International Poster Journal of Dentistry and Oral Medicine, 1/2015
Poster 858, Language: English
Introduction: Along with clinical examination Magnetic Resonanz Imaging (MRI) has become a standard tool in Temporomandibular joint disorder diagnosis. Even though MRI diagnosis usually focuses on pathologies of the joint directly, pathological alterations of the muscles can be found as well.
Objectives: Is there evidence for correlations between MRI muscle findings and clinical symptoms of TMD?
Material and Methods: Digital MR- Images of 65 patients treated for TMD at the dental clinic of Goethe University Frankfurt, Germany between 2004- 2012 have been evaluated. One patient showing noticeable alterations in MR muscle appearance between right and left muscles was defined as reference for the muscle alterations of interest. Fibrous, lipomatic and edematic alterations were recorded and the width of the masseter, medial and lateral pterygoid muscle was measured in the axial plane. Those findings were then matched with clinical findings of palpation, limitation or hypermobility in jaw opening and klicking, deviation and deflexion.
Results: Just like in the clinical examinations most alterations in MR signaling were found in the masseter muscle. 93% showed at least one of the alterations of interest while 46% of the masseter were painful on palpation. Still, statistically this was not significant (p> 0,05). With 17% alterations in MR signaling and 13% of clinical symptoms, findings in the medial pterygoid muscle were less frequent. Here as well, there was no proof of correlation between MR - and clinical findings (p> 0,05). Most of the MR- findings in lateral pterygoid muscles (42%) were of lipomatic nature. They were correlated with clinical findings of klicking, limitation or hypermobility in jaw opening and deviation or deflexion but no statistically significant correlations were found (p> 0,05).
Conclusion: Although MR findings of muscle alteration such as fibrosis, liposis or edema can be detected quite frequently in patients with TMD, there is no evidence of correlations between MR signaling and clinical symptoms. Therefore a thoroughly performed clinical examination is inevitable.
Since no differenciation has been made between severeties of muscle alterations, further investigation is needed to determine if the severness of signal alterations correlates with clinical symptoms.
Keywords: MRI pathologies, TMD, masticatory muscles
Journal of Oral & Facial Pain and Headache, 3/2014
Pages 205-222, Language: English
Aims: To carry out a systematic review and meta-analysis comparing the effects of occlusal splint therapy ("usual treatment") and psychosocial interventions for the treatment of myofascial temporomandibular disorder (TMD) pain in adult patients.
Methods: Independent screening and evaluation of randomized clinical trials included comparisons between "usual treatment" based on splint therapy and psychosocial interventions for TMD treatment within electronic databases (PubMed/MEDLINE, CENTRAL, EMBASE), ongoing trials databases (Current Controlled Trials, ClinicalTrials.gov), and additional sources. The outcomes selected for the systematic review were self-reported pain, pain interference, unassisted jaw opening without pain, muscle pain upon palpation, depression, and somatization. The effect measures were analyzed using a random-effect model (Review Manager computer program).
Results: The outcomes "longterm self-reported pain" and "long-term depression" were significantly different for the comparisons of "usual treatment" and psychosocial interventions, and they favored the latter (P < .005 and P < .05, respectively). These results must be viewed with caution due to the limited number of studies available. A tendency toward greater improvements of psychological outcomes was observed for psychosocial interventions, while physical functioning was slightly more responsive to "usual treatment."
Conclusion: No evidence was found to distinguish the clinical effectiveness between "usual treatment" and psychosocial interventions for myofascial TMD pain. Future studies of TMD and related subdiagnoses should be reported according to core standardized outcomes to facilitate comparisons.
Keywords: meta-analysis, myofascial pain, oral myofascial pain, systematic review, temporomandibular disorders
International Poster Journal of Dentistry and Oral Medicine, 4/2002
Poster 151, Language: German
Thesis: Aim of this study was to compare newly developed and conventional retention systems by objective measurements of the clinical adhesion force of prostheses.
Material and methods: The adhesion force was measured for each prosthesis with a specially developed device. Therefore the prosthesis was connected with a plate at the occlusal surface. A centered fastened loop served as a loose coupling with a dynamometer-box (Fa. Typ U2A, Hottinger Baldwin Measurements, Marlborough, USA), which avoids the prosthesis to stand on edge during the pull-off phase. The device was calibrated prior to each series of measurements. 10 consecutive measurements for each prosthesis were performed in a prospective clinical trial. Mean values were calculated and defined as adhesion force.
Test group: 8 metal-free tapered crown prostheses (primary crown: ceramic, Empressâ 2; frame: fibre composite, Vectrisâ: Fa. Ivoclar Schaan-Liechtenstein) on 28 abutments (6 teeth, 22 implants).
Control group: 12 conventional tapered crown prostheses on 58 abutments (24 teeth, 34 implants).
Results: The relative standard deviation of the 10 single-measurements was 3,9 % on average. The average adhesion force of the test group (4,8N±1,7N) did not significantly differ from the control group (5,1N±2,9N); (Anova, p