Randomized controlled trial on physical therapy for TMJ closed lock

This study evaluated the one-year effect of physical therapy on pain and mandibular dysfunction associated with anterior disc displacement without reduction of the temporomandibular joint (closed lock). Forty-nine individuals were randomly assigned to either a physical therapy group [n = 23, mean age (SD) 34.7 (14.0) yrs] or a control group [n = 26, mean age 38.5 (15.1) yrs]. At baseline and after 3, 6, 12, 26, and 52 wks, pain and mandibular function were evaluated. All patients received extensive information about avoiding parafunctions and oral habits on all evaluation days. The physical therapy group received, in a 6-week period, 9 sessions of physical therapy, including joint mobilization, exercises, and massage, and the information on avoiding parafunctions and oral habits was repeated each time. All pain variables decreased, and all function variables increased significantly over time for both groups. The interaction between time and treatment group was not significant. Hence, physical therapy had no significant additional effect in patients with anterior disc displacement, without reduction, of the temporomandibular joint (ClinicalTrials.gov number, CT01475630)

One-year evaluation of the effect of physical therapy for masticatory muscle pain: A randomized controlled trial

Physical therapy is widely used to decrease pain and restore function in patients suffering from masticatory muscle pain. Controlled studies on its efficacy are scarce. This study evaluated the 1-year effect of a 6-week physical therapy programme in a single blind, randomized, controlled trial. Fifty-three subjects were randomly assigned to either a physical therapy group [n = 26; 19 women, mean age (SD) 36.6 years (15.5 years)] or a control group [n = 27; 20 women, mean age (SD) 42.9 years (15.1 years)]. In the physical therapy group, the patients received education, muscle stretching, exercises and homework for nine treatments in 6 weeks. In the control group, the patients received education on the evaluation days only. At baseline and after 3, 6, 12, 26 and 52 weeks, pain and masticatory function were evaluated using visual analogue scales, the McGill Pain Questionnaire, pressure pain thresholds of the masseter and temporalis muscles, the mandibular function impairment questionnaire, and active and passive maximal mouth opening. All pain rating variables decreased and all function variables increased significantly over time in both groups. No significant differences in improvement between the groups (time-treatment interaction) were found. These data suggest that the long-term decrease in pain and the improvement of function are not related to active physical therapy

Diagnostic accuracy of temporomandibular disorder pain tests: a multicenter study

AIMS: To estimate the diagnostic accuracy of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) clinical examination and of the dynamic/static tests for the recognition of TMD pain. Since the diagnosis of TMD pain is especially complicated in persistent orofacial pain patients, the test outcomes in persistent TMD pain patients were contrasted to those in two control groups: a group of persistent dental pain patients and a group of pain-free subjects. METHODS: In 125 persistent TMD pain patients, 88 persistent dental pain patients, and 121 pain-free subjects, a blind and standardized clinical examination was performed. RESULTS: For the RDC/TMD, sensitivity (88%) was high and specificity was low (pain-free group: 71%; dental pain group: 45%). For the dynamic/static tests, sensitivity was 65% and specificities were 91% and 84%, respectively. Comparing the outcomes of the two examinations showed higher positive likelihood ratios for dynamic/static tests (P < .001), and lower negative likelihood ratios for the RDC/TMD examination (P < .01). CONCLUSION: For the confirmation of a suspicion of TMD pain, it is better to rely on positive dynamic/static tests. To confirm the absence of TMD pain, it is better to rely on a negative RDC/TMD examination

Diagnostic accuracy of temporomandibular disorder pain tests: a multicenter study.

To estimate the diagnostic accuracy of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) clinical examination and of the dynamic/static tests for the recognition of TMD pain. Since the diagnosis of TMD pain is especially complicated in persistent orofacial pain patients, the test outcomes in persistent TMD pain patients were contrasted to those in two control groups: a group of persistent dental pain patients and a group of pain-free subjects.In 125 persistent TMD pain patients, 88 persistent dental pain patients, and 121 pain-free subjects, a blind and standardized clinical examination was performed.For the RDC/TMD, sensitivity (88\%) was high and specificity was low (pain-free group: 71\%; dental pain group: 45\%). For the dynamic/static tests, sensitivity was 65\% and specificities were 91\% and 84\%, respectively. Comparing the outcomes of the two examinations showed higher positive likelihood ratios for dynamic/static tests (P < .001), and lower negative likelihood ratios for the RDC/TMD examination (P < .01).For the confirmation of a suspicion of TMD pain, it is better to rely on positive dynamic/static tests. To confirm the absence of TMD pain, it is better to rely on a negative RDC/TMD examination

Bureauonderzoek en inventariserend veldonderzoek Opwaardering 380kV-verbinding Diemen-Lelystad (DIM-LLS380) en Lelystad-Ens (LLS-ENS380)

diverse onderzoeken op de hoogspanningsverbinding tussen Diemen en Ens; gemeenten Diemen, Gooise Meren, Almere, Lelystad, Dronten en Noordoostpolde