Pages 11-26, Language: English, German
Several studies on the association carried out on changes in posture and craniomandibular dysfunction (CMD) have demonstrated different results. The aim of this study was to test the effects of stabilization splints in centric relation on the posture of walking CMD patients and controls. The posture of 20 CMD patients and 19 healthy subjects was evaluated with the sonoSens® Monitor before (U1), immediately after (U2), and 1 week after (U3) the insertion of a stabilization splint with centric relation. The sonoSens® Monitor is a diagnostic system for the dynamic monitoring of posture. The technology consists of a device measuring the delay of ultrasound impulses, using four pairs of small sensors that are placed at specific sites on the neck and the back. During each measurement the sensors continuously record changes in distance between each pair of sensors, while the subjects are walking straight ahead for 7 minutes. The range of flexion and torsion of the body while walking was recorded for the cervical, thoracic and lumbar spine. At each appointment a clinical functional examination was performed. All measured parameters were tested for group differences with a non-parametric test. There were no significant differences between the groups at U1, U2 and U3 for the regularity indices or for the sagittal and frontal range of motion and of torsion. There were also no statistically significant differences of these parameters within the groups between U1, U2 and U3. Pain and the impairment in quality of life were reduced significantly for the test group between U1 and U3 (P < 0.03), whereas no changes were recorded for the control group. The results of this study indicate that oral appliance therapy has no significant influence on the posture of CMD patients and controls measured while they walked. However, further studies are necessary to verify these results.
Keywords: centric splint, craniomandibular dysfunction, gait analysis, posture
Pages 27-38, Language: English, German
CMD diagnoses and stress and mental state parameters of a pool comprising 564 subjects involved in the Study of Health in Pomerania (SHIP-0) and the associated project Munderkrankungen und Kraniomandibuläre Dysfunktionen (Oral Health and Craniomandibular Dysfunction) were examined for potential connections. The CMD findings were obtained in an anamnestic process and by clinical function analysis, while the stress and mental state parameters were determined by using three questionnaires (BSKE = Befindlichkeitsskalierung anhand von Kategorien und Eigenschaftswörterlisten [Scale of mental states, based on categories and lists of adjectives], SEF = Stresserfahrungsfragebogen [stress experience questionnaire], and SVF = Stressverarbeitungsfragebogen [stress management questionnaire]). Evidence suggests that there may be tendencies for many CMD symptoms to be related to stress and mental state parameters, in particular to negative parameters. Life-stress events were found to have almost no influence on CMD. Among the symptoms, "headache" and "palpatory pain of masticatory muscles" were found to be most strongly connected with negative coping strategies (stress management strategies) and also with a habitually negative mental state. These subjective symptoms were found to be more dependent on negative stress management than objective CMD findings or painless symptoms. Some combinations suggest that there are noticeable differences between males and females with respect to their stress management and their mental state.
Keywords: CMD, stress, mental state, SHIP, coping
Open AccessPages 39-50, Language: English, German
This study aims to determine the prevalence of TMD symptoms in a non-TMD adult population in Israel. The extent to which gender and biological factors related to TMD interact with psychosocial factors in terms of their influence upon the pain experience is assessed. Non-TMD adults were recruited from the general population and completed questionnaires on TMD symptoms as well as a psychological assessment (Research Diagnostic Criteria for Temporomandibular Disorders [RDC/TMD] Axis II, SCL-90, and Perceived Stress Scale). A total of 240 subjects (103 males, 127 females, mean age 35.7±12.5 years) participated. The prevalence of individuals with at least one TMD symptom was 37%, and no gender differences were found. However, significant differences were found between the levels of psychological factors among females and males who did not suffer from chronic pain. In examining the interaction between reported pain and each gender separately (t test, followed by Bonferroni correction), a significant increase was observed in the measures of somatization (pain excluded) (P = 0.01) among men reporting pain, and a tendency to significance regarding the level of depression (P = 0.065). There was no significant increase in any of the measures of psychological distress in the presence of pain among females. The authors' results showed that the gender difference was dependent upon the level of pain, indicating an important role of pain in the development of psychological distress, especially among males. It appears that the psychological state of a person influences the presence of symptoms of functional disorders of the masticatory system. Epidemiological investigations on non-TMD patient populations should use the RDC/TMD to enable comparisons to be made with results of future studies on these patient populations.
Keywords: temporomandibular disorders, psychological status, gender, pain, RDC/TMD Axis II
Pages 51-60, Language: English, German
The vast majority of disorders of the masticatory system that dentists are likely to meet in their practices are due to dysfunctional strains on the affected tissues that occur either in the maximal intercuspal position (clenching) or in excentric positions of the mandible (grinding), and are generally summarized under the collective term "bruxism." There is a general consensus that these disorders are strongly dependent on behavior. Therefore, the more dentists can motivate their patients to show insight and cooperate, the more successful they will be with their treatment. This motivation can be substantially facilitated if the patient is an active partner in the examination and healing process. In other words, dentists and patients need to act jointly. To act jointly (Latin: communicare) is also the original meaning of communication. The modern definition of "exchange of information" or "mutual control" has only emerged over the last few decades, parallel with the development of electronic communication techniques.