scholarly journals Efficacy of Selective Grinding Guided by an Occlusal Splint in Management of Myofascial Pain: A Prospective Clinical Trial

2017 ◽  
Vol 11 (1) ◽  
pp. 301-311
Author(s):  
Felipe J. Fernández-González ◽  
Jorge Cabero-López ◽  
Aritza Brizuela ◽  
Ivan Suazo ◽  
Esteban Pérez-Pevida ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Myofascial Pain ◽  
Vertical Displacement ◽  
Occlusal Splint ◽  
Significant Difference ◽  
Before And After ◽  
Skeletal Pattern ◽  
Condylar Position ◽  
The Stability ◽  
Facial Types

Background:For patients whose centric relation (CR) has not been considered at the start and during treatment, the task of achieving an occlusal scheme that works together with the temporomandibular joint, the muscles, and the structures of the stomatognathic apparatus becomes a major concern.Objective:This study aims to describe a reproducible, predictable and to date unreported procedure of selective grinding guided by an occlusal splint and to analyze condylar position (CP) based on the skeletal pattern.Methods:A total of 72 symptomatic patients (38 females and 34 males) were classified into three groups: hyperdivergent, intermediate and hypodivergent. CP was quantified by mounted casts on a measures condyle displacement (MCD) device. Helkimo index was also performed in order to assess the severity of the temporomandibular joint (TMJ) disorders attending to clinical dysfunction, occlusal state and anamnestic dysfunction. Once the stability had been obtained, the splint was progressively reduced until the maximum intercuspation (MIC) was achieved.Results:The vertical displacement was found to be significantly different between the hyperdivergent and other two groups (p<0.01). Comparisons of MCD analysis before and after the selective grinding procedure identified a statistically significant difference in the horizontal and vertical CP (p<0.01) between the different groups whereas the Helkimo Index showed a clear improvement of TMJ disorders.Conclusion:All facial types, specially the hyperdivergent face type, showed a reduction in condylar displacement (CD) and less craniomandibular symptoms using this procedure, making it an excellent technique for clinicians.

scholarly journals Is distal segment ostectomy essential for stabilization of the condylar position in patients with facial asymmetry?

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Ki Eun Hong ◽  
Eun Sup Shin ◽  
Jun Park ◽  
Ji Eon Yun ◽  
Chul Hoon Kim ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Clinical Symptoms ◽  
Mandibular Condyle ◽  
Facial Asymmetry ◽  
Position Change ◽  
Sagittal Split Ramus Osteotomy ◽  
Group I ◽  
Significant Difference ◽  
Before And After ◽  
Condylar Position

Abstract Background The purpose of this retrospective study was to evaluate the postoperative change in the position and stability of the mandibular condyle after bilateral sagittal split ramus osteotomy (BSSRO) and BSSRO with distal segmental ostectomy (DSO) in patients with facial asymmetry using 3D computed tomography. Methods The condyles of the patient diagnosed with facial asymmetry were divided into the deviated side (DS) and the non-deviated side (NDS). Group I, which was treated with BSSRO only, and Group II, which additionally received DSO along with BSSRO, were superimposed on the condyle using the pre-and postoperative 3D CT. The amount of condylar change in anteroposterior displacement, mediolateral displacement, and rotation was measured. The clinical symptoms of temporomandibular joint were also evaluated before and after surgery for each patient. Results Between Groups I and II, there was no statistically significant difference in the anteroposterior condylar position on both DS and NDS. And also, there was no statistical difference between the two groups in the mediolateral change on DS but, statistically significant difference on NDS. The change in the rotation of the condyle was observed to rotate inward from both condylar heads of Groups I and II, and a statistically significant difference was observed between the two groups on both DS and NDS. Moreover, no difference in clinical temporomandibular joint symptoms was observed after surgery in each DS and NDS condyle of the two groups. Conclusions As a result of analyzing the condylar position change of the group treated with BSSRO alone and the group treated with BSSRO and DSO in patients with facial asymmetry, there were statistically significant differences in the mediolateral displacement of NDS and the condyle rotation of NDS and DS. However, the anteroposterior condylar position did not show any difference in the bilateral condyles. In addition, since worsening clinical symptoms of bilateral temporomandibular joint were not observed before and after surgery in both groups, it is concluded that it is not necessary to accompany DSO in patients with facial asymmetry (minimum 3 mm, maximum 7 mm).

scholarly journals Temporomandibular Joint Osseous Morphology of Class I and Class II Malocclusions in the Normal Skeletal Pattern: A Cone-Beam Computed Tomography Study

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 541
Author(s):  
Xiao-Chuan Fan ◽  
Lin-Sha Ma ◽  
Li Chen ◽  
Diwakar Singh ◽  
Xiaohui Rausch-Fan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Temporomandibular Joint ◽  
Cone Beam Computed Tomography ◽  
Class Ii ◽  
Class I ◽  
Cone Beam ◽  
Glenoid Fossa ◽  
Linear Measurements ◽  
Significant Difference ◽  
Skeletal Pattern

(1) Background—The aim of the present study was to evaluate the correlation between the temporomandibular joint (TMJ) osseous morphology of normal skeletal pattern individuals with different dental malocclusions by using cone-beam computed tomography (CBCT). (2) Methods—The CBCT images of bilateral TMJs in 67 subjects with skeletal class I and average mandibular angle (26 males and 41 females, age range 20–49 years) were evaluated in this study. The subjects were divided into class I, class II division 1, and class II division 2 according to the molar relationship and retroclination of the maxillary incisors. Angular and linear measurements of TMJ were evaluated and the differences between the groups were statistically analyzed. (3) Results—Intragroup comparisons showed statistical differences for articular eminence inclination, the width of the glenoid fossa, the ratio of the width of the glenoid fossa to the depth of the glenoid fossa, the condylar angle, and the intercondylar angle between the malocclusion groups. The measurements of the glenoid fossa shape showed no significant difference between the left and right sides. Females showed more differences in the morphological parameters of TMJ between the three malocclusion groups than the males. (4) Conclusion—The present study revealed differences in the TMJ osseous morphology between dental class I and class II malocclusions in the normal skeletal pattern.

scholarly journals Orthosiphon versus Placebo in Nephrolithiasis with Multiple Chronic Complaints: A Randomized Control Trial

2009 ◽  
Vol 6 (4) ◽  
pp. 495-501 ◽  
Author(s):  
Amorn Premgamone ◽  
Pote Sriboonlue ◽  
Srinoi Maskasem ◽  
Wattana Ditsataporncharoen ◽  
Bungornsri Jindawong
Keyword(s):  
Myofascial Pain ◽  
White Blood Cells ◽  
Analog Scale ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Randomized Control ◽  
Group 2 ◽  
Primary Measure ◽  
Group 1

Nephrolithiasis in the communities of Northeast Thailand frequently presents with multiple chronic health complaints, i.e. myofascial pain, back pain, dyspepsia, arthralgia, headache, fatigue, frank paresthesia, dysuria and any of these aggravated by purine-rich food (PRF). We assessed the efficacy of Orthosiphon in treating subjects with at least two active symptoms and negative for urine white blood cells. Subjects were randomly allocated to two groups. Crude extract of Orthosiphon given in a capsule (equivalent to 1.6–1.8 g of dried leaves of Orthosiphon) two times a day to Group 1 (n= 36) and a placebo to Group 2 (n= 40) for 14 days. The medication for each subject was packed and its code kept secret until the data analysis. Both groups were asked not to consume any of 25 purine-rich foods (PRFs) during treatment. The primary measure was the reduced sum of active severity symptoms as recorded using the visual analog scale before and after therapy (i.e. on day 7 and 14). The data on 76 subjects were processed. The mean of the total scores (95% CI) of the symptoms in each group were decreased significantly (P< 0.001); 185.6 (153.3, 218.0) to 94.7 (58.2, 131.2) in the Orthosiphon group and 196.1 (164.4, 227.8) to 89.6 (62.8, 116.5) in the placebo group. When comparing between groups, no statistically significant difference was found. The mean consumption in PRFs was significantly decreased (P< 0.001) in both groups; however, Orthosiphon did not have additional benefit over placebo at 7 and 14 days of treatment during which they reduced these foods.

scholarly journals Comparison of Two Different Treatment Methods to Treat the Temporomandibular Joint Disorders (Myofascial Pain) in a Short Period of Time - A Retrospective Study

2021 ◽  
Vol 10 (38) ◽  
pp. 3342-3345
Author(s):  
Hamad Nasser Albageah ◽  
Abdulaziz Abdulhakim Alwakeel
Keyword(s):  
Retrospective Study ◽  
Temporomandibular Joint ◽  
Masseter Muscle ◽  
Orofacial Pain ◽  
Myofascial Pain ◽  
Temporomandibular Joint Disorder ◽  
Short Period ◽  
Significant Difference ◽  
Joint Disorder ◽  
Pain Patients

BACKGROUND Temporomandibular joint(TMJ)is the third most common site of pain in the orofacial area, while the masseter muscle was the primary painful masticatory muscle. The temporal and frontal region were pain areas indicated by temporomandibular joint disorder (TMDs) patients. The purpose of this study was to compare two different treatment modalities, physical therapy and occlusal appliance to treat myofascial pain. METHODS This retrospective study comprises of all orofacial pain patients attending orofacial pain clinics of Dental University Hospital, King Saud University in Riyadh, Saudi Arabia. Patients were categorized into two groups, the first group: patients treated by the occlusal appliance (hard type). The second group: patients treated by physiotherapy home exercises, including posture position modification. Physical therapy included muscle stretching and isometric tension against resistance exercises and guided jaw movements. Methods of clinical examination was based on the research diagnostic criteria for temporomandibular disorders (RDC/TMD) criteria. The data of pain level was collected based on the visual analog scale (VAS). RESULTS 16.1 % of patients were male, and 83.9 % of the patients were female. With the mean age being 31.1 years old. 92.9 % were Saudi patients and 7.1 % were non-Saudi. 50 % of the patients were using an occlusal appliance, and 50 % went for physiotherapy. The independent t-test showed a highly significant difference between different management methods with a P – value of 0.038 and a mean difference of 0.32143. 80.5 % of the patients reported masseter muscle pain as one of their main complaints. CONCLUSIONS A significant difference was observed between physiotherapy and occlusal appliances with education in treating patients with myofascial pain. Patients using the occlusal appliances showed a high percentage of pain reduction (85.7 %) compared to physiotherapy treatment (57.1 %) in a short period of time. Henceforth, patient’s education plays a significant role in pain reduction. KEY WORDS Temporomandibular Joint Disorder, Occlusal Appliance, Myofascial Pain, Physiotherapy

scholarly journals Phototherapy versus Occlusal Splint to control painful symptoms in Temporomandibular Disorder: controlled, randomized cost-effectiveness clinical trial

2020 ◽  
Vol 9 (11) ◽  
pp. e66991110251
Author(s):  
Ana Paula Taboada Sobral ◽  
Sergio de Sousa Sobral ◽  
Glaucia Gurnhak Giacon ◽  
Thalita Molinos Campos ◽  
Anna Carolina Ratto Tempestini Horliana ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cost Effectiveness ◽  
Pain Intensity ◽  
Myofascial Pain ◽  
Positive Impact ◽  
Temporomandibular Disorder ◽  
Cost Effective ◽  
Cost Ratio ◽  
Occlusal Splint ◽  
Before And After

Objective: To compare the efficacy of photobiomodulation and occlusal splint in patients with TMD-associated myofascial pain. Material and methods: 23 patients were randomized into 2 groups: laser group (LG) (n = 12) and occlusal splint group (OSG) (n=11). For the LG, laser was applied to 3 points on each side of the face. Twelve applications were made, 2 sessions per week. In the OSG, patients were instructed to use the device during sleep, 8 hours per night, for a period of 6 weeks, and 12 adjustment and follow-up sessions were performed. Patients in both groups were reevaluated 30 days after the end of the treatments. Results: There was a decrease in pain intensity, according to a visual analogue scale, in both groups before and after 1 month (LG, p = 0.008 and OSG p = 0.002), but with no difference between groups. For the quality of life, both treatments had a positive impact, with this impact being higher in the LG compared to the OSG (p <0.05). Regarding the cost-effectiveness analysis, laser was more cost-effective than the occlusal splint in the clinical trial. The incremental cost of the laser was $3,483.45 compared to the splint, but it had a cost ratio of $4,569.02 for controlled pain intensity while the splint showed $6,691.91 ratio for controlled pain intensity. Conclusion: The photobiomodulation was more cost-effective in controlling painful symptoms in patients with TMD and myofascial pain.

scholarly journals Radial extarcorporeal shock waves: therapeutic myofascial protocol

2021 ◽  
pp. 1-5
Author(s):  
Barassi Giovanni ◽  
Guglielmi Vito ◽  
Della Rovere Franco ◽  
Di Iulio Antonella ◽  
Licameli Marco ◽  
...  
Keyword(s):  
Shock Waves ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Numerical Rating Scale ◽  
Trigger Points ◽  
Upper Trapezius ◽  
Significant Difference ◽  
Before And After ◽  
Numerical Rating ◽  
Base Of Support

The purpose of this study is to evaluate the effectiveness of radial shock waves in myofascial upper trapezius syndrome following the global treatment scheme of key trigger points. Materials and methods 26 patients treated with rESWT (Radial shock wave therapy) after a global postural and myofascial assessment of the patient and the identification of the key trigger points. At the end of the treatment each subject was re-evaluated through the Numerical Rating Scale - NRS and through the examination with Electronic Baropodometer. In this study, we compared the values of NRS and the values of postural biometrics before and after 2 sessions of rESWT, and a statistically significant difference (P <0.05) in all measurements emerged in the values measured with NRS. In the static percentage load, a statistically significant reduction in the percentage load differences (right / left) (P <0.05) was observed in all three evaluation moments (T0, T1, T2). The percentage and statistically significant improvement (P <0.05) were recorded at time T2 in the surface of the ellipse. Greater control of balance and greater awareness of the base of support was found in the calculation of the sway path, in particular with closed eyes. Based on this experience, the use of radial shock waves in pathologies related to myofascial pain with postural implications would be desirable.

Dynamic High-Field MR Imaging in Experimental Porcine Acute Pancreatitis

1995 ◽  
Vol 36 (2) ◽  
pp. 182-187 ◽  
Author(s):  
A. Piironen ◽  
R. Kivisaari ◽  
P. Pitkäranta ◽  
V.-P. Poutanen ◽  
P. Laippala ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Mr Imaging ◽  
High Field ◽  
Spin Echo ◽  
Flip Angle ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
The Stability ◽  
Signal Intensities

The effects of acute pancreatitis on MR imaging signal intensities (SIs) were determined in an experimental study at 1.0 T. Oedematous pancreatitis was induced in 9 piglets and haemorrhagic pancreatitis in 11 piglets. Each animal served as its own control for MR imaging before and after induction of pancreatitis. T1-weighted spin echo (450/15 ms) and dynamic turbo FLASH (flip angle 8°) sequences were used without contrast medium in testing the stability of the SI measurements. There was no significant difference in the SI-versus-time curves of the pancreas in piglets with oedematous and haemorrhagic pancreatitis. However, the difference in mean SIs between healthy and diseased piglets was significant. Thus, although non-contrast MR may be useful in the diagnosis of acute pancreatitis, it does not distinguish between oedematous and haemorrhagic pancreatitis.

scholarly journals Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders

2021 ◽  
Vol 12 ◽  
Author(s):  
Felice Festa ◽  
Chiara Rotelli ◽  
Antonio Scarano ◽  
Riccardo Navarra ◽  
Massimo Caulo ◽  
...  
Keyword(s):  
Nuclear Magnetic Resonance ◽  
Magnetic Resonance ◽  
Temporomandibular Joint ◽  
Myofascial Pain ◽  
Default Mode ◽  
Visual Analog Scales ◽  
Starting Point ◽  
Before And After ◽  
The Brain ◽  
Nuclear Magnetic

Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of the contracted skeletal muscle fibers. A correct clinical treatment of myofascial pain has the potential to modify the functional activation of cerebral networks associated with pain and unconscious teeth clenching, specifically the pain network (PN) and default mode network (DMN). In this study, research is presented as a case series of five patients with myofascial pain: three were diagnosed with intra- and extra-articular disorders, and two were diagnosed with only extra-articular disorders. All five patients received gnathological therapy consisting of passive splints and biofeedback exercises for tongue–palatal vault coordination. Before and after treatment, patients underwent pain assessments (through measures of visual analog scales and muscular palpation tests), nuclear magnetic resonance of the temporomandibular joint, and functional nuclear magnetic resonance of the brain. In each patient, temporomandibular joint nuclear magnetic resonance results were similar before and after the gnathological treatment. However, the treatment resulted in a considerable reduction in pain for all patients, according to the visual analog scales and the palpation test. Furthermore, functional nuclear magnetic resonance of the brain clearly showed a homogeneous modification in cerebral networks associated with pain (i.e., PN and DMN), in all patients. In conclusion, gnathological therapy consisting of passive aligners and biofeedback exercises improved myofascial pain in all five patients. Most importantly, this study showed that all five patients had a homogeneous functional modification of pain and default mode networks. Using passive splints in combination with jaw exercises may be an effective treatment option for patients with TMD. This research could be a starting point for future investigations and for clinicians who want to approach similar situations.

scholarly journals The difference of matrix metalloproteinase-9 level in saliva between myofascial pain and disc displacement of temporomandibular joint disorders

2017 ◽  
Vol 29 (2) ◽  
Author(s):  
Elita Rafni ◽  
Yanwirasti Y. ◽  
Eriyati Darwin ◽  
Rasmi Rikmasari
Keyword(s):  
Matrix Metalloproteinase ◽  
Temporomandibular Joint ◽  
Myofascial Pain ◽  
Matrix Metalloproteinase 9 ◽  
Temporomandibular Joint Disorders ◽  
Disc Displacement ◽  
Noninvasive Treatment ◽  
Significant Difference ◽  
The Difference ◽  
Metalloproteinase 9

Introduction: Saliva is the type of liquid which contains enzyme, hormone, antibody, constituent microbe, and cytokines. Matrix metalloproteinase-9 (MMP-9) is one kind of proteolysis cellular enzyme in saliva that has a role in inflammation. Saliva is very easy to take and noninvasive treatment, proved efficient for early diagnosis. The purpose of this research was to study the difference MMP-9 level in saliva patient with temporomandibular joint disorders between myofascial pain and disc displacement. Methods: Cross sectional comparative study. The research was carried out at the Prosthodontics Clinic of Arifin Achmad Pekanbaru Hospital and at Biomedical Laboratory of Faculty of Medicine, Universitas Andalas Padang, Indonesia. The saliva samples were taken from 37 myofascial pain patients and 37 disc displacement patients. MMP-9 levels were examined by the Elisa and the data result was analyzed using the t-test. Result: The average value of MMP-9 level of disc displacement was 650.98±384.94 pg/mL and myofascial pain was 168.70±41.24 pg/mL. There was a significant difference on MMP-9 level in saliva between myofascial pain and disc displacement (p<0.05). Conclusion: The MMP-9 level in saliva of patients with disc displacement of temporomandibular joint disorders was higher than patients with myofascial pain.

Improved Visualization and Assessment of Condylar Position in the Glenoid Fossa for Different Occlusions: A CBCT Study

2016 ◽  
Vol 17 (8) ◽  
pp. 679-686 ◽  
Author(s):  
Amandeep Kaur ◽  
Amanpreet S Natt ◽  
Simranjeet K Mehra ◽  
Karan Maheshwari ◽  
Amanjot Kaur
Keyword(s):  
Orthodontic Treatment ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Cone Beam ◽  
Glenoid Fossa ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Condylar Position ◽  
The Stability ◽  
The Right

ABSTRACT Introduction The position of the condyle in the glenoid fossa plays an important role in the stability of occlusion after orthodontic treatment. Cone beam computed tomography (CBCT) provides an optimal imaging of the osseous components of the temporomandibular joint (TMJ) and give a full size truly threedimensional (3D) description in real anatomical size. The present study aimed to visualize and compare the position of condyle in the glenoid fossa for different occlusions by using CBCT. Materials and methods Cone beam computed tomographic images of 45 subjects, aged 18 to 42 years, were evaluated. Subjects were equally divided into three groups according to the A point, nasion, B point (ANB) angle. Results In the sagittal plane, condyle is positioned nonconcentrically; positioned anteriosuperiorly in class I and III occlusions and lies posteriosuperiorly in class II occlusion. In the frontal plane, condyle is positioned centrally (mediolaterally) in all the three types of occlusions. In the axial plane, the parameters showed significant difference between the different occlusions. No statistical significant distinction could be made in the position of the condyle when comparing the right and left joints. Conclusion The position of condyle in glenoid fossa influences sagittal, transverse, and vertical relationships of the jaws which eventually contribute to development of various malocclusions. Nonconcentricity is the feature of the condyle in the sagittal plane in different malocclusions. Clinical significance An important consideration in orthodontic treatment is the recognition of the importance that the dentition should be in harmony with the related musculoskeletal structures. Therefore, the condylar position is an important concern in maintaining or restoring temporomandibular harmony with the dentition and the position of the condyle in the glenoid fossa plays an important role in the stability of occlusion after orthodontic treatment. How to cite this article Kaur A, Natt AS, Mehra SK, Maheshwari K, Singh G, Kaur A. Improved Visualization and Assessment of Condylar Position in the Glenoid Fossa for Different Occlusions: A CBCT Study. J Contemp Dent Pract 2016;17(8):679-686.

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