THE FEATURES OF ORTHODONTIC TREATMENT OF PATIENTS WITH MALOCCLUSION AND TEMPOROMANDIBULAR DISORDERS

The effectiveness of the developed algorithm of clinical and laboratory stages of treatment of patients with malocclusion, complicated TMD was proved by the evaluation of objective criteria for functional restoration of masticatory organ. The study group consisted of 24 patients with malocclusion of varying degrees of severity and various clinical manifestations of TMD. Everyone had a clinical examination and electromyography of masticatory muscles at the beginning of orthodontic treatment, after 1, 3 months of functional correction. After the first stage of orthodontic treatment by using of the proposed method a physiological muscle balance, the absence of complaints and symptoms of TMD were found in all patients.

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The Efficiency of Anterior Repositioning Splints in the Management of Pain Related to Temporomandibular Joint Disc Displacement with Reduction

Pain Research and Management ◽

10.1155/2018/9089286 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Malgorzata Pihut ◽

Malgorzata Gorecka ◽

Piotr Ceranowicz ◽

Mieszko Wieckiewicz

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Rating Scale ◽

Numerical Rating Scale ◽

Masticatory Muscles ◽

Control Group ◽

Study Group ◽

Disc Displacement ◽

Temporomandibular Joint Disc ◽

Disc Displacement With Reduction

Background and Objective. Intra-articular temporomandibular disorders are often related to pain in the area of the temporomandibular joint, ear, and temple. The aim of the study was to investigate the efficiency of anterior repositioning splints in decreasing pain related to temporomandibular joint disc displacement with reduction. Methods. The research material consisted of 112 patients, aged 24 to 45 years, of both genders, who reported for treatment at the Consulting Room of Temporomandibular Joint Dysfunctions at the Jagiellonian University in Cracow between 2014 and 2016 due to pain in the area of the temporomandibular joint(s) and noise(s) of temporomandibular joint(s) present during jaw movements with comorbid contracture of masticatory muscles. Subjects were examined according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and, after diagnosis of painful disc displacement with reduction and masticatory muscle contracture, they were assigned randomly to either the study or control groups (56 patients in each). In the study group, we used an anterior repositioning splint on the full lower arch for about 20 hours usage over a 4-month period. In the control group, a noninvasive therapy was applied using a biostimulation laser over 12 sessions performed every second day on the area of both temporomandibular joints with mouth open and while performing muscle self-exercises with a dominant protrusive position of the mandible. Pain intensity was evaluated using the Verbal Numerical Rating Scale (VNRS) immediately before the treatment and then after 4 and 16 weeks. The obtained data were analyzed using the Mann–Whitney U test p≤0.005. Results. The VNRS values reported during the final examination for the study group were significantly lower than for the control group p=0.0004. Conclusions. The anterior repositioning splint is an efficient tool in decreasing pain related to disc displacement with reduction. This trial is registered with Clinicaltrials.gov NCT03057262.

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Examination of the bioelectrical activity of the masticatory muscles during Angle’s Class II division 2 therapy with an activator

Vojnosanitetski pregled ◽

10.2298/vsp130901058p ◽

2014 ◽

Vol 71 (12) ◽

pp. 1116-1122

Author(s):

Djordje Petrovic ◽

Sanja Vujkov ◽

Branislava Petronijevic ◽

Ivan Sarcev ◽

Igor Stojanac

Keyword(s):

Maximal Voluntary Contraction ◽

Orthodontic Treatment ◽

Class Ii ◽

Masticatory Muscles ◽

Voluntary Contraction ◽

First Year ◽

Bioelectrical Activity ◽

Study Group ◽

Electromyographic Activity ◽

Angle Class

Background/Aim. The muscles of the orofacial region have great influence on the development of dentition and occlusion formation. It is known that improper function of these muscles is one of the major etiological factors in malocclusion. A correlation between function disorders of orofacial muscle and occlusion disorders has been confirmed, as well as a correlation between the bioelectric activity of the masticatory muscles, recorded by electromyography, and bite force upon maximal voluntary contraction of these muscles. The aim of the study was to analyze the bioelectriacal activity of temporal and masseter muscles. Methods. The sample consisted of 100 subjects of both sexes, divided into the control group (n = 30) with neutral and complete dental arches, and the study group (n = 70) of patients with distal occlusion. Electromyographic measurement of bioelectric potentials in all the subjects was conducted for the examined muscles in the physiologic rest position, central mandible occlusion, and during maximal voluntary contraction of muscles and saliva swallowing, in Angle Class I and II/2 occlusal relation-ships, prior to treatment, after one year of the orthodontic treatment and after the treatment with an activator. Results. Comparing the values of thebioelectrical activity in the control and the study group before the treatment, a decreased muscle activity was established in all the three positions in the study group. After the first year of orthodontic treatment the results showed an elevation in the bioelectrical activity in both muscles. After treatment with an activator, the bioelectrical activity in both muscles in the study group was higher than before the treatment, as it is confirmed by a positive highly significant coefficient of correlation. Conclusion. In all the three measured positions of the mandible with Angle Class II/2 malocclusion, bioelectrical activity was lowest at baseline and increased during the first year of treatment, and at the end of the treatment it partially reduced close to the approximate values in normal occlusion. Research on electromyographic activity of masticatory muscles is useful in everyday clinical practice, especially in present distinctive skeletal discrepancy before, during and after orthodontic treatment, if on the bases of the results we can evaluate the treatment, but also determine the start and duration of the retention period and retention device type.

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Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249576 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9576

Author(s):

Joanna Kuć ◽

Krzysztof Dariusz Szarejko ◽

Maria Gołębiewska

Keyword(s):

Soft Tissue ◽

Temporomandibular Disorders ◽

Myofascial Pain ◽

Temporomandibular Disorder ◽

Masticatory Muscles ◽

Study Group ◽

Functional Evaluation ◽

Entire Study ◽

Significant Difference ◽

Soft Tissue Mobilization

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.

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SPIELBERGER STATE-TRAIT ANXIETY INVENTORY FOR PATIENTS WITH EXCESSIVE TOOTH ABRASION AND TEMPOROMANDIBULAR DISORDERS

Ukrainian Dental Almanac ◽

10.31718/2409-0255.3.2019.08 ◽

2019 ◽

pp. 49-56

Author(s):

N.S. Mahera

Keyword(s):

Trait Anxiety ◽

Temporomandibular Disorders ◽

Masticatory Muscles ◽

Control Group ◽

Study Group ◽

State Trait Anxiety Inventory ◽

Situational Anxiety ◽

Personal Anxiety ◽

High Level ◽

Tooth Abrasion

Hypertonia and parafunction of masticatory muscles (bruxism), which cause prolonged non-functional sliding movements of the mandible against the maxilla with teeth closed, contribute to the development of functional overload. Increased activity of masticatory muscles may occur due to the agitation of the central nervous system. On the periphery, its action manifests itself in the form of dysfunctions and bruxism, which leads to fatigue in the masticatory muscles, their spasm and the development of symptoms of the pain dysfunction syndrome. There is also an inverse relationship between local disturbances of occlusion and the development of stress. This case occurs, because in stress situations the adaptive capacity for local disturbances of the motor part of the masticatory system, including the disturbances of occlusion, is reduced. This causes a motor reaction in the form of dysfunctions of closing masticatory apparatus, which, in long-term stressful situations, can turn into well-established habits. This explains the appearance of pain symptoms of dysfunction in stressful situations. Consequently, there is convincing evidence that psychological and psychosocial factors play an important role in understanding the TMDs, but there is no conclusive evidence that these factors are etiologic ones. The purpose of the study is to determine personal and situational anxiety in patients with excessive tooth abrasion alone and those with both excessive tooth abrasion and temporomandibular disorders, comparing them with each other. Materials and Methods. 68 patients were included in the study, 31 (45.6%) included male and 37 (54.4%) contained female patients aged 21 to 70. Studied patients were divided into two groups: the control group and the study group. The control group included 31 patients diagnosed only with excessive tooth abrasion in combination with possible other occlusal disorders. The study group included 37 patients with excessive tooth abrasion, possibly with other occlusal disorders and various forms of temporomandibular disorders: muscle, articular, and combined. The study was conducted individually using the Spielberger State-Trait Anxiety Inventory (STAI), which included instructions and 40 questions, 20 of which were designed to assess the level of situational anxiety (SA) and 20 – to assess the level of personal anxiety (PA). Online questionnaire at: http://psytests.org/psystate/spielberger-run.html was used for automatic data processing of Spielberger psychological evaluation of patients. Results. A high level of personal anxiety was observed in patients of the study group with both excessive tooth abrasion and TMDs, in comparison with patients in the control group (48.6% of patients in the study group vs. 0% in the control group), p<0.001. Furthermore, a significant prevalence of patients with a high level of situational anxiety was determined among the patients in the study group with excessive tooth abrasion and TMDs, in comparison with patients in the control group with excessive tooth abrasion alone (64.0% in the study group vs. 3.2% in the control group, p<0.001). Thus, statistically significant signs of a high level of personal and situational anxiety were found among patients with excessive tooth abrasion and present temporomandibular disorders in comparison with patients who have only excessive tooth abrasion.

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Temporomandibular Disorders and Bruxism Prevalence in a Portuguese Sample

Medical Sciences Forum ◽

10.3390/msf2021005037 ◽

2021 ◽

Vol 5 (1) ◽

pp. 37

Author(s):

João Belo ◽

André Almeida ◽

Paula Moleirinho-Alves ◽

Catarina Godinho

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Masticatory Muscles ◽

Diagnostic Aspects ◽

Relevant Role

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.

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Orthodontic Treatment and Craniocervical Posture in Patients with Temporomandibular Disorders: An Observational Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063295 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3295

Author(s):

Maria Paço ◽

José Alberto Duarte ◽

Teresa Pinho

Keyword(s):

Temporomandibular Disorders ◽

Orthodontic Treatment ◽

Hyoid Bone ◽

Craniofacial Morphology ◽

P Value ◽

Skeletal Class ◽

Treatment Data ◽

Phase Data ◽

Condylar Displacement ◽

Clinical Records

Orthodontic treatment acts through the application of forces and/or by stimulating and redirecting the functional forces within the craniofacial complex. Considering the interrelationship between craniomandibular and craniocervical systems, this intervention may alter craniocervical posture. Thus, our aim is to (a) compare craniocervical posture, hyoid bone position, and craniofacial morphology before, after, and also in the contention phase at least one year after the orthodontic treatment, in patients with temporomandibular disorders and (b) to verify whether the presence of condylar displacement, the skeletal class, or the facial biotype interferes with the abovementioned outcomes. To do so an observational, analytical, longitudinal, and retrospective design study was carried out. A non-probabilistic convenience sampling method was applied. The sample consisted of clinical records of patients diagnosed with temporomandibular disorders in order to compare pre-orthodontic treatment with post-orthodontic treatment (n = 42) and contention phase data (n = 26). A cephalometric analysis of several variables was performed. The p-value was set as 0.05. When the pre- and post-orthodontic treatment data were analyzed, there were statistically significant changes in variables concerning craniocervical posture (CV angle, C0-C1, and AA-PNS) and also concerning hyoid bone position (C3-Rgn). When pre- and post-orthodontic treatment and contention phase data were analyzed the variables concerning craniocervical posture (C0-C1, CVT/Ver, NSL/OPT, NSL/CVT, NSL/Ver; OPT/CVT, OPT/Ver) and facial biotype had statistically significant changes. This allowed us to conclude that in the sample studied, there were significant differences regarding hyoid bone position (pre- versus post-orthodontic treatment) and craniocervical posture (pre- versus post-orthodontic versus contention), with the craniocervical posture being prone to return to basal values. The presence of condylar displacement was found to significantly increase the H-H1 distance in the three moments of evaluation. Facial biotype was found to significantly increase the NSL/Ver angle on hypodivergent compared to hyperdivergent in the contention phase.

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SAT0316 ANTI-PM/SCL ANTIBODIES IN SYSTEMIC SCLEROSIS: CLINICAL ASSOCIATIONS IN THE RESCLE COHORT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3304 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1103.1-1104

Author(s):

N. Iniesta-Arandia ◽

G. Espinosa ◽

A. Guillen del Castillo ◽

C. Tolosa ◽

G. M. Lledó ◽

...

Keyword(s):

Systemic Sclerosis ◽

Survival Data ◽

Death Rate ◽

Administrative Support ◽

Medical Science ◽

Survival Rates ◽

Clinical Manifestations ◽

Study Group ◽

Allergy Immunol ◽

Science Service

Background:Anti-PM/Scl antibodies are associated to systemic sclerosis (SSc) but are not specific to SSc. The true prevalence of anti-PM/Scl antibodies in SSc is unknown, ranging from 2.5% to 12.5%. An association between anti-PM/Scl antibodies with muscular involvement, pulmonary fibrosis, calcinosis, and a relatively benign prognosis have been described.Objectives:To compare the clinical manifestations and prognosis of SSc patients according the presence of anti-PM/Scl antibodies in the cohort of RESCLE (Spanish Scleroderma Registry).Methods:From the Spanish Scleroderma Study Group database, we selected patients in whom anti-PM/Scl antibodies had been tested. We compared demographic features, clinical manifestations, laboratory characteristics, and survival data between patients according the anti-PM/Scl antibodies status.Results:72 out of 947 (7%) patients tested positive for anti-PM/Scl antibodies. As presenting SSc manifestations, patients with anti-PM/Scl antibodies had higher prevalence of puffy fingers (11% versus 2%; p=0.002) and arthralgias (11% versus 4%; p=0.03), and lower prevalence of Raynaud’s phenomenon (65% versus 82%, p=0.002). Regarding cumulative manifestations, myositis (51% versus 15%; p<0.001), arthritis (43% versus 22%; p=0.001), and interstitial lung disease (ILD) (60% versus 45%, p=0.014) were more prevalent in patients with anti-PM/Scl antibodies. In fact, those patients with anti-Pm/Scl antibodies presented with FVC (77.4% ± 23.1% versus 85.8% ± 23,1%; p=0.006) and more severe ILD defined as FVC <70% (41% versus 24%; p=0.004). Death rate was similar in patients with and without PM/Scl antibodies (18% versus 17%; p=0.871).We did not find differences in terms of death rate nor in the causes of death (SSc and non-SSc related) according to the anti-PM/Scl antibodies profile.The 5- and 10-years survival rates of patients with anti-PM/Scl antibodies were 91% and 82% respectively, without differences with those without these antibodies (93% and 85%, respectively).Conclusion:In Spanish SSc patients, the presence of anti-PM/Scl antibodies confer a distinctive clinical profile. However, anti-PM/Scl antibodies do not play a role in the prognosis of these patients.References:[1]Stochmal A, Czuwara J, Trojanowska M, Rudnicka L. Antinuclear antibodies in systemic sclerosis: an update. Clin Rev Allergy Immunol 2020;58(1):40-51. doi: 10.1007/s12016-018-8718-8.Acknowledgments:We gratefully acknowledge all investigators who are part of the RESCLE Registry. We also thank the RESCLE Registry Coordinating Centre, S&H Medical Science Service, for their quality control data, logistic and administrative support and Prof. Salvador Ortiz, Universidad Autónoma de Madrid and Statistical Advisor S&H Medical Science Service for the statistical analysis of the data presented in this paper.Disclosure of InterestsNerea Iniesta-Arandia: None declared, Gerard Espinosa Speakers bureau: Glaxo-Smith-Kline, Janssen, Boehringer, Rovi, Alfredo Guillen del Castillo: None declared, Carles Tolosa Consultant of: Actelion pharmaceuticals, GSK, MSD., Gema Maria Lledó: None declared, Dolores Colunga Argüelles Consultant of: Actelion pharmaceuticals, GSK, MSD., Cristina González-Echávarri: None declared, Luis Sáez-Comet: None declared, Norberto Ortego: None declared, Jose Antonio Vargas-Hitos: None declared, Manuel Rubio-Rivas: None declared, Mayka Freire: None declared, Juan José Rios: None declared, Monica Rodriguez-Carballeira: None declared, Luis Trapiella Martínez: None declared, Vicent Fonollosa Pla Speakers bureau: Actelion, Carmen Pilar Simeón-Aznar Consultant of: Actelion pharmaceuticals, GSK, MSD., on behalf of RESCLE Investigators, Autoimmune Diseases Study Group (GEAS): None declared

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Short-Term Effect of Orthodontic Treatment with Clear Aligners on Pain and sEMG Activity of Masticatory Muscles

Medicina ◽

10.3390/medicina57020178 ◽

2021 ◽

Vol 57 (2) ◽

pp. 178

Author(s):

Alessandro Nota ◽

Silvia Caruso ◽

Shideh Ehsani ◽

Gianmaria Fabrizio Ferrazzano ◽

Roberto Gatto ◽

...

Keyword(s):

Surface Electromyography ◽

Orthodontic Treatment ◽

Masticatory Muscles ◽

Rank Test ◽

Nominal Data ◽

Chi Square ◽

Initial Reduction ◽

Signed Rank Test ◽

Chi Square Test ◽

Semg Activity

Background and objectives: The aim of this study is to evaluate mandibular elevator muscles activity and pain on palpation in the early stages of orthodontic treatment with clear aligners using surface electromyography (sEMG). Materials and methods: Surface electromyography (sEMG) activity and pain level on muscle palpation of masseter and anterior temporalis muscles were recorded in a sample of 16 adult subjects (aged 18–32 years; mean 22.5 +/− 3.5 SD) undergoing orthodontic treatment with clear aligners before the treatment (T0), after 1 month of treatment (two clear aligners) (T1), and after 3 months of treatment (T2) (six clear aligners). A chi-square test for nominal data, a Friedman test, and a Wilcoxon-signed rank test as post hoc analysis were applied. Results: No statistically significant differences in muscular pain were observed. At T1, the sEMG activity of masseter muscles at mandibular rest position showed a statistically significant reduction, but after 3 months (T2), the data appeared similar to T0 (p = 0.03 and p = 0.02). Conclusions: During the treatment with clear aligners, subjects could experience an initial reduction in the masseter basal activity after 1 month of treatment. This effect tends to decrease to baseline levels after 3 months of therapy.

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PAINFUL TEMPOROMANDIBULAR DISORDERS ARE AN URGENT HEALTHCARE PROBLEM

Natural resources of the Earth and environmental protection ◽

10.26787/nydha-2713-203x-2021-2-1-18-22 ◽

2021 ◽

Vol 2 (1) ◽

pp. 18-22

Author(s):

Kirsanov S.I.

Keyword(s):

Temporomandibular Disorders ◽

Scientific Literature ◽

Pain Syndrome ◽

Masticatory Muscles ◽

Close Attention ◽

Maxillofacial Region ◽

Social Nature ◽

Number Of Factors ◽

High Prevalence

Despite nearly a century of research on diseases affecting the temporomandibular joint (TMJ), masticatory muscles and associated structures, this problem still remains open. Pain syndrome caused by TMJ diseases ranks first in terms of prevalence among non-odontogenic pain syn-dromes in the maxillofacial region and leads to a signifi-cant deterioration in the quality of life of patients. The high prevalence of these diseases in female patients and the presence of a number of factors of a somatic, psycho-logical and social nature, contributing to such a high prevalence, indicate the need for more close attention of researchers to these aspects, which can become a way to develop new effective methods for the diagnosis and treatment of TMJ diseases in this category of patients. A review of scientific literature was carried out in order to identify topical scientific issues related to the study, di-agnosis and treatment of TMJ diseases.

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The Molecular Basis of Beta-Thalassemia Intermedia in Egyptian Children and its Association with the Clinical Phenotype

QJM ◽

10.1093/qjmed/hcab113.024 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Iman Ahmed Ragab ◽

Shereen Mohamed Abd El-Ghany ◽

Tarek Mostafa Kamal ◽

Ghada Samir Abd El-Halim Elsayed

Keyword(s):

Clinical Manifestations ◽

Cross Sectional Study ◽

Beta Thalassemia ◽

Compound Heterozygous ◽

Beta Globin ◽

Thalassemia Intermedia ◽

Cross Sectional ◽

Pediatric Hematology ◽

Egyptian Children ◽

Degrees Of Severity

Abstract Background β-thalassemia syndromes involve a collection of extremely diverse phenotypes. The term β-thalassemia intermedia (β-TI) was suggested to describe patients who had clinical manifestations that are too severe to be termed minor thalassemia yet too mild to be termed major thalassemia. However, there remains substantial overlap between the three conditions. Aim of the Work To evaluate the variable clinical phenotypes among pediatric patients with βTI and to study the phenotype / genotype correlation with the encountered β-chain mutations. Patients and Methods A cross-sectional study was conducted on 37 Egyptian children and adolescents with TI following up regularly in the Pediatric Hematology clinic – Ain Shams University. Detailed Clinical evaluation and laboratory investigations were done. Reverse hybridization PCR based assay covering beta globin Mediterranean mutations onto specific biotinylated primers, was done. Results IVS 1.6 (T>C) was the most frequent mutation detected in 20 patients and 31 alleles (47.7%), followed by IVS 1.110 (G>A) detected in 7 patients and 8 alleles (12.31%), followed by IVS 1.1 (G>A) and CD27 knossos (G>T), each was detected in 6 patients and 6 alleles (9.23%). β+β+ was the most frequent genotype (54%), followed by β+β/β°β (21.6%) and β°β+ (13.5%). 60% of β°β+ patients had TDT(Transfusion dependent thalassemia), while 87.5% of β + β/β°β patients and 55% of β + β+ patients had NTDT ((Non transfusion dependent thalassemia). Conclusion Inheritance of mild β+ thalassemia mutations among Egyptian children; as IVS 1.6 (T>C) and IVS 1.110 (G>A) is the most frequent contributor to TI phenotype in either homozygous or compound heterozygous states. Patients with the same underlying genotype presented variable phenotypes with different degrees of severity.

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