Evaluation of Temporomandibular Disk Position in Symptomatic Temporomandibular Disorder Patients with Gnathological Splint Therapy Using MRI

2020 ◽  
Vol 11 (1) ◽  
pp. 97
Author(s):  
K. Sridhar ◽  
M. S. Kannan ◽  
Anon Faisaltajir ◽  
Anon Gnanashanmugam
Keyword(s):  
Temporomandibular Disorder ◽  
Splint Therapy

scholarly journals Internet-Based Multimodal Pain Program With Telephone Support for Adults With Chronic Temporomandibular Disorder Pain: Randomized Controlled Pilot Trial

10.2196/22326 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22326
Author(s):  
Julia Lam ◽  
Peter Svensson ◽  
Per Alstergren
Keyword(s):  
Pain Intensity ◽  
Temporomandibular Disorder ◽  
Functional Limitation ◽  
Pilot Trial ◽  
The Internet ◽  
Occlusal Splint ◽  
Splint Therapy ◽  
Randomized Controlled ◽  
Temporomandibular Pain

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

scholarly journals Interdisciplinary Management of an Orthodontic Patient with Temporomandibular Disorder

2017 ◽  
Vol 7 ◽  
pp. 230-241 ◽  
Author(s):  
Tsang Tsang Franklin She ◽  
Anita-Tak Ying Wong
Keyword(s):  
Temporomandibular Disorder ◽  
Anterior Segment ◽  
Computer Software ◽  
Signs And Symptoms ◽  
Class Ii ◽  
Interdisciplinary Management ◽  
Skeletal Class ◽  
Splint Therapy ◽  
Skeletal Class Ii ◽  
Anterior Disc Displacement

A 21-year-old female patient presented with temporomandibular disorder, skeletal Class II, Angle Class II division 2 malocclusion, gummy smile, and incomplete overbite was managed successfully by splint therapy and orthodontic camouflage with miniscrew anchorage and extraction. She was treated with occlusal splint to alleviate signs and symptoms of anterior disc displacement without reduction and the associated masticatory dysfunction and revealed the true malocclusion before orthodontic treatment. Computer software facilitated the formulation of visual treatment objective (VTO) and occlusogram which guided the whole arch intrusion, retraction of the upper anterior segment, mesialization of lower left dentition, and distalization of lower right dentition. In this case report, the rationale and importance of preorthodontic splint therapy and specific considerations in orthodontic mechanics for managing this patient were discussed.

scholarly journals Internet-Based Multimodal Pain Program With Telephone Support for Adults With Chronic Temporomandibular Disorder Pain: Randomized Controlled Pilot Trial (Preprint)

2020 ◽  
Author(s):  
Julia Lam ◽  
Peter Svensson ◽  
Per Alstergren
Keyword(s):  
Pain Intensity ◽  
Temporomandibular Disorder ◽  
Functional Limitation ◽  
Pilot Trial ◽  
The Internet ◽  
Occlusal Splint ◽  
Splint Therapy ◽  
Randomized Controlled ◽  
Temporomandibular Pain

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: <i>P</i>=.58; 6 months: <i>P</i>=.41), pain-related disability (3 months: <i>P</i>=.51; 6 months: <i>P</i>=.12), jaw functional limitation (3 months: <i>P</i>=.45; 6 months: <i>P</i>=.90), degree of depression (3 months: <i>P</i>=.64; 6 months: <i>P</i>=.65), anxiety (3 months: <i>P</i>=.93; 6 months: <i>P</i>=.31), stress (3 months: <i>P</i>=.66; 6 months: <i>P</i>=.74), or catastrophizing (3 months: <i>P</i>=.86; 6 months: <i>P</i>=.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, <i>P</i>=.04; Wilcoxon: z=–2.3, <i>P</i>=.02). In the occlusal splint group, jaw function limitation was also reduced at the 6-month follow-up (Friedman: χ2=20.0, <i>P</i>=.045; Wilcoxon: z=–2.3, <i>P</i>=.02), and there was a reduction in characteristic pain intensity at the 3- and 6-month follow-up (Friedman: χ2=25.1, <i>P</i>=.01; Wilcoxon 3 months: z=–3.0, <i>P</i>=.003; Wilcoxon 6 months: z=-3.3, <i>P</i>=.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. CLINICALTRIAL ClinicalTrials.gov NCT04363762; https://clinicaltrials.gov/show/NCT04363762

scholarly journals Evaluation of the 3 mm Thickness Splint Therapy on Temporomandibular Joint Disorders (TMDs)

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Nihat Akbulut ◽  
Ahmet Altan ◽  
Sibel Akbulut ◽  
Cemal Atakan
Keyword(s):  
Temporomandibular Disorder ◽  
Treatment Success ◽  
Mouth Opening ◽  
Normal Diet ◽  
Temporomandibular Joint Disorders ◽  
Negative Effects ◽  
Remarkable Effect ◽  
Splint Therapy ◽  
Diet Score

Objective. This study aimed at finding out whether the 3 mm thickness of stabilization splints has positive or negative effects on all temporomandibular disorder (TMD) symptoms. Materials and Methods. The statistical calculation included 25 (22 females; 3 males) TMD patients who received 3 mm thickness stabilization splint therapy. They were evaluated according to follow-up treatment period, TMD pain, muscle pain, mouth opening, diet score, and splint usage time per day. Results. There was important treatment success that 22 (88%) of patients were totally healed. There was not any remarkable effect or advancement of splints on total healings of TMDs in first 3 months’ period (11/25 patients, 44%). The mouth opening mean reached 38, 67 mm at 6 months and 41 mm at 12 months with remarkable success. Except one (4%) patient, other 24 (96%) patients had a normal diet score of 3 at the end of splint therapy. There was no correlation between splint usage duration a day and total healing of TMDs. Conclusion. We conclude that 3 mm splint therapy should maintain at least 6 months to achieve remarkable results. Splint should be used at least 12 h a day consistent with our results. Finally, diet score should be incorporated with TMD pain and amount of mouth opening; hence, we advise to use in one term as “total healing.”

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