Treating Parafunctional Habits for Alleviating Temporomandibular Disorder and Lower Back Pain: A Phase II Clinical Trial
Effect of parafunctional habits on lumbar pains
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Abstract
Objectives: Temporomandibular disorders (TMDs) include a series of signs and symptoms in the temporomandibular joints (TMJ) and muscles of mastication, which are associated with or caused by parafunctional habits. Many of these patients also suffer from lumbar pains. This study aimed to evaluate the effectiveness of treating parafunctional habits in alleviating symptoms of TMD and lower back pain.
Materials and Methods: This phase II clinical trial was conducted on 136 patients suffering from TMDs and lumbar pain, who consented to participate in this study. They were provided with instructions on how to discontinue their parafunctional habits including clenching and bruxism. The Helkimo and Rolland Morris questionnaires were used to assess TMD and lower back pain, respectively. Data were statistically analyzed using paired Student's t-test, Wilcoxon, Mann-Whitney, and Spearman correlation tests, with the significance level set at P<0.05.
Results: The mean severity score of TMD significantly decreased after the intervention. Following treatment of TMD, the mean severity score of lumbar pain decreased from 8 to 2 (P=0.0001).
Conclusion: Based on our findings, it appears that the elimination of parafunctional habits improves TMD and lumbar pain.
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2. Lee KC, Wu YT, Chien WC, Chung CH, Chen LC, Shieh YS. The prevalence of first-onset temporomandibular disorder in low back pain and associated risk factors: A nationwide population-based cohort study with a 15-year follow-up. Medicine (Baltimore). 2020 Jan;99(3):e18686.
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4. Winocur E, Littner D, Adams I, Gavish A. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescents: a gender comparison. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Oct;102(4):482-7.
5. Cooper BC; International College of Cranio-Mandibular Orthopedics (ICCMO). Temporomandibular disorders: A position paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). Cranio. 2011 Jul;29(3):237-44.
6. Ingervall B. Functionally optimal occlusion: the goal of orthodontic treatment. Am J Orthod. 1976 Jul;70(1):81-90.
7. Le Bell Y, Jämsä T, Korri S, Niemi PM, Alanen P. Effect of artificial occlusal interferences depends on previous experience of temporomandibular disorders. Acta Odontol Scand. 2002 Aug;60(4):219-22.
8. Bonjardim LR, Gaviao MB, Carmagnani FG, Pereira LJ, Castelo PM. Signs and symptoms of temporomandibular joint dysfunction in children with primary dentition. J Clin Pediatr Dent. 2003 Fall;28(1):53-8.
9. Li DTS, Leung YY. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (Basel). 2021 Mar 6;11(3):459.
10. Yassaei S, ToodeZaeim M, Kargar J. The Association between Some of Parafunctional Habits with Signs of Temporomandibular Disorders in High School Girls. J Mashhad Dent Sch. 2008 Sep 22;32(3):243-52.
11. Winocur E, Gavish A, Finkelshtein T, Halachmi M, Gazit E. Oral habits among adolescent girls and their association with symptoms of temporomandibular disorders. J Oral Rehabil. 2001 Jul;28(7):624-9.
12. Pergamalian A, Rudy TE, Zaki HS, Greco CM. The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders. J Prosthet Dent. 2003 Aug;90(2):194-200.
13. Bader G, Lavigne G. Sleep bruxism; an overview of an oromandibular sleep movement disorder. REVIEW ARTICLE. Sleep Med Rev. 2000 Feb;4(1):27-43.
14. Näyhä S, Videman T, Laakso M, Hassi J. Prevalence of low back pain and other musculoskeletal symptoms and their association with work in Finnish reindeer herders. Scand J Rheumatol. 1991;20(6):406-13.
15. Hill JJ, Keating JL. Risk factors for the first episode of low back pain in children are infrequently validated across samples and conditions: a systematic review. J Physiother. 2010;56(4):237-44.
16. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992 Dec;5(4):383-9; discussion 397.
17. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et all. COST B13 Working Group on Guidelines for Chronic Low Back Pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006 Mar;15 Suppl 2(Suppl 2):S192-300.
18. Wiesinger B, Malker H, Englund E, Wänman A. Back pain in relation to musculoskeletal disorders in the jaw-face: a matched case-control study. Pain. 2007 Oct;131(3):311-319.
19. Wiesinger B, Malker H, Englund E, Wänman A. Does a dose-response relation exist between spinal pain and temporomandibular disorders? BMC Musculoskelet Disord. 2009 Mar 2;10:28.
20. Lim PF, Smith S, Bhalang K, Slade GD, Maixner W. Development of temporomandibular disorders is associated with greater bodily pain experience. Clin J Pain. 2010 Feb;26(2):116-20.
21. Kim D, Ko SG, Lee EK, Jung B. The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study. BMC Musculoskelet Disord. 2019 Dec 29;20(1):631
22. Silveira A, Armijo-Olivo S, Gadotti IC, Magee D. Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability. J Oral Facial Pain Headache. 2014 Spring;28(2):138-46.
23. Li DTS, Leung YY. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (Basel). 2021 Mar 6;11(3):459.
24. Ajanovic M, Bejtovic B. Correlation between values of the helkimo anamnestic and clinical dysfunction index in patients suffering from post traumatic stress disorder. Mater Sociomed. 2009 Apr 1;21(2):85.
25. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006 Jun 15;31(14):E454-9.
26. Kuć J, Szarejko KD, Gołębiewska M. The Prevalence and Overlaps of Temporomandibular Disorders in Patients with Myofascial Pain with Referral-A Pilot Study. Int J Environ Res Public Health. 2021 Sep 18;18(18):9842.
27. Carlsson GE, Magnusson T. Management of Temporomandibular Disorders in the General Practice.: Postgraduate textbook. Quintessence; 2000.
28. Plesh O, Adams SH, Gansky SA. Temporomandibular joint and muscle disorder-type pain and comorbid pains in a national US sample. J Orofac Pain. 2011 Summer;25(3):190-8.
29. Kafas P, Leeson R. Assessment of pain in temporomandibular disorders: the bio-psychosocial complexity. Int J Oral Maxillofac Surg. 2006 Feb;35(2):145-9.
30. Altindag O, Gur A, Altindag A. The relationship between clinical parameters and depression level in patients with myofascial pain syndrome. Pain Med. 2008 Mar;9(2):161-5.
31. Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64.
32. Halliwell B. Oxygen radicals, nitric oxide and human inflammatory joint disease. Ann Rheum Dis. 1995 Jun;54(6):505-10.
2. Lee KC, Wu YT, Chien WC, Chung CH, Chen LC, Shieh YS. The prevalence of first-onset temporomandibular disorder in low back pain and associated risk factors: A nationwide population-based cohort study with a 15-year follow-up. Medicine (Baltimore). 2020 Jan;99(3):e18686.
3. Agha-Hosseini F, Sheykhbahaei N, Mirzaii-Dizgah I, Fatehi F. The efficacy of oral habit modification on headache. J Korean Assoc Oral Maxillofac Surg. 2017 Dec;43(6):401-406.
4. Winocur E, Littner D, Adams I, Gavish A. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescents: a gender comparison. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Oct;102(4):482-7.
5. Cooper BC; International College of Cranio-Mandibular Orthopedics (ICCMO). Temporomandibular disorders: A position paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). Cranio. 2011 Jul;29(3):237-44.
6. Ingervall B. Functionally optimal occlusion: the goal of orthodontic treatment. Am J Orthod. 1976 Jul;70(1):81-90.
7. Le Bell Y, Jämsä T, Korri S, Niemi PM, Alanen P. Effect of artificial occlusal interferences depends on previous experience of temporomandibular disorders. Acta Odontol Scand. 2002 Aug;60(4):219-22.
8. Bonjardim LR, Gaviao MB, Carmagnani FG, Pereira LJ, Castelo PM. Signs and symptoms of temporomandibular joint dysfunction in children with primary dentition. J Clin Pediatr Dent. 2003 Fall;28(1):53-8.
9. Li DTS, Leung YY. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (Basel). 2021 Mar 6;11(3):459.
10. Yassaei S, ToodeZaeim M, Kargar J. The Association between Some of Parafunctional Habits with Signs of Temporomandibular Disorders in High School Girls. J Mashhad Dent Sch. 2008 Sep 22;32(3):243-52.
11. Winocur E, Gavish A, Finkelshtein T, Halachmi M, Gazit E. Oral habits among adolescent girls and their association with symptoms of temporomandibular disorders. J Oral Rehabil. 2001 Jul;28(7):624-9.
12. Pergamalian A, Rudy TE, Zaki HS, Greco CM. The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders. J Prosthet Dent. 2003 Aug;90(2):194-200.
13. Bader G, Lavigne G. Sleep bruxism; an overview of an oromandibular sleep movement disorder. REVIEW ARTICLE. Sleep Med Rev. 2000 Feb;4(1):27-43.
14. Näyhä S, Videman T, Laakso M, Hassi J. Prevalence of low back pain and other musculoskeletal symptoms and their association with work in Finnish reindeer herders. Scand J Rheumatol. 1991;20(6):406-13.
15. Hill JJ, Keating JL. Risk factors for the first episode of low back pain in children are infrequently validated across samples and conditions: a systematic review. J Physiother. 2010;56(4):237-44.
16. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992 Dec;5(4):383-9; discussion 397.
17. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et all. COST B13 Working Group on Guidelines for Chronic Low Back Pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006 Mar;15 Suppl 2(Suppl 2):S192-300.
18. Wiesinger B, Malker H, Englund E, Wänman A. Back pain in relation to musculoskeletal disorders in the jaw-face: a matched case-control study. Pain. 2007 Oct;131(3):311-319.
19. Wiesinger B, Malker H, Englund E, Wänman A. Does a dose-response relation exist between spinal pain and temporomandibular disorders? BMC Musculoskelet Disord. 2009 Mar 2;10:28.
20. Lim PF, Smith S, Bhalang K, Slade GD, Maixner W. Development of temporomandibular disorders is associated with greater bodily pain experience. Clin J Pain. 2010 Feb;26(2):116-20.
21. Kim D, Ko SG, Lee EK, Jung B. The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study. BMC Musculoskelet Disord. 2019 Dec 29;20(1):631
22. Silveira A, Armijo-Olivo S, Gadotti IC, Magee D. Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability. J Oral Facial Pain Headache. 2014 Spring;28(2):138-46.
23. Li DTS, Leung YY. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (Basel). 2021 Mar 6;11(3):459.
24. Ajanovic M, Bejtovic B. Correlation between values of the helkimo anamnestic and clinical dysfunction index in patients suffering from post traumatic stress disorder. Mater Sociomed. 2009 Apr 1;21(2):85.
25. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006 Jun 15;31(14):E454-9.
26. Kuć J, Szarejko KD, Gołębiewska M. The Prevalence and Overlaps of Temporomandibular Disorders in Patients with Myofascial Pain with Referral-A Pilot Study. Int J Environ Res Public Health. 2021 Sep 18;18(18):9842.
27. Carlsson GE, Magnusson T. Management of Temporomandibular Disorders in the General Practice.: Postgraduate textbook. Quintessence; 2000.
28. Plesh O, Adams SH, Gansky SA. Temporomandibular joint and muscle disorder-type pain and comorbid pains in a national US sample. J Orofac Pain. 2011 Summer;25(3):190-8.
29. Kafas P, Leeson R. Assessment of pain in temporomandibular disorders: the bio-psychosocial complexity. Int J Oral Maxillofac Surg. 2006 Feb;35(2):145-9.
30. Altindag O, Gur A, Altindag A. The relationship between clinical parameters and depression level in patients with myofascial pain syndrome. Pain Med. 2008 Mar;9(2):161-5.
31. Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64.
32. Halliwell B. Oxygen radicals, nitric oxide and human inflammatory joint disease. Ann Rheum Dis. 1995 Jun;54(6):505-10.
| Issue | Vol 20 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v20i11.12657 | |
| Keywords | ||
| Temporomandibular joint Bruxism Self Care Lumbosacral Region Pain | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Aghahoseini F, Mirzaii-Dizgah I, Shirazian S, Javaheri-Mahd M. Treating Parafunctional Habits for Alleviating Temporomandibular Disorder and Lower Back Pain: A Phase II Clinical Trial. Front Dent. 2023;20.
