1
|
Gressler LE, Cowley T, Velezis M, Aryal S, Clare D, Kusiak JW, Cowley AW, Sedrakyan A, Marinac-Dabic D, Reardon M, Schmidt L, Feldman JG, DiFabio V, Bergman S, Simonyan V, Yesha Y, Vasiliu-Feltes I, Durham J, Steen AI, Woods P, Kapos FP, Loyo-Berrios N. Building the foundation for a modern patient-partnered infrastructure to study temporomandibular disorders. Front Digit Health 2023; 5:1132446. [PMID: 37255961 PMCID: PMC10226081 DOI: 10.3389/fdgth.2023.1132446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/25/2023] [Indexed: 06/01/2023] Open
Abstract
Background Conflicting reports from varying stakeholders related to prognosis and outcomes following placement of temporomandibular joint (TMJ) implants gave rise to the development of the TMJ Patient-Led RoundTable initiative. Following an assessment of the current availability of data, the RoundTable concluded that a strategically Coordinated Registry Network (CRN) is needed to collect and generate accessible data on temporomandibular disorder (TMD) and its care. The aim of this study was therefore to advance the clinical understanding, usage, and adoption of a core minimum dataset for TMD patients as the first foundational step toward building the CRN. Methods Candidate data elements were extracted from existing data sources and included in a Delphi survey administered to 92 participants. Data elements receiving less than 75% consensus were dropped. A purposive multi-stakeholder sub-group triangulated the items across patient and clinician-based experience to remove redundancies or duplicate items and reduce the response burden for both patients and clinicians. To reliably collect the identified data elements, the identified core minimum data elements were defined in the context of technical implementation within High-performance Integrated Virtual Environment (HIVE) web-application framework. HIVE was integrated with CHIOS™, an innovative permissioned blockchain platform, to strengthen the provenance of data captured in the registry and drive metadata to record all registry transaction and create a robust consent network. Results A total of 59 multi-stakeholder participants responded to the Delphi survey. The completion of the Delphi surveys followed by the application of the required group consensus threshold resulted in the selection of 397 data elements (254 for patient-generated data elements and 143 for clinician generated data elements). The infrastructure development and integration of HIVE and CHIOS™ was completed showing the maintenance of all data transaction information in blockchain, flexible recording of patient consent, data cataloging, and consent validation through smart contracts. Conclusion The identified data elements and development of the technological platform establishes a data infrastructure that facilitates the standardization and harmonization of data as well as perform high performance analytics needed to fully leverage the captured patient-generated data, clinical evidence, and other healthcare ecosystem data within the TMJ/TMD-CRN.
Collapse
Affiliation(s)
- Laura Elisabeth Gressler
- Center for Devices and Radiological Health (CDRH), Food and Drug Administration, Silver Spring, MD, United States
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | | | - Marti Velezis
- Center for Devices and Radiological Health (CDRH), Food and Drug Administration, Silver Spring, MD, United States
| | - Suvekshya Aryal
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | | | | | - Allen W. Cowley
- Department of Physiology, Medical College of Wisconsin, Madison, WI, United States
| | - Art Sedrakyan
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Danica Marinac-Dabic
- Center for Devices and Radiological Health (CDRH), Food and Drug Administration, Silver Spring, MD, United States
| | | | | | | | - Vincent DiFabio
- Oral and Maxillofacial Surgery, University of Maryland Medical System, Baltimore, MD, United States
| | - Suzie Bergman
- Dentistry on Officers Row, Vancouver, WA, United States
| | | | - Yelena Yesha
- Department of Computer Science, University of Miami, Miami, FL, United States
| | | | - Justin Durham
- School of Dental Sciences, NewcastleUnited Kingdom
- Newcastle-Upon Tyne Hospitals’ NHS Foundation Trust, Newcastle, United Kingdom
| | - Andrew I. Steen
- Center for Devices and Radiological Health (CDRH), Food and Drug Administration, Silver Spring, MD, United States
| | - Phillip Woods
- Center for Devices and Radiological Health (CDRH), Food and Drug Administration, Silver Spring, MD, United States
| | - Flavia P. Kapos
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Nilsa Loyo-Berrios
- Center for Devices and Radiological Health (CDRH), Food and Drug Administration, Silver Spring, MD, United States
| |
Collapse
|
2
|
Cintra DN, de Oliveira SAS, Lorenzo IA, Costa DMF, Bonjardim LR, Costa YM. The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome. J Oral Rehabil 2022; 49:746-753. [PMID: 35388515 DOI: 10.1111/joor.13330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 11/27/2022]
Abstract
AIM This topical review presents common patients' misbeliefs about temporomandibular disorders (TMD) and discusses their possible impact on the diagnosis, treatment and prognosis. We also discussed the possible influence of the beliefs and behaviors of health care providers on the beliefs of patients with TMD and present possible strategies to overcome the negative impacts of such misbeliefs. METHODS This topical review was based on a non-systematic search for studies about the beliefs of patients and professionals about TMD in PubMed and Embase. RESULTS Patients' beliefs can negatively impact the diagnosis, treatment, and prognosis of TMD. These beliefs can be modulated by several factors such as culture, psychosocial aspects, gender, level of knowledge, and previous experiences. Moreover, primary health care professionals, including dentists, may lack sufficient experience and skills regarding TMD diagnosis and treatment. Misbeliefs of the health care professionals can be based on outdated evidence that is not supported by rigorous methodological investigations. Education and dissemination of knowledge to patients and the general population are effective for prevention, promotion of health and disruption of the cycle of misinformation and dissemination of misbeliefs. CONCLUSION The lack of basic information about TMD and the dissemination of mistaken and outdated concepts may delay the diagnosis, hinder the treatment, and consequently increase the risk of worsening the condition. Education is key to overcome TMD misbeliefs.
Collapse
Affiliation(s)
- Débora N Cintra
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sara A S de Oliveira
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Isadora A Lorenzo
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Dyna Mara F Costa
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Leonardo R Bonjardim
- epartment of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Yuri M Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| |
Collapse
|
3
|
LIN J, ZHANG W, LAI R. Pain characteristics and countermeasures to improve intraoperative pain for patients with temporomandibular joint disorder during treatment of orthodontics. Food Sci Technol 2022. [DOI: 10.1590/fst.05621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Junsheng LIN
- The First Affiliated Hospital Jinan University, China
| | | | - Renfa LAI
- The First Affiliated Hospital Jinan University, China
| |
Collapse
|
4
|
Rota AC, Biato ECL, Macedo SB, Moraes ACR. [At the forefront of the temporomandibular dysfunction: a study of experiences]. Cien Saude Colet 2021; 26:4173-4182. [PMID: 34586269 DOI: 10.1590/1413-81232021269.14592020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/07/2020] [Indexed: 11/21/2022] Open
Abstract
How does one address an ailment related to such unique experiences without dissociating it from relationships, living conditions and society? Temporomandibular Disorder (TMD) is one of a group of chronic disorders that are difficult to diagnose and provide treatment. As in other similar ailments, such difficulties may accentuate a negative impact on health. The study seeks to identify experiences of health service users with TMD, aiming to contribute to reflection and management practices for the issue. A qualitative otobiographical study was developed, using interviews with people undergoing TMD treatment. Based on the Nietzschean premise that the process of subjectivation is fed by experiences, the method seeks to identify traces of these experiences through the texts resulting from the interviews. Patients' experiences were grouped into five categories: recognition; frustrations; concealment; sadness, fear and death; and destinies. A variety of negative effects have been described in the first three stages, whereas the last one, namely destinies, elicits feelings of well-being. The value of the interactive (professional-user) space, which expresses itself as the power to create innovative and sensitive ways of dealing with health-disease processes, needs to be highlighted.
Collapse
Affiliation(s)
- Alexandre Cardoso Rota
- Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
| | | | - Sérgio Bruzadelli Macedo
- Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
| | - Aline Cardoso Rota Moraes
- Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
| |
Collapse
|
5
|
Manrriquez SL, Robles K, Pareek K, Besharati A, Enciso R. Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis. J Dent Anesth Pain Med 2021; 21:183-205. [PMID: 34136641 PMCID: PMC8187022 DOI: 10.17245/jdapm.2021.21.3.183] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 12/20/2022] Open
Abstract
This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with “general HA.” Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.
Collapse
Affiliation(s)
- Salvador L Manrriquez
- Orofacial Pain and Oral Medicine Clinic, Division of Diagnostic Sciences, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Kenny Robles
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Kam Pareek
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA.,Department of Diagnostic Sciences, University of the Pacific-Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
| | - Alireza Besharati
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Reyes Enciso
- Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| |
Collapse
|
6
|
Karic V, Chandran R, Abrahamse H. Photobiomodulation and Stem Cell Therapy for Temporomandibular Joint Disc Disorders. Photobiomodul Photomed Laser Surg 2020; 38:398-408. [PMID: 32486898 DOI: 10.1089/photob.2019.4790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Temporomandibular disorder (TMD) refers to a group of disorders affecting the temporomandibular joint (TMJ) and its related muscles. The two commonly used treatment modalities for TMD are occlusal splint therapy and relaxation therapy. Neither comprises definitive treatment. Objective: The objective of this review was to report updated information on photobiomodulation and stem cells, as an alternative treatment for the degenerative TMJ disc as a part of TMJ disorders. Materials and methods: With only a few research studies reported till date, this review also proposes the mechanism of laser irradiation on inflammatory mediators to treat TMD. Results: Photobiomodulation of stem cells with and without scaffolds could be used indirectly or directly as modulation of degenerative changes of the TMJ disc. Conclusions: The need for a distinct shift of the research margin in this field of dentistry is evident, specifically regarding the application of photobiomodulation and stem cells for tissue engineering of the TMJ disc.
Collapse
Affiliation(s)
- Vesna Karic
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.,Department of Prosthodontic and Oral Rehabilitation, and Laser Therapy in Dentistry Division, School of Oral Sciences, Health Sciences Faculty, WITS University, Johannesburg, South Africa
| | - Rahul Chandran
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| |
Collapse
|
7
|
Tribst JP, Kohn BM, de Oliveira Dal Piva AM, Spinola MS, Borges AL, Andreatta Filho OD. Influence of restoration thickness on the stress distribution of ultrathin ceramic onlay rehabilitating canine guidance: a 3D-finite element analysis. ACTA ACUST UNITED AC 2019; 68:126-131. [PMID: 31014062 DOI: 10.23736/s0026-4970.19.04183-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The rehabilitation of canine guidance can be performed with adhesive indirect materials, but can the restoration thickness be reduced without mechanical disadvantages? Thus the goal of this study was to analyze the stress of upper canines which received different thicknesses of ceramic fragments for the rehabilitation of the canine guidance using finite element analysis. METHODS A superior canine was modeled using a computer aided design software. The dental tissues were individually shaped containing enamel, dentin and periodontal ligament. The following three different ceramic fragment thicknesses were then implemented: 0.3, 0.7 and 1.5 mm. Lithium disilicate was chosen as the ceramic material. The solid geometries were exported to the analysis software. The materials were considered isotropic, homogeneous and linear. The set was submitted to efforts in the incisal third in the palatine face to analyze maximal principal stress, mimicking mandibular lateral movement. The applied load was 100N, and the fixation region was on the medullary bone. RESULTS For restoration, the thinner the ceramic, the higher the stress concentration was; while for the adhesive surface of teeth, the thicker the ceramic, the higher the stress concentration. CONCLUSIONS The smaller the ceramic thickness was, the lower stress concentration showed at the adhesive interface, while the stress concentration was higher on the restoration intaglio surface.
Collapse
Affiliation(s)
- João P Tribst
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University, Unesp, São José dos Campos, SP, Brazil
| | - Bianca M Kohn
- Institute of Science and Technology, São Paulo State University, Unesp, São José dos Campos, SP, Brazil
| | - Amanda M de Oliveira Dal Piva
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University, Unesp, São José dos Campos, SP, Brazil -
| | - Manuela S Spinola
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University, Unesp, São José dos Campos, SP, Brazil
| | - Alexandre L Borges
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University, Unesp, São José dos Campos, SP, Brazil
| | - Osvaldo D Andreatta Filho
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University, Unesp, São José dos Campos, SP, Brazil
| |
Collapse
|