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Reduction in Orthopedic Conditions through Teledontic Treatment of Pharyngorofacial Disorders
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Joseph Yousefian, Michael N. Brown
A subspecialty of dentistry which is referenced hereinafter as teledontics, treats disorders involving the teeth, temporomandibular joint (TMJ) as well as the nasopharynx, oropharynx and maxillofacial structures, referred to as pharyngorofacial disorders (POFD). POFD correctly conveys that the dysfunction is not only in the TMJ and masticatory system but involves other oral, dental, nasopharyngeal, cervical, atlantooccipital and facial bone structures. POFD encompasses temporomandibular joint disorders (TMJD or TMD) as well as sleep breathing disorders such obstructive sleep apnea (OSA) and obstructive sleep apnea syndrome (OSAS). Dental clinicians specializing in treatment of POFD are increasingly being recognized for their contribution to regenerative orthopedics.1 This chapter presents the biologic basis for why treating pharyngorofacial disorders (POFDs) is also clinically observed to alleviate musculoskeletal pain beyond the TMD, promote oxygenation to tissues, and make weight loss easier to achieve in response to standard lifestyle modifications.
Diagnosis and Management of Facial Pain
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Rajiv K. Bhalla, Timothy J. Woolford
What precipitates or is associated with the pain? Sinogenic pain is associated with adverse rhinological symptoms, but should be differentiated from trigeminal autonomic symptoms. Migraine may have preceding aura and is often associated with nausea. Trigger factors, such as certain foods, withdrawal of stress and sleep disruption, are well recognized. Cluster headaches are frequently triggered by alcohol and wake the patient. The pain of temporomandibular joint disorder is exacerbated by chewing, and that of trigeminal neuralgia and myofascial pain is provoked by trigger points.
Chronic Posttraumatic Stress
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
Primary symptoms: spinal column; general medical disorders (including cardiac); dental Temporomandibular joint disorder (TMJ); mobility and gait; dizziness and imbalance; partial seizures; sleep disorder (bad dreams); loss of stamina; muscle; dysarthria; pain; headache (lateralized and bilateral, traumatic and referred pain); visual (bilateral central scotoma, diplopia); tinnitus; autonomic (sweating, nausea, frequent urination, bowel control, hyperventilation); sexual (loss of libido, impotence); oversensitivity (heat, cold, bright light, loud sound).
Platelet rich plasma in oral and maxillofacial surgery from the perspective of composition
Published in Platelets, 2021
Eduardo Anitua, Sofía Fernández-de-Retana, Mohammad H. Alkhraisat
Temporomandibular Joint disorders are associated with chronic pain and discomfort. The injection of PRP has been previously investigated. The evidence arisen from systematic reviews and metanalyses proposed that this treatment could be effective in reducing the pain reported by patients [119,120]. In this case, all the studies, covering this application included in this review, reported to be evaluating the efficacy of P-PRP (Supplementary Table S6). First, one RCT evaluating the injection of P-PRP in comparison to hyaluronic acid demonstrated the superiority of the P-PRP in terms of pain reduction [121]. These results are in agreement with other clinical investigations found by other sources [122,123]. In contrast, two RCTs evaluating the efficacy of P-PRP in comparison to hyaluronic acid [124] or arthrocentesis [125], did not find statistically significant differences in terms of pain or maximum mouth opening. Nevertheless, in these last RCTs, the authors did not activate the P-PRP prior to its application and the description of the preparation method disagrees with the discard of leukocytes from the final product. The different results obtained with different protocols highlight the importance of evaluating the preparation protocol of PRP to allow the drawing of conclusions (Figure 3).
Effect of sagittal split ramus osteotomy on stress distribution of temporomandibular joints in patients with mandibular prognathism under symmetric occlusions
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Hedi Ma, Jingheng Shu, Quanyi Wang, Haidong Teng, Zhan Liu
Mandibular prognathism affects the facial appearance and quality of daily life negatively. It was reported that mandibular prognathism alone accounted for 43% of all mandibular deformities (Tsang et al. 1998). Sagittal split ramus osteotomy (SSRO) is the representative orthognathic surgery for patients with mandibular prognathism (Fang et al. 2007). However, postoperative complications, such as skeletal relapse, condylar absorption, and temporomandibular joint disorder (TMD), are found to occur (Martis et al. 1984; Mitsukawa et al. 2013). Inappropriate condylar positioning can lead to postoperative complications (Rebellato et al. 1999). Biomechanical studies have demonstrated that postoperative complications are related to changes in stresses in the postoperative osteotomy area and the temporomandibular joint (TMJ) (Ueki et al. 2006). Condylar positioning is related to joint spaces. The reduction in joint spaces can lead to the squeezing of the articular disc, leading to an increase in the stress levels in the TMJ and osteoarthritis (Zhang et al. 2018). This in turn may cause pain in the joint and other symptoms of TMD. Thus, it is essential to understand the biomechanical environment of TMJ to analyse the effects of SSRO on mandibular prognathism patients.
The diagnosis and management of temporal arteritis
Published in Clinical and Experimental Optometry, 2020
Melvin Lh Ling, Jason Yosar, Brendon Wh Lee, Saumil A Shah, Ivy W Jiang, Anna Finniss, Alexandra Allende, Ian C Francis
Jaw claudication occurs in up to 50 per cent of patients with TA and may be misdiagnosed as temporomandibular joint disorder (TMJD).1997 In TA, jaw claudication is caused by masseter muscle ischaemia and is characterised by pain that develops with or soon after chewing, and subsides with rest. In contrast, TMJD causes jaw pain with any movement, emphasising the difference between the mechanical and ischaemic nature of the pain.2009 Patients with jaw claudication often avoid chewy foods or meat, although this is not a distinguishing feature from TMJD.1991 In one study, 54 per cent of patients with positive temporal artery biopsies had jaw claudication compared with only three per cent who had negative biopsies.1995 Asking a patient to chew gum is a simple method of evaluating jaw claudication,2016 but in the absence of chewing gum in the clinic, the authors simply ask the patient to open and close the jaw rapidly and forcefully 20 times. Jaw claudication alone should not be used to rule in TA due to the potential morbidity associated with steroid treatment, as demonstrated in one case by the authors of mandibular osteomyelitis misdiagnosed as TA.2011