| 1. |
- Abrahamsson, Cecilia, et al.
(författare)
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TMD before and after correction of dentofacial deformities by orthodontic and orthognathic treatment
- 2013
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier. - 0901-5027 .- 1399-0020. ; 46:6, s. 752-758
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The aims of the study were to investigate the alteration of temporomandibular disorders (TMD) after correction of dentofacial deformities by orthodontic treatment in conjunction with orthognathic surgery; and to compare the frequency of TMD in patients with dentofacial deformities with an age and gender matched control group. TMD were evaluated in 121 consecutive patients (treatment group), referred for orthognathic surgery, by a questionnaire and a clinical examination. 18 months after treatment, 81% of the patients completed a follow-up examination. The control group comprised 56 age and gender matched subjects, of whom 68% presented for follow-up examination. TMD were diagnosed according to research diagnostic criteria for TMD. At baseline examination, the treatment group had a higher frequency of myofascial pain (P=.035) and arthralgia (P=.040) than the control group. At follow-up, the frequencies of myofascial pain, arthralgia and disc displacement had decreased in the treatment group (P=.050, P=.004, P=.041, respectively). The frequency of TMD was comparable in the two groups at follow-up. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, seem to have a positive treatment outcome in respect of TMD pain
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| 2. |
- Al-Harthy, Mohammad, et al.
(författare)
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Temporomandibular disorder pain in adult Saudi Arabians referred for specialised dental treatment
- 2010
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 34:3, s. 149-158
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine the frequency of Temporomandibular Disorders (TMD) pain in Saudi Arabians,aged 20-40, who were referred to the Specialist Dental Centre in Makkah. The material included 325 patients (135 males,190 females) who answered a history questionnaire. Patients reportingTMD pain in the last month were offered a clinical examination. History questionnaires and clinical examinations were done according to the Arabic version of the Research Diagnostic Criteria for TMD (RDC/TMD). Fifty-eight patients (18%) reported TMD pain; 46 were clinically examined. Mean age of clinically examined TMD pain patients was 30 +/- 7 years with a male-female ratio of 1:6 (P < 0.001). All TMD pain patients had a diagnosis of myofascial pain, and 65% had diagnoses of arthralgia or osteoarthritis. Headaches or migraines in the last 6 months and headaches in the last month were reported in high frequencies in the TMD pain group, 93% and 71% respectively, with differences (P < 0.001) between the TMD pain and non-TMD pain groups. Graded Chronic Pain Scale assessments classified 45% of the TMD pain patients in grade 1, 53% in grade II, 2% in grade III, and 0% in grade IV. Severe depression scores were found in 38% of the TMD pain patients and severe somatisation scores in 60% with differences (P < 0.001) between the TMD pain and non-TMD pain groups. In conclusion, the study found a frequency of TMD pain in this Saudi Arabian cohort of 18%. The TMD pain group presented high scores of depression and somatisation but low disability grades on the Graded Chronic Pain Scale.
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| 3. |
- Christidis, N, et al.
(författare)
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Effectiveness of a prefabricated occlusal appliance in patients with temporomandibular joint pain : a randomized controlled multicenter study
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 28:2, s. 128-137
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the effectiveness of a prefabricated appliance and compare it to the effectiveness of a stabilization appliance in patients with temporomandibular joint (TMJ) pain. METHODS: This randomized, controlled multicenter study comprised 48 patients diagnosed with TMJ arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders. The effectiveness of a prefabricated appliance (Relax), worn by half of the patients (referred to as the R group), was compared to the effectiveness of a stabilization appliance, worn by the other half of patients (S group). Treatment outcome was assessed according to the recommendations by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) on an intent-to-treat basis. To analyze the differences between groups, the chi-square test and the Mann-Whitney U test were used, while the Friedman analysis of variance (ANOVA) on ranks was used for the analyses between baseline data and follow-up measurements, all with a significance level set at P < .05. RESULTS: There were no differences between the groups at baseline. A 30% reduction of pain intensity was reported by 62.5% of the R group and 58.3% of the S group at the 10-week follow-up; 58% and 50.3%, respectively, at the 6-month follow-up; and 41.7% in both groups at 12 months. At the 12-month follow-up, pain intensity had decreased and physical function had improved in both groups (P < .005 and P < .016, respectively), without significant group differences. Emotional function (depression and nonspecific physical symptoms) did not change. Overall improvement of "better" to "symptom-free" was observed in 67% of the R group and 58% of the S group. No side effects occurred. CONCLUSION: The effectiveness of the prefabricated appliance seems to be similar to that of the stabilization appliance in alleviating TMJ pain. Since the prefabricated appliance requires only one visit for construction, it is convenient for both the general practitioner and for the patient
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| 4. |
- Dahl, Sara, et al.
(författare)
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Can sense of coherence be a predictor for treatment outcome in patients with TMD-pain?
- 2011
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Ingår i: Svenska tandläkaresällskapets 47:e odontologisk riksstämma 2011. - : Svenska tandläkaresällskapet. ; , s. 110-110
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aims. To investigate whether SOC (sense of coherence) changed after twelve months of treatment of TMD-pain, and if any such change could be correlated with treatment outcome. Another objective was to examine whether SOC was correlated with grade of depression and somatisation. Materials and Methods. 73 patients participated in the double-blind randomized controlled trial. The TMD-treatment was active for at least ten weeks and consisted of either a resilient or a non-occluding control appliance. Patients were diagnosed according to RDC/TMD and completed the SOC-29 at baseline and after twelve months. Treatment outcome was evaluated as a reduction of pain registered as characteristic pain intensity. No difference was found between the resilient appliance and the control appliance in reducing pain at the 12-months follow-up. Therefore the material was pooled together. Results. Of the 73 participating TMD-pain patients, a total of 44 patients filled in the SOC-29 at both baseline and after twelve months, and 42 of them also stated values for depression and somatisation. There was no correlation between high SOC and treatment outcome. No differences were found in the mean value of SOC for patients younger and older than 30 respectively 40 years. Significant correlations were found between mean differences of SOC and grade of depression, and between mean differences of grade of depression and somatisation. Conclusion. Our results showed that SOC was not a predictor for treatment outcome in TMD-pain patients previously treated with an appliance. SOC seems to be correlated to grade of depression.
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| 5. |
- Doepel, Marika, et al.
(författare)
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Effectiveness of Prefabricated Occlusal Appliance in TMD Patients with Headache
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To compare the short- and long-term effectiveness of a prefabricated occlusal appliance with a stabilization appliance for the treatment of headache in myofascial pain patients. Methods: Sixty-five myofascial pain patients of whom 57 reported headache were included in a randomized controlled trial at two centres for Stomatognathic Physiology in Sweden and Finland. Patients were randomly assigned to a prefabricated appliance (R-group, 27 women, 5 men, mean age 38 years) or a stabilization appliance group (S-group, 31 women 2 men, mean age 37 years). RDC/TMD was used for history-taking and clinical examination. Frequency and intensity of headache were assessed using a verbal scale (1=continuous, 2=recurrent, 3=rarely) and a numeric rating scale (NRS) respectively at baseline, 10-week, 6-and 12-month follow-ups. Results: At baseline there were no differences between the groups regarding frequency and intensity of headache. At the follow-ups a statistically significant decrease in both frequency and intensity was observed within the two groups without any differences between the groups. At baseline 72% and 70% in the R and S groups reported recurrent or continuous headache which decreased significantly (p< .01) within both groups to 44% and 31% at 10-week and to 26% and 18% at the 12-month follow-up. Mean intensity (NRS) of headache at baseline decreased within both groups from 6 to 3 at 10-week follow-up and to 2 and 3 in the R and S groups respectively (p< .001) at 12-month follow-up. Conclusions: In both short- and long-term the prefabricated appliance seemed to have a similar effectiveness in the treatment of headache in myofascial pain patients.
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| 6. |
- Doepel, M., et al.
(författare)
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Long-term effectiveness of a prefabricated oral appliance for myofascial pain
- 2012
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 39:4, s. 252-260
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Tidskriftsartikel (refereegranskat)abstract
- Summary The long-term effectiveness of a prefabricated oral appliance (R) was compared with a stabilisation appliance (S) in patients with myofascial pain. Sixty-five patients diagnosed with myofascial pain at two centres for Stomatognathic Physiology in Sweden and Finland were included in a randomised controlled trial using Research Diagnostic Criteria for Temporomandibular Disorders, with history questionnaires and clinical examinations performed by blinded examiners at baseline and at 6- and 12-month follow-ups. Patients were randomly assigned either to the R or the S group. Treatment outcome was measured according to IMMPACT for four chronic pain outcome domains: pain intensity, overall improvement, physical functioning and emotional functioning. Physical functioning was classified for Graded Chronic Pain severities and assessed by the Jaw Functional Limitation scale. Emotional functioning composed of scores of non-specific physical symptoms and depression. There were no differences between groups at baseline. At both follow-ups, all outcome domains showed significant within-group improvement, without significant differences between groups. At 12 months, 72% of all patients reported a 30% reduction in worst pain and 63% of the patients a 50% reduction in worst pain. Overall improvement ‘better’ to ‘symptom-free’ was observed in 81% in the R and 64% in the S group at the 12-month follow-up. Graded Chronic Pain, Functional Limitation of the Jaw, non-specific physical symptoms and depression showed statistically significant reduction at 12-month follow-up. Results support the hypothesis that the effectiveness of the prefabricated appliance is similar to that of the stabilisation appliance in the long-term when treating patients with myofascial pain.
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| 7. |
- Ekberg, EwaCarin, et al.
(författare)
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Short-term evaluation of a standardized pain-school program in patients with TMD pain.
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Systematic reviews have concluded that behavioral therapy is effective in treating TMD pain. However, most of the studies included different treatment modes, making it difficult to determine which part of the treatment was most important. It has also been found that patients with TMD pain and major psychological disturbances were in need of a combined therapeutic approach. Aim: The purpose of this descriptive study was to evaluate a standardized pain-school program in patients with TMD pain Material and methods: During 2006 and 2011, 99 patients with TMD pain were referred for treatment with a 5-session pain-school program. The patients were examined according to RDC/TMD, at the Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University. The program consisted of a standardized program where the patients underwent treatment individually for 7 weeks by two special trained dental assistants. Three to four weeks after the last visit an evaluation of the treatment outcome were performed by the same dentist as before treatment. Results: Out of 99 patients 85 patients with a mean age of 39 ± 1.9 years (min 13 years-max 78 years) fulfilled the whole program. Patients fulfilling the program 74 patients were women (mean age 38 years) and 11 were men (mean age 52 years). All patients had at least one pain diagnoses, where 67 patients had myofascial pain, 44 patients had arthralgia/osteoarthritis, 22 patients had headache, and 7 patients had other pain conditions (whiplash, neuralgia, burning mouth syndrome and atypical odontalgia). Most of the patients (74%) had more than one pain diagnosis. 54 patients (67%) were responders and 28 patients were non-responders (33%) to the program. 53 (72%) women and 4 (36%) men reported benefit of the program. Seventy of the patients had had two or more treatments previous to the pain-school, where the most common treatments were information and counseling, and appliance therapy. These treatments had not given sufficient pain relief. In the group having three or more treatments previously 75% of the patients were responders compared to 60% among patients having only information and counseling. Among the 28 non-responders, 5 patients were younger than 20 years of age (10), 7 patients were men (11), 10 patients had high scores of depression according to RDC/TMD (23). Conclusion: This 5-session pain-school intervention seems to be effective in alleviating TMD pain in patients previously treated with usual therapies. The results of this evaluation indicate that there is a need of RCTs evaluating the effectiveness of this program in a short and a long term perspective.
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| 8. |
- Eriksson, Lill, et al.
(författare)
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Lavage treatment of painful jaw movements at disc displacement without reduction : a randomized controlled trial in a short-term perspective
- 2013
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier. - 0901-5027 .- 1399-0020. ; 42:3, s. 356-363
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Tidskriftsartikel (refereegranskat)abstract
- This study compared the short-term efficacy of two treatments (local anesthetics (A) and local anesthetics and lavage (AL)) in patients with permanently displaced discs and temporomandibular disorder (TMD) pain. 45 patients participated in the single-blind randomized controlled trial. All patients had received: a Research Diagnostic Criteria/TMD diagnosis of disc displacement without reduction; and magnetic resonance imaging confirmation of non-reducing disc displacement. Participants were randomized to treatment with A or AL and were assessed at baseline and at 1 and 3 month follow-ups. The primary outcome measure defining success was reduction in pain intensity of at least 30% during jaw movement. At the 3 month follow-up, the success rate was 76% for A and 55% for AL. Both groups reported similar pain relief with no significant difference between the groups. Similar trends were observed for outcome measures in the physical functioning, emotional functioning, and global improvement domains with no significant difference between the groups. Use of lavage to supplement extra-articular local anesthetic treatment of painful jaw movements at non-reducing discs does not appear to improve TMD pain and mouth opening capacity in the short term
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| 9. |
- Erixon, Caroline L., et al.
(författare)
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Self-perceived effects of occlusal appliance therapy on TMD patients : an eight-year follow-up
- 2013
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Ingår i: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 37:1, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- There are few long-term follow-up studies of treatment of temporomandibular disorders (TMD).The aim of this questionnaire study was to evaluate eight-year outcomes of appliance therapy in patients suffering from arthralgia/osteoarthritis and/or myofascial pain. The subjects comprised 120 patients, originally randomly assigned to treatment with an occlusal or a control (palatal) appliance. Eight years later, a questionnaire was sent to 118 eligible patients: 90 (76%) responded. The outcome measures were intensity and frequency of pain, physical and emotional functioning, and overall improvement of pain and headache. Maximum pain intensity had decreased by > 30% in 54 patients (60%); frequency of pain had also decreased significantly. A majority, 57/90, reported improved physical function. Fifty-nine patients reported moderate to severe depression and 61 reported non-specific physical symptoms. Sixty-eight patients reported an overall improvement in TMD pain and 61 perceived overall improvement in severity of headaches. In the intervening years, 57 patients had undergone further treatment, most frequently in the form of another occlusal appliance. The majority of respondents reported improvement in TMD pain and headache. However, it is difficult to evaluate the long-term outcome of appliance therapy as more than 60% of the patients had additional treatments during the eight years.
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| 10. |
- 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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| 11. |
- 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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| 12. |
- 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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| 13. |
- 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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