1
|
Harhoff AC, Pohl T, Loibl C, Adler W, Süßenbach-Mädl M, Ries J, Seidel A, Wichmann M, Matta RE. Impact of manual therapy on body posture-3-D analysis with rasterstereography - pilotstudy. Head Face Med 2024; 20:49. [PMID: 39272140 PMCID: PMC11395571 DOI: 10.1186/s13005-024-00450-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
INTRODUCTION The relationship between posture and temporomandibular disease (TMD) is unclear. The aim of our study was to determine the influence of manual therapy (MT) on posture in TMD patients compared with healthy subjects. MATERIAL/METHOD After consideration of inclusion and exclusion criteria, 30 subjects were included. These were divided into two groups: group A comprised 15 healthy subjects and group B 15 patients with present proven TMD disease. Rasterstereographic images were taken at different times. Group A subjects were scanned twice within half a year and group B before initiation as well as after the first MT and after completion of the prescribed MT. The different posture variables were calculated using DIERS Formetric software. RESULTS To illustrate the differences between the two groups, 10 different postural variables were examined. Significant differences between the two groups were observed in pelvic tilt, surface rotation, and kyphotic apex. Pelvic tilt: mean = 7.581, p-value = 0.029; surface rotation: mean = 3.098, p = 0.049; and mean kyphotic apex = 11.538 and 11.946, respectively, with p-values of 0.037 and 0.029, respectively. CONCLUSION MT leads to a change in posture in TMD patients. This could influence the course of TMD treatment.
Collapse
Affiliation(s)
- Alessia Celine Harhoff
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, Erlangen, 91054, Germany, Province Bavaria
| | - Tobias Pohl
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, Erlangen, 91054, Germany, Province Bavaria
| | - Christine Loibl
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, Erlangen, 91054, Germany, Province Bavaria
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University of Erlangen, Waldstrasse 6, Erlangen, 91054, Germany
| | - Martin Süßenbach-Mädl
- Physiotherapy Praxis Ganzheitliche Physiotherapie, Bismarkstrasse 26, Erlangen, 91054, Germany
| | - Johannes Ries
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, Erlangen, 91054, Germany, Province Bavaria
| | - Anna Seidel
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, Erlangen, 91054, Germany, Province Bavaria
| | - Manfred Wichmann
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, Erlangen, 91054, Germany, Province Bavaria
| | - Ragai-Edward Matta
- Department of Prosthodontics, Erlangen University Hospital, Glueckstrasse 11, Erlangen, 91054, Germany, Province Bavaria.
| |
Collapse
|
2
|
Al Turkestani N, Li T, Bianchi J, Gurgel M, Prieto J, Shah H, Benavides E, Soki F, Mishina Y, Fontana M, Rao A, Zhu H, Cevidanes L. A comprehensive patient-specific prediction model for temporomandibular joint osteoarthritis progression. Proc Natl Acad Sci U S A 2024; 121:e2306132121. [PMID: 38346188 PMCID: PMC10895339 DOI: 10.1073/pnas.2306132121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Temporomandibular joint osteoarthritis (TMJ OA) is a prevalent degenerative disease characterized by chronic pain and impaired jaw function. The complexity of TMJ OA has hindered the development of prognostic tools, posing a significant challenge in timely, patient-specific management. Addressing this gap, our research employs a comprehensive, multidimensional approach to advance TMJ OA prognostication. We conducted a prospective study with 106 subjects, 74 of whom were followed up after 2 to 3 y of conservative treatment. Central to our methodology is the development of an innovative, open-source predictive modeling framework, the Ensemble via Hierarchical Predictions through Nested cross-validation tool (EHPN). This framework synergistically integrates 18 feature selection, statistical, and machine learning methods to yield an accuracy of 0.87, with an area under the ROC curve of 0.72 and an F1 score of 0.82. Our study, beyond technical advancements, emphasizes the global impact of TMJ OA, recognizing its unique demographic occurrence. We highlight key factors influencing TMJ OA progression. Using SHAP analysis, we identified personalized prognostic predictors: lower values of headache, lower back pain, restless sleep, condyle high gray level-GL-run emphasis, articular fossa GL nonuniformity, and long-run low GL emphasis; and higher values of superior joint space, mouth opening, saliva Vascular-endothelium-growth-factor, Matrix-metalloproteinase-7, serum Epithelial-neutrophil-activating-peptide, and age indicate recovery likelihood. Our multidimensional and multimodal EHPN tool enhances clinicians' decision-making, offering a transformative translational infrastructure. The EHPN model stands as a significant contribution to precision medicine, offering a paradigm shift in the management of temporomandibular disorders and potentially influencing broader applications in personalized healthcare.
Collapse
Affiliation(s)
- Najla Al Turkestani
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah21589, Saudi Arabia
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| | - Tengfei Li
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC27599
| | - Jonas Bianchi
- Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA94103
| | - Marcela Gurgel
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| | - Juan Prieto
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC27599
| | - Hina Shah
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC27599
| | - Erika Benavides
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| | - Fabiana Soki
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| | - Yuji Mishina
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| | - Arvind Rao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI48109
- Department of Computational Medicine & Bioinformatics, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| | - Hongtu Zhu
- Department of Radiology and Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC27599
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI48109
| |
Collapse
|
3
|
Nayak MM, Shyam Krishnan K, D'souza MC, Rao SS, Makwana VR. Thermal ultrasound, manipulation and exercise on pain and mouth opening in Chronic temporomandibular joint disorder. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 27:e1934. [PMID: 34981596 DOI: 10.1002/pri.1934] [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: 07/29/2021] [Revised: 11/07/2021] [Accepted: 12/10/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND A 60-year-old female patient reported with a chief complaint of pain in bilateral temporomandibular joints (TMJ) region since 11/2 years. The pain was initially reported to be insidious in onset, moderate in intensity, aggravated on chewing food and during excessive mouth opening. On examination her mouth opening was found to be less than 8 mm and standard head and neck examination showed grade 2 tenderness with swelling on bilateral TMJ and forward neck posture with rounded shoulders. The patient reported her pain to be 6 at rest in NPRS (with 0 being no pain and 10 being maximum) and 8 out of 10 on mouth opening. METHODOLOGY/MANAGEMENT A 4-week Physiotherapy Intervention program, which consisted of Ultrasound Therapy at varying intensity, TMJ manipulation, Cervical Range of Motion Exercises and Manual Cervical traction was administered. Repeated evaluation of pain and other functional outcomes were done on a weekly basis. RESULTS There was significant improvement in her mouth opening (41 mm), restoration of masticatory functions, complete resolution of pain and overall improvement in quality of life after the 4 weeks intervention program. CONCLUSION A structured Physiotherapy intervention program consisting of Non-thermal Ultrasound, Manipulation and exercise targeting TMJ and Upper quarter, proved to be highly effective in increasing functions and reducing signs and symptoms in Chronic TMJ Dysfunction which can be highly disabling. The recovery observed in this patient, who was not on any standard treatment for almost 18 months, hence the severe limitations she encountered, is a testament to the need of designing individualized treatment protocols addressing the many facets of impairment in TMJ Disorders.
Collapse
Affiliation(s)
- Megha M Nayak
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - K Shyam Krishnan
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Molly Cynthia D'souza
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Suchita S Rao
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Vrunda R Makwana
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
4
|
Govind A, Ploussard D, Hoffman S, Zhang Z, Wu Y. Medicare coverage patterns favor non-invasive and minimally-invasive treatments of knee osteoarthritis compared to temporomandibular joint osteoarthritis. Cranio 2020; 41:144-150. [PMID: 32991257 DOI: 10.1080/08869634.2020.1826174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare Medicare coverage patterns for treatments of knee osteoarthritis (OA) to those of temporomandibular joint (TMJ) OA. METHODS The International Classification of Diseases (ICD)-10 codes were used to identify knee OA, TMJ OA, and related diagnoses. The AAPC Coder was utilized to search for Medicare insurance coverage by state/district for the indicated CPT codes. The coverage for treatments of TMJ OA and knee OA was analyzed by Fisher's exact test. RESULTS There was a statistically significant difference in the coverage of physical therapy, massage therapy, and arthrocentesis for TMJ OA and knee OA. The current study showed that arthrocentesis was covered 100% in all states/districts for knee OA and 0% for TMJ OA. CONCLUSION Medicare covers TMJ OA treatments to a lesser degree than knee treatments. Documentation of this discrepancy serves as an important first step in advocating for improvements in coverage, and subsequently, in access to care.
Collapse
Affiliation(s)
- Akshay Govind
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Danielle Ploussard
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Sydney Hoffman
- Dental Student, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Zhenzhen Zhang
- Knight Cancer Institute, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Ying Wu
- Department of Integrative Biomedical and Diagnostic Sciences, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
5
|
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]
|
6
|
Shaffer SM, Stuhr SH, Sizer PS, Courtney CA, Brismée JM. The status of temporomandibular and cervical spine education in post-professional physical therapy training programs recognized by Member Organizations of IFOMPT: an investigation of didactic and clinical education. J Man Manip Ther 2018; 26:102-108. [PMID: 29686484 DOI: 10.1080/10669817.2017.1422614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Objectives The purpose of this investigation was to establish an international baseline of the quantity of physical therapist education on temporomandibular disorders (TMD) during post-professional Orthopedic Manual Physical Therapy (OMPT) education. Methods An electronically distributed survey was sent to programs and data analyzed for trends, including a comparison of TMD and cervical spine disorders education. Current data were compared to pre-existing data from the United States. Results For the current data-set, the Mann-Whitney U test demonstrated statistical significance when comparing TMD and cervical spine disorders education for both the hours of didactic training provided (p < 0.0001) and the number of patients seen during clinical training (p < 0.006). When comparing the United States and international data, statistically significant greater exposure was reported for both didactic (p < 0.0001) and clinical education (p < 0.006) of TMD topics in the United States but not for didactic (p = 0.23) or clinical education (p = 0.15) of cervical spine topics. Discussion These data again indicate a lack of uniformity between post-professional training programs in OMPT with respect to TMD education. There is, however, consistency in that most programs provided more training on cervical spine disorders than TMD. Based on these findings, further investigations are appropriate to determine if TMD education is adequate during post-professional OMPT education.
Collapse
Affiliation(s)
- Stephen M Shaffer
- Program in Physical Therapy, Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Sarah H Stuhr
- School of Physical Therapy, College of Health Professions, Pacific University, Hillsboro, OR, USA
| | - Phillip S Sizer
- Program in Physical Therapy, Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Carol A Courtney
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Jean-Michel Brismée
- Program in Physical Therapy, Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| |
Collapse
|
7
|
Grondin F, Hall T. Changes in cervical movement impairment and pain following orofacial treatment in patients with chronic arthralgic temporomandibular disorder with pain: A prospective case series. Physiother Theory Pract 2016; 33:52-61. [PMID: 27911133 DOI: 10.1080/09593985.2016.1247934] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to investigate the influence of isolated temporomandibular joint (TMJ) manual therapy on pain and range of motion (ROM) of the TMJ and cervical spine including flexion-rotation test (FRT) in people suffering chronic pain arising from chronic arthralgic temporomandibular disorder (TMD). An experienced clinician managed a case series of 12 patients with TMD (mean duration 28.6 months +/- 26.9). The intervention comprised four-weekly sessions of transverse medial accessory TMJ mobilization and advice. Patients were examined prior to and one-week following the intervention period. Outcome measures included jaw disability (JFLS-20), jaw pain measured by Visual Analogue Scale (VAS), maximal mouth opening ROM, cervical ROM including FRT, and pain during cervical movement. A paired t-test revealed significant improvement following the intervention in disability (p < 0.001), VAS pain score at rest (p < 0.001) and at maximum mouth opening (p < 0.001), jaw opening ROM (p < 0.001), FRT ROM to the left (p = 0.024) and right (p = 0.001). In contrast, no significant change was identified for total cervical ROM (p = 0.905). After the intervention, five patients (41.66%) had no pain at rest or at maximal mouth opening, and all had a negative FRT. The effect sizes indicate a moderate to strong, clinically significant effect for all variables apart from total cervical ROM. While a case series cannot identify a cause and effect relationship, these results provide preliminary evidence for the influence of TMJ manual therapy on measures of TMD including pain, as well as upper but not whole cervical movement and associated pain in patients with a diagnosis of TMJ arthralgia.
Collapse
Affiliation(s)
- Francis Grondin
- a Laboratory of Anatomy , Bordeaux University , Bordeaux Cedex, France
| | - Toby Hall
- b School of Physiotherapy and Exercise Science , Curtin University of Technology , Perth , WA , Australia
| |
Collapse
|
8
|
Shaffer SM, Brismée JM, Sizer PS, Courtney CA. Temporomandibular disorders. Part 2: conservative management. J Man Manip Ther 2014; 22:13-23. [PMID: 24976744 DOI: 10.1179/2042618613y.0000000061] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables.
Collapse
Affiliation(s)
- Stephen M Shaffer
- Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, USA
| | - Phillip S Sizer
- Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, USA
| | - Carol A Courtney
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, USA
| |
Collapse
|
9
|
Brantingham JW, Cassa TK, Bonnefin D, Pribicevic M, Robb A, Pollard H, Tong V, Korporaal C. Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review. J Manipulative Physiol Ther 2013; 36:143-201. [PMID: 23697915 DOI: 10.1016/j.jmpt.2013.04.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 02/09/2013] [Accepted: 02/20/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The purpose of this study was to complete a systematic review of manual and manipulative therapy (MMT) for common upper extremity pain and disorders including the temporomandibular joint (TMJ). METHODS A literature search was conducted using the Cumulative Index of Nursing Allied Health Literature, PubMed, Manual, Alternative, and Natural Therapy Index System (MANTIS), Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, Google Scholar, and hand search inclusive of literature from January 1983 to March 5, 2012. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, and physical therapies. Inclusion criteria required an extremity peripheral diagnosis (for upper extremity problems including the elbow, wrist, hand, finger and the (upper quadrant) temporomandibular joint) and MMT with or without multimodal therapy. Studies were assessed using the PEDro scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring was complete, evidence grades of "A, B, C and I" were applied. RESULTS Out of 764 citations reviewed, 129 studies were deemed possibly to probably useful and/or relevant to develop expert consensus. Out of 81 randomized controlled or clinical trials, 35 were included. Five controlled or clinical trials were located and 4 were included. Fifty case series, reports and/or single-group pre-test post-test prospective case series were located with 32 included. There is Fair (B) level of evidence for MMT to specific joints and the full kinetic chain combined generally with exercise and/or multimodal therapy for lateral epicondylopathy, carpal tunnel syndrome, and temporomandibular joint disorders, in the short term. CONCLUSION The information from this study will help guide practitioners in the use of MMT, soft tissue technique, exercise, and/or multimodal therapy for the treatment of a variety of upper extremity complaints in the context of the hierarchy of published and available evidence.
Collapse
|
10
|
de Souza RF, Lovato da Silva CH, Nasser M, Fedorowicz Z, Al-Muharraqi MA. Interventions for the management of temporomandibular joint osteoarthritis. Cochrane Database Syst Rev 2012; 2012:CD007261. [PMID: 22513948 PMCID: PMC6513203 DOI: 10.1002/14651858.cd007261.pub2] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is the most common form of arthritis of the temporomandibular joint (TMJ), and can often lead to severe pain in the orofacial region. Management options for TMJ OA include reassurance, occlusal appliances, physical therapy, medication in addition to several surgical modalities. OBJECTIVES To investigate the effects of different surgical and non-surgical therapeutic options for the management of TMJ OA in adult patients. SEARCH METHODS We searched the following databases: the Cochrane Oral Health Group Trials Register (to 26 September 2011); CENTRAL (The Cochrane Library 2011, Issue 3); MEDLINE via OVID (1950 to 26 September 2011); EMBASE via OVID (1980 to 26 September 2011); and PEDro (1929 to 26 September 2011). There were no language restrictions. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing any form of non-surgical or surgical therapy for TMJ OA in adults over the age of 18 with clinical and/or radiological diagnosis of TMJ OA according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guideline or compatible criteria.Primary outcomes considered were pain/tenderness/discomfort in the TMJs or jaw muscles, self assessed range of mandibular movement and TMJ sounds. Secondary outcomes included the measurement of quality of life or patient satisfaction evaluated with a validated questionnaire, morphological changes of the TMJs assessed by imaging, TMJ sounds assessed by auscultation and any adverse effects. DATA COLLECTION AND ANALYSIS Two review authors screened and extracted information and data from, and independently assessed the risk of bias in the included trials. MAIN RESULTS Although three RCTs were included in this review, pooling of data in a meta-analysis was not possible due to wide clinical diversity between the studies. The reports indicate a not dissimilar degree of effectiveness with intra-articular injections consisting of either sodium hyaluronate or corticosteroid preparations, and an equivalent pain reduction with diclofenac sodium as compared with occlusal splints. Glucosamine appeared to be just as effective as ibuprofen for the management of TMJ OA. AUTHORS' CONCLUSIONS In view of the paucity of high level evidence for the effectiveness of interventions for the management of TMJ OA, small parallel group RCTs which include participants with a clear diagnosis of TMJ OA should be encouraged and especially studies evaluating some of the possible surgical interventions.
Collapse
Affiliation(s)
- Raphael Freitas de Souza
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto,
| | | | | | | | | |
Collapse
|
11
|
Maluf SA, Moreno BGD, Alfredo PP, Marques AP, Rodrigues G. Exercícios terapêuticos nas desordens temporomandibulares: uma revisão de literatura. FISIOTERAPIA E PESQUISA 2008. [DOI: 10.1590/s1809-29502008000400016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A articulação temporomandibular faz parte do sistema estomatognático que, junto com os dentes, periodonto, coluna cervical, crânio e cintura escapular, é responsável pela mastigação, fonação, deglutição, respiração e expressão facial. Exercícios terapêuticos têm sido empregados na reabilitação e prevenção das disfunções temporomandibulares (DTM). Este estudo teve como objetivo revisar a literatura a respeito, verificando a eficácia dos exercícios terapêuticos nas DTM. Foram examinados periódicos do período entre 1991 e agosto de 2008, nas bases de dados Medline, Lilacs e Pubmed, utilizando as palavras-chave "desordem temporomandibular", "terapia por exercícios" e as correspondentes em inglês. Foram selecionados relatos de caso, artigos de revisão e ensaios clínicos com mais de 20 pacientes, num total de 53 artigos. A maioria relatou efeitos positivos na redução da dor, melhora da mobilidade e dos aspectos psicológicos, sugerindo que os exercícios podem contribuir no tratamento da DTM. Entretanto, o tipo, tempo de duração, número de repetições, freqüência e intensidade dos exercícios não está bem descrita. A falta de padronização das pesquisas, bem como da forma de avaliar, dificultam a comparação dos resultados. Mais estudos com métodos padronizados devem ser estimulados.
Collapse
|
12
|
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]
|
13
|
Tanaka E, Detamore M, Mercuri L. Degenerative Disorders of the Temporomandibular Joint: Etiology, Diagnosis, and Treatment. J Dent Res 2008; 87:296-307. [DOI: 10.1177/154405910808700406] [Citation(s) in RCA: 470] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Temporomandibular joint (TMJ) disorders have complex and sometimes controversial etiologies. Also, under similar circumstances, one person’s TMJ may appear to deteriorate, while another’s does not. However, once degenerative changes start in the TMJ, this pathology can be crippling, leading to a variety of morphological and functional deformities. Primarily, TMJ disorders have a non-inflammatory origin. The pathological process is characterized by deterioration and abrasion of articular cartilage and local thickening. These changes are accompanied by the superimposition of secondary inflammatory changes. Therefore, appreciating the pathophysiology of the TMJ degenerative disorders is important to an understanding of the etiology, diagnosis, and treatment of internal derangement and osteoarthrosis of the TMJ. The degenerative changes in the TMJ are believed to result from dysfunctional remodeling, due to a decreased host-adaptive capacity of the articulating surfaces and/or functional overloading of the joint that exceeds the normal adaptive capacity. This paper reviews etiologies that involve biomechanical and biochemical factors associated with functional overloading of the joint and the clinical, radiographic, and biochemical findings important in the diagnosis of TMJ-osteoarthrosis. In addition, non-invasive and invasive modalities utilized in TMJ-osteoarthrosis management, and the possibility of tissue engineering, are discussed.
Collapse
Affiliation(s)
- E. Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, The University of Tokushima Graduate School of Oral Sciences, 3-18-15 Kuramoto-cho, Tokushima 770-8504, Japan
- Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, KS, USA; and
- Department of Surgery, Division of Oral and Maxillofacial Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - M.S. Detamore
- Department of Orthodontics and Dentofacial Orthopedics, The University of Tokushima Graduate School of Oral Sciences, 3-18-15 Kuramoto-cho, Tokushima 770-8504, Japan
- Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, KS, USA; and
- Department of Surgery, Division of Oral and Maxillofacial Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - L.G. Mercuri
- Department of Orthodontics and Dentofacial Orthopedics, The University of Tokushima Graduate School of Oral Sciences, 3-18-15 Kuramoto-cho, Tokushima 770-8504, Japan
- Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, KS, USA; and
- Department of Surgery, Division of Oral and Maxillofacial Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
| |
Collapse
|
14
|
Klobas L, Axelsson S, Tegelberg A. Effect of therapeutic jaw exercise on temporomandibular disorders in individuals with chronic whiplash-associated disorders. Acta Odontol Scand 2006; 64:341-7. [PMID: 17123910 DOI: 10.1080/00016350600825310] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of a specific therapeutic jaw exercise on the temporomandibular disorders of patients with chronic whiplash-associated disorders. MATERIAL AND METHODS Ninety-four consecutive patients with whiplash-related conditions were referred to and accepted for a treatment period at a center for functional evaluation and rehabilitation during 2001-2002. The patients followed a program of physical therapy, occupational therapy, and pain management. At the start of their stay, they were examined by a physician specialized in rehabilitation medicine and also by a dentist who performed a functional examination of the stomatognathic system. Of the 93 patients who accepted participation in the study, 55 were diagnosed with temporomandibular disorders and chronic whiplash-associated disorders in accordance with the inclusion criteria. They were randomized into a jaw exercise group (n = 25), who performed specific therapeutic jaw exercises, and a control group (n = 30). Both groups undertook the whiplash rehabilitation program at the center. RESULTS There were no inter- or intra-group differences in symptoms and signs of temporomandibular disorders at baseline, nor at the 3-week and 6-month follow-ups, except for an increase of maximum active mouth-opening capacity in the control group. CONCLUSIONS In conclusion, the therapeutic jaw exercises, in addition to the regular whiplash rehabilitation program, did not reduce symptoms and signs of temporomandibular disorders in patients with chronic whiplash-associated disorders.
Collapse
Affiliation(s)
- Luciano Klobas
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
| | | | | |
Collapse
|