Cranio
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The aim of this study was to observe the association between facial and/or mandibular asymmetry and internal derangement of the temporomandibular joint (TMJ) in patients with temporomandibular dysfunction (TMD). The sample consisted of 17 patients with facial and/or condylar-mandibular asymmetry who had signs and symptoms of TMD. ⋯ The results of this study suggest a possible association between facial and/or condylar-mandibular asymmetry and DD. Based on these findings, it is important to consider the need for treating this disorder, particularly in growing patients, in order to prevent the generation of asymmetry, which is very difficult to treat once it sets in.
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Comparative Study
Clinical study on the comparison of masticatory efficiency and jaw movement before and after temporomandibular disorder treatment.
In this clinical study, pre- and post-rehabilitation changes in intraborder mandible movements, chewing cycles, masticatory efficiencies, and borders of the chewing area of patients with unilateral muscular disorders (MD) (n = 20) or unilateral disc derangement disorders (DDD) (n = 20) of temporomandibular disorder (TMD) were observed and compared with healthy individuals with full dentition (n = 20) (48 female, 12 male; mean age: 28). The MD patients received stabilization splints and the DDD patients, anterior positioning splints for six weeks. ⋯ Pre- and post-rehabilitation chewing cycles along the frontal plane on both sides in the MD group were similar to the control group. Considering the majority of the improvements in the diagnostic measures, patients with MD and DDD may benefit from occlusal splint therapy.
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The current study aimed to research the prevalence of temporomandibular disorders (TMD) in patients with subjective tinnitus, as compared to controls, and the association between symptoms of TMD, tinnitus, and chronic pain. Two hundred patients were divided into two groups, according to the presence (experimental) or not (control) of subjective tinnitus. The subgroups were determined according to the RDC/TMD criteria. ⋯ The severity of tinnitus was significantly associated with the severity of chronic pain (p = .000). The PPT values were lower (p > 0.05), while the Visual Analog Scale (VAS) was statistically higher (p = .000) for the tinnitus patients. These results suggest that an association exists between TMD and subjective tinnitus.
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The diagnosis of orofacial pain associated with temporomandibular disorders after repeated temporomandibular joint (TMJ) surgeries can be quite difficult. This case report describes a 52-year-old woman who had previously undergone five TMJ surgeries and developed divergent pain caused by a trigger point in the left preauricular area. Computed tomography and magnetic resonance imaging could not be used to identify a lesion because of metallic artifacts from a TMJ prosthesis. ⋯ Moreover, a neurological examination performed with local anesthesia was clinically effective in ruling out other diagnoses of orofacial pain. Ultimately, a histopathological examination of a biopsy specimen from the painful site confirmed the lesion to be a traumatic neuroma. This case report suggests the value of including traumatic neuroma in the differential diagnosis of patients with a history of previous TMJ surgery who present with orofacial pain in the region of the TMJ.
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Randomized Controlled Trial Comparative Study
Myofascial pain of the jaw muscles: comparison of short-term effectiveness of botulinum toxin injections and fascial manipulation technique.
A randomized controlled trial was performed to compare the short-term effectiveness of botulinum toxin injections and physiatric treatment provided by means of Fascial Manipulation techniques in the management of myofascial pain of jaw muscles. Thirty patients with a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnosis of myofascial pain were randomized to receive either single-session botulinum toxin injections (Group A) or multiple-session Fascial Manipulation (Group B). Maximum pain levels (VAS ratings) and jaw range of motion in millimeters (maximum mouth opening, protrusion, right and left laterotrusion) were assessed at baseline, at the end of treatment, and at a three-month follow-up. ⋯ Differences between the two treatment protocols as to changes in the outcome parameters at the three-months follow-up were not relevant clinically. Findings from the present investigation are in line with literature data supporting the effectiveness of a wide spectrum of conservative treatment approaches to myofascial pain of the jaw muscles. Future studies on larger samples over a longer follow-up span are needed on the way to identify tailored treatment strategies.