scholarly journals Complications Following Masseteric Nerve Neurectomy with Radiofrequency for the Treatment of Temporomandibular Disorders—A Case Series and Literature Review

2021 ◽  
Vol 11 (13) ◽  
pp. 5824
Author(s):  
Il-San Cho ◽  
Jung Hwan Jo ◽  
Ji Woon Park
Keyword(s):  
Physical Therapy ◽  
Literature Review ◽  
Male Patient ◽  
Temporomandibular Disorders ◽  
Scientific Evidence ◽  
Mouth Opening ◽  
Case Series ◽  
Chief Complaint ◽  
Joint Disease ◽  
Masseteric Nerve

This article describes two cases of masseteric nerve neurectomy with radiofrequency done with the intention to treat temporomandibular disorders and related symptoms; the patients then visited our clinic complaining of side-effects after the procedure. A literature review was conducted to find scientific evidence relevant to masseteric nerve neurectomy with radiofrequency. A 21-year-old male patient visited with the chief complaint of swelling of both cheeks, dizziness, and generalized lethargy occurring after masseteric nerve neurectomy using radiofrequency. His mouth opening range was restricted. Magnetic resonance imaging indicated post-procedural inflammation with hemorrhage within both masseter muscles. A 28-year-old male patient visited with the chief complaint of occlusal discomfort and disocclusion after masseteric nerve neurectomy using radiofrequency. His occlusion was abnormal with only both second molars occluding. Overbite was −1 mm. Cone-beam computed tomography indicated degenerative joint disease of both condyles. In case 1, pharmacotherapy and physical therapy relieved overall symptoms. In case 2, although exacerbation of symptoms repeatedly occurred, long-term stabilization splint and physical therapy alleviated the temporomandibular disorders symptoms. However, the occlusion remained unstable. Scientific evidence of masseteric nerve neurectomy using radiofrequency for the treatment of temporomandibular disorders is still lacking. Therefore, conservative treatment should remain as the first line approach for temporomandibular disorders.

scholarly journals Acupuncture in Temporomandibular Disorders Painful Symptomatology: An Evidence-Based Case Report

2020 ◽  
Vol 14 (04) ◽  
pp. 692-696
Author(s):  
Lia Dietrich ◽  
Igor Vinícius Santos Rodrigues ◽  
Marcelo Dias Moreira de Assis Costa ◽  
Roberta Furtado Carvalho ◽  
Gisele Rodrigues da Silva
Keyword(s):  
Case Report ◽  
Chinese Medicine ◽  
Temporomandibular Disorders ◽  
Myofascial Pain ◽  
Scientific Evidence ◽  
Muscle Relaxation ◽  
Mouth Opening ◽  
Evidence Based ◽  
Complementary Treatment ◽  
Emotional Balance

AbstractTemporomandibular dysfunction (TMD) is complex and multifactorial. Its etiology involves various factors, such as malocclusion, psychological patterns, parafunctional habits, and the temporomandibular joint anatomy. Symptoms include myofascial pain, joint clicking, mouth opening limitation, headaches, earaches, and neck pain, comprising one of the greatest causes of nondental pain. Acupuncture has been used to treat these conditions by acting locally both in muscle relaxation and pain management as well as reaching physical, mental, and emotional balance. The aim of this study is to present a brief literature review reporting the efficacy of acupuncture on TMDs and a case report in which the painful symptomatology of TMD was treated with a systemic protocol, based on scientific evidence and concepts of traditional Chinese medicine. Acupuncture may be a complementary treatment for TMD, and in this case report, it eliminated the patient’s painful symptomatology.

scholarly journals Clinical Reasoning for the Examination and Physical Therapy Treatment of Temporomandibular Disorders (TMD): A Narrative Literature Review

2020 ◽  
Vol 9 (11) ◽  
pp. 3686
Author(s):  
César Fernández-de-las-Peñas ◽  
Harry Von Piekartz
Keyword(s):  
Physical Therapy ◽  
Literature Review ◽  
Clinical Examination ◽  
Clinical Reasoning ◽  
Temporomandibular Disorders ◽  
Peripheral Sensitization ◽  
Top Down ◽  
Bottom Up ◽  
Narrative Literature ◽  
Narrative Literature Review

The current narrative literature review aims to discuss clinical reasoning based on nociceptive pain mechanisms for determining the most appropriate assessment and therapeutic strategy and to identify/map the most updated scientific evidence in relation to physical therapy interventions for patients with temporomandibular disorders (TMDs). We will also propose an algorithm for clinical examination and treatment decisions and a pain model integrating current knowledge of pain neuroscience. The clinical examination of patients with TMDs should be based on nociceptive mechanisms and include the potential identification of the dominant, central, or peripheral sensitization driver. Additionally, the musculoskeletal drivers of these sensitization processes should be assessed with the aim of reproducing symptoms. Therapeutic strategies applied for managing TMDs can be grouped into tissue-based impairment treatments (bottom-up interventions) and strategies targeting the central nervous system (top-down interventions). Bottom-up strategies include joint-, soft tissue-, and nerve-targeting interventions, as well as needling therapies, whereas top-down strategies include exercises, grade motor imagery, and also pain neuroscience education. Evidence shows that the effectiveness of these interventions depends on the clinical reasoning applied, since not all strategies are equally effective for the different TMD subgroups. In fact, the presence or absence of a central sensitization driver could lead to different treatment outcomes. It seems that multimodal approaches are more effective and should be applied in patients with TMDs. The current paper also proposes a clinical decision algorithm integrating clinical diagnosis with nociceptive mechanisms for the application of the most appropriate treatment approach.

scholarly journals Use of monoclonal antibodies for allergic bronchopulmonary aspergillosis in patients with asthma and cystic fibrosis: literature review

2020 ◽  
Vol 14 ◽  
pp. 175346662096164 ◽  
Author(s):  
Isabel C. Eraso ◽  
Saveria Sangiovanni ◽  
Eliana I. Morales ◽  
Liliana Fernández-Trujillo
Keyword(s):  
Cystic Fibrosis ◽  
Literature Review ◽  
Case Reports ◽  
Scientific Evidence ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Case Series ◽  
Lung Damage ◽  
Biological Drugs ◽  
Significant Clinical Improvement ◽  
Sparing Effect

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction (HR) mediated by antigens to Aspergillus fumigatus. It is estimated that 2–15% of patients with cystic fibrosis (CF) and between 1% and 5% of asthmatics develop ABPA, affecting approximately 4.8 million people worldwide. The goals of treatment are controlling inflammation, reducing the number of exacerbations and limiting the progression of lung damage. Systemic steroids are therefore used as the mainstay therapy, along with antifungal medications. However, many patients do not respond or develop side effects to treatment. In this scenario, biological drugs such as Omalizumab, Mepolizumab, Benralizumab and Dupilumab have been implemented in clinical practice, even though there is a lack of scientific evidence to support their use. We performed a literature review of the studies carried out which analyzed biologics for the management of ABPA in adult populations with asthma and CF. To our knowledge this is the first literature review that included all biologics. We included a total of 32 studies, all but one were descriptive studies, and the vast majority evaluated the use of Omalizumab. Biologics appeared to have more benefit for patients with ABPA and asthma than CF, specifically at decreasing the frequency of acute exacerbations and by having a steroid-sparing effect. Although a decrease in serum IgE level is considered a measure of therapy success, values may not decline as expected in the context of a significant clinical improvement, highlighting the importance of measuring patient-oriented outcomes. As evidence comes mainly from case series and case reports, randomized controlled trials are needed to evaluate further the safety and efficacy of biologics in ABPA. The reviews of this paper are available via the supplemental material section.

scholarly journals The Association between Occlusal Features and Temporomandibular Disorders in Northern Jordan: A Cross-sectional Study

2021 ◽  
Vol 15 (1) ◽  
pp. 145-150
Author(s):  
Mohammad S. Alrashdan ◽  
Ashraf Shaweesh ◽  
Abeer A. Khasawneh ◽  
Mohamed H. Sannoh
Keyword(s):  
Logistic Regression ◽  
Temporomandibular Disorders ◽  
Multinomial Logistic Regression ◽  
Mouth Opening ◽  
Cross Sectional Study ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Dental Occlusion ◽  
Cross Sectional ◽  
Axis I

Objective: To evaluate the possible correlation between basic occlusal features and the outcomes of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I. Materials and Methods: A convenient sample of Northern Jordanians was used in the study. Participants were examined in accordance with DC/TMD protocol. Nine occlusal features represented the independent variables; overjet, overbite, midline deviation, pain-free opening, maximum assisted opening, maximum unassisted opening, lateral excursions and protrusion, in addition to the opening pattern (classified as straight, corrected deviation and uncorrected deviation). DC/TMD diagnostic outcomes and their associated features represented the dependent variables, namely, pain-related TMD, Intra-articular Disorders (IAD), Degenerative Joint Disease (DJD), joint sounds (clicking and crepitus), joint locking and headache attributed to TMD. Binary logistic regression, multinomial logistic regression and Chi-square tests were used for statistical analyses. Results: A total of 400 participants represented the study population (mean age = 32.3±12.4 years, males=48%, females=52%). 71 subjects (18%) were diagnosed with pain-related TMD, 52 (13%) with IAD, 6 (1.5%) with DJD and 38 (10%) with headache due to TMD. Gender had a significant correlation with pain-related TMD (p= 0.014, OR= 2.16). Maximum pain free opening had a significant inverse relationship with pain related TMD (p= 0.013, OR=0.94), while midline deviation and corrected deviation mouth opening pattern had a significant correlation with IAD (p= 0.04,0.02, OR= 1.30,2.74, respectively). Overbite, midline deviation and pain free opening were significantly associated with unilateral open/close clicking (p= 0.04,0.05,0.03, OR= 0.77, 1.31, 0.94, respectively). Conclusion: There is a minimal clinical significance of the correlation between dental occlusion and TMD.

Infrapopliteal Arterial Pseudoaneurysm Development Secondary to Blunt Trauma: Case Series and Literature Review

2020 ◽  
Vol 54 (4) ◽  
pp. 367-374
Author(s):  
Matthew T. Chrencik ◽  
Brian Caraballo ◽  
John Yokemick ◽  
Peter J. Pappas ◽  
Brajesh K. Lal ◽  
...  
Keyword(s):  
Literature Review ◽  
Blunt Trauma ◽  
Case Series ◽  
Duplex Ultrasound ◽  
Endovascular Coiling ◽  
Skeletal Trauma ◽  
Delay In Diagnosis ◽  
Tibial Arteries ◽  
Pulsatile Mass ◽  
Orthopedic Injuries

Objectives: Infrapopliteal arterial pseudoaneurysms (IAP) following blunt trauma with associated orthopedic injuries are uncommon, often present in a delayed fashion, and encompass a diagnostic and therapeutic dilemma. Herein, we present a series of IAPs that were diagnosed following blunt trauma and their management. Methods: Case series consisting of 3 patients and a review of the international literature. Results: Our case series included 3 patients presenting with IAPs following blunt trauma with associated orthopedic injuries. They were all identified in a delayed manner (>3 weeks) after the orthopedic injuries were treated. All patients presented with pain and a pulsatile mass while one concurrently had neurologic deficits. The pseudoaneurysms were diagnosed by duplex ultrasound and confirmed by angiography to be originating from the tibioperoneal trunk, anterior tibial, and posterior tibial arteries respectively. Two patients were treated with surgical excision. Of these, one required an arterial bypass procedure while the other underwent direct ligation only. The third patient was treated by endovascular coiling. A literature review from 1950 to the present found 51 reported cases of IAP resulting from blunt trauma. Ninety percent of trauma-related infrapopliteal injuries occurred in men with a mean delay in diagnosis of 5.6 months (median 1.8 months) after injury. Since 1950, management has shifted from primarily ligation to incorporating minimally invasive endovascular techniques when appropriate. Conclusions: Infrapopliteal artery pseudoaneurysms are rare following blunt skeletal trauma. A delay in diagnosis often occurs and can result in major morbidity and extensive surgical intervention. We recommend a high index of suspicion and a thorough vascular examination in patients with lower extremity skeletal trauma to help identify and treat these injuries early and effectively.

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