| 51. |
- Linné Erixon, Caroline, et al.
(författare)
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Observations over eight years of TMD; after initially appliance therapy
- 2011
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Ingår i: Svenska tandläkaresällskapets 47:e odontologisk riksstämma 2011. - : Svenska tandläkaresällskapet. ; , s. 22-22
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim. Long-term follow-up studies of patients treated for temporomandibular disorders (TMD) pain are sparse in the literature. The aim of this study was to evaluate after 8 years the treatment outcome of patients with temporomandibular joint (TMJ) pain and/or myofascial pain. Materials and Methods. 120 patients were initially randomly assigned to two treatment modalities: an occlusal appliance or a control appliance. A questionnaire was sent to 118 eligible patients after 8 years. Ninety patients (76%) returned the questionnaire. Outcome measures were assessment of pain intensity, frequency of pain, physical and emotional functioning, overall improvement of pain and headache. Results. At follow-up the worst pain had decreased by 30% in 64 out of 90 patients. Also pain frequency decreased significantly. A better physical functioning was reported by a majority of all patients, 57/90. 50 out of 90 patients had a moderate to severe depression, while the value for non-specific physical symptoms was 61 patients out of 90. 68 patients (76%) reported overall improvement of their TMD pain. 61 patients felt that their headache had overall improved. As far as treatment modality, 57 patients had received another treatment in addition to the initial appliance, most often another occlusal appliance. Conclusion. Eight years after appliance therapy a majority of patients reported an improvement of their TMD pain and headache.
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| 52. |
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| 53. |
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| 54. |
- Nilner, Maria, et al.
(författare)
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Short-term Effectiveness of a Prefabricated Occlusal Appliance in Patients with Myofascial Pain
- 2008
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 22:3, s. 209-218
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To compare the short-term effectiveness of a stabilization appliance with a prefabricated occlusal appliance in myofascial pain patients in a randomized controlled trial. Methods: Sixty-five patients at 2 centres were assigned to a stabilization appliance group (S group, n = 33) or a prefabricated appliance (Relax) group (R group, n = 32). The patients had been suffering from temporomandibular disorder (TMD) pain for 3 months to 40 years. The patients were examined for symptoms and signs of temporomandibular disorders according to the Research Diagnostic Criteria for TMD and treated by a general practitioner. Treatment outcomes regarding pain, registered on a visual analogue scale, and overall ratings of pain, registered on a verbal scale, were evaluated at 6- and 10- week follow-up appointments, and the data from the groups were compared statistically, results: The main treatment outcome in the 2 groups was a positive improvement of overall symptoms without any statistically significant differences between groups at either 6 or 10 weeks. At the 6-week follow-up, 72% of ala patients reported a 30% reduction of the worst pain, and 55% of the patients reported a 50% reduction of the worst pain, whereas at the 10-week follow-up, the percentages were 69% and 61%, respectively. According to the verbal scale, 85% of all patients reported themselves to be “better,” “much better,” or “symptom-free” at the 6-week follow-up, and 83% reported this at the 10-week follow-up. Conclusion: The effectiveness of the prefabricated occlusal appliance seemed to be the same as that of the stabilization appliance. The prefabricated appliance can therefore be recommended as a short-term therapy in adult patients with myofascial pain.
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| 55. |
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| 56. |
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| 57. |
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| 58. |
- Nilsson, Håkan, et al.
(författare)
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Do psychological factors and general health influence the short-term efficacy of resilient appliance therapy in patients with temporomandibular disorder pain?
- 2010
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 68:3, s. 141-147
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To study how sense of coherence (SOC), grade of depression and non-specific physical symptoms and general health influence the efficacy of intraoral appliance therapy in patients with temporomandibular disorder (TMD) pain. A second objective was to study the association between SOC, grade of depression, grade of non-specific physical symptoms and general health. Material and methods. A total of 73 TMD pain patients participated; 36 were treated with a resilient appliance and 37 with a non-occluding control appliance in a randomized controlled trial for a period of 10 weeks. All patients had at least one pain diagnosis according to the research diagnostic criteria for TMD, including both the Symptom Checklist-90-Revised (Axis II) measuring grade of depression and non-specific physical symptoms, and general health (physical characteristics). Patients also filled in the 29-item SOC questionnaire. Results. A low grade of SOC was found in eight of the patients in the treatment group and in 17 of the control group at baseline, with a statistically significant difference between the groups. Logistic regression analyses revealed that, after correcting for the background variables, the resilient appliance did not differ from the non-occluding control appliance in terms of treatment outcome. No statistically significant differences were found when correlating mean SOC with grade of depression, grade of non-specific physical symptoms and general health. Conclusions. These findings indicate that none of the studied background variables (age, gender, SOC, depression, non-specific physical symptoms or general health) seemed to influence the short-term efficacy of intraoral appliances. No association was found between SOC and depression, non-specific physical symptoms or general health in TMD pain patients.
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| 59. |
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| 60. |
- Nilsson, Håkan, et al.
(författare)
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Long-term Efficacy of a Resilient Appliance in TMD Pain Patients. A Randomized, Controlled Trial (Malmö)
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Treatment with intraoral appliances is often used to reduce pain and functional disturbances in patients with TMD. In text-books the resilient appliance/soft splint is a recommended type of intraoral appliance in patients with TMD. It is easy to produce and constitutes a relatively inexpensive treatment. A recently published randomized controlled trial showed no difference in efficacy between the resilient appliance compared to the control appliance in a short-term perspective in patients with TMD-pain. Aim: To investigate the long-term efficacy of the resilient appliance in patients with TMD-pain. Methods: A randomized, controlled trial was performed in 80 recruited TMD pain patients. They were randomly allocated to one of two groups: treatment with a resilient appliance or treatment with a hard, palatal, non-occluding appliance. Primary treatment outcome measures were judged positive when patients’ TMD-pain at worst (VAS) and CPI decreased by at least 30%. Additional treatment outcomes were frequency of TMD-pain, jaw function/activity and headache the last six months. Results: Patient characteristics did not differ between the groups. There were no statistically significant differences between groups neither regarding frequency of TMD-pain, jaw function/activity and headache the last six months, nor regarding a 30% reduction in pain at worst and CPI. There were however statistically significant differences within the groups regarding reduced pain intensity, frequency and enhanced jaw function between baseline and 12 months follow-up. Conclusion: There was no statistically significant difference between the resilient appliance and the non-occluding control appliance in reducing TMD pain, jaw function/activity and headache in a 12 months perspective.
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| 61. |
- Nilsson, Håkan, et al.
(författare)
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Long-term efficacy of resilient appliance therapy in TMD pain patients : a randomised, controlled trial
- 2011
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Ingår i: Journal of Oral Rehabilitation. - : Wiley-Blackwell. - 1365-2842 .- 0305-182X. ; 38:10, s. 713-721
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Tidskriftsartikel (refereegranskat)abstract
- Summary The aim was to investigate long-term efficacy of a resilient appliance in patients with pain due to temporomandibular disorders (TMD). A randomised, controlled trial was performed in 80 recruited TMD pain patients. They were randomly allocated to one of two groups: treatment with a resilient appliance or treatment with a hard, palatal, non-occluding appliance. The primary treatment outcome was judged positive when patients' characteristic pain intensity decreased by at least 30%. Additional treatment outcomes were physical functioning, emotional functioning and headache. At the 12-month follow-up 50% of the patients in the treatment group and 42% in the control group had a 30% reduction of characteristic pain intensity, when calculated in an intent-to-treat analysis. Jaw function improved in both groups at the 6- and 12-month follow-up. Emotional functioning improved in both groups at the 6-month follow-up; an improvement concerning grade of depression was found in the control group at 12 months. Headache decreased in both groups at both follow-ups. There were no statistically significant differences found regarding primary and additional outcomes between groups at the 6- and 12-months follow-up. There was no statistically significant difference between the resilient appliance and the non-occluding control appliance in reducing TMD pain, physical functioning, emotional functioning and headache in a 12 months perspective.
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| 62. |
- Nilsson, Håkan, et al.
(författare)
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Long-Term Efficacy of Resilient Appliance Therapy in TMD Patients
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To investigate long-term efficacy of a resilient appliance in patients with pain due to temporomandibular disorders (TMD). Methods: A randomized, controlled trial was performed in 80 recruited TMD pain patients. They were randomly allocated to one of two groups: treatment with a resilient appliance or treatment with a hard, palatal, non-occluding appliance. The primary treatment outcome measure was judged positive when patients' characteristic pain intensity decreased by at least 30%. Additional treatment outcomes were physical functioning, emotional functioning and headache. Number needed to treat was measured on the basis of primary treatment outcome at 12 months. Results: At 12 months follow-up 50% of the patients in the treatment group and 42% in the control group had a 30% reduction of characteristic pain intensity, when calculated as intent to treat analysis. Jaw function improved in both groups at 6 and 12 month follow-up. Emotional function improved in both groups at 6 months follow-up; an improvement concerning grade of depression was found in the control group at 12 month. Headache decreased in both groups at both follow-ups. There were no statistically significant differences found regarding primary and additional outcomes between groups at 6 and 12 months follow-up. NNT was 14 when calculated on a 30% reduction of CPI at 12 months follow-up. Conclusion: There was no statistically significant difference between the resilient appliance and the non-occluding control appliance in reducing TMD pain, physical functioning, emotional functioning and headache in a 12 months perspective.
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| 63. |
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| 64. |
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| 65. |
- Nilsson, Håkan, et al.
(författare)
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Short-term treatment of a resilient appliance in TMD pain patients : a randomized controlled trial
- 2009
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Ingår i: Journal of Oral Rehabilitation. - : Blackwell Publishing. - 1365-2842 .- 0305-182X. ; 36:8, s. 547-555
-
Tidskriftsartikel (refereegranskat)abstract
- To investigate the short-term efficacy of a resilient appliance in patients with temporomandibular disorders (TMD) suffering from pain, a randomized, controlled trial was performed in 80 recruited TMD pain patients. They were randomly allocated to one of two groups: treatment with a resilient appliance or treatment with a hard, palatal, non-occluding appliance. The primary treatment outcome measure was judged positive when patients' TMD pain at worst, according to the Visual Analog Scale (VAS), decreased by at least 30%. One additional treatment outcome was reduction of characteristic pain intensity. Number needed to treat was measured on the basis of primary treatment outcome at 10 weeks. At baseline, patient characteristics and TMD pain did not differ between the groups. There were no significant differences between groups regarding a 30% reduction in VAS-reported TMD pain at worst at 10 weeks' follow-up; 61% in the treatment group and 46% in the control group. After 6 and 10 weeks of treatment, CPI decreased in both groups. Number needed to treat was 9.1 for both the resilient and the control appliance therapy during 10 weeks. There was no statistically significant difference between the resilient appliance and the non-occluding control appliance in reducing TMD pain from a short-term perspective.
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| 66. |
- Nilsson, Ing-Marie, et al.
(författare)
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Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations : Comprehensive and short-form adaptations for children
- 2023
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 50:2, s. 99-112
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed.OBJECTIVE: To present comprehensive and short-form adaptations of Axis I and II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings.METHODS: Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children.RESULTS: The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire, and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, and (ii) adding anxiety and depression assessments that have been validated in children, and (iii) adding three constructs (stress, catastrophizing, and sleep disorders) to assess psychosocial functioning in children.CONCLUSION: The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.
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| 67. |
- Nordin, Sara, et al.
(författare)
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Achieved Competencies and Satisfaction in Temporomandibular Disorders and Orofacial Pain Education
- 2016
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0376 .- 2333-0384. ; 30:2, s. 156-164
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To assess dental students' achieved competencies and perceived satisfaction with their temporomandibular disorders (TMD) and orofacial pain education and to compare these with the results of their final examination in TMD and orofacial pain. METHODS: Dental students from two consecutive classes (2011/2012 and 2012/2013) at the Department of Orofacial Pain and Jaw Function at the dental school in Malmö, Sweden completed two self-evaluations, one at the beginning of semester seven and one at the end of semester eight. The questionnaire that they were given concerned achieved competencies and satisfaction with education in TMD and orofacial pain. Items focused on anatomy, physiology, and clinical training. Students estimated their competence and satisfaction on a numeric rating scale and described their idea of treating TMD and orofacial pain patients on a verbal rating scale. Outcome variables were tested with paired samples t test for differences over time and independent samples t test for between-class comparisons; both were adjusted for multiple testing with Bonferroni correction. RESULTS: Significant improvement in all items was observed for achieved competencies and satisfaction in both classes between semester seven and semester eight (P < .05). No differences in competencies or satisfaction occurred between classes at the end of the clinical course in semester eight (P > .05). CONCLUSION: This study has shown that expansion in undergraduate TMD and orofacial pain education at the dental school in Malmö has allowed all students to develop the same level of competence, independent of prior experience. The study also pointed out that continuous evaluation and enhancement of TMD and orofacial pain education in undergraduate dental education is beneficial
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| 68. |
- Paulsson, Liselotte, et al.
(författare)
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Mandibular function, temporomandibular disorders, and headache in prematurely born children
- 2009
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 67:1, s. 30-37
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate mandibular function, signs, and symptoms of temporomandibular disorders (TMDs) and headache in prematurely born 8- to 10-year-old children, and to compare the findings with matched full-term born controls. MATERIAL AND METHODS: Seventy-three preterm children were selected from the Medical Birth Register--one group comprising 36 extremely preterm children born before the 29th gestational week, the other group 37 very preterm children born during gestational weeks 29 to 32. The preterm children were compared with a control group of 41 full-term children matched for gender, age, nationality, and living area. The subjective symptoms of TMD and headache were registered using a questionnaire. Mandibular function, signs, and symptoms of TMD and headache were registered. TMD diagnoses were set per Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD). RESULTS: No significant differences between groups or gender were found for TMD diagnoses according to RDC/TMD or for headache. The preterm children had smaller mandibular movement capacity than the full-term control group, but when adjusting for weight, height, and head circumference mostly all group differences disappeared. CONCLUSIONS: Prematurely born children of 8 to 10 years of age did not differ from full-term born children when considering diagnoses according to RDC/TMD, signs, and symptoms of TMD or headache.
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| 69. |
- Rongo, Roberto, et al.
(författare)
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Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents : An international Delphi study—Part 1‐Development of Axis I
- 2021
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 48:7, s. 836-845
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To develop new instruments and to adapt the diagnostic criteria for temporomandibular disorders (DC/TMD) for the evaluation of TMD in children and adolescents.METHOD: A modified Delphi method was used to seek international consensus among TMD experts. Fourteen clinicians and researchers in the field of orofacial pain and TMD worldwide were invited to participate in a workshop initiated by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM scientific network) at the General Session of the International Association for Dental Research (IADR, London 2018), as the first step in the Delphi process. Participants discussed the protocols required to make physical diagnoses included in the Axis I of the DC/TMD. Thereafter, nine experts in the field were added, and the first Delphi round was created. This survey included 60 statements for Axis I, and the experts were asked to respond to each statement on a five-item Likert scale ranging from "Strongly disagree" to "Strongly agree". Consensus level was set at 80% agreement for the first round, and at 70% for the next.RESULTS: After three rounds of the Delphi process, a consensus among TMD experts was achieved and two adapted DC/TMD protocols for Axis I physical diagnoses for children and adolescents were developed.CONCLUSION: Through international consensus among TMD experts, this study adapted the Axis I of the DC/TMD for use in evaluating TMD in children and adolescents.
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| 70. |
- Rongo, Roberto, et al.
(författare)
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Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II
- 2022
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Ingår i: Journal of Oral Rehabilitation. - : WILEY. - 1365-2842 .- 0305-182X. ; 49:5, s. 541-552
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Tidskriftsartikel (refereegranskat)abstract
- Background Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. Objectives To develop a new standardised instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments. Methods A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2 and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophising, sleep problems and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritise the suggested instruments from most to least recommended. Results The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophising, stress and resilience. Conclusion Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.
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| 71. |
- Visscher, Corinne, et al.
(författare)
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A multicentre study to diagnostic accuracy of temporomandibular pain tests
- 2008
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Konferensbidrag (refereegranskat)abstract
- Objectives: To study the diagnostic accuracy of the clinical examination of the Research Diagnostic Criteria (RDC) and of the dynamic and static pain tests for the recognition of temporomandibular disorder (TMD) pain. Methods: A blind examination, including all clinical tests needed for a RDC diagnosis of TMD pain, and the dynamic and static pain tests, was performed in 125 chronic TMD pain patients, 88 chronic dental pain patients, and 121 pain-free subjects. Allocation was based upon the results of an oral history and a dental examination. As indicators for diagnostic accuracy, sensitivity and specificity of the RDC examination and of the dynamic and static pain tests were compared to recommended levels of .70 and .90, respectively. Results: For the RDC examination, high sensitivity (.88), but lower specificity (.45-.71) was found. The specificity did not reach its recommended level. For the dynamic and static pain tests, specificity (.84-.91) and sensitivity (.65) did not differ from the recommended levels. Comparing the outcomes of the two examinations showed that the positive likelihood ratios of the dynamic and static pain tests were higher (p<.001), while the negative likelihood ratios of the RDC examination were lower (p<.01). Conclusion: For the confirmation of a suspected TMD origin of orofacial pain, it is better to rely on the dynamic and static pain tests. To rule out a TMD origin, more value should be attached to the RDC examination (no funding sources).
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| 72. |
- Visscher, Corinne, et al.
(författare)
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Accuracy of RDC/TMD examination and dynamic/static tests
- 2008
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Konferensbidrag (refereegranskat)abstract
- Objectives: To study the diagnostic accuracy of the clinical examination of the Research Diagnostic Criteria (RDC) and of the dynamic and static pain tests for the recognition of temporomandibular disorder (TMD) pain and to improve the RDC accuracy by 1) changing the myofascial pain cutoff of 3 painful muscle palpation sites, or 2)omitting unreliable palpation sites. Methods: In 4 European dental faculties, a blind examination was performed in 125 chronic TMD pain patients, 88 chronic dental pain patients, and 121 pain-free subjects. Allocation was based upon the results of an oral history and a dental examination. Results: Sensitivity and specificity of the RDC were .88 and 45-.71, respectively. Increasing the myofascial pain cutoff better met the recommended levels for specificity and sensitivity of .70 and .90, respectively. When unreliable muscle palpation sites (i.e., the intraoral and submandibular sites) were omitted, the accuracy of the RDC/TMD examination did not change. For the dynamic and static pain tests, sensitivity (.65) and specificity (.84-.91) did not differ significantly from the recommended levels. Conclusion: A suspected TMD origin of orofacial pain is best confirmed by pain on the dynamic or static tests, while it is better denied by a negative outcome of the RDC examination. The intraoral and submandibular palpation sites of the RDC examination do not contribute to its diagnostic accuracy and can better be omitted, while the cutoff for a myofascial pain diagnosis should be increased.
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| 73. |
- Visscher, Corine M, et al.
(författare)
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Diagnostic accuracy of temporomandibular disorder pain tests : a multicenter study
- 2009
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Ingår i: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 23:2, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To estimate the diagnostic accuracy of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) clinical examination and of the dynamic/static tests for the recognition of TMD pain. Since the diagnosis of TMD pain is especially complicated in persistent orofacial pain patients, the test outcomes in persistent TMD pain patients were contrasted to those in two control groups: a group of persistent dental pain patients and a group of pain-free subjects. METHODS: In 125 persistent TMD pain patients, 88 persistent dental pain patients, and 121 pain-free subjects, a blind and standardized clinical examination was performed. RESULTS: For the RDC/TMD, sensitivity (88%) was high and specificity was low (pain-free group: 71%; dental pain group: 45%). For the dynamic/static tests, sensitivity was 65% and specificities were 91% and 84%, respectively. Comparing the outcomes of the two examinations showed higher positive likelihood ratios for dynamic/static tests (P < .001), and lower negative likelihood ratios for the RDC/TMD examination (P < .01). CONCLUSION: For the confirmation of a suspicion of TMD pain, it is better to rely on positive dynamic/static tests. To confirm the absence of TMD pain, it is better to rely on a negative RDC/TMD examination.
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