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Dewake N, Miki M, Ishioka Y, Nakamura S, Taguchi A, Yoshinari N. Association between clinical manifestations of occlusal trauma and magnetic resonance imaging findings of periodontal ligament space. Dentomaxillofac Radiol 2023; 52:20230176. [PMID: 37772599 DOI: 10.1259/dmfr.20230176] [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] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the association between clinical manifestations of occlusal trauma of the teeth and maximum signal intensity of periodontal ligament space on MRI. METHODS 20 subjects (males: 9, females: 11, mean age: 35.9 ± 14.0 years, range: 22-65 years) participated in this study. Subjective symptoms of bruxism, tooth mobility, fremitus, occlusal contact area, occlusal force, widening of the periodontal ligament space, and thickening of the lamina dura were defined as clinical manifestations of occlusal trauma. The total number of clinical manifestations was used to evaluate the degree of clinical occlusal trauma, with a score of 7 indicating the highest degree of occlusal trauma. The maximum signal intensity in the periodontal ligament space was evaluated by a specific T2 weighted MRI sequence: IDEAL image. RESULTS Spearman's rank correlation between the total clinical occlusal trauma score and maximum signal intensity in the periodontal ligament space was 0.529 for all teeth, 0.517 for anterior teeth, and 0.396 for molar teeth (p < 0.001 for all). CONCLUSIONS A significant correlation between the degree of occlusal trauma and the signal intensity of the periodontal ligament space suggests a new potential MRI-based method for objectively determining occlusal trauma.
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Affiliation(s)
- Nanae Dewake
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Manabu Miki
- Department of Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri, Japan
| | - Yasuaki Ishioka
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Suguru Nakamura
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Akira Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Nobuo Yoshinari
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan
- Department of Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri, Japan
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Thomas DC, Singer SR, Markman S. Temporomandibular Disorders and Dental Occlusion: What Do We Know so Far? Dent Clin North Am 2023; 67:299-308. [PMID: 36965932 DOI: 10.1016/j.cden.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Throughout the recorded history in the literature of temporomandibular disorders (TMD) there have been a variety of opinions as to its primary cause. Those supporting an occlusal basis of TMD opined that occlusal dysfunction is either the primary cause for or a significant etiopathogenic factor in the causation of TMD. Most of the current literature, however, points to evidence in another direction and questions the causal role of occlusion and occlusal disharmony in TMD etiopathogenesis. Recognition of this evidence-based literature is paramount in eliminating and preventing the chances of overtreatment of patients with TMD.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA; Eastman Institute of Oral Health, Rochester, NY 14642, USA.
| | - Steven R Singer
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA
| | - Stanley Markman
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA
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Prosthodontic Treatment in Patients with Temporomandibular Disorders and Orofacial Pain and/or Bruxism: A Review of the Literature. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4020025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Temporomandibular disorders are a group of conditions affecting the temporomandibular joints, the jaw muscles, and related structures. Patients with temporomandibular signs and/or symptoms frequently present with indications for prosthetic treatment. The management of these patients aims to achieve patient comfort, occlusal stability, and the complex restoration of the teeth. The goal of this review is to provide an overview of the relationship between prosthodontics and temporomandibular disorders and/or bruxism with a focus on the cause-and-effect implications and the strategies for planning prosthetic treatments in patients with temporomandibular disorders and/or bruxism.
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Jamali Z, Hadilou N, Nourizadeh A. Effect of the posterior stop on temporomandibular disorders: A systematic review. J Dent Res Dent Clin Dent Prospects 2022; 16:147-152. [PMID: 36704181 PMCID: PMC9871174 DOI: 10.34172/joddd.2022.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 09/09/2022] [Indexed: 01/20/2023] Open
Abstract
Background. Temporomandibular disorders have common signs and symptoms, including pain in the masticatory muscles, limitation or deviation in a mandibular range of motion, and other common patient complaints, such as headache and earache. The main focus of this study was to collect comprehensive and integrated data on the effect of the posterior stop on temporomandibular joint disorders, as well as prevention, treatment, and follow-up care for the patients. Methods. The authors conducted the search in PubMed, SCOPUS, Web of Science, Cochrane Library, CINHAL, Medline, ProQuest, Google Scholar, Magiran, IranDoc, SID, and Iranmedex databases for relevant articles. A list of selected study sources, related conferences, and grey literature were manually searched in addition to the databases mentioned above. A 21-year time limit was imposed (2000-2021). Results. Finally, 16 articles were selected to be reviewed in this systematic review. The designs of the included studies were heterogeneous, and due to the low number of studies covered, the authors could not carry out a meta-analysis. Conclusion. The causes of temporomandibular disorders are multifactorial and complex. Therefore, it is difficult to investigate the relationship between this disorder and predictors. The results of the present study indicate that to determine the effect of the posterior stop on temporomandibular joint disorders, more clinical trials and case-control studies should be conducted.
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Affiliation(s)
- Zahra Jamali
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Negin Hadilou
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding author: Negin Hadilou,
| | - Amin Nourizadeh
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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A Prosthodontic Approach as a Complementary Solution for a Complicated Orthodontic Treatment of a Patient with Cleidocranial Dysplasia. Case Rep Dent 2021; 2021:6618813. [PMID: 34336308 PMCID: PMC8295508 DOI: 10.1155/2021/6618813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/23/2021] [Indexed: 11/21/2022] Open
Abstract
This clinical report describes a prosthodontic rehabilitation of a 29-year-old patient with cleidocranial dysplasia (CCD), who, after completing an orthodontic treatment, was not satisfied with the aesthetic outcome. Besides aesthetics, the patient complained about mastication muscles pain, and clicking while eating but was not aware about her unilateral open bite on the right side. The aim of this treatment was to improve smile appearance and patient's well-being, as well as to restore the proper occlusal vertical dimension (OVD) along with complete intercuspation and to establish masticatory function. The first phase of the treatment concentrated on eliminating the muscle pain and temporomandibular joint (TMJ) clicking with a repositioning splint. During the second phase, the functional and aesthetic rehabilitation was obtained using adhesive prosthesis overlays and veneers.
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Di Paolo C, Falisi G, Panti F, Di Giacomo P, Rampello A. "RA.DI.CA." Splint for the Management of the Mandibular Functional Limitation: A Retrospective Study on Patients with Anterior Disc Displacement without Reduction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9057. [PMID: 33291679 PMCID: PMC7730108 DOI: 10.3390/ijerph17239057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
The study aimed at assessing the effectiveness of the RA.DI.CA. splint in the management of temporomandibular joint disc displacement without reduction (ADDwoR) and jaw functional limitation. The authors developed a retrospective clinical study. A total of 2739 medical records were screened. One hundred and forty-one patients with chronic unilateral disc displacement without reduction and jaw limitation, treated with a multifunctional RA.DI.CA. splint, were enrolled. Temporomandibular pain, headache, familiar pain, neck pain, and emotional strain, maximum spontaneous mouth opening, and lateral excursions were evaluated at baseline (T0), after therapy (T1), and during the follow-up (T2). Descriptive statistical analysis was performed. Wilcoxon test assessed changes in symptomatology and functional aspects before and after treatment and between T1 and T2, with p < 0.05. Ninety-nine patients (70%) declared themselves "healed" from jaw functional limitation with no residual painful symptoms, 31 (22%) improved their symptoms and jaw function, 11 (8%) reported no changes compared to T0 and no one worsened. As for all parameters analyzed, the comparison between the ones before and after treatment was statistically significant (p < 0.05). The RA.DI.CA. splint proved to be highly performing and promoting functional and symptomatologic recovery, also in the medium and long term, through the restoration of the functional disc-condyle relationship and the healing of joint tissues.
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Affiliation(s)
| | | | | | - Paola Di Giacomo
- Gnathologic Division, Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (C.D.P.); (G.F.); (F.P.); (A.R.)
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Li Z, Xia Y, Liu Z, Liu Y. Oral rehabilitation following successful TMD treatment with condylar position changes: A case report. Cranio 2020; 40:381-386. [PMID: 32729790 DOI: 10.1080/08869634.2020.1795589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND A 31-year-old woman with crowns, fixed partial prostheses, and dental restorations complained of recurrent pain in the left and right temporomandibular joints during the last 2 years. CLINICAL PRESENTATION The symptoms of temporomandibular disorder (TMD) resolved successfully after a 3-month-long treatment with a repositioning splint. Pre- and post-operative cone-beam computed tomography revealed slight changes in the condylar position after splint use. Minimally invasive oral rehabilitation guided by digital design was performed to maintain the acquired stable position. The status of the restorations was good, and the TMD symptoms did not relapse during the 3-year follow-up. CONCLUSION This case report demonstrates the importance of a stable adapted condylar position after extensive prosthodontic treatment.
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Affiliation(s)
- Zhongjie Li
- Department of Temporomandibular Joint, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yingfeng Xia
- Department of Stomatology, The Second Hospital of Shandong University, Jinan, Shandong, China
| | - Zhan Liu
- Provincial Key Lab for Biomechanical Engineering, Sichuan University, Chengdu, China
| | - Yang Liu
- Department of Temporomandibular Joint, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Park JH, Lee GH, Moon DN, Kim JC, Park M, Lee KM. A digital approach to the evaluation of mandibular position by using a virtual articulator. J Prosthet Dent 2020; 125:849-853. [PMID: 32624222 DOI: 10.1016/j.prosdent.2020.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 10/23/2022]
Abstract
The purpose of this technique report was to describe a fully digital technique to evaluate the mandibular position both in centric relation occlusion (CRO) and maximal intercuspation position (MIP). The procedure transfers data relative to the position of the maxillary and mandibular dentition to a virtual articulator based on a single cone beam computed tomography (CBCT) image. A CBCT scan of the patient was obtained in CRO, and the maxillary and mandibular casts were scanned both in CRO and MIP with an intraoral scanner. The model CRO scan data were registered on the dental part of the CBCT image by using a virtual articulator program, and a virtual facebow transfer process and mounting was performed. The virtual articulator was positioned in the right and left condyle medial pole and right orbitale. The mandibular position was evaluated in CRO and MIP by superimposing the data of the mandible position in both CRO and MIP. A quantitative 3D measurement was obtained by using the grid function. Based on this protocol, it is possible to use a fully digital approach to transfer the position of a patient's maxillary dentition to a virtual articulator based on the data from a single CBCT scan and intraoral scans. This technique eliminates the traditional facebow transfer and mounting process and complicated laboratory procedures for evaluating mandibular positional changes in CRO and MIP.
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Affiliation(s)
- Jae Hyun Park
- Professor and Chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz; International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Gye-Hyeong Lee
- Private practice, Yeosu, Republic of Korea; President, Roth Orthodontic Society, Seoul, Republic of Korea; Clinical Professor, Department of Orthodontics, Graduate School of Dentistry, Chonnam National University, Gwangju, Republic of Korea; Clinical Professor, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Da-Nal Moon
- Private practice, Gwangju, Republic of Korea; Clinical Professor, Department of Orthodontics, Graduate School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | | | - Mirinae Park
- Postgraduate student, Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Kyung-Min Lee
- Associate Professor, Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.
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Abstract
The relationship between temporomandibular disorders (TMDs) and occlusion remains controversial. Some authors believe that occlusion is the primary factor in the onset of TMD symptoms, whereas others feel that occlusion has no role in this at all. The majority of reasoning behind causation is based upon anecdotal rather than scientific evidence. Existing evidence in the literature supports the absence of a disease-specific association. This article describes this controversy and provides the reader with findings from contemporary literature.
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Affiliation(s)
- Ziad Al-Ani
- Senior Lecturer, Glasgow Dental Hospital and School
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10
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Banafa A, Suominen AL, Sipilä K. Factors associated with signs of temporomandibular pain: an 11-year-follow-up study on Finnish adults. Acta Odontol Scand 2020; 78:57-63. [PMID: 31401930 DOI: 10.1080/00016357.2019.1650955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Pain in the temporomandibular region is a main complaint causing disability and distress among temporomandibular disorders sufferers.Objectives: The aim of the study was, over an 11-year follow-up on Finnish adult population, to investigate the prevalence of clinically assessed pain-related temporomandibular disorder (TMD) signs, i.e. temporomandibular joint (TMJ) and masticatory muscles (MM) pain on palpation, and their association with sociodemographic background and denture status.Methods: The data were based on the nationally representative Finnish Health 2000 and Health 2011 Surveys (BRIF8901). The sample comprised 1210 adults who underwent clinical oral examinations including TMD signs assessment. Statistical evaluations included chi-square tests and logistic regressions.Results: The prevalence of palpatory MM pain decreased from 9.5% at baseline to 4.6% in the follow-up. Cross-sectionally, presence of palpatory MM pain significantly associated with gender (p < .001, p = .002) and educational level (p < .001, p = .001) in both years, and with age (p = .006) and denture status (p = .022) at baseline. The prevalence of palpatory TMJ pain increased from 2.1% at baseline to 3.5% in the follow-up. Presence of palpatory TMJ pain significantly associated with gender in both years (p = .012, p = .032). Female gender, lower education and palpatory MM pain at baseline predicted palpatory MM pain in the follow-up.Conclusion: Palpatory MM pain is relatively prevalent in adults, yet with a favourable prognosis. Women and people with low education are more susceptible groups. Previous experience of palpatory MM pain increases the risk of exhibiting it later in life.
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Affiliation(s)
- Aisha Banafa
- Faculty of Health Sciences, School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Kirsi Sipilä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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Del Vecchio A, Floravanti M, Boccassini A, Gaimari G, Vestri A, Di Paolo C, Romeo U. Evaluation of the efficacy of a new low-level laser therapy home protocol in the treatment of temporomandibular joint disorder-related pain: A randomized, double-blind, placebo-controlled clinical trial. Cranio 2019; 39:141-150. [PMID: 30999823 DOI: 10.1080/08869634.2019.1599174] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: This study analyzed a home, low-level laser therapy (LLLT) protocol to manage temporomandibular joint disorders (TMJDs)-related pain.Methods: Ninety TMJD patients (12M, 78F) between 18 and 73 years were randomly subdivided into three groups. Study group (SG) received 1-week home protocol LLLT by B-cure Dental Pro: 808 nm, 5 J/min, 250 mW, 15 KHz for 8', 40 J each, over pain area, twice daily. Placebo group (PG) followed the same protocol using sham devices. Drugs group (DG) received conventional drugs. Pain was evaluated by visual analog scale (VAS) before and after therapy.Results: Statistical analysis showed that treatment was effective (F(2,83) = 4.882; p = .010). Bonferroni post-hoc analysis indicated a lower pain decrease in PG. SG registered a 34-point decrease per patient, while in PG and DG, the reduction was 25.6 and 35.3, respectively.Conclusion: The study supports the efficacy of home LLLT management of TMJD related pain.
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Affiliation(s)
- Alessandro Del Vecchio
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Miriam Floravanti
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Armando Boccassini
- Department of TMJ Dysfunction, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Gianfranco Gaimari
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Annarita Vestri
- Department of Public Health and Infectious Diseases, Policlinic Umberto I Rome, Rome, Italy
| | - Carlo Di Paolo
- Department of TMJ Dysfunction, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
| | - Umberto Romeo
- COU Oral Pathology and Medicine, Department of Oral and Maxillo Facial Sciences Sapienza, University of Rome, Rome, Italy
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12
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Chang CL, Wang DH, Yang MC, Hsu WE, Hsu ML. Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint. Kaohsiung J Med Sci 2018; 34:223-230. [DOI: 10.1016/j.kjms.2018.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/02/2018] [Accepted: 01/12/2018] [Indexed: 01/01/2023] Open
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13
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Hanchi Z, Tingting L, Bilu X, Zhongjie L, Yang L. [Features of condylography curves]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:555-560. [PMID: 29188656 DOI: 10.7518/hxkq.2017.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
With the kinematic face bow, the condyle movements representing temporomandibular joint function can be recorded instantly. The condylography curves can be utilized for diagnostic analysis, as different pathophysiological conditions have unique curve patterns. By tracing the specific alterations on the curves, the structural and functional statuses of the temporomandibular joint can be predicted. However, to the best of our knowledge, no standardized and practicable evaluation protocol for jaw movement tracing exists. In the current study, the features of either normal or abnormal curves were reviewed. Such features can be clinically used for determining temporomandibular joint status, thereby contributing to a comprehensive diagnosis.
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Affiliation(s)
- Zhao Hanchi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lan Tingting
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiang Bilu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li Zhongjie
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Liu Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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de S Leão R, da S Júnior EZ, de Alencar MG, Catunda RQ, de Moraes SL, do E Vasconcelos BC. Use of Mini-anchors and Rehabilitation with 0° Cusp Angle Teeth Complete Denture in Recurrent Condylar Dislocation: Technical Adequacy and Procedure. J Contemp Dent Pract 2017; 18:337-341. [PMID: 28349915 DOI: 10.5005/jp-journals-10024-2042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM To report a case of association between the surgical treatment of temporomandibular dysfunction and rehabilitation with denture total prosthesis (TP) using nonanatomic teeth (cusp 0°) in patients with anterior recurrent dislocation of the temporo-mandibular joint (TMJ) and persistent uncontrolled mandibular movement, showing a technical adaptation and conduct. INTRODUCTION There are several treatment approaches available for dislocation of the TMJ. The use of condylar mini-anchors for recurrent TMJ dislocation is a valid option and should be considered since it does not alter the joint anatomy. In edentulous patients undergoing TMJ surgical procedures, prosthetic rehabilitation can be seen as a means of treatment preservation. CASE REPORT A 73-year-old female patient attended the oral and maxillofacial surgery clinic presenting with joint instability, ligament laxity, and chronic recurrent TMJ dislocations. She had already been through three previous unsuccessful surgical procedures. A treatment plan was done based on the installation of a mini-anchor in the patient's TMJ through the preauricular surgical access. Dislocations were then resolved, but the lack of mandibular control even to a lesser extent after surgery precluded the use of prosthetics even at rest. Thus, it was planned to manufacture two conventional TPs with 0° cusp angle teeth, a clinical protocol shortened to three sessions in an attempt to improve the stability of the prosthesis. CONCLUSION The use of an individual mini-anchor is simple and effective, and the use of artificial teeth is well suited to the case. CLINICAL SIGNIFICANCE A multidisciplinary intervention (surgery/ prosthesis) is of utmost importance for the resolution and preservation of the treatment of these complex cases.
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Affiliation(s)
- Rafaella de S Leão
- Department of Restorative Dentistry, Dentistry School University of Pernambuco, Recife, Brazil, Phone: +005581996933610 e-mail:
| | | | | | - Raisa Q Catunda
- Department of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Sandra Ld de Moraes
- Department of Prosthodontics, Dentistry School, University of Pernambuco, Recife, Brazil
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Marquezan M, Figueiró C. Temporomandibular disorder treatment in a patient wearing removable prostheses: A case report. Cranio 2016; 35:122-127. [PMID: 27240163 DOI: 10.1080/08869634.2016.1187823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIM The purpose of this intervention was to treat the patient, a 51-year-old woman, who was wearing a maxillary denture and a mandibular bilateral distal-extension partial denture (both unfit) and was suffering from temporomandibular disorder (TMD). METHODOLOGY The treatment suggested was to construct a superior repositioning splint (SRS), and after remission of the symptomatology, fabricate new dentures. RESULTS The occlusal splint was effective and the symptomatology ceased after about five months of treatment. The new dental prostheses were made and followed up for 10 years with no return of the pain. CONCLUSIONS SRS and subsequent construction of new dentures after remission of the symptomatology was an effective treatment for TMD in the case described.
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Affiliation(s)
- Mariana Marquezan
- a Department of Pediatric Dentistry and Orthodontics , Universidade Federal do Rio de Janeiro (UFRJ) , Rio de Janeiro , Brazil.,b Department of Restorative Dentistry , Universidade Federal de Santa Maria (UFSM) , Santa Maria , Rio Grande do Sul , Brazil
| | - Cláudio Figueiró
- b Department of Restorative Dentistry , Universidade Federal de Santa Maria (UFSM) , Santa Maria , Rio Grande do Sul , Brazil
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Malheiros AS, Carvalhal ST, Pereira TL, Filho EMM, Tonetto MR, Gonçalves LM, Bandeca MC, De Jesus Tavarez RR. Association between Tooth Loss and Degree of Temporomandibular Disorders: A Comparative Study. J Contemp Dent Pract 2016; 17:235-239. [PMID: 27207204 DOI: 10.5005/jp-journals-10024-1833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the association between tooth loss and the signs and symptoms of temporomandibular disorders (TMDs). MATERIALS AND METHODS One hundred fifty patients with an average age of 49.2 (±14.06) years were divided into three groups (n = 50/group) according to the degree of tooth loss: GI (dentate -control), GII (edentulous), GIII (partially dentate). After performing anamnesis and clinical examination, a questionnaire was used, so that the patients could fill in information on signs and symptoms of TMD. After analyzing this information, it was possible to classify the degree of severity of TMD. As age is a confounding variable to the level of TMD, an analysis of covariance (ANCOVA) was used to check for differences in the degree of TMD between groups (covariate = age). A post hoc test (Bonferroni) was performed to compare the groups two by two (5% significance level). RESULTS The mean level of TMD according to the groups was GI - 1.95; GII - 2.15; GIII - 2.55. There were significant differences between the study groups (p > 0.05). A post hoc test (Bonferroni) confirmed the difference between edentulous patients and the other groups. CONCLUSION The tooth loss is directly related to the signs and symptoms of TMD. The degree of TMD was significantly higher in edentulous patients.
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Affiliation(s)
| | | | | | | | - Mateus Rodrigues Tonetto
- Department of Post Graduation Program in Integrated Dental Science University of Cuiaba, Cuiaba, Mato Grosso Brazil
| | | | - Matheus Coelho Bandeca
- Department of Post Graduation Program in Dentistry University CEUMA, São Luis, Maranhão, Brazil
| | - Rudys Rodolfo De Jesus Tavarez
- Professor, Department of Post Graduation Program in Dentistry University CEUMA, Avenida dos Holandeses No.07, Edificio Metropolitam, Calhau, São Luis, Maranhão, Brazil, CEP: 65071-380, Phone: (55)9832272360, e-mail:
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Ghurye S, McMillan R. Pain-Related Temporomandibular Disorder - Current Perspectives and Evidence-Based Management. ACTA ACUST UNITED AC 2015; 42:533-6, 539-42, 545-6. [PMID: 26506809 DOI: 10.12968/denu.2015.42.6.533] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Pain-related temporomandibular disorder (TMD) is one of the top three most common chronic pain conditions, along with headaches and back pain. TMD has complex pathophysiology and significant associations with a variety of other chronic pain conditions, eg fibromyalgia, irritable bowel syndrome and migraine. Chronic TMD is associated with a negative impact upon quality of life and high levels of healthcare utility. It is important that clinicians are able to diagnose TMD correctly, provide appropriate management in keeping with current evidence-based practice, and identify when to refer patients to specialist care. The presence of risk factors, eg anxiety, depression, pain-related disability and chronic pain conditions elsewhere in the body, may help to identify which TMD patients require referral for multidisciplinary management. TMD should be managed using a holistic approach, incorporating patient education and encouragement towards self-management. TMD care pathways should consider using the three'pillars'of pain management: physical therapies, pharmacotherapy and clinical psychology.
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ASSIS JFCD, SILVA PLPD, LIMA JASD, FORTE FDS, BATISTA AUD. The knowledge level of dental surgeons regarding the relationship between occlusal factors and Temporomandibular Disorders (TMD). REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.11615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AbstractIntroductionThe relationship between dental occlusion and temporomandibular disorders (TMD) remains a subject of disagreement. Many professionals erroneously base diagnosis and treatment strictly on the occlusal factor, despite the fact that current scientific evidence does not show such a relationship.ObjectiveTo evaluate the knowledge of dental surgeons (DSs) from João Pessoa (PB)-Brazil, regarding the relationship between occlusal factors and TMD.Materials and methodA sample of 100 DSs who do not have expertise in TMD and orofacial pain (CG Group) and seven DSs with this specialty (EG Group) completed a questionnaire that addresses issues concerning knowledge of TMD and its relationship with occlusal factors. The questionnaire also contained information used to characterize the sample, such as age, gender, and length of experience. The current literature's degree of consensus was established as the "gold standard" response for each statement and was compared with the responses of the specialists and non-specialists. Data were tabulated using the SPSS software package and analyzed descriptively (by percentage) and statistically using the chi-square and Fisher's exact tests (p < 0.05).ResultA wide divergence could be observed between the knowledge of DSs who do not specialize in TMD and orofacial pain and that of professionals who do.ConclusionThere was low agreement between specialists and non-specialists. The relationship between dental occlusion and TMD remains unclear for the vast majority of participating professionals, which may prove to be reflected in diagnostic behaviors and inappropriate occlusal treatment for the management of TMD.
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El-Zawahry MM, El-Ragi AA, El-Anwar MI, Ibraheem EM. The Biomechanical Effect of Different Denture Base Materials on the Articular Disc in Complete Denture Wearers: A Finite Element Analysis. Open Access Maced J Med Sci 2015; 3:455-61. [PMID: 27275270 PMCID: PMC4877839 DOI: 10.3889/oamjms.2015.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/07/2015] [Accepted: 06/09/2015] [Indexed: 12/02/2022] Open
Abstract
AIM: The objective of the present study was to evaluate the effect of different denture base materials on the stress distribution in TMJ articular disc (AD) in complete denture wearers. MATERIAL AND METHODS: A three dimensional Finite Element (FEA) models of an individual temporomandibular joint (TMJ) was built on the basis CT scan. The FEA model consisted of four parts: the condyle, the articular disc, the denture base, and the articular eminence skull. Acrylic resin and chrome-cobalt denture base materials were studied. Static loading of 300N was vertically applied to the central fossa of the mandibular second premolar. Stress and strain were calculated to characterize the stress/strain patterns in the disc. RESULTS: The maximum tensile stresses were observed in the anterior and posterior bands of (AD) on load application with the two denture base materials. The superior boundaries of the glenoid fossa showed lower stress than those on the inferior boundaries facing the condyle. CONCLUSIONS: Within the limitations of the present study it may be concluded that: The denture base material may have an effect in stress-strain pattern in TMJ articular disc. The stiffer denture base material, the better the distribution of the load to the underling mandibular supporting structures & reducing stresses induced in the articular disc.
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Affiliation(s)
| | - Ahmed A El-Ragi
- Civil Engineering Department, Faculty of Engineering, Fayoum University, Egypt
| | | | - Eman M Ibraheem
- Prosthodontics Department, National Research Centre, Giza, Egypt
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Moreno-Hay I, Okeson JP. Does altering the occlusal vertical dimension produce temporomandibular disorders? A literature review. J Oral Rehabil 2015; 42:875-82. [PMID: 26140528 DOI: 10.1111/joor.12326] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2015] [Indexed: 11/27/2022]
Abstract
The purpose of this review was to present a comprehensive review of the scientific evidence available in the literature regarding the effect of altering the occlusal vertical dimens-ion (OVD) on producing temporomandibular disorders. The authors conducted a PubMed search with the following search terms 'temporoman-dibular disorders', 'occlusal vertical dimension', 'stomatognatic system', 'masticatory muscles' and 'skeletal muscle'. Bibliographies of all retrieved articles were consulted for additional publications. Hand-searched publications from 1938 were included. The literature review revealed a lack of well-designed studies. Traditional beliefs have been based on case reports and anecdotal opinions rather than on well-controlled clinical trials. The available evidence is weak and seems to indicate that the stomatognathic system has the ability to adapt rapidly to moderate changes in occlusal vertical dimension (OVD). Nevertheless, it should be taken into consideration that in some patients mild transient symptoms may occur, but they are most often self-limiting and without major consequence. In conclusion, there is no indication that permanent alteration in the OVD will produce long-lasting TMD symptoms. However, additional studies are needed.
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Affiliation(s)
- I Moreno-Hay
- Orofacial Pain Center, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - J P Okeson
- Orofacial Pain Center, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Abduo J, Tennant M. Impact of lateral occlusion schemes: A systematic review. J Prosthet Dent 2015; 114:193-204. [PMID: 25957242 DOI: 10.1016/j.prosdent.2014.04.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 04/21/2014] [Indexed: 01/09/2023]
Abstract
STATEMENT OF PROBLEM Although several lateral occlusion philosophies have been proposed in the literature, there is a lack of compelling evidence supporting any scheme. PURPOSE The purpose of this systematic review was to investigate the clinical implications of different lateral occlusion schemes. MATERIAL AND METHODS A literature search was completed through PubMed (MEDLINE), Google Scholar, and Cochrane Library, up to January 2014. The literature search aimed to retrieve 2 study categories: group 1: comparative studies; group 2: clinical outcome studies. The inclusion criteria were peer-reviewed human clinical studies published in English. The search was further supplemented by manual searching through the reference lists of the selected studies. RESULTS The initial search revealed a total of 680 studies; however, after applying the inclusion criteria, 26 studies were found suitable for the analysis (13 for group 1 and 13 for group 2). The most commonly evaluated lateral occlusion schemes were canine-guided occlusion (CGO) and group function occlusion (GFO). Group 1 studies evaluated the impact of lateral occlusion schemes on muscular electromyographic (EMG) activity, condylar displacement, mastication, and mandibular movement. Group 2 studies evaluated the impact of restored occlusion on longevity, patient comfort, and pathologic consequences. CGO was associated with narrower mastication and less EMG activity of the masticatory muscles during clenching. GFO was associated with wider mandibular movement and quicker mastication. During mastication, there was no difference in EMG activity between the 2 lateral occlusion schemes. Furthermore, the long-term studies indicated that there is no difference between the 2 schemes in patient comfort and restoration longevity. CONCLUSION Although there are immediate differences between the different lateral occlusion schemes, patients have the capability to successfully adapt to CGO or GFO.
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Affiliation(s)
- Jaafar Abduo
- Senior Lecturer, Melbourne Dental School, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, Western Australia, Australia.
| | - Marc Tennant
- Professor, School of Anatomy, Physiology and Human Biology, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, Western Australia, Australia
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The association between Occlusion Time and Temporomandibular Disorders. J Electromyogr Kinesiol 2014; 25:151-4. [PMID: 25218790 DOI: 10.1016/j.jelekin.2014.08.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 08/19/2014] [Accepted: 08/20/2014] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Recently, some published studies show there is a multifactorial origin for Temporomandibular Disorders, but the dental occlusion's contribution to the development of Temporomandibular Disorders, and how it may influence the adaptive capacity of the Stomatognathic system, it's still unclear. The aim of this study is to evaluate the correlation between the Occlusion Time and Temporomandibular Disorders. METHODS A total of 54 patients were enrolled in the study (24 males and 30 females, mean age 27.94 ± 8.21 years). The TMD group (8 males and 10 females) consisted of subjects who presented with at least 1 of the following signs of Temporomandibular Disorders: Temporomandibular Joint sounds (clicking or crepitation), Temporomandibular Joint locking episodes, limited mandibular opening, painful limitation of mandibular movements, pain to palpation of the Temporomandibular Joint or of the masticatory muscles. The control group (16 males and 20 females) presented as free from Temporomandibular Disorders. The T-Scan III computerized occlusal analysis system was to record the subjects' Occlusion. Times during eight mandibular opening-closing movements. RESULTS The two-ways ANOVA test analyzed the variations for group and sex, showing that the TMD group mean Occlusion Time (0.64 ± 0.21s) was statistically significantly longer than the control group mean Occlusion Time (0.45 ± 0.17s) (p<0.001). Significant differences were also found for gender where the mean OT of female subjects was longer than males one with statistical significance (p-value<0.01). CONCLUSIONS The computerized analysis of the Occlusion Time in patients affected by TMJ problems has to be carefully considered as adjunctive instrumental device.
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Reissmann DR, Heydecke G, Schierz O, Marré B, Wolfart S, Strub JR, Stark H, Pospiech P, Mundt T, Hannak W, Hartmann S, Wöstmann B, Luthardt RG, Böning KW, Kern M, Walter MH. The randomized shortened dental arch study: temporomandibular disorder pain. Clin Oral Investig 2014; 18:2159-69. [DOI: 10.1007/s00784-014-1188-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 01/13/2014] [Indexed: 11/24/2022]
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Abduo J, Tennant M, McGeachie J. Lateral occlusion schemes in natural and minimally restored permanent dentition: a systematic review. J Oral Rehabil 2013; 40:788-802. [DOI: 10.1111/joor.12095] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2013] [Indexed: 11/28/2022]
Affiliation(s)
- J. Abduo
- Melbourne Dental School; Melbourne University; Melbourne Vic. Australia
- School of Anatomy; Physiology and Human Biology; University of Western Australia; Crawley WA Australia
| | - M. Tennant
- School of Anatomy; Physiology and Human Biology; University of Western Australia; Crawley WA Australia
| | - J. McGeachie
- School of Anatomy; Physiology and Human Biology; University of Western Australia; Crawley WA Australia
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Boscato N, Almeida RC, Koller CD, Presta AA, Goettems ML. Influence of anxiety on temporomandibular disorders - an epidemiological survey with elders and adults in Southern Brazil. J Oral Rehabil 2013; 40:643-9. [DOI: 10.1111/joor.12076] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- N. Boscato
- Graduate Program of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - R. C. Almeida
- Graduate Program of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - C. D. Koller
- Graduate Program of Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - A. A. Presta
- School of Dentistry; West University of Santa Catarina; Santa Catarina Brazil
| | - M. L. Goettems
- Graduate Program of Dentistry; Federal University of Pelotas; Pelotas Brazil
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Khan MT, Verma SK, Maheshwari S, Zahid SN, Chaudhary PK. Neuromuscular dentistry: Occlusal diseases and posture. J Oral Biol Craniofac Res 2013; 3:146-50. [PMID: 25737904 DOI: 10.1016/j.jobcr.2013.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 03/28/2013] [Indexed: 12/17/2022] Open
Abstract
Neuromuscular dentistry has been a controversial topic in the field of dentistry and still remains debatable. The issue of good occlusion and sound health has been repeatedly discussed. Sometimes we get complains of sensitive teeth and sometimes of tired facial muscles on getting up in the morning. Owing to the intimate relation of masticatory apparatus with the cranium and cervico-scapular muscular system, the disorders in any system, draw attention from concerned clinicians involved in management, to develop an integrated treatment protocol for the suffering patients. There may be patients reporting to the dental clinics after an occlusal restoration or extraction, having pain in or around the temporomandibular joint, headache or neck pain. Although their esthetic demands must not be undermined during the course of treatment plan, whenever dental treatment of any sort is planned, occlusion/bite should be given prime importance. Very few dentist are able to diagnose the occlusal disease and of those who diagnose many people resort to aggressive treatment modalities. This paper aims to report the signs of occlusal disease, and discuss their association with TMDs and posture.
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Affiliation(s)
- Mohd Toseef Khan
- Assistant Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Sanjeev Kumar Verma
- Associate Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Sandhya Maheshwari
- Professor and Head, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Syed Naved Zahid
- Assistant Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
| | - Prabhat K Chaudhary
- Assistant Professor, Department of Orthodontics, Dr. ZADCH, AMU, Aligarh, Uttar Pradesh, India
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Xie Q, Li X, Xu X. The difficult relationship between occlusal interferences and temporomandibular disorder - insights from animal and human experimental studies. J Oral Rehabil 2013; 40:279-95. [PMID: 23356664 DOI: 10.1111/joor.12034] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Q. Xie
- Department of Prosthodontics; Peking University School and Hospital of Stomatology; Beijing China
| | - X. Li
- Department of Prosthodontics; Peking University School and Hospital of Stomatology; Beijing China
| | - X. Xu
- Department of Prosthodontics; Peking University School and Hospital of Stomatology; Beijing China
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Nascimento MM, Vasconcelos BC, Porto GG, Ferdinanda G, Nogueira CM, Raimundo RDC. Physical therapy and anesthetic blockage for treating temporomandibular disorders: a clinical trial. Med Oral Patol Oral Cir Bucal 2013; 18:e81-5. [PMID: 23229236 PMCID: PMC3548651 DOI: 10.4317/medoral.17491] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 09/19/2011] [Indexed: 11/26/2022] Open
Abstract
Purpose: the aim of this study was to evaluate the use of physical therapy and anesthetic blockage of the auriculotemporal nerve as a treatment for temporomandibular joint disorders.
Methods: the sample comprised of twenty patients with a diagnosis of disc displacement with/ without reduction and arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Axis I Group IIa, IIb and IIIa). Ten patients (group 1) underwent a cycle of eight anesthetic blockages of the auriculotemporal nerve with injections (1 per week) of 1 ml of bupivacaine 0.5% without vasoconstrictor for 8 weeks. The other 10 patients (group 2) received anesthetic blockage and physical therapy (massage and muscular stretching exercises). After the end of treatment all patients were evaluated at baseline, 1st week, 4th week and 2 months. The t-Student and F (ANOVA) tests were used for statistical analysis, with a significance rate of 5%.
Results: there was a significant difference when both groups were compared according to VAS score (p=0.027). There was no significant difference for the other variables: MMO and jaw protrusion.
Conclusion: the anesthetic blockage and physical therapy, when used together, are effective in the reduction of pain in patients with TMD.
Key words:Temporomandibular joint disorders, physical therapy, physiotherapy and nerve block, local anesthetic, bupivacaine.
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Sipilä K, Näpänkangas R, Könönen M, Alanen P, Suominen AL. The role of dental loss and denture status on clinical signs of temporomandibular disorders. J Oral Rehabil 2012; 40:15-23. [DOI: 10.1111/j.1365-2842.2012.02345.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2012] [Indexed: 01/01/2023]
Affiliation(s)
- K Sipilä
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Oulu, Oulu, Finland.
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Abstract
The purpose of this article is to discuss the clinical considerations related to increasing the occlusal vertical dimension (OVD) when restoring a patient's dentition. Thorough extraoral and intraoral evaluations are mandatory to assess the suitability of increasing OVD. In the literature, multiple techniques have been proposed to quantify OVD loss. However, the techniques lack consistency and reliability, which in turn affects the decision of whether to increase the OVD. Therefore, increasing OVD should be determined on the basis of the dental restorative needs and aesthetic demands. In general, a minimal increase in OVD should be applied, though a 5 mm maximum increase in OVD can be justified to provide adequate occlusal space for the restorative material and to improve anterior teeth aesthetics. The literature reflects the safety of increasing the OVD permanently, and although signs and symptoms may develop, these are usually of an interim nature. Whenever indicated, the increase in OVD should be achieved with fixed restorations rather than a removable appliance, due to the predictable patient adaptation. The exception to this is for patients with TMD, where increasing the OVD should still be achieved using removable appliances to control TMD-associated symptoms before considering any form of irreversible procedure.
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Affiliation(s)
- J Abduo
- Faculty of Dentistry, The University of Western Australia, Crawley, Western Australia, Australia.
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Manfredini D, Castroflorio T, Perinetti G, Guarda-Nardini L. Dental occlusion, body posture and temporomandibular disorders: where we are now and where we are heading for. J Oral Rehabil 2012; 39:463-71. [PMID: 22435603 DOI: 10.1111/j.1365-2842.2012.02291.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this investigation was to perform a review of the literature dealing with the issue of relationships between dental occlusion, body posture and temporomandibular disorders (TMD). A search of the available literature was performed to determine what the current evidence is regarding: (i) The physiology of the dental occlusion-body posture relationship, (ii) The relationship of these two topics with TMD and (iii) The validity of the available clinical and instrumental devices (surface electromyography, kinesiography and postural platforms) to measure the dental occlusion-body posture-TMD relationship. The available posturographic techniques and devices have not consistently found any association between body posture and dental occlusion. This outcome is most likely due to the many compensation mechanisms occurring within the neuromuscular system regulating body balance. Furthermore, the literature shows that TMD are not often related to specific occlusal conditions, and they also do not have any detectable relationships with head and body posture. The use of clinical and instrumental approaches for assessing body posture is not supported by the wide majority of the literature, mainly because of wide variations in the measurable variables of posture. In conclusion, there is no evidence for the existence of a predictable relationship between occlusal and postural features, and it is clear that the presence of TMD pain is not related with the existence of measurable occluso-postural abnormalities. Therefore, the use instruments and techniques aiming to measure purported occlusal, electromyographic, kinesiographic or posturographic abnormalities cannot be justified in the evidence-based TMD practice.
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Affiliation(s)
- D Manfredini
- Department of Maxillofacial Surgery, TMD Clinic, University of Padova, Carrara, Italy.
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Suvinen TI, Reade PC, Kemppainen P, Könönen M, Dworkin SF. Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain 2012; 9:613-33. [PMID: 15978854 DOI: 10.1016/j.ejpain.2005.01.012] [Citation(s) in RCA: 258] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2004] [Accepted: 01/31/2005] [Indexed: 11/20/2022]
Abstract
Several studies have reported that musculoskeletal disorders of the stomatognathic system, commonly known as temporomandibular disorders (TMD) resemble musculoskeletal disorders and chronic pain disorders in general. There is also general consensus that combined biomedical and biopsychosocial methods best support the assessment and management of the cardinal features of TMD, i.e., pain and dysfunction or physical (peripheral) and psychosocial (central) factors. This overview of the aetiology of TMD will outline conceptualizations of past models and present the current view that patients with TMD should be assessed according to both the physical disorder and the psychosocial illness impact factors. The conceptual theories outlined in this review include biomedical models related to temporomandibular joints, muscles of mastication and occlusal factors, psychological models and the biopsychosocial models. An integrated and multidimensional approach concerning physical and psychosocial factors in temporomandibular pain and dysfunction is presented as an example of how the biopsychosocial model and information processing theory may apply in the conceptualization and management of TMD for various health care professionals.
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Abstract
It is the aim of this paper to give a few examples of dogmas related to prosthodontics and oral implants and to discuss the controversial role of occlusion in the aetiology of temporomandibular disorders. New knowledge is developing at a rapidly increasing rate in dentistry, as in other areas of society. Our lecturers at university taught us many useful things. But, as time goes by, what is still relevant? Some methods are so well established that they deserve to be called dogmas. It is implied that a dogma is not supported by strong evidence, even though it has existed and been practised for a long time. In the era of evidence-based dentistry it is appropriate to scrutinize such issues. A review of the current literature indicates that conflicting opinions exist concerning a number of common procedures in clinical dentistry, mainly due to a scarcity of good studies with unambiguous results. There is therefore a need for more high-quality clinical research in attempting to reach the goal of evidence-based clinical practice. The dental community should take an active part in this process.
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Affiliation(s)
- Gunnar E Carlsson
- Department of Prosthetic Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
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MANFREDINI D, BUCCI MB, MONTAGNA F, GUARDA-NARDINI L. Temporomandibular disorders assessment: medicolegal considerations in the evidence-based era. J Oral Rehabil 2010; 38:101-19. [DOI: 10.1111/j.1365-2842.2010.02131.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Goiato MC, Rosalino Garcia A, Dos Santos DM, Pesqueira AA. TMJ Vibrations in Asymptomatic Patients Using Old and New Complete Dentures. J Prosthodont 2010; 19:438-42. [DOI: 10.1111/j.1532-849x.2010.00614.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Vallon D, Nilner M. Undergraduates' and graduates' perception of achieved competencies in temporomandibular disorders and orofacial pain in a problem-based dental curriculum in Sweden. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2009; 13:240-247. [PMID: 19824961 DOI: 10.1111/j.1600-0579.2009.00583.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIMS Aims of this study were to assess undergraduates' and graduates' perceptions of their education by documenting their attitudes and investigating acquired competencies in temporomandibular disorders (TMD) and orofacial pain (OP). METHODS In 2006, 141 undergraduates (in semesters 1, 6, and 10 of a 5-year dental programme) and 60 graduates of 2000 and 2001 were invited to fill in questionnaires designed for their levels. The four questionnaires contained open-ended questions, closed-ended questions, and questions requiring a scaled response on an 11-point numerical rating scale (NRS). Questions covered personal experience of pain, attitudes toward TMD/OP, clinical competencies, and satisfaction with their education. Participants rated importance of and satisfaction with clinical competencies on a 5-point scale. RESULTS The importance of understanding TMD/OP patients was rated high (NRS 9-10) and attitudes to given statements about TMD/OP patients were positive. In general, perception of clinical competencies increased with level of education. Mean scores for importance of and satisfaction with clinical competencies of 10th semester undergraduates and graduates were above 4.0. Median graduate satisfaction with undergraduate education in TMD/OP patient management was high (NRS 9). All but one graduate had treated patients with TMD/OP. One-third of the responding graduates expressed a wish for additional training, such as in pharmacological treatment and evaluation of treatment outcome. CONCLUSION In general, the perception of acquired clinical competencies in TMD and OP increased with level of education, and the importance of, and satisfaction with, training was highly rated. Positive attitudes toward these kinds of patients were expressed at all levels.
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Affiliation(s)
- D Vallon
- Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden.
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Yokoyama M, Atsumi T, Tsuchiya M, Koyama S, Sasaki K. Dynamic changes in bone metabolism in the rat temporomandibular joint after molar extraction using bone scintigraphy. Eur J Oral Sci 2009; 117:374-9. [DOI: 10.1111/j.1600-0722.2009.00635.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
The purpose of this review was to evaluate the literature on the rehabilitation of tooth wear, with some pertinent historical, epidemiological and aetiological aspects of tooth wear provided as background information. In historical skull material, extensive tooth wear, assumed to be the result of coarser diets, was found even in relatively young individuals. Such wear is seldom seen in current populations. Although many of the factors associated with extensive tooth wear in historical material are no longer present or prevalent, new risk factors have emerged. In the young individual, the literature points to a global rise in soft drink consumption as the most significant factor in the development of tooth wear through dental erosion. Among older individuals, lifestyle changes and chronic diseases that are controlled with medications that may, in turn, result in regurgitation and/or dry mouth, are possible reasons amongst others for the widespread clinical impression of an increasing prevalence of tooth wear. The aetiology of tooth wear is multifactorial and the role of bruxism is not known. Clinical controlled trials of restorative and prosthodontic approaches for the range of clinical conditions that wear can give rise to, are limited in number and quality. Equally, the striking lack of evidence regarding the long-term outcomes of treatment methods and materials calls for caution in clinical decision-making. Notwithstanding these observations, clinicians have provided and continue to provide rehabilitative strategies for managing their patients' worn dentitions that range traditionally from extensive prosthodontics to an increasing reliance on adhesive techniques.
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Affiliation(s)
- A Johansson
- Department of Clinical Dentistry - Prosthodontics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
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Carlsson GE. Critical review of some dogmas in prosthodontics. J Prosthodont Res 2009; 53:3-10. [DOI: 10.1016/j.jpor.2008.08.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2008] [Accepted: 06/02/2008] [Indexed: 10/21/2022]
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Ikebe K, Hazeyama T, Iwase K, Sajima H, Gonda T, Maeda Y, Nokubi T. Association of symptomless TMJ sounds with occlusal force and masticatory performance in older adults. J Oral Rehabil 2008; 35:317-23. [PMID: 18405267 DOI: 10.1111/j.1365-2842.2007.01841.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K Ikebe
- Division of Oromaxillofacial Regeneration, Osaka University Graduate School of Dentistry, Osaka, Japan
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Al-Jabrah OA, Al-Shumailan YR. Prevalence of temporomandibular disorder signs in patients with complete versus partial dentures. Clin Oral Investig 2006; 10:167-73. [PMID: 16636843 DOI: 10.1007/s00784-006-0046-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2005] [Accepted: 04/03/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine the prevalence of signs of a temporomandibular disorder (TMD) in completely edentulous patients wearing upper and lower complete dentures (CD) and to compare this to the prevalence of signs in partially edentulous patients wearing upper and lower clasp-retained acrylic removable partial dentures (RPD). MATERIALS AND METHODS A questionnaire and a clinical examination were used to assess 200 patients. One hundred of these were complete denture wearers being treated for the provision of replacement CD. The other 100 patients were partially edentulous patients, who had RPD replacing upper and lower partially missing teeth and their supporting structures. RESULTS It was shown that there was a statistically significant difference between the two groups regarding the presence of temporomandibular signs. Partially edentulous patients wearing upper and lower RPD had a significantly higher prevalence of TMD signs than edentulous patients wearing CD (36% compared to 17%). They also exhibited significantly (P<0.04) more signs of joint tenderness (18%) on clinical examination compared to (5%) only in the CD-wearing patients. Tenderness upon palpation in the periauricular region was the most common site reported in both groups. CONCLUSIONS The partially edentulous patients (wearing RPD) exhibited more TMD signs when compared with the CD-wearing patients. Significantly, more partially edentulous patients had joint tenderness (P<0.04) than did CD-wearing patients. The masseter muscle most commonly demonstrated muscle tenderness.
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Affiliation(s)
- Osama A Al-Jabrah
- Department of Dentistry, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.
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Landi N, Manfredini D, Tognini F, Romagnoli M, Bosco M. Quantification of the relative risk of multiple occlusal variables for muscle disorders of the stomatognathic system. J Prosthet Dent 2004; 92:190-5. [PMID: 15295330 DOI: 10.1016/j.prosdent.2004.05.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
STATEMENT OF PROBLEM There is no consensus on the association between occlusion and temporomandibular disorders (TMD). PURPOSE The purpose of this study was to quantify the relative risk of multiple occlusal variables for muscle disorders of the stomatognathic system. MATERIAL AND METHODS Eight occlusal features: retruded contact position (RCP) to maximum intercuspation (MI) slide length, vertical overlap, horizontal overlap, unilateral posterior reverse articulation, anterior open occlusal relationship, incisor dental midline discrepancy, mediotrusive interferences, and laterotrusive interferences, were clinically assessed by the same trained operator. The sample consisted of 81 women with a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I diagnosis of muscle disorder, for example myofascial pain, with or without limited opening, and 48 healthy women (control group). A stepwise multiple logistic regression was used to identify the significant associations between occlusal features and disease. RESULTS A slide from the retruded contact position to maximum intercuspation > or =2 mm and mediotrusive interferences were the only 2 occlusal features significantly associated with the presence of myofascial pain according to the RDC/TMD criterion symptoms. The odds ratio for myofascial pain was 2.57 for a slide from RCP to MI > or =2 mm and 2.45 for mediotrusive interferences. The percentage of the total log likelihood for myofascial pain explained by the significant occlusal factors amounted to 10.8% (Nagelkerke's R2=0.108). The multifactorial model, including the 2 significant occlusal factors, showed an acuracy to predict disease of 66.7% (sensitivity 71.6%; specificity 58.3%). CONCLUSION Occlusal features showed a low predictive value to detect muscle disorders of the stomatognathic system. Multifactorial complex pathologies, such as TMD, should be studied using multivariate statistical analyses, as univariate models may overestimate some resulting associations.
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Affiliation(s)
- Nicola Landi
- Department of Neuroscience, Section of Prosthetic Dentistry, University of Pisa, Italy.
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Kapur N, Kamel IR, Herlich A. Oral and craniofacial pain: diagnosis, pathophysiology, and treatment. Int Anesthesiol Clin 2003; 41:115-50. [PMID: 12872029 DOI: 10.1097/00004311-200341030-00010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Neeraj Kapur
- Department of Anesthesiology, Temple University Hospital, Philadelphia, PA 19140, USA
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