IntroductionTo evaluate whether the hypothesis that estrogen levels are associated with temporomandibular disorders (TMD) in humans can be confirmed or contradicted by available literature.Material and methodsA systematic review based on the content of PubMed, Scopus, and Cochrane Library databases was performed. Studies were identified using a combination of key words ‘temporomandibular disorder’ and ‘estrogen’. Nine studies were included into our review.ResultsThe relationship between estrogen levels and TMD was found in seven out of nine reviewed papers. Results from two papers suggest that a high estrogen level is associated with an increased prevalence of TMD. Five additional papers found a relationship between a low estrogen level and an increase in TMD pain. In considering the value of evidence and inconsistencies of results in the reviewed publications, we state that there is weak evidence to support the hypothesis that estrogen levels are associated with TMD.ConclusionsResults of reviewed studies were divergent and sometimes contradictory. One possible explanation is that estrogen influences TMD pain processing differently than temporomandibular joints (TMJ) structures, as shown in many animal studies. Estrogen may influence TMD pain processing differently than TMJ structures. We suggest consideration of the dual action of estrogen when planning future studies on its association with TMD.
Active myofascial trigger points (MTrPs) in masticatory muscles are associated with a reduced range of motion and muscle weakness within the stomatognathic system. However, it is hard to identify the most effective treatment technique for disorders associated with MTrPs. The objective of this study was to analyze the acute effect of the compression technique (CT) on active maximal mouth opening (MMO) and electromyographic activity of the masseter (MM) and temporalis anterior (TA) muscles in subjects with active myofascial trigger points in the MM muscles. The study group comprised 26 women (mean age 22 ± 2) with bilateral active myofascial trigger points (MTrPs) in the MM. The control group comprised 26 healthy women (mean age 22 ± 1) without the presence of MTrPs in the MM. Masticatory muscle activity was recorded in two conditions (during resting mandibular position and maximum voluntary clenching) before and after the application of the CT to the MTrPs in MM. After the CT application, a significant decrease in resting activity (3.09 μV vs. 2.37 μV, p = 0.006) and a significant increase in clenching activity (110.20 μV vs. 139.06 μV, p = 0.014) within the MM muscles were observed in the study group, which was not observed within TA muscles. Controls showed significantly higher active MMO values compared to the study group before CT (50.42 mm vs. 46.31 mm, p = 0.024). The differences between the study group after CT and controls, as well as among the study group before and after CT did not reach the assumed level of significance in terms of active MMO. The compression technique appears to be effective in the improvement of the active maximal mouth opening and gives significant acute effects on bioelectric masticatory muscle activity. Therefore, CT seems to be effective in MTrPs rehabilitation within the stomatognathic system.
This study aimed to assess the relationship between the occurrence of cervical myofascial pain with active myofascial trigger points (MTrPs) within the upper trapezius muscle and the electromyographic asymmetry index (AsI) of masticatory muscles: temporalis anterior (TA), superficial part of the masseter muscle (MM), and anterior belly of the digastric muscle (DA). The study group comprised 100 subjects (80 women and 20 men) aged 18 to 30 years (mean 23 ± 2.6 years) reporting pain in the neck muscles, diagnosed with myofascial pain with active MTrPs only within the upper trapezius muscle. The control group comprised 60 healthy, pain-free subjects (42 women and 18 men) aged 20 to 30 years (mean 22.8 ± 2.6 years) without MTrPs in the upper trapezius muscle. The palpation measurement, based on the diagnostic criteria of Travell and Simons, was used to diagnose active MTrPs. The masticatory muscle activity was recorded using an 8-channel device for surface electromyography—BioEMG IIITM. Significant differences in electromyographic patterns between the group with MTrPs in the right side of upper trapezius muscle and the control group were observed within resting activity for the AsI TA (MTrPs: 8.64 vs. controls: −3.22; p = 0.001) and AsI MM (MTrPs: 7.05 vs. controls: −2.09; p = 0.018). Controls presented different electromyographic patterns during maximum voluntary clenching with cotton rolls between teeth within masseter muscle compared to the MTrPs group (MTrPs: 9.27 vs. controls: −0.43 vs. p = 0.041). Participants with MTrPs in the left side of upper trapezius muscle presented predomination of left-sided electromyographic patterns at rest within temporalis anterior in comparison to controls (MTrPs: −19.22 vs. controls: -3.22; p = 0.001). MTrPs within the trapezius muscle may be related to asymmetry within the masticatory muscle activity, suggesting that the presence of myofascial pain within the cervical muscles plays a role in the imbalance of the stomatognathic system. A unilateral active MTrPs within the trapezius muscle may increase the sEMG activity on the same side of the temporalis anterior and masseter muscles.
The genus Alchemilla, belonging to the Rosaceae family, is a rich source of interesting secondary metabolites, including mainly flavonoids, tannins, and phenolic acids, which display a variety of biological activities, such as anti-inflammatory, antimicrobial, and antioxidant. Alchemilla species are used in traditional medicine for treatment of acute diarrhea, wounds, dysmenorrhea, and menorrhagia. In this review, we focus on the phenolic compound composition and antioxidative activity of Alchemilla species. We can assume that phytomedicine and natural products chemistry are of significant importance due to the fact that extract combinations with various bioactive compounds possess the activity to protect the human body rather than disturb damaging factors.
Introduction. Several studies analyzed the gender differences in masticatory muscle activity. Previous scientific reports indicate the predominance of the masseter muscle activity in male subjects and the predominance of the temporalis anterior in women. However, there is a lack of studies analyzing the differences in the activity of the mandibular abduction muscles between men and women. Aim. The presented study evaluated the sex differences in activity within temporalis anterior, masseter, and digastric muscle in healthy young adults. Material and methods. Thirty-six healthy young adults aged 20 to 29 years (mean 22±2.6 years) were qualified for the presented study. The subjects were divided into two equal groups (n=18) in terms of gender. The masticatory muscle activity was recorded within the temporalis anterior (TA), the superficial masseter muscle (MM), and the anterior bellies of the digastric muscle (DA). Electromyographic activity was recorded in three conditions: at rest, during maximum voluntary clenching at the intercuspal position, and during maximum voluntary clenching with cotton rolls between teeth. Results. Significant differences in electromyographic activity between the male and female group were observed within resting activity for the TA-R (Women: 1.98 µV vs. Men: 1.26 µV; p=0.000), TA-L (Women: 2.13 µV vs. Men: 1.33 µV; p=0.000), DA-R (Women: 2.17 µV vs. Men: 1.29 µV; p=0.001), DA-L (Women: 2.13 µV vs. Men: 1.37 µV; p=0.005). Moreover, significant difference in resting activity index was observed within left side (Women: -9.89 % vs. Men: 10.39%; p=0.037), and within right side during clenching with cotton rolls between teeth (Women: 9.83% vs. Men: 25.59%; p=0.016). Conclusions. Women represent higher resting sEMG activity within the temporalis anterior and digastric muscles than men. Electromyographic patterns may be influenced by gender at rest and during clenching tasks.
Introduction. There are reports in literature which indicate the connection between impacted third molars and occurrence of symptoms of craniomandibular dysfunctions and headaches. Objectives. The aim of this study was evaluation of the outcome of patients who reported specific symptoms of craniomandibular dysfunction and had impacted mandibular third molars. Materials and method. The research material consisted of 10 women who reported to the Department of Craniomandibular Disfunctions of the Medical University in Lublin, Poland, with pain and acoustic symptoms in the Temporomandibular joint (TMJ) area. During preliminary therapy, the patients used a silicone occlusal device; ionotherapy was ordered and the patients were recommended to eliminate parafunctions. Results. Clicks before treatments were present in 6 patients, after treatment with silicone occlusal device and ionotherapy with Profenid gel in 5 patients, while two years after extraction of the impacted teeth the clicks were no longer present, and differences in the presence of clicks analyses by means of the Q-Cochran test were statistically significant between examinations 1m vs.3 (Q=10.33; p<0.01) and examinations 2 vs.3 (Q=8.40; p<0.05). Conclusions. The study showed that extraction of the mandibular third molars can cause regression of some symptoms of craniomandibular disorders.
Introduction. Impairment of mandible mobility model is one of the criteria for clinical diagnosis of temporomandibular joint (TMJ) disc displacement. Objectives. Analysis of the range and pattern of the mandibular opening in patients with anterior disc displacement without reduction. Materials and method. According to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) the range and pattern of mandibular opening were analyzed in 49 patients (45 women and 4 men) with uni-and bilateral anterior disc displacement without reduction on MR imagines. Results. The average range of opening in patients with unilateral lack of disc reduction was 33.74 mm, and 28.93 mm in patients with bilateral lack of reduction. The difference between the average range of opening in both groups was statistically significant (p<0.05). Uncorrected mandibular deviation was the most frequent opening pattern in patients with unilateral lack of reduction (19 out of 35 cases). In 11 out of 14 cases with bilateral lack of reduction the straight opening pattern was found. Conclusions. TMJ disc displacement with bilateral lack of reduction during opening can cause greater opening limitation than unilateral lack of reduction. Anterior disc displacement without reduction in the MR images can clinically present with limitation of mandibular opening as well as correct range of this movement, which can cause difficulties in the clinical diagnosis of these problems.
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