mouth opening (MMO) and joint noise if it was present or absent preoperatively and postoperatively. The results show improvement in the symptoms in all follow-up appointments since the VAS of pain decreased significantly with increased MMO and the absence of clicking in most cases during follow-up appointments. We conclude from this study that nanofat intra-articular injection was influential in managing ID symptoms and was safe without significant side effects.
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Affiliation(s)
- Huda Akram Ali
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Baghdad, Baghdad, Iraq
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20
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Cutrim RC, Santos-de-Araújo AD, Pontes-Silva A, Protazio JB, Anselmo-E-Silva CI, Costa CPS, Gonçalves MC, de Oliveira Brito Monzani J, de Almeida LV, Filho EMM, De Jesus Tavarez RR, Dibai-Filho AV, Bassi-Dibai D. Short-term heart rate variability at rest in individuals with temporomandibular disorder: a comparative analysis. Clin Oral Investig 2023; 27:6559-6566. [PMID: 37733026 DOI: 10.1007/s00784-023-05261-2] [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: 07/23/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Compare heart rate variability (HRV) indices in participants with and without myogenic temporomandibular disorder (TMD). Secondarily, we correlated HRV indices with pain and quality of life variables. METHODS This is a comparative observational cross-sectional study. Individuals of both genders with and without a history of TMD were included. Short-term heart rate variability was assessed using a Polar V800. Central sensitization was assessed using the Central Sensitization Inventory. Pain through the numeric pain scale and the impact of oral health on quality of life using the OHIP-14 questionnaire. RESULTS A total of 80 participants were enrolled in the study: most individuals included in both groups were young adults, women and slightly overweight. We observed a decrease in HRV in the TMD group (p < 0.01) when compared to the control group. In addition, we observed a greater impact of oral health on quality of life, central sensitization in addition to high resting pain scores (p < 0.01). We observed significant correlation between the LF index of HRV and the FAI score (r = 0.311; p = 0.05). The NPS, CSI and OHIP-14 scores did not correlate with any of the HRV indices (p > 0.05). CONCLUSION The short-term HRV in individuals with TMD is significantly lower when compared to a control group. Furthermore, there seems to be a relationship between the severity of the dysfunction and the HRV variables. CLINICAL RELEVANCE Using portable and low-cost devices, the HRV can be easily collected and analyzed, without the need for an arsenal of equipment such as the conventional electrocardiogram. This measure can contribute to the therapy adopted and identify individuals prone to unfavorable outcomes involving ANS modulation.
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Affiliation(s)
| | - Aldair Darlan Santos-de-Araújo
- Department of Physical Therapy, Postgraduate Program in Physiotherapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - André Pontes-Silva
- Department of Physical Therapy, Postgraduate Program in Physiotherapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Jhonata Botelho Protazio
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Cassius Iury Anselmo-E-Silva
- Department of Physical Therapy, Postgraduate Program in Physiotherapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Cyrene Piazera Silva Costa
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís, MA, Brazil
- Postgraduate Program in Management of Health Services and Programs, Universidade Ceuma, São Luís, MA, Brasil
| | | | | | - Lucivalda Viegas de Almeida
- Postgraduate Program in Management of Health Services and Programs, Universidade Ceuma, São Luís, MA, Brasil
| | | | | | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
- Postgraduate Program in Adult Health, Universidade Federal Do Maranhão, São Luís, MA, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís, MA, Brazil.
- Postgraduate Program in Management of Health Services and Programs, Universidade Ceuma, São Luís, MA, Brasil.
- Postgraduate Program of Environment, Ceuma University, São Luís, MA, Brazil.
- Physical Therapy Departament, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença, São Luís, MA, Brazil.
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Vasegh Z, Safi Y, Azar MS, Ahsaie MG, Arianezhad SM. Assessment of bony changes in temporomandibular joint in patients using cone beam computed tomography - a cross sectional study. Head Face Med 2023; 19:47. [PMID: 37898789 PMCID: PMC10612346 DOI: 10.1186/s13005-023-00392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND AND AIM The aim of this study is to evaluate the changes in the temporomandibular joint (TMJ) in patients with temporomandibular disorder (TMD) and the relationship between age, sex, and types of TMJ change using Cone Beam Computed Tomography (CBCT). METHODS AND MATERIAL CBCT records of 200 patients (123 women and 67 men) were retrieved and assessed. Right and left TMJs were evaluated separately, resulting in a total of 400 TMJs. The images were analyzed using On demand 3D Application The radiographic findings were classified as erosion, proliferative changes mainly, including flattening and osteophytes of the condyle, sclerosis, Ely cyst, hypoplasia and hyperplasia of the condyles, ankylosis, and joint cavity. Data analysis was performed using descriptive statistics, paired T-tests, and repeated measure ANOVA (Analysis of Variance) in SPSS Software. RESULTS The most prevalent types of condylar bony changes observed was osteophyte (63.5%) followed by flattening of the articular surface (42%), erosion (40%), ankylosis (10%) and sclerosis (10%). 7.5% of joints showed hyperplastic condyles but only 2% showed hypoplasia. The least prevalent change observed was Ely Cyst (1%). Osteophyte was the most prevalent change observed in all age groups and both sexes except for men aged 31 ~ 50, where flattening was more frequent. A statistically significant difference was found between sex and prevalence of erosion in the age group of 10 ~ 30 (P = 0.001); as well as between sex and condylar hyperplasia in the same age group. CONCLUSION Based on the findings of this research, the prevalence of bony changes of TMJ from highest to lowest is as follows: osteophyte, flattening of the articular surface, erosion, ankylosis, sclerosis, hyperplastic condyles, hypoplastic condyles and Ely Cyst. CBCT is an accurate 3 dimensional imaging modality for assessment of TMJ bony structures.
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Affiliation(s)
- Zahra Vasegh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sanaei Azar
- DDS, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Ghazizadeh Ahsaie
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Marjan Arianezhad
- Resident of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshju Blv, Velenjak St, Tehran, Iran.
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Salami AA, Kanmodi KK, Leuke Bandara D, Aladelusi TO, Amzat J, Lin D, Ojo TO, Jayasinghe RD. The use of Qigong and Tai Chi in the management of temporomandibular joint dysfunction: A systematic review. Health Sci Rep 2023; 6:e1639. [PMID: 37877129 PMCID: PMC10591026 DOI: 10.1002/hsr2.1639] [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: 04/25/2023] [Revised: 09/15/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
Background and Aims Qigong and Tai Chi (QTC) are mind-body exercises involving a sequence of graceful movements, which promote self-healing, meditation, and self-cultivation. There is growing evidence that Qigong and/or Tai Chi therapy may improve the physical and psychological health among adults with multiple health conditions including joint movement. This systematic review aims to synthesize the available evidence on the type and effectiveness of QTC therapies used in the management of temporomandibular joint (TMJ) dysfunction. Methods This systematic review followed the AMSTAR-2 guideline, and it was reported based on guidelines in the PRISMA checklist. The review involved a systematic search of nine electronic databases. After deduplication and screening of the literature retrieved from the search, only one article was included based on the review's inclusion criteria. Data was extracted from this article and synthesized. Results The only included article was on a non-randomized control trial which investigated the role of Tai Chi Qigong (a form of Qigong) therapy in improving joint mobility and alleviating trismus among 52 survivors of nasopharyngeal carcinoma who had TMJ disorders. The study reported, at different time intervals (at pretest; at mid-intervention; at posttest; and at follow-up posttest), that no significant difference (p > 0.05) was observed concerning mouth opening capacity between the intervention group and the control group. However, over time, less severe deterioration in mouth-opening was noted among the participants in the intervention group (p = 0.181) as compared to the control group (p < 0.001). Conclusion The role of QTC therapies in improving joint mobility and alleviating trismus is not yet fully understood, but it seems promising. The available evidence is inadequate to categorically conclude on the efficacy of these therapies. Further studies will be required to fully assess the effectiveness of QTC therapies in the management of TMJ dysfunction.
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Affiliation(s)
- Afeez A. Salami
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Department of Oral and Maxillofacial SurgeryUniversity College HospitalIbadanNigeria
| | - Kehinde K. Kanmodi
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of DentistryUniversity of RwandaKigaliRwanda
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Dhanushka Leuke Bandara
- Department of Oral Medicine & Periodontology, Faculty of Dental SciencesUniversity of PeradeniyaPeradeniyaSri Lanka
| | - Timothy O. Aladelusi
- Department of Oral and Maxillofacial SurgeryUniversity College HospitalIbadanNigeria
| | - Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
- Department of SociologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Dan Lin
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Temitope O. Ojo
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Ruwan D. Jayasinghe
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Department of Oral Medicine & Periodontology, Faculty of Dental SciencesUniversity of PeradeniyaPeradeniyaSri Lanka
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Gębska M, Dalewski B, Pałka Ł, Kołodziej Ł. Evaluation of the efficacy of manual soft tissue therapy and therapeutic exercises in patients with pain and limited mobility TMJ: a randomized control trial (RCT). Head Face Med 2023; 19:42. [PMID: 37684652 PMCID: PMC10486124 DOI: 10.1186/s13005-023-00385-y] [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: 05/06/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
The limited number of randomized controlled trials (RCTs) comparing the efficacy of soft tissue manual therapy and self-therapy interventions prompted the authors to focus on the analgesic and myorelaxant use of massage, post-isometric muscle relaxation (PIR) and therapeutic exercise in TMD patients. OBJECTIVES To evaluate the effectiveness of soft tissue therapy and therapeutic exercises in female patients with pain, increased masseter muscle tension and limited mandibular mobility. MATERIAL AND METHODS The study was conducted on a group of 82 women (G1) with the Ib disorder diagnosed in DC/TMD (Ib-myofascial pain with restricted mobility). The control group (G2) consisted of 104 women without diagnosed TMDs (normal reference values for TMJ ROM and masseter muscle sEMG bioelectric activity). Diagnostic procedures were performed in both groups (sEMG of the masseter muscles at baseline and during exercise, measurement of TMJ mobility, assessment of pain intensity-NRS scale). The G1 group was randomly divided into 3 therapeutic groups in which the therapy was carried out for 10 days: therapeutic exercises (TE), manual therapy - massage and therapeutic exercises (MTM_TE), manual therapy - PIR and therapeutic exercises (MTPIR_TE). Each time after therapy, the intensity of pain and TMJ mobility were assessed. Sealed, opaque envelopes were used for randomization. After 5 and 10 days of therapy, bilateral sEMG signals of the masseter muscles were acquired. RESULTS Massage, PIR and self-therapy led to a decrease in sEMG at rest as well as in exercise. After day 6 of therapy, the groups obtained a significant difference (p = 0.0001). Each of the proposed forms of therapy showed a minimal clinically significant difference (MID) in the sEMG parameter at the endpoint, with the most considerable difference in the MTM_TE group. The forms of MT used were effective in reducing the patients' pain intensity; however, a significant difference between therapies occurred after 4 treatments (p = 0.0001). Analyzing the MID between methods, it was observed that self-therapy had an analgesic effect only after 8 treatments, while PIR after 3 and massage after 1 treatment. After day 7, the mean pain score in the MTM_TE group was 0.889 and in the TMPIR_TE group was 3.44 on the NRS scale. In terms of MMO, a significant difference was obtained between monotherapy and each form of TM, i.e. massage (p = 0.0001) and PIR (p = 0.0001). Analyzing mandibular lateral movements, the authors got a significant difference in the proposed MT forms, of which massage treatments exceeded the effectiveness of PIR. CONCLUSIONS Soft tissue manual therapy and therapeutic exercise are simple and safe interventions that can potentially benefit patients with myogenic TMDs, with massage showing better analgesic effects than PIR.
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Affiliation(s)
- Magdalena Gębska
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, Szczecin, 70-204, Poland
| | - Bartosz Dalewski
- Department of Dental Prosthetics, Pomeranian Medical University, Szczecin, 70-204, Poland
| | | | - Łukasz Kołodziej
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, Szczecin, 70-204, Poland
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Roberts A. The biopsychosocial model: Its use and abuse. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:367-384. [PMID: 37067677 PMCID: PMC10107555 DOI: 10.1007/s11019-023-10150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
The biopsychosocial model (BPSM) is increasingly influential in medical research and practice. Several philosophers and scholars of health have criticized the BPSM for lacking meaningful scientific content. This article extends those critiques by showing how the BPSM's epistemic weaknesses have led to certain problems in medical discourse. Despite its lack of content, many researchers have mistaken the BPSM for a scientific model with explanatory power. This misapprehension has placed researchers in an implicit bind. There is an expectation that applications of the BPSM will deliver insights about disease; yet the model offers no tools for producing valid (or probabilistically true) knowledge claims. I argue that many researchers have, unwittingly, responded to this predicament by developing certain patterns of specious argumentation I call "wayward BPSM discourse." The arguments of wayward discourse share a common form: They appear to deliver insights about disease gleaned through applications of the BPSM; on closer inspection, however, we find that the putative conclusions presented are actually assertions resting on question-begging arguments, appeals to authority, and conceptual errors. Through several case studies of BPSM articles and literatures, this article describes wayward discourse and its effects. Wayward discourse has introduced into medicine forms of conceptual instability that threaten to undermine various lines of research. It has also created a potentially potent vector of medicalization. Fixing these problems will likely require reimposing conceptual rigor on BPSM discourse.
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Affiliation(s)
- Alex Roberts
- Department of Political Science, University of South Dakota, Vermillion, SD, USA.
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25
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Wang X, Yang Y, Lin L, Yao Q, Zhang J. Obesity and temporomandibular joint disorders: a systematic review and meta-analysis. BMC Oral Health 2023; 23:607. [PMID: 37644424 PMCID: PMC10466750 DOI: 10.1186/s12903-023-03322-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Temporomandibular joint disorders (TMD) is the most common non-dental pain complaint in the maxillofacial region, which presents a variety of symptoms and signs, including temporomandibular joints (TMJ) and masticatory muscle pain, joint noise, tinnitus, headaches, irregular or restricted mandibular function, masticatory difficulty, and restricted mouth opening. When comes to the relationship between obesity and TMD, it has remained controversial and inconsistent, therefore, we first conducted this meta-analysis to estimate the unclear relationship between obesity and TMD. METHODS Searches were conducted in PubMed, Web of Science, Embase, and Cochrane Library. Subjects were divided into five groups according to BMI level in this study, including the normal weight group: 18.5 ≤ BMI < 25, overweight group: 25 ≤ BMI < 30, obesity group: BMI ≥ 30, control group: BMI < 25, and overweight and obesity group: BMI ≥ 25. Statistics analyses were conducted using Stata (15.0). The number of PROSPERO was CRD42022368315. RESULTS Eight studies were included in this study, and six articles with a total of 74,056 participants were synthesized for meta-analysis. Compared to normal weight individuals, overweight and obesity together decreased the risk of TMD (OR = 0.66, 95% CI = 0.46-0.95), and it was significantly decreased by obesity alone (OR = 0.58). Moreover, it was lower in obesity compared with control subjects (OR = 0.83, 95% CI = 0.73-0.94). Furthermore, in overweight and obese individuals, it was much lower in obesity than in overweight (OR = 0.82, 95% CI = 0.71-0.94). CONCLUSIONS Obesity is not a risk factor for TMD, and maybe a protective factor for TMD, of which patients with larger BMI are less likely to suffer from TMD pain. Therefore, the value of BMI should be taken into consideration in the assessment of TMD.
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Affiliation(s)
- Xia Wang
- Center of Stomatology, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, 410011, China
| | - Yan Yang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Linni Lin
- Center of Stomatology, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, 410011, China
| | - Qianqian Yao
- Center of Stomatology, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, 410011, China.
| | - Jingjing Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, 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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Zhang Z, Zong M, Liu J, Ren J, Liu X, Zhang R, Cui J, Sun L, Song H, Zhang Y, Li B, Wu X. Biosafety evaluation of BaSi 2O 2N 2:Eu 2+/PDMS composite elastomers. Front Bioeng Biotechnol 2023; 11:1226065. [PMID: 37485317 PMCID: PMC10360121 DOI: 10.3389/fbioe.2023.1226065] [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: 05/20/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
In recent years, mechanoluminescent (ML) materials have shown great potential in stress sensing, mechanical energy collection and conversion, so they have attracted wide attention in the field of stomatology. In the early stage of this study, BaSi2O2N2:Eu2+ ML phosphors were synthesized by two-step high temperature solid state method, and then mixed with Polydimethylsiloxane (PDMS) in different proportions to obtain BaSi2O2N2:Eu2+/PDMS ML composites with different mass fractions (10%,20%,30%,40%,50%). Then its biosafety was evaluated by Cell Counting Kit-8 (CCK-8), Calcein-AM/PI fluorescence staining, hemolysis, oral mucosal irritation, acute and subacute systemic toxicity tests. The experimental results show that the biosafety of BaSi2O2N2:Eu2+/PDMS ML composite elastomers with different mass fraction is in line with the existing standards, and other related properties can be further studied.
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Affiliation(s)
- Zheyuan Zhang
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Mingrui Zong
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Jinrong Liu
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Jianing Ren
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Xiaoming Liu
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Ran Zhang
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Jiayu Cui
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Lingxiang Sun
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Hao Song
- Research Institute of Photonics, Dalian Polytechnic University, Dalian, Liaoning, China
| | - Yanjie Zhang
- Research Institute of Photonics, Dalian Polytechnic University, Dalian, Liaoning, China
| | - Bing Li
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
| | - Xiuping Wu
- School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, Shanxi, China
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Manikandhan R, Manikandan S, Ponvel K, Parameswaran R, Shankar S. Comparison of Occlusal Digital Analysis Using T-Scan in Orthognathic Surgery with Only Conventional Orthodontic Patients. J Maxillofac Oral Surg 2023; 22:397-409. [PMID: 37122794 PMCID: PMC10130267 DOI: 10.1007/s12663-023-01862-2] [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: 11/07/2022] [Accepted: 01/20/2023] [Indexed: 02/11/2023] Open
Abstract
Aim and Objectives The aims of this study were to compare the changes in occlusal parameters, TMJ status clinically in patients after the completion of orthognathic surgery, and patients undergoing only orthodontic treatment and with patients having normal occlusion, using T-Scan. Methodology This prospective controlled clinical trial, consisting of three groups with a sample size of twelve. Group 1 consisted of patients who underwent orthognathic surgery and orthodontic treatment. Group 2 consists of patients who underwent only orthodontic treatment (camouflage). Clinical examination of the patient (TMJ and Occlusal status) and T-Scan was performed at the time of debonding of the orthodontic brackets, 6 months and 1-year after first evaluation for group 1 and 2 patients. Results The collected data between groups are compared and interpreted. The statistical analysis was performed using STATA/IC version 16.1 statistical software. Intragroup comparison for the study variables occlusion time, disocclusion time and maximum bite force between different time periods (T1, T2, T3) for all the three intervention groups using repeated measures. Hypothesis testing for maximum bite force, occlusion time and disocclusion time in orthognathic group (Group 1) as compared to orthodontic group (Group 2) for three different time periods using repeated measures ANOVA and Bonferroni test showed P value < 0.05 which is statistically significant. Conclusion In conclusion, evaluation of occlusion using T-Scan give us an insight of the discrepancies in occlusion which is useful during pre-operative planning and especially in the post-operative follow-up period during the retention phase. Examination of TMJ in these patients at various intervals is necessary as any minor occlusal disturbances may lead to TMJ disorders.
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Affiliation(s)
- R. Manikandhan
- Meenakshi Cleft and Craniofacial Center, Department of Oral & Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India
| | - S. Manikandan
- Department of Oral & Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India
| | - Keerthana Ponvel
- Department of Oral & Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India
| | - Ratna Parameswaran
- Department of Orthodontics and Dentofacial Orthopaedics, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India
| | - Sathya Shankar
- Department of Prosthodontics and Crown & Bridge, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India
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Agha-Hosseini F, Mirzaii-Dizgah I, Shirazian S, Javaheri-Mahd M. Treating Parafunctional Habits for Alleviating Temporomandibular Disorder and Lower Back Pain: A Phase II Clinical Trial. Front Dent 2023; 20:11. [PMID: 37312825 PMCID: PMC10258407 DOI: 10.18502/fid.v20i11.12657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 11/26/2022] [Indexed: 06/15/2023] Open
Abstract
Objectives: Temporomandibular disorders (TMDs) include a series of signs and symptoms in the temporomandibular joints (TMJ) and muscles of mastication, which are associated with or caused by parafunctional habits. Many of these patients also suffer from lumbar pains. This study aimed to evaluate the effectiveness of treating parafunctional habits in alleviating symptoms of TMD and lower back pain. Materials and Methods: This phase II clinical trial was conducted on 136 patients suffering from TMDs and lumbar pain, who consented to participate in this study. They were provided with instructions on how to discontinue their parafunctional habits including clenching and bruxism. The Helkimo and Rolland Morris questionnaires were used to assess TMD and lower back pain, respectively. Data were statistically analyzed using paired Student's t-test, Wilcoxon, Mann-Whitney, and Spearman correlation tests, with the significance level set at P<0.05. Results: The mean severity score of TMD significantly decreased after the intervention. Following treatment of TMD, the mean severity score of lumbar pain decreased from 8 to 2 (P=0.0001). Conclusion: Based on our findings, it appears that the elimination of parafunctional habits improves TMD and lumbar pain.
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Affiliation(s)
- Farzaneh Agha-Hosseini
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Academy of Medical Sciences, Tehran, Iran
| | - Iraj Mirzaii-Dizgah
- Department of Physiology, School of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Shiva Shirazian
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Javaheri-Mahd
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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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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Rodrigues ALP, Cardoso HJ, Ângelo DF. Patient experience and satisfaction with different temporomandibular joint treatments: A retrospective study. J Craniomaxillofac Surg 2023; 51:44-51. [PMID: 36739190 DOI: 10.1016/j.jcms.2023.01.006] [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: 06/30/2022] [Revised: 10/10/2022] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
This retrospective study aimed to evaluate patient satisfaction with different temporomandibular joint (TMJ) treatments. Patients were included in the study according to the following inclusion criteria: 1) arthrogenous and/or myogenous temporomandibular disorders (TMD); 2) Dimitroulis classification category between 1-4; 3) conservative treatment without any improvement at least for 3 months; 4) indication for one of the following TMD treatments: injection of botulinum toxin; arthrocentesis; arthroscopy, and open surgery without alloplastic material; and 5) age ≥16 years. An independent satisfaction questionnaire with 11 queries was applied via phone call to all patients, which included 6 questions using a 10-point Likert scale and 5 yes-or-no questions. The principal outcome was the overall satisfaction with the clinical result of the treatment, and the secondary outcomes were specific satisfaction with the following: 1) pain reduction; 2) range of mouth opening; 3) chewing ability; 4) postoperative recovery; 5) the fulfillment of expectations; 6) treatment choice; 7) treatment recommendation to a friend; and 8) the need for another intervention. Anxiety and depression were also included as variables. Data were analyzed using descriptive statistics, non-parametric Kruskal-Wallis and Spearman rank correlation coefficient tests. A total of 120 patients (mean age 41.20 ± 17.78 years) were enrolled, comprising 109 women (90%) and 11 men (10%). The overall clinical satisfaction of all patients was 8.24 ± 2.23 (mean ± SD), and 97 patients (80.8%) stated that they would repeat the treatment. Patients submitted to TMJ arthrocentesis and arthroscopy had higher overall clinical satisfaction (9.09 ± 0.971 and 9.03 ± 1.13, p = 0.021) followed by open surgery (8.38 ± 1.84). The authors observed three statistically significant correlations: 1) overall clinical satisfaction and patient expectations (r = 0.803; p < 0.0001); 2) overall clinical satisfaction and post-treatment pain (r = -0.299; p = 0.003); and (3) the presence of depression and the need for further TMJ treatment (r = 0.186; p = 0.043). Within the limitations of the study it seems that patient expectations should be addressed ad initium, and the presence of a diagnosis of depression with concomitant TMD must alert the clinical team and patient for the possible need of additional treatment.
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Affiliation(s)
| | | | - David Faustino Ângelo
- Faculty of Medicine, Lisboa University, Portugal; Instituto Português da Face, Lisboa, Portugal; Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Portugal.
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Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Spagnuolo G, Woźniak K. Surface electromyography in the assessment of masticatory muscle activity in patients with pain-related temporomandibular disorders: a systematic review. Front Neurol 2023; 14:1184036. [PMID: 37206909 PMCID: PMC10188953 DOI: 10.3389/fneur.2023.1184036] [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: 03/10/2023] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Background Temporomandibular disorders (TMD) are a set of painful conditions affecting the orofacial region that are prevalent and constitute the most frequent type of non-dental pain complaint in the maxillofacial area. Pain-related TMD (TMD-P) is characterized by ongoing pain in the masticatory muscles, the temporomandibular joint, or surrounding structures. Due to the multiple factors that contribute to the development of this condition, it can be challenging to accurately diagnose. One of the useful method for assessing patients with TMD-P is surface electromyography (sEMG). The aim of this systematic review was to provide a comprehensive overview of the current scientific literature on the evaluation of masticatory muscle activity (MMA) in individuals diagnosed with TMD-P, through the utilization of sEMG. Methods To gather relevant information, electronic databases such as PubMed, Web of Science, Scopus, and Embase were searched using specific keywords including: "pain" AND ("temporomandibular disorder*" OR "temporomandibular dysfunction*") AND "surface electromyography" AND "masticatory muscle activity." The inclusion criteria were studies assessing MMA in patients with TMD-P using sEMG. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was utilized to evaluate the quality of the studies that were included in the review. Results The search strategy identified 450 potential articles. Fourteen papers met the inclusion criteria. Global quality rating for significant part of the articles was weak. Most studies showed greater sEMG activity of the masseter (MM) and temporal anterior (TA) muscles at rest in TMD-P subjects than in the asymptomatic controls, while the MM and TA muscles were less active in the pain-related TMD group compared to the non-TMD group during maximal voluntary clenching (MVC). Conclusion There were differences in MMA in the TMD-pain population compared to a healthy control group during various tasks. The diagnostic efficacy of surface electromyography in assessing individuals with TMD-P remains unclear.
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Affiliation(s)
- Liliana Szyszka-Sommerfeld
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
- *Correspondence: Liliana Szyszka-Sommerfeld,
| | | | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Napoli, Italy
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland
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Talian I, Laputková G, Schwartzová V. Identification of crucial salivary proteins/genes and pathways involved in pathogenesis of temporomandibular disorders. OPEN CHEM 2022. [DOI: 10.1515/chem-2022-0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Abstract
Temporomandibular disorder (TMD) is a collective term for a group of conditions that lead to impairment of the function of the temporomandibular joint. The proteins/genes and signaling pathways associated with TMD are still poorly understood. The aim of this study was to identify key differentially expressed salivary proteins/genes (DEGs) associated with TMD progression using LC-MS/MS coupled with a bioinformatics approach. The protein–protein interaction network was obtained from the STRING database and the hub genes were identified using Cytoscape including cytoHubba and MCODE plug-ins. In addition, enrichment of gene ontology functions and the Reactome signaling pathway was performed. A total of 140 proteins/genes were differentially expressed. From cluster analysis, a set of 20 hub genes were significantly modulated: ALB, APOA1, B2M, C3, CAT, CLU, CTSD, ENO1, GSN, HBB, HP, HSPA8, LTF, LYZ, MMP9, S100A9, SERPINA1, TF, TPI1, and TXN. Two enriched signaling pathways, glycolysis and gluconeogenesis, and tryptophan signaling pathway involving the hub genes CAT, ENO1, and TPI1 have been identified. The rest of the hub genes were mainly enriched in the innate immune system and antimicrobial peptides signaling pathways. In summary, hub DEGs and the signaling pathways identified here have elucidated the molecular mechanisms of TMD pathogenesis.
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Affiliation(s)
- Ivan Talian
- Department of Medical and Clinical Biophysics, Faculty of Medicine, University of P. J. Šafárik , Košice , 040 11 , Slovak Republic
| | - Galina Laputková
- Department of Medical and Clinical Biophysics, Faculty of Medicine, University of P. J. Šafárik , Košice , 040 11 , Slovak Republic
| | - Vladimíra Schwartzová
- Clinic of Stomatology and Maxillofacial Surgery, Faculty of Medicine, University of P. J. Šafárik and Louis Pasteur University Hospital , Košice , 041 90 , Slovak Republic
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Zhu R, Zheng YH, Zhang ZH, Fan PD, Wang J, Xiong X. Development of a new category system for the profile morphology of temporomandibular disorders patients based on cephalograms using cluster analysis. Front Public Health 2022; 10:1045815. [PMID: 36466455 PMCID: PMC9713943 DOI: 10.3389/fpubh.2022.1045815] [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: 09/16/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aims to develop a new category scheme for the profile morphology of temporomandibular disorders (TMDs) based on lateral cephalometric morphology. Methods Five hundred and one adult patients (91 males and 410 females) with TMD were enrolled in this study. Cluster tendency analysis, principal component analysis and cluster analysis were performed using 36 lateral cephalometric measurements. Classification and regression tree (CART) algorithm was used to construct a binary decision tree based on the clustering results. Results Twelve principal components were discovered in the TMD patients and were responsible for 91.2% of the variability. Cluster tendency of cephalometric data from TMD patients were confirmed and three subgroups were revealed by cluster analysis: (a) cluster 1: skeletal class I malocclusion; (b) cluster 2: skeletal class I malocclusion with increased facial height; (c) cluster 3: skeletal class II malocclusion with clockwise rotation of the mandible. Besides, CART model was built and the eight key morphological indicators from the decision tree model were convenient for clinical application, with the prediction accuracy up to 85.4%. Conclusion Our study proposed a novel category system for the profile morphology of TMDs with three subgroups according to the cephalometric morphology, which may supplement the morphological understanding of TMD and benefit the management of the categorical treatment of TMD.
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Affiliation(s)
- Rui Zhu
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yun-Hao Zheng
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Zi-Han Zhang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Pei-Di Fan
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jun Wang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xin Xiong
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China,Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Sichuan, China,*Correspondence: Xin Xiong
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Muacevic A, Adler JR, Al Mazyad B, Al Yousef S, Hatab Alanazi S. The Association Between Post-Traumatic Stress Disorder and Temporomandibular Disorders: A Systematic Review. Cureus 2022; 14:e31896. [PMID: 36579250 PMCID: PMC9792336 DOI: 10.7759/cureus.31896] [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: 10/10/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022] Open
Abstract
The purpose of this systematic study was to discover a connection between temporomandibular joint disorders and post-traumatic stress disorder. A systematic review of observational studies on post-traumatic stress disorder and the incidence of temporomandibular joint disorders (TMD) was conducted. Electronic searches of PubMed, the Saudi Digital Library, Science Direct, the Virtual Health Library (VHL), Scopus, Web of Science, Sage, EBSCO Information Services, and Ovid were performed. There was a consensus among the reviewing examiners. Only studies with the following Medical Subject Headings (MeSH) terms were included: "Posttraumatic stress disorder" combined with "temporomandibular joint disorder," "myofascial pain," "orofacial pain," "internal derangement," "disc displacement with reduction," or "disc displacement without reduction." Only full-text studies in the English language published between 2010 and June 2020 were considered. Of a total of 381 articles meeting the initial screening criteria, only eight were included in the qualitative analysis. Overall, pain is exacerbated in patients with PTSD; that is, their TMD is heightened in all aspects of pain, chronicity, decreased response to conventional therapies, and the need for more potent treatment options as compared with patients with just TMD. The evidence, albeit weak, obtained from the studies included in this review suggests a relationship between PTSD and TMDs.
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Wang M, Qian Y, Zhao H, Zhu M, Yu H, Shen SG. Mandibular stability and condylar changes following orthognathic surgery in mandibular hypoplasia patients associated with preoperative condylar resorption. Clin Oral Investig 2022; 26:7083-7093. [PMID: 36151404 DOI: 10.1007/s00784-022-04668-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate postoperative mandibular stability and condylar changes in patients with mandibular hypoplasia and preoperative condylar resorption (CR) undergoing orthognathic surgery. MATERIALS AND METHODS Fifty-four patients were included in this retrospective study. Computed tomography (CT) scans were acquired preoperatively (T0), 2-7 days immediate postoperatively (T1), and at least 1 year postoperatively (T2). Three-dimensional (3D) cephalometric analysis and measurements of condylar angle, volume, and position (joint spaces) were performed. A 2-mm mandibular relapse was deemed clinically acceptable. We also analyzed the correlations between relapse and postoperative CR and susceptible factors using a multivariate logistic regression model. RESULTS The results showed one year after the surgery, the average mandibular relapse was 1.0 mm (p < 0.05), and the average reduction of condylar volume was 152.4 mm3 (12.7%). Condyle-fossa relationships were improved immediately after the surgery, with a tendency of returning to their original state in the follow-up (p < 0.05). Anteroposterior advancement at point B (B-CP advancement) at T1 and superior joint space (SJS) at T0 were significantly correlated with mandibular relapse, and postoperative CR was mainly associated with vertical increasement at point B (B-AP increasement) at T1. The optimal cut-off values were as follows: 1.6 mm for SJS, 4.2 mm for B-CP advancement, and 1.8 mm for B-AP increasement. Concomitant advancement Genioplasty showed no significant correlation with relapse and postoperative CR. CONCLUSIONS While patients with mandibular hypoplasia and preoperative CR were vulnerable to further condylar resorption after mandibular advancement, the treatment outcomes were generally clinically acceptable. Postoperative relapse was associated with a larger than 4.2 mm of mandibular advancement measured at B-CP and a larger than 1.6 mm of superior joint space measured at SJS, and postoperative CR was associated with a larger than 1.8 mm of mandibular vertical increasement measured at B-AP. CLINICAL RELEVANCE The findings of this study suggested that the mandibular advancement might be limited to 5 mm for patients with preoperative CR. A concomitant advancement genioplasty might also be considered to achieve a better facial profile in these patients.
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Affiliation(s)
- Minjiao Wang
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Yifeng Qian
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Hanjiang Zhao
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Min Zhu
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China
| | - Hongbo Yu
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China.
| | - Steve Gf Shen
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, 200011, Shanghai, China. .,Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China.
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Ferrillo M, Gallo V, Lippi L, Bruni A, Montrella R, Curci C, Calafiore D, Invernizzi M, Migliario M, de Sire A. The 50 most-cited articles on temporomandibular disorders: A bibliometric analysis. J Back Musculoskelet Rehabil 2022; 36:279-297. [PMID: 36189581 DOI: 10.3233/bmr-220152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are musculoskeletal conditions involving masticatory muscles and temporomandibular joints. Bibliometric analysis has been introduced as a new method for collecting and analyzing information on scientific articles. OBJECTIVE The aim of this study was to identify the 50 most cited articles on TMD, performing a bibliometric analysis of the identified papers to favor research and clinical practice. METHODS On December 17, 2021 a systematic research was performed to find all papers on TMD published in the literature. The Incites Journal Citation Reports dataset and Scopus database was used to obtain bibliometric indexes of the authors and metrics data of the journals, including Impact Factor, Eigenfactor Score, and Normalized Eigenfactor. VOSviewer was used to visualize the keyword mapping networking, with the nodes standing for keywords and the edges for keyword relationships. RESULTS Out of 24372 papers obtained by the search strategy, the 50 most cited articles on TMD were analyzed. The paper with the highest number of citations (n= 3020) was on TMD research diagnostic criteria. Rate of citations per year collected by the 50 most cited articles on TMD has been increasing over time (from 627 in 2006 to 1483 in 2021). Most of them were cross-sectional studies (n= 20; 40.0%) and narrative reviews (n= 14; 28.0%). CONCLUSION This bibliometric study showed an increasing number of citations for articles on TMD, testifying a high interest in the last years. Starting from this analysis, future studies might provide high-quality evidence on TMD management.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.,Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Vittorio Gallo
- CIR Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy.,Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandro Bruni
- CIR Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Roberta Montrella
- CIR Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Claudio Curci
- Physical and Rehabilitative Medicine Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Dario Calafiore
- Physical and Rehabilitative Medicine Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Mario Migliario
- Dental Clinic, Department of Translational Medicine, University of Eastern Piedmont "A. Avogadro", Novara, Italy
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Alketbi N, Talaat W. Prevalence and characteristics of referred pain in patients diagnosed with temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in Sharjah, United Arab Emirates. F1000Res 2022; 11:656. [PMID: 36249999 PMCID: PMC9490275 DOI: 10.12688/f1000research.109696.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Referred pain often complicates and delays the diagnosis of temporomandibular disorders (TMD). Elaborating the prevalence and characteristics of TMD-associated referred pain as well as the distribution of referred pain in different TMD classes will significantly improve the diagnostic process. The objectives of the present study were to assess the prevalence and to evaluate the characteristics of referred pain associated with TMD diagnosed according to the DC/TMD. METHODS A total of 252 patients were evaluated using the DC/TMD Axes-I and -II assessment tools. Different modalities were used to treat the diagnosed TMD. Referred pain was diagnosed when the location of the perceived pain in response to palpation extended beyond the boundary of the structure that was examined. For pain locations that were perceived as deep, patients were asked to locate the surface of the area of pain. The result of the assessment was identified as positive if the patient described his perceived pain during the clinical examination as being familiar pain that was experienced in the same location in the last 30 days. Results: TMD-associated referred pain was recorded in 153 patients (60.7%). The most common referred pain location was the temporal area (45.2%), followed by the ear (42.1%). The referred pain was recorded in disc displacement with reduction with intermittent locking and myofascial pain with referral in all patients (100%). The proportion of patients with referred pain was significantly different between the different TMD diagnostic subgroups (P < 0.001). The recorded percentage of improvement in the referred pain following the treatment was 50.41% after 3 months and 56.65% after 6 months. CONCLUSIONS Referred pain is a prominent feature of TMD. The prevalence of referred pain associated with TMD was 60.7%. A strong strength association between the different diagnostic subgroups and the presence of referred pain existed.
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Affiliation(s)
- Nawal Alketbi
- Oral and Craniofacial Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Wael Talaat
- Oral and Craniofacial Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates,Oral and Maxillofacial Surgery, Suez Canal University, Ismaillia, Egypt,
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Tagawa DT, de Albuquerque Franco A, Puchnick A, Wolosker AMB, Florez BM, Dominguez GC, Yamashita HK, Cevidanes LHS, de Arruda Aidar LA, Junior HC. Temporomandibular joint articular disc position and shape in skeletal Class
III. Orthod Craniofac Res 2022; 26:185-196. [PMID: 35946345 DOI: 10.1111/ocr.12599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the position and shape of the temporomandibular joint (TMJ) articular disc among the sagittal and vertical skeletal patterns in Angle Class III, Class III subdivision malocclusion and normal occlusion. The null hypothesis was that there was no difference in disc position and shape in different (1) malocclusions and (2) skeletal patterns. METHODS This cross-sectional observational study evaluated 105 patients divided into 3 groups: Class III (33, 9.39 ± 1.96 years), Class III subdivision (45, 9.51 ± 1.59 years) and a normal occlusion (27, 10.24 ± 0.87 years) was included as healthy control. Severity of the maxilla-mandibular anteroposterior discrepancy and vertical facial pattern were determined using 2D cephalometry, and the position and shape of the articular discs were evaluated in magnetic resonance images. Statistical parametric and non-parametric tests and Kappa analysis for intra-observer and inter-observer assessment were used (p ≤ .05). RESULTS Significant between-group differences were found in articular disc position. In the normal occlusion group, all the articular discs were well positioned. In Class III and Class III subdivision, the discs were displaced in 30.3% and 12.2% of the TMJs, respectively. Sagittal and vertical skeletal patterns did not affect the findings significantly. The Class III subdivision malocclusion group is probably different from the other groups, showing 97.7% of biconcave discs in both TMJs. CONCLUSION The longitudinal follow-up of this sample becomes relevant as the two groups with malocclusion in the pre-peak phase of pubertal growth showed differences in the prevalence of displacement and form of the articular disc, with no association with their vertical facial characteristics.
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Affiliation(s)
- Daniella Torres Tagawa
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
- Department of Orthodontics, Universidade Santa Cecília Santos Brazil
| | | | - Andrea Puchnick
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
| | - Angela Maria Borri Wolosker
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
| | | | | | - Helio Kiitiro Yamashita
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
| | | | | | - Henrique Carrete Junior
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
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Reis PHF, Laxe LAC, Lacerda‐Santos R, Münchow EA. Distribution of anxiety and depression among different subtypes of temporomandibular disorder: A systematic review and meta‐analysis. J Oral Rehabil 2022; 49:754-767. [DOI: 10.1111/joor.13331] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/22/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Laisa Araújo Cortines Laxe
- Postgraduate Program in Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
- Department of Restorative Dentistry School of Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
| | - Rogério Lacerda‐Santos
- Postgraduate Program in Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
- Department of Dentistry Health Science Institute Federal University of Juiz de Fora Governador Valadares Brazil
| | - Eliseu Aldrighi Münchow
- Postgraduate Program in Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
- Department of Conservative Dentistry School of Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
- Postgraduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
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Abstract
Symmetry of the face is one of the most important features for the perception of attractiveness. Asymmetry of the face means that the right and left sides of the face are not identical. Subclinical facial asymmetry is very common in the general population. Most people have some slight facial asymmetry, and this is the normal biological situation in humans. Abnormalities from soft tissue, dental, and skeletal elements lead to facial asymmetry. Asymmetry has many causal factors, and its aetiology includes both congenital and acquired conditions. Neurological facial asymmetry is scarcely addressed in the dental literature. In this narrative review, we focus on the most common neurological causes of facial asymmetry. From a neurological point of view, facial asymmetry can result from disturbances of the cranial nerves, developmental disorders, or myopathies. In the broad range of differential diagnostics of facial asymmetry, neurological abnormalities should be taken into consideration. The treatment must be related to the underlying cause. Complete knowledge of the aetiological factors and the character of the asymmetry plays a crucial role in formulating a treatment plan.
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Kao YH, Tseng CH, Yu CK, Wu JH. A case of sialolithiasis that mimicked temporomandibular joint disorder. J Formos Med Assoc 2022; 121:2135-2137. [PMID: 35246358 DOI: 10.1016/j.jfma.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/20/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Yu-Hsun Kao
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih-Huang Tseng
- Division of Oral Pathology and Radiology, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih Kai Yu
- Division of Family Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ju-Hui Wu
- Division of Family Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Castro-Martín E, Galiano-Castillo N, Fernández-Lao C, Ortiz-Comino L, Postigo-Martin P, Arroyo-Morales M. Myofascial Induction Therapy Improves the Sequelae of Medical Treatment in Head and Neck Cancer Survivors: A Single-Blind, Placebo-Controlled, Randomized Cross-Over Study. J Clin Med 2021; 10:jcm10215003. [PMID: 34768520 PMCID: PMC8584513 DOI: 10.3390/jcm10215003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 01/09/2023] Open
Abstract
Head and neck cancer (HNC) is the sixth most common cancer worldwide. Yet, less than 60% of HNC survivors receive adequate therapy for treatment-related sequelae. The objective of this study was to determine the efficacy of myofascial induction therapy (MIT) in improving cervical and shoulder pain and range of motion, maximal mouth opening, and cervical muscle function in HNC survivors. This crossover, blinded, placebo-controlled study involved 22 HNC survivors (average age 56.55 ± 12.71) of which 13 were males (59.1%) who received, in a crossover fashion, both a single 30-min session of MIT in the form of manual unwinding and simulated pulsed shortwave therapy (placebo), with a 4-week washout interval between the two. Cervical and shoulder pain (visual analogue scale) and range of motion (cervical range of motion device and goniometer), maximum mouth opening (digital caliper), and cervical muscle function (deep cervical flexor endurance test) were measured before and after the treatment and placebo sessions. A single session of MIT improved cervical and affected side shoulder pain, cervical range of motion, maximum mouth opening, and cervical muscle function. The associated effect sizes ranged from moderate to large. The present study suggests that MIT, in the form of manual unwinding, improves cervical (−3.91 ± 2.77) and affected-side shoulder (−3.64 ± 3.1) pain, cervical range of motion (flexion: 8.41 ± 8.26 deg; extension: 12.23 ± 6.55; affected-side rotation: 14.27 ± 11.05; unaffected-side rotation: 11.73 ± 8.65; affected-side lateroflexion: 7.95 ± 5.1; unaffected-side lateroflexion: 9.55 ± 6.6), maximum mouth opening (3.36 ± 3.4 mm), and cervical muscle function (8.09 ± 6.96 s) in HNC survivors.
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Affiliation(s)
- Eduardo Castro-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
- Correspondence: (C.F.-L.); (L.O.-C.)
| | - Lucía Ortiz-Comino
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, 52005 Melilla, Spain
- Correspondence: (C.F.-L.); (L.O.-C.)
| | - Paula Postigo-Martin
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
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Relationship between Clinical Symptoms and Magnetic Resonance Imaging in Temporomandibular Disorder (TMD) Patients Utilizing the Piper MRI Diagnostic System. J Clin Med 2021; 10:jcm10204698. [PMID: 34682820 PMCID: PMC8539230 DOI: 10.3390/jcm10204698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 02/02/2023] Open
Abstract
Clinical problems of the temporomandibular joint (TMJ) and the masticatory musculature are both included in the term temporomandibular disorder (TMD). The purpose of the present study was to examine the pathology of the joints of patients diagnosed with TMD utilizing the dedicated Piper MRI-based classification, and to link these pathologies with various symptoms while considering their severity. In total, 64 patients with clinical TMD were examined. Symptoms were recorded using a questionnaire. The clinical examination included diagnosing the occlusion in centric relation, which was followed by a standardized MRI. It was confirmed that, although they occurred in a high percentage in all classes, muscle pain and occlusal interference are not indicators of TMJ damage. The results indicate that the progressive degradation of the TMJ, represented by qualification to the higher Piper classes, is associated with an increase in TMJ pain only up to a certain stage. For the highest Piper classes, the joint pain occurs in a smaller percentage of patients, but sounds are more frequent.
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Kuć J, Szarejko KD, Gołębiewska M. The Prevalence and Overlaps of Temporomandibular Disorders in Patients with Myofascial Pain with Referral-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9842. [PMID: 34574764 PMCID: PMC8471332 DOI: 10.3390/ijerph18189842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
The aim of the study was to evaluate the temporomandibular joint, the prevalence of single and multiple diagnosis and potential sided domination of temporomandibular dysfunction in patients with temporomandibular disorder-myofascial pain with referral. The study group enrolled 50 people-37 females and 13 males between 18 and 25 years old with an average age of 23.36 ± 2.14. The patients underwent joint vibration analysis. Sixty seven percent of all examined tem-poromandibular joints were classified as group I according to Mark Piper's classification. Class IIIA appeared in 17% of joints. Eight percent of temporomandibular joints were classified as class IVA. There were no statistically significant differences in the prevalence of temporomandibular disorder with respect to gender (p = 0.838639). The relatively high prevalence of multiple diagnoses proved the overlapping nature of muscle and intraarticular disorders. Twenty eight percent of the subjects suffered from a combination of myofascial pain with referral and bilateral temporoman-dibular dysfunction. In 62% of the patients a lack of intraarticular disorders was reported. The suggestion that there exists sided domination in the occurrence of temporomandibular disorders has not been confirmed. Due to the small sample size, such differences cannot be excluded. Fur-ther research is needed.
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Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, 24A M. Sklodowskiej-Curie St., 15-276 Bialystok, Poland
| | | | - Maria Gołębiewska
- Department of Dental Techniques, Medical University of Bialystok, 13 Washington St., 15-269 Bialystok, Poland;
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Comparative Evaluation of Occlusion before and after Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126568. [PMID: 34207403 PMCID: PMC8296451 DOI: 10.3390/ijerph18126568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023]
Abstract
The aim of the study was to evaluate occlusal parameters in patients with myofascial pain with referral before and after soft tissue mobilization. The study group consisted of 50 people (37 females and 13 males, average age 23.36 ± 2.14 years) diagnosed with myofascial pain with referral. All patients underwent triplicate soft tissue mobilization. Occlusal parameters were evaluated six times, before and after each treatment, using T-scan III. A decreasing tendency of the occlusion time was observed after the first, second, and third therapy. After the third treatment, the mean occlusion time in the entire study group was 0.119 s. The 1st soft tissue mobilization shortened both right and left disclusion times to 0.181 s and 0.185 s, respectively. After the third treatment, these parameters amounted to 0.159 s and 0.165 s, respectively. The Friedman test for the entire study group indicated that soft tissue mobilization altered the occlusion time and both disclusion times (p < 0.05). In conclusion, soft tissue mobilization affects biotensegrity of the masticatory system, thus modifying occlusal parameters. The occlusion time and both disclusion times cannot be considered as cofactors of the existing temporomandibular disorders-myofascial pain with referral.
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Electromyography-Guided Adjustment of an Occlusal Appliance: Effect on Pain Perceptions Related with Temporomandibular Disorders. A Controlled Clinical Study. Diagnostics (Basel) 2021; 11:diagnostics11040667. [PMID: 33917788 PMCID: PMC8068158 DOI: 10.3390/diagnostics11040667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The purpose of this study is to evaluate the effect of an electromyography-guided adjustment of an occlusal appliance on the management of Temporomandibular disorder-related pain. Methods: Data from 40 adult patients (20 males and 20 females), who underwent treatment with occlusal appliances, were recorded. A total of 20 appliances were adjusted according to electromyographic data (group 1), while the others were adjusted by a clinical conventional procedure (group 2). Muscle pain to palpation, pain during articular movements and headache were recorded by a VAS score (from 0 to 100) before the beginning of treatment (T0), at T1 (4 weeks) and T2 (8 weeks). Results: Results showed a reduction of pain in both groups, with a better trend for group 1, where better results were achieved at T1 and maintained stability at T2, with an improved mean value regarding all parameters studied. After 8 weeks, only small recurrences started to occur in muscle pain to palpation in group 2. Conclusions: An occlusal appliance seems to be able to achieve a clinical improvement of Temporomandibular disorder (TMD)-related pain and headache, independently from the adjustment procedure adopted. However, the use of a surface electromyographic activity of masticatory muscles (sEMG) device as an aid in the calibration procedure seems to allow a better trend because the improvement of symptoms was obtained before, after the first four weeks, with an improvement in percentages of all the variables investigated. While the conventional procedure obtained later the improvement.
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