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Jaw Opening (jaw + opening)
Selected AbstractsFacilitation of laryngeal mask airway insertion,Effects of remifentanil administered before induction with target-controlled propofol infusionANAESTHESIA, Issue 9 2001K. Grewal Eighty-six adult day-case patients were recruited into a prospective, randomised study and allocated to one of two groups. Patients received either intravenous remifentanil 0.3 µg.kg,1 or an equivalent volume of sodium chloride 0.9% followed by induction of anaesthesia with propofol target-controlled infusion until the effect (brain) site calculated concentration was 2 µg.ml,1. Jaw opening and ease of laryngeal mask insertion were assessed immediately after mask insertion. A higher incidence of failure of induction of anaesthesia was observed in the control group compared with the remifentanil group [15 (35%) vs. 3 (7%); p < 0.01] and addition of remifentanil significantly increased the ease and success of laryngeal mask insertion, with grade 1 (no coughing/gagging) conditions observed in 29 (68%) of the remifentanil group and 21 (49%) of the control group (p < 0.01). The doses of remifentanil and propofol used were not associated with any significant cardiorespiratory instability. In conclusion, when combined with propofol target-controlled infusion, remifentanil 0.3 µg.kg,1 facilitates laryngeal mask insertion with minimal adverse haemodynamic changes. [source] Diagnostic sub-types, psychological distress and psychosocial dysfunction in southern Chinese people with temporomandibular disordersJOURNAL OF ORAL REHABILITATION, Issue 3 2008L. T. K. LEE Summary, The study aimed to assess the distribution of temporomandibular disorders (TMD) sub-types, psychological distress and psychosocial dysfunction in southern Chinese people seeking treatment for TMD using Research Diagnostic Criteria for TMD (RDC/TMD) and investigate potential cross-cultural differences in sub-type prevalence and psychosocial impact. Eighty-seven consecutive patients (77 females; 10 males) with a mean age of 39·3 years (s.d. 12·8) newly referred to the specialist TMD clinic at the Prince Philip Dental Hospital, Hong Kong over a 20-month period took part in the study. RDC/TMD history questionnaire and clinical assessment data were used to derive Axis I and II findings. Group I muscle disorders were the most common and found in 57·5% of patients. Group II (disc displacement) disorders were found in 42·5% and 47·1% of the right and left temporomandibular joints (TMJ) respectively. Group III disorders (arthralgia/arthrosis/arthritis) were revealed in 19·5% and 23·0% of right and left TMJ's respectively. In the Axis II assessment, 42·5% of patients had moderate/severe depression scores, 59·7% had moderate/severe somatization scores and based on graded chronic pain scores 15·0% had psychosocial dysfunction (grade III and IV). While acknowledging the small sample size, the distribution of RDC/TMD Axis I and II diagnoses was fairly similar in Chinese TMD patients compared with Western and other Asian patient groups. However, in Chinese patients, myofascial pain with limited jaw opening and TMJ disc displacement with reduction were more common and a significant number experienced psychological distress and psychosocial dysfunction. The findings have implications for the management of TMD in Chinese people. [source] Short-term efficacy of physical therapy compared to splint therapy in treatment of arthrogenous TMDJOURNAL OF ORAL REHABILITATION, Issue 11 2007F. ISMAIL Summary, A prospective randomized study was carried out to evaluate the efficacy of physical therapy in addition to splint therapy on treatment outcome in patients with temporomandibular disorders (TMD) with respect to objective and subjective parameters. Twenty-six patients suffering from an arthrogenic TMD and exhibiting a painfully restricted jaw opening were randomized in two groups. Thirteen patients were treated solely with Michigan splint (group I), 13 patients received supplementary physical therapy (group II). Before treatment a clinical examination and electronic recording of jaw movements were performed and subjective pain level was evaluated by visual analogue scales. After 3 months of therapy maintenance of improvement was evaluated. Within treatment groups comparison of data before and after treatment was analysed using Wilcoxon test. Groups were compared by Mann,Withney- U test. A P -value < 0.05 was considered significant. Compared with the baseline, in both groups mandibular movement capacity increased significantly after treatment, whereas subjective pain decreased significantly (P < 0.05). Active jaw opening increased from 28.6 ± 5.8 to 35.9 ± 4.8 mm in group I and from 30.1 ± 5.4 to 40.8 ± 4.1 mm in group II. After therapy the difference of active jaw opening between groups was significant (P < 0.05). Physical therapy also gave a supplementary improvement of protrusive mandibular movement capacity during electronic registration and subjective pain level. For none of these parameters this difference between groups was significant. Physical therapy seems to have a positive effect on treatment outcome of patients with TMD. [source] Changes in jaw muscle EMG activity and pain after third molar surgeryJOURNAL OF ORAL REHABILITATION, Issue 1 2007M. ERNBERG summary, Limited jaw-opening capacity is frequently encountered following third molar surgery and may impair function. The aim of this study was to investigate the electromyographic (EMG) activity in jaw muscles after third molar surgery to obtain more insight into the mechanisms of restrictions in jaw opening. Twenty subjects were examined before, 24 h and 1 week after surgery. Ten healthy controls were subjected to the same examination at two different occasions for intersession variability. The EMG activity of the masseter and anterior digastricus muscles was recorded at different jaw positions and during maximum voluntary clenching. Pain intensity was assessed at rest and during movements. The EMG activity in the jaw muscles increased with opening level (P < 0·01), but did not change after surgery. In contrast, the EMG activity during clenching was decreased in all muscles after surgery (P < 0·05). The pain intensity after surgery increased with jaw opening level (P < 0·001), but was in general not correlated to EMG level. Pain intensity during clenching was increased after surgery (P < 0·001), but not correlated to EMG level. The EMG activity did not change between visits in the control group. In conclusion, the results indicate that third molar surgery does not influence the EMG activity in the masseter and anterior digastricus muscles during various levels of static jaw opening, but decreases the EMG activity during clenching. However, these changes are not influenced by pain intensity. The results have implications for the understanding of the phenomenon of trismus. [source] Comparative prospective study on splint therapy of anterior disc displacement without reductionJOURNAL OF ORAL REHABILITATION, Issue 7 2005M. STIESCH-SCHOLZ summary A prospective randomized study was carried out to compare the therapeutic success of two different types of splint in patients with painful anterior disc displacement of the temporomandibular joint. The patients in Group I (n = 20) received stabilization splint therapy and the patients in Group II (n = 20) pivot splint therapy. Clinical investigation of the craniomandibular system was performed before and 1, 2 and 3 months after therapy and this was accompanied by subjective evaluation by the patients of their symptoms, using a validated questionnaire with visual analogue scales (VAS). There was a significant increase in maximum jaw opening and a significant reduction in subjective pain in both groups during the course of therapy (Wilcoxon test, P < 0·05). Active jaw opening increased by a mean of 8·05 mm in the group of patients treated with a stabilization splint (Group I). The comparable figure with pivot splint therapy (Group II) was 8·26 mm. The VAS scale value in Group I was reduced by 30·54 units and in Group II by 39·36 scale units. However, neither of these differences between the groups was statistically significant (Mann,WhitneyU -test, P > 0·05). It can be concluded that both types of splint provided effective therapy in patients with anterior disc displacement. [source] Is there a greater mandibular movement capacity towards the left?JOURNAL OF ORAL REHABILITATION, Issue 4 2005Verification of an observation from 192 summary, In 1921, the German dentist Hans Wertheim reported that more individuals were able to shift the mandible more towards the left than to the right. This study analyses the deviation from symmetrical mobility of the lower jaw in either direction. Using a millimetre ruler, maximum jaw opening (MJO), maximum left laterotrusion (MLL), and maximum right laterotrusion (MRL) were recorded in 141 healthy individuals and in 141 patients with temporomandibular disorders (TMDs). For both sexes, the mean maximum movements to the left and to the right were greater in the healthy group as compared with the TMD group. Healthy subjects as well as patients were able to move the mandible more to one side. Only a minority had identical values for MLL and MRL. The majority of healthy individuals and TMD patients could move more to the left (P < 0·001). In the healthy group, the mean ratio between MJO and MLL was 5·0, and 5·5 between MJO and MRL. In the TMD group, the corresponding values were 4·6 and 6.1. The mean absolute difference between MLL and MLR (in mm) was 1·24 [95% confidence interval (CI): 0·99; 1·49] among healthy females, and 2·09 (95% CI: 1·52; 2·66) among healthy males. In the TMD group, the corresponding values were 2·62 (95% CI: 2·21; 3·04) and 2·83 (95% CI: 1·67; 4·00), respectively. From the results of our study we conclude that moderate deviations from symmetric movements (mean: 1·2 mm for women, 2·1 mm for men) appear to be the norm even in healthy individuals. [source] Symptoms and signs of temporomandibular disorders and oral parafunctions among Saudi childrenJOURNAL OF ORAL REHABILITATION, Issue 12 2003N. M. A. Farsi summary, This study aimed to record the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunctions among Saudi children. A questionnaire and a clinical examination of signs and symptoms of TMD were performed on 1940 stratified randomly selected schoolchildren. The sample was divided into three groups, 505 with primary, 737 with mixed and 734 with permanent dentition. The prevalence of TMD signs was found to be 20·7% and the most common sign of TMD was joint sounds (11·8%). The second most common sign was restricted mouth opening (5·3%). Muscle and temporomandibular joint (TMJ) pain as well as deviation upon jaw opening appeared infrequently. TMJ sounds were significantly increasing with age (P < 0·05). TMD symptoms as reported by the parents were evident in 24·2% of the returned questionnaires (1113). The most common symptoms were headache (13·6%) and pain on chewing (11·1%). The incidence of headache was found to be significantly increasing from primary to permanent dentition (P < 0·01). No sex difference in the prevalence of any symptom was reported. Nail biting was the most common oral parafunction (27·7%) while bruxism was the least common (8·4%). All parafunctions except bruxism were significantly related to age. Cheek biting and thumb sucking were reported more in females than in males. The importance of a screening examination for symptoms and signs of TMD should not be overlooked in the clinical assessment of the pediatric patient. [source] Is the superior belly of the lateral pterygoid primarily a stabilizer?JOURNAL OF ORAL REHABILITATION, Issue 6 2001An EMG study The aim of the present study was to compare the activity levels within the two bellies of the lateral pterygoid muscle between different jaw positions to test the hypothesis that the upper head is primarily a stabilizer. Electromyographic (EMG) recordings, using monopolar concentric needle electrodes, were made from 14 healthy subjects during mandibular rest position (RP), clenching in intercuspal position and jaw opening, first about 10 mm and then about 25 mm. Both bellies had very little activity during RP. The activity level of the superior belly was high during clenching and large opening (LO) with a dip during low opening degree. This pattern differed from that of the inferior belly where the activity was relatively low during clenching and then gradually increased to its highest level during LO. The results support that the lower belly is primarily a jaw opener while the superior belly acts as a stabilizer keeping the disc and condyle in a functionally stable position during clenching and jaw movements. [source] Temporomandibular joint sound evaluation with an electronic device and clinical evaluationORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 2 2001R. A. Tanzilli Sound analysis to diagnose internal derangement has received much attention as an alternative to radiographic examination. The purpose of this study was to compare findings with an electronic device (sonography) and clinical examination to magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). Twenty-three symptomatic patients (46 joints) were evaluated for this study. All patients had jaw joint pain and one or more of the following findings; limitation of jaw opening, painful mandibular movement with or without clicking or crepitation. The presence or absence of joint sounds was evaluated clinically by palpation and auscultation and with sonography. If sounds were present (clicking or crepitation) on either examination the patient was considered positive for disc displacement for that examination. Two by two tables were constructed comparing sonography and clinical examination with MRI findings. The sensitivity of the sonogram was 84% and the specificity was 33% when compared with MRI findings. The sensitivity of the clinical examination was 70% and the specificity was 40% when compared with MRI findings. This study suggests that clinical and sonographic examination has a high sensitivity (low false negative examinations) but low specificity (high false positive examinations). [source] | ||||||||||