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1.
J Oral Facial Pain Headache ; 34(4): 364-373, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33290442

RESUMO

AIMS: To study the effect and cost-effectiveness of jaw exercise treatment in patients with masticatory myofascial pain. METHODS: A total of 97 patients with myofascial pain according to the RDC/TMD were randomized into three groups: (1) jaw exercises; (2) stabilization appliance; or (3) no treatment. After 3 months, the patients were evaluated according to the following instruments: pain intensity according to a visual analog scale (VAS); global improvement according to the Patient Global Impression of Change scale (PGIC); depression and anxiety according to the Hospital Anxiety and Depression Scale (HADS); jaw function according to the Jaw Functional Limitation Scale (JFLS-20); consumption of analgesics; and frequency of tension-type headache. RESULTS: Pain intensity during jaw movement decreased significantly more in the jaw exercise group compared to the no treatment group (P < .001). There was no statistically significant difference between the jaw exercise and stabilization appliance groups in this aspect. The patients in the treatment groups reported greater improvement on the PGIC compared to the no treatment group (P < .001). There was a significant decrease in headache frequency (P = .028), consumption of analgesics (P = .007), and JFLS scores (P = .008) in the jaw exercise group compared to the no treatment group. In the jaw exercise group, patients had fewer appointments and a lower mean treatment time compared to the group that received stabilization appliance treatment. CONCLUSION: Jaw exercises are effective in reducing pain intensity, headache, and consumption of analgesics in patients with masticatory myofascial pain. Jaw exercises are also cost-effective when compared to treatment with a stabilization appliance.


Assuntos
Terapia por Exercício , Dor Facial , Dor Facial/terapia , Humanos , Arcada Osseodentária , Medição da Dor , Resultado do Tratamento
2.
Front Neurol ; 10: 953, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31555205

RESUMO

Background: When population-based databases are unavailable, nationwide assessments of the disease burden of multiple sclerosis (MS) resort to clinical, administrative or convenience-sampled data sources, which may produce results of limited external validity. Our aim was to develop a framework for estimating measures of occurrence of chronic diseases, and more broadly disease burden, that mitigate these limitations and to apply this framework to estimate the prevalence of multiple sclerosis (MS) in Switzerland. Methods: We developed a 7-step framework which implements the combination of several data sources together with a resampling and critical appraisal approach. The framework was applied to estimate the MS prevalence for 2016 in Switzerland, for which four distinct data sources (Swiss MS registry, Swiss national MS treatment registry, MediService database, and Swiss MS cohort study) were combined. Results were reviewed by disease experts and compared to earlier Swiss estimates and current prevalence estimates from other countries. Results: We estimate that in the year 2016 between 14,650 and 15,700 persons with MS have been living in Switzerland, yielding a period prevalence of 174-187/100,000 inhabitants. Compared to the last estimate in 1986, we detected a substantial increase of MS diagnoses which coincides with a higher number of diagnoses in women below the age of 65. Conclusions: Internationally, Switzerland is a high-prevalence country for MS, although estimates were somewhat lower than recent evaluations of Northern European countries. In addition, we corroborate previous reports that the prevalence increase coincides with a higher number of MS diagnoses among women. The proposed framework has wide applicability and the potential to place estimates of disease occurrence and burden with imperfect data availability on more solid grounds.

3.
J Oral Facial Pain Headache ; 33(4): 389­398, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31247061

RESUMO

AIMS: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises. METHODS: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from "strongly agree" to "strongly disagree." The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts' earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement. RESULTS: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality. CONCLUSION: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.


Assuntos
Transtornos da Articulação Temporomandibular , Consenso , Técnica Delfos , Terapia por Exercício , Humanos , Mialgia
4.
J Oral Rehabil ; 46(9): 800-806, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31074880

RESUMO

BACKGROUND: The most common non-dental pain in the orofacial region is pain associated with temporomandibular disorders (TMD), and jaw exercises are a common treatment in these cases. Since masticatory myofascial pain has components of an affective and cognitive nature, knowledge about the patients' experiences of the condition and treatment is important. OBJECTIVE: The aim was to study the patients' experiences of jaw exercises in the treatment of masticatory myofascial pain. METHODS: A questionnaire, containing 24 statements that should be answered according to a five-item verbal Likert scale, was sent to 150 consecutive patients with masticatory myofascial pain according to the Research Diagnostic Criteria for TMD after they had been treated with jaw exercises for 3-12 months. RESULTS: The response rate was 73% (n = 109), and 79% of the responders were women. 71% of the patients reported that it was easier to remember the jaw exercises if they put them in conjunction with an already established routine. Before examination, 49% of the patients suspected serious disease behind their symptoms, but these concerns were greatly relieved by the information provided. As a result, 78% reported that information about the underlying cause of their symptoms made them more involved in the treatment. Finally, 72% of the respondents reported that the jaw exercises were effective in reducing their symptoms. CONCLUSIONS: Information about the cause of the symptoms and the treatment is important to reassure and make the patient involved in the treatment. Most patients report that jaw exercises are an effective treatment and they appreciated to have tools to tackle the problems themselves if the symptoms should return.


Assuntos
Síndromes da Dor Miofascial , Transtornos da Articulação Temporomandibular , Terapia por Exercício , Dor Facial , Feminino , Humanos , Inquéritos e Questionários
5.
Acta Odontol Scand ; 75(6): 429-436, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28554268

RESUMO

OBJECTIVE: The aim of this study was to investigate knowledge and competence in temporomandibular disorders (TMD) among dentists and dental hygienists working in the public dental service (PDS) in Sweden. MATERIALS AND METHODS: The study population comprised all general dentists (n = 110) and dental hygienists (n = 80) working in the PDS in two Swedish counties: Kronoberg (K) and Blekinge (B). The participants filled out a questionnaire comprised of 15 questions. RESULTS: The results of these questions are presented. The overall response rate for the general dentists was 87%, while the rate for the dental hygienists was 71%. Statistically significant differences between the general dentists in the two counties were found regarding the following: education in the field of TMD over the last 5 years (K: 37%, B: 73%), evaluation of occlusion when examining patients with suspected TMD ('always': K: 61%, B: 82%), and a desire for consultation of the OFP (orofacial pain)/TMD specialist by telephone (K: 71%, B: 44%). Regarding the dental hygienists, there was a statistically significant difference concerning the use of the treatment modality 'reassurance' (K: 41%, B: 7%). CONCLUSIONS: The majority of the dental care providers in both counties - irrespective of professional category - had a positive attitude towards patients with TMD. Knowledge and competence in the field are sparse and require postgraduate education. There is a great need of an OFP/TMD specialist for more complicated patients and a need to implement updated knowledge and competence in the PDS in these two counties.


Assuntos
Competência Clínica/normas , Assistência Odontológica/métodos , Higienistas Dentários/normas , Odontólogos/normas , Transtornos da Articulação Temporomandibular/terapia , Adulto , Dor Facial/terapia , Feminino , Humanos , Masculino , Encaminhamento e Consulta , Inquéritos e Questionários , Suécia/epidemiologia , Transtornos da Articulação Temporomandibular/prevenção & controle
6.
J Oral Facial Pain Headache ; 31(1): 46-54, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28118420

RESUMO

AIMS: To investigate patients' experiences of therapeutic jaw exercises for treating masticatory myofascial pain. METHODS: A total of 10 patients were selected for the interview study. All patients had received treatment with jaw exercises at a specialist clinic. Semi-structured interviews were conducted in a nonclinical environment according to an interview guide with 10 domains. The interviews were transcribed and translated into English. Systematic text condensation (STC) was used to arrange and analyze the text material. RESULTS: In the systematic process of analyzing the qualitative data, four main themes were identified: "Patient Adherence," "Symptoms," "Treatment Effect," and "Participation." Most informants were initially skeptical of the jaw exercises due to their simplicity. Later on, the simplicity of the exercises and the fact that they did not need more advanced treatment were valued most by a majority of patients. Some informants suspected serious disease behind their symptoms. Treatment effects on pain and physical impairment were reported. To do the jaw exercises in conjunction with an already established routine seemed important to enhance adherence. Trust in the caregiver and being able to remedy their pain by themselves were also important to the informants. CONCLUSION: Jaw exercises are a useful treatment valued by patients due to their simplicity and effectiveness. However, before the treatment, patients should be informed about the cause of the symptoms, and any skepticism should be addressed. Results from this qualitative study cannot be generalized, but the study design and the selected population allow the results to be transferable to similar contexts.


Assuntos
Terapia por Exercício , Doenças Maxilomandibulares/terapia , Músculos da Mastigação , Mialgia/terapia , Manejo da Dor , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Cooperação do Paciente , Adulto Jovem
7.
Acta Odontol Scand ; 74(6): 460-5, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27327618

RESUMO

OBJECTIVE: The aim of the study was to investigate the self-perceived level of knowledge, attitudes and clinical experience in treatment of temporomandibular disorders (TMD) among general practising dentists (GPDs). MATERIAL AND METHODS: A web-based questionnaire was sent to all GPDs in the public dental health service in the County of Uppsala in 2010 (n = 128) and 2014 (n = 113). The GPDs were asked to answer questions in the following categories: Demographic information, Quality assurance, Clinical experience and treatment, Need for specialist resources in the field of TMD and Attitudes. Between the two questionnaires, the GPDs were offered TMD education and an examination template including three TMD questions was introduced in the computer case files. The results were also compared with a previous questionnaire from 2001. RESULTS: The response rate was 71% (2010) and 73% (2014). The majority of the GPDs were women (70% in 2010 and 72% in 2014). The reported frequency of taking a case history of facial pain and headache increased between 2010 and 2014. In 2014, the GPDs were more secure and reported higher frequency of good clinical routines in treatment with jaw exercises and pharmacological intervention compared to 2001. Interocclusal appliance was the treatment with which most dentists felt confident and reported good clinical routines. CONCLUSIONS: The GPDs felt more insecure concerning TMD diagnostics, therapy decisions and treatment in children/adolescents compared to adults. There is a high need for orofacial pain/TMD specialists and a majority of the GPDs wants the specialists to offer continuing education in TMD.


Assuntos
Atitude do Pessoal de Saúde , Odontologia Geral/organização & administração , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/terapia , Adolescente , Adulto , Criança , Dor Facial/diagnóstico , Dor Facial/terapia , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Odontologia em Saúde Pública , Inquéritos e Questionários , Suécia , Adulto Jovem
8.
Swed Dent J ; 37(1): 1-11, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23721032

RESUMO

The study aimed to examine possible time trends in the prevalence of clinical signs indicative of temporomandibular disorder (TMD) in an adult population, to analyse possible associations between TMD signs and associated factors and to estimate the need for TMD treatment. Three independent, stratified and randomly selected samples of around 100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years participated in the Jönköping studies in 1983,1993 and 2003. The study material consisted of 1,693 subjects who, after answering a questionnaire and being interviewed about the presence of TMD symptoms, were clinically examined in terms of the presence of TMD signs according to the Clinical Dysfunction Index (Di) by Helkimo. Associations between clinical signs and the Di as dependent variables and each of the independent variables of age group, gender, reported bruxism, trauma, self-perceived healthiness and the year of investigation were analysed in binary logistic regression models. Estimates of the need for TMD treatment were based on the presence of a combination of severe symptoms and clinical signs. The prevalence of severely impaired jaw movement capacity, relating to horizontal movements, had increased in 2003. The prevalence of muscle pain and temporomandibular joint pain upon posterior palpation was found to vary statistically significantly between 1993 and 2003. Gender differences were noted in these changes overtime. Female gender, advancing age, awareness of bruxism, self-perceived health impairment and the wearing of complete dentures were associated with TMD signs and a higher degree of clinical dysfunction. The estimated need for TMD treatment increased from 5% in 1983 to 8% in 2003 and was higher in women than in men. In conclusion, the results indicate that the prevalence of some TMD signs and of estimated treatment need increased during the period 1983-2003.


Assuntos
Transtornos da Articulação Temporomandibular/epidemiologia , Adulto , Fatores Etários , Idoso , Atitude Frente a Saúde , Bruxismo/epidemiologia , Estudos Transversais , Prótese Total/estatística & dados numéricos , Dor Facial/epidemiologia , Feminino , Nível de Saúde , Humanos , Masculino , Músculos da Mastigação/fisiopatologia , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Amplitude de Movimento Articular/fisiologia , Autoimagem , Fatores Sexuais , Suécia/epidemiologia , Articulação Temporomandibular/lesões , Adulto Jovem
9.
Swed Dent J ; 36(3): 125-32, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23230806

RESUMO

The aims of this study were to investigate what kind of interocclusal appliances that were chosen among Swedish dentists when treating temporomandibular disorders (TMD), the clinical rationale for the treatment, the diagnoses that warranted the appliance treatment, the use of adjunct TMD treatments and prognostic considerations, and possible differences in these respects between children/adolescents and adults with TMD, and, finally, possible differences between private practitioners and general practitioners in the public dental service. During the 12-months-period April 2009-March 2010 all general dental practitioners in the county of Jönköping, Sweden, were asked to fill in a questionnaire when performing a TMD treatment with an interocclusal appliance. A total of 394 questionnaires were filled in and returned, 216 (55%) from dentists in public dental service and 178 (45%) from private practitioners. It was found that in 40% of the cases, no pre-treatment recording of the functional status in the masticatory system had been made. The commonest reasons for the treatment were bruxism, headache, and replacement of a previous appliance. Less than half of the appliances made were hard acrylic appliances. Some kind of adjunct therapy had been made in 22% of the cases treated in public dental service. The corresponding figure for those treated by private practitioners was 25%. Therapeutic jaw exercises was the commonest adjunct therapy followed by selective occlusal adjustment. In the vast majority of cases, the dentists judged the prognosis of the treatment to be good. It is concluded that a large number of appliances made to treat TMD were soft appliances, especially in public dental service. This reflects a possible overuse of soft appliances at the expense of hard acrylic appliances. Furthermore, in a large number of cases, the treatment was performed without any pre-treatment registrations, and adjunct therapies were rarely used. In all these respects,there is an improvement potential for the treatment of TMD in general dental practice.


Assuntos
Odontologia Geral/estatística & dados numéricos , Placas Oclusais/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Transtornos da Articulação Temporomandibular/terapia , Adolescente , Bruxismo/terapia , Criança , Feminino , Cefaleia/terapia , Humanos , Masculino , Programas Nacionais de Saúde/estatística & dados numéricos , Prática Privada/estatística & dados numéricos , Inquéritos e Questionários , Suécia , Adulto Jovem
10.
Cranio ; 30(2): 110-3, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22606854

RESUMO

The aim of this study was to examine contemporary human skull material for possible differences between Caucasians and African-Americans in respect to size and form of the temporomandibular condyles. The material consisted of a total of 129 Caucasian skulls (94 males and 35 females) and 76 African-American skulls (40 males and 36 females). Their mean age at death was 46 years for the Caucasians (range: 19-89 years) and 37 years for the African-Americans (range: 18-70 years). The mediolateral and anteroposterior dimensions of the 410 condyles were measured, and the condylar form was estimated using both anterior and superior views. No statistically significant differences could be found between Caucasians and African-Americans for any of the recorded variables. In conclusion, the present results lend no support for the existence of ethnic differences between the two groups examined in respect of temporomandibular joint size and form. It is likely that other factors such as evolution, overall cranial size, dietary differences, and genetic factors, irrespective of ethnicity, can explain the differences found in different skull samples.


Assuntos
Afro-Americanos , Articulação Temporomandibular/anatomia & histologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cefalometria , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem
11.
Dental press j. orthod. (Impr.) ; 17(2): 97-103, Mar.-Apr. 2012.
Artigo em Inglês | LILACS-Express | LILACS | ID: lil-626375

RESUMO

INTRODUCTION: The possibility that orthodontic treatment in childhood might be a risk factor for the development of temporomandibular disorders (TMD) later in life has been an issue of great controversy in dental literature. OBJECTIVE: To determine a possible negative or positive correlation between orthodontic treatment and TMD by presenting the results and conclusions from a number of key-papers dealing with this subject. RESULTS AND CONCLUSION: According to current knowledge, there is no scientific evidence to support that orthodontic treatment is a risk factor for the development of TMD. On the other hand, there is some evidence to support that a proper orthodontic treatment performed in childhood might have a positive effect upon the functional status of the masticatory system later in life.

12.
Acta Odontol Scand ; 70(3): 207-12, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22050387

RESUMO

OBJECTIVE: The first aim of this study was to examine a contemporary human skull material for possible ethnic differences in respect of degenerative changes in the temporomandibular joints (TMJs). A second aim was to see if there was any correlation between such changes and occlusal support in any of the two groups and, if so, if this correlation was sex-related. MATERIALS AND METHODS: The material consisted of 129 Caucasian skulls and 76 skulls from Afro-Americans. Ninety-four of the Caucasian skulls came from males (73%) and the corresponding figure for the Afro-Americans was 40 (53%). Their mean age at death was 46 years (range: 19-89 years) and 37 years (range: 18-70 years), respectively. RESULTS: Dental status was in general poor and 13% of the Afro-Americans and 26% of the Caucasians were edentulous. Form and surface changes of the TMJs were more common in the present material compared to most previous studies. No differences could be found between the two ethnic groups in respect of degenerative joint changes in the TMJs. In men, no correlation of clinical relevance could be found between severity of joint changes and occlusal support. However, in both Caucasian and Afro-American women, such a correlation was obvious, especially in higher age. CONCLUSIONS: The present findings give no evidence for any differences in the prevalence of degenerative changes in the TMJs in Caucasians and Afro-Americans. The strong correlation found between such changes and occlusal support in women but not in men might be explained by hormonal differences.


Assuntos
Má Oclusão/etnologia , Côndilo Mandibular/patologia , Osteoartrite/etnologia , Transtornos da Articulação Temporomandibular/etnologia , Articulação Temporomandibular/patologia , Adolescente , Adulto , Afro-Americanos , Idoso , Brasil/epidemiologia , Relação Central , Feminino , Humanos , Masculino , Má Oclusão/complicações , Má Oclusão/patologia , Pessoa de Meia-Idade , Osteoartrite/complicações , Osteoartrite/patologia , Prevalência , Índice de Gravidade de Doença , Distribuição por Sexo , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/patologia , Adulto Jovem
13.
Acta Odontol Scand ; 70(3): 213-23, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22126531

RESUMO

OBJECTIVES: The aims were (1) to study possible secular trends in the prevalence of temporomandibular disorder (TMD) symptoms in adults and (2) to analyse possible associations between TMD symptoms and background factors. MATERIALS AND METHODS: The investigation has a repeated cross-sectional design. Three independent, randomly selected samples of ∼100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years, a total of 1704 subjects, participated in the Jönköping studies in 1983, 1993 and 2003. All the subjects were evaluated using a questionnaire and a structured interview relating to the presence of TMD symptoms. Associations between symptoms and the Anamnestic Dysfunction Index (Ai) as dependent variables and each of the independent variables, age group, gender, reported bruxism, trauma (1983), self-perceived health impairment and the year of investigation were analysed in binary logistic regression models. RESULTS: The prevalence of the separate symptoms, apart from for TMJ clicking, did not vary to any statistically significant degree between the different examination years. However, the prevalence of recurrent headache in 20-year-old subjects rose remarkably in 2003 and an increase in the Ai I and Ai II for the whole population was observed during the 20-year period. Reported bruxism, which increased during the study period, and self-perceived health impairment were associated with most of the TMD symptoms and the Ai. CONCLUSIONS: An increase in the prevalence of TMD symptoms expressed as Anamnestic Dysfunction Index I and II has been noted over a 20-year period.


Assuntos
Saúde Bucal/estatística & dados numéricos , Transtornos da Articulação Temporomandibular/epidemiologia , Adulto , Distribuição por Idade , Idoso , Estudos Transversais , Estudos Epidemiológicos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Saúde Bucal/tendências , Prevalência , Distribuição por Sexo , Suécia/epidemiologia , Adulto Jovem
14.
Swed Dent J ; 35(3): 133-42, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22135944

RESUMO

The aims of the present study were to investigate patient adherence to treatment with hard acrylic interocclusal appliance in general dentistry in Sweden and to see if some general factors could predict patient adherence or non-adherence. During the period January - May 2009 a postal questionnaire was sent to all adult patients (> or = 20 years of age) that had received a hard acrylic interocclusal appliance from the public dental health service in the County of Uppsala during 2007 (n=388). The same questionnaire was also sent to all adult patients that had received a hard acrylic interocclusal appliance at a specialist clinic during the same year (n=69). The response rate in general dental practice was 71% and at the specialist clinic the response rate was 91%. In general dental practice, 97% of the hard acrylic interocclusal appliances were stabilisation appliances. At the specialist clinic other types of interocclusal appliances was used to a greater extent. A vast majority of patients in both general dental practice and at the specialist clinic experienced that the interocclusal appliance had a positive treatment effect. In general dental practice, 73% of the patients still used their interocclusal appliances 1 1/2-2 years after they had received them. The corresponding figure at the specialist clinic was 54%. The main reasons for not using the interocclusal appliance, besides disappearance/reduction of TMD symptoms, were different kinds of comfort problems. From the results of this study it is concluded that the patient adherence to hard acrylic stabilisation appliances made in general dental practice in Sweden is good. It can also be concluded that a perceived good treatment effect, as well as treatment of more long-term conditions, predicted a better patient adherence to hard acrylic stabilisation appliances. More studies concerning factors affecting patient adherence in TMD therapy are warranted.


Assuntos
Placas Oclusais , Desenho de Aparelho Ortodôntico , Cooperação do Paciente , Transtornos da Articulação Temporomandibular/terapia , Resinas Acrílicas , Adulto , Bruxismo/terapia , Odontologia Geral , Humanos , Placas Oclusais/efeitos adversos , Especialidades Odontológicas , Inquéritos e Questionários , Resultado do Tratamento
15.
Swed Dent J ; 35(4): 187-93, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22372306

RESUMO

The aims of the present study were to investigate if there are differences concerning preferred body posture during sleep between 100 patients, 66 women and 34 men, mean age: 49 years (range: 20-85 years) referred to a specialist clinic because of TMD and 100 matched controls from a public dental clinic. The participants were asked to answer a questionnaire with questions about TMD symptoms and neck or shoulder pain. They were also asked about preferred sleeping position as well as about perceived sleep quality. No differences could be found between the two groups in respect of sleeping position. However, significantly more individuals in the TMD group compared to the controls had changed their preferred sleeping position due to their face and/or jaw and/ or neck-shoulder symptoms. Subjects in the TMD group also more frequently stated that they often felt insufficiently rested at awakening and/or felt tired or sleepy in the daytime because of symptoms from face/jaws. A significant number in the control group reported TMD symptoms indicating a latent need for TMD treatment. It is concluded that sleep position seems to have little or no significance for the development or maintenance of TMD symptoms. However, the study indicates that TMD symptoms and associated neck- and shoulder pain affect the quality of sleep.


Assuntos
Postura , Transtornos do Sono-Vigília/etiologia , Sono , Transtornos da Articulação Temporomandibular/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/complicações , Cervicalgia/fisiopatologia , Postura/fisiologia , Autorrelato , Dor de Ombro/complicações , Dor de Ombro/fisiopatologia , Sono/fisiologia , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/terapia , Adulto Jovem
16.
Acta Odontol Scand ; 68(5): 305-11, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20586673

RESUMO

OBJECTIVE: Controversy exists concerning the etiological factors behind degenerative changes in the temporomandibular joints (TMJs). Tooth attrition, occlusal support, food consistency, ageing, gender and genetics are some possible causative factors that have been discussed in the literature. The aim of this study was to examine contemporary human skull material for possible relations between degenerative form and surface changes in the TMJs in relation to occlusal support. MATERIAL AND METHODS: The material consisted of 259 human skulls from 170 males and 89 females, with an age range of 18-100 years. RESULTS: Dental status was in general poor, and 22% of skulls were edentulous. Form and surface changes of both the condyles and the temporal components were more common in the present material compared to that in most previous studies. In males, irrespective of age, only weak and clinically insignificant correlations could be found between degenerative TMJ changes and occlusal support. In women, however, the correlations between these variables were in general much stronger, especially at higher ages. CONCLUSIONS: The present findings do not lend support to the hypothesis that loss of occlusal support is a causative factor for degenerative changes in the TMJs in male subjects. In women, such a correlation was obvious in the present sample, at least at higher ages. It can be speculated that hormonal factors play a role in the sex difference found.


Assuntos
Oclusão Dentária , Dentição , Osteoartrite/classificação , Transtornos da Articulação Temporomandibular/classificação , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Remodelação Óssea/fisiologia , Feminino , Humanos , Arcada Edêntula/classificação , Arcada Parcialmente Edêntula/classificação , Masculino , Côndilo Mandibular/patologia , Pessoa de Meia-Idade , Fatores Sexuais , Osso Temporal/patologia , Atrito Dentário/classificação , Desgaste dos Dentes/classificação , Adulto Jovem
17.
Swed Dent J ; 32(2): 69-81, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18700335

RESUMO

UNLABELLED: Controversy exists concerning the etiological factors behind degenerative changes in the temporomandibularjoints (TMJs). Occlusal factors, ageing, gender and genetics are some factors that have been discussed. The aim of the present study was to examine a contemporary human skull material in respect of gender, age, occlusal variables and form and surface changes in the temporomandibular joints. The material consisted of 259 human skulls, 170 males and 89 females, with an age range of 18-100 years. The over all dental status was poor, and 22% were edentulous. Both medio-lateral and antero-posterior dimensions as well as anterior and superior shape of the condyles were in good agreement with previous results. Form and surface changes of both the condyles and the temporal components were, however, more common in the present material compared to most previous studies. Men had on average more degenerative changes in the TMJs compared to women. In agreement with many previous studies, there was an increase of such changes with increasing age. Severe tooth attrition was a common finding, especially in men, but no correlation was found between this variable and the severity of degenerative changes in the TMJs. Abfractions were found in only 3 cases. Considering the common finding of severe tooth attrition,the rare occurrence of abfractions does not lend support to the hypothesis that abfractions are mainly caused by occlusal loading. IN CONCLUSION: Condylar dimensions and shape of the condyles were in good agreement with previously presented results. Severe tooth attrition and pronounced degenerative changes in the TMJs were common findings but no statistically significant association was found between these two variables.


Assuntos
Transtornos da Articulação Temporomandibular/etiologia , Articulação Temporomandibular/anatomia & histologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cefalometria , Feminino , Humanos , Arcada Edêntula/patologia , Masculino , Côndilo Mandibular/patologia , Pessoa de Meia-Idade , Osteoartrite/patologia , Fatores Sexuais , Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/patologia , Atrito Dentário/patologia
18.
Swed Dent J ; 32(1): 9-16, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18540516

RESUMO

The aim of this study was to evaluate the treatment effect of a combined treatment with a stabilisation appliance and a soft appliance in the opposing jaw in patients refractory to previous TMD treatment. During a 5-year-period, 2001-2005, a total of 98 patients received the combined treatment at the Department of Stomatognathic Physiology, the Institute for Postgraduate Dental Education, Jönköping, Sweden. Before the patients received the combined treatment, they had already been given several different TMD treatments during a long period of time, either before referral or at the specialist clinic, with only minor or no effect on their TMD symptoms. The patients were followed prospectively (n=10), or analysed retrospectively (n=88). The data registered were gender, age, main indication for TMD treatment, number of visits to the clinic before and after the introduction of the combined treatment, as well as according to a clinical (Di) and anamnestic (Ai) dysfunction index. The most common causes for treatment in the retrospective material were problems of muscular origin and problems of both muscular and TMJ origin. In the prospective material, most of the patients had mainly muscular symptoms. Both the clinical and anamnestic dysfunction index decreased statistically significantly in the retrospective material after the introduction of the combined treatment. There was a numerical improvement of both indices also in the prospective material. In conclusion, the present investigation showed that a combined treatment with a hard acrylic stabilisation appliance and a soft appliance in the opposing jaw seems to give a remarkable improvement of TMD signs and symptoms in apparently therapy resistant TMD patients. General conclusions should, however, be made with caution due to the fact that the study did not include any control group. There is an obvious need for randomized controlled studies concerning the efficacy and effectiveness of the combined treatment presented in this study.


Assuntos
Placas Oclusais , Transtornos da Articulação Temporomandibular/terapia , Resinas Acrílicas , Adolescente , Adulto , Idoso , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Aparelho Ortodôntico , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Estudos Retrospectivos , Transtornos da Articulação Temporomandibular/diagnóstico , Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Síndrome da Disfunção da Articulação Temporomandibular/terapia
19.
Acta Odontol Scand ; 66(2): 88-92, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18446549

RESUMO

OBJECTIVE: To evaluate the presence of symptoms of temporomandibular disorders (TMDs) in patients referred to a specialist clinic because of muscular problems 18-20 years earlier and who had received mainly acupuncture and/or interocclusal appliance therapy. MATERIAL AND METHODS: Sixty-five subjects who had received therapy at a TMD specialist clinic 18-20 years earlier were mailed a questionnaire with questions about TMD symptoms, their attitude towards the therapy, and their opinion about the outcome. Fifty-five subjects (85%) answered and returned the questionnaire. RESULTS: Before therapy, 87% had had severe TMD symptoms, but this figure decreased to 38% at the long-term follow-up. The mean values of the subjects' complaints at worst and at best before treatment, measured with a visual analog scale, were 66 (range 26-100) and 31 (range 0-100), respectively. The corresponding figures at the long-term follow-up were 32 (range 0-96) and 16 (range 0-70). Headache at least once a week was originally reported by 73% of the women and by 77% of the men. Headache prevalence 18-20 years later was 35% in women and 54% in men. The majority of patients were positive about the therapy they had received, and would recommend it to a friend with similar complaints. CONCLUSIONS: A majority of the patients reported a lasting improvement in their symptoms. Patients' overall opinions of the therapy received were positive.


Assuntos
Terapia por Acupuntura/psicologia , Placas Oclusais , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Cefaleia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Satisfação do Paciente , Autoavaliação (Psicologia) , Estatísticas não Paramétricas , Inquéritos e Questionários , Síndrome da Disfunção da Articulação Temporomandibular/complicações , Síndrome da Disfunção da Articulação Temporomandibular/psicologia
20.
Swed Dent J ; 31(2): 55-63, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17695050

RESUMO

The aim of this study was to investigate if a TMD-trained general dental practitioner could individually predict actual treatment outcome in selected patients diagnosed with temporomandibular disorders (TMD) with similar results as a TMD specialist. The patients were examined, individually predicted, treatment planned, treated and had their treatment outcome evaluated by the therapist, respectively. Out of 2618 patients referred to a TMD specialist clinic, 1086 patients started treatment. They were all divided into Muscle or Mainly TMJ symptoms. Prediction of the treatment outcome as Good or Dubious was based on the patient's history, the clinical and, sometimes, radiological findings. The degree of improvement was graded using a Numeric Rating Scale 0-100. A clinical important improvement, defined as an improvement of initial complaints of 50% or more, was judged as a correct prediction of Good treatment outcome. Seven-hundred-sixty-nine patients treated by the TMD specialist (Sample 1) was compared with 164 patients treated by the TMD-trained general dental practitioner (Sample 2). For patients with Muscle symptoms in Sample 1, a 50% improvement or more was reached by 93% of those predicted Good and 57% of those predicted Dubious. The corresponding figures in Sample 2 were 100% and 82%, respectively. In Sample 1, patients with Mainly TMJ symptoms reached a 50% improvement or more in 94% of those with prediction Good and 73% of those predicted Dubious. In Sample 2 the figures were 100% and 87%, respectively. ATMD-trained general dental practitioner could individually predict treatment outcome with similar results as a TMD specialist in selected patients diagnosed with TMD. Whether the method is possible to generalize has to be investigated further.


Assuntos
Odontologia Geral/normas , Avaliação de Resultados em Cuidados de Saúde/normas , Transtornos da Articulação Temporomandibular/terapia , Adolescente , Adulto , Criança , Competência Clínica , Odontólogos , Educação Continuada em Odontologia , Feminino , Odontologia Geral/educação , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Placas Oclusais , Ortodontia , Prognóstico , Garantia da Qualidade dos Cuidados de Saúde , Especialidades Odontológicas/educação , Transtornos da Articulação Temporomandibular/diagnóstico , Resultado do Tratamento
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