| 1. |
- Carlsson, Alexandra, et al.
(författare)
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Reported opening limitations as a TMD symptom: A clinical report on diagnoses and outcome
- 2017
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Ingår i: Clinics in Surgery - Oral and Maxillofacial Surgery. - 2474-1647. ; 2, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study diagnoses of reported mouth opening limitations and the outcome after treatment, to better understand the symptom and the prognosis. Methods: New referrals to an Orofacial Pain & Temporomandibular Disorders (TMD) Clinic with the symptom of “jaw locking” in the referral were considered for this clinical prospective report. This referrals constituted 5.8 % of all the referrals during a ten month period, and 40 patients were included. Case history, clinical examination and diagnoses were made according to the RDC/TMD criteria. MRI and CT examinations of the temporomandibular joint were performed when indicated. Reported symptoms and clinical signs were compared for different diagnoses. The treatment was non-invasive and conservative, no patient underwent surgery. At end of treatment, the clinical examination was repeated, the primary and definite diagnoses were compared, and the improvement after treatment was evaluated. Results: The main diagnoses were disc displacement with reduction (DDwR), 23 %, disc displacement without reduction (DDwoR), 30 %, and myofascial pain with limited opening (wLO), 45 %. General hypermobility was significantly more frequent in the disc displacement diagnosis compared with myofascial pain (p < .05). After treatment, the mean opening capacity was good, regardless of the diagnosis. Conclusions: A report of jaw locking is not indicative of a single diagnosis of TMD. A diagnosis based on the history and a clinical examination is generally accurate. The symptom of opening limitations responds well to conservative treatment methods.
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| 2. |
- Ellie, Saghafi, et al.
(författare)
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A method for preventive intervention regarding temporomandibular pain and dysfunction
- 2018
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 76:7, s. 482-487
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Adolescent girls frequently suffer from temporomandibular disorder (TMD) symptoms and associated headache. A program aimed at informing about risk behavior for TMD symptoms, how to influence harmful habits and about general relaxation was tested. Material and methods: Eighty girls at two high schools, 16 years of age, with or without symptoms, were invited to the health information on two occasions and 60 girls participated. Firstly, a questionnaire regarding symptoms and oral parafunctional habits was administrated. Structured information was given about the normal anatomy and function of muscles and joints, about the occlusion, oral habits and symptoms of orofacial pain/dysfunction and headache. General relaxation was instructed and trained. At a three-month follow-up, the same questionnaire regarding symptoms as at baseline was completed. Result: The information provided was perceived as useful and instructive. At the follow-up, 77% reported that they used what they had learned. Headache once a week or more decreased from 49% at baseline to 35% and headache 'never/rarely' changed from 11% to 25% (p = .002). Reported joint sounds had decreased by the follow-up (p = .053), as had the use of chewing gum (p = .002). A majority of the girls suggested that the information should be scheduled during school hours. Conclusion: Health information about the jaw system can influence risk factors for TMD symptoms and the frequency of symptoms among adolescent girls.
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| 3. |
- Isacsson, G., et al.
(författare)
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Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia-A multicentre randomised controlled trial
- 2019
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Ingår i: J Oral Rehabil. - : Wiley. - 0305-182X .- 1365-2842. ; 46:1, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- Background Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation. Objective The objective of the present study was to determine the efficacy for reducing pain of a single-dose intra-articular (IA) injection of methylprednisolone to the TMJ. The hypothesis was that methylprednisolone would effectively reduce TMJ pain. Methods This randomised, double-blind, parallel-group, multicentre, controlled study included visits for enrolment, treatment and 4-week follow-up. The study included patients 18 years and older who had been diagnosed with unilateral TMJ arthralgia. All participants were randomly assigned to receive 1 mL IA injections of methylprednisolone or saline. The primary outcome was change in recorded pain intensity on a visual analogue scale (VAS) at maximum jaw opening, analysed in the per protocol population. Results In total, 54 patients were randomly assigned to single-dose IA injections with methylprednisolone (n = 27) or saline (n = 27). Between baseline and the 4-week follow-up, VAS-rated pain intensity at maximum jaw opening decreased from a mean of 61.0 (95% confidence interval [CI]: 50.1; 70.7) to 33.9 (95% CI: 21.6; 46.2) in the methylprednisolone group and from 59.6 (95% CI: 50.7; 65.9) to 33.9 (95% CI: 23.8; 43.9) in the saline group. The between-group difference was not significant (P = 0.812). Treatment-related adverse events were doubled in the methylprednisolone group. Conclusion Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia.
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| 4. |
- Mejersjö, Christina
(författare)
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Bettfysiologi i grundutbildningen på tandläkarprogrammet vid Göteborgs Universitet : Pedagogiskt projektarbete
- 2015
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aktuell undersökning gjordes i syfte att få en uppfattning om hur undervisningen i bettfysiologi i grundutbildning uppfattas av studenter och lärare, och att få underlag för förbättringsområden. Resultaten visar att man till stora delar är nöjd med undervisningen och når uppsatta utbildningsmål, men att det finns områden där undervisningen kan förbättras, såsom ytterligare samarbete med andra ämnen, ge bättre förutsättningar för studenters repetition av tidigare kurser, ta med bettfysiologi mera i allmäntandvården på Barn och Vuxenkliniken och kanske använda några s.k. kvoter för utförd bettfysiologisk vård.
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| 5. |
- Mejersjö, Christina, et al.
(författare)
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Diclofenac sodium and occlusal splint therapy in TMJ osteoarthritis: a randomized controlled trial
- 2008
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 35:10, s. 729-738
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to compare treatment with diclofenac sodium (Voltaren 3 x 50 mg) to occlusal splint therapy in a randomized, single-blind controlled trial of patients with a diagnosis of temporomandibular joint (TMJ) osteoarthritis (OA) in accordance with Research Diagnostic Criteria for temporomandibular disorders. Patients with general joint disorders or restrictions against medication with non-steroidal anti-inflammatory drug were not included. Twenty-seven females and two males (aged 36-76 years) included, answered a standardized questionnaire and were clinically examined and they underwent TMJ tomography. The treatment was randomized to either splint (n = 15) or diclofenac (n = 14). The temperatures over the TMJs were determined. The patients were re-examined 1 week, 1 month and 3 months after the start of treatment. A 1-year follow-up was carried out using questionnaires. After 1 week of treatment with diclofenac, significant reductions of pain and discomfort, TMJ tenderness and joint pain on jaw movements were noted. The splint therapy gave a significant reduction of reported symptoms after 1 month of treatment. Both treatments gave few adverse effects and were on an equal level. Estimation of the degree of inflammation by measuring the surface temperature over the TMJ was not reliable. Structural changes of the symptomatic TMJs were radiographically found in 82%, the contralateral, symptom-free TMJ had changes in 36%. There was a discrepancy between the clinical and the radiographical findings. Diclofenac gave a more rapid improvement, but both treatments gave a significant reduction of symptoms of TMJ OA within 3 months which remained at the one-year follow-up.
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| 6. |
- Mejersjö, Christina, et al.
(författare)
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Ear symptoms in patients with orofacial pain and dysfunction - An explorative study on different TMD symptoms, occlusion and habits
- 2021
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Ingår i: Clinical and Experimental Dental Research. - : Wiley. - 2057-4347. ; 7:6, s. 1167-1174
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Ear symptoms coincident with TMD symptoms have been noticed for a long time. The aim was to investigate the relationship between reported ear symptoms in TMD patients and different TMD symptoms, dental occlusion, oral parafunction and habits. Material and methods: Consecutive patients, >= 18 years of age and referred to a specialist clinic for orofacial pain and dysfunction during a three-month period, were considered for the study. Patients with poor general or psychiatric health were excluded. One hundred thirty-two patients were included and studied with regard to reported ear symptoms in relation to clinical dysfunction, occlusion, habits and subjective rating of their symptoms. A clinical examination was performed according to RDC/TMD and extended with occlusal factors, parafunctions and habits. Results: Ear symptoms were reported by 72% of the TMD patients, with ear fullness in 49% as the most frequent symptom. The patients with ear symptoms were significantly older and proportionally more often females. Ear symptoms were significantly correlated to the subjective index, to myalgia (p= 0.003), decreased opening capacity (p = 0.01), TMJ pain (p = 0.02), parafunctions (p = 0.007), and some occlusal factor (p = 0.018-0.003). Muscle pain on palpation was significantly associated with ear fullness, and changed hearing and sensitivity to sound, on the same side (p < 0.005). Conclusions: Ear symptoms are frequently reported by TMD patients. Concomitant ear symptoms are associated with oral parafunction and muscle pain on palpation on the same side as the ear symptoms.
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| 7. |
- Mejersjö, Christina, et al.
(författare)
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Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students
- 2016
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:4, s. 279-284
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Tidskriftsartikel (refereegranskat)abstract
- Objective The use of chewing-gum and piercing has become common among adolescents and might result in increased oral muscle activity and overloading. Aim To investigate the frequency of oral piercing and parafunctions in relation to symptoms of temporomandibular disorders (TMD) among adolescents. Materials and methods One hundred and twenty-four third level high school students, living either in a city or in a small town, enrolled in either science or media programmes, were included. The students completed a questionnaire regarding different parafunctions and symptoms of TMD. A clinical examination of the temporomandibular system and estimation of the tooth wear was performed in 116 students. Results Chewing-gum was used by 86% of the students (25% with a daily use) and 14% had an oral piercing. The science students used more chewing gum than the media students (p=0.008), while the media students had more piercings (p<0.001). Symptoms once a week or more were reported with 39% for headache, 18% for clicking, 7% for facial pain and 6% for difficulty to open wide. Girls reported more headaches (p=0.007) and more severe symptoms (p=0.003), had more medical consultations and used more analgesics (both p<0.05) and had more clinical signs (p=0.01) than boys. Girls had more oral piercings and used more chewing gum than boys (both p<0.05). The media students had more sick leave (p<0.01) than the science students. Chewing-gum use was associated with headache (p<0.01), with difficulty to open wide (p<0.05) and with tenderness of the temporomandibular joints and muscles (both p<0.05). Oral piercing was associated with headache and muscle tenderness (both p<0.05) and daily nail biting with headache (p<0.05) and tooth wear (p=0.004). Conclusions There is an association between use of chewing gum, nail biting, oral piercing, and symptoms of TMD.
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| 8. |
- Mejersjö, Christina, et al.
(författare)
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Short clinical examination for temporomandibular symptoms in general practice.
- 2018
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 76:3, s. 183-187
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the study are to assess the reliability of the short clinical examination, and to compare the information gained with a well-known and validated examination, the diagnostic criteria for temporomandibular disorders (DC/TMD).The study comprises 52 consecutive, newly referred patients at their first visit and examination to an Orofacial Pain and TMD Clinic, 15 years and older, mean age 44 years. The patients first answered three screening questions for reported symptoms. The clinical examination was performed using both the short examination and the DC/TMD and the result was compared. Another group of 40 newly referred patients, with similar inclusion criteria, was examined twice according to the short clinical examination by two examiners, and the inter-examiner variation was studied. The protocol of the short clinical examination is described.The overall agreement between the two methods was fairly good to excellent, as was the degree of agreement between repeated examinations and two examiners using the short clinical examination method. The sensitivity and specificity of the short examination for diagnoses were acceptable to high (with DC/TMD as the golden standard).The short clinical examination has acceptable reliability and, together with three screening questions, provides enough information about the jaw function to decide whether there is a dysfunction.
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| 9. |
- Mejersjö, Christina, et al.
(författare)
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Temporomandibular dysfunction in adult patients with myotonic dystrophy (DM1)
- 2017
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X. ; 44:10, s. 749-755
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Tidskriftsartikel (refereegranskat)abstract
- Myotonic muscle dystrophy is a systemic disease with early engagement of the facial muscles. Our aim was to study dysfunction of the temporomandibular system in patients with 'classic' dystrophia myotonica (DM1) and compare it with TMD patients and healthy controls. The study included 27 referred patients with DM1, 18 women and nine men, aged 30-62 years, and two matched control groups: patients with temporomandibular disorders symptoms (TMD) and healthy controls, both groups were consecutive patients. The patients answered questions regarding facial pain, jaw function and dysfunction. A clinical examination of the temporomandibular system including the occlusion was performed, and the maximum bite force and finger forces were measured. Among the DM1 patients, 33% reported difficulty biting off, and 22% had difficulty chewing, avoiding foods like meat and raw vegetables, and 37% of the DM1 patients scored their pain and discomfort as moderate to fairly severe. Their main complaints were TMJ clicking and locking, difficulty opening wide and tiredness. They had more clinical signs of dysfunction compared with the controls (P < 0.001), but no statistically significant difference to the TMD patients. The maximum bite force in DM1 patients was impaired compared to both the TMD patients and the controls (P < 0.001). Significantly more occlusal interferences were found in DM1 patients and were associated with chewing difficulties (P < 0.001). In conclusion, patients suffering from DM1 had an increased prevalence of TMD symptoms, reported impaired chewing function and had a decreased maximum bite force.
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| 10. |
- Pauli, Nina, et al.
(författare)
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Temporomandibular disorder as risk factor for radiation-induced trismus in patients with head and neck cancer
- 2022
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Ingår i: Clinical and Experimental Dental Research. - : Wiley. - 2057-4347. ; 8:1, s. 123-129
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to investigate if patients with temporomandibular disorders (TMD) prior to head and neck cancer (HNC) treatment are at higher risk of developing trismus after oncological treatment. Materials and Methods: Eighty-three study patients underwent detailed dental examination prior oncological treatment and 6 months after radiotherapy completion, including evaluation of temporomandibular jaw function, palpation of the jaw muscles, and measurement of mouth opening capacity. TMD criteria were based on both clinical examination findings and patient-reported symptoms. TMD at baseline was used in regression analysis in order to predict restricted mouth opening. Results: At the 6 months follow-up more than a third of the patients (35%) were examined with reduced mouth opening of >20% compared to baseline. A majority of the patients had bilateral tenderness of both the temporal and the masseter muscle. At the 6 months follow-up, 42% of the study patients reported mouth opening problems. About one-third of the patients suffered from fatigue and stiffness of the jaw as well as pain when mowing the jaw. Two questions from the validated symptom-specific Gothenburg Trismus Questionnaire were found to be related to a statistically significant increased risk of restricted mouth opening after radiotherapy; "During the last week, have you felt: Pain on moving the jaw?" (OR [95% CI] 5.9 (1.2-29.4) [p = 0.030]) and "During the last week, have you felt pain and tenderness in the muscles of mastication?" (OR [95% CI] 5.90 [1.19-29.40] [p = 0.030]). Conclusions: TMD is common amongst HNC patients. Patients who suffer from pain in the jaw muscles and pain when moving the jaw before start of treatment are at higher risk of radiation-induced trismus after 6 months. Clinicians should strive for optimizing the patients pain treatment and oral health before, during, and after radiotherapy.
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