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Al-Hadad SA, Ahmed MMS, Zhao Y, Wang L, Hu W, Li C, Chen X, Alhammadi MS. Skeletal, dentoalveolar and soft tissue changes after stabilization splint treatment for patients with temporomandibular joint disorders. BMC Oral Health 2024; 24:479. [PMID: 38643111 PMCID: PMC11032605 DOI: 10.1186/s12903-024-04260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/15/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Temporomandibular disorder (TMD) is a grouping of heterogeneous disorders with multifactorial origins. Stabilization splints (SS) have demonstrated an acceptable treatment effect in TMD. The possible changes at the skeletal, dental, and soft tissue levels need to be addressed to evaluate the benefit/risk ratio of this therapeutic procedure. Accordingly, this study aimed to three‑dimensionally evaluate skeletal, dentoalveolar and soft tissue changes after SS treatment for patients with TMD. METHODS This retrospective study included 74 adult patients with myofascial and/or intra-articular disorders (25 males and 49 females), with an average age of 22.88 ± 4.8 years, who underwent SS treatment. Pre- and post-treatment Cone beam computed tomography were analysed using Invivo 6.0.3 software. The primary outcome was the vertical skeletal and dentoalveolar changes, while the secondary outcomes were the anteroposterior skeletal, dentoalveolar and soft tissue changes. Paired t-test and Wilcoxon rank sum test were used for statistical analyses. RESULTS For the primary outcome; skeletally, there was a significant increase in mandibular plane inclination (difference: 0.82°±1.37), decrease facial height ratio (difference: 0.45%±1.07) and at the dentoalveolar level, the inclination of the functional (FOP-SN, FOP-FH) and bisecting (BOP-SN, BOP-FH) occlusal planes exhibited a significant increase too (difference: 0.38 ± 1.43°, 0.49 ± 1.62°, 0.44 ± 1.29° and 0.41 ± 1.17°, respectively) and also a decrease in the overbite (difference: -0.54 ± 0.83). For the secondary outcomes; there was a significant decrease in mandibular position (SNB) (difference: 1.60 ± 1.36°) and increase in the overjet (difference: 0.93 ± 1.04, p < 0.001) and a significant lower lip retrusion (difference: 0.33 ± 1.01 mm p < 0.01), was observed too. CONCLUSIONS SS therapy resulted in significant vertical skeletal and dentoalveolar changes that were manifested mainly by facial height ratio, mandibular and occlusal plane changes, and to a lesser extent, significant anteroposterior skeletal, dentoalveolar, and soft tissue changes in the form of mandibular position, increased overjet and a more retrusive lower lip. These changes should be considered during patients' selection prior to initiating SS therapy.
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Affiliation(s)
- Saba Ahmed Al-Hadad
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, IBB, Republic of Yemen
| | - Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Lu Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Wanqing Hu
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Chushen Li
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
| | - Maged Sultan Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Ganem A, Rossouw PE, Michelogiannakis D, Javed F. Antinociceptive Efficacy of Shamanic Healing for the Management of Temporomandibular Disorders: An Evidence-Based Review. JOURNAL OF RELIGION AND HEALTH 2024; 63:942-953. [PMID: 37269379 DOI: 10.1007/s10943-023-01844-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
The aim of this evidence-based review was to assess the antinociceptive efficacy of shamanic healing (SH) for management of temporomandibular disorders (TMD). The addressed focused question was "Is SH effective for the management of TMD?" Indexed databases were searched without time and language restrictions up to and including January 2023 using the following keywords: "disc displacement disorders"; "healing"; "inflammation"; "pain"; "shamanic"; "therapy"; "temporomandibular joint"; "temporomandibular disorders" and "temporomandibular joint disorders". Clinical studies were considered eligible for inclusion. Editorials, case-reports, case-series and commentaries were excluded. Literature search was performed in accordance with the guidelines of the preferred reporting items for systematic review and meta-analysis. Pattern of this evidence-based review was customized to summarize the pertinent information. In the present review, three studies were included and processed for data extraction. All participants were females with a mean age of 38.3 ± 8.3 years (range 25-55 years). Self-rated pain was assessed before application of SH (baseline) and after 9 months of follow-up. In one study, SH significantly reduced self-rated TMD pain scores (P < 0.001) at 9-months' follow-up interview. In all studies patients reported that management of TMD via SH helped improve their quality of life. In one study patients perceived improvements in sleep, energy levels, digestion, and back pain at follow-up. In another study patients reported that they felt "calmer" and "at peace" at follow-up interview. The possible contribution of SH for managing pain among TMD patients warrants additional research. There is a dire need for well-designed and power-adjusted randomized clinical trials with adequate groups and long-term follow-up.
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Affiliation(s)
- Atheer Ganem
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA.
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Musa M, Awad R, Izeldin S, Zhao Y, Wu H, Wang L, Al-Hadad SA, Saif BS, Ahmed MMS, Chen X. Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders with and without skeletal lateral mandibular asymmetry: a cone beam computed tomographic study. BMC Oral Health 2024; 24:363. [PMID: 38515064 PMCID: PMC10956259 DOI: 10.1186/s12903-024-04119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Temporomandibular disorders (TMDs) encompass pain and dysfunction in the jaw, muscles, and adjacent structures. This study aimed to explore the quantitative (condylar position, morphology) and qualitative (bone mineral density (BMD)) therapeutic outcomes following a stabilization splint (S.S.) therapy in adult patients diagnosed with TMD (Arthralgia) with/without lateral mandibular asymmetry (MA) using cone beam computed tomography (CBCT). METHODS In this retrospective clinical study, 60 adult TMD patients who received S.S. therapy were enrolled and allocated into the TMD group (TMDG) and TMD with MA group (TMD + MAG). The diagnosis was made according to the Diagnostic Criteria for TMD (DC/TMD) AXIS I. MA was measured from the mid-sagittal plane to the Menton point. CBCT was used to scan the temporomandibular joints pre- (T0) and post- (T1)-treatment for three-dimensional analysis. Intra- and intergroup statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal‒Wallis test. RESULTS For quantitative comparisons, there was a statistically significant difference between T0 and T1 in the joint spaces of TMD + MAG (anterior, superior, posterior, and coronal lateral on the deviated side as well as in the superior, coronal medial joint space of the contralateral side). Morphologically, the deviated side had a narrower condylar width, reduced condylar height, and a steeper eminence angle. In contrast, the contralateral side tended to have a greater condylar length. For qualitative measurements, BMD also showed statistical significance between T0 and T1 in the majority of the condyle slopes (AS, SS, PS, and LS on the deviated side and in AS and MS on the contralateral side) of TMD + MAG. Additionally, only the AS and PS showed significance in TMDG. CONCLUSION Multiple joint space widening (AJS and CMS) and narrowing (SJS, PJS, and CLS) could characterize the deviated side in TMD + MA. Factors like narrower condylar width, reduced condylar height, and steeper eminence angle on the deviated side can worsen TMD + MA. Proper alignment of the condyle-disc position is essential for optimal function and load distribution, potentially affecting bone mineral density (BMD). MA plays a prominent role in disturbing bone densities. S.S. therapy shows more evident outcomes in TMD + MAG (on the deviated side compared to the contralateral side) than the TMDG.
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Affiliation(s)
- Mazen Musa
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics, Al Tegana Dental Teaching Hospital, Faculty of Dentistry, University of Science and Technology Omdurman, Khartoum, Sudan
| | - Riham Awad
- Department of Pediatrics Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
- Department of Pediatrics Dentistry, Faculty of Dentistry, International University of Africa, Khartoum, Sudan
| | - Salma Izeldin
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics, Faculty of Dentistry, Karary University, Omdurman, Khartoum, Sudan
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Hao Wu
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Lu Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Saba Ahmed Al-Hadad
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Bdr Sultan Saif
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Orthodontics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
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Huth KC, Bex A, Kollmuss M, Wuersching SN. Recording the maxillomandibular relationship with the Aqualizer system prior to occlusal splint therapy for treating temporomandibular disorders: a randomized controlled trial. Sci Rep 2023; 13:22535. [PMID: 38110552 PMCID: PMC10728157 DOI: 10.1038/s41598-023-49911-7] [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: 08/02/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
Temporomandibular disorders (TMD) present a public health issue and are one of the most common musculoskeletal conditions causing chronic pain. This study compares the outcomes of occlusal splint therapy in patients with TMD following two different maxillomandibular relationship (MMR) registration techniques. 40 TMD patients were randomly allocated to MMR registration with the Aqualizer system (AQU) or with chin point guidance (CPG) prior to fabricating occlusal splints. TMD symptoms, subjective pain intensity, and quality of life (QoL) were recorded at baseline and after 3 and 6 months. The treatment led to an overall reduction of TMD symptoms in both groups (Conover test, p < 0.00001). TMJ sounds, TMJ pain with palpation and muscle pain with palpation subsided regardless of the type of MMR registration method used (Cohen's d > 0.8). AQU-based occlusal splints led to a better improvement of TMJ pain with maximum opening compared to CPG-based occlusal splints (Cohen's d = 0.9; CPG d = 0.13). In both groups, occlusal splint treatment had little to no effect on correcting lateral mandible deviation or improving restricted jaw opening. After 6 months occlusal splints in both groups had a large effect on improving subjective pain intensity (Cohen's d > 0.8), however, patients reported a higher QoL in the AQU group compared to the CPG group (Mann-Whitney-U-test, p < 0.05). The results of this study support the premise that occlusal splints are effective in relieving pain-related TMD symptoms. The Aqualizer can be considered for determining MMR in cases, where guided registration techniques are not possible.Trial registration: DRKS00031998.
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Affiliation(s)
- Karin Christine Huth
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Alexandra Bex
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany.
| | - Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
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Ahmed MMS, Zhao Y, Al-Hadad SA, Li C, Wang L, Hu W, Ahmed MMS, Musa M, Chen X, Alhammadi MS. Three-dimensional evaluation of upper pharyngeal airway, hyoid bone, and craniocervical changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation: A retrospective study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101646. [PMID: 37751814 DOI: 10.1016/j.jormas.2023.101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/23/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE This study aimed primarily to analyze the three-dimensional (3D) changes in the pharyngeal airway (PA), and secondarily, the hyoid bone (HB) and the craniocervical (CC) following stabilization splint (SS) therapy in adult patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD). METHODS Thirty-five adult patients with TMD and MD, who were treated using SS with a mean age of 25.14 ± 6.11 years, were enrolled in this retrospective clinical study. Pre- and post-therapeutic cone-beam computed tomography (CBCT) scans were analyzed. PA dimension,nasopharyngeal, oropharyngeal, hypopharyngeal, sub-hypopharyngeal, and total pharyngeal airway spaces were measured in surface area, volume, minimum constricted area (MCA) and width, HB position, and CC posture were analyzed three-dimensionally using InVivo 6.0.3 and Dolphin 11.95 software. Wilcoxon rank-sum or Paired t-test was conducted, and P < 0.05 was considered significant. RESULTS SS therapy was administered for a period of 9.49 ± 4.02 months. The oropharyngeal airway space showed a significant decrease in sagittal width. The hypopharyngeal surface area, volume, MCA, and sagittal width decreased significantly. In terms of HB, hyoid-mandibular plane (H-MP), retrognathia-third vertebra's most inferior-anterior (RGN-C3ia), and retrognathia-Sella (RGN-S) distances significantly decreased. The Nasion-Sella line and the line that passes through C2ip to the odontoid process posterior tangent (NSL-OPT) angle in CC posture also decreased significantly. CONCLUSION SS therapy in TMD patients with MD mainly results in narrowing of the hypopharyngeal region, no change in HB position and improvement in head posture. These results undoubtedly assist in diagnosis and treatment of clinical conditions.
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Affiliation(s)
- Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Saba Ahmed Al-Hadad
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Chunshen Li
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Lu Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Wangqing Hu
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Moutaz Mohammed Saleh Ahmed
- Chengdu University of Traditional Chinese Medicine, International Education College, Chengdu, Sichuan, People's Republic of China
| | - Mazen Musa
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China; Department of Orthodontics, Al Tegana Dental Teaching Hospital, University of Science and Technology, Omdurman, Khartoum 11111, Sudan
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China.
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
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