Novel Diagnostic and Therapeutic Approaches in Temporomandibular Disorders (TMDs) and Myofascial Pain

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (28 July 2023) | Viewed by 40717

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Special Issue Editors


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Guest Editor
Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta 2, 41-800 Zabrze, Poland
Interests: temporomandibular disorders; intramuscular injections in the treatment of TMD; collagen in the treatment of TMD; myorelaxant therapies in TMD; management of TMD; myofascial pain

E-Mail Website
Guest Editor
Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta sq. 2, 41-800 Zabrze, Poland
Interests: temporomandibular disorders; intramuscular injections in the treatment of TMD; collagen in the treatment of TMD; myorelaxant therapies in TMD; management of TMD; myofascial pain

Special Issue Information

Dear Colleagues,

We are pleased to invite you to submit a manuscript to the forthcoming Special Issue “Novel Diagnostic and Therapeutic Approaches in Temporomandibular Disorders and Myofascial Pain”, for the journal Life (IF: 3.251).

This Special Issue will cover a diverse scope of topics, from diagnostics to the management of temporomandibular disorders and myofascial pain, with a special focus on innovations in those areas. Intense research progress in the subject as well as technological development, access to knowledge, and novel digital tools allow developing more precise, reproducible, and dedicated diagnostic and therapeutic protocols. We are thrilled to hear about new tools and equipment assisting the diagnostic and treatment process, innovative therapeutic methods, new substances and medications used, as well as novel modifications of already widely used methods.

We encourage you to submit your work to this Special Issue to help to summarize and develop this field of research to further assist dental practitioners and researchers in providing the latest, best possible treatments for our patients.

Dr. Zuzanna Nowak
Prof. Dr. Aleksandra Nitecka-Buchta
Guest Editors

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Keywords

  • temporomandibular disorders
  • TMD
  • temporomandibular disorder diagnostics
  • innovative temporomandibular disorder treatment
  • myofascial pain
  • prolotherapy
  • alternative therapies for masticatory muscle pain
  • myorelaxant therapies in TMD

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Published Papers (14 papers)

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Editorial

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2 pages, 189 KiB  
Editorial
Editorial for “Novel Diagnostic and Therapeutic Approaches in Temporomandibular Disorders and Myofascial Pain” Special Issue in Life
by Zuzanna Nowak
Life 2023, 13(10), 2049; https://doi.org/10.3390/life13102049 - 13 Oct 2023
Viewed by 788
Abstract
In the dynamic and complex field of temporomandibular disorders (TMDs), keeping our knowledge up to date is of great importance [...] Full article

Research

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12 pages, 2414 KiB  
Article
Penetrating Offenders in Hemifacial Spasm: Surgical Tactics and Prognosis
by Hyun-Seok Lee and Kwan Park
Life 2023, 13(10), 2021; https://doi.org/10.3390/life13102021 - 7 Oct 2023
Viewed by 1918
Abstract
(1) Background: In cases of hemifacial spasm (HFS), there are various patterns related to the vascular compression of the facial nerve, including a very rare form that is seen when the offending vessel penetrates the facial nerve. However, there have been few reports [...] Read more.
(1) Background: In cases of hemifacial spasm (HFS), there are various patterns related to the vascular compression of the facial nerve, including a very rare form that is seen when the offending vessel penetrates the facial nerve. However, there have been few reports in the literature regarding the associated surgical techniques and postoperative prognosis. (2) Methods: A retrospective review was conducted of 4755 patients who underwent microvascular decompression (MVD) surgery from April 1997 to June 2023. In total, 8 out of the 4755 patients (0.2%) exhibited a penetrating offending vessel; the medical and surgical records of these 8 patients were then analyzed. Surgery was then attempted to maximally decompress the penetrating offender. (3) Results: Seven out of the eight patients (87.5%) were spasm-free immediately after surgery, and one had only 10% residual spasm compared to their preoperative condition. That patient was also spasm-free one year later. Postoperative facial palsy occurred in one patient (12.5%) who was assessed as grade II in the House–Brackmann grading system. In another patient, the resection of a small facial nerve bundle did not result in facial palsy. There were no cases of hearing loss or other complications. (4) Conclusions: Decompressing the penetrating offender did not increase the incidence of facial palsy, and the prognosis for hemifacial spasms was good. Therefore, when a penetrating pattern was encountered during MVD surgery, decompression between the penetrating offender and the facial nerve may offer good results. Full article
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11 pages, 1345 KiB  
Article
Operative Findings of over 5000 Microvascular Decompression Surgeries for Hemifacial Spasm: Our Perspective and Current Updates
by Jae Sung Park and Kwan Park
Life 2023, 13(9), 1904; https://doi.org/10.3390/life13091904 - 13 Sep 2023
Cited by 4 | Viewed by 1433
Abstract
Hemifacial spasm (HFS) is a hyperactive cranial neuropathy, and it has been well established that the cause of primary HFS is compression on the root exit zone (REZ) of the facial–vestibulocochlear nerve complex (CN VII-VIII) by a vessel or vessels. MVD is the [...] Read more.
Hemifacial spasm (HFS) is a hyperactive cranial neuropathy, and it has been well established that the cause of primary HFS is compression on the root exit zone (REZ) of the facial–vestibulocochlear nerve complex (CN VII-VIII) by a vessel or vessels. MVD is the only curative treatment option for HFS with a high success rate and low incidence of recurrence and complications. We categorize six classical compressive patterns on the REZ as well as five challenging types. Knowledge of these patterns may help in achieving a better surgical outcome. Full article
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13 pages, 2162 KiB  
Article
Reliability and Responsiveness of a Novel Device to Evaluate Tongue Force
by Marta Carlota Diaz-Saez, Alfonso Gil-Martínez, Inae Caroline Gadotti, Gonzalo Navarro-Fernández, Javier Gil-Castillo and Hector Beltran-Alacreu
Life 2023, 13(5), 1192; https://doi.org/10.3390/life13051192 - 16 May 2023
Cited by 2 | Viewed by 1560
Abstract
Background: Measurements of tongue force are important in clinical practice during both the diagnostic process and rehabilitation progress. It has been shown that patients with chronic temporomandibular disorders have less tongue strength than asymptomatic subjects. Currently, there are few devices to measure tongue [...] Read more.
Background: Measurements of tongue force are important in clinical practice during both the diagnostic process and rehabilitation progress. It has been shown that patients with chronic temporomandibular disorders have less tongue strength than asymptomatic subjects. Currently, there are few devices to measure tongue force on the market, with different limitations. That is why a new device has been developed to overcome them. The objectives of the study were to determine the intra- and inter-rater reliability and the responsiveness of a new low-cost device to evaluate tongue force in an asymptomatic population. Materials and Methods: Two examiners assessed the maximal tongue force in 26 asymptomatic subjects using a developed prototype of an Arduino device. Each examiner performed a total of eight measurements of tongue force in each subject. Each tongue direction was measured twice (elevation, depression, right lateralization, and left lateralization) in order to test the intrarater reliability. Results: The intrarater reliability using the new device was excellent for the measurements of the tongue force for up (ICC > 0.94), down (ICC > 0.93) and right (ICC > 0.92) movements, and good for the left movement (ICC > 0.82). The SEM and MDC values were below 0.98 and 2.30, respectively, for the intrarater reliability analysis. Regarding the inter-rater reliability, the ICC was excellent for measuring the tongue up movements (ICC = 0.94), and good for all the others (down ICC = 0.83; right ICC = 0.87; and left ICC = 0.81). The SEM and MDC values were below 1.29 and 3.01, respectively, for the inter-rater reliability. Conclusions: This study showed a good-to-excellent intra- and inter-reliability and good responsiveness in the new device to measure different directions of tongue force in an asymptomatic population. This could be a new, more accessible tool to consider and add to the assessment and treatment of different clinical conditions in which a deficit in tongue force could be found. Full article
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17 pages, 3625 KiB  
Article
Complicated Relationships between Anterior and Condylar Guidance and Their Clinical Implications—Comparison by Cone Beam Computed Tomography and Electronic Axiography—An Observational Cohort Cross-Sectional Study
by Łukasz Lassmann, Zuzanna Nowak, Jean-Daniel Orthlieb and Agata Żółtowska
Life 2023, 13(2), 335; https://doi.org/10.3390/life13020335 - 26 Jan 2023
Cited by 6 | Viewed by 4280
Abstract
A complex prosthodontic treatment is believed to be more successful when the condylar path is replicated using the articulator. However, there is an ongoing major disagreement between the researchers as the exact relationship between the posterior and anterior determinants has not been clear. [...] Read more.
A complex prosthodontic treatment is believed to be more successful when the condylar path is replicated using the articulator. However, there is an ongoing major disagreement between the researchers as the exact relationship between the posterior and anterior determinants has not been clear. The purpose of this study was to investigate whether the protrusive movement of the mandible does correlate with the temporomandibular joint (TMJ) anatomy or with incised features. Subjects (15 males and 15 females) were qualified for this study based on an initial interview including the following criteria: age 21–23 (+/−1), no history of trauma, orthodontic treatment, or temporomandibular disorders (TMD). For each patient, the angle of the condylar path, incisal guidance angle (IGA), interincisal angle, as well as overbite and overjet were measured on cone beam computed tomography (CBCT). This was followed by the examination with the Modjaw® electronic axiograph recording and calculating the functional sagittal condylar guidance angle (SCGA) for the right and left TMJ during the protrusion. The results show that the mean functional axiographic measurement of SCGA in protrusion significantly correlates with the TMJ anatomy presented on CBCT. Moreover, a significant correlation was found between the values of SCGA in the functional and anatomical measurements in all its variants. It turned out that, statistically, the AB measurement was the most accurate. Finally, results showed that incisal relationships of permanent teeth such as overbite, overjet, incisal guidance angle and interincisal angle do not correlate with TMJ anatomy, and therefore, regarding an analyzed study group, do not affect the TMJ formation in young adults. Full article
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10 pages, 1043 KiB  
Article
Professional Factors Associated with Case Resolution without Referrals of Orofacial Pain Cases to Secondary Dental Care by Telehealth in Brazil: A Cross-Sectional Study in 2019 and 2020
by Ricardo Luiz de Barreto Aranha, Renata de Castro Martins, Ligia Cristelli Paixão and Mauro Henrique Nogueira Guimarães de Abreu
Life 2023, 13(1), 29; https://doi.org/10.3390/life13010029 - 22 Dec 2022
Cited by 1 | Viewed by 1756
Abstract
This study aimed to identify professional factors associated with case resolution without a referral of orofacial pain to secondary health care by Brazilian Primary Health Care (PHC) practitioners who demanded asynchronous teleconsulting, stratified by year, in 2019 and 2020 (the COVID-19 Pandemic burst). [...] Read more.
This study aimed to identify professional factors associated with case resolution without a referral of orofacial pain to secondary health care by Brazilian Primary Health Care (PHC) practitioners who demanded asynchronous teleconsulting, stratified by year, in 2019 and 2020 (the COVID-19 Pandemic burst). A cross-sectional study employed secondary databases from asynchronous teleconsulting Telehealth Brazil Networks from January 2019 to December 2020. The outcome was the dichotomous variable “If referral to secondary care was avoided.” As covariates: sex, healthcare professions, and category of orofacial pain doubts. A negative binomial regression model estimated each covariate’s unadjusted and adjusted PR (95%CI) and p values, stratified for 2019 and 2020. There was a difference in descriptive factors associated with case resolution without a referral from 2019 to 2020. Females prevailed in both years, and the total demand decreased to a third from 2019 to 2020. The rate of resoluteness decreased by 19.1%. In 2019, nurses (PR = 0.69 CI 95% 0.57–0.83) and other professionals (PR = 0.84 CI 95% 0.73–0.97) showed less frequency of case resolution without a referral than did general dentists. In 2020, oral-cavity-related doubts (PR = 1.18 CI 95% 1.06–1.32) and temporomandibular disorders (PR = 1.33 95% 1.15–1.54) surpassed other causes of orofacial pain in case resolution without a referral, and female professionals avoided referrals more frequently than men (PR = 1.24 CI 95% 1.21–1.38). In conclusion, in 2019, oral cavity doubts and the PHC profession influenced the case resolution. Female professionals and oral cavity doubts scored the higher case resolution without a referral for the service in 2020. Full article
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11 pages, 388 KiB  
Article
Functioning of the Masticatory System in Patients with an Alloplastic Total Temporomandibular Joint Prostheses Compared with Healthy Individuals: A Pilot Study
by Caroline M. Speksnijder, Nadiya E. A. Mutsaers and Sajjad Walji
Life 2022, 12(12), 2073; https://doi.org/10.3390/life12122073 - 10 Dec 2022
Cited by 6 | Viewed by 1448
Abstract
Background: Most patients with temporomandibular joint (TMJ) issues are successfully treated with nonsurgical methods. However, when end-stage TMJ pathologies occur, invasive management can be required, such as a total TMJ replacement. This cross-sectional pilot study aimed to provide insight into the functioning of [...] Read more.
Background: Most patients with temporomandibular joint (TMJ) issues are successfully treated with nonsurgical methods. However, when end-stage TMJ pathologies occur, invasive management can be required, such as a total TMJ replacement. This cross-sectional pilot study aimed to provide insight into the functioning of the masticatory system, pain, and patient satisfaction in patients treated with a total joint replacement (TJR). Methods: A cross-sectional pilot study was conducted to determine the postoperative clinical results of an alloplastic TJR TMJ. Masticatory performance and also insight into maximum voluntary bite force (MVBF), active and passive maximum mouth opening (aMMO/pMMO), pain, and patient satisfaction were measured. Masticatory performance, MVBF, and aMMO of patients with a TJR TMJ were compared with healthy individuals. Results: Masticatory performance is equal between patients with a TJR TMJ and healthy individuals, but both MVBF and aMMO were significantly smaller in patients with a TJR TMJ. However, patients had almost no pain and were very satisfied with the TJR TMJ treatment. Conclusion: This study revealed that most patients with an alloplastic TJR TMJ were able to function without pain, showed good masticatory performance, and were highly satisfied with their alloplastic TJR TMJ. However, MVBF and aMMO were lower than in healthy individuals. Full article
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10 pages, 1347 KiB  
Article
Medium-Term Effect of Treatment with Intra-Articular Injection of Sodium Hyaluronate, Betamethasone and Platelet-Rich Plasma in Patients with Temporomandibular Arthralgia: A Retrospective Cohort Study
by Bruno Macedo de Sousa, Antonio López-Valverde, Francisco Caramelo, María João Rodrigues and Nansi López-Valverde
Life 2022, 12(11), 1739; https://doi.org/10.3390/life12111739 - 29 Oct 2022
Cited by 7 | Viewed by 1763
Abstract
Temporomandibular joint disorders are associated with pain and reduced jaw mobility. The aim of this study was to compare the long-term effect on pain of intra-articular TMJ injections of betamethasone, sodium hyaluronate and platelet-rich plasma. The sample was made up of 114 patients, [...] Read more.
Temporomandibular joint disorders are associated with pain and reduced jaw mobility. The aim of this study was to compare the long-term effect on pain of intra-articular TMJ injections of betamethasone, sodium hyaluronate and platelet-rich plasma. The sample was made up of 114 patients, who were randomly distributed into three groups at least three years ago and who achieved a total remission of pain after treatment. We found that the median number of months without pain was, according to each group, as follows: platelet-rich plasma: 33; sodium hyaluronate: 28; betamethasone: 19. Both platelet-rich plasma and sodium hyaluronate lead to significant pain-free time after treatment; when we compare bethametasone with the two other substances, it proved to be very ineffective. Full article
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Review

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12 pages, 5999 KiB  
Review
Lateral Spread Response: Unveiling the Smoking Gun for Cured Hemifacial Spasm
by Kyung Rae Cho, Sang Ku Park and Kwan Park
Life 2023, 13(9), 1825; https://doi.org/10.3390/life13091825 - 29 Aug 2023
Cited by 2 | Viewed by 1826
Abstract
Hemifacial spasm (HFS) is a rare disorder characterized by involuntary facial muscle contractions. The primary cause is mechanical compression of the facial nerve by nearby structures. Lateral spread response (LSR) is an abnormal muscle response observed during electromyogram (EMG) testing and is associated [...] Read more.
Hemifacial spasm (HFS) is a rare disorder characterized by involuntary facial muscle contractions. The primary cause is mechanical compression of the facial nerve by nearby structures. Lateral spread response (LSR) is an abnormal muscle response observed during electromyogram (EMG) testing and is associated with HFS. Intraoperative monitoring of LSR is crucial during surgery to confirm successful decompression. Proper anesthesia and electrode positioning are important for accurate LSR monitoring. Stimulation parameters should be carefully adjusted to avoid artifacts. The disappearance of LSR during surgery is associated with short-term outcomes, but its persistence does not necessarily indicate poor long-term outcomes. LSR monitoring has both positive and negative prognostic value, and its predictive ability varies across studies. Early disappearance of LSR can occur before decompression and may indicate better clinical outcomes. Further research is needed to fully understand the implications of LSR monitoring in HFS surgery. Full article
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12 pages, 957 KiB  
Review
Novel Diagnostic and Therapeutic Approaches to Temporomandibular Dysfunction: A Narrative Review
by Brendan Moxley, William Stevens, Joel Sneed and Craig Pearl
Life 2023, 13(9), 1808; https://doi.org/10.3390/life13091808 - 25 Aug 2023
Cited by 2 | Viewed by 2272
Abstract
Temporomandibular dysfunction (TMD) is a burgeoning area of study within the dental field. TMD is caused by abnormalities in the temporomandibular joint or muscles of mastication and can lead to pain, loss of function, and other complications. As this area of patient care [...] Read more.
Temporomandibular dysfunction (TMD) is a burgeoning area of study within the dental field. TMD is caused by abnormalities in the temporomandibular joint or muscles of mastication and can lead to pain, loss of function, and other complications. As this area of patient care receives increased focus, the ability to accurately diagnose TMD becomes paramount. The aim of this review is to summarize novel diagnostic and therapeutic techniques that have been proposed within the last approximately 3 years in order to inform readers of the cutting-edge advances in the field of TMD diagnosis and management, while also analyzing the clinical relevance of each study. A PubMed search was completed on 1 March 2023, using MeSH terms related to TMD diagnosis and treatment. The search yielded seven articles that pertained to the aim of this review article. The main findings from each study are summarized in this review article. These novel methods of diagnosing and treating TMD may improve our ability to assess and treat patients suffering from TMD. Full article
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Other

15 pages, 1493 KiB  
Systematic Review
Comparative Evaluation of Condylar Guidance Angles Measured Using Arcon and Non-Arcon Articulators and Panoramic Radiographs—A Systematic Review and Meta-Analysis
by Amjad Obaid Aljohani, Mohammed Ghazi Sghaireen, Muhammad Abbas, Bader Kureyem Alzarea, Kumar Chandan Srivastava, Deepti Shrivastava, Rakhi Issrani, Merin Mathew, Ahmed Hamoud L Alsharari, Mohammed Ali D. Alsharari, Naif Abdulrahman Aljunaydi, Saif Alanazi, Mosheri Muslem S. Alsharari and Mohammad Khursheed Alam
Life 2023, 13(6), 1352; https://doi.org/10.3390/life13061352 - 8 Jun 2023
Cited by 2 | Viewed by 3276
Abstract
The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs (LCGVs) being two of the most prominently recognized. This systematic review aimed at evaluating the efficacy of two different types [...] Read more.
The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs (LCGVs) being two of the most prominently recognized. This systematic review aimed at evaluating the efficacy of two different types of CGV measurement protocols—articulators (both arcon and non-arcon) and panoramic radiographs. Additionally, it attempts to determine which of the mentioned methods performs better across several parameters. Several important web databases were searched using search terms derived from medical subject headings (MeSH), using keywords linked to “Arcon articulator”, “Condylar guidance angle”, “non-arcon articulator”, “Panoramic x-ray” and “Radiographic examination”, which constituted the first step in the study selection strategy. After completion, the search strategy which initially turned up to 831 papers, eventually ended up with 13 studies. The review and subsequent meta-analysis revealed that panoramic radiographs had noticeably greater efficacy in terms of the CGVs as compared to the articulators in the majority of the studies. Within the articulators, the arcon types recorded slightly higher CGVs than the non-arcon variety owing to the precision of jaw movement simulation in the former. However, further studies are required to validate these findings and establish more precise guidelines for the use of CGV measurement protocols in prosthodontic practice. Full article
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10 pages, 1526 KiB  
Brief Report
Preliminary Findings of the Efficacy of Botulinum Toxin in Temporomandibular Disorders: Uncontrolled Pilot Study
by José A. Blanco-Rueda, Antonio López-Valverde, Antonio Márquez-Vera, Roberto Méndez-Sánchez, Eva López-García and Nansi López-Valverde
Life 2023, 13(2), 345; https://doi.org/10.3390/life13020345 - 28 Jan 2023
Cited by 5 | Viewed by 7952
Abstract
Temporomandibular disorders are a common pathology affecting up to 70% of the population, with a maximum incidence in young patients. We used a sample of twenty patients recruited in the Maxillofacial Surgery Service of the University Hospital of Salamanca (Spain), who met the [...] Read more.
Temporomandibular disorders are a common pathology affecting up to 70% of the population, with a maximum incidence in young patients. We used a sample of twenty patients recruited in the Maxillofacial Surgery Service of the University Hospital of Salamanca (Spain), who met the inclusion criteria, with unilateral painful symptomatology of more than three months’ duration. All patients were randomly treated by intramuscular and intra-articular injections of botulinum toxin (100 U) in eight predetermined points. Pain symptomatology was assessed by the visual analog scale (VAS) at the different locations, together with joint symptomatology, at baseline and six weeks after treatment. Adverse effects were also evaluated. In 85% of the patients, pain upon oral opening improved and 90% showed improvement in pain upon mastication. A total of 75% of the patients reported improvement in joint clicking/noise. Headaches improved or disappeared in 70% of the patients treated. Despite the limitations of the study and the preliminary results, intramuscular and intra-articular infiltrations with botulinum toxin were effective in the treatment of symptoms associated with temporomandibular disorders (TMDs), with minimal adverse effects. Full article
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28 pages, 2281 KiB  
Systematic Review
Effectiveness of Manual Trigger Point Therapy in Patients with Myofascial Trigger Points in the Orofacial Region—A Systematic Review
by Frauke Müggenborg, Ester Moreira de Castro Carletti, Liz Dennett, Ana Izabela Sobral de Oliveira-Souza, Norazlin Mohamad, Gunnar Licht, Harry von Piekartz and Susan Armijo-Olivo
Life 2023, 13(2), 336; https://doi.org/10.3390/life13020336 - 27 Jan 2023
Cited by 4 | Viewed by 5133
Abstract
The objective was to compile, synthetize, and evaluate the quality of the evidence from randomized controlled trials (RCTs) regarding the effectiveness of manual trigger point therapy in the orofacial area in patients with or without orofacial pain. This project was registered in PROSPERO [...] Read more.
The objective was to compile, synthetize, and evaluate the quality of the evidence from randomized controlled trials (RCTs) regarding the effectiveness of manual trigger point therapy in the orofacial area in patients with or without orofacial pain. This project was registered in PROSPERO and follows the PRISMA guidelines. Searches (20 April 2021) were conducted in six databases for RCTs involving adults with active or latent myofascial trigger points (mTrPs) in the orofacial area. The data were extracted by two independent assessors. Four studies were included. According to the GRADE approach, the overall quality/certainty of the evidence was very low due to the high risk of bias of the studies included. Manual trigger point therapy showed no clear advantage over other conservative treatments. However, it was found to be an equally effective and safe therapy for individuals with myofascial trigger points in the orofacial region and better than control groups. This systematic review revealed a limited number of RCTs conducted with patients with mTrPs in the orofacial area and the methodological limitations of those RCTs. Rigorous, well-designed RCTs are still needed in this field. Full article
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19 pages, 3200 KiB  
Systematic Review
The Efficacy of Manual Therapy Approaches on Pain, Maximum Mouth Opening and Disability in Temporomandibular Disorders: A Systematic Review of Randomised Controlled Trials
by Leonardo Sette Vieira, Priscylla Ruany Mendes Pestana, Júlio Pascoal Miranda, Luana Aparecida Soares, Fabiana Silva, Marcus Alessandro Alcantara and Vinicius Cunha Oliveira
Life 2023, 13(2), 292; https://doi.org/10.3390/life13020292 - 20 Jan 2023
Cited by 9 | Viewed by 3791
Abstract
Temporomandibular disorder (TMD) is a common condition disabling people and bringing up costs. The aim of this study was to investigate the effects of manual therapy on pain intensity, maximum mouth opening (MMO) and disability. Searches were conducted in six databases for randomised [...] Read more.
Temporomandibular disorder (TMD) is a common condition disabling people and bringing up costs. The aim of this study was to investigate the effects of manual therapy on pain intensity, maximum mouth opening (MMO) and disability. Searches were conducted in six databases for randomised controlled trials (RCTs). Selection of trials, data extraction and methodological quality assessment were conducted by two reviewers with discrepancies resolved by a third reviewer. Estimates were presented as mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). Quality of the evidence was assessed using the GRADE approach. Twenty trials met the eligibility criteria and were included. For pain intensity, high and moderate quality evidence demonstrated the additional effects of manual therapy at short- (95% CI −2.12 to −0.82 points) and long-term (95% CI −2.17 to −0.40 points) on the 0–10 points scale. For MMO, moderate to high quality evidence was found in favour of manual therapy alone (95% CI 0.01 to 7.30 mm) and its additional effects (95% CI 1.58 to 3.58 mm) at short- and long-term (95% CI 1.22 to 8.40 mm). Moderate quality evidence demonstrated an additional effect of manual therapy for disability (95% CI = −0.87 to −0.14). Evidence supports manual therapy as effective for TMD. Full article
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