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Clinical crown lengthening — a case report

Weronika Lipska Marcin Lipski Małgorzata Lisiewicz Andrzej Gala Krzysztof Gronkiewicz Dagmara Darczuk Maria Chomyszyn-Gajewska
Folia Medica Cracoviensia | 2015 | No 3
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Authors and Affiliations

Weronika Lipska
Marcin Lipski
Małgorzata Lisiewicz
Andrzej Gala
Krzysztof Gronkiewicz
Dagmara Darczuk
Maria Chomyszyn-Gajewska

Risk factors for the development of temporomandibular disorders related to the work environment — a literature review and own experience

Małgorzata Pihut Magdalena Orczykowska Andrzej Gala
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 3 | 43-49 | DOI: 10.24425/fmc.2022.142367
Keywords temporomandibular disorders TMD work environment pain of the temporomandibular joints stress emotional tension
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Abstract

This article characterizes the etiology of temporomandibular disorder with particular emphasis on emotional factors that have a major impact on the development of these dysfunctions and the most common their symptoms. They mainly affect people in the third and fourth decade of life and women predominate among this group of patients.
The article analyzes the current literature (Pub Med Database, Scopus and EMBASE) in relation to the conditions in the work environment, which often constitute important causes of emotional tensions, constant state of mental tension and susceptibility to the effects of stressors, which have an impact on the state of functioning of the musculoskeletal system of the masticatory system.
Despite the high frequency of temporomandibular disorders, unfortunately only a few studies describe the influence of harmful factors related to the work environment, and own experience (information from the patient’s interview) and data from the literature indicate a significant share of these factors in the devel-opment of temporomandibular disorder. The relationships and anatomical connections affecting the influence of stressors on the functioning of masticatory muscles and temporomandibular joints are also discussed. In conclusion, it should be stated that the work environment and the emotional tensions generated in it constitute a serious sociological problem and increase the risk of developing and intensify the symptoms of TMD.
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Authors and Affiliations

Małgorzata Pihut
1
Magdalena Orczykowska
1
Andrzej Gala
1
  1. Prosthodontic and Orthodontic Department, Dental Institute, Jagiellonian University Medical College, Kraków, Poland

Physiotherapeutic rehabilitation of adolescent patients with temporomandibular disorders

Małgorzata Pihut Elżbieta Zarzecka-Francica Andrzej Gala
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 3 | 79-90 | DOI: 10.24425/fmc.2022.142370
Keywords temporomandibular disorder physiotherapy manual therapy kinesitherapy adolescent
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Abstract

TMD is a group of pathological changes including increased tension in the masticatory muscles, pain in the muscles and/or the temporomandibular joints, abnormal range of the mandibular movement or the presence of acoustic symptoms in the joints in the form of clicking or poping. The aim of the project was to compare the effectiveness of two methods of physiotherapeutic rehabilita-tion, used in adolescent patients with temporomandibular disorders.
Material and Methods: The material consisted of 68 patients, aged 14 to 17, of both sexes, generally healthy, who came to the Dental Prosthetics Department for treatment due to pain in the masticatory muscles. Dental examination and diagnostics revealed Ia in all cases in accordance with RDC/TMD protocol. Manual therapy was performed in group I (34 people) and kinesitherapy with massage was performed in group II (34 people). Patients were allocated randomly to both groups. Contraindications were considered for both methods.
Results: Within the first study, mean values of pain intensity between group I and group II were not significantly different (6.12 and 6.24 respectively). Within the second study significantly lower VAS scores in both groups have been revealed (0.92 and 0.74 respectively). Results of the first and second study differed significantly in both groups. Similar results were obtained for the maximum abduction of the mandible.
Conclusions: The results of the conducted studies indicate a beneficial effect of the assessed phy-siotherapeutic procedures in terms of functional rehabilitation of adolescent patients with temporoman-dibular disorders.
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Authors and Affiliations

Małgorzata Pihut
1
Elżbieta Zarzecka-Francica
1
Andrzej Gala
1
  1. Prosthodontics and Orthodontics Department, Dental Institute, Jagiellonian University Medical College, Kraków, Poland

Frequency of occurrence of the pain form of the temporomandibular disorders and gender distribution

Małgorzata Pihut Agnieszka Pac Andrzej Gala
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 2 | 25-33 | DOI: 10.24425/fmc.2021.137221
Keywords temporomandibular disorders pain treatment epidemiology occurrence and frequency
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Abstract

Temporomandibular disorders includes abnormalities of the masticatory muscles, temporo-mandibular joints and the surrounding structures. The aim of the study was to carry out a retrospective assessment of the frequency of the pain form of TMD based on the analysis of medical records of patients treated at the Prosthodontics Department at Jagiellonian University in Kraków.
Material and Methods: The study included the results of a medical history and a clinical examina-tion of patients, who came for consultation at the Prosthodontics Department at Jagiellonian University in Kraków, due to pain of the masticatory muscles or/and TMJ and painless symptom of TMD like limitation of the jaw movements and joints’ sounds. Out of all the analyzed results of the examination of treated patients, a group of patients with a painless and painful TMD was selected.
Results: The study involved the results of a detailed specialized functional examination of 334 patients (210 women and 124 men), ranging from 41 to 68 years. Analysis of the results of clinical examinations conducted in all patients revealed that 161 had the painless form — SG (99 women and 62 men) and 173 patients had the pain form of the TMD — CG (111 women and 62 men). In the CG 104 patients reported mostly pain in the masticatory muscles, while the remaining (69 patients) had a history of pain in one or simultaneously two TMJs.
Conclusion: The analysis of the patients forms allows to conclude that more than half of patients seeking help are patients with the painful form of the TMD and these abnormalities occur more frequently in women than in men.
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Bibliography

1. Okeson J.: Management of temporomandibular disorders and occlusion. Elsevier, 2019.
2. Branco L., Santis T., Alfaya T., Goday C., Fraqoso Y., Bussadori S.: Association between headache and temporomandibular joint disorders in children and adolescents. J Oral Scien. 2013; 55 (1): 39–43.
3. Bonjardim L., Gavido M., Pereira L., Castelo P., Garcia R.: Signs and symptoms of temporoman-dibular disorders in adolescents. Braz Oral Res. 2005; 19 (2): 93–98.
4. Echeverii H.: Evaluation of etiological factor in relation to myofascial pain dysfunction syndrome. Clinical study of 100 students of the University of Antioquia Dental School. Revista de la Facultad de Odontologia Universidad de Antioquia. 1991; 2 (2): 75–87.
5. Fillingim R.B., Ohrbach R., Greenspan J.D., Knott C., Diatchenko L., Dubner R., Bair E., Baraian C., Mack N., Slade G.D., Maixner W.: Psychological factors associated with development of TMD: The OPPERA perspective cohort study. J Pain. 2013; 14: 75–90.
6. Kleinrok M.: Temporomandibular joint dysfunctions. Czelej Editor 2012; 5–23.
7. Auerbach S., Laskin D., Frantsve L., Orr T.: Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients. J Oral Maxillofac Surg. 2001; 59: 628–633.
8. De Leeuw R., Bertoli E., Schmidt J., Carson C.: Prevalence of traumatic stressors in patient with temporomandibular disorder. J Oral Maxillofac Surg. 2005; 63 (1): 42–50.
9. Martins R., Garbin C., Garcia A.R., Garbin A., Miguel N.: Stress levels and quality of sleep in subjects with temporomandibular joint dysfunction. Rev Odonto Scien. 2010; 25: 32–36.
10. Grey R., Davies S., Quayle A.: The clinical guide to temporomandibular disorders. The clinical guide series. British Dental Journal. 2003: 23–30, 55–60.
11. Osiewicz M., et al.: Research diagnostic criteria for temporomandibular disorders (RDC/TMD) — the polish version af a dual-axis system for diagnosis of TMD RDC/TMD form. J Stoma. 2013; 66 (5): 576–649.
12. Ferreira C., Da Silva M., de Fellicio C.: Orofacial myofunctional disorder in subjects with temporo- mandibular disorder. Cranio: the journal of craniomandibular practice. 2009; 27 (4): 268–274.
13. Hirai K., Ikawa T., Shigeta Y., Shigemoto S., Ogawa T.: Evaluation of sleep bruxism with a novel designed occlusal splint. J Prosthodont Res. 2017; 61 (3): 333–343.
14. Liu F., Steinkeler A.: Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dental Clinics of North America. 2013; 57 (3): 465–479.
15. Glaros A., Williams K., Lauste L.: The role of parafunctions, emotions and stress in predicting facial pain. J Am Dent Assoc. 2005; 136: 451–458.
16. Bertolli E., de Leeuw R., Schmidt J.E., Okeson J.P., Carlson C.R.: Prevalence and impact of post- traumatic stress disorder symptoms in patients with masticatory muscle or temporomandibular joint pain: differences and similarities. J Orofac Pain. 2007; 21: 107–119.
17. Fredricson A., Khodabandehlou F., Weiner C., Naimi-Akbar A., Adami J., Resen A.: Are there early signs that predict development of temporomandibular joint disease? J Oral Sci. 2018; 60 (2): 194–200.
18. Glaros A.G., Hanson A.H., Ryen C.: Headache and oral parafunctional behaviors. Appl Psychophysiol Biofeedback. 2014; 39 (1): 59–66.
19. Pełka P., Williams S., Lipski M., Loster B.W.: Quantitation of condylar position in temporomandibular joint — A methodological study. Folia Med Cracov. 2016; 56 (4): 43–50.
20. Piech J., Pihut M., Kulesa-Mrowiecka M.: Physiotherapy in hypomobility of temporomandibular joints. Folia Med Cracov. 2020; 60 (2): 123–134.
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Authors and Affiliations

Małgorzata Pihut
1
Agnieszka Pac
2
Andrzej Gala
1
  1. Department of Prosthodontics, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Epidemiology, Jagiellonian University Medical College, Kraków Poland

The mechanism of beneficial effect of radiofrequency therapy on masticatory muscles in temporomandibular disorders — a literature review

Michał Górnicki Andrzej Gala Małgorzata Pihut
Folia Medica Cracoviensia | 2020 | Vol. 60 | No 1 | 75-83 | DOI: 10.24425/fmc.2020.133488
Keywords radiofrequency temporomandibular disorders physiotherapy supportive treatment
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Abstract

Temporomandibular disorders (TMD) is one of the most common problem in contemporary dentistry. It is a term covering dysfunction of the masticatory muscles and the temporomandibular joints. Patients are suffering from severe pain, followed by limited mandibular opening and sounds in the temporomandibular joints during jaw movement. TMD influences the quality of life because the symptoms can become chronic and difficult to manage. Radiofrequency waves (RF) are electromagnetic waves with low energy and high frequency. They provide pain relief without causing significant damage to the nervous tissue. The RF therapy is commonly used for physiotherapeutic treatment of skeletal muscle relaxation, as a supportive therapy. The rehabilitation effect of these waves is based on diathermy by means of high-voltage quick alternating current. RF has also found application in physical therapy, as a therapeutic tool for various types of chronic pain syndromes. The aim of this literature review is to show the beneficial effect of radiofrequency waves on the pain of the masticatory muscles in the course of TMD.

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Authors and Affiliations

Michał Górnicki
Andrzej Gala
Małgorzata Pihut

Temporomandibular disorders and their impact on the development of the overloading changes within temporomandibular joints

Małgorzata Pihut Andrzej Gala Małgorzata Kulesa-Mrowiecka
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 4 | 45-56 | DOI: 10.24425/fmc.2022.144082
Keywords TMD temporomandibular disorder ultrasound evaluation temporomandibular joint pain disc displacement with reduction masticatory muscles
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Abstract

TMD is a disease within the masticatory system that increases its reach among the society every year in the third and fourth decade of life. The etiology of TMD is complex and it is often difficult to establish the cause in a specific case. The aim of the study was to determine the impact of TMD on pathomorphological changes within the temporomandibular joints, evaluated in USG examinations and evaluation the assessment of differences in the number of pathological changes between various forms of TMD.
Material and Methods: The study material included a group of 386 patients, both sexes, aged 20 to 46 years, who came for prosthetic treatment due to symptoms of TMD. Ultrasound examination of the temporomandibular joints supplemented the clinical diagnosis of TMD in all the subjects. Axis I of the DC/TMD were used.
Results: Group I included 116 women and 89 men, group II consisted of 102 women and 79 men. Pathological morphological changes in the temporomandibular joints were found in all the examined patients. The changes in soft tissue structures were significantly increased in group II, but numerous pathomorphological changes were also present in the group of patients with the muscle form of TMD.
Conclusion: The results of the conducted studies with the use of USG temporomandibular joints revealed numerous pathomorphological changes within the temporomandibular joints. This indicates the usefulness of the USG examination in additional diagnostic tests in the group of patients with TMD.
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Authors and Affiliations

Małgorzata Pihut
1
Andrzej Gala
1
Małgorzata Kulesa-Mrowiecka
2
  1. Prosthodontic and Orthodontic Department, Dental Institute, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Rehabilitation in Internal Diseases, Institute of Physiotherapy, Faculty of Health Science, Jagiellonian University, Kraków, Poland

Psychoemotional disturbance in adult patients with temporomandibular disorders. Research article

Małgorzata Pihut Magdalena Krasińska-Mazur Joanna Biegańska-Banaś Andrzej Gala
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 1 | 57-65 | DOI: 10.24425/fmc.2021.137213
Keywords temporomandibular disorder psychological factor stress anxiety depression psychological management medical interview
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Abstract

Temporomandibular disorders (TMD) encompass a diverse group of abnormalities in the functioning of the masticatory muscles, temporomandibular joints, and surrounding structures within the facial skull. One of the important etiological factors, contributing to the development of TMD are psychoemotional disorders, which include: depression, dysthymia, personality disorders, panic attacks as well as states and anxiety neuroses.
The aim of the study was to carry out a retrospective evaluation of the occurrence of psychoemotional disorders reported in the application form of medical interview of patients treated at the Consulting Room of Temporomandibular Disorders in Dental Institute (University Dental Clinic) for TMD.
The research material consisted of a subjective survey according to the protocol of the RDC/TMD questionnaire, axis II, of the 360 patients (224 women, 136 men), aged 19 to 43 who came to the University Dental Clinic in Krakow due to TMD management.
Result: The results of the conducted studies indicate the common occurrence of emotional disorders in the group of patients treated for TMD, both in the group of muscular and joint form of dysfunctions. The most often the patients selected: loss of sexual interest or pleasure, crying easily, feeling lonely, indifference to every-thing and feeling of worthlessness. These aspects show a significant influence of emotional factors on TMD.
Conclusion: The results of the conducted research indicate a significant frequencies of psychological and emotional disturbances reported in a survey among patients with TMD. Key
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Authors and Affiliations

Małgorzata Pihut
1
Magdalena Krasińska-Mazur
1
Joanna Biegańska-Banaś
2
Andrzej Gala
1
  1. Consulting Room of Temporomandibular, Disorders, Dental Institute, Prosthodontics Department, Jagiellonian University Medical College, Kraków, Poland
  2. Institute of Nursing and Midwifery, Department of Health Psychology, Jagiellonian University Medical College, Kraków, Poland

The significance of masticatory muscle’s relaxation in the treatment of the temporomandibular disorders — Review article

Małgorzata Pihut Magdalena Orczykowska Piotr Ceranowicz Ilona Korzonek Andrzej Gala
Folia Medica Cracoviensia | 2023 | Vol. 63 | No 1 | 45-52 | DOI: 10.24425/fmc.2023.145429
Keywords temporomandibular disorder TMD relaxation of the masticatory muscles botulinum toxin injection physiotherapy manual therapy exercise of masticatory muscles allotypes myosin
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Abstract

Temporomandibular disorder (TMD) is a disease of multifactorial etiology and a complex of symptoms, related to disorders of the masticatory muscles, temporomandibular joints and the surround-ing orofacial structures. One of the main problems in the course of TMD disorders is the systematic increase in the tension of the masticatory muscles (masseter muscles, temporalis and medial and lateral pterygoid muscles), what is the cause of many damages and the development of pathological conditions in the stomatognathic system.
The article discusses the differences in the structure of the masticatory and skeletal muscles, as well as the different nature and isoforms of myosin, which determines the much faster generation of contraction in the masticatory muscles and consequently easier generation of excessive, harmful tensions in the masti-catory muscles.
The article describes the causes of increased tension in the masticatory muscles and methods of their relaxation used in the basic and supportive treatment of temporomandibular disorders. The use of occlusal splints, physiotherapeutic procedures and TMD treatment with botulinum toxin type A were character-ized. A role of psychological support and the methods used for patients with TMD were emphasized.
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Authors and Affiliations

Małgorzata Pihut
1
Magdalena Orczykowska
1
Piotr Ceranowicz
2
Ilona Korzonek
3
Andrzej Gala
1
  1. Prosthodontic and Orthodontic Department Dental Institute, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Nutrition-Related Disease Prevention, Medical University of Silesia, Katowice, Poland

Differential diagnosis of temporomandibular disorders — a review of the literature

Magdalena Krasińska-Mazur Paulina Homel Andrzej Gala Justyna Stradomska Małgorzata Pihut
Folia Medica Cracoviensia | 2022 | Vol. 62 | No 2 | 121-137 | DOI: 10.24425/fmc.2022.141703
Keywords differential diagnosis of TMD pain of non-dental origin chronic orofacial pain Lyme disease orofacial symptoms
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Abstract

Pain in the masticatory muscles or temporomandibular joints may in some cases be a symptom of other afflictions occurring in this region. The aim of the study was to present the differential diagnosis of temporomandibular disorders (TMD) and other diseases in the craniofacial area, based on review of the literature. Using the key words: “differential diagnosis of TMD”, “pain of non-dental origin” and “chronic orofacial pain”, PUBMED and Scopus databases were systematically searched for articles in English from 2005 to 2020. Additionally, the PUBMED database was supplementarily reviewed using the keywords “Lyme disease orofacial symptoms” for the English-language articles published in the years 1996–2020. Out of 445 publications from PUBMED and Scopus databases as well as other sources, 57 articles describ-ing the pathogenesis and characteristic symptoms of diseases that may cause pain similar to that occurring in TMD as well as diagnostic methods used in differential diagnosis of TMD were selected for analysis. Dental and jawbones-related conditions, ear and maxillary sinus diseases, as well as ailments of neuro-pathic and vascular origin, were taken into account. Neoplastic processes taking place in this region and less often occurring diseases caused by viruses, bacteria and parasites were also described. Conclusions. Correct diagnosis of temporomandibular disorders is based on medical history and thorough physical examination, as well as results of additional tests. Pain localized in the head and neck structures may have diverse, sometimes complex aetiology, and may require multidisciplinary treatment. Observation of the patient’s behaviour and — in selected cases — the results of additional laboratory tests, also play a sig-nificant role.
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Authors and Affiliations

Magdalena Krasińska-Mazur
1
Paulina Homel
1
Andrzej Gala
1
Justyna Stradomska
1
Małgorzata Pihut
1
  1. Department of Prosthodontics and Orthodontics, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland

The effect of root canal rinsing protocol on the push-out bond strength to the dentin cementation of the fiber post

Bartosz Ciapała Krzysztof Górowski Wojciech I. Ryniewicz Andrzej Gala Jolanta E. Loster
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 4 | 81-92 | DOI: 10.24425/fmc.2021.140006
Keywords fiber post rinsing protocols adhesion bonding cementation
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Abstract

Background: Studies on the effect of root canal rinsing protocols on fiber post bonding to dentin are inconclusive. This study reports investigation of this topic. Objectives: to determine effects of irrigation protocol by means of a push-out test on the strength of adhesion between the post and dentin in an in vitro study.
Materials and Method: Thirty human single-rooted teeth were prepared using hand instruments and the step-back technique, filled with gutta-percha, sealed with AH Plus (Dentsply), and divided into three groups: A: rinsed with NaCl; B: rinsed with 2% chlorhexidine (CHX); C: not rinsed before cementa-tion of posts. The fiber posts were set using RelyX and Built-it. The tooth roots were sliced and the push- out test was performed. The area of contact between the post and dentin was calculated and the destroying force was established. The results were statistically analyzed.
Results: The mean adhesive strength was 10.69 MPa in group A, 16.33 MPa in group B, and 16.72 MPa in C. The adhesive strength in group B and C was statistically significantly higher than in group A (p = 0.0016, ANOVA).
Conclusion: Rinsing root canals with CHX seems to be the most effective method prior to setting a fiber post.
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Authors and Affiliations

Bartosz Ciapała
1
Krzysztof Górowski
2
Wojciech I. Ryniewicz
2
Andrzej Gala
2
Jolanta E. Loster
2
  1. Department of Integrated Dentistry, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Dental Prosthetics and Orthodontics, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland

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