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The Manifestations and the Treatment of Temporomandibular Disorders in Patients with Chronic Whiplash-associated Disorders Grades 2 and 3
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Käkkirurgi.
2013 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The main aim of this project was to encircle the subtype of temporomandibular disorders (TMD) present in patients with chronic whiplash-associated disorders (WAD) and study the debut of TMD symptoms, the provoking factors and the outcome of conservative TMD treatments. The results could add to the aetiological discussion about TMD mainly as being part of chronic WAD pain or not.

The subjects were referred patients with chronic WAD at a specialized rehabilitation centre where they were diagnosed using a standardized classification of WAD diagnosing that resulted in approximately 20% WAD grade 2 and 80% WAD grade 3. In Studies I and II, a total 136 individuals with chronic WAD were found to have a significantly higher prevalence of pain associated with TMD compared to a control group of 66 general dental patients. The symptoms debuted approximately six months after the whiplash injury and were most often provoked by stress. In Study III, the effect of a therapeutic jaw exercise (TJE) program on TMD was studied over six months in patients with chronic WAD and TMD, randomized to TJE (25 subjects) or not (30 subjects). TJE had no effect on TMD. In Study IV, patients with chronic WAD and TMD were found to have a mainly myogenous origin of TMD pain. Five months of stabilisation appliance therapy (SAT) equally resulted in an almost complete perceived reduction of jaw pain and frontal headache in patients with chronic WAD and TMD (n=14) and TMD patients without WAD (n=10). In the long-term, TMD was significantly lower in patients with chronic WAD who were treated compared to patients with chronic WAD and TMD who were not treated (n=9).

TMD in patients with chronic WAD grades 2 or 3 may be the same kind of musculoskeletal disorder as in TMD patients without WAD, and not primarily part of the WAD pain. A functional TMD examination as well as assessment of perceived stress can be recommended as part of the standardized screening procedure for patients with chronic WAD grades 2 and 3. Patients with symptoms and signs of TMD could be recommended SAT. Patients with symptoms of frontal headache alone should also be considered as candidates for SAT.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2013. , s. 54
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 900
Nyckelord [en]
Temporomandibular, TMD, Muscle, Whiplash, Whiplash-associated disorders, WAD, Chronic, Prevalence, Treatment
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Käkkirurgi
Identifikatorer
URN: urn:nbn:se:uu:diva-198420ISBN: 978-91-554-8660-0 (tryckt)OAI: oai:DiVA.org:uu-198420DiVA, id: diva2:616272
Disputation
2013-05-30, Grönwallsalen, Akademiska sjukhuset, Ingång 50, 751 85 Uppsala, Uppsala, 09:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2013-05-08 Skapad: 2013-04-15 Senast uppdaterad: 2013-08-30
Delarbeten
1. Symtoms and signs of temporomandibular disorders in individuals with chronic whiplash-associated disorders
Öppna denna publikation i ny flik eller fönster >>Symtoms and signs of temporomandibular disorders in individuals with chronic whiplash-associated disorders
2004 (Engelska)Artikel i tidskrift (Refereegranskat) Published
Identifikatorer
urn:nbn:se:uu:diva-65938 (URN)
Tillgänglig från: 2008-10-17 Skapad: 2008-10-17 Senast uppdaterad: 2013-08-30
2. The precipitation of symptoms of temporomandibular disorders (TMD) in patients with chronic whiplash-associated disorders (WAD)
Öppna denna publikation i ny flik eller fönster >>The precipitation of symptoms of temporomandibular disorders (TMD) in patients with chronic whiplash-associated disorders (WAD)
2013 (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Käkkirurgi
Identifikatorer
urn:nbn:se:uu:diva-198418 (URN)
Tillgänglig från: 2013-04-15 Skapad: 2013-04-15 Senast uppdaterad: 2024-04-02
3. Effect of therapeutic jaw exercise on temporomandibular disorders in individuals with chronic whiplash-associated disorders
Öppna denna publikation i ny flik eller fönster >>Effect of therapeutic jaw exercise on temporomandibular disorders in individuals with chronic whiplash-associated disorders
2006 (Engelska)Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, nr 6, s. 341-347Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: The aim of this study was to investigate the effect of a specific therapeutic jaw exercise on the temporomandibular disorders of patients with chronic whiplash-associated disorders. MATERIAL AND METHODS: Ninety-four consecutive patients with whiplash-related conditions were referred to and accepted for a treatment period at a center for functional evaluation and rehabilitation during 2001-2002. The patients followed a program of physical therapy, occupational therapy, and pain management. At the start of their stay, they were examined by a physician specialized in rehabilitation medicine and also by a dentist who performed a functional examination of the stomatognathic system. Of the 93 patients who accepted participation in the study, 55 were diagnosed with temporomandibular disorders and chronic whiplash-associated disorders in accordance with the inclusion criteria. They were randomized into a jaw exercise group (n = 25), who performed specific therapeutic jaw exercises, and a control group (n = 30). Both groups undertook the whiplash rehabilitation program at the center. RESULTS: There were no inter- or intra-group differences in symptoms and signs of temporomandibular disorders at baseline, nor at the 3-week and 6-month follow-ups, except for an increase of maximum active mouth-opening capacity in the control group. CONCLUSIONS: In conclusion, the therapeutic jaw exercises, in addition to the regular whiplash rehabilitation program, did not reduce symptoms and signs of temporomandibular disorders in patients with chronic whiplash-associated disorders.

Nyckelord
exercise movement techniques, randomized clinical trial, temporomandibular joint disorders, whiplash injuries
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-10458 (URN)10.1080/00016350600825310 (DOI)000242333500003 ()17123910 (PubMedID)
Tillgänglig från: 2007-03-26 Skapad: 2007-03-26 Senast uppdaterad: 2023-11-13Bibliografiskt granskad
4. Stabilization appliance therapy has an equally extensive alleviating effect on jaw pain and frontal headache in patients with myogenous temporomandibular disorders (TMD), with or without chronic whiplash-associated disorders (WAD) grades 2 and 3
Öppna denna publikation i ny flik eller fönster >>Stabilization appliance therapy has an equally extensive alleviating effect on jaw pain and frontal headache in patients with myogenous temporomandibular disorders (TMD), with or without chronic whiplash-associated disorders (WAD) grades 2 and 3
2013 (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Käkkirurgi
Identifikatorer
urn:nbn:se:uu:diva-198419 (URN)
Tillgänglig från: 2013-04-15 Skapad: 2013-04-15 Senast uppdaterad: 2024-04-02

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