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Zhu Y, Xu J, Zhang J, Wan Y, He Y, Lei J, Zhang Y, Yang C, Yang Y. Exercise therapy in postoperative patients with temporomandibular joint internal derangement: A systematic review. J Oral Rehabil 2024. [PMID: 38873746 DOI: 10.1111/joor.13780] [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: 01/29/2024] [Revised: 05/16/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Postoperative patients with temporomandibular joint internal derangement (ID) often have problems such as limited mouth opening and pain. Exercise therapy can be advantageous for improving the recovery of patients following surgery. However, there is continuing discussion on the precise aspects of the exercise program, including the optimal timing, length, intensity, and use of assistive equipment. Hence, this study aimed to incorporate pre-existing exercise treatment regimens and investigate their impact. METHODS Publications that detailed the clinical treatment of patients with temporomandibular joint ID who received postoperative exercise therapy interventions were included. Nine databases were searched until October 1st, 2023. The JBI critical appraisal tools were used to assess the methodological quality of the included studies. RESULTS Five studies were finally included for subsequent analysis; two were randomised controlled studies, and three were quasi-experimental. Exercises suitable for such patients encompass vertical, transverse, and horizontal stretching, among which vertical stretch can be divided into active and passive movements. The start time ranged from the first to the fifth week after surgery, with a duration of 1-6 months. Although the data in the studies could not be integrated and further analysed, preliminary results showed that maximum mouth opening and pain in patients improved significantly. The therapeutic effect of combining three exercise methods was best and was related to patient compliance. CONCLUSION Exercise therapy positively affects postoperative rehabilitation in patients with temporomandibular joint ID. It is proposed that targeted, comprehensive studies be conducted to provide a basis for designing more sophisticated exercise therapy regimens and further confirm its curative effect.
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Affiliation(s)
- Yongkang Zhu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Jiaqi Xu
- Nursing Department, Peking University Third Hospital, Beijing, People's Republic of China
| | - Jing Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Yifan Wan
- Franklin and Marshall College, Lancaster, Pennsylvania, USA
| | - Yang He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Jie Lei
- Center for TMD & Orofacial Pain, Department of Oral & Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology, Beijing, People's Republic of China
| | - Yi Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Chengfengyi Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Yue Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
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Multidisciplinary and Nonpharmacological Management of Pain in Temporomandibular Disorders (TMDs). Pain Res Manag 2022; 2022:3604386. [PMID: 36267665 PMCID: PMC9578907 DOI: 10.1155/2022/3604386] [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: 04/08/2022] [Revised: 08/06/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022]
Abstract
Temporomandibular joint dysfunction (TMD) is not a single diagnosis, but a term covering a group of conditions that involve pain and dysfunction of the masticatory muscles within the temporomandibular joint (TMJ) and associated structures. It is a set of disease entities comprising various ailments and clinical symptoms. One of the most distressing symptoms for TMD patients is pain. Pain is subjective and always unpleasant. The VAS (visual analogue scale) was used in this research. The aim of this study was to assess the influence of physical stimuli, namely extremely low frequency magnetic field (ELF-MF) and LED light, on the experience of pain caused by increased tension in the masticatory muscles in adults. Out of 150 people examined, 104 were enrolled in the study after meeting the eligibility criteria. The study group was divided into 4 subgroups. Each subgroup received physical therapy treatment using a different physical stimulus. The effects of four therapeutic modalities were compared. In terms of VAS scores, pain attenuation was observed in all subgroups. The study confirmed the analgesic effect of the selected physical therapy methods. The authors focused on the analysis of the results obtained for each subgroup, comparing the effects of individual modalities on pain intensity (according to VAS scores). After the treatment, pain relief was observed in each of the studied subgroups. Treatment using ELF-MF and ELF-MF in combination with LED light in the course of TMD brings about a significant improvement in the subjective pain experience expressed in VAS pain scores. The use of selected physical stimuli and their beneficial effect on pain symptoms during mandibular movements has important implications for patients' daily life and work. Incorporation of therapeutic methods can help enhance patient satisfaction and comfort during manual TMJ therapy and lengthy dental procedures.
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Use of Transcutaneous Electrical Nerve Stimulation (TENS) for the Recovery of Oral Function after Orthognathic Surgery. J Clin Med 2022; 11:jcm11123268. [PMID: 35743339 PMCID: PMC9225233 DOI: 10.3390/jcm11123268] [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: 03/03/2022] [Revised: 04/07/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
The oral functions of patients are markedly diminished immediately after orthognathic surgery, and novel approaches are needed to accelerate their recovery. The aim of this study was to examine the usefulness of weekly applications of transcutaneous electrical nerve stimulation (TENS) for this purpose, based on the evidence of its effectiveness in other types of patients with muscle alterations. Maximum jaw opening, bite force, pain, and facial inflammation were compared between patients receiving TENS and those receiving sham-TENS for 30 min at baseline and weekly over a four-week period after orthognathic surgery and were also compared between the before and after of each procedure. TENS was applied at 220 Hz, applying the maximum intensity tolerated by each individual patient. The TENS procedure was identical for all patients, but the device was not turned on in the sham-TENS group. Patients were blinded to their group membership. Results were analyzed separately in skeletal class II and III patients. Improvements in jaw opening and inflammation were significantly greater in the TENS than in the sham-TENS group, attributable to the muscle relaxation achieved with the procedure. Research is warranted on the benefits of a more frequent application of TENS.
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Postoperative Physiotherapy After Open Temporomandibular Joint Surgery: A 3-Step Program. J Oral Maxillofac Surg 2019; 77:932-950. [DOI: 10.1016/j.joms.2018.12.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 12/24/2018] [Accepted: 12/24/2018] [Indexed: 11/30/2022]
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Elgohary HM, Eladl HM, Soliman AH, Soliman ES. Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer. Ann Rehabil Med 2018; 42:846-853. [PMID: 30613078 PMCID: PMC6325320 DOI: 10.5535/arm.2018.42.6.846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/26/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC). METHODS Sixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks. RESULTS ANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05). CONCLUSION The LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.
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Affiliation(s)
- Hany Mohamed Elgohary
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hadaya Mosaad Eladl
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ashraf Hassan Soliman
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Faculty of Physical Therapy, Badr University in Cairo, Cairo, Egypt
| | - Elsadat Saad Soliman
- Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Surgical Versus Nonsurgical Management of Degenerative Joint Disease. Oral Maxillofac Surg Clin North Am 2018; 30:291-297. [DOI: 10.1016/j.coms.2018.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Comparison of two physiotherapy programmes for rehabilitation after temporomandibular joint arthroscopy. Int J Oral Maxillofac Surg 2018; 47:755-761. [DOI: 10.1016/j.ijom.2017.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 09/01/2017] [Accepted: 10/23/2017] [Indexed: 11/17/2022]
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Dentists' Awareness of Physical Therapy in the Treatment of Temporomandibular Disorders: A Preliminary Study. Pain Res Manag 2018; 2018:1563716. [PMID: 29682129 PMCID: PMC5851176 DOI: 10.1155/2018/1563716] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 11/30/2017] [Accepted: 12/18/2017] [Indexed: 01/19/2023]
Abstract
Background Physical therapy (PT) has been shown to be one of the most effective conservative treatments for temporomandibular disorders (TMD). Not all dentists are aware of the importance of the collaboration with physical therapists in the treatment of TMD pain. Objectives To determine the awareness of dentists in Florida about the importance of PT for TMD pain and to create awareness related to collaborations. Methods An online questionnaire was used. A contact list of dentists was obtained from the Florida Dental Association. The overall awareness and information on patient referral were presented per dentist specialty. Results A total of 256 dentists completed the survey. Prior to the survey, 41% of the dentists reported not aware that PTs can treat TMD patients. Oral surgeons and orthodontists were more aware about PT compared to other specialties. After the survey, 81% of the dentists were more likely to refer their TMD patients to PT, and 80% were interested to know more about the benefits of collaborations. Conclusion This study shows the lack of dentists' awareness in Florida about the benefits of PT for TMD treatment. This study increased the awareness of the surveyed dentists in Florida about the benefit from a multidisciplinary approach.
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Effect of an early supervised rehabilitation programme compared with home-based exercise after temporomandibular joint condylar discopexy: a randomized controlled trial. Int J Oral Maxillofac Surg 2017; 46:314-321. [DOI: 10.1016/j.ijom.2016.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 05/19/2016] [Accepted: 07/29/2016] [Indexed: 11/23/2022]
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Oh JS, Kim SH, Park KN. Effects of controlled condylar rotation exercise on symmetrical mouth opening in patients with temporomandibular disorder. J Phys Ther Sci 2015; 27:1319-21. [PMID: 26157210 PMCID: PMC4483388 DOI: 10.1589/jpts.27.1319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/11/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the effects of a 4-week program of
active condylar rotation exercise on the extent of the lateral mandibular shift during
mouth opening in patients with temporomandibular disorder. [Subjects and Methods] Patients
with temporomandibular disorder (n = 12; 7 men and 5 women) were recruited. The active
range of temporomandibular motion was recorded using 3-dimensional ultrasound-based motion
analysis. The paired t-test was used to assess changes in lateral mandibular shift before
and after active condylar rotation exercise. [Results] The degree of the lateral
mandibular shift during mouth opening and the mouth opening-lateral mandibular shift ratio
were significantly lower after active condylar rotation exercise than before the exercise.
[Conclusion] Active condylar rotation exercise may effectively reduce the degree of the
lateral mandibular shift during mouth opening to produce symmetrical mouth opening in
patients with mild temporomandibular disorder.
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Affiliation(s)
- Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
| | - Si-Hyun Kim
- Kinetic Ergocise Based on Movement Analysis Laboratory, Republic of Korea
| | - Kyue-Nam Park
- Department of Physical Therapy, College of Medical Science, Jeonju University, Republic of Korea
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Calixtre LB, Moreira RFC, Franchini GH, Alburquerque-Sendín F, Oliveira AB. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil 2015; 42:847-61. [PMID: 26059857 DOI: 10.1111/joor.12321] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 01/24/2023]
Abstract
There is a lack of knowledge about the effectiveness of manual therapy (MT) on subjects with temporomandibular disorders (TMD). The aim of this systematic review is to synthetise evidence regarding the isolated effect of MT in improving maximum mouth opening (MMO) and pain in subjects with signs and symptoms of TMD. MEDLINE(®) , Cochrane, Web of Science, SciELO and EMBASE(™) electronic databases were consulted, searching for randomised controlled trials applying MT for TMD compared to other intervention, no intervention or placebo. Two authors independently extracted data, PEDro scale was used to assess risk of bias, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) was applied to synthetise overall quality of the body of evidence. Treatment effect size was calculated for pain, MMO and pressure pain threshold (PPT). Eight trials were included, seven of high methodological quality. Myofascial release and massage techniques applied on the masticatory muscles are more effective than control (low to moderate evidence) but as effective as toxin botulinum injections (moderate evidence). Upper cervical spine thrust manipulation or mobilisation techniques are more effective than control (low to high evidence), while thoracic manipulations are not. There is moderate-to-high evidence that MT techniques protocols are effective. The methodological heterogeneity across trials protocols frequently contributed to decrease quality of evidence. In conclusion, there is widely varying evidence that MT improves pain, MMO and PPT in subjects with TMD signs and symptoms, depending on the technique. Further studies should consider using standardised evaluations and better study designs to strengthen clinical relevance.
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Affiliation(s)
- L B Calixtre
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - R F C Moreira
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - G H Franchini
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | | | - A B Oliveira
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
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Teng TTY, Ko EWC, Huang CS, Chen YR. The Effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for Class III correction: Part I—Jaw-motion analysis. J Craniomaxillofac Surg 2015; 43:131-7. [DOI: 10.1016/j.jcms.2014.10.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/01/2014] [Accepted: 10/22/2014] [Indexed: 11/29/2022] Open
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Ahmad ZH, Ravikumar H, Karale R, Preethanath RS, Sukumaran A. Study of the anesthetic efficacy of inferior alveolar nerve block using articaine in irreversible pulpitis. J Contemp Dent Pract 2014; 15:71-4. [PMID: 24939268 DOI: 10.5005/jp-journals-10024-1190] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The purpose of this study was to determine the anesthetic efficacy of inferior alveolar nerve block (IANB) using 4% articaine and 2% lidocaine supplemented with buccal infiltration. MATERIALS AND METHODS Forty five patients, diagnosed with irreversible pulpitis of a mandibular posterior tooth were included in the study. The first group of 15 patients received 2% lidocaine with 1:200000 epinephrine, the second group 2% lidocaine with 1: 80,000 epinephrine and the third group of 15 subjects received 4% articaine with 1:100000 epinephrine. During the access cavity preparation those patients who complained of pain received an additional buccal infiltration. The percentage of subjects who got profound anesthesia and failure to achieve anesthesia were calculated and tabulated using a visual analog scale. RESULTS The results revealed that 87% of subjects who received 4% Articaine with 1:100,000 epinephrine got satisfactory anesthesia with inferior alveolar nerve block alone. Only 2 (13%) subjects received an additional buccal infiltration and none of the patients failed to obtain complete anesthesia with articaine. In comparison only 40% of subjects got complete anesthesia with 2% lidocaine with 1:200000 and 60% with 2% lidocaine with 1:80,000. CONCLUSION It can be concluded that 4% articaine can be used effectively for obtaining profound anesthesia for endodontic procedures in patients with irreversible pulpitis.
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Affiliation(s)
- Zeeshan H Ahmad
- Assistant Consultant, King Saud University Medical City, Riyadh, Saudi Arabia
| | - H Ravikumar
- Professor, Department of Oral Surgery, Triveni Dental College and Research Centre, Bilaspur, Chhattisgarh, India
| | - Rupali Karale
- Reader, Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India
| | - R S Preethanath
- Lecturer, Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Anil Sukumaran
- Professor, Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Oh DW, Kang TW, Kim SJ. Effect of stomatognathic alignment exercise on temporomandibular joint function and swallowing function of stroke patients with limited mouth opening. J Phys Ther Sci 2013; 25:1325-9. [PMID: 24259786 PMCID: PMC3820193 DOI: 10.1589/jpts.25.1325] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 05/29/2013] [Indexed: 12/20/2022] Open
Abstract
[Purpose] This study investigated the effects of stomatognathic alignment exercise on
temporomandibular joint function and swallowing function of stroke patients presenting
limited mouth opening. [Subjects] Fourteen subjects with post-stroke hemiparesis
presenting limited mouth opening were randomly assigned to either the experimental group
or the control group, with 7 subjects in each group. [Methods] Subjects in the
experimental group participated in a stomatognathic alignment exercise program that
consisted of mobility exercises of the TMJ and neck and postural correction. Main outcome
measures were neck mobility, the active maximum range of mouth opening, the
craniomandibular index (CMI), and the Mann assessment of swallowing ability (MASA) score.
[Results] The changes in the values of the range of mouth opening, CMI, MASA, and all the
parameters of neck mobility were significantly different between the groups. Furthermore,
post-test values appeared to be significantly different for the range of mouth opening,
the craniomandibular index, and the MASA scores between the groups (p>0.05).
[Conclusion] Stomatognathic alignment exercise may improve TMJ function and swallowing
function of patients with post-stroke hemiparesis.
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Affiliation(s)
- Duck-Won Oh
- Department of Physical Therapy, College of Health Science, Cheongju University, Republic of Korea
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Abstract
Facial gunshot wounds pose a challenge for head and neck surgeons as it is usually accompanied by significant soft and bone tissue loss and impairment of the stomatognathic system. This article reports the case of a patient who had sustained facial gunshot wound and had the projectile lodged at the upper disk space of the right-side temporomandibular joint, which caused mandible function impairment and pain. The projectile was surgically removed via endaural access, and the patient was later submitted to physiotherapy. After treatment, the function of the joint was reestablished, the pain disappeared, and the aesthetics results were considered excellent, with no sequels. The surgical removal of the projectile of the temporomandibular joint combined with the postsurgical physiotherapy showed to be an efficient treatment to the present case.
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Mercuri LG. Osteoarthritis, Osteoarthrosis, and Idiopathic Condylar Resorption. Oral Maxillofac Surg Clin North Am 2008; 20:169-83, v-vi. [DOI: 10.1016/j.coms.2007.12.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Sato S, Kawamura H. Evaluation of mouth opening exercise after pumping of the temporomandibular joint in patients with nonreducing disc displacement. J Oral Maxillofac Surg 2008; 66:436-40. [PMID: 18280374 DOI: 10.1016/j.joms.2007.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Accepted: 09/04/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to investigate whether an additional mouth opening exercise contributes to better outcome in patients with nonreducing disc displacement who underwent pumping of the temporomandibular joint (TMJ). PATIENTS AND METHODS Twenty-three female patients with nonreducing disc displacement of the TMJ underwent pumping of the TMJ and did mouth opening exercise after this treatment (rehabilitation group). Thirty-six female patients with nonreducing disc displacement of the TMJ underwent pumping of the TMJ, but did not do mouth opening exercise (non-rehabilitation group). Patients' signs and symptoms were examined monthly. Clinical evaluation was conducted according to the criteria presented by the 1995 American Association of Oral and Maxillofacial Surgeons. Outcomes were compared between the 2 groups at 12-month follow-up. Chi-square tests were used to assess the difference in good resolution rate between the 2 groups. When significant difference was not found, a non-inferiority test (Delta = 0.1) was used. Level of significance was set on P values less than .05. RESULTS In both groups, clinical signs and symptoms improved. There was a good resolution rate of 60.9% in the rehabilitation group and 75% in the non-rehabilitation group. No significant difference was observed between the 2 groups. The non-inferiority test showed that the good resolution rate of the non-rehabilitation group was significantly equivalent or more to that of the rehabilitation group (P < .05). CONCLUSIONS Mouth opening exercise did not seem to contribute to better outcomes in patients with nonreducing disc displacement who underwent pumping of the TMJ.
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Affiliation(s)
- Shuichi Sato
- Division of Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, Sendai, Japan.
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Mannheimer JS. Limited evidence to support the use of physical therapy for temporomandibular disorder. How effective are physical therapy interventions in the management of temporomandibular disorder? Evid Based Dent 2007; 8:110-111. [PMID: 18158547 DOI: 10.1038/sj.ebd.6400528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Jeffrey S Mannheimer
- Department of Rehabilitation Medicine. College of Physicians and Surgeons, Columbia University, New York, USA
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