Management Of Temporomandibular Joint Disorders Research Articles

Platelet-Rich Plasma in Oral and Maxillofacial Surgery: A Comprehensive Literature Review.

Platelet-rich plasma (PRP) is well recognized and frequently used therapeutic tool for surgeons in oral and maxillofacial surgery (OMFS). It is become popular due to its regenerative potential of autologous blood components that enhance tissue repair while improving overall surgical outcomes. we decided to discuss historical evolution of PRP and OMFS, preparation methods and biological mechanisms, OMFS applications, more precisely, efficacy of PRP in OMFS. PRP was originated from early explorations in wound healing research and now it has made continuous refinement and is being used in widespread application across diverse medical specialities. In OMFS, PRP is prepared through centrifugation methods where PRP is concentrate platelets and other important growth factors that are essential for tissue regeneration, or improving bone density and regrowth. Clinical applications span from bone and soft tissue augmentation to the management of temporomandibular joint disorders and maxillofacial pathology. Various pieces of evidence promise promising outcomes, but the efficacy of PRP in enhancing bone regeneration remains debated among researchers and physicians, which necessitates further research and comprehensive validation. Complications of PRP administration are rare but may include infection, nerve damage, tissue calcification, or even blindness in some cases, which emphasizes careful patient selection and monitoring is evident. PRP future in OMFS is promising for more personalized therapies and standardized protocols. More discoveries will be made through mixed or combination treatments with PRP and it will expand applications, technological advancements, and efficacy in long-term outcome.

Evaluation of Efficacy of 10% Dextrose Prolotherapy in Management of Temporomandibular Joint Disorders: A Prospective Study

Evaluation of Efficacy of 10% Dextrose Prolotherapy in Management of Temporomandibular Joint Disorders: A Prospective Study

Dental practitioners’ knowledge, management practices, and attitudes toward collaboration in the treatment of temporomandibular joint disorders: a mixed-methods study

BackgroundTemporomandibular joint disorders (TMDs) are a variety of conditions that affect different parts of the temporomandibular joints (TMJ) and can cause orofacial pain and functional impairment. This study aims to investigate dental practitioners’ knowledge and management of Temporomandibular Joint Disorders (TMDs), particularly their knowledge of the role physical therapy plays in TMD treatment.MethodsA mixed-methods approach was adopted to provide a comprehensive view of current knowledge, management practices, and attitudes toward collaboration among dental practitioners in treating TMD. Data were collected from a convenience sample of 335 dentists in Karachi using a detailed questionnaire to assess their knowledge of the role of physical therapy in the treatment of TMD. Twenty dentists were chosen for face-to-face, in-depth interviews to explore their experiences and challenges in managing TMDs based on their responses to the administered questionnaire.ResultsThe cumulative quantitative and qualitative findings of the study revealed a landscape marked by individualized approaches to referral practices and significant gaps in interdisciplinary collaboration. Most practitioners holding a bachelor’s degree predominantly used medication (65.2%) and cause-specific treatment (65.3%) for TMD treatment. Thematic analysis of clinical efficacy and practitioner challenges in managing TMD revealed significant issues faced by dental professionals.ConclusionsThe study successfully validated a questionnaire to understand dental practitioners’ knowledge regarding physical therapy in TMD treatment. The study identified significant gaps in knowledge and a lack of collaboration between dentists and physiotherapists. The limited referral practices highlighted in the study, along with insights from dentist interviews, emphasize the need for improved interdisciplinary approaches to managing TMDs within dental practice.

Occlusal splints and its implications in temporomandibular disorders: A review

Occlusal splints are described as “Any removable artificial occlusal surface affecting the relationship of the mandible to the maxilla used for diagnosis or therapy. Prosthodontic management of Temporomandibular joint disorders (TMDs) has been a controversial topic. The purpose of this article is to make prosthodontists aware about use and significance of splints in dealing with temporomandibular disorders (TMDs) the by usage of easy and less difficult remedy.

Surgical vs. Non-Surgical Management of Temporomandibular Joint Disorders: Clinical Outcomes

ABSTRACT Background: Temporomandibular joint disorders (TMDs) encompass a range of clinical conditions affecting the temporomandibular joint (TMJ) and associated structures. Management approaches for TMDs vary and include both surgical and non-surgical interventions. Materials and Methods: In this retrospective cohort study, medical records of 150 patients diagnosed with TMDs were reviewed. Patients were categorized into two groups: surgical intervention and non-surgical intervention. The surgical group underwent various surgical procedures, including arthroscopy, arthroplasty, and joint replacement, while the non-surgical group received conservative treatments such as physical therapy, pharmacotherapy, and occlusal splints. Pain levels, TMJ function, quality of life (QoL), and patient satisfaction were assessed at baseline and post-treatment (6 months and 1 year). Results: At the 6-month follow-up, both groups experienced a significant reduction in pain scores (surgical group: 6.3 ± 1.2 to 2.4 ± 0.9, non-surgical group: 6.1 ± 1.1 to 3.2 ± 1.0). TMJ function improved in both groups (surgical group: 2.5 ± 0.8 to 4.8 ± 0.6, non-surgical group: 2.6 ± 0.7 to 4.2 ± 0.9). QoL scores increased (surgical group: 35.2 ± 4.6 to 50.3 ± 5.1, non-surgical group: 35.5 ± 4.2 to 45.7 ± 4.8), and patient satisfaction rates were high (surgical group: 92%, non-surgical group: 87%) at the 1-year follow-up. Conclusion: Both surgical and non-surgical management approaches demonstrated significant improvements in pain relief, TMJ function, QoL, and patient satisfaction for individuals with TMDs.

Global Postural Exercise Program Versus Muscle Energy Technique on Management of Temporomandibular Joint Disorders

Objective: To compare between the effects of global postural exercise program against muscle energy technique on maximum pressure pain threshold, maximal mouth opening range of motion as well as quality of life on patients with temporomandibular joint disorders. Methods: 63 patients having temporomandibular disorders were randomized into three groups; Group (A) were given global postural exercise program in addition to conventional therapy (in the form of LASER and hot packs), Group (B) were given muscle energy technique as well as traditional therapy and the Group (C) control were given traditional therapy only. All patients were examined by the pressure algometer, paquimeter and Arabic version of Oral health impact profile 14 questionnaire as well as the duration of treatment were 6 weeks. Results: there were no significant statistical differences revealed pretreatment for all variables, Mmaximal mouth opening range of motion, quality of life scale, as well as pain) as in mouth opening (P=0.130), OHIP-14 (P=0.642), right temporalis muscles (P=0.384), left temporalis muscles (P=0.930), right masseter muscles (P=0.790), left masseter muscles (P=0.064), right trapezius muscle (P=0.403), and left trapezius muscle (P=0.058) among groups where (P>0.05). While after-treatment and follow up , there were significant statistical differences were P value was (P<0.05), in mouth opening (P=0.0001 and P=0.0001, respectively), OHIP-14 (P=0.0001 and P=0.0001, respectively), right temporalis muscles (P=0.035 and P=0.020, respectively), left temporalis muscles (P=0.0001 and P=0.0001, respectively), right masseter muscles (P=0.001 and P=0.0001, respectively), left masseter muscles (P=0.004 and P=0.035, respectively), right trapezius muscle (P=0.0001 and P=0.0001, respectively), and left trapezius muscle (P=0.031 and P=0.001, respectively) between groups. Conclusion: Both Muscle energy technique and global postural exercise program improved mouth opening, pressure pain threshold, as well as quality of life in temporomandibular joint disorders patients, with the superiority of muscle energy technique over global postural exercise program.

Correlation between mental well-being and severity of class II temporomandibular joint disorders, compared to non-temporomandibular joint disorders

Temporomandibular joint disorders (TMDs) are one of the most common ailments encountered in the craniofacial region, with various clinical, radiological and psychological manifestations but often go undiagnosed due to lack of a diagnostic protocol to assess and correlate all these factors in order to create an effective management plan based on early diagnosis. The objectives of this research are to assess, compare and co-relate the severity of clinical and radiological findings with mental well-being in class II (vertical growth pattern) TMD cases as compared to class I non-TMD cases. Grading of skeletal class II cases on the severity of TMD will be done using Diagnostic Criteria for TMDs (DC/TMD). Bilateral sagittal as well as coronal magnetic resonance imaging (MRI) images will be obtained. Evaluation and grading of mental well-being and anxiety will be done using the Warwick-Edinburgh and Hamilton scales, respectively. The expected results are a probable positive correlation between the severity of clinical and radiological symptoms of TMDs and deteriorating mental well-being in the form of stress, anxiety and depression. A cause-effect relationship may be evaluated with the aim of early diagnosis and management of TMDs as improving the quality of life of these cases. This study will aid in identifying the clinical symptoms and articular disc position on MRI as they correlate with the mental well-being status and anxiety levels in TMD cases. Further management and early intervention can be undertaken in such cases to prevent or stall the progression of TMD into severe forms while improving the quality of life (QoL) in such cases.

Comment on: "Comparison of the effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders".

Comment on: "Comparison of the effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders".

Materials and manufacturing techniques for occlusal splints: A literature review.

To review the materials and fabrications methods of occlusal splints with their advantages and shortcomings and to clarify the indications for each. Temporomandibular joint disorders (TMDs) encompass a range of conditions affecting the masticatory system. Occlusal splints are currently recognized as a viable option for the management of TMDs when they are adopted in conjunction with additional approaches varying from conservative procedures (counseling, biofeedback, physical therapy, pharmacotherapy) to irreversible and less conservative ones (occlusal adjustments, orthodontics, arthroscopy, and surgery). These splints can vary in design, function, and material. The components used to fabricate the splints must withstand occlusal forces, be aesthetically pleasing, comfortable, and minimally interfering with function and phonetics. Traditional methods for fabricating splints include sprinkle-on, thermoforming, and lost wax techniques. However, with the advancement of CAD/CAM technology, additive (3D printing) and subtractive (milling) manufacturing methods expand the range of possibilities by introducing novel solutions for elaborating splints. An electronic search was conducted on PubMed using the following keywords: "occlusal splint", "guard and "materials", and "manufacturing". Thirteen in vitro publications were screened and they consisted of four clinical studies, nine reviews (three of them were systematic reviews), and five case reports. The choice of material is crucial for the success of splint therapy. Factors such as biocompatibility, ease of fabrication, adjustability, cost, and patient preference should be considered. Newer materials and techniques are emerging because of advancements in material science and manufacturing techniques. However, it should be noted that most of the evidence is based on in vitro studies with different methodologies, limiting their validity in daily practice.

Recommendations on the Use of Oral Orthotic Occlusal Appliance Therapy for Temporomandibular Joint Disorders: Current Evidence and Clinical Practice.

'Temporomandibular joint disorders (TMDs)' denote an umbrella term that includes arthritic, musculoskeletal and neuromuscular conditions involving the temporomandibular joint, the masticatory muscles, and the associated tissues. Occlusal devices are one of the common treatment modalities utilized in the conservative management of TMDs. The indications for the available 'oral splints' or 'oral orthotic occlusal devices' remain ambiguous. A joint international consortium was formulated involving the subject experts at TMJ Foundation, to resolve the current ambiguity regarding the use of oral orthotic occlusal appliance therapy for the temporomandibular joint disorders based on the current scientific and clinical evidence. The recommendations and the conclusion of the clinical experts of the joint international consort has been summarized for understanding the indications of the various available oral orthotic occlusal appliances and to aid in the future research on oral occlusal orthotics. The use of the oral orthotic occlusal appliances should be based on the current available scientific evidence, rather than the archaic protocols.

Guardians of the temporomandibular joint: The occlusal splints- an overview

Management of temporomandibular joint disorders requires a multifaceted approach. Splint therapy is one among the preferred treatment modalities. There are various schools of thought pertaining to splint therapy which is often challenging to both dentists and patients. Hence a thorough knowledge regarding splints and its application proves to be of great importance in proper treatment planning. Occlusal splint therapy is a non- invasive, reversible and conservative type of treatment recommended for parafunctional habit, unstable occlusion, stress related pain symptoms, occlusal interferences, in extensive restorative treatment and also other masticatory muscle disorders. Its function has been proved to reduce appropriate symptoms by altering the occlusal equilibrium, distributing forces associated with parafunctional activities and normalizing periodontal ligament proprioception. This article enumerates various aspects of splint therapy such as types of splints, their uses, functions, design, fabrication and its modification with a clear insight on the physiologic and therapeutic effects of various splints. This knowledge gives way to the selection, designing and application of a specific occlusal splint which would help in achieving appropriate and successful treatment planning for the patient.

Ultrazvučna terapija u zbrinjavanju poremećaja temporomandibularnog zgloba

Introduction: Temporomandibular joint disorder (TMD) is a collective term given to the disorders affecting the Temporomandibular joint (TMJ), masticatory muscles and their related structures. The aetiology of TMD is complex and their management includes various invasive and non-invasive methods. The increasing trend in non-invasive, non-pharmacological interventions for the management of TMJ pain has led to the development of modalities of physical therapy. Ultrasound is an electrophysical treatment modality used in the management of TMD. The aim of this study is to provide an insight into ultrasound based treatment modalities used for the effective management of TMD. Materials and methods: Electronic database search was carried out in Google Scholar and PubMed using the search terms "ultrasound therapy", "therapeutic ultrasound" and "temporomandibular joint disorders". The results obtained from the database search were screened and included for the review. Commonly used therapeutic ultrasound methods in the management of temporomandibular joint disorders with the treatment protocols, advantages, limitations and other factors to be considered for an effective treatment outcome is discussed in the present review. Conclusion: Various new ultrasound-based TMJ therapeutic modalities may be developed in the near future.

Systemic scleroderma: imaging findings of diagnosis and clinical management of temporomandibular joint disorders

Systemic scleroderma: imaging findings of diagnosis and clinical management of temporomandibular joint disorders

Nerve blocks and interventional procedures in the management of temporomandibular joint disorders: a scoping review

Nerve blocks and interventional procedures in the management of temporomandibular joint disorders: a scoping review

Comparison of the effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders: A randomized control study.

Splint therapy is a well-established modality in the management of temporomandibular joint disorders (TMDs). We aimed to evaluate and compare the effectiveness of hard and soft splints in the symptomatic management of TMDs using the modified Helkimo index. This study included 91 patients diagnosed with TMDs. Participants were randomly allocated into two treatment groups. All these patients were treated by hard or soft stabilization splint therapy. Group 1: hard splint group, n=42 (mean age - 31.62 ± 8.5 years), 10 males and 32 females; group 2: soft splint group, n=49 (mean age - 32.86 ± 9.06 years), 13 males and 36 females. The anamnestic and clinical dysfunction component of the modified Helkimo index was used to evaluate the outcomes at baseline (T0 ), first month (T1 ), and third month (T2 ). Symptoms such as clicking of the joints, temporomandibular joint (TMJ) pain and muscle pain showed improvement in both groups (P< .05). Restriction and deviation of mouth opening did not show significant improvement in either group. The patients who underwent hard splint therapy showed an early improvement of symptoms at T1 (P< .05). However, there was no statistical difference in the improvement of symptoms between hard and soft splints at T2 . Both hard and soft stabilization splints were effective in the symptomatic management of TMDs. However, hard splints provide an earlier reduction of symptoms.

The use of pharmacologic agents in the management of temporomandibular joint disorder

The use of pharmacologic agents in the management of temporomandibular joint disorder

Comparative efficacy of low-level laser therapy (LLLT) to TENS and therapeutic ultrasound in management of TMDs: a systematic review & meta-analysis

ABSTRACT Objective To assess the reduction in pain, muscle tenderness, joint clicking, and improvement in mouth opening (MO) after low-level laser therapy (LLLT) compared to transcutaneous electrical nerve stimulation (TENS) and therapeutic ultrasound (US) among temporomandibular joint disorder (TMD) patients. Methods A systematic search of online sources of electronic databases was undertaken. The quality of the study was assessed using the Cochrane risk of bias assessment tool for randomized controlled trials (RCTs). Results Twelve RCTs were included in the systematic review, and 9 were included in the meta-analysis. For reduction in pain between LLLT and TENS, LLLT was found to be better than TENS, at 95% CI. LLLT was also proven to be better in reducing pain than therapeutic US, at 81% CI. Conclusion This systematic review and meta-analysis compared the effectiveness of LLLT, TENS, and therapeutic US in TMD. LLLT provided relatively more effective pain relief and improvement in MO.

Efficacy of customized soft occlusal splints in the management of temporomandibular joint disorders among the population of Parsa District of Nepal: A cross-sectional study

Background: In recent years, temporomandibular joint disorders (TMDs) have been a highly debated topic. TMD is the collective term of clinical problems that involves the masticatory apparatus, temporomandibular joint (TMJ), and its associated structures or both. It is really a tough challenge for both the dental and the medical specialists and is often difficult to diagnose and treat such a disorder as the presenting symptoms can be variable. A variety of treatment modalities have been described in the literature for its management and the conservative method is most preferred. The objective of the present study was to evaluate the effectiveness of soft occlusal splint therapy among the population of Parsa district of Nepal in the management of TMDs. Materials and Methods: Thirty subjects with signs and symptoms of TMDs were included in the study, out of which 13 (43.3%) subjects were males and 17 (56.7%) were females, with age ranging from 21 to 40 years. Soft occlusal splints were given to the patients for about 3 months and evaluated for reduced mouth opening, tenderness of TMJ (preauricular), TMJ sounds, and mandibular deviation after 1 week of initiation of therapy and every month for 3 consecutive months. Results: There was a significant improvement of 3.06 mm (9.7%) in mouth opening, 86.7% of subjects showed significant reduction in preauricular tenderness, 80.0% subjects showed reduction in TMJ sounds, and 76.7% of subjects showed improvement in mandibular deviation after 3 months of the splint therapy. Paired t-test and Chi-square tests were done for comparison. Conclusions: Soft occlusal splints can be used effectively as a conservative treatment modality in reducing the signs and symptoms related to TMDs.

Effectiveness of cervical spine manual therapy in the management of temporomandibular joint disorders: A systematic review

Effectiveness of cervical spine manual therapy in the management of temporomandibular joint disorders: A systematic review

Efficacy of pulsed short wave therapy in symptomatic TMD patients: Randomized control trial

Context: Temporomandibular joint (TMJ) is a ginglymoarthroidal joint of synovial variety. The joint's pathology includes those predominantly of musculoskeletal origin, which poses a complex problem in the clinical scenario. The management of temporomandibular joint disorders (TMD) remains a challenge due to the intricate anatomy of the joint and the multipart etiologies associated with it. Aims: This study aimed to compare the effectiveness of pulsed short wave therapy (PSWT) with pharmacotherapy in symptomatic TMD patients. Methods and Material: A total of 62 patients were included in this randomized control trial and were randomly allotted into two groups. Patients in Group I received PSWTand Group II received a combination of a muscle relaxant and a nonsteroidal anti-inflammatory drug (NSAID) for 5 consecutive days. Visual analog scale (VAS) scores were recorded during the follow-up. Statistical Analysis Used: The statistical analysis was performed using Stata/SE 17.0 statistical software. Results: There was a statistically significant difference in the groups for different periods. Kaplan–Meier function and extended survivor function tests showed better pain alleviation in the short wave therapy group. Conclusion: The current study shows that PSWT decreased pain without adverse effects. Therefore, it could be considered a safe and potentially effective adjuvant therapeutic modality for TMD.