| 1. |
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| 2. |
- Abrahamsson, Cecilia, et al.
(författare)
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Alterations of temporomandibular disorders before and after orthognathic surgery
- 2007
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Ingår i: Angle orthodontist. - : Angle Orthodontist. - 0003-3219 .- 1945-7103. ; 77:4, s. 729-734
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVE: To answer the question whether orthognathic surgery does affect the prevalence of signs and symptoms of temporomandibular disorders (TMDs). MATERIALS AND METHODS: A literature survey in the PubMed and Cochrane Library electronic databases was performed and covered the period from January 1966 to April 2006. The inclusion criteria were controlled, prospective or retrospective studies comparing TMDs before and after orthognathic surgery in patients with malocclusion. There were no language restrictions, and three reviewers selected and extracted the data independently. The quality of the retrieved articles was evaluated by four reviewers. RESULTS: The search strategy resulted in 467 articles, of which 3 met the inclusion criteria. Because of few studies with unambiguous results and heterogeneity in study design, the scientific evidence was insufficient to evaluate the effects that orthognathic surgery had on TMD. Moreover, the studies had problems with inadequate selection description, confounding factors, and lack of method error analysis. CONCLUSION: To obtain reliable scientific evidence, additional well-controlled and well-designed studies are needed to determine how and if orthognathic surgery alters signs and symptoms of TMD.
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| 3. |
- Abrahamsson, Cecilia, et al.
(författare)
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TMD in consecutive patients referred for orthognathic surgery
- 2009
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Ingår i: Angle orthodontist. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 0003-3219 .- 1945-7103. ; 33:4, s. 201-226
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. MATERIALS AND METHODS: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). RESULTS: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. CONCLUSIONS: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.
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| 4. |
- Al-Harthy, Mohammad, et al.
(författare)
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Pain related temporomandibular disorders in adult Saudi arabians referred for specialized dental treatment
- 2007
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Ingår i: Pain related temporomandibular disorders in adult Saudi arabians reffered for specialized dental treatment..
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- The aim of the present study was to examine the frequencies of pain-related symptoms of TMD in patients in the age of 20-40 years referred for specialized dental treatments in Makkah, Saudi Arabia by using Research Diagnostic Criteria for TMD (RDC/TMD). Three hundred and twenty-five consecutive Saudi patients in the age of 20-40 years: 135 males and 190 females were interviewed according to the RDC/TMD history questionnaire. The results revealed that pain related TMD and orofacial pain were found among 58 (18%) patients. All other patients formed the non-pain group (267,82%). In the pain group, there were 79% females compared to 21% males (P<0.01). Both genders in the pain group reported high frequencies of both migraines in the last six months and headache moderately to extremely in the last month showing significant difference in comparison with the non-pain group (P<0.01). Symptoms of TMD were significantly more prevalent in the pain group than in the non-pain group. The most common pain related TMD symptoms were TMJ clicking, TMJ crepitation, TMJ locking, stiff jaw, tinnitus, bruxism and uncomfortable bite. Regarding Graded Chronic Pain severity in the pain group, most patients reported their pain to be grade I and II. Jaw disability checklist according to RDC/TMD showed that four or more disturbed jaw activities were found in 31 patients (53%) while 13 patients (22%) had not affected mandibular functions. In conclusion, the findings of the present study showed high frequencies of pain related TMD in this Saudi arabian patient population.
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| 5. |
- Al-Harthy, Mohammad, et al.
(författare)
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Temporomandibular Disorders per RDC/TMD in Adult Saudi Arabians Referred for Specialized Dental Treatment
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The aim of this study was to determine frequency of Temporomandibular Disorders (TMD) pain in Saudi Arabians, ages 20 to 40, which were referred to a dental specialist clinic in Makkah. Materials and Methods: 325 referred patients (135 males, 190 females) answered history questionnaires. Patients reporting TMD pain in these questionnaires were clinically examined. History questionnaires and clinical examinations were done per Axis I and Axis II of the Arabic version of Research Diagnostic Criteria for TMD (RDC/TMD). Results: The male-female ratio of the study group was 1:1.4. Fifty-eight patients (18%) had TMD pain; 46 were clinically examined. Mean age of examined TMD pain patients was 30 years (±7) with a male-female ratio of 1:6. All TMD pain patients had a diagnosis of myofascial pain and 65% had diagnoses of arthralgia or osteoarthritis. Graded chronic pain severity was reported to be grade I in 45%, grade II in 53%, grade III in 2% and grade IV in none of the patients. Psychological status assessment showed that 38% of the TMD pain patients had severe depression scores and 60% severe somatization scores. Conclusion: The present study showed a high frequency of TMD pain in this Saudi Arabian cohort, and 18% of the patients met criteria for subdiagnoses of TMD. Depression and somatization per Axis II had significantly higher scores in the TMD pain group compared to the non-pain group.
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| 6. |
- Al-Harthy, Mohammad, et al.
(författare)
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TMD in Adult Saudi Arabians According to RDC/TMD
- 2008
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Konferensbidrag (refereegranskat)abstract
- Objective: To examine the frequency of pain-related TMD in Saudi Arabians 20 to 40years old referred to a d specialist clinic in Makka. Materials and Methods: 325 referred patients (135 males, 190 females) filled in history questionnaires. Patients reporting pain-related TMD were clinically examined. The history and clinical examinations were performed according to an Arabic version of RDC/TMD Axis I and Axis II (Dworkin et al 1992). Results: All patients had a male-female ratio of 1:1.4. TMD pain patients were found to be 18% (n=58), out of which 46 were clinically examined. The 46 TMD pain patients had a mean age of 30 years (±7) with a male-female ratio of 1:6. All TMD pain patients had a diagnosis of myofascial pain and 66% had diagnoses of arthrogenous origin. The graded chronic pain was reported to be grade I in 45%, grade II in 53%. Axis II assessment of psychological status showed that 38% of the TMD pain patients yielded severe depression scores and 60% high nonspecific physical symptom scores. Conclusion: The present study showed a high frequency of TMD pain in this Saudi Arabian cohort and 18% of the patients met criteria for subdiagnoses of TMD. Depression and somatization according to SCL-90R had significantly higher scores in the pain group compared to the non-pain group. The high frequency of pain-related TMD found among the patients referred to specialized dental clinics should make health planners considering TMD/orofacial pain as specialty in dentistry in Saudi Arabia.
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| 7. |
- Bondemark, Lars, et al.
(författare)
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Funktionsstörningar och smärta
- 2008
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Ingår i: Tandläkartidningen. - 0039-6982. ; 100:9-10, s. 64-68
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Orofaciala funktionsstörningar och smärta är en sammanfattning av kliniska problem och sjukdomar som involverar bett, käkar, tuggmuskulatur, käkleder och omgivande strukturer. Orsakerna är oftast multifaktoriella för de barn, ungdomar och vuxna som drabbas.
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| 8. |
- Doepel, Marika, et al.
(författare)
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Salivary cortisol and IgA levels in myofascial pain patients treated with occlusal appliances in a short term perspective (Stockholm)
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: In many studies the endocrinological response of individuals to different kind s of stresses has been tested. There seems to be widespread agreement that stress, depression, disability and dysfunctional illness behaviors are critical aspects of patients suffering from TMD (temporomandibular disorders) symptoms like pain. We wanted to explore treatment-induced changes in salivary cortisol, IgA and flow rate values in TMD patients suffering from myofascial pain. Methods: TMD paitents (n=39) were randomized into two groups and treated with two different occlusal appliances. Percieved stress regarding family work, economy, relationships, general health and stress in general was wvaluated at baseline according to a verbal scale. Paraffin stimulated saliva samples were collected before treatment and during follow-up at 6 and 10 weeks. Flow rate was measured immediately after the saliva collection while salivary sortisol, and IgA were determined from -70° C-stored samples. Results: No clear association between reported stress and cortisol or IgA values could be observed at baseline. At 10 weeks´ follow-up 92% of the patients felt better-much better-symptom free and no difference was found between the two appliance groups. Cortisol, IgA and flow-rate values showed no systematic between-appliance groups differences. All salivary parameters showed interindividual differences but stayed intraindividually on a similar level throughout the study and no statistically significant changes could be observed when comparing before and after treatment levels. Conclusion: To conclude, there were no treatment induced changes in saliva parameters despite successful appliance therapy in myofascial pain patients.
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| 9. |
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| 10. |
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| 11. |
- Ekberg, EwaCarin, et al.
(författare)
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Effectiveness of a prefabricated occlusal appliance, Relax, in the long-term (Helsinki)
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To compare the long-term effectiveness of a prefabricated occlusal appliance with a stabilization appliance in myofascial pain patients. Methods: Sixty-five patients with the diagnosis myofascial pain at two centres for Stomatognathic Physiology in Sweden and Finland were included in a randomized controlled trial. Patients were randomly assigned to a prefabricated appliance (R-group, 27 women, 5 men, mean age 38 years) or a stabilization group (S-group, 31 women 2 men, mean age 37 years). General practitioners performed the treatment. History and clinical examination was performed according to RDC/TMD. At the 6 months- and 1 year follow-up the treatment outcome regarding pain according to the visual analogue scale and overall rating of pain according to the verbal scale was evaluated. Results: At baseline there were no differences between the groups regarding frequency of myofascial pain, number of years suffering from the pain, worst or mean pain during the last six months. At the 12-months follow-up 30% and 50% pain relief in the R- and S-groups were reported in 24 and 21 patients and 23 and 17 patients respectively. According to a verbal scale 26 and 21 patients in the two groups reported themselves to be better, much better or symptom-free. All calculations were done per protocol. An increased open bite was registered in one patient. Conclusions: In a long-term perspective both appliances seemed to have an equal effectiveness in the treatment of patients suffering from myofascial pain. The prefabricated appliance, Relax, can be recommended as a long-term treatment modality when used night time only. Frontal open bite should be regarded as a contraindication.
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| 12. |
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| 13. |
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| 14. |
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| 15. |
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| 16. |
- Ekberg, EwaCarin, et al.
(författare)
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Treatment outcome of short- and long-term appliance therapy in patients with TMD of myogenous origin and tension-type headache
- 2006
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 33:10, s. 713-721
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to compare the short- and long-term effect of a stabilization appliance with a control appliance in myofascial pain patients suffering from episodic or chronic tension-type headache. Sixty patients (mean age 29 +/- 12 years) with temporomandibular disorders (TMD) of myogenous origin and headache were studied in this prospective controlled study. Seventy-seven per cent of the patients reported episodic and 23% chronic tension-type headache at the start of the study. The 60 patients were randomly assigned to a treatment group (stabilization appliance) or to a control group (control appliance). The patients were interviewed regarding symptoms of headache and myofascial pain and clinically examined for masticatory muscle tenderness. At the 10-week and the 6- and 12-month evaluations of appliance therapy, the treatment outcome of tension-type headache was studied. At the 10-week evaluation, 17 patients dropped-out from the control group by requesting another appliance and receiving a stabilization appliance. Another patient in the control group dropped out later during the trial. In an intent-to-treat analysis, significant differences in improvement of headache between treatment and control groups were found at the follow-ups. A 30% reduction of muscles tender to palpation correlated significantly to improvement of headache at all follow-ups. The stabilization appliance seems to have a positive effect on tension-type headache, both in a short- and in a long-term perspective in patients with TMD with pain of myogenous origin.
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| 17. |
- Englesson-Sahlström, Lotta, et al.
(författare)
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Lavage question in treatment of painful reduced mouth opening capacity
- 2008
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Ingår i: Journal of Cranio-Maxillofacial Surgery. - 1010-5182 .- 1878-4119. ; 36:Suppl 1, s. 162-163
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: To compare treatment with local anaesthetics and local anaesthetics and lavage in patients with temporomandibular joint (TMJ) pain and reduced mouth opening in a randomized controlled trial. METHODS: Forty-one women and four men (mean age 35 years) participated. All patients had had TMJ pain för more than 3 months, had reduced mouth opening capacity, and had non-reducin disc displacement confirmed by magnetic resonance imaging. The patient were randomized to treatment with extra-articular local anaesthetics alone (control) or with extra-articular local anaesthetics and lavage (treatment). All patients were examined at basline and at 1 and 3 months by an examiner blind to treatment. Successful treatment was determined as 30% or more pain reduction on a 100-mm visual analog scale (VAS). RESULTS: At baseline, mean pain intensity (VAS) on movement of the TMJ was 58 among the controls and 61 in the treatment group. At the 3-month folow-up, treatment was considered succesful in 76% of the controls and 50% of the treatment group. Mouth opening capacity without assistance was 34 mm and 33 mm at baseline and 43 mm and 38 mm after 3 months among the controls and in the treatment group, respectively. These differences between groups in median pain intesity, successful treatment outcome, and mouth opening capacity with assistance were nonsignificant. CONLUSIONS: Use of lavage to supplement extra-articular local anaesthetic treatment of painful reduced mouth opening at non-reducing discs does not appear to improve treatment outcome.
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| 18. |
- Englesson Sahlström, Lotta, et al.
(författare)
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Lavage Questionable in Treatment of Painful Reduced Mouth Opening (Stockholm)
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To compare treatment with local anaesthetics and local anaesthetics in combination with lavage in patients with temporomandibular joint (TMJ) pain and reduced mouth opening in a randomized controlled trial. Material and methods: Forty-one women and four men (mean age of 35 years) participated. All patients had had TMJ pain for more than 3 months, had reduced mouth opening capacity, and had non-reducing disc displacement confirmed by magnetic resonance imaging. The patients were randomized to treatment with extra-articular local anaesthetic alone (control) or with extra-articular local anaesthetic in combination with lavage (treatment). All patients were examined at baseline and at 1 and 3 months by an examiner blind to treatment. Successful treatment was determined as 30% or more pain reduction on a 100-mm analog scale (VAS). Results: At baseline, mean pain intensity (VAS) of the TMJ during mandibular movements was rated 58 among the controls and 61 in the treatment group. At the 3 months follow-up, treatment was considered successful in 76% of the controls and 50% of the treatment group. Mouth opening capacity was 34 mm and 33 mm at baseline and 43mm and 38 mm after 3 months among the controls and in the treatment group, respectively. These differences between groups in pain intensity (VAS), successful treatment outcome (≥ 30%), and mouth opening capacity (mm) were non-significant between groups. Conclusion: Use of lavage to supplement extra-articular local anesthetic treatment of painful reduced mouth opening at non-reducing dics does not appear to improve treatment outcome. only.
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| 19. |
- Gillborg, Susanna, et al.
(författare)
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TMD-pain among adults in the county of Scania
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The prevalence of TMD has been shown in epidemiological studies to be 10-15 % and it is most often women in their 20-40´s, but also men, children and elderly have TMD. The most common reason for seeking care for TMD seems to be pain. In a recently published meta-analysis of the epidemiological literature the need for TMD treatment was estimated to be about 15 % among adults. Objectives: This study evaluates the prevalence of TMD-pain in adults in the county of Scania. Methods: A questionnaire was 2006 mailed to a randomized selected sample of 10000 individuals in the county of Scania. If the subjects answered yes to one or both of following questions, the subject was classified as having TMD-pain (1) “ Do you have pain in your temples, face, jaw joint or jaws once a week or more?” and (2) “Do you have pain when you open your mouth wide or chew once a week or more?”. Results: 6123 subjects (64%) answered the questionnaire. 1210 subjects (20,4 %) reported TMD-pain. Mean age was 47 years, with a female-male ratio of 7:5. A higher prevalence of TMD-pain was found for the ages 20-59 with the highest figure for the ages between 20 and 29 years. TMD-pain was reported by 19–21 % of subjects born in Sweden or another Nordic country compared to 32 % of the subjects born in another country. Length of education was not related TMD-pain. A higher prevalence of reported TMD-pain was found for subjects being unemployed, retired or were on sick leave compared to other occupations. TMD-pain was reported by 19 % of married subjects, 23 % of not married subjects compared to 27 % of subjects with another family-situation. Conclusion: The study found a high prevalence (20,4 %) of TMD-pain among adults in the county of Scania.
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| 20. |
- Henrikson, Thor, et al.
(författare)
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Can orthodontic treatment improve mastication? A controlled, prospective and longitudinal study
- 2009
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 33:2, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To prospectively and longitudinally evaluate the self-perceived masticatory ability and the tested masticatory efficiency in orthodontically treated and untreated groups. DESIGN: Prospective observational cohort. SUBJECTS AND METHODS: Three groups of age matched adolescent girls were included. Sixty-five Class II subjects received orthodontic treatment fixed appliance treatment (Orthodontic group), 58 subjects were orthodontically untreated (Class II group) and 60 subjects had a normal occlusion (Normal group).The self-perceived masticatory ability was assessed on a visual analogue scale while the masticatory efficiency was evaluated with a masticatory efficiency test using round silicon tablets. Registrations were performed at the start and after two years when all subjects in the Orthodontic group had finished orthodontic treatment. RESULTS: Over the two-year period the self-perceived masticatory ability increased significantly in the Orthodontic group. After treatment, the Orthodontic group perceived their masticatory ability as high as the Normal group did. The masticatory efficiency increased significantly, during the two years, in all three groups. However,the normal occlusion group presented a significantly better masticatory efficiency than both the Orthodontic group and the Class II group on both registrations. CONCLUSIONS: Orthodontic treatment was beneficial for the self-perceived masticatory ability. The masticatory efficiency increases with age during adolescence. Normal occlusion subjects had a better masticatory efficiency than subjects with orthodontically treated as well as untreated Class II malocclusion.
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| 21. |
- Limchaichana, Napat, et al.
(författare)
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Clinical diagnoses and MRI findings in patients with TMD pain
- 2007
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Ingår i: Journal of Oral Rehabilitation. - : Wiley-Blackwell. - 1365-2842 .- 0305-182X. ; 34:4, s. 237-245
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to correlate clinical diagnoses in temporomandibular disorders patients suffering from pain diagnosed as arthralgia/osteoarthritis or myofascial pain according to the Research Diagnostic Criteria for temporomandibular disorders with findings made on magnetic resonance imaging. The temporomandibular joints of 60 consecutive patients, 41 with arthralgia/osteoarthritis and 19 with myofascial pain, were examined clinically and with magnetic resonance imaging. The most common magnetic resonance imaging findings were disc displacements and structural bone changes, which were found in both pain groups. However, disc displacements were found significantly (p = 0.002) more often in the arthralgia/osteoarthritis group. 104 joints were found to have no clinical diagnosis of disc displacements, but 64 of these joints had findings of disc displacements on magnetic resonance imaging. Joint fluid was found both in the arthralgia/osteoarthritis group (20 patients) and in the myofascial pain group (5 patients). Patients having a combination of disc displacement and joint fluid were significantly (p = 0.047) more common in the arthralgia/osteoarthritis group. In conclusion, the magnetic resonance imaging findings of disc displacement and structural bone changes were common in temporomandibular disorders patients with pain of both myogenous and arthrogenous origin. The clinical diagnoses for subdivision into myogenous and arthrogenous pain groups were not confirmed by magnetic resonance imaging.
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| 22. |
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| 23. |
- Limchaichana, Napat, et al.
(författare)
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Resilient appliance-therapy treatment outcome in patients with TMD pain correlated to MRI-determined changes in condyle position
- 2009
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Ingår i: Cranio. - : CHROMA, Inc. - 0886-9634 .- 2151-0903. ; 27, s. 185-193
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this research was to study if changes in condyle position in temporomandibular disorders (TMD) patients could be a factor that is affected by resilient appliance therapy and if it influences the treatment outcome. The study investigated 48 patients randomly assigned to a treatment group (T group = 21 patients, using resilient appliance) or a control group (C group = 27 patients, using nonoccluding appliance). Changes in the condyle-fossa relationship (with and without the appliance) were determined in an MRI examination. Ten weeks after treatment, the treatment outcome was measured. The results showed that with the appliance, change in condyle position occurred in 76% of the T group and 22% of the C group (p < 0.001). Sixty-seven percent (67%) of the T group and 44% of the C group experienced a successful treatment outcome. Treatment outcome was not related to changes in condyle position in patients with TMD pain.
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| 24. |
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| 25. |
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| 26. |
- 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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| 27. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- 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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| 32. |
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| 33. |
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| 34. |
- 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
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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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| 35. |
- 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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| 36. |
- 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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| 37. |
- 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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| 38. |
- 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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