The effect of the RW-splint on the position and occlusal relationship of class Ⅱ malocclusion patients with temporomandibular disorder / 口腔疾病防治

Objective@#To explore the effect of RW splints on the position and occlusal relationship of classⅡ malocclusion patients with temporomandibular disorder (TMD) to provide a basis for the diagnosis and design of this kind of patient. @*Methods @#Fifteen patients with class Ⅱ malocclusions with TMD were enrolled in this study. After 8 months of RW-splint treatment, the changes in jaw position (∠ANB, SN-MP, ∠S-G0/N-Me) and occlusal relationship (molar, cuspid teeth displacement and anterior overbite/overjet value) were recorded by a condylar displacement measuring instrument at the CR position and CO position.@*Results@#After RW-splint treatment, the mean values of ∠ANB (t=4.971, P=0.001) and ∠SN-MP (t=9.895, P ＜ 0.01) were increased in all 15 patients, and the mean value of S-G0/N-Me (t=5.342, P=0.005) was decreased. The mean values of the distal movement of the first molars on the left and right sides of the mandible were (1.57 ± 0.79) mm and (1.69 ± 1.29) mm, respectively; the mean values of the distal movement of the canines on the left and right sides of the mandible were (1.54 ± 0.50) mm and (1.51 ± 1.08) mm, respectively; and the mean values of the overbite were (1.16 ± 0.60) mm and (1.99 ± 0.85) mm, respectively. @*Conclusion@# After RW-splint treatment, the jaw rotates clockwise, and the relationship between the molars and canines changes obviously in class Ⅱ patients with TMD, which provides a reference for the diagnosis and treatment plan of this kind of patient.

Aplicação da estimulação elétrica nervosa transcutânea em indivíduos com disfunção temporomandibular: ensaio clínico randomizado / Application of transcutaneous nervous electric stimulation in individuals with temporomandibular dysfunction: randomized clinical trial

INTRODUÇÃO: A fisioterapia dispõe de vários recursos para o tratamento da disfunção temporomandibular, como a estimulação elétrica nervosa transcutânea (TENS), mas com muitas variações nos protocolos e parâmetros dosimétricos. OBJETIVO: Analisar a eficácia da estimulação elétrica nervosa transcutânea (TENS), com duração de fase e frequência fixas, na analgesia e funcionalidade de disfunções temporomandibulares. MÉTODOS: A amostra foi composta por 20 indivíduos, separados em grupo tratado e placebo, ao longo de 2 semanas de tratamento, avaliados pelo Questionário de Sintomas Mandibulares e Hábitos Orais, analisando dor e função articular. RESULTADOS: Ambos os grupos apresentaram redução na dor e escore geral, comparados ao momento préintervenção, para a função, apenas o TENS apresentou redução dos valores, mas, não houve diferenças entre os grupos. CONCLUSÃO: TENS não foi diferente do placebo no controle da dor porém, promoveu a melhora funcional nos voluntários.

INTRODUCTION: Physiotherapy has several resources for the treatment of temporomandibular dysfunction, such as transcutaneous electrical nerve stimulation (TENS), but with many variations in protocols and dosimetric parameters. OBJECTIVE: To analyze the efficacy of transcutaneous electrical nerve stimulation (TENS), with fixed phase duration and frequency, in the analgesia and functionality of temporomandibular disorders. METHODS: The sample consisted of 20 individuals, separated in a treated group and placebo, during 2 weeks of treatment, evaluated by Questionnaire on Mandibular Symptoms and Oral Habits, analyzing pain and joint function. RESULTS: Both groups presented reduction in pain and general score, compared to the pre-intervention moment, for the function, only the TENS showed a reduction of the values, but there were no differences between the groups. CONCLUSION: TENS was not different from placebo in pain control, however, it promoted functional improvement in volunteers.

Surgical management of chronic temporomandibular joint dislocations

Temporomandibular joint dislocation is described as the movement of mandibular condyle out of the fossa beyond its anatomical and functional boundaries causing pain and discomfort. It is often managed by conservative methods, but in long-standing, chronic conditions, surgical treatment is the only option. The goal of surgical treatment is to reposition the condyle and prevent further recurrences. Materials and Methods: This retrospective analysis involving a single center and a surgeon with 19 patients and 23 joint surgeries performed over a 10-year period. Patients who fulfilled inclusion and exclusion criteria and had earlier undergone surgical correction with hook-shaped miniplates and miniscrews fixed with or without bone grafts formed the study group. Results: In all, 12 were female (mean age, 41.9 ± 12.07 years) and the rest 9 were male (mean age, 39.8 ± 13.6 years), ranging from 32 years to 58 years. All patients had the dislocation for an average period of 19.26 ± 12.6 months before the surgery. The mean maximal mouth opening (without pain) preoperatively was 17.78 ± 2.13 mm (12–25 mm) while postoperatively it was 32.28 ± 3.17 mm (27–37 mm). There were no immediate or late surgical complications in the follow-up period that ranged from 8 to 37 months. Discussion: When proper case selection is employed and properly done, using hook-shaped miniplates with or without bone graft is more cost-effective, giving excellent short- and long-term effects. Conclusion: The results in this Indian population are very similar to that reported from other parts of the world.

Disfunción temporomandibular: causas y tratamientos / Temporomandibular dysfunction: causes and treatments

Introducción: la articulación temporomandibular (ATM) es muy compleja y está compuesta por el hueso temporal y el maxilar inferior o mandíbula. La disfunción temporomandibular (DTM) comprende una serie de signos y síntomas, entre ellos el dolor bucofacial y las alteraciones funcionales como los ruidos articulares y las limitaciones a los movimientos mandibulares. Objetivo: realizar revisión bibliográfica sobre las causas más frecuentes de la DTM y sus posibles tratamientos en pacientes adultos. Metodología: se realizó una revisión bibliográfica de bases de datos electrónicas de los últimos 10 años. Se excluyeron reportes de casos. Resultados: se detectaron 40 artículos en bases bibliográficas de internet de los cuales se incluyeron 30 que reunían los criterios de inclusión. Se encontró al dolor y al ruido articular como síntomas más frecuentes de la DTM y está asociada con el sexo femenino y el bruxismo o parafunción en mayores porcentajes. La placa neuromiorelajante es el tratamiento más mencionado. Conclusiones: el dolor de la ATM fue la variable medida en mayor proporción. Entre los factores que se encontraron asociados a la DTM, tuvo mayor porcentaje el sexo femenino seguido del bruxismo o parafunción y los pacientes parcialmente edéntulos.

Introduction: the temporomandibular joint is very complex and is composed of the temporal bone and the lower jaw or mandible. Temporomandibular dysfunction (TMD) comprises a series of signs and symptoms, including orofacial pain and functional alterations such as joint noises and limitations to mandibular movements. Objective: to describe the most frequent causes of TMD and its possible treatments in adult patients. Methodology: a bibliographic review of electronic databases of the last 10 years was carried out. Case reports were excluded. Results: 40 articles were detected in internet bibliographic bases, of which 30 were included that met the inclusion criteria. Joint pain and noise were found as the most frequent symptoms of TMD and are associated with female sex and bruxism or parafunction in higher percentages. The neuromyorelaxing plaque is the most mentioned treatment. Conclusions: TMJ pain was the most widely measured variable. Among the factors that were found associated with TMD, the female sex had a higher percentage followed by bruxism or parafunction and partially edentulous patients.

Infliximab Partially Alleviates the Bite Force Reduction in a Mouse Model of Temporomandibular Joint Pain

Temporomandibular joint (TMJ) disorder is clinically important because of its prevalence, chronicity, and therapy-refractoriness of the pain. In this study, we investigated the effect of infliximab in a mouse model of TMJ pain using a specially-engineered transducer for evaluating the changes in bite force (BF). The mice were randomly divided into three groups (7 mice per group): the control group, the complete Freund's adjuvant (CFA) group, and the infliximab group. BF was measured at day 0 (baseline BF). After measuring the baseline BF, CFA or incomplete Freund's adjuvant was injected into both TMJs and then the changes in BF were measured at days 1, 3, 5, 7, 9, and 13 after the TMJ injection. For measuring the BF, we used a custom-built BF transducer. Control, CFA, and infliximab groups showed similar baseline BF at day 0. From day 1, a significant reduction in BF was observed in the CFA group, and this reduction in BF was statistically significant compared to that in the control group (P < 0.05). This reduction in BF was maintained until day 7, and BF started to recover gradually from day 9. In the infliximab group also, the reduction in BF was observed on day 1, and this reduction was maintained until day 7. However, the degree of reduction in BF was less remarkable compared to that in the CFA group. The reduction in BF caused by injection of CFA into the TMJ could be partially alleviated by the injection of anti-tumor necrosis factor alpha, infliximab.