Journal of Advanced Clinical and Research Insights

1.Review Article

Definition of pain and classification of pain disorders

K. Hanoch Kumar, P. Elavarasi
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:87–90] [No. of Hits: 1319]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.112]

ABSTRACT

Pain of any origin comprises an individual’s life. The prevention and management of pain is an important aspect of health care. Psychological factors play a key role in both onset and progress of any pain disorder. In pain disorders, pain is perceived in different anatomic locations such as lower back, head region, abdomen, and chest. Abnormal signal transmission and processing in the nervous system are the legitimate explanation for this condition. Although evidence suggests that pain disorder is widely prevalent in the general population, research still fails to address numerous aspects of pain diagnosis and management. Diagnostic criteria for pain differ in various Diagnostic and Statistical Manual of Mental Disorders (DSM) such as DSM-III, DSM-III revised, DSM-IV, and DSM-IV-textual revisions; hence, a more comprehensive classification is the need of the hour. The ability to understand and investigate the pathophysiologic process underlying a disorder depends on a valid, reliable classification system and common terminology to make effective communication among the academicians, clinicians, researchers, and patients. After the classification criteria are achieved, the validity and reliability of the criteria must be analyzed. Once the criteria have proven valid and reliable, research effort can be directed toward gaining better insight into prevalence, etiology, and natural course of a given disorder, eventually leading to more effective treatment. In this review, various definitions of pain along with few diagnostic classification systems for various pain disorders have been presented.

Keywords Classification, orofacial pain, pain definitions

How to cite this article: Kumar KH, Elavarasi P. Definition of pain and classification of pain disorders. J Adv Clin Res Insights 2016;3:87-90.

2.Review Article

Functional anatomy and biomechanics of temporomandibular joint and the far-reaching effects of its disorders

Chaya M. David, P. Elavarasi
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:101–106] [No. of Hits: 8576]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.115]

ABSTRACT

The temporomandibular joint (TMJ) is pivotal in the normal functions such as mastication, speech, esthetics, and overall wellbeing. However, a thorough knowledge of this joint, its anatomy and functional biomechanics is essential for the correct analysis of several of its disorders. It is important to understand the far-reaching effects of any disorder in its anatomy, function, and the psychological impact on the patients. This article takes us through the normal anatomy and functions of the joint and a brief review of its far-reaching effects which at times may sound very vague; however, such knowledge will help to look into a new arena of managing disorders of the TMJ.

Keywords Anatomy, biomechanics, temporomandibular disorders, temporomandibular joint

How to cite this article: David CM, Elavarasi P. Functional anatomy and biomechanics of temporomandibular joint and the far-reaching effects of its disorders. J Adv Clin Res Insights 2016;3:101-106.

3.Case Report

Diagnostic tests for temporomandibular disorders 81

Prafulla Thumati
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:81–86] [No. of Hits: 456]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.111]

ABSTRACT

Etiology and treatment of temporomandibular disorders (TMDs) have two schools of thought; one depends on the Axis I (physical/functional) and the other is on Axis II (biopsychosocial) as per the research diagnostic criteria for TMDs. TMDs are a group of musculoskeletal disorders affecting the structure and/or function of the temporomandibular joints (TMJ), masticatory muscles, dentition, and supporting structures.
The initial TMD diagnosis is based on history, clinical examination and imaging, if indicated. Diagnosis is greatly enhanced with physiologic measurement devices providing objective measurements of the functional status of the masticatory system: TMJ’s, muscles, and dental occlusion. Dental occlusion may have a significant role in TMD. Therefore, the majority of dentists treating TMD believe occlusion plays a major role.
Initially, reversible TMD treatment leading to healthy masticatory muscle function and a stable occlusion is most often successful. This is accomplished using objective measurement technologies such as T-scan (digital analysis of occlusion), joint vibratography, electromyography (EMG), joint tracker, and ultra low frequency Transcutaneous Electrical Nerve Stimulation (TENS). Literature substantiates the scientific validity of the physical/functional basis of TMD, the efficacy of measurement devices and TENS. A scientific basis for TMD diagnosis and treatment is presented to help the clinician to diagnose the situation before planning any treatment.

Keywords Disclusion time, disclusion time reduction, immediate complete anterior guidance development enameloplasty, myofascial pain, T-scan/BioEMG III

How to cite this article: Thumati P. Diagnostic tests for temporomandibular disorders. J Adv Clin Res Insights 2016;3:81-86.

4.Review Article

The management of temporomandibular disorder using occlusal splint therapy and bio-behavioral therapy

Darshana Sachin Nayak
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:94–100] [No. of Hits: 3170]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.114]

ABSTRACT

Temporomandibular disorder (TMD) is a collective term that includes a number of clinical complaints involving the muscles of mastication, the temporomandibular joint, and associated orofacial structures. Diagnosing orofacial pain can be quite difficult as patients may have multiple pain complaints and often present with a confusing constellation of signs and symptoms. Management of TMD is based on certain basic principles that include the formulation of an accurate diagnosis, gradual escalation of therapy, restraining from irreversible forms of treatment and the psychophysiological aspects of the disease. A multidisciplinary model that includes patient awareness and self-care, cognitive behavioral intervention, occlusal splint therapy (OST) is endorsed for the management of most patients. The current article reviews the management of TMD by the OST and bio-behavioral therapies.

Keywords Bio-behavioral therapy, occlusal splint therapy, temporomandibular disorder, temporomandibular joint

How to cite this article: Nayak DS. The management of temporomandibular disorder using occlusal splint therapy and biobehavioral therapy. J Adv Clin Res Insights 2016;3:94-100.

5.Review Article

Possible etiological factors and clinical features of TMD

Preeti Dhir
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:91–93] [No. of Hits: 857]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.113]

ABSTRACT

The temporomandibular joint (TMJ) is decisive for normal jaw function such as chewing, swallowing, speaking, oral health, and nutrition. Temporomandibular disorders (TMDs) refer to a group of disorders affecting the TMJ, masticatory muscles, and the associated structures. TMDs are considered as a multifactorial disorder. These conditions have been unable to reveal a common etiology or biological basis in terms of apparent signs and symptoms, and hence considered a heterogeneous group of health problems associated with chronic pain. These disorders share the symptoms of pain, limited mouth opening, and joint noises. The causes of TMDs range from traumatic injury to immune-mediated systemic disease to neoplastic growth to incompletely understood neurobiological mechanisms. This article presents an overview of the various etiological factors, signs, and symptoms related to TMDs.

Keywords Clinical features, etiology, temporomandibular disorders, temporomandibular joint

How to cite this article: Dhir P. Possible etiological factors and clinical features in temporomandibular disorders. J Adv Clin Res Insights 2016;3:91-93.

6.Clinical Commentary

Dry needling technique in myogenous temporomandibular disorders: A clinical commentary

P. Rajkannan
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:107–109] [No. of Hits: 3032]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.116]

ABSTRACT

Dry needling technique has gained huge popularity in recent years, and physical therapists (PTs) all around the globe are keen to learn this technique. Dry needling is a skilled intervention provided by PTs that uses a monofilament needle to advance into the skin and to treat the underlying myofascial trigger points (MTrPs), muscular tissues, and connective tissues for neuromuscular pain and movement impairments.[1] Dry needling is certainly different from acupuncture in a very fundamental way.

How to cite this article: Rajkannan P. Dry needling technique in myogenous temporomandibular disorders: A clinical commentary. J Adv Clin Res Insights 2016;3:107-109.

7.Original Article

Attitude and awareness of temporomandibular joint disorders among general dental practitioners in Southern India

M. Shashi Kiran, E. Tatu Joy, S. Vidya, Sowmya Krishna, Sushmini Hegde
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:72–75] [No. of Hits: 668]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.109]

ABSTRACT

Aim: To evaluate the awareness of diagnosis and management of temporomandibular disorders (TMDs) among general dental practitioners and to understand their attitude toward the relevance of these disorders.

Materials and Methods: A questionnaire containing 17 questions regarding etiology, signs and symptoms, investigations and management of temporomandibular joint disorders and about the relevance of managing the same in routine clinical practice was answered by 100 general dental practitioners in Southern India. The results obtained were tabulated and were analyzed using non-parametric Spearman’s rank correlation and Pearson (parametric) correlations.

Results: Our study found that while clinicians were well versed with the etiologic factors responsible for TMD and their diagnosis, the domain of management of TMD was an area that needed improvement.

Conclusion: General dental practitioners could benefit from education programs aimed at highlighting the management aspect of TMD.

Keywords Attitude, awareness, dental questionnaire, temporomandibular disorders

How to cite this article: Kiran MS, David CM, Joy ET, Vidya S, Krishna S, Hegde S. Attitude and awareness of temporomandibular joint disorders among general dental practitioners in Southern India. J Adv Clin Res Insights 2016;3:72-75.

8.Case Report

Cone beam computed tomography as diagnostic modality in temporomandibular disorders: A report of four cases

Arun V. Subramaniam, Tulsi Subramaniam, Sreeja Das, Snehi Kaisar
[Year:2016] [Month:May-June] [Volume:3 ] [Number:3] [Pages No:76–80] [No. of Hits: 305]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.110]

ABSTRACT

A considerable number of people suffer from temporomandibular joint (TMJ) disorders. Detailed history and clinical examination are essential for diagnosing TMJ disorders. Diagnosis of temporomandibular disorder (TMD) is based on clinical and radiographic investigations, where the latter is an important part of the clinical diagnosis. There are varieties of imaging techniques modalities to visualize TMJ ranging that include TMJ projections such as transpharyngeal view, transcranial view, orthopantomography, and conventional tomographic sections of TMJ. The TMJ disorders are frequently associated with degenerative bone changes such as flattening, erosion, osteophytes, subchondral bone sclerosis, pseudophytes, and articular eminence pneumatization which can be challenging to detect on conventional radiographs. Due to superimposition of the anatomic structures, accurate evaluation of the TMJ by conventional radiography is limited. To overcome this limitation, advanced modalities such as magnetic resonance imaging, arthrography and conventional computed tomography (CT) have been used for TMJ imaging for evaluating the joint space and the position of the condyle within the glenoid fossa. Accurate evaluation of the TMJ by conventional radiography is limited by structure superimposition. CT has been extensively used and proven imaging modality to assess the contours of the cortical bone and TMJ dynamics for evaluating the osseous changes in TMJ; however, high cost, large radiation dose, and long scanning time pose severe limitations. Due to high spatial resolution characteristics along with comparatively low dose, cone beam CT (CBCT) is an emerging technique that is being widely used in maxillofacial imaging. It is superior to conventional radiographic techniques in detecting bony TMJ changes because it detects three-dimensionally the bony structures with accuracy and involves a very slight increase in dosage of radiation when compared with the newer digital panoramic imaging and cephalometric imaging. Hence, a study of 4 cases of TMJ disorders that have been diagnosed with the help of CBCT has been presented in this article.

Keywords Arthrography, cone beam computed tomography, flattening, erosion, osteophytes, pseudophytes, subchondral bone sclerosis, temporomandibular joint

How to cite this article: Subramaniam AV, Subramaniam T, Das S, Kaisar S. Cone beam computed tomography as diagnostic modality in temporomandibular disorders: A report of four cases. J Adv Clin Res Insights 2016;3:76-80.