1
|
Ramachandran A, Jose R, Tunkiwala A, Varma R B, M Shanmugham A, Nair PK, Kumar KS, Sam LM. Effect of deprogramming splint and occlusal equilibration on condylar position of TMD patients - A CBCT assessment. Cranio 2019; 39:294-302. [PMID: 31451061 DOI: 10.1080/08869634.2019.1650216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Assessment of clinical symptoms and condylar position of TMD patients using CBCT imaging with deprogramming splint therapy and occlusal equilibration. The hypothesis tested was the alleviation of symptoms of TMD with possible changes in condylar position occurs with this treatment.Methods: The condylar position of 12 TMD patients was observed from CBCT images, and clinically, symptom severity score, mouth opening, and range of motion were compared pre- and post-treatment.Results: All patients reported a statistically significant decrease in the symptom severity score and increase in mouth opening and range of motion (p < .05). A significant decrease was only achieved in the left anterior joint space (p < .05).Conclusion: Deprogramming splint therapy and occlusal equilibration benefitted patients with a reduction in clinical symptoms, and minor changes in condylar position were observed.
Collapse
Affiliation(s)
- Anu Ramachandran
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Renju Jose
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Ali Tunkiwala
- Consultant Prosthodontist, Private Practice, Mumbai, India
| | - Beena Varma R
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Aravind M Shanmugham
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Priya K Nair
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Krishna S Kumar
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Lisa Maria Sam
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| |
Collapse
|
2
|
Sahebi M, Zeighami S, Hajimahmoudi M. The Effect of Flat Dual-Cure Stabilizer Occlusal Splint in Pain Relief of Individuals Suffering from Migraine Headaches. Open Dent J 2018; 12:501-509. [PMID: 30197689 PMCID: PMC6110061 DOI: 10.2174/1874210601812010501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/29/2018] [Accepted: 07/11/2018] [Indexed: 11/22/2022] Open
Abstract
Background: No study on the effect of dual-cure stabilizer splint without canine ramp in migraine patients is present. Objective: This study was conducted to determine the effects of maxillary flat dual-cure stabilizer occlusal splint on severity, frequency and episodes of headaches in individuals suffering from a migraine. Methods: In this interventional clinical trial, 30 eligible patients were divided into 2 groups (case and control); each group consisted of 8 men and 7 women. Dual-cure stabilizer splint was made for patients in the case group and they used the adjusted splint 20 hours a day for 6 weeks. The severity, frequency and episodes of migraine attacks before and after using the splint were determined. For grading pain, severity visual analogue scale was used. The data were analyzed using SPSS 20 and Kolmogorov-Smirnov test and paired t-test. Results: The severity, frequency, and episodes of migraine attacks before and after using the splint were reduced by 56%, 68%, and 72%, respectively. The reduction was statistically significant (p < 0.05). Discussion: Despite the effect of occlusal devices on the migraine disorder is controversial, the most researchers agree that using these appliances can be effective in reducing headache in migraine patients. Conclusion: Given the favorable effects of dual-cure stabilizer splint on reducing the severity, frequency and episodes of migraine headaches, the device can be used as an effective alternative therapy besides common pain-relieving methods.
Collapse
Affiliation(s)
- Majid Sahebi
- Dental Research Center, Dentistry Research Institute and Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, North Kargar Street, Enghelab Square, Tehran, Iran
| | - Somayeh Zeighami
- Dental Research Center, Dentistry Research Institute and Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, North Kargar Street, Enghelab Square, Tehran, Iran
| | - Mohammadreza Hajimahmoudi
- Dental Research Center, Dentistry Research Institute and Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, North Kargar Street, Enghelab Square, Tehran, Iran
| |
Collapse
|
3
|
Abstract
Temporomandibular disorders (TMD) and primary headaches can be perpetual and debilitating musculoskeletal and neurological disorders. The presence of both can affect up to one-sixth of the population at any one time. Initially, TMDs were thought to be predominantly musculoskeletal disorders, and migraine was thought to be solely a cerebrovascular disorder. The further understanding of their pathophysiology has helped to clarify their clinical presentation. This article focuses on the role of the trigeminal system in associating TMD and migraine. By discussing recent descriptions of prevalence, diagnosis, and treatment of headache and TMD, we will further elucidate this relationship.
Collapse
Affiliation(s)
- Steven B Graff-Radford
- The Pain Center, Cedars-Sinai Medical Center, 444 South San Vicente Boulevard #1101, Los Angeles, CA 90048, USA; The Program for Headache and Orofacial Pain, Cedars-Sinai Medical Center, Los Angeles, CA, USA; UCLA School of Dentistry, Los Angeles, CA, USA.
| | - Jeremy J Abbott
- West Coast Ear, Nose & Throat Medical Group, 301 South Moorpark Road, Thousand Oaks, CA 91361, USA
| |
Collapse
|
4
|
Thumati P, Thumati RP. The effect of disocclusion time-reduction therapy to treat chronic myofascial pain: A single group interventional study with 3 year follow-up of 100 cases. J Indian Prosthodont Soc 2016; 16:234-41. [PMID: 27621541 PMCID: PMC5000572 DOI: 10.4103/0972-4052.176529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/19/2015] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate the longevity of reduced disclusion time in treating and removing myofascial pain dysfunction symptoms following the T-Scan-based, immediate complete anterior guidance development (ICAGD) coronoplasty. This measured occlusal adjustment has been shown to reduce the muscle hyperactivity of myofascial pain. METHODS Myofascial pain symptomatic patients were recruited as per the diagnostic criteria for temporomandibular disorders (TMDs), including the clinical protocol and assessment instruments outlined by the international RDC/TMD consortium network (version: January 20, 2014) to assess the efficacy of reduced disclusion time in left and right lateral excursions to resolve the myofascial pain symptoms. As per the inclusion and exclusion criteria, 100 cases were treated with ICAGD in three visits, each 1 week apart. Recall disclusion time measurements were recorded every 3 months over 3 years. The RDC/TMD questionnaire was used for symptom assessment at every recall visit. ICAGD brought pretreatment prolonged disclusion time down to <0.4 s, as quantified from T-Scan force and time data records, while the subjects were assessed for symptom relief. The Wilcoxon signed-rank test was used for statistical analysis (P < 0.05). RESULTS Changes in the intensity of many symptoms from reducing the disclusion time to <0.4 s were statistically significant from treatment day 1, and onward through the 3-year period of observation (P < 0.05). CONCLUSION The results indicate that ICAGD reduces the musculoskeletal symptoms of myofascial pain, such that this methodology increases clinical therapeutic success.
Collapse
Affiliation(s)
- Prafulla Thumati
- Department of Prosthodontics, Dayananda Sagar Dental College and Research Center, Rajiv Gandhi University of Health Sciences, Kumarswamy Layout, Bengaluru, Karnataka, India
| | - Roshan P. Thumati
- Department of Prosthodontics, Government Dental College and RI, Bengaluru, Karnataka, India
| |
Collapse
|
5
|
Koh H, Robinson PG. WITHDRAWN: Occlusal adjustment for treating and preventing temporomandibular joint disorders. Cochrane Database Syst Rev 2016; 2016:CD003812. [PMID: 26727292 PMCID: PMC10680411 DOI: 10.1002/14651858.cd003812.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The Cochrane Oral Health Group withdrew this review as of Issue 1, 2016. The review is out of date and does not meet current Cochrane methodological standards. It will be superseded by a new Cochrane review on Occlusal interventions for managing temporomandibular disorders. The editorial group responsible for this previously published document have withdrawn it from publication.
Collapse
Affiliation(s)
- Holy Koh
- National University of SingaporeDepartment of Preventive DentistryNational University Hospital5 Lower Kent Ridge RoadSingaporeSingapore119074
| | - Peter G Robinson
- School of Clinical Dentistry, University of SheffieldClaremont CrescentSheffieldUKS10 2TA
| | | |
Collapse
|
6
|
Thumati P, Manwani R, Mahantshetty M. The effect of reduced disclusion time in the treatment of myofascial pain dysfunction syndrome using immediate complete anterior guidance development protocol monitored by digital analysis of occlusion. Cranio 2014; 32:289-99. [PMID: 25252768 DOI: 10.1179/2151090314y.0000000004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
STATEMENT OF PROBLEM Chronic myofascial pain dysfunction syndrome (MPDS) has been a nightmare for patients suffering from it, who have been treated with various treatment options with varied outcomes. This population of patients has been neglected, due to nagging revisits to a clinician and decreased percentage of success. OBJECTIVE T-Scan-based immediate complete anterior guidance development (ICAGD) has been shown by a researcher to reduce the muscle hyperactivity consistent with MPDS. The purpose of this study is to evaluate the effect of reduced disclusion time in lateral excursions in treating the MPDS symptoms. MATERIALS AND METHODS Fifty-one myofascial pain patients with symptoms in the area of the head and neck region were treated with ICAGD. The quantified force and time data from T-Scan records were used to correct the prolonged disclusion time, and the subjects were assessed for the symptom relief. The Wilcoxon Signed Ranks Test was used for statistical analysis (P<0·05 denotes significant changes). RESULTS The changes in disclusion time and intensity of various symptoms were found to be statistically significant (P<0·05) from Day 1 onwards, and patients were relieved of their symptoms after reduction of disclusion time of less than 0·5 seconds. CONCLUSION The results clearly indicated that ICAGD protocol reduces musculoskeletal-based symptoms of MPDS patients, and this protocol can prove beneficial for the clinical treatment success.
Collapse
|
7
|
Scopel V, Alves da Costa GS, Urias D. An Electromyographic Study of Masseter and Anterior Temporalis Muscles in Extra-Articular Myogenous TMJ Pain Patients Compared to an Asymptomatic and Normal Population. Cranio 2014; 23:194-203. [PMID: 16128354 DOI: 10.1179/crn.2005.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of the therapy with a centric relation stabilization appliance (CRSA) in patients with temporomandibular disorders of myogenous origin by electromyography and compare the results with two asymptomatic control groups. Three groups of 20 patients each were selected for the study. Electromyography (EMG) of masseter and anterior temporalis muscles was performed during mandibular rest position. In the treated group, the occlusal appliance reduced the electrical activity of the analyzed muscles at right and left sides (p<0.0001), and equilibrated muscular activity between right and left sides (p<0.0001), reaching values close to the control groups. Although there was not a statistically significant difference, the normal control group presented lower EMG values than control group II and presented the lowest asymmetry index of all subjects. More than 85% of all subjects, including the controls, demonstrated a statistically significant temporal anterior activity prevalence (p<0.0001). Treatment with the CRSA reduced the activity index, although the prevalence of the temporal muscle over the masseter was maintained. The significant laterodeviating (torque) effect found in the temporomandibular disorder patients was reduced after treatment. No side prevalence was found in the control groups.
Collapse
|
8
|
Torii K, Chiwata I. Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study. Head Face Med 2010; 6:5. [PMID: 20346167 PMCID: PMC2859855 DOI: 10.1186/1746-160x-6-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Accepted: 03/27/2010] [Indexed: 11/25/2022] Open
Abstract
Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs). However, a recent report described a discrepancy between the habitual occlusal position (HOP) and the bite plate-induced occlusal position (BPOP) and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP) as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI) and the Helkimo Clinical Dysfunction Index (CDI) before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p < 0.001). The changes in the mean HOP-BPOP differences on the x-axis (mediolateral) and the y-axis (anteroposterior) were significant (p < 0.05), whereas the change on the z-axis (superoinferior) was not significant (p > 0.1). Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted.
Collapse
Affiliation(s)
- Kengo Torii
- Torii Dental Clinic, 1-23-2 Ando, Aoi-ku, Shizuoka-shi, 420-0882, Japan.
| | | |
Collapse
|
9
|
|
10
|
Rinchuse DJ, Kandasamy S, Sciote J. A contemporary and evidence-based view of canine protected occlusion. Am J Orthod Dentofacial Orthop 2007; 132:90-102. [PMID: 17628256 DOI: 10.1016/j.ajodo.2006.04.026] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2005] [Revised: 04/01/2006] [Accepted: 04/01/2006] [Indexed: 12/17/2022]
Affiliation(s)
- Donald J Rinchuse
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pa, USA.
| | | | | |
Collapse
|
11
|
Abstract
Temporomandibular disorders and facial pain cause significant discomfort and disability for affected patients. Understanding the clinical presentation, pathogenesis, and therapy is essential in helping patients who have these problems. This article critically reviews these aspects, with an emphasis on their relationship to headache.
Collapse
|
12
|
Abstract
BACKGROUND The authors conducted a cross-sectional survey to assess headache disability in patients with orofacial pain. METHODS The authors administered a Migraine Disability Assessment (MIDAS) questionnaire to 337 university-based clinic patients with OFP and 367 general dental (GD) patients, who served as controls. They made primary and secondary diagnoses in patients with OFP according to standard diagnostic criteria. The authors classified the patients into three major categories: primary headache (PH), musculoskeletal disorders (MS) and neuropathic pain (NP). They categorized the MIDAS score into four severity grades (I, the lowest, through IV, the highest). The authors analyzed the data using chi(2), t test, one-way analysis of variance and logistic regression for calculated odds ratios. RESULTS Patients with OFP had a greater prevalence of headache than did patients in the GD group (72.7 percent versus 31.9 percent, respectively; P < .001), with a higher total MIDAS score, number of headache days in the previous three months and headache severity (P < .001). Within the OFP group, the diagnostic prevalence of PH, MS and NP was 7.1 percent, 79.8 percent and 13.1 percent, respectively (P < .001). The authors categorized 56 percent of patients with OFP and headache into the high-impact headache group (MIDAS grades III and IV; P < .001). CONCLUSIONS Patients with OFP had a higher prevalence of headache with greater disability impact than did control subjects. The degree of disability was related strongly to the MS diagnosis. CLINICAL IMPLICATIONS The coexistence of PH and MS disorders can lead to higher headache disability. Clinicians need to treat both disorders concomitantly, which will result in improved treatment outcomes.
Collapse
Affiliation(s)
- Somsak Mitrirattanakul
- Occlusion Unit, Faculty of Dentistry, Mahidol University, Bangkok, 6 Yothi Street, Ratchatevi, Bangkok, 10400 Thailand.
| | | |
Collapse
|
13
|
Abstract
Headache is a common symptom, but when severe, it may be extremely disabling. It is assumed that patients who present to dentists with headache often are diagnosed with a temporomandibular disorder (TMD), although many may have migraine. TMD as a collective term may include several clinical entities, including myogenous and arthrogenous components. Because headache and TMD are so common they may be integrated or separate entities. Nevertheless, the temporomandibular joint (TMJ) and associated orofacial structures should be considered as triggering or perpetuating factors for migraine. This article discusses the relationship between the TMJ, muscles, or other orofacial structures and headache.
Collapse
Affiliation(s)
- Steven B Graff-Radford
- Pain Center, Cedars-Sinai Medical Center, 444 South San Vicente, #1101 Los Angeles, CA 90048, USA.
| |
Collapse
|
14
|
Abstract
Treatment of tension-type headache remains very challenging. In addition to conventional therapies, alternative methods such as physical therapy, acupuncture, and botulinum toxin have been studied. In this article, recent literature is reviewed and discussed and challenges for the evaluation of these approaches are considered. Although the clinical evidence is still incomplete, certain treatments are promising and the active ongoing research hopefully will soon yield more answers. Of note, the specific issue of psychologic therapy is dealt with elsewhere in this issue.
Collapse
Affiliation(s)
- Marc E Lenaerts
- Department of Neurology, Headache Section, Oklahoma University Health Sciences Center, 711 Stanton L. Young Boulevard, Suite 215, Oklahoma City, OK 73104, USA.
| |
Collapse
|
15
|
Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorders. Cochrane Database Syst Rev 2003:CD003812. [PMID: 12535488 DOI: 10.1002/14651858.cd003812] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There has been a long history of using occlusal adjustment in the management of temporomandibular disorders (TMD). It is not clear if occlusal adjustment is effective in treating TMD. OBJECTIVES To assess the effectiveness of occlusal adjustment for treating TMD in adults and preventing TMD. SEARCH STRATEGY We searched the Cochrane Oral Health Group's Trials Register (April 2002); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2002); MEDLINE (1966 to 8th April 2002); EMBASE (1980 to 8th April 2002) and handsearched journals of particular importance to this review. Additional reports were identified from the reference lists of retrieved reports and from review articles of treating TMD. There were no language restrictions. Unpublished reports or abstracts were considered from the SIGLE database. SELECTION CRITERIA All randomised or quasi-randomised controlled trials (RCTs) comparing occlusal adjustment to placebo, reassurance or no treatment in adults with TMD. The outcomes were global measures of symptoms, pain, headache and limitation of movement. DATA COLLECTION AND ANALYSIS Data were independently extracted, in duplicate, by two reviewers, Holy Koh (HK) and Peter G Robinson (PR). Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed and relative risk values calculated using random effects models where significant heterogeneity was detected (P<0.1). MAIN RESULTS Over 660 trials were identified by the initial search. Six of these trials, which reported results from a total of 392 patients, were suitable for inclusion in the review. From the data provided in the published reports, symptom-based outcomes were extracted from trials on treatment. Data on incidence of symptoms were extracted from trials on prevention. Neither showed any difference between occlusal adjustment and control group. REVIEWER'S CONCLUSIONS There is an absence of evidence, from RCTs, that occlusal adjustment treats or prevents TMD. Occlusal adjustment cannot be recommended for the management or prevention of TMD. Future trials should use standardised diagnostic criteria and outcome measures when evaluating TMD.
Collapse
Affiliation(s)
- H Koh
- Department of Dental Public Health & Community Dental Education, Guy's, King's and St. Thomas' School of Dentistry, King's College London, London, UK, SE5 8AN.
| | | |
Collapse
|
16
|
Tsukiyama Y, Baba K, Clark GT. An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders. J Prosthet Dent 2001; 86:57-66. [PMID: 11458263 DOI: 10.1067/mpr.2001.115399] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Occlusal adjustment therapy has been advocated as a treatment modality for temporomandibular disorders. In contrast to this position, a panel at the 1996 National Institute of Health technology assessment conference on TMD indicated that no clinical trials demonstrate that occlusal adjustment is superior to noninvasive therapies. PURPOSE This article summarizes the published experimental studies on occlusal adjustments and temporomandibular disorders. MATERIAL AND METHODS Eleven research experiments involving 413 subjects with either bruxism (n = 59), temporomandibular disorders (n = 219), headaches and temporomandibular disorders (n = 91), or chronic cervical pain (n = 40) were selected for critical review from the English dental literature. RESULTS Three experiments evaluated the relationship between occlusal adjustment and bruxism. Six experiments evaluated occlusal adjustment therapy as a treatment for patients with primary temporomandibular disorders. One experiment looked at occlusal adjustment effect on headache/temporomandibular disorder symptoms; another looked at its effect on chronic neck pain. Most of these experiments used a mock adjustment or a comparison treatment as the control condition in adults who had an existing nonacute general temporomandibular disorder. Overall, the data from these experiments did not demonstrate elevated therapeutic efficacy for occlusal adjustment over the control or the contrasting therapy. CONCLUSION The experimental evidence reviewed was neither convincing nor powerful enough to support the performance of occlusal therapy as a general method for treating a nonacute temporomandibular disorder, bruxism, or headache.
Collapse
Affiliation(s)
- Y Tsukiyama
- Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | | | | |
Collapse
|
17
|
Abstract
Control of occlusal contacts is important to the success of restorative dentistry. Tooth surface loss can contribute to a loss of stability in the occlusion. An occlusal splint is often part of pre-restorative management and can also have a valuable role in protecting both teeth and restorations from excessive loads and further wear.
Collapse
Affiliation(s)
- N J Capp
- Eastman Dental Institute for Oral Healthcare Sciences, University of London
| |
Collapse
|
18
|
Tsolka P, Morris RW, Preiskel HW. Occlusal adjustment therapy for craniomandibular disorders: a clinical assessment by a double-blind method. J Prosthet Dent 1992; 68:957-64. [PMID: 1494127 DOI: 10.1016/0022-3913(92)90558-r] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Fifty-one patients with craniomandibular disorders were divided in two groups. One group underwent mock occlusal adjustment, the other was treated with adjustments to remove significant slides and non-working side interferences. Both groups received identical counseling. The results show that there was no significant difference in the improvements on the signs and symptoms obtained by real or mock adjustments after the first treatment session.
Collapse
Affiliation(s)
- P Tsolka
- Department of Prosthetic Dentistry, United Medical School, London, England
| | | | | |
Collapse
|
19
|
|
20
|
Abstract
A review of the literature on bruxism--a condition which has been clinically recognized since the late nineteenth century--is presented. It will be seen that there is not complete agreement on the definition of this activity, and its aetiology and treatment remain controversial.
Collapse
Affiliation(s)
- K D Faulkner
- School of Dental Science (Restorative Dentistry), University of Melbourne
| |
Collapse
|
21
|
Abstract
Fifty-seven patients suffering from migraine, tension headache or tension vascular headache were prescribed a soft occlusal splint for night-time wear. Dental, psychosocial/psychiatric and neurological data were recorded prior to commencement of therapy and at the conclusion of a 3 month treatment period. A statistically significant number of patients presenting with migraine or tension vascular headache experienced marked improvement or complete relief of headache symptoms, but most patients suffering from tension headache failed to benefit from splint therapy. A majority of patients displaying intercurrent features of craniomandibular dysfunction experienced reduction in these symptoms also. There was a statistically significant association between TMJ improvement and headache type. Prior to treatment, patients who subsequently benefited from splint therapy in terms of headache improvement had experienced significantly fewer headaches than patients who failed to respond, although headache intensity and duration were similar in both groups. It is suggested that headache type and frequency may be prognostic indicators of the likely success of dental splint therapy in treatment of headache. Nevertheless, the use of occlusal splints in the treatment of patients complaining of headache in the absence of evidence of craniomandibular dysfunction should not be embarked upon until medical examination has excluded the possibility of organic neurological disorder.
Collapse
|
22
|
Abstract
A dynamic model is proposed to depict the etiology of temporomandibular disorders. A balance is described between destructive factors in the masticatory system that result in dysfunction, and adaptive factors that tend to return it homeostatically to normal. Five factors that cause or potentiate muscle hyperfunction are included on one side of the model with five other factors that affect the ability of the system to adapt on the other side. Relationships among the etiologic factors are discussed, and literature support for each is cited.
Collapse
Affiliation(s)
- M W Parker
- Department of Comprehensive Dentistry, Naval Dental School, Bethesda, MD 20814-5077
| |
Collapse
|
23
|
Jendresen MD, Klooster J, McNeill C, Phillips RW, Schallhorn RG. Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 1988; 59:703-38. [PMID: 3042964 DOI: 10.1016/0022-3913(88)90386-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- M D Jendresen
- University of California, San Francisco School of Dentistry 94143-0758
| | | | | | | | | |
Collapse
|