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STUDIES CONDUCTED AT TUFTS SCHOOL OF DENTAL MEDICINE

STUDIES CONDUCTED AT TUFTS SCHOOL OF DENTAL MEDICINE. T.M.Disorders and Orofacial Pains. Maxillomandibular Relationships in TMD Patients Before and After Short Term Bite Plate Therapy. Fu, A., Mehta, N., Forgione, A. Clark, E. Hayes,C, Kugel,G.and Abdallah,E.

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STUDIES CONDUCTED AT TUFTS SCHOOL OF DENTAL MEDICINE

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  1. STUDIES CONDUCTED AT TUFTS SCHOOL OF DENTAL MEDICINE

  2. T.M.Disorders and Orofacial Pains Maxillomandibular Relationships in TMD Patients Before and After Short Term Bite Plate Therapy Fu, A., Mehta, N., Forgione, A. Clark, E. Hayes,C, Kugel,G.and Abdallah,E. J.Dent.Res. Vol 76 1997 I.A.D.R.Abst # 2363

  3. T.M.Disorders and Orofacial PainsMaxillo- mandibular relationship in TMD patients after short term bite plate therapy • Mandibular shifts in all patients. 9 subjects to the left and 11 to the right • After 4 weeks of bite plate therapy and second set of registrations taken • A binominal test performed to evaluate the rate of occurrence of mandibular shift All subjects shifted to the frenal midline position following the 4 week period ( Binomial p < 0.001 )

  4. T.M.Disorders and Orofacial PainsAppliance Therapy on Symptom Sites Effect of Appliance therapy on Specific Symptom sites on TMD: E. Abdallah, A. Aboushala, N. Mehta and A. Forgione. Presented I.A.D.R. Abst.# 1688,March 1995 Retrospective study of 55 patients of the Gelb Pain Center Only flat plane bite appliance therapy in three dimensions V.A.S. score over 8 weeks. First and fourth visit Symptom Sites were weighted by number of areas

  5. T.M.Disorders and Orofacial Pains: Update 2001 . Appliance Therapy on Symptom Sites 1st 4th

  6. T.M.Disorders and Orofacial Pains Quantitative Assessment of Head and Body Posture and Range of Neck Motion in Craniomandibular Disorders Patients and Asymptomatic Women Wu.H, Mehta. N, Forgione,A. Clark.E, and El- Bermani.W J Dent Res. Vol. 75,1996 Abst. # 1608

  7. T.M.Disorders and Orofacial PainsQuantitive Assessment of Posture and Cervical Function • To find if differences exist between head, body posture, leg length and neck function in symptomatic CMD female patients and asymptomatic female controls. • To assess differences in muscle pain and headaches in the two groups

  8. T.M.Disorders and Orofacial Pains Quantitive Assessment of Posture and Cervical Function • Static head posture, shoulder and pelvic balance as well as neck ROM evaluated • Light emitting diodes and a computer assisted video digitizing posture analysis system used • Muscle palpation and questionnaires

  9. T.M.Disorders and Orofacial PainsQuantitive Assessment of Posture and Cervical Function • 40 female subjects. Ages 18 -55 • 20 CMD with chronic orofacial pain and headaches. 3 or more a month. • 20 age matched asymptomatic controls • No history of trauma in past 10 month

  10. T.M.Disorders and Orofacial PainsQuantitive Assessment of Posture and Cervical Function • CMD patients had significantly more foreword head posture than controls (P<0.001) • CMD patients had significantly more pelvis imbalance than controls (P< 0.001) • CMD patients had more functional leg length discrepancy than controls.(P<0.017) • CMD patients had significantly less cervical ROM in all movements than the controls. (P<0.001) • CMD patients had multiple muscle pains in masticatory and cervical muscles and significantly more headaches than controls.( 8.8 a month)

  11. T.M.Disorders and Orofacial Pains Effect of intraoral Appliances on neck flexures in deep bite patients EFFECT OF VERTICAL DIMENSION AND MANDIBULAR POSITION ON ISOMETRIC STRENGTH OF THE CERVICAL FLEXURES AL - ABBASI , H . , MEHTA , N . R . , FORGIONE , A . , CLARK , E . J. of Cranio. Vol 17 # 2: April 1999

  12. T.M.Disorders and Orofacial PainsEffect of intraoral Appliances on neck flexures in deep bite patients Mean Peak Strength of neck flexors biting with or without Intra-oral appliance (N=15)

  13. T.M.Disorders and Orofacial Pains Effect of Altering Vertical Dimension of Occlusion on Isometric Strength of Cervical Flexors and Deltoid Muscles in a Normal Female Group Chafka. A, Mehta.N, Kugel. G, Hayes, C. Forgione, A J. Dent. Res. Vol 77Special issue 1998 Abst # 735

  14. T.M.Disorders and Orofacial Pains Effect of Altering Vertical Dimension of Occlusion on Isometric Strength of Cervical Flexors and Deltoid Muscles in a Normal Female Group 20 female staff and students 20 – 40 years of age Full complement of teeth , no major restorative, no TMJ Deep Bite Subjects as assessed by anterior incisal overlap All subjects had 2,4,6,10mm acrylic bite plates in same occlusal position by mounting in C.O. on a Whipmix Assigned to groups randomly. Two independent examiners Testing pre (habitual), with height and post (habitual) Cervical muscle and Deltoids tested with Kinesiometer

  15. T.M.Disorders and Orofacial Pains

  16. T.M.Disorders and Orofacial Pains

  17. T.M.Disorders and Orofacial Pains ABOUSHALA ,A., MEHTA, N., FORGIONE, A.,KUGEL,G.,CHAPMAN, R.,CLARK,E. EFFECT OF VERTICAL DIMENSION ON STERNOCLEIDOMASTOID STRENGTH IN DENTURE PATIENTS J. Dent. Res, Vol 77 IADR Abst# 456, 1998

  18. T.M.Disorders and Orofacial PainsVertical Dimension and SCM strength in Complete Denture patients Means of Isometric Strengths of Cervical Flexors ( kg )

  19. T.M.Disorders and Orofacial PainsVertical Dimension and SCM strength in Complete Denture patients Means and Standard Deviations of Resistance ( Kg ) of the Cervical Flexors in six conditions

  20. Treatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective Outcomes Study N. Mehta, J. Al- Ghamdi, A. Forgione presented IADR 2000 T.M.Disorders and Orofacial Pains

  21. T.M.Disorders and Orofacial PainsTreatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective Outcomes study 524 patients selected randomly from a pool of 5000. Pain for 48 weeks. At least 3 visits. Pretreatment, penultimate and ultimate. 80% had mean of 7 visits, 20% had mean of 12 visits Assessments done by 0 to 10 V.A.S. SCL 90 and SF 36 and Chronic Graded Pain Scales for psychological 10 Symptom sites left and right sides

  22. T.M.Disorders and Orofacial PainsTreatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective outcomes study • Interdisciplinary Treatments Commonly Used • Medications .Neurological agents, muscle relaxants, anti inflammatory, narcotics, anxiolytics, antidepressants • Psychological treatments : short term , biofeedback • Physical medicine. PT., Chiropractic, OT, Osteopathic • Acupuncture, Integrative medicine , Nutritional supplements • Maxillomandibular Reorientation therapy

  23. T.M.Disorders and Orofacial PainsTreatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective outcomes study P < 0.001

  24. T.M.Disorders and Orofacial PainsTreatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective outcomes study Symptom #Patients #Improved # Same # Worse Earache 270 235 9 26 Earstuff. 246 208 17 21 TMJPain 454 403 23 28 TMJClick 384 332 21 31 FacePain 372 322 19 31 HeadPain 391 337 24 30 ArmPain/Ting 168 140 7 21 NeckPain/Stiff 399 347 19 33 Upper Back 299 247 19 33 Lower Back 245 209 17 19 P< 0.001

  25. T.M.Disorders and Orofacial PainsTreatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective outcomes study Total Number of Patients 524 Number of patients improved 488 ( 93% ) Number of Patients worse 31 Number of patients same 5 P< 0.001

  26. T.M.Disorders and Orofacial PainsTreatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective outcomes study

  27. T.M.Disorders and Orofacial PainsTreatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective outcomes study VAS Mark. O, Mehta.N. Forgione.A. Self Reported TMD Symptoms in 200 American Dental Students. IADR Abs # 826 1997

  28. T.M.Disorders and Orofacial Pains: Update 2002Treatment Effectiveness of a multidisciplinary pain center . 524 out of 5000 patients. A Retrospective outcomes study Total Number of Patients 524 Number of patients improved 488 ( 93% ) Number of Patients worse 31 Number of patients same 5 P< 0.001

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