The study aimed at assessing the effectiveness of the RA.DI.CA. splint in the management of temporomandibular joint disc displacement without reduction (ADDwoR) and jaw functional limitation. The authors developed a retrospective clinical study. A total of 2739 medical records were screened. One hundred and forty-one patients with chronic unilateral disc displacement without reduction and jaw limitation, treated with a multifunctional RA.DI.CA. splint, were enrolled. Temporomandibular pain, headache, familiar pain, neck pain, and emotional strain, maximum spontaneous mouth opening, and lateral excursions were evaluated at baseline (T0), after therapy (T1), and during the follow-up (T2). Descriptive statistical analysis was performed. Wilcoxon test assessed changes in symptomatology and functional aspects before and after treatment and between T1 and T2, with p < 0.05. Ninety-nine patients (70%) declared themselves “healed” from jaw functional limitation with no residual painful symptoms, 31 (22%) improved their symptoms and jaw function, 11 (8%) reported no changes compared to T0 and no one worsened. As for all parameters analyzed, the comparison between the ones before and after treatment was statistically significant (p < 0.05). The RA.DI.CA. splint proved to be highly performing and promoting functional and symptomatologic recovery, also in the medium and long term, through the restoration of the functional disc-condyle relationship and the healing of joint tissues.
Temporomandibular disorders (TMD) are functional diseases of the masticatory system; their symptoms are clicking, difficulty opening the mouth wide, ear pain, facial pain and headaches. The relationships among distress, emotional factors and TMD are well known. It was shown that patients with TMD have little awareness of their inner states and emotions, and it was found that those reporting oro-facial pain presented higher alexithymia than did asymptomatic people. Other authors confirmed that alexithymia was higher in the painful TMD group than controls. This study was aimed to evaluate whether alexithymia and its components can be considered as predisposing factors for pain severity, poor health and greater social difficulties in patients with TMD. One hundred thirty-three patients received a diagnosis of TMD and completed the 20-item Toronto Alexithymia Scale. Multiple stepwise regressions showed that alexithymia and age explained 10% of the pain and 31% of poor health and also that alexithymia explained 7% of social difficulty. A direct comparison of patients with TMD based on alexithymia revealed a higher presence of pain in alexithymic patients with TMD than in those characterised by moderate or no alexithymia. In conclusion, alexithymia partly predicts pain, poor health and social difficulties in patients with TMD. Furthermore, alexithymic patients have more pain than those with moderate or low alexithymia.
This study aims to evaluate the functional variations of the electromyographic response and clinical symptomatology in TMD patients. This study has been performed and compared before and after the application of a therapeutic protocol based on the use of an oral device working on the proper mandibular repositioning through the proprioceptive-based lingual re-education called “Lingual Ring”. Between January to December 2016, 32 TMD patients have been recruited out of a series of 321 individuals recruited at the Neurosensorial and Motorial Surgery Department, in Palermo (Italy). All the patients underwent the Surface Electromyography (sEMG) of Masseter and Temporal muscles, with different registrations at T0, T1, T2, and T3; to evaluate the variations of the Electromyographic values, it was assigned the application of the Lingual Ring as the only therapy. The study demonstrated a neat rebalancing of the EMG tracks and important improvements with the TMD related issues. The clinical responses, due to the treatment at the end of the therapeutic protocol, were: absence or reduction of muscular or articular pain; absence or reduction of articular noises; absence or reduction of the cephalalgia. Hence, significant results, both clinical and in terms of instrumental EMG, were assessed. We can affirm that the adopted methodology allowed the monitoring of the Electromyographic variation and clinical symptoms. Moreover, the usage of the “Lingual Ring device” allowed to carry out a simple and immediate therapeutic protocol that is minimally invasive, ensuring a clear rebalancing of the EMG tracks as well as the TMD related pain.
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