| 1. |
- Canales, Giancarlo De La Torre, et al.
(författare)
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The role of tryptophan and its derivatives in musculoskeletal pains : A systematic review and meta-analysis
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842.
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Forskningsöversikt (refereegranskat)abstract
- Background: Studies present ambiguous findings regarding the role of tryptophan and its metabolites, kynurenine and serotonin in chronic musculoskeletal pain. This systematic review aimed to investigate the expression of tryptophan and its metabolites, serotonin and kynurenine in patients with local and generalized chronic musculoskeletal pain in comparison with pain-free controls.Methods: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL) and Web of Science for clinical and observational trials from the beginning of each database to 21 April 2023. Out of 6734 articles, a total of 17 studies were included; 12 studies were used in the meta-analysis of serotonin, 3 regarding tryptophan and 2 studies for a narrative synthesis regarding kynurenine. Risk of bias was assessed using the quality assessment tool for observational cohort and cross-sectional studies of the National Heart, Lung, and Blood Institute, while the certainty of evidence was by GRADE.Results: All included studies showed a low risk of bias. The meta-analysis showed lower blood levels of tryptophan (p < .001; very low quality of evidence) and higher blood levels of serotonin (p < .001; very low-quality evidence) in patients with generalized musculoskeletal pain, when compared to pain-free individuals. In local chronic musculoskeletal pain, there were higher blood levels of serotonin (p=.251; very low quality of evidence) compared to pain-free individuals. Regarding kynurenine, the studies reported both higher and lower blood levels in generalized chronic musculoskeletal pain compared to pain-free individuals.Conclusions: The blood levels of tryptophan and its metabolites serotonin and kynurenine seem to influence chronic musculoskeletal pain.
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| 2. |
- Christidis, Nikolaos, et al.
(författare)
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Psychological treatments for temporomandibular disorder pain—A systematic review
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 51:7, s. 1320-1336
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Forskningsöversikt (refereegranskat)abstract
- Objective: Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard treatment, psychological treatments have been suggested. The aim was to investigate the effects of psychological treatments on patients with painful TMD in a short- and long-term perspective.Materials and Methods: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) reporting psychological interventions for TMD. Registered beforehand in PROSPERO (CRD42022320106). In total, 18 RCTs were included; six RCTs that could be used in the meta-analysis, and all 18 RCTs were used in the narrative synthesis. Risk of bias was assessed by the Cochrane's tool for assessing risk of bias and certainty of evidence by GRADE.Results: The narrative synthesis indicates that psychological treatment options seem equivalent to standard treatment for painful TMD. The meta-analysis showed that a combination of psychological treatment and standard treatment and manual treatment (very low-quality evidence) are significantly better in pain reduction than just counselling and standard treatments of TMD.Conclusion:This study indicates that psychological treatments seem to reduce pain intensity in individuals with painful TMD, and that the effect seems to be equally good as standard treatment. However, a combination of psychological treatments and standard treatments seems to have an even better effect. This indicates that psychological treatments are promising as an additional treatment approach for painful TMDs.
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| 3. |
- De la Torre Canales, Giancarlo, et al.
(författare)
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Botulinum toxin-a for the treatment of myogenous temporomandibular disorders : an umbrella review of systematic reviews
- 2024
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Ingår i: Drugs. - : Adis. - 0012-6667 .- 1179-1950.
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Forskningsöversikt (refereegranskat)abstract
- Objective: Temporomandibular disorders (TMDs) encompass several conditions that cause pain and impair function of the masticatory muscles (M-TMDs) and temporomandibular joints. There is a large interest among clinicians and researchers in the use of botulinum toxin-A (BoNT-A) as a treatment for M-TMD. However, due to the lack of consistent evidence regarding the efficacy as well as adverse events of BoNT-A, clinical decision making is challenging. Therefore, this umbrella review aimed to systematically assess systematic reviews (SRs) evaluating BoNT-A treatment effects on pain intensity, mandibular movements, and adverse events in patients with M-TMDs.Method: An electronic search was undertaken in the databases MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL), Web of Science, Epistemonikos, ClinicalTrials.gov, and ICTRP to identify SRs investigating BoNT-A effects on M-TMDs, published from the inception of each database until 6 December 2023. The quality of evidence was rated according to the critical appraisal checklist developed by the umbrella review methodology working group. Only high-quality SRs were included.Results: In total, 18 SRs were included. BoNT-A was shown to be more effective than placebo to reduce pain intensity, but not compared to standard treatments. Additionally, BoNT-A was not superior to placebo or standard treatments regarding improvement of mandibular movements. BoNT-A was considered to have a higher risk for adverse events on muscle and bony tissue compared with other treatments.Conclusion: The synthesis in this umbrella review provides the highest level of evidence present. Taken together, there are indications of effectiveness of BoNT-A for treatment of M-TMDs, supported by moderate evidence. However, considering the risk of causing serious adverse events, treatment with BoNT-A is recommended to be the last treatment alternative.
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| 4. |
- Grigoriadis, Anastasios, et al.
(författare)
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Adaptability of mastication in people with implant-supported bridges
- 2011
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 38:4, s. 395-404
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to determine whether people with implant-supported bridges in both jaws, thus lacking periodontal receptors, adjust jaw muscle activity to food hardness during mastication.Materials and Methods: Thirteen participants with implant-supported bridges in both jaws and 13 with natural dentition chewed and swallowed soft and hard gelatine-based model foods, while electromyographic (EMG) activity of the masseter and temporal muscles was recorded bilaterally together with the position of the mandible. Data were compared by using a mixed-design anova model and a P-value<0.05 was considered statistically significant.Results: The number of chewing cycles and the duration of the masticatory sequence increased with food hardness in both groups, whereas vertical and lateral amplitude of the jaw movements, and the jaw-opening velocity, increased significantly with food hardness only for the dentate group. Although both groups adapted the EMG activity to the hardness of the food, the implant participants showed a significantly weaker increase in EMG activity with increased food hardness early during the masticatory sequence than the dentate participants did. In addition, the implant group showed significantly less reduction of muscle activity during the progression of the masticatory sequence than the dentate group.Conclusions: People with implant-supported bridges show an impaired adaptation of the muscle activity to food hardness during mastication. We suggest that a lack of sensory signals from periodontal mechanoreceptors accounts for the impairment.
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| 5. |
- Grigoriadis, Anastasios, et al.
(författare)
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Effect of Sudden Deprivation of Sensory Inputs From Periodontium on Mastication
- 2019
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Ingår i: Frontiers in Neuroscience. - : Frontiers Media SA. - 1662-4548 .- 1662-453X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the effect of sudden deprivation of sensory inputs from the periodontium on jaw kinematics and time-varying activation profile of the masseter muscle.Methods: Fourteen (age range: 22-26 years; four men) healthy and natural dentate volunteers participated in a single experimental session. During the experiment, the participants were asked to eat six hard visco-elastic test food models, three each before and after an anesthetic intervention. The movements of the jaw in three dimensions and electromyographic (EMG) activity of the masseter muscle on the chewing side were recorded.Results: The results of the study showed no significant differences in the number of chewing cycles (P = 0.233) and the duration of chewing sequence (P = 0.198) due to sudden deprivation of sensory inputs from the periodontium. However, there was a significant increase in the jaw opening velocity (P = 0.030) and a significant increase in the duration of occlusal phase (P = 0.004) during the anesthetized condition. The EMG activity of the jaw closing phase was significantly higher during the control condition [116.5 arbitrary units (AU)] than anesthetized condition (93.9 AU). The temporal profile of the masseter muscle showed a biphasic increase in the excitatory muscle drive in the control condition but this increase was virtually absent during the anesthetized condition.Conclusion: Sudden deprivation of sensory inputs from the periodontium affects the jaw kinematics and jaw muscle activity, with a clear difference in the time-varying activation profile of the masseter muscle. The activation profile of the masseter muscle shows that periodontal mechanoreceptors contribute to approximately 20% of the EMG activity during the jaw closing phase.
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| 6. |
- Grigoriadis, Anastasios
(författare)
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Masticatory function in people with dental implants
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In use, since the 1960´s, dental implants have been reported to allow chewing that is as efficient as with natural dentition. However, input from periodontal mechanoreceptors (PMRs) around the tooth is important for sensorimotor regulation of biting and chewing. Since there is no periodontal ligament between osseointegrated implants and the alveolar bone, there are no mechanoreceptors in close proximity and, consequently, for individuals with such implants the sensory information sent to the central nervous system concerning chewing forces should be different than with natural teeth. The present thesis was designed to characterize the regulation of mastication in individuals with bimaxillary implant-supported bridges and to compare this to chewing with natural teeth, in order to gain new insights into the role of PMRs in this connection. In the first study participants with natural dentition or fixed bimaxillary implant-supported prostheses chewed and swallowed two model foods of differing hardness while the electromyographic activity of the jaw-closing muscles and the position of the mandible were monitored. Those with implants exhibited impaired sensory-motor regulation during chewing, with less elevation of jaw muscle activity in response to hard food and attenuated adaptation of this activity as the masticatory sequence progressed. Next, we characterized the temporal profile of masseter muscle activity during natural chewing by young adults and the influence of food hardness on this profile. The excitatory drive of the masseter muscle was found to be biphasic, demonstrating an early component prior to tooth-food contact and a late component during this contact. To test our hypothesis that sensory input from the PMRs is required to achieve this later increase we finally investigated the effects of the absence of sensory input from PMRs in subjects with fixed bimaxillary implant-supported prostheses on activation of the masseter muscle during the jaw-closing phase of a chewing cycle. Dentate participants exhibited a biphasic muscle drive during jaw-closing and throughout the masticatory sequence, with a component that starts just before the jaw-closing phase and is based on information from preceding chewing cycles, with no need for input from PMRs; and a late component that starts upon contact with the food, which is signaled by the PMRs. In contrast, participants with dental implants showed no such biphasic drive in the beginning of the masticatory sequence. Adaptation of muscle activity during jaw-closing by the latter appeared to involve modifying the rate of the early component; while the more pronounced adaptation by dentate individuals seemed to reflect additional modification of the late, post-contact component, presumably in response to signals from the PMRs. However, later during the masticatory sequence, implant participants did show a biphasic drive during jaw-closing, probably achieved by prediction based on the gradually changing properties of the bolus during chewing. Moreover, the temporal profile of muscle activity during chewing was the same regardless of the hardness of the food. In conclusion, sensory information provided by the PMRs appears to be most critical during the beginning of the masticatory sequence, when initial food contact occurs, whereas prediction of food properties based on information from other mechanoreceptors is utilized more effectively later on.
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| 7. |
- Kumar, Abhishek, et al.
(författare)
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Chewing and its influence on swallowing, gastrointestinal and nutrition-related factors : a systematic review
- 2022
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Ingår i: Critical Reviews in Food Science and Nutrition. - : Taylor and Francis Ltd.. - 1040-8398 .- 1549-7852. ; , s. 1-31
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Forskningsöversikt (refereegranskat)abstract
- The study aimed to evaluate the hypothesis that chewing is a mechanical and physiological contributor to swallowing, physiologic/pathologic processes of the gastrointestinal tract (GIT), and nutrition-related factors. A search strategy was applied to three different databases to investigate if chewing function in adults affects the swallowing, physiologic/pathologic processes of the GIT, and nutrition-related factors compared to controls with no exposure. The included studies were evaluated for methodological quality and risk of bias and certainty of evidence. The results showed 71 eligible studies. Overall, the results showed that 46 studies supported the hypothesis while 25 refuted it. However, the GRADE analysis showed low to very low certainty of the evidence to support the hypothesis that chewing is an important contributor in the swallowing process, and physiologic/pathologic processes in the GIT. The GRADE analysis also showed a moderate to very low certainty of the evidence to suggest that chewing function contributes to nutrition-related parameters. The overall results of the current study showed that a majority (64.7%) of the studies (46 out of 71) supported the hypothesis. However, robust studies with proper design, adequate sample size, and well-defined outcome parameters are needed to establish conclusive evidence.
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| 8. |
- Kumar, Abhishek, et al.
(författare)
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Vibratory stimulus to the masseter muscle impairs the oral fine motor control during biting tasks
- 2019
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Ingår i: Journal of Prosthodontic Research. - : Elsevier. - 1883-1958 .- 2212-4632. ; 63:3, s. 354-360
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigated the effect of vibratory stimulus on masseter muscles during oral fine motor biting tasks.Methods: Sixteen healthy individuals (age: 24.5 ± 2.4 years) participated in experiment I during which the participants were asked to “hold and split” half a roasted peanut placed on a force transducer with their front teeth. The participant performed ten series with ten trials of the “hold and split” behavioral task while vibratory stimulus was applied on the masseter muscle every alternate series. Further, fourteen participants participated (age: 25.2 ± 4.8 years) in experiment II during which they performed a series each of the behavioral task at baseline, an adjusted baseline without and with vibration as well as with and without visual feedback. Hold and split forces along with the variability of hold force and duration and force rate during the split were measured.Results: The results of the study showed an increase in the magnitude of the hold force (P = 0.002), force rate during the split (P < 0.001) and a significant decrease in the duration of split (P < 0.001) due to the vibratory stimulus. However, there was no significant effect of the vibratory stimulus on the variability of hold forces (P = 0.879) or mean split force (P = 0.683) during the “hold and split” behavioral task. The results of experiment II also showed an increase in hold force due to the vibratory stimulus (P < 0.001).Conclusions: Vibratory stimulus to the masseter muscles impairs the oral force control during a standardized biting task and provide further insight into the sensorimotor regulation of the masticatory system.
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| 9. |
- Zhang, Yuanxiu, et al.
(författare)
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Comparison of Pain-Generated Functional Outcomes in Experimental Models of Delayed-Onset Muscle Soreness and Nerve Growth Factor Injection of the Masticatory Muscles
- 2020
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 34:4, s. 311-322
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To compare two pain models of myalgic TMD, delayed-onset muscle soreness (DOMS) and injections of nerve growth factor (NGF), in terms of pain-related and motor function outcomes, as well as activity-related temporal summation. Methods: Fifty age- and gender-matched healthy participants were recruited and randomized into one of three groups: to a repeated eccentric contraction task to cause DOMS (n = 20), to receive NGF injections into the masseter muscle (n = 20), or to a control group (n = 10). Mechanical sensitivity of masticatory muscles, chewing parameters, jaw function limitation, maximum bite force, and activity-related temporal summation were assessed at baseline and at days 1, 2, and 7 following the intervention. Results: Compared to baseline, both model groups showed increased mechanical sensitivity, jaw function limitation, pain on chewing, and decreased chewing efficiency, lasting longer in the NGF group than in the DOMS group (P < .05). Furthermore, also compared to baseline, the NGF group showed increased pain on maximum bite and decreased pain-free maximum opening (P < .05). No increases in activity-related temporal summation were shown for any of the model groups when compared to baseline or the control group (P > .05). Conclusion: Both models produced similar pain-related outcomes, with the NGF model having a longer effect. Furthermore, the NGF model showed a more substantial effect on motor function, which was not seen for the DOMS model. Finally, neither of the models were able to provoke activity-related temporal summation of pain.
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