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Pecenek D, Gokcen-Rohlig B, Ongul D, Ayvalioglu DC. Evaluation of the clinical performance of different occlusal device materials. J Prosthet Dent 2024:S0022-3913(24)00295-6. [PMID: 38806342 DOI: 10.1016/j.prosdent.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/30/2024]
Abstract
STATEMENT OF PROBLEM Computer aided technologies have been used to fabricate occlusal devices. However, the clinical behavior of the newly developed materials developed for occlusal devices is unknown. PURPOSE The purpose of this prospective, double-blind study was to assess the clinical efficacy of recently introduced computer-aided design and computer-aided manufacturing (CAD-CAM) materials for the fabrication of occlusal devices. MATERIAL AND METHODS A total of 24 participants were divided randomly into 2 study groups; polyetheretherketone (PEEK) and polymethyl methacrylate (PMMA), and a control group (CG). Conventional impressions and gypsum casts were obtained from all participants. In the study groups, the casts were digitalized with an extraoral digital scanner, designed with a software program (Bite Occlusal Device Module; exocad GmbH) and milled from PEEK and PMMA blocks. Clear resin sheets were used for occlusal device fabrication in the CG. The baseline measurements were made during the initial appointments. After 6 months, the participants returned for follow-up evaluations. Clinical performance based on surface roughness, wear of the antagonist teeth, occlusal device fit and therapeutic effect, as well as participant satisfaction were compared using the 1-way ANOVA test between the main groups (α=.05). The post hoc and Kruskal Wallis-H tests were used to compare the nonparametric group. RESULTS The therapeutic effects of the occlusal devices did not differ. All participants showed improvement in palpation and mandibular movement scores, but no statistically significant differences were found among the groups (P>.05). PEEK and PMMA had statistically less surface wear than CG (P<.001) and led to less antagonist tooth wear. No significant participant satisfaction difference was seen among the groups (P>.05). The control group had the best fit (P<.001). CONCLUSIONS Recent CAD-CAM materials exhibit clinically acceptable outcomes, and their performance is comparable with that of traditional materials. CAD-CAM materials appear suitable in terms of accuracy, surface wear, and therapeutic efficacy.
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Affiliation(s)
- Duygucan Pecenek
- Graduate student, Department of Prosthodontics, Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey
| | - Bilge Gokcen-Rohlig
- Professor, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Deger Ongul
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Demet Cagıl Ayvalioglu
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Altınbas University, Istanbul, Turkey
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Romeo A, Incorvati C, Vanti C, Turolla A, Marinelli F, Defila L, Gulotta C, Marchetti C, Pillastrini P. Physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: A randomised controlled trial. J Oral Rehabil 2024. [PMID: 38757854 DOI: 10.1111/joor.13729] [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: 01/04/2023] [Revised: 04/17/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Myogenic temporomandibular disorders (M-TMD) commonly involve occlusal splint (OS) therapy and musculoskeletal physiotherapy (MPT). OBJECTIVES To compare the effects of combining OS with MPT and education (EG) against OS and education (CG), in chronic M-TMD patients. METHODS In this double-blind randomised controlled trial, 62 participants were assigned to either EG or CG. The primary outcomes, pain levels at rest (VAS rest), maximum oral opening (VAS open) and during chewing (VAS chew), were measured by Visual Analogue Scale (VAS) in cm. The secondary outcome was the range of motion (ROM) for maximum oral opening. Both interventions lasted 3 months, with outcomes assessed at baseline (T0), post-treatment (T1) and 3 months post-treatment (T2). RESULTS Intention-to-treat analysis revealed significant improvements favouring EG (VAS rest = -1.50 cm [CI95%: -2.67, -0.32], p = .04; VAS open = -2.00 cm [CI95%: -3.23, -0.75], p < .01; VAS chew = -1.71 cm [CI95%: -2.90, -0.52], p = .01; ROM = 4.61 [CI95%: 0.93, 8.30], p = .04). Additionally, VAS measures were influenced by follow-up times (VAS rest = -0.73 cm [CI95%: -1.30, -0.17], p = 0.03; VAS open = -0.97 cm [CI95%: -1.57, -0.37], p < .01; VAS chew = -1.15 cm [CI95%: -1.73, -0.58], p < .01). At T1, EG demonstrated higher number of responders compared to CG for VAS open (χ2(1) = 4.39, p = .04) and VAS chew (χ2(1) = 11.58, p < .01). CONCLUSION Adding MPT to education and OS yields better outcomes in terms of pain reduction and ROM improvement, in chronic M-TMD. TRIAL REGISTRATION NUMBER NCT03726060.
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Affiliation(s)
- Antonio Romeo
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
| | - Cristina Incorvati
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
| | - Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Marinelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Defila
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
| | - Chiara Gulotta
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
| | - Claudio Marchetti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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3
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Mota MML, Aguiar IHAE, de Lima AS, de Oliveira Neto OB, da Silva PLP, Moretti EC, Lemos GA. Effectiveness of Laser Acupuncture for Reducing Pain and Increasing Mouth Opening Range in Individuals with Temporomandibular Disorder: A Systematic Review and Network Meta-Analysis. Curr Pain Headache Rep 2024:10.1007/s11916-024-01251-5. [PMID: 38648000 DOI: 10.1007/s11916-024-01251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW Laser acupuncture (LA) demonstrates promising results in the treatment of musculoskeletal disorders. However, its effects on temporomandibular disorder (TMD) are not yet fully understood. Thus, the aim of this systematic review and network meta-analysis was to assess the effectiveness of LA on pain intensity and maximum mouth opening range (MMO) related to TMD. A search was carried out in 11 electronic databases and references of included studies to locate randomized clinical trials (RCTs) that evaluated LA as a primary treatment for TMD. The risk of bias was assessed using the RoB 2 tool. Network meta-analysis was conducted on the MetaInsight platform, considering the pain intensity and counseling (C) as the outcome of reference. The GRADE system was used to assess the certainty of the evidence. RECENT FINDINGS Five studies evaluated pain intensity, four with a high risk of bias and one with a low risk. Two studies evaluated pain intensity on palpation (one with high and one with low risk of bias), and one study with high risk of bias evaluated MMO. Laser parameters were: 690-810 nm, 40-150 mW, and 7.5-112.5 J/cm2. Occlusal splint (OS) [- 2.47; CI 95% - 3.64, - 1.30] and Physiotherapy (PT) [-2.64; CI 95% - 3.94, - 1.34] reduced pain intensity compared to C. The ranking of treatments in order of effectiveness was PT > OS > LA > C > CR (craniopuncture). The certainty of the evidence was very low or low. The data do not support the indication of LA for the treatment of TMDs and new placebo-controlled RCTs must be conducted to demonstrate its effectiveness more precisely.
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Affiliation(s)
| | | | | | | | | | - Eduarda Correia Moretti
- University of Alagoas, Human Anatomy Sector, Institute of Biological and Health Sciences, Federal, Maceió, AL, Brazil
| | - George Azevedo Lemos
- University of Alagoas, Human Anatomy Sector, Institute of Biological and Health Sciences, Federal, Maceió, AL, Brazil.
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Christidis N, Al-Moraissi EA, Al-Ak'hali MS, Minarji N, Zerfu B, Grigoriadis A, Schibbye R, Christidis M. Psychological treatments for temporomandibular disorder pain-A systematic review. J Oral Rehabil 2024. [PMID: 38616535 DOI: 10.1111/joor.13693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard treatment, psychological treatments have been suggested. The aim was to investigate the effects of psychological treatments on patients with painful TMD in a short- and long-term perspective. MATERIALS AND METHODS An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) reporting psychological interventions for TMD. Registered beforehand in PROSPERO (CRD42022320106). In total, 18 RCTs were included; six RCTs that could be used in the meta-analysis, and all 18 RCTs were used in the narrative synthesis. Risk of bias was assessed by the Cochrane's tool for assessing risk of bias and certainty of evidence by GRADE. RESULTS The narrative synthesis indicates that psychological treatment options seem equivalent to standard treatment for painful TMD. The meta-analysis showed that a combination of psychological treatment and standard treatment and manual treatment (very low-quality evidence) are significantly better in pain reduction than just counselling and standard treatments of TMD. CONCLUSION This study indicates that psychological treatments seem to reduce pain intensity in individuals with painful TMD, and that the effect seems to be equally good as standard treatment. However, a combination of psychological treatments and standard treatments seems to have an even better effect. This indicates that psychological treatments are promising as an additional treatment approach for painful TMDs.
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Affiliation(s)
- Nikolaos Christidis
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences, Huddinge, Sweden
| | - Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | | | - Natalie Minarji
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences, Huddinge, Sweden
| | - Bethel Zerfu
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences, Huddinge, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences, Huddinge, Sweden
| | - Robert Schibbye
- Department of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences, Huddinge, Sweden
| | - Maria Christidis
- The Swedish Red Cross University, The Institute of Health Sciences, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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5
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Chamani G, Zarei MR, Rad M, Mafi S. Comparison of low-level laser therapy and standard treatment for temporomandibular disorders: An assessment of therapeutic and placebo effects. J Oral Rehabil 2024; 51:657-665. [PMID: 38012102 DOI: 10.1111/joor.13634] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Despite extensive research on the use of low-power lasers for TMD treatment, the extent of their effectiveness remains uncertain. OBJECTIVE This study aimed to investigate the therapeutic or placebo effect of LLLT for TMD, and to compare it with standard treatment methods. A unique aspect of this study was the inclusion of a control group that received only standard treatment, allowing for an assessment of the placebo effect of LLLT. METHODS A total of 42 patients with TMD were referred to Kerman Dental School Pain Clinic and were randomly assigned to three groups: group A received LLLT, group B was a placebo group and group C was a control group that received only standard treatment. The laser groups received gallium-aluminium-arsenide laser treatment twice a week for 10 sessions. Patients' jaw movement rate indicators and VAS index were evaluated at the start of treatment, and indicators were re-recorded every week for 5 weeks. SPSS 21 was used for statistical analysis, including ANOVA and Tukey's post hoc tests for inter-group comparisons. The repeated measurement test was used to analyse the data. RESULTS All groups showed significant improvement in VAS indicators (p = .0001), lateral jaw movements (p = .0001), forward jaw movement (p = .007) but not for maximum mouth opening. No significant difference was observed between the groups at the end of the study (p = .000). CONCLUSION Our study provides insights into LLLT's effectiveness for TMD, suggesting it cannot replace standard treatment alone. These findings contribute to the literature and emphasise the importance of including a control group in future studies to assess the placebo effect of LLLT.
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Affiliation(s)
- Goli Chamani
- FAAOP Diplomat, American Board of Orofacial Pain Professor of Oral Medicine and Orofacial Pain Division of Oral Diagnostics and Rehabilitation Department of Dental Medicine, Karolinska Institute Scandinavian Center for Orofacial Neuroscience (SCON) Huddinge, Huddinge, Sweden
| | - Mohammad Reza Zarei
- Oral Medicine Department, Orofacial Pain Clinic, Kerman School of Dentistry, Kerman, Iran
| | - Maryam Rad
- Oral Medicine specialist, PhD by research in Epidemiology, Kerman, Iran
| | - Sahar Mafi
- Department of Oral Medicine, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University of Tehran, Tehran, Iran
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Rodgers LJ, Bialosky JE, Minick SA, Coronado RA. An overview of systematic reviews examining the quantitative sensory testing-derived hypoalgesic effects of manual therapy for musculoskeletal pain. J Man Manip Ther 2024; 32:67-84. [PMID: 37908101 PMCID: PMC10795637 DOI: 10.1080/10669817.2023.2267954] [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: 06/23/2023] [Accepted: 10/03/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Changes in quantitative sensory testing (QST) after manual therapy can provide insight into pain relief mechanisms. Prior systematic reviews have evaluated manual-therapy-induced QST change. This overview of systematic reviews aims to consolidate this body of literature and critically review evidence on the hypoalgesic effects of manual therapy in clinical populations. METHODS A comprehensive search was conducted on PubMed, CINAHL, PsycInfo, and Embase. Peer-reviewed systematic reviews with or without meta-analysis were eligible if the reviews examined the effect of manual therapy compared to non-manual therapy interventions on QST outcomes in clinical populations. Methodological quality was assessed with the AMSTAR 2 tool. Meta-analysis results and qualitative (non-meta-analysis) interpretations were summarized by type of manual therapy. Overlap of studies was examined with the corrected covered area (CCA) index. RESULTS Thirty systematic reviews, including 11 meta-analyses, met inclusion. There was a slight overlap in studies (CCA of 1.72% for all reviews and 1.69% for meta-analyses). Methodological quality was predominantly low to critically low. Eight (27%) reviews examined studies with a range of manual therapy types, 13 (43%) reviews focused on joint-biased manual therapy, 7 (23%) reviews focused on muscle-biased manual therapy, and 2 (7%) reviews focused on nerve-biased manual therapy. Twenty-nine (97%) reviews reported on pressure pain threshold (PPT). Meta-analytic results demonstrated conflicting evidence that manual therapy results in greater hypoalgesic effects compared to other interventions or controls. CONCLUSION Our overview of QST effects, which has relevance to mechanisms underlying hypoalgesia, shows conflicting evidence from mostly low to critically low systematic reviews.
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Affiliation(s)
- Logan J. Rodgers
- Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Joel E. Bialosky
- Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Brooks-UF-PHHP Research Collaboration, Gainesville, FL, USA
| | - Sophie A. Minick
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rogelio A. Coronado
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Health, Vanderbilt University Medical Center, Nashville, TN, USA
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Barjandi G, Svedenlöf J, Jasim H, Collin M, Hedenberg-Magnusson B, Christidis N, Ernberg M. Clinical aspects of mastication myalgia-an overview. FRONTIERS IN PAIN RESEARCH 2024; 4:1306475. [PMID: 38264542 PMCID: PMC10803665 DOI: 10.3389/fpain.2023.1306475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Mastication myalgia is the most common cause of non-odontogenic pain in the orofacial region and is often associated with a reduced quality of life. The purpose of this review is to provide an overview of the clinical aspects of myalgia based on available research. The review includes epidemiological, diagnostic, and etiological aspects. In addition, the potential risk factors related to the transition from acute to chronic myalgia are explored and treatment strategies are presented for its management. As a result, this review may increase clinical knowledge about mastication myalgia and clarify strategies regarding prevention, diagnostics, and management to improve prognosis and reduce patient suffering.
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Affiliation(s)
- Golnaz Barjandi
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Johanna Svedenlöf
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Hajer Jasim
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
- Department of Orofacial Pain and Jaw Function, Eastman Institute, Stockholm, Sweden
| | - Malin Collin
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Britt Hedenberg-Magnusson
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
- Department of Orofacial Pain and Jaw Function, Eastman Institute, Stockholm, Sweden
| | - Nikolaos Christidis
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
| | - Malin Ernberg
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
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8
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Christidis N, Al-Moraissi EA, Barjandi G, Svedenlöf J, Jasim H, Christidis M, Collin M. Pharmacological Treatments of Temporomandibular Disorders: A Systematic Review Including a Network Meta-Analysis. Drugs 2024; 84:59-81. [PMID: 38103150 PMCID: PMC10789663 DOI: 10.1007/s40265-023-01971-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Temporomandibular disorders (TMD) comprise a cluster of conditions with a wide range of etiological factors that causes pain and discomfort in the masticatory muscles (TMD-M) and temporomandibular joints (TMD-J). More than 50% of the patients with TMD report regular usage of drugs. However, there is still no consensus, nor is there any evidence-based support for clinicians when choosing between different drugs. Therefore, this systematic review, including a network meta-analysis (NMA), aimed to evaluate the scientific evidence and discuss the pharmacological treatment options available to treat painful TMD. METHOD An electronic search was undertaken to identify randomized controlled trials (RCTs) investigating pharmacological treatments for TMD-M and/or TMD-J, published until 6 April 2023. Since only 11 articles could be used for an NMA regarding TMD-M, a narrative synthesis was also performed for all 40 included RCTs. The quality of evidence was rated according to Cochrane's tool for assessing risk of bias, while the certainty of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS When it comes to TMD-M, evidence arises for wet needling therapies with BTX-A, granisetron, and PRP as well as muscle relaxants. For TMD-J, evidence points toward pharmacological treatment approaches including non-steroidal antiinflammatory drugs (NSAIDs) and glucocorticosteriods (for inflammatory conditions) as well as hyaluronic acid and dextrose. CONCLUSIONS The evidence clearly indicates that the pharmacological treatment approaches differ between TMD-M and TMD-J. Therefore, it is of great importance to first try to uncover each patient's individual and multifactorial etiology and then employ a multifaceted treatment strategy, including pharmacological treatment approaches.
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Affiliation(s)
- Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden.
| | - Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - Golnaz Barjandi
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden
| | - Johanna Svedenlöf
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden
| | - Hajer Jasim
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden
- Department of Orofacial Pain and Jaw Function, Public Dental Services, Folktandvården Stockholms län AB, SE-102 31, Eastmaninstitutet Stockholm, Sweden
| | - Maria Christidis
- The Institute of Health Sciences, The Swedish Red Cross University, SE-141 21, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-14183, Huddinge, Sweden
| | - Malin Collin
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-14104, Huddinge, Sweden
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9
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Wieckiewicz M, Winocur E. Editorial: Orofacial pain, bruxism, and sleep, volume II. Front Neurol 2023; 14:1331275. [PMID: 38357292 PMCID: PMC10866288 DOI: 10.3389/fneur.2023.1331275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/09/2023] [Indexed: 02/16/2024] Open
Affiliation(s)
- Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wrocław, Poland
| | - Ephraim Winocur
- Department of Oral Rehabilitation, Maurice and Gabriela School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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10
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Menéndez-Torre Á, Pintado-Zugasti AM, Zaldivar JNC, García-Bermejo P, Gómez-Costa D, Molina-Álvarez M, Arribas-Romano A, Fernández-Carnero J. Effectiveness of deep dry needling versus manual therapy in the treatment of myofascial temporomandibular disorders: a systematic review and network meta-analysis. Chiropr Man Therap 2023; 31:46. [PMID: 37924127 PMCID: PMC10625247 DOI: 10.1186/s12998-023-00489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/01/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Temporomandibular disorders (TMDs) are the most common cause of orofacial pain of non-dental origin, with approximately 42% of diagnoses corresponding to myofascial pain. Manual therapy and dry needling are commonly used interventions for the treatment of myofascial temporomandibular disorders. However, it is unclear whether one of them could be superior to the other. OBJECTIVES The aim of the present systematic review and network meta-analysis was to compare the effectiveness of manual therapy and dry needling in patients with myofascial TMD. METHODS This is a systematic review and network meta-analysis. Randomized clinical trials were searched in the databases of Pubmed, PEDro, CINAHL, Web of Science, Scopus, Cochrane, Google Academic and EMBASE. The methodological quality of studies included in this review was judged using the Physiotherapy Evidence Database (PEDro) scale. A frequentist network meta-analysis was carried out, assuming random effects, to estimate the effects of interventions for temporomandibular joint pain measured on a 10-point visual analogue scale. RESULTS Out of 3190 records identified, 17 met the inclusion criteria for qualitative analysis and eight were included in the network meta-analysis. Indirect comparisons between dry needling and manual therapy showed no significant differences in their effects on pain reduction (Odds Ratio [95%CI]; - 0.263 [- 1.517, 0.992]). The ranking of treatments shows that manual therapy (SUCRA = 0.932) followed by deep dry needling (SUCRA = 0.775) present the highest values of estimation and can be considered the most likely to reduce pain. CONCLUSIONS The results of the network meta-analysis should be considered with caution due to the low quality of the evidence available and the high variability of the study protocols in terms of the method of application of dry needling and manual therapy interventions. PROSPERO under identifier: (CRD42020186470).
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Affiliation(s)
- Ángela Menéndez-Torre
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933, Alcorcón, Spain
- Servicio de Fisioterapia, Centro Médico Gava, 28600, Navalcarnero, Madrid, Spain
| | - Aitor Martín Pintado-Zugasti
- Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, 28008, Madrid, Spain
| | - Juan Nicolás Cuenca Zaldivar
- Rehabilitation Service, Guadarrama Hospital, Madrid, Spain.
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain.
| | - Paula García-Bermejo
- DINAMIA Clinic. Alfonso VI, 28806, Alcalá de Henares, Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Diego Gómez-Costa
- Department of Nursing and Estomatology, Faculty of Health Sciences, Rey Juan Carlos University, Avenida de Atemas s/n, Alcorcón, 28922, Madrid, Spain
| | - Miguel Molina-Álvarez
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, Madrid, Spain
| | - Alberto Arribas-Romano
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933, Alcorcón, Spain
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madrid, Spain
| | - Josué Fernández-Carnero
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, 28046, Madrid, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora, Universidad Rey Juan Carlos-Banco de Santander, 28922, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain
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11
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Santana-Penín U, Santana-Mora U, López-Solache A, Mora MJ, Collier T, Pocock SJ, Lorenzo-Franco F, Varela-Centelles P, López-Cedrún JL. Remodeling dental anatomy vs sham therapy for chronic temporomandibular disorders. A placebo-controlled randomized clinical trial. Ann Anat 2023; 250:152117. [PMID: 37302432 DOI: 10.1016/j.aanat.2023.152117] [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: 04/01/2023] [Revised: 05/08/2023] [Accepted: 05/20/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence regarding the etiology or effective treatments for chronic orofacial pain, the majority diagnosed as temporomandibular disorder (TMD), is limited. PURPOSE To investigate whether occlusal equilibration therapy (ET) and decreasing the (higher) angle of the lateral guidance on the nonworking-side leads to a reduction in chronic TMDs intensity. METHODS It was conducted a randomized, explanatory, single blind with blinded assessment, placebo-controlled trial with strong protection against bias involving patients with chronic TMDs. Participants were randomly assigned to receive equilibration therapy or sham therapy. ET in this study consisted of minimal invasive occlusal remodeling to obtain balanced occlusion with reduction of the steeper angle of lateral mandibular movement with respect to the Frankfort plane. The primary outcome was a change in the pain intensity score (on a 0-10 point scale, with 0 indicating no pain and 10 the worst possible pain) at month 6. Secondary outcomes include maximum unassisted mouth opening and psychological distress. RESULTS A total of 77 participants underwent randomization, 39 of whom received ET and 38 sham therapy. The trial was stopped early for efficacy, according to preestablished rules when 67 participants (n = 34, n = 33, respectively) had completed the analysis. At month 6, the mean unadjusted pain intensity score was 2.1 in the ET and 3.6 in the sham therapy group (adjusted mean difference, -1.54; 95% confidence interval [CI] -0.5 to -2.6; P = 0.004; ANCOVA model). The mean increase in maximum unassisted mouth opening (main secondary outcome) was significantly higher in the real therapy group (adjusted mean difference 3.1 mm, 95% CI 0.5-5.7, p = 0.02). CONCLUSION ET significantly reduced the intensity of facial pain associated with chronic TMDs and increased maximum unassisted mouth opening, as compared with sham therapy, over the course of 6 months. There were no serious adverse events. Funded by the Instituto de Salud Carlos III from the Ministry of Science and Innovation of the Government of Spain and European Regional Development Fund, Grant nº PI11/02507; "una manera de hacer Europa".
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Affiliation(s)
- Urbano Santana-Penín
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Urbano Santana-Mora
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Alicia López-Solache
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - María Jesús Mora
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Timothy Collier
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stuart J Pocock
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Pablo Varela-Centelles
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - José Luís López-Cedrún
- Oral and Maxillofacial Surgery Service, University Hospital of A Coruña, A Coruña, Spain
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12
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2023; 130:453-532. [PMID: 37453884 DOI: 10.1016/j.prosdent.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | - Frederick Eichmiller
- Vice President and Science Officer (Emeritus), Delta Dental of Wisconsin, Stevens Point, Wis
| | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md
| | - Matthias Troeltzsch
- Private practice, Oral, Maxillofacial, and Facial Plastic Surgery, Ansbach, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
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13
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Bhargava D, Chávez Farías C, Ardizone García I, Mercuri LG, Bergman S, Anthony Pogrel M, Sidebottom AJ, Srouji S, Şentürk MF, Elavenil P, Moturi K, Anantanarayanan P, Bhargava PG, Singh VD. Recommendations on the Use of Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders: Current Evidence and Clinical Practice. J Maxillofac Oral Surg 2023; 22:579-589. [PMID: 37534353 PMCID: PMC10390439 DOI: 10.1007/s12663-023-01939-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/20/2023] [Indexed: 08/04/2023] Open
Abstract
Background 'Temporomandibular joint disorders (TMDs)' denote an umbrella term that includes arthritic, musculoskeletal and neuromuscular conditions involving the temporomandibular joint, the masticatory muscles, and the associated tissues. Occlusal devices are one of the common treatment modalities utilized in the conservative management of TMDs. The indications for the available 'oral splints' or 'oral orthotic occlusal devices' remain ambiguous. Methods A joint international consortium was formulated involving the subject experts at TMJ Foundation, to resolve the current ambiguity regarding the use of oral orthotic occlusal appliance therapy for the temporomandibular joint disorders based on the current scientific and clinical evidence. Results The recommendations and the conclusion of the clinical experts of the joint international consort has been summarized for understanding the indications of the various available oral orthotic occlusal appliances and to aid in the future research on oral occlusal orthotics. Conclusion The use of the oral orthotic occlusal appliances should be based on the current available scientific evidence, rather than the archaic protocols.
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Affiliation(s)
- Darpan Bhargava
- Joint International Consortium on Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders, TMJ Foundation, TMJ Consultancy Services, Bhopal, Madhya Pradesh India
- Oral and Maxillofacial Surgery, People’s University, Bhopal, Madhya Pradesh India
- DAMER India, Bhopal, India
| | - Camilo Chávez Farías
- Joint International Consortium on Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders, TMJ Foundation, TMJ Consultancy Services, Bhopal, Madhya Pradesh India
- Department of Temporomandibular Joint Disorders, Orofacial Pain and Dental Sleep Medicine, Complutense University of Madrid, Madrid, Spain
| | - Ignacio Ardizone García
- Department of Temporomandibular Joint Disorders, Orofacial Pain and Dental Sleep Medicine, Complutense University of Madrid, Madrid, Spain
| | - Louis G. Mercuri
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, USA
- Department of Bioengineering, University of Illinois, Chicago, USA
- Stryker/TMJ Concepts, Ventura, CA USA
| | - Suzie Bergman
- Joint International Consortium on Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders, TMJ Foundation, TMJ Consultancy Services, Bhopal, Madhya Pradesh India
- Division for Temporomandibular Joint Disorders and Orthodontics, Dentistry On Officers Row, McGann Postgraduate School of Dentistry, Progressive Orthodontic Seminars, Vancouver, WA USA
| | - M. Anthony Pogrel
- Department of Oral and Maxillofacial Surgery, UCSF School of Dentistry, UCSF Dental Center, San Francisco, CA USA
| | - Andrew J. Sidebottom
- Oral and Maxillofacial Surgery & Temporomandibular Joint Related Surgery, Nottingham, UK
| | - Samer Srouji
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Naharia, Israel
| | - Mehmet Fatih Şentürk
- Department of Oral and Maxillofacial Surgery, Dentistry Faculty, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - P. Elavenil
- Department of Oral & Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, India
| | - Kishore Moturi
- Joint International Consortium on Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders, TMJ Foundation, TMJ Consultancy Services, Bhopal, Madhya Pradesh India
- Department of Oral and Maxillofacial Surgery, Vishnu Dental College, Bhimavaram, India
| | - P. Anantanarayanan
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu India
| | - Preeti G. Bhargava
- Joint International Consortium on Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders, TMJ Foundation, TMJ Consultancy Services, Bhopal, Madhya Pradesh India
- Department of Oral & Maxillofacial Surgery, TMJ Consultancy Services, Bhopal, Madhya Pradesh India
| | - Vankudoth Dal Singh
- Joint International Consortium on Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders, TMJ Foundation, TMJ Consultancy Services, Bhopal, Madhya Pradesh India
- Department of Oral and Maxillofacial Surgery, Lenora Institute of Dental Sciences, Rajahmundry, India
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14
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Silva ARP, Bodanezi AV, Chrun ES, Lisboa ML, de Camargo AR, Munhoz EA. Palliative oral care in terminal cancer patients: Integrated review. World J Clin Cases 2023; 11:2966-2980. [PMID: 37215429 PMCID: PMC10198072 DOI: 10.12998/wjcc.v11.i13.2966] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/07/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Palliative care (PC) aims to improve quality of life in patients and its families against life threatening diseases, through suffering’s prevention and relief. It is the duty of the dental surgeon to possess the knowledge needed to treat a patient with little life span, in order to establish an adequate treatment plan for each situation.
AIM To synthesize the published evidence on oral conditions, impact, management and challenges in managing oral conditions among palliative patients.
METHODS Articles were selected from PubMed and Scopus electronic platforms, using a research strategy with diverse descriptors related to “palliative care”, “cancer” and “oral health”. The article’s selection was done in two phases. The first one was performed by the main researcher through the reading of the abstracts. In the second phase two researchers selected eligible articles after reading in full those previous selected. Data was tabulated and analyzed, obtaining information about what is found in literature related to this subject and what is necessary to be approached in future researches about PC.
RESULTS As results, the total of 15 articles were eligible, being one a qualitative analysis, 13 (92.8%) clinical trials and one observational study. Of the 15 articles, 8 (53.4%) involved questionnaires, while the rest involved: one systematic review about oral care in a hospital environment, 2 oral exams and oral sample collection, one investigation of terminal patient’s (TP) oral assessment records, 2 collection of oral samples and their respective analysis and one treatment of the observed oral complications.
CONCLUSION It can be concluded that the oral manifestations in oncologic patients in terminal stage are, oral candidiasis, dry mouth, dysphagia, dysgeusia, oral mucositis and orofacial pain. Determining a protocol for the care of these and other complications of cancer – or cancer therapy – based on scientific evidence with the latest cutting-edge research results is of fundamental importance for the multidisciplinary team that works in the care of patients in PC. To prevent complications and its needed to initial the dentist as early as possible as a multidisciplinary member. It has been suggested palliative care protocol based on the up to date literature available for some frequent oral complications in TP with cancer. Other complications in terminal patients and their treatments still need to have further studying.
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Affiliation(s)
- Ana Rute Preis Silva
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Augusto Vanni Bodanezi
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Emanuely Silva Chrun
- Department of Pathology, Federal University of Santa Catarina, Florianopolis 88040900, Brazil
| | - Mariah Luz Lisboa
- Professor Polydoro São Thiago Ernani Hospital, Federal University of Santa Catarina, Florianopolis 88040900, Brazil
| | - Alessandra R de Camargo
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Etiene Andrade Munhoz
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
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15
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Almăşan O, Hedeşiu M, Leucu£a DC, Buduru S, Dinu C. Oral splints in the management of nociceptive pain and migraines: A scoping review. Exp Ther Med 2023; 25:28. [PMID: 36561612 PMCID: PMC9748760 DOI: 10.3892/etm.2022.11727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
Temporomandibular disorders (TMDs) are characterized by numerous pain manifestations. Their treatment often involves the use of an oral splint. Recent research has found a relationship between migraines, nociceptive pain and TMDs. The aim of the present study was to perform a scoping review of studies in order to evaluate the effectiveness of the various types of oral splint in the treatment of migraine or nociceptive pain. Publications were retrieved from seven databases (PubMed, Web of Science, EMBASE, Scopus, ProQuest, SpringerLink and Ovid). Out of the 15 included publications, three studies were before and after studies, with no control group, whereas the other twelve studies were clinical trials, among which two publications were crossover studies. A clear, single distinction of pain was difficult to describe. Therefore, numerous publications focused on a combination of various types of pains, including myofascial, temporomandibular joint, headaches and migraine-like symptoms, all of which mimicked TMD pain. Overall, six studies used the stabilization splint (SS), three explored the comparison between the SS and the nociceptive trigeminal inhibition splint (NTIS) and two the NTIS. The majority of publications reported a positive outcome of splint therapy. Regarding the type of oral splint usage, the most commonly used one was the SS, followed by the NTIS. The definition and assessment of pain were heterogenous in the identified articles. The findings of the current study showed that occlusal splints may help with pain management, and that effective treatment of TMD-related pain at an early stage can enhance the quality of life of patients.
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Affiliation(s)
- Oana Almăşan
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Mihaela Hedeşiu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucu£a
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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Diagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update. Diagnostics (Basel) 2022; 12:diagnostics12122914. [PMID: 36552921 PMCID: PMC9776546 DOI: 10.3390/diagnostics12122914] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022] Open
Abstract
Myogenous temporomandibular disorders (M-TMDs) are the most common chronic orofacial pain, affecting the masticatory muscles and, thus, jaw movement. While a concise diagnosis is crucial to formulate a rational treatment plan, the similarities in clinical presentations that M-TMDs share with other neuromuscular disorders affecting the temporomandibular joint (TMJ) could easily confuse physicians. In addition to the basics, such as thorough history taking and meticulous clinical examinations, different imaging techniques are useful adjuncts to facilitate the diagnostic process. This review presents an overview of the current understanding on a variety of diagnostic and treatment modalities for M-TMD patients. It is essential to highlight that there is not a single treatment for all, and the benefits of multidisciplinary strategies have been noted for the effective management of myogenous TMD pain. Treatment modalities ranging from conservative to minimally invasive options are discussed in this review.
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BATISTA JFDOL, VILA-NOVA TEL, MORAES SLD, PELLIZZER EP, VASCONCELOS BCDE, GOMES JMDL, LEMOS CAA, HEIMER MV. Are exercises with or without occlusal splints more effective in the reduction of pain in patients with temporomandibular disorders of myogenic origin? A systematic review. J Appl Oral Sci 2022. [DOI: 10.1590/1678-7757-2022-0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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18
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Effects of Therapeutic and Aerobic Exercise Programs on Pain, Neuromuscular Activation, and Bite Force in Patients with Temporomandibular Disorders. J Pers Med 2021; 11:jpm11111170. [PMID: 34834522 PMCID: PMC8623244 DOI: 10.3390/jpm11111170] [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: 09/09/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023] Open
Abstract
Pain in masticatory muscles is one of the most frequent symptoms in patients with temporomandibular disorders (TMD) and can lead to changes in the patterns of neuromuscular activity of masticatory muscles and decrease in bite force. This study assesses the effects of three eight-week exercise programs on pain intensity, neuromuscular activation, and bite force of masticatory muscles in patients with TMD. Forty-five patients were divided into three groups: a therapeutic exercise program (G1), a therapeutic and aerobic exercise program (G2), and an aerobic exercise program (G3). The masticatory muscles’ pain was evaluated using the numeric pain rating scale (NPRS), surface electromyographic (sEMG) activity of the masseter was recorded during maximum voluntary contraction and at rest, and bite force was evaluated using a dynamometer. These parameters were evaluated twice at baseline (A01/A02), at the end of the eight-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). After intervention, G2 showed the best results, with a significantly decrease in masticatory muscles’ pain and increase in bite force. These results suggest that interventions to reduce pain in patients with TMD should be multimodal.
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