Ipsilateral Molar Clenching Induces Less Pain and Discomfort than Contralateral Molar Clenching in Patients with Unilateral Anterior Disc Displacement of the Temporomandibular Joint

Kumazaki, Yohei; Kawakami, Shigehisa; Hirata, Atsutoshi; Oki, K.; Minagi, Shogo

doi:10.11607/ofph.1405

Cited by 9 publications

(9 citation statements)

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“…Disc displacements may be partial or complete, depending on their extension. Trauma, anatomy of TMJ, bruxism, stress, masticatory muscle contracture, and abnormal dental occlusion may lead to elongation of the disc ligaments and indirectly to disc displacements and excessive load within temporomandibular joints and retrodiscal tissues [ 7 , 15 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Clicking may occur in the initial, middle, and final phase of the mandible opening movement. Different studies have reported that pain is a comorbid symptom of temporomandibular joint (TMJ) disc displacement [ 7 , 8 ]. When the disc is anteriorly displaced, the ligaments of the rear disc are elongated, stretched, and damaged, and the bilaminar zone is compressed; and thus, pain can be generated.…”

Section: Introductionmentioning

confidence: 99%

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The Efficiency of Anterior Repositioning Splints in the Management of Pain Related to Temporomandibular Joint Disc Displacement with Reduction

Pihut

Górecka

Ceranowicz

et al. 2018

Pain Research and Management

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Background and Objective Intra-articular temporomandibular disorders are often related to pain in the area of the temporomandibular joint, ear, and temple. The aim of the study was to investigate the efficiency of anterior repositioning splints in decreasing pain related to temporomandibular joint disc displacement with reduction. Methods The research material consisted of 112 patients, aged 24 to 45 years, of both genders, who reported for treatment at the Consulting Room of Temporomandibular Joint Dysfunctions at the Jagiellonian University in Cracow between 2014 and 2016 due to pain in the area of the temporomandibular joint(s) and noise(s) of temporomandibular joint(s) present during jaw movements with comorbid contracture of masticatory muscles. Subjects were examined according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and, after diagnosis of painful disc displacement with reduction and masticatory muscle contracture, they were assigned randomly to either the study or control groups (56 patients in each). In the study group, we used an anterior repositioning splint on the full lower arch for about 20 hours usage over a 4-month period. In the control group, a noninvasive therapy was applied using a biostimulation laser over 12 sessions performed every second day on the area of both temporomandibular joints with mouth open and while performing muscle self-exercises with a dominant protrusive position of the mandible. Pain intensity was evaluated using the Verbal Numerical Rating Scale (VNRS) immediately before the treatment and then after 4 and 16 weeks. The obtained data were analyzed using the Mann–Whitney U test (p ≤ 0.005). Results The VNRS values reported during the final examination for the study group were significantly lower than for the control group (p=0.0004). Conclusions The anterior repositioning splint is an efficient tool in decreasing pain related to disc displacement with reduction. This trial is registered with Clinicaltrials.gov NCT03057262.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Efficiency of Anterior Repositioning Splints in the Management of Pain Related to Temporomandibular Joint Disc Displacement with Reduction

Pihut

Górecka

Ceranowicz

et al. 2018

Pain Research and Management

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“…A previous experimental study showed that biting on a rigid interference placed unilaterally in the molar region caused a frontal, upward rotation of the mandibular condyle contralateral to the interference in all subjects [11]. A recent study reported that patients with unilateral TMJ disc displacement had a higher prevalence of elicited contralateral TMJ pain when biting on a bite force transducer in the molar region [12]. Unilateral clenching in the molar region has been shown to induce a significant reduction of the TMJ joint space contralateral to the biting side [13].…”

Section: Introductionmentioning

confidence: 99%

The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia

et al. 2019

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Objective Pain in the orofacial region may originate from different structures, and one challenge for the clinician is to determine the primary origin of pain reported by the patient. In clinical practice, it is important to discriminate between a temporomandibular joint (TMJ) pain disorder and jaw muscle pain; therefore, tests that are proposed for such purposes warrant evaluation. The aim of the present study was to evaluate the outcome of a TMJ compression test in relation to a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis. Methods A study population (n = 300), randomly selected from the adult population in Västerbotten, Sweden, was examined according to the DC/TMD criteria and with a TMJ compression test. This test is comprised of forceful unilateral biting for 20 s on a wooden spatula in the first molar region. Familiar pain on the contralateral side to the clenching side was considered a positive test outcome. Results Positive contralateral outcome of the TMJ compression test was associated with an arthralgia diagnosis (B = 1.737; OR 5.7, 95% CI 3.3-9.9). This association was confounded by concurrent myalgia (B = 1.737 → B = 0.996, 42.7%). Conclusion In a general population, a negative TMJ compression test was strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD. The association between a positive TMJ compression test and a DC/TMD arthralgia diagnosis was confounded by the presence of myalgia. Clinical relevance Concurrent myalgia renders the usefulness of the TMJ compression test for predicting an arthralgia diagnosis questionable.

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“…Temporomandibular joint disc displacement with reduction (DDwR) is the most common pathology among temporomandibular disorders (TMD) 1,2) , and the dislocation of the temporomandibular joint disc is said to underlie the mechanism of TMD onset 3,4) . It has been reported that TMD patients with DDwR notice temporomandibular noise and pain due to dislocation of the temporomandibular joint disc when carrying out opening and closing movements of the mouth and masticatory movements 5,6) .…”

Section: Introductionmentioning

confidence: 99%

Short-term effects of range-of-motion exercise on temporomandibular joints of patients who undergo disc displacement with reduction of temporomandibular joint

Sakuma

Yamaguchi

Taguchi³

et al. 2021

J Phys Ther Sci

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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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Ipsilateral Molar Clenching Induces Less Pain and Discomfort than Contralateral Molar Clenching in Patients with Unilateral Anterior Disc Displacement of the Temporomandibular Joint

Abstract: Patients with unilateral ADD had fewer reports of TMJ pain and discomfort when they were molar clenching on the ipsilateral side compared to molar clenching on the contralateral side.

Cited by 9 publications

References 0 publications

The Efficiency of Anterior Repositioning Splints in the Management of Pain Related to Temporomandibular Joint Disc Displacement with Reduction

The Efficiency of Anterior Repositioning Splints in the Management of Pain Related to Temporomandibular Joint Disc Displacement with Reduction

The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia

Short-term effects of range-of-motion exercise on temporomandibular joints of patients who undergo disc displacement with reduction of temporomandibular joint

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