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The precipitation of symptoms of temporomandibular disorders (TMD) in patients with chronic whiplash-associated disorders (WAD)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
2013 (English)Article in journal (Other academic) Submitted
Place, publisher, year, edition, pages
2013.
National Category
Medical and Health Sciences
Research subject
Oral and Maxillofacial Surgery
Identifiers
URN: urn:nbn:se:uu:diva-198418OAI: oai:DiVA.org:uu-198418DiVA: diva2:616027
Available from: 2013-04-15 Created: 2013-04-15 Last updated: 2013-08-30Bibliographically approved
In thesis
1. The Manifestations and the Treatment of Temporomandibular Disorders in Patients with Chronic Whiplash-associated Disorders Grades 2 and 3
Open this publication in new window or tab >>The Manifestations and the Treatment of Temporomandibular Disorders in Patients with Chronic Whiplash-associated Disorders Grades 2 and 3
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 54 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 900
Keyword
Temporomandibular, TMD, Muscle, Whiplash, Whiplash-associated disorders, WAD, Chronic, Prevalence, Treatment
National Category
Medical and Health Sciences
Research subject
Oral and Maxillofacial Surgery
Identifiers
urn:nbn:se:uu:diva-198420 (URN)978-91-554-8660-0 (ISBN)
Public defence
2013-05-30, Grönwallsalen, Akademiska sjukhuset, Ingång 50, 751 85 Uppsala, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2013-05-08 Created: 2013-04-15 Last updated: 2013-08-30

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Klobas, Luciano

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