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Physiotherapeutic rehabilitation of adolescent patients with temporomandibular disorders

Małgorzata Pihut Elżbieta Zarzecka-Francica Andrzej Gala
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 3 | 79-90 | DOI: 10.24425/fmc.2022.142370
Keywords temporomandibular disorder physiotherapy manual therapy kinesitherapy adolescent
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Abstract

TMD is a group of pathological changes including increased tension in the masticatory muscles, pain in the muscles and/or the temporomandibular joints, abnormal range of the mandibular movement or the presence of acoustic symptoms in the joints in the form of clicking or poping. The aim of the project was to compare the effectiveness of two methods of physiotherapeutic rehabilita-tion, used in adolescent patients with temporomandibular disorders.
Material and Methods: The material consisted of 68 patients, aged 14 to 17, of both sexes, generally healthy, who came to the Dental Prosthetics Department for treatment due to pain in the masticatory muscles. Dental examination and diagnostics revealed Ia in all cases in accordance with RDC/TMD protocol. Manual therapy was performed in group I (34 people) and kinesitherapy with massage was performed in group II (34 people). Patients were allocated randomly to both groups. Contraindications were considered for both methods.
Results: Within the first study, mean values of pain intensity between group I and group II were not significantly different (6.12 and 6.24 respectively). Within the second study significantly lower VAS scores in both groups have been revealed (0.92 and 0.74 respectively). Results of the first and second study differed significantly in both groups. Similar results were obtained for the maximum abduction of the mandible.
Conclusions: The results of the conducted studies indicate a beneficial effect of the assessed phy-siotherapeutic procedures in terms of functional rehabilitation of adolescent patients with temporoman-dibular disorders.
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Authors and Affiliations

Małgorzata Pihut
1
Elżbieta Zarzecka-Francica
1
Andrzej Gala
1
  1. Prosthodontics and Orthodontics Department, Dental Institute, Jagiellonian University Medical College, Kraków, Poland

Frequency of occurrence of the pain form of the temporomandibular disorders and gender distribution

Małgorzata Pihut Agnieszka Pac Andrzej Gala
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 2 | 25-33 | DOI: 10.24425/fmc.2021.137221
Keywords temporomandibular disorders pain treatment epidemiology occurrence and frequency
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Abstract

Temporomandibular disorders includes abnormalities of the masticatory muscles, temporo-mandibular joints and the surrounding structures. The aim of the study was to carry out a retrospective assessment of the frequency of the pain form of TMD based on the analysis of medical records of patients treated at the Prosthodontics Department at Jagiellonian University in Kraków.
Material and Methods: The study included the results of a medical history and a clinical examina-tion of patients, who came for consultation at the Prosthodontics Department at Jagiellonian University in Kraków, due to pain of the masticatory muscles or/and TMJ and painless symptom of TMD like limitation of the jaw movements and joints’ sounds. Out of all the analyzed results of the examination of treated patients, a group of patients with a painless and painful TMD was selected.
Results: The study involved the results of a detailed specialized functional examination of 334 patients (210 women and 124 men), ranging from 41 to 68 years. Analysis of the results of clinical examinations conducted in all patients revealed that 161 had the painless form — SG (99 women and 62 men) and 173 patients had the pain form of the TMD — CG (111 women and 62 men). In the CG 104 patients reported mostly pain in the masticatory muscles, while the remaining (69 patients) had a history of pain in one or simultaneously two TMJs.
Conclusion: The analysis of the patients forms allows to conclude that more than half of patients seeking help are patients with the painful form of the TMD and these abnormalities occur more frequently in women than in men.
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Bibliography

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4. Echeverii H.: Evaluation of etiological factor in relation to myofascial pain dysfunction syndrome. Clinical study of 100 students of the University of Antioquia Dental School. Revista de la Facultad de Odontologia Universidad de Antioquia. 1991; 2 (2): 75–87.
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9. Martins R., Garbin C., Garcia A.R., Garbin A., Miguel N.: Stress levels and quality of sleep in subjects with temporomandibular joint dysfunction. Rev Odonto Scien. 2010; 25: 32–36.
10. Grey R., Davies S., Quayle A.: The clinical guide to temporomandibular disorders. The clinical guide series. British Dental Journal. 2003: 23–30, 55–60.
11. Osiewicz M., et al.: Research diagnostic criteria for temporomandibular disorders (RDC/TMD) — the polish version af a dual-axis system for diagnosis of TMD RDC/TMD form. J Stoma. 2013; 66 (5): 576–649.
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16. Bertolli E., de Leeuw R., Schmidt J.E., Okeson J.P., Carlson C.R.: Prevalence and impact of post- traumatic stress disorder symptoms in patients with masticatory muscle or temporomandibular joint pain: differences and similarities. J Orofac Pain. 2007; 21: 107–119.
17. Fredricson A., Khodabandehlou F., Weiner C., Naimi-Akbar A., Adami J., Resen A.: Are there early signs that predict development of temporomandibular joint disease? J Oral Sci. 2018; 60 (2): 194–200.
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Authors and Affiliations

Małgorzata Pihut
1
Agnieszka Pac
2
Andrzej Gala
1
  1. Department of Prosthodontics, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Epidemiology, Jagiellonian University Medical College, Kraków Poland

The mechanism of beneficial effect of radiofrequency therapy on masticatory muscles in temporomandibular disorders — a literature review

Michał Górnicki Andrzej Gala Małgorzata Pihut
Folia Medica Cracoviensia | 2020 | Vol. 60 | No 1 | 75-83 | DOI: 10.24425/fmc.2020.133488
Keywords radiofrequency temporomandibular disorders physiotherapy supportive treatment
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Abstract

Temporomandibular disorders (TMD) is one of the most common problem in contemporary dentistry. It is a term covering dysfunction of the masticatory muscles and the temporomandibular joints. Patients are suffering from severe pain, followed by limited mandibular opening and sounds in the temporomandibular joints during jaw movement. TMD influences the quality of life because the symptoms can become chronic and difficult to manage. Radiofrequency waves (RF) are electromagnetic waves with low energy and high frequency. They provide pain relief without causing significant damage to the nervous tissue. The RF therapy is commonly used for physiotherapeutic treatment of skeletal muscle relaxation, as a supportive therapy. The rehabilitation effect of these waves is based on diathermy by means of high-voltage quick alternating current. RF has also found application in physical therapy, as a therapeutic tool for various types of chronic pain syndromes. The aim of this literature review is to show the beneficial effect of radiofrequency waves on the pain of the masticatory muscles in the course of TMD.

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Authors and Affiliations

Michał Górnicki
Andrzej Gala
Małgorzata Pihut

Psychoemotional disturbance in adult patients with temporomandibular disorders. Research article

Małgorzata Pihut Magdalena Krasińska-Mazur Joanna Biegańska-Banaś Andrzej Gala
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 1 | 57-65 | DOI: 10.24425/fmc.2021.137213
Keywords temporomandibular disorder psychological factor stress anxiety depression psychological management medical interview
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Abstract

Temporomandibular disorders (TMD) encompass a diverse group of abnormalities in the functioning of the masticatory muscles, temporomandibular joints, and surrounding structures within the facial skull. One of the important etiological factors, contributing to the development of TMD are psychoemotional disorders, which include: depression, dysthymia, personality disorders, panic attacks as well as states and anxiety neuroses.
The aim of the study was to carry out a retrospective evaluation of the occurrence of psychoemotional disorders reported in the application form of medical interview of patients treated at the Consulting Room of Temporomandibular Disorders in Dental Institute (University Dental Clinic) for TMD.
The research material consisted of a subjective survey according to the protocol of the RDC/TMD questionnaire, axis II, of the 360 patients (224 women, 136 men), aged 19 to 43 who came to the University Dental Clinic in Krakow due to TMD management.
Result: The results of the conducted studies indicate the common occurrence of emotional disorders in the group of patients treated for TMD, both in the group of muscular and joint form of dysfunctions. The most often the patients selected: loss of sexual interest or pleasure, crying easily, feeling lonely, indifference to every-thing and feeling of worthlessness. These aspects show a significant influence of emotional factors on TMD.
Conclusion: The results of the conducted research indicate a significant frequencies of psychological and emotional disturbances reported in a survey among patients with TMD. Key
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Authors and Affiliations

Małgorzata Pihut
1
Magdalena Krasińska-Mazur
1
Joanna Biegańska-Banaś
2
Andrzej Gala
1
  1. Consulting Room of Temporomandibular, Disorders, Dental Institute, Prosthodontics Department, Jagiellonian University Medical College, Kraków, Poland
  2. Institute of Nursing and Midwifery, Department of Health Psychology, Jagiellonian University Medical College, Kraków, Poland

Risk factors for the development of temporomandibular disorders related to the work environment — a literature review and own experience

Małgorzata Pihut Magdalena Orczykowska Andrzej Gala
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 3 | 43-49 | DOI: 10.24425/fmc.2022.142367
Keywords temporomandibular disorders TMD work environment pain of the temporomandibular joints stress emotional tension
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Abstract

This article characterizes the etiology of temporomandibular disorder with particular emphasis on emotional factors that have a major impact on the development of these dysfunctions and the most common their symptoms. They mainly affect people in the third and fourth decade of life and women predominate among this group of patients.
The article analyzes the current literature (Pub Med Database, Scopus and EMBASE) in relation to the conditions in the work environment, which often constitute important causes of emotional tensions, constant state of mental tension and susceptibility to the effects of stressors, which have an impact on the state of functioning of the musculoskeletal system of the masticatory system.
Despite the high frequency of temporomandibular disorders, unfortunately only a few studies describe the influence of harmful factors related to the work environment, and own experience (information from the patient’s interview) and data from the literature indicate a significant share of these factors in the devel-opment of temporomandibular disorder. The relationships and anatomical connections affecting the influence of stressors on the functioning of masticatory muscles and temporomandibular joints are also discussed. In conclusion, it should be stated that the work environment and the emotional tensions generated in it constitute a serious sociological problem and increase the risk of developing and intensify the symptoms of TMD.
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Authors and Affiliations

Małgorzata Pihut
1
Magdalena Orczykowska
1
Andrzej Gala
1
  1. Prosthodontic and Orthodontic Department, Dental Institute, Jagiellonian University Medical College, Kraków, Poland

A proposal for a database of sounds generated by temporomandibular joints and a tool for automated diagnosis based on an RDC/TMD questionnaire

Justyna Grochala Marcin Kajor Małgorzata Pihut Jolanta E. Loster
Folia Medica Cracoviensia | 2023 | Vol. 63 | No 3 | 91-102 | DOI: 10.24425/fmc.2023.147216
Keywords auscultation TMJ temporomandibular joints TMJ sounds database TMD temporomandibular disorder RDC/TMD
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Abstract

The prevalence of TMD indicates a need to develop new tools that are useful in the case of screening examinations. These methods can support diagnosis at the early stage of the disorder. The purpose of this research was to develop a comprehensive tool that would function as both a database of sounds generated by TMJ and as software which facilitates automated diagnosis. The software would also use the data from the RDC/TMD questionnaire. Such a tool may significantly reduce the time spent by dentists on making manual RDC/TMD diagnoses. Moreover, this solution would enable dentists who do not specialise in TMD to make effective diagnoses. 95 patient took part in the clinical examination: 30 man and 65 females. The mean age of the participants was 33 years. Patients participating in the clinical process were examined according to the Polish version of the RDC/TMD questionnaire (Axis I and Axis II). Subsequently, all subjects were auscultated with an electronic stethoscope. An application has been im-plemented based on the RDC/TMD diagnostic flow chart. This tool was used for the automated generation of RDC/TMD diagnoses for all patients. As a result of the kind permission and participation of the patients under examination, it was possible to store records of ninety-five people. Each record contains RDC/TMD questionnaire data, auscultation signals and RDC/TMD diagnoses. For the first time, a database was created that has the potential to facilitate further examination. However, the developed system is universal and can therefore be adapted to new DC/TMD criteria.
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Authors and Affiliations

Justyna Grochala
1
Marcin Kajor
2
Małgorzata Pihut
1
Jolanta E. Loster
3
  1. Jagiellonian University Medical College, Department of Dental Prosthetics and Orthodontics, Institute of Dentistry, Kraków, Poland
  2. AGH University of Science and Technology, Department of Automatics, Computer Science and Biomedical Engineering, Faculty of Electrical Engineering, Kraków, Poland
  3. Prof. Loster’s Orthodontics, Kraków, Poland

Temporomandibular disorders and their impact on the development of the overloading changes within temporomandibular joints

Małgorzata Pihut Andrzej Gala Małgorzata Kulesa-Mrowiecka
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 4 | 45-56 | DOI: 10.24425/fmc.2022.144082
Keywords TMD temporomandibular disorder ultrasound evaluation temporomandibular joint pain disc displacement with reduction masticatory muscles
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Abstract

TMD is a disease within the masticatory system that increases its reach among the society every year in the third and fourth decade of life. The etiology of TMD is complex and it is often difficult to establish the cause in a specific case. The aim of the study was to determine the impact of TMD on pathomorphological changes within the temporomandibular joints, evaluated in USG examinations and evaluation the assessment of differences in the number of pathological changes between various forms of TMD.
Material and Methods: The study material included a group of 386 patients, both sexes, aged 20 to 46 years, who came for prosthetic treatment due to symptoms of TMD. Ultrasound examination of the temporomandibular joints supplemented the clinical diagnosis of TMD in all the subjects. Axis I of the DC/TMD were used.
Results: Group I included 116 women and 89 men, group II consisted of 102 women and 79 men. Pathological morphological changes in the temporomandibular joints were found in all the examined patients. The changes in soft tissue structures were significantly increased in group II, but numerous pathomorphological changes were also present in the group of patients with the muscle form of TMD.
Conclusion: The results of the conducted studies with the use of USG temporomandibular joints revealed numerous pathomorphological changes within the temporomandibular joints. This indicates the usefulness of the USG examination in additional diagnostic tests in the group of patients with TMD.
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Authors and Affiliations

Małgorzata Pihut
1
Andrzej Gala
1
Małgorzata Kulesa-Mrowiecka
2
  1. Prosthodontic and Orthodontic Department, Dental Institute, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Rehabilitation in Internal Diseases, Institute of Physiotherapy, Faculty of Health Science, Jagiellonian University, Kraków, Poland

The significance of masticatory muscle’s relaxation in the treatment of the temporomandibular disorders — Review article

Małgorzata Pihut Magdalena Orczykowska Piotr Ceranowicz Ilona Korzonek Andrzej Gala
Folia Medica Cracoviensia | 2023 | Vol. 63 | No 1 | 45-52 | DOI: 10.24425/fmc.2023.145429
Keywords temporomandibular disorder TMD relaxation of the masticatory muscles botulinum toxin injection physiotherapy manual therapy exercise of masticatory muscles allotypes myosin
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Abstract

Temporomandibular disorder (TMD) is a disease of multifactorial etiology and a complex of symptoms, related to disorders of the masticatory muscles, temporomandibular joints and the surround-ing orofacial structures. One of the main problems in the course of TMD disorders is the systematic increase in the tension of the masticatory muscles (masseter muscles, temporalis and medial and lateral pterygoid muscles), what is the cause of many damages and the development of pathological conditions in the stomatognathic system.
The article discusses the differences in the structure of the masticatory and skeletal muscles, as well as the different nature and isoforms of myosin, which determines the much faster generation of contraction in the masticatory muscles and consequently easier generation of excessive, harmful tensions in the masti-catory muscles.
The article describes the causes of increased tension in the masticatory muscles and methods of their relaxation used in the basic and supportive treatment of temporomandibular disorders. The use of occlusal splints, physiotherapeutic procedures and TMD treatment with botulinum toxin type A were character-ized. A role of psychological support and the methods used for patients with TMD were emphasized.
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Authors and Affiliations

Małgorzata Pihut
1
Magdalena Orczykowska
1
Piotr Ceranowicz
2
Ilona Korzonek
3
Andrzej Gala
1
  1. Prosthodontic and Orthodontic Department Dental Institute, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Nutrition-Related Disease Prevention, Medical University of Silesia, Katowice, Poland

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