The application of intra-articulr injections for management of the consequences of disc displacement without reduction

The aim of the study was to make a comparative studies on the effectiveness of platelet rich plasma (PRP) and hyaluronic acid (HA) in intra-articular injections to the temporomandibular joints—in double blind studies application—based on the analysis of selected clinical parameters of functional effciency and the mean value of joint’s pain intensity before and after management. The study enrolled a group of 100 patients, aged 21 to 43 years, of both sexes, who came for the prosthodontic treatment. All patients had II b group of disorder according to the Research Diagnostic Criteria/Temporomandibular Disorder, and were consecutively, alternately assigned to the groups, 50 patients in each. Study group PRP was treated with intra-articular injection of platelet rich plasma and study group HA had injection with hyaluronic acid. The examination was double-blind, so that the injecting physician and the patient were not informed what kind of medicinal substance they received in the joint injection. The final selected clinical parameters did not differ statistically significantly between the groups, what means that both administered substances were effective in the repair of intra-articular structures. The results of research showed that the use of PRP and HA in intraarticular joint’s injections positively a ects in selected clinical parameters and decrease of the pain in temporomandibular joints in the case of disc displacement without reduction

Psychoeducation program on strategies for coping with stress in patients with temporomandibular joint dysfunction

Lack of educational projects in the available literature was an inspiration to develop a psychoeducational program. The objective was to provide patients with basic information on the contribution of stressors in the occurrence of temporomandibular joint dysfunction and educate on methods for coping with stress most commonly used in psychology. In the course of three meetings, patients are familiarised with the issue of experienced stress as a potential source of psychosomatic illnesses (in particular, temporomandibular joint dysfunction). Preliminary patients’ opinions, expressed through self-report methods, indicate significant usefulness of the developed psychoeducational program for the process of treatment and the quality of patients’ lives

Physiotherapy in hypomobility of temporomandibular joints

Introduction: Temporomandibular disorders (TMD) are the second most common cause of chronic pain in the human musculoskeletal system. The triad of symptoms of TMD includes: pain within the temporomandibular joint (TMJ), limitation of its mobility and crepitations. The aim of the study was to present the methods of physiotherapy and to assess its effectiveness in patients with hypomobility of temporomandibular joints. Material and Methods: 44 patients (40.2 ± 10.6 years) were examined for signs of TMD using the Manual Functional Analysis of masticatory system (MFA) questionnaire due to DC/TMD. In the above group, 20 patients showed hypomobility of TMJs and myofascial pain. They underwent a 3-week phy-siotherapy consisting of manual therapy and exercises. In the study group, linear measurements of TMJs mobility and palpation of selected masticatory muscles were performed. Pain was assessed before and after 3 weeks of therapy according to Numerical Rating Scale (NRS). Statistical processing of the data was done with STATISTICA 13 and was conducted considering significance at a p-value <0.05. Results: Significant improvement in TMJ’s mobility, which increased on average by 6.6 mm (p = 0.0005) and reducing of pain, a decrease of 3 points on average on the NRS Scale (p = 0.00002) were achieved. Conclusions: The applied physiotherapy algorithm, including manual therapy and exercises of mas-ticatory muscles, is effective in the case of improvement TMJ’s range of motion and reduction of pain in patients with hypomobility of TMJ’s

Objawy dysfunkcji układu ruchowego narządu żucia u pacjentów dorosłych z chorobami tarczycy

Wprowadzenie. Zaburzenia endokrynologiczne mają wpływ na funkcjonowanie niemalże całego organizmu. Choroby tarczycy dotyczą 2-5% społeczeństwa, częściej występują u kobiet i w wieku starszym. Cel badań. Ukazanie wpływu chorób tarczycy na objawy dysfunkcji układu ruchowego narządu żucia (URNŻ). Materiał i metodyka. Badania retrospektywne przeprowadzono na podstawie analizy 322 kart badań pacjentów Manualnej Funkcjonalnej Analizy URNŻ (MFA) w oparciu o kryteria DC/TMD, którzy poddali się fizjoterapii Stomatognatycznej na terenie Klinik Stomatologicznych w Krakowie. Grupę 44 pacjentów (40,2 ±10,6 lat) z zaburzeniami URNŻ i współwystępującymi chorobami tarczycy, podzielono na cztery podgrupy: niedoczynność tarczycy (N1=13), nadczynność tarczycy (N2=11), choroba Hashimoto (N3=11), guzki tarczycy (N4=9). Zastosowano kwestionariusz Manualnej Funkcjonalnej Analizy URNŻ (MFA) oraz kwestionariusz badania palpacyjnego mięśni głowy i szyi wg Festy. Dane zostały poddane analizie statystycznej z uwzględnieniem wskaźnika p-value 0.05). Wnioski. Choroby tarczycy mają wpływ na objawy bezpośrednie i pośrednie dysfunkcji URNŻ. Aczkolwiek nie wykazano statystycznie istotnych różnic pomiędzy rodzajami chorób tarczycy a objawami dysfunkcji URNŻ.Introduction. Endocrine disorders have influence on the functioning of almost the whole body. Thyroid diseases affect 2-5% of society, more often in women and the elderly. The aim of the study. The aim of the study was The aim of the study was The aim of the study was The aim of the study was The aim of the study was The aim of the study was The aim of the study was The aim of the study was The aim of the study was The aim of the study was The aim of the study was to present an impact of thyroid diseases on temporomanidbular disorders (TMD). Materials and methods. Research material was a retrospective medical records of 322 patients aged (40,2 ±10,6 years) with the Questionnaires of Manual Functional Analysis of masticatory system (MFA) due to DC/TMD of patients with TMD, who underwent physiotherapy for TMD in Dentists Clinic in Kraków, from November 2017 to April 2018. Fourty four (40,2 ±10,6 years) patients with TMD and cooccurring thyroid diseases was isolated and divided according to the diagnosis of thyroid disease into four groups: hypothyroidism (N1=13), hyperthyroidism (N2=11), Hashimoto’s disease (N3=11) thyroid nodules (N4=9). A questionnaire of Manual Functional Analysis of masticatory sys-tem (MFA) and a questionnaire for palpation of head and neck muscles according to Festa were used. Statistical processing of the data was conducted considering significance at a p-value 0.05). Conclusions. Thyroid diseases have some influence on signs and symptoms of TMD. However, there were no statistically significant differences between the types of thyroid diseases and the symptoms of TMD

The efficiency of anterior repositioning splints in the management of pain related to temporomandibular joint disc displacement with reduction

Background and Objective. Intra-articular temporomandibular disorders are often related to pain in the area of the temporomandibular joint, ear, and temple. The aim of the study was to investigate the efficiency of anterior repositioning splints in decreasing pain related to temporomandibular joint disc displacement with reduction. Methods. The research material consisted of 112 patients, aged 24 to 45 years, of both genders, who reported for treatment at the Consulting Room of Temporomandibular Joint Dysfunctions at the Jagiellonian University in Cracow between 2014 and 2016 due to pain in the area of the temporomandibular joint(s) and noise(s) of temporomandibular joint(s) present during jaw movements with comorbid contracture of masticatory muscles. Subjects were examined according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and, after diagnosis of painful disc displacement with reduction and masticatory muscle contracture, they were assigned randomly to either the study or control groups (56 patients in each). In the study group, we used an anterior repositioning splint on the full lower arch for about 20 hours usage over a 4-month period. In the control group, a noninvasive therapy was applied using a biostimulation laser over 12 sessions performed every second day on the area of both temporomandibular joints with mouth open and while performing muscle self-exercises with a dominant protrusive position of the mandible. Pain intensity was evaluated using the Verbal Numerical Rating Scale (VNRS) immediately before the treatment and then after 4 and 16 weeks. The obtained data were analyzed using the Mann–Whitney U test p≤0.005. Results. The VNRS values reported during the final examination for the study group were significantly lower than for the control group p=0.0004. Conclusions. The anterior repositioning splint is an efficient tool in decreasing pain related to disc displacement with reduction. This trial is registered with Clinicaltrials.gov NCT03057262

Incidence of otolaryngological symptoms in patients with temporomandibular joint dysfunctions

The functional disorders of the masticatory organ are the third stomatological disease to be considered a populational disease due to its chronicity and widespread prevalence. Otolaryngological symptoms are a less common group of dysfunction symptoms, including sudden hearing impairment or loss, ear plugging sensation and earache, sore and burning throat, difficulties in swallowing, tinnitus, and vertigo. The diagnostic and therapeutic problems encountered in patients with the functional disorders of the masticatory organ triggered our interest in conducting retrospective studies with the objective of assessing the incidence of otolaryngological symptoms in patients subjected to prosthetic treatment of the functional disorders of masticatory organ on the basis of the analysis of medical documentation containing data collected in medical interviews. Material and Methods. Retrospective study was conducted by analyzing the results of medical interviews of 1208 patients, who had reported for prosthetic treatment at the Functional Disorders Clinic of the Department of Dental Prosthetics of Jagiellonian University Medical College in Cracow between 2008 and March 14, 2014. Results. Otolaryngological symptoms were observed in 141 patients. The most common symptoms in the study group were earache and sudden hearing impairment; no cases of sudden hearing loss were experienced

Identification of biomechanical properties of temporomandibular discs

Purpose of the Paper. The study was aimed at identifying the biomechanical properties of the temporomandibular disc. Material. Experimental and model tests were conducted on ten fresh porcine temporomandibular joint discs. The average thickness of disc tissue was, accordingly, 2.77 mm for the anterior zone, 3.98 mm for the posterior, and 1.54 mm for the intermediate. The selection of research material in the form of porcine discs was due to the similarity to human discs. Methods. Discs were loaded in cycles, a temporary course with the amplitude 3 N and frequency 0.07 Hz, and growth in the load was 1 N/s. The selection of load frequency was due to real conditions of temporomandibular joint functioning during mastication. The necessary experimental research was conducted on a testing machine with a measurement range of 2.5 kN. Results. The obtained numeric calculation results indicate that the number of load cycles has a decisive impact on the limitation of energy dispersion capacity through disc tissue. This phenomenon was observed in all the studies on the disc areas. Along with the growth in load cycles, discs are stiffened, and the most significant stiffness was observed in the intermediate area. Conclusions. Based on the conducted research, it should be concluded that excessive load affecting temporomandibular joints caused by the act of mastication and occlusal forces generated during parafunction and in people with defined long-term bruxism has crucial importance on biomechanical disc properties and hence the course of temporomandibular joint conditions