Most often, painful internal derangement causes a reactive muscle response. This muscle response and myalgia can be treated by soft diet, heat, and massage to the affected muscles, limiting the range of motion to within the pain-free range, NSAIDs, muscle relaxants, physical therapy, and even botulinum toxin injections (e.g., Botox).
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It is important to record the findings of the extraoral and intraoral examination. This is normally done during the examination process. There are many different methods of recording results, including checklists and free text.
The procedures were approved by the Internal Review Board (IRB) of the Post-Graduate School of Orthodontics, University of Ferrara, Ferrara, Italy (Prot. #032_2016). All individuals gave their informed consent in accordance with the Helsinki Declaration and understood that they were free to withdraw from the experiment at any time.
After 12.66±15.64 therapeutic sessions, the patients experienced pain relief and improvement in MMO. After 5.90±6.08 therapeutic sessions, the acute TMD patients reported that they were free of pain at rest (endpoint); in contrast, chronic TMD patients required 16.21±17.98 therapeutic sessions before they could report a similar outcome (Table 2). After 8.73±7.44 therapeutic sessions, the patients without disc displacement reported that they were free of pain at rest; in contrast, the patients with disc displacement required 15.06±18.82 therapeutic sessions before they could report a similar outcome. No negative side effects were reported during or after LAT.
Temporomandibular joint dysfunction syndrome (TMD), is a collective term characterized by symptoms involving chewing muscles, temporomandibular joint and orofacial structures. The efficacy of low intensity laser (LLLT) Gallium arsenide, in combination with a non-steroidal anti-inflammatory drug (NSAID) was evaluated. The main objective was to evaluate the maximum mouth opening without pain (ABM), arthralgia in the joint capsule through visual analog scale (VAS), laterality, protrusion, joint noises and count of tablets ingested per group. A controlled clinical trial (double-blind-randomized) was carried out in 30 subjects, who presented DTM of arthrogenic etiology; 5 applications of LLLT were made with wavelength of 810 nm, output optical power of 100-200 mw, emission PW=Pulsed (1-10,000Hz), dose of 10 jouls-cm², time of 1.44 minutes in mouth closed and with the mouth half open. One more follow-up appointment per month. There were two groups: experimental and control group, where different variables were analyzed (ABM, laterality, protrusion, VAS and sociodemographic). In the control group, a supposed LT application (not active) was made, for later comparison. Pain-free ABM was assessed in all appointments in addition to the other clinical parameters. Repeated measures analysis was performed with mixed models. Thirty patients were included of which 28 finished the treatment, two of them were lost during follow-up. The groups were similar in all their baseline variables. There were no statistically significant differences when applying the final multiple regression analysis, in the ABM, or in any other of the clinical parameters analyzed. LT was not effective in treating arthrogenic DTM.
ABM, joint capsule (by means of VAS with millimeter ''ruler''), right and left laterality, protrusion (with vernier caliper), pathological noises (by stethoscope/number of sounds) in TMJ and count of capsules (NSAIDs) ingested for each group were evaluated. Regarding the ABM, the patient was asked to open his mouth as much as possible (without pain) and the measurement was made from incisal edge to incisal edge in the central area. The joint capsule force was digitally applied in the central-lateral part in order to find a PT, later it marked a line on a ruler, using VAS (0 to 100mm). The right and left laterality were recorded, that is; the movement of the jaw to the side to which it moves (working: right or left). A reference line was drawn in the upper central anterior teeth, going down to the lower anterior teeth on the buccal aspect, the patient was asked to bring his jaw to one side, as far as possible and another reference line was again marked with the same characteristic than the previous one, then the patient was asked to do the same, to the opposite side and marking a third line again. These lines corresponded to the laterality that were recorded. The protrusion was also registered, that is; movement carried out by the jaw when it is brought forward. A line was placed in the area of premolars from the upper to the lower, when it is in occlusion. Following this, the patient was asked to bring his jaw as far forward as possi- ble and another reference line was again marked, the distance between the lines being the recorded protrusion. The number of pathological joint noises (clicks) was recorded, using a stethoscope in the two joints, the patient was instructed to make repeated opening and closing movements. With a minimum: 0 (zero noises) and a maximum: 4 noises at the ATMs. Concerning the medication, in both cases the same presentation and dose of the NSAID (Piroxicam- 20mg tablet-oral use) was used at ''free demand'' (1 tablet every 12 hours/ maximum). The patient was monitored after finishing their treatment (in both groups) for one more months, in order to evaluate the changes produced and accumulation, if applicable. 2b1af7f3a8