Introduction. Temporomandibular disorders (TMD) is a multifactorial group of musculoskeletal disorders often with combined etiologies that demand different treatment plans. While pain is the most common reason why patients decide to seek help, TMD is not always painful. Pain is often described by patients as a headache, prompting patients to seek the help of neurologists, surgeons, and ultimately dentists. Due to the unique characteristics of this anatomical area, appropriate diagnostic tools are needed, as well as therapeutic regimens to alleviate and/or eliminate the pain experienced by patients. Aim of the Study. The aim of this study is to collect and organize information on the diagnosis and treatment of pain in TMD, through a review of the literature supplemented by our own clinical experience. Material and Methods. The study was conducted by searching scientific databases PubMed, Scopus, and Google Scholar for documents published from 2002–2022. The following keywords were used to build the full list of references: TMD, pain, temporomandibular joint (TMJ), TMJ disorders, occlusal splint, relaxing splints, physiotherapy TMD, pharmacology TMD, natural therapy TMD, diagnostic criteria for TMD, and DC/TMD. The literature review included 168 selected manuscripts, the content of which was important for pain diagnosis and clinical treatment of TMD. Results. An accurate diagnosis of TMD is the foundation of appropriate treatment. The most commonly described treatments include physiotherapy, occlusal splints therapy, and pharmacological treatment tailored to the type of TMD. Conclusions. Based on the literature review and their own experience, the authors concluded that there is no single ideal form of pain therapy for TMD. Treatment of TMD should be based on a thorough diagnostic process, including the DC/TMD examination protocol, psychological evaluation, and cone beam computer tomography (CBCT) imaging. Following the diagnostic process, once a diagnosis is established, a treatment plan can be constructed to address the patient’s complaints.
Modern high-resolution volumetric tomography, commonly known as cone beam computed tomography (CBCT), is one of the most innovative imaging techniques which can provide views of anatomical structures not attainable by conventional techniques. Magnetic field LED therapy is a physical therapy method, combining the effects of the Extremely Low Frequency-Electromagnetic Field (ELF-EMF) and high-power light radiation emitted by Light Emitting Diodes (LEDs). The method has been widely applied in the treatment and rehabilitation of complications of many medical conditions, including in dentistry. The aim of this study was to use CBCT to assess the effectiveness of the simultaneous use of electromagnetic field and LED light in the physical therapy of paranasal sinusitis. Treatments employing the electromagnetic field combined with LED light were administered to a 39-year-old female outpatient of the physiotherapy ward for rehabilitation therapy of paranasal sinusitis. Normal sinus pneumatization was restored almost completely. Reduction in the swelling of the sinus mucosa was so significant that even the pneumatization of the ethmoid bulla was restored. Physical therapy with the simultaneous use of ELF-EMF and LED light was found to be effective in the rehabilitation of the patient with paranasal sinusitis. Positive effects of the treatment were confirmed by CBCT findings.
Increased pressure on the heel apophysis is often implicated as a cause of paediatric heel pain. However, there are few reports on the causes of the increased pressure and its origin. Therefore, the aim of this study was to analyse the distribution of pressure on the feet in children with heel pain. The study included 33 paediatric patients with non-traumatic heel pain, i.e., 24 boys (73%) and 9 girls (27%), aged on average 11.2 years (±3 years). Pedobarographic diagnostics proved a decrease in the pressure on the heels in relation to the ground and the transfer of the projection of the centre of gravity to the forefoot. While standing, the average contribution of the pressure on the heel was 0.52, SD = 0.14 in children with normal and reduced weight. In overweight children, the average pressure on the heel was higher (0.60, SD = 0.08), but the small number of children with this characteristic (n = 4) did not allow conclusions to be drawn in this area. Heel underload was also demonstrated during gait. However, the assessment of this aspect requires additional observational analyses in the field of propulsion and gait phases. The reduced pressure on the heel promotes apophysis traction, causing intracanal compression. Studies have shown that the causes of apophysis traction may be postural defects (in particular, forward inclination of body posture) and overpronation of the foot, or defects in the metatarsal area.
Background. Bell’s palsy is a spontaneous paralysis of the facial nerve (i.e. cranial nerve VII). It presents with muscle weakness leading to facial asymmetry, with a drooping corner of the mouth, loss of the ability to whistle, blink, close the eyelid, purse lips or grin. The forehead on the affected side becomes smooth and the patient is not able to frown or raise eyebrows. Objective. The aim of the study was to evaluate the effect of combined electrophysical and physiotherapeutic methods on accelerating recovery from facial nerve palsy. Material and Methods. The authors describe two cases of Bell’s palsy, treated with simulta-neous application of electrophysical agents, in the form of an extremely low-frequency elec-tromagnetic field (ELF-EMF) and high-energy LED light, and physiotherapy modalities, i.e. proprioceptive neuromuscular facilitation (PNF) and kinesiotaping (KT). Results. After four weeks of electrophysical and physiotherapeutic treatments, a fully satis-factory and stable therapeutic effect was achieved. Conclusions. The interdisciplinary therapy using ELF-EMF + LED combined with PNF and KT treatments proved to be effective in accelerating recovery from facial nerve palsy. Further studies are needed to establish appropriate protocols.
Any clinical procedure in dentistry, especially one that involves a breach of tissue integrity, carries the risk of complications, which can occur in any speciality. These include: postopera-tive wound pain, tissue swelling, bleeding, redness, elevated temperature, trismus, decreased sensation as a result of nerve damage. Postoperative patient care aims to minimise the risk of complications and to treat those which have developed. To this end, we can resort to physical therapy, one of the modalities of which is light therapy, using electromagnetic wave ranges of red, infrared, yellow and ultraviolet light. Yet, it remains unclear which wavelength should be used to treat any specific disease entity and which form of therapeutic light should be used in the rehabilitation of a specific complication following dental procedures? In this study, we used the Cason CA380 infrared digital pyrometer with a laser pointer and the Fluke Ti 400 thermal imaging camera. On the basis of the tests and statistical analysis, it can be concluded that the application of light significantly increases the temperature of the irradiated facial skin surface. Irrespective of the type of light used, each was associated with an increase in temper-ature. A more pronounced increase in temperature on the facial skin surface after a given ap-plication suggests that the effect of light therapy is shallow, which is relevant to the choice of a specific light wavelength to be applied in a particular disease entity or dental complication.
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