Correlation of splint therapy outcome with the electromyography of masticatory muscles in temporomandibular disorder with myofascial pain

2011 ◽  
Vol 70 (1) ◽  
pp. 72-77 ◽  
Author(s):  
Emad T. Daif
Author(s):  
Joanna Kuć ◽  
Krzysztof Dariusz Szarejko ◽  
Maria Gołębiewska

The aim of the study was functional evaluation of soft tissue mobilization in patients with temporomandibular disorder-myofascial pain with referral. The study group consisted of 50 individuals—37 females and 13 males. The average age was 23.36 ± 2.14 years. All subjects were diagnosed with myofascial pain with referral (diagnostic criteria for temporomandibular disorders). Soft tissue mobilization was applied three times. Electromyography of selected masticatory muscles was performed six times—before and after the treatment. After each mobilization, a decreasing tendency of muscular activity was observed in the entire study group. The Friedman test indicated that mobilization altered the activity of the right temporal muscle (p = 0.00010), both masseters (p = 0.0000), right sternocleidomastoid (p = 0.00251), left sternocleidomastoid (p = 0.00033), and right and left digastric muscles (p = 0.00045 and p = 0.00000, respectively). With respect to symmetry a statistically significant difference was noted in the case of the sternocleidomastoid muscles (p = 0.00729). In conclusion, soft tissue mobilization seems to be effective in the relaxation of masticatory muscles in patients with temporomandibular disorders. Our findings proved that soft tissue mobilization does not improve the symmetry and synergy of the masticatory muscles limited by dental occlusion.


2018 ◽  
Author(s):  
Dr Malathi Dayalan ◽  
Dr Sudeshna Sharma ◽  
Dr Shweta Poovani ◽  
Dr Saher Altaf

BACKGROUND Masticatory system is a complex functional unit, primarily engaged in chewing, swallowing and breathing functions, and some parts are involved in taste recognition and determination of food consistency. Sophisticated functional performances of speech and emotional expressions are specifically human qualities. Irregularities in occlusion appears to be the precipitating factor in the pathogenesis of myofascial pain dysfunction syndrome. Tek- Scan III records the bite length, number, distribution, timing, duration and the relative force of each tooth contact. It also records the sequence of occlusal contacts in terms of time and the associated force with each occlusal contact. The aim of this study was to treat masticatory muscle disorders with occlusal equilibration, and compare the efficacy of treatment outcomes between selective grinding and stabilization splints using Tek-Scan III. OBJECTIVE Objective of this study was to compare the efficacy of occlusal equilibration achieved through selective griding and stabilization splints using Tek-Scan III. METHODS In this in vivo study, 40 patients with masticatory muscle disorders were selected based on the inclusion and exclusion criteria. The occlusal discrepancies were analyzed using Tek-Scan III. The selected 40 subjects were then randomly divided into 2 groups based on the treatment they recieved; Group I – Selective grinding group (20) and Group II – Stabilization splint group (20). Comparison of pre-treatment and post treatment results were evaluated in terms of pain, mouth opening, left and right side force percentage as recorded through Tek-Scan III and reduction of disclusion time. Statistical analysis was carried out with Kolmogorov Smirnov test, Wilcoxon matched pair test and Mann-Whitney U test. RESULTS Wilcoxon matched pairs test demonstrated that there was statistically significant results ( p = 0.0007) in both the groups for reduction of disclusion time, elimination of pain and improved mouth opening. Patients in Group I showed better results as compared to Group II in terms of disclusion time, pain and mouth opening. CONCLUSIONS Occlusal equilibration brought about by reducing the disclusion time using the Tek- Scan III reduced the symptoms of pain in masticatory muscles. Patients in group I (Selective grinding) however showed better results when compared to patients in group II (Stabilization splints).


2021 ◽  
Vol 5 (1) ◽  
pp. 37
Author(s):  
João Belo ◽  
André Almeida ◽  
Paula Moleirinho-Alves ◽  
Catarina Godinho

Temporomandibular disorder (TMD) encompasses a set of disorders involving the masticatory muscles, the temporomandibular joint and associated structures. It is a complex biopsychosocial disorder with several triggering, predisposing and perpetuating factors. In the etiology of TMD, oral parafunctions, namely bruxism, play a relevant role. The study of bruxism is complicated by some taxonomic and diagnostic aspects that have prevented achieving an acceptable standardization of diagnosis. The aim of this study was to analyze the prevalence of temporomandibular disorders and bruxism in a Portuguese sample.


2018 ◽  
Vol 23 (2) ◽  
Author(s):  
Geovana De Oliveira Polette Petrolli ◽  
Pamella Monteiro Mendes ◽  
Fernanda Angeloni De Souza ◽  
Matheus Coelho Blois

 Introdução: a disfunção temporomandibular (DTM) abrange muitos problemas clínicos nas articulações, na musculatura e em outras regiões da oroface. A ori­gem multifatorial e sua etiologia envolvem fatores psi­cocomportamentais, oclusais e neuromusculares, seu diagnóstico é realizado pela anamnese detalhada, com a identificação dos fatores predisponentes, iniciadores e perpetuantes, e pelo exame físico, que consiste em palpação da musculatura, mensuração da movimenta­ção ativa e verificação dos ruídos articulares. Objetivo: sistematizar as evidências científicas e verificar a eficá­cia do tratamento de disfunções temporomandibulares de origem muscular com a toxina botulínica do tipo A (TBX-A). Materiais e método: a busca bibliográfica foi realizada nas bases de dados PubMed e SciELO, com os descritores: “myofascial pain”, “botulinum toxin” e “masticatory muscles”. Foram analisados ensaios clíni­cos randomizados, que apresentaram tratamento para DTM com a utilização da TBX-A em pacientes de am­bos os sexos. A qualidade metodológica dos artigos se­lecionados foi verificada de acordo com a escala de Ja­dad. Considerações finais: observou-se que o tratamen­to para a DTM por meio da TBX-A auxilia no tratamento de dores orofaciais permanentes como coadjuvante, aliado a tratamentos conservadores. Os estudos que de­monstraram resultados clínicos significativos utilizaram uma dose total de 100 U de TBX-A, sendo 30 U nos músculos masseteres e 20 U nos músculos temporais, bilateralmente.


2015 ◽  
Vol 16 (9) ◽  
pp. 1056-1061 ◽  
Author(s):  
Marc Schmitter ◽  
Alexandra Kares-Vrincianu ◽  
Horst Kares ◽  
Justo Lorenzo Bermejo ◽  
Hans-Jürgen Schindler

Revista CEFAC ◽  
2017 ◽  
Vol 19 (5) ◽  
pp. 702-711 ◽  
Author(s):  
Taysa Vannoska de Almeida Silva ◽  
Maria das Graças Wanderley de Sales Coriolano ◽  
Carla Cabral dos Santos Accioly Lins

ABSTRACT Temporomandibular joint dysfunction is a set of disorders involving the masticatory muscles, temporomandibular joint and associated structures. It is known that the progression of motor symptoms in Parkinson's disease is an indication that these people are more prone to the development of this dysfunction. Thus, this study aims to investigate the signs and symptoms of temporomandibular dysfunction in people with Parkinson's disease. The search was performed in the databases: MEDLINE/ PubMed, LILACs, CINAHL, SCOPUS, Web of Science and PEDro, without timing or language restriction. Specific descriptors were used for each database and keywords, evaluated by the instruments: Critical Appraisal Skill Program and Agency for Health care and Research and Quality. A total of 4,209 articles were found but only 5 were included. After critical analysis of the methodology of the articles, one did not reach the minimum score required by the evaluation instruments, thus, it was excluded. The selected articles addressed, as signs and symptoms of temporomandibular joint dysfunction, the following: myofascial pain, bruxism, limitation of mouth opening, dislocation of the articular disc and asymmetry in the distribution of occlusal contacts. Further studies are needed in order to determine the relationship between cause and effect of the analyzed variables, so as to contribute to more specific and effective therapeutic interventions.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Wyllka Cyntya Galvão da Silva ◽  
Karolinne Domingos Medeiros ◽  
Eloisa Cesário Fernandes ◽  
Sandja Gabriela Oliveira ◽  
Caio Rodrigues Maia ◽  
...  

Introdução: A Disfunção Temporomandibular (DTM) é um quadro patológico que afeta o sistema estomatognático e, frequentemente, acompanhada de dor. Objetivos: Aferir o nível de dor dos pacientes portadores de DTM e a prevalência de sintomatologia articular e muscular. Percebeu-se que a relação entre a origem da DTM e a sintomatologia dolorosa é pouco relatada na literatura. Materiais e Métodos: Trata-se de um estudo descritivo, observacional de corte transversal, desenvolvido com 30 pacientes com DTM, diagnosticado pelo Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A amostra foi determinada pelas estimativas de atendimento. A associação entre a sintomatologia e a origem da DTM foram verificadas através do teste qui-quadrado, com intervalos de confiança (95%). Foi usada uma ficha clínica para a coleta de dados com idade, gênero e nível da dor, que foi aferido através da Escala Visual Analógica de dor. Resultados: Constatou-se que 26 pacientes eram do sexo feminino e 4 do sexo masculino. Quinze apresentaram idade inferior a 36,5 anos, e os outros uma idade superior a esta. Quanto a origem da DTM, 19 tinham desordem articular e 11 muscular. A categoria moderada foi o nível mais prevalente, seguida do intenso. Determinou-se que não houve associação estatisticamente significante entre as variáveis deste estudo com a DTM. Conclusão: Constatou-se que, os fatores etiológicos analisados isoladamente não influenciam de forma única no desenvolvimento da DTM, mas poderão atuar em conjunto com outros fatores, já que a sua causa é multifatorial.Descritores: Dimensão Vertical; Boca Edêntula; Dor Facial; Síndrome da Disfunção da Articulação Temporomandibular.ReferênciasDworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301-55.Gonçalves DAG, Bigal ME, Jales LCF, Camparis CM, Speciali JG. Headache and symptoms of temporomandibular disorders: an epidemiologic study. Headache. 2010;50(2):231-41.Piccin CF, Pozzebon D, Chiodelli L, Boufleus J, Pasinato F, Corrêa ECR. Aspectos clínicos e psicossociais avaliados por critérios de diagnóstico para disfunção temporomandibular. Revista Cefac. 2016;18(1):113-19.Winocur E, Emodi-Perlman A. Occlusion, orthodontic treatment and temporomandibular disorders: myths and scientific evidences. in: Orthodonthics-basis aspects and clinical considerations. In Tech. 2012.Jorge JMS, Dini C, Santos L, Camara de Bem SH, Custodio W. Associação entre dimensão vertical de oclusão e transtornos temporomandibulares. ClipeOdonto – UNITAU. 2016;8(1):44- 50.Bayma PTC, Feltrin PP, Dias CAS, Costa JF, Laganá DC, Inoue RT. Temporomandibular disorders in otolaryngology patients. RGO (Porto Alegre). 2010;58(3):313-17.Martinez JE, Grassi DC, Marques LG. Análise da aplicabilidade de três instrumentos de avaliação de dor em distintas unidades de atendimento: ambulatório, enfermaria e urgência. Rev Bras Reumatol. 2011;51(4):299-308.Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE et al. Painful temporomandibular disorder: decade of discovery from OPPERA studies. J Dental Res. 2016; 95(10):1084-92.Rauhala K., Oikarinen KS, Raustia AM. Role of temporomandibular disorders (TMD) in facial pain: occlusion, muscle and TMJ pain. Cranio. 1999;17(4):254-61.Manfredini D, Favero L, Gregorini G, Cocilovo F, Guarda-Nardini L. Natural course of temporomandibular disorders with low painrelated impairment: a 2-to-3-year follow-up study. J Oral Rehabil. 2013;40(6):436-42.Freitas LS. Associação da disfunção Temporomandibular com o polimorfismo 102T-C do gene receptor da serotonina HTR2A [tese]. São José do Rio Preto: Faculdade de Medicina do São José do Rio Preto – FAMERP; 2011.Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res. 2008;87(4):296-307.Lopes PRR, Campos PSF, Nascimento RJM. Dor e inflamação nas disfunções temporomandibulares: revisão de literatura dos últimos quatro anos. R Ci med biol. 2011;10(3):317-25.Wang X, Guo H, Wang Y, Yi X. The effects of estrogen on cytoplasmic ca2+ concentration of masticatory muscles myoblast in acid condition. 5th International Conference on Bioinformatics and Biomedical Engineering (iCBBE); 10-12 May 2011; Wuhan, China. Anais. Disponível em http://www.icbbe.org/2011/Proceeding2010.aspx.Cairns BE. Pathophysiology of TMD Pain—Basic Mechanisms and Their Implications for pharmacotherapy. J Oral Rehabil. 2010; 37(6):391-410.Portinho CP, Razera MV, Splitt BI, Gorgen ARH, Faller GJ, Collares MVM. Apresentação clínica inicial em pacientes com disfunção Temporomandibular. Rev Bras Cir Craniomaxilofac. 2012;15(3):109-12.


2018 ◽  
Vol 24 (3) ◽  
pp. 107-111 ◽  
Author(s):  
Alexis Kahn ◽  
Helios Bertin ◽  
Pierre Corre ◽  
Morgan Praud ◽  
Arnaud Paré ◽  
...  

Introduction: Temporomandibular disorders (TMD) are a common and invalidating disease sometimes difficult to treat. Current international recommendations favour reversible and non-invasive treatments, including the injection of botulinum toxin (BTX) into masticatory muscles. There is no strong evidence of its effectiveness. Objective: The main goal of this study was to assess the effectiveness of BTX six months following injection, in terms of pain, mouth opening, improvement of symptoms and duration of effect. Materials and methods: A retrospective study carried out at Nantes University Hospital between 2014 and 2016. Results: Thirty-four patients were included. The mean age was 37 years (17–76) and seventy six percents were female. Eighty percent of patients reported a significant improvement, notably in cases of arthralgia, which decreased in 8/18 (44%) patients (p < 0.05). The mean duration of measured efficacy was 4.2 months. Discussion: Significant improvement in cases of arthralgia and a tendency for improvement in cases of myalgia, with a mean duration of action of 4.2 months. Although BTX injection do not guarantee complete resolution of myofascial pain, it have been shown to have beneficial effects on some symptoms have been shown. Conclusion: Botulinum toxin should be considered as an alternative treatment when other conservative methods fail to yield satisfactory results. A thorough multicentre assessment is necessary in the future to scientifically validate its use.


10.2196/22326 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22326
Author(s):  
Julia Lam ◽  
Peter Svensson ◽  
Per Alstergren

Background Chronic pain from temporomandibular disorders remains an undertreated condition with debate regarding the most effective treatment modalities. Objective The aim of the study was to investigate the treatment effect of an internet-based multimodal pain program on chronic temporomandibular disorder pain and evaluate the feasibility of a larger randomized controlled trial. Methods An unblinded randomized controlled pilot trial was conducted with 43 participants (34 females, 9 males; median age 27, IQR 23-37 years) with chronic temporomandibular pain. Participants were recruited within the Public Dental Health Service and randomized to intervention (n=20) or active control (n=23). The intervention comprised a dentist-assisted internet-based multimodal pain program with 7 modules based on cognitive behavior therapy and self-management principles. The control group received conventional occlusal splint therapy. Primary outcomes included characteristic pain intensity, pain-related disability, and jaw functional limitation. Secondary outcomes were depression, anxiety, catastrophizing, and stress. Outcomes were self-assessed through questionnaires sent by mail at 3 and 6 months after treatment start. Feasibility evaluation included testing the study protocol and estimation of recruitment and attrition rates in the current research setting. Results Only 49% of participants (21/43) provided data at the 6-month follow-up (internet-based multimodal pain program: n=7; control: n=14). Of the 20 participants randomized to the internet-based multimodal pain program, 14 started treatment and 8 completed all 7 modules of the program. Between-group analysis showed no significant difference for any outcome measure at 3- or 6-month follow-up—characteristic pain intensity (3 months: P=.58; 6 months: P=.41), pain-related disability (3 months: P=.51; 6 months: P=.12), jaw functional limitation (3 months: P=.45; 6 months: P=.90), degree of depression (3 months: P=.64; 6 months: P=.65), anxiety (3 months: P=.93; 6 months: P=.31), stress (3 months: P=.66; 6 months: P=.74), or catastrophizing (3 months: P=.86; 6 months: P=.85). Within-group analysis in the internet-based multimodal pain program group showed a significant reduction in jaw functional limitation score at the 6-month follow-up compared to baseline (Friedman: χ2=10.2, P=.04; Wilcoxon: z=–2.3, P=.02). In the occlusal splint group, jaw function limitation was also reduced at the 6-month follow-up (Friedman: χ2=20.0, P=.045; Wilcoxon: z=–2.3, P=.02), and there was a reduction in characteristic pain intensity at the 3- and 6-month follow-up (Friedman: χ2=25.1, P=.01; Wilcoxon 3 months: z=–3.0, P=.003; Wilcoxon 6 months: z=-3.3, P=.001). Conclusions This study was not able to demonstrate a difference in treatment outcome between an internet-based multimodal pain program and occlusal splint therapy in patients with chronic temporomandibular pain. However, the findings suggested that the internet-based multimodal pain program improves jaw function. The results also confirmed the treatment effect of occlusal splint therapy for chronic temporomandibular pain. Furthermore, because of the high attrition rate, this pilot study showed that a randomized controlled trial with this design is not feasible. Trial Registration ClinicalTrials.gov NCT04363762; https://clinicaltrials.gov/show/NCT04363762


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