[Purpose] The efficacy of exercise therapy in temporomandibular disorders has been recognized. Here, we present our experience with exercise therapy. [Participant and Methods] A 25-year-old female with a sudden onset of mouth opening limitation in October 2018 was admitted to our hospital in November 2018. Based on our initial findings, the patient was diagnosed with left disc derangement of the temporomandibular joint without reduction. A definitive diagnosis was established following magnetic resonance imaging in December 2018. Subsequently, range-of-motion exercises for the temporomandibular joint as passive movements and self-traction therapy as active movements were conducted. Magnetic resonance imaging was repeated 4 months after the first treatment. [Results] The temporomandibular joint disc remained in anterior dislocation during mouth opening and closing. The mouth opening joint motion was significantly improved compared to the pre-therapy range. The pain-related visual analog scale score also significantly improved. [Conclusion] The range of motion of the temporomandibular joint was improved by range-of-motion exercises for the temporomandibular joint, and was maintained and managed using self-traction therapy. Improvement of the range of motion was confirmed by magnetic resonance imaging.
In fields using functional near-infrared spectroscopy (fNIRS), there is a need for an easy-to-understand method that allows visual presentation and rapid analysis of data and test results. This preliminary study examined whether deep learning (DL) could be applied to the analysis of fNIRS-derived brain activity data. To create a visual presentation of the data, an imaging program was developed for the analysis of hemoglobin (Hb) data from the prefrontal cortex in healthy volunteers, obtained by fNIRS before and after tooth clenching. Three types of imaging data were prepared: oxygenated hemoglobin (oxy-Hb) data, deoxygenated hemoglobin (deoxy-Hb) data, and mixed data (using both oxy-Hb and deoxy-Hb data). To differentiate between rest and tooth clenching, a cross-validation test using the image data for DL and a convolutional neural network was performed. The network identification rate using Hb imaging data was relatively high (80‒90%). These results demonstrated that a method using DL for the assessment of fNIRS imaging data may provide a useful analysis system.
Background/purpose Elucidating the transmission mechanism of pain signals from the orofacial area and the corresponding modification mechanism will not only aid in the understanding of pain mechanisms but also provide useful information regarding the development of pain mitigation methods. In this study, the involvement of the pain suppression system in the trigeminal area was investigated through an analysis of the activation status over time in the prefrontal cortex using functional near-infrared spectroscopy (fNIRS). Materials and methods In 28 healthy, right-handed male volunteers (average age, 30.1 ± 4.2 years) as subjects, a mild, intermittent, acute pain stimulus was administered through the implementation of pocket probing of the gingiva surrounding the right maxillary central incisor. In the prefrontal cortex, the levels of hemoglobin (Hb) were measured using the fNIRS measurement system. Average values of both oxy-Hb and deoxy-Hb were calculated at four stages: rest stage, 20 s prior to the pain stimulus application, and three stages at 20-s intervals within 1 min of stimulation. One-way analysis of variance and multiple comparisons were used to compare representative values to investigate the changes due to pain. Results Oxy-Hb levels decreased the most during the 20 s stage directly after stimulus application. This change was seen mainly on the contralateral side, after which it returned to the resting baseline level before the stimulus application. Conclusion Our data demonstrate that in healthy males, a mechanism exists to mitigate pain involving the pain suppression system in the 20 s after feeling mild pain to the gingiva.
Purpose: Although the modern diet tends to be softer than in the past, the effects of a softer diet on temporomandibular disorders have not been clarified. Therefore, this study investigated the effects of eating soft food on the morphology and surface of the mandibular condyle by comparing mice that consumed a powder diet with mice that consumed a traditional solid diet. Methods: We used the Senescence-Accelerated Mouse Prone 8 (SAMP8) that develops degenerative joint disease of the mandibular condyle in an age-dependent manner. Thirty male SAMP8 mice were divided into three equal groups of ten: 1) Solid diet (SD) group, fed a solid diet until the age of 7 months, 2) Powder diet (PD) group, fed a powder diet until the age of 7 months, and 3) Weaning group (WG), which were weaned at 3 weeks. In the experiment, the mandibular condyle was photographed under a stereomicroscope. The condylar surface was evaluated using Chen's classification, and its morphology was image-analyzed using image J software to assess condylar length, width, area and circularity. In addition, bone mineral density (BMD) was evaluated by analyzing soft X-ray images. Results: In terms of morphology, the SD group showed significantly larger changes than the PD group and WG in condylar length, width, area, and BMD. Circularity showed increasingly large values in the order of WG>PD>SD, with significantly greater circularity in the WG as compared to the SD group. Additionally, the condylar surface did not change in the WG according to Chen's classification. However, the SD and PD groups showed significant changes. The differences between all groups were significant. Conclusions: These results show that the morphology of the mandibular condyle remains almost unchanged from that in the weaning period by feeding a powder diet, and that a powder diet tends to suppress the growth of the condyle.
We investigated the short-term effects of an exercise therapy program that combined a rangeof-motion exercise for the temporomandibular joint with self-traction therapy for patients with temporomandibular joint disorders who undergo disc displacement with reduction of the painful temporomandibular joint. [Participants and Methods] The program involved 31 patients with moderate or higher functional pain. The range-of-motion exercise for the temporomandibular joint was performed at the first visit by the therapist, and the patients were instructed to perform self-traction therapy in the morning and while bathing for the next 2 weeks, until their next visit. The maximum mouth opening distance and the visual analog scale scores at the first consultation and 2 weeks later were compared to assess the changes in pain on motion and mastication as well as the impact of the program on daily activities. [Results] All symptoms of the patients showed significant improvements after 2 weeks of starting the treatment. [Conclusion] The results of this study suggest that an exercise therapy program combining range-ofmotion exercises for the temporomandibular joint and self-traction therapy may be an effective conservative therapy for reducing the pain and obstacles experienced by patients with temporomandibular joint disorders who undergo disc displacement with reduction of the painful temporomandibular joint.
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