Biomedical subjects

C M Visscher

Publications and source records attributed to C M Visscher.

13 recordsLinked to original sources

PubMed2006

[Occupational differentiation in dentistry 2. From Brueghel's syndrome to a radiant smile. An advanced postgraduate programme in oral kinesiology].

Oral movement disorders, jaw pain, and tooth wear are examples of clinical problems that are part of the dental discipline 'oral kinesiology'. About half of the advanced postgraduate programme in oral kinesiology involves the diagnosis, indication, and management of patients with one or more oral kinesiologic problems. The remaining time is available for thematic courses and a research project. The breadth of the programme will hopefully lead to improved care for patients whose treatment until now has been dispersed between various dental specialists. Successful candidates will obtain an advanced postgraduate diploma in Oral Kinesiology, and can also apply to be recognized as a gnathologist.

Bruxism↗

PubMed2004

Oral kinesiology. A new postgraduate programme in the Netherlands.

As one of the dental differentiations in The Netherlands, temporomandibular disorders (TMD) focuses on the diagnosis and treatment of pain and dysfunction of the masticatory system. Bruxism (i.e. tooth clenching and/or grinding) is thought to play an important aetiological role in TMD. Among others, bruxism may result in TMD pain and dental attrition. The close relationship between TMD, bruxism, and attrition necessitates an integrated approach to these clinical problems. This could be achieved through the multidisciplinary differentiation 'oral kinesiology', that covers not only the diagnosis and treatment of TMD and bruxism but also the restoration of worn dentitions. This article focuses on the background of oral kinesiology, as well as on the rationale to develop a curriculum for the postgraduate training of dentist-kinesiologists in the Netherlands. Further, the oral kinesiology curriculum of the Academic Centre for Dentistry Amsterdam will be introduced. This curriculum will ensure that specialized professionals, who are able to approach the different aspects of oral kinesiology in an integrated manner, are available not only for general dental practice but also for centres for special dental care and university departments. This will lead to improved care for patients, whose management is until now dispersed between various dental specialists.

Bruxism↗

PubMed2002

Is there a relationship between head posture and craniomandibular pain?

An often-suggested factor in the aetiology of craniomandibular disorders (CMD) is an anteroposition of the head. However, the results of clinical studies to the relationship between CMD and head posture are contradictory. Therefore, the first aim of this study was to determine differences in head posture between well-defined CMD pain patients with or without a painful cervical spine disorder and healthy controls. The second aim was to determine differences in head posture between myogenous and arthrogenous CMD pain patients and controls. Two hundred and fifty persons entered the study. From each person, a standardized oral history was taken and blind physical examinations of the masticatory system and of the neck were performed. The participants were only included into one of the subgroups when the presence or absence of their symptoms was confirmed by the results of the physical examination. Head posture was quantified using lateral photographs and a lateral radiograph of the head and the cervical spine. After correction for age and gender effects, no difference in head posture was found between any of the patient and non-patient groups (P > 0.27). Therefore, this study does not support the suggestion that painful craniomandibular disorders, with or without a painful cervical spine disorder, are related to head posture.

Adult↗

PubMed2001

Psychological distress in chronic craniomandibular and cervical spinal pain patients.

Recent studies to chronic pain have shown that the number of painful body areas is related to the level of psychological distress. Therefore, the first aim of this study was to analyse differences in level of psychological distress between craniomandibular pain patients with or without cervical spinal pain. In this analysis, the number of painful body areas below the cervical spine was also taken into account. The second aim was to determine psychological differences between subgroups of craniomandibular pain patients. In this study, 103 out of 250 persons with or without craniomandibular pain were included in the final analyses. Patients who suffered from both craniomandibular and cervical spinal pain showed higher levels of psychological distress, as measured with the Symptom Checklist 90 (SCL-90) than patients with local craniomandibular pain and persons without pain. Further, a positive relationship was found between the number of painful body areas below the cervical spine, as measured on a body drawing, and the SCL-90 scores. No psychological differences were found between myogenous and arthrogenous craniomandibular pain patients. In conclusion, chronic craniomandibular pain patients with a coexistent cervical spinal pain showed more psychological distress compared to patients with only a local craniomandibular pain and asymptomatic persons.

Adult↗

PubMed2001

Prevalence of cervical spinal pain in craniomandibular pain patients.

It has often been suggested that patients with a craniomandibular disorder (CMD) more often suffer from a cervical spine disorder (CSD) than persons without a CMD. However, in most studies no controlled, blind design was used, and conclusions were based on differing signs and symptoms. In this study, the recognition of CMD and CSD was based upon the presence of pain. The aim of this study was to determine the prevalence of cervical spinal pain in persons with or without craniomandibular pain, using a controlled, single-blind design. From 250 persons, a standardised oral history was taken, and a physical examination of the masticatory system and the neck was performed. Three classification models were used: one based on symptoms only; a second on signs only; and a third one based on a combination of symptoms and signs. The CMD patients were also subdivided in three subgroups: patients with mainly myogenous pain; mainly arthrogenous pain; and both myogenous and arthrogenous pain. Craniomandibular pain patients more often showed cervical spinal pain than persons without craniomandibular pain, independent of the classification model used. No difference in the prevalence of cervical spinal pain was found between the three subgroups of craniomandibular pain patients.

Adult↗

PubMed2000

Clinical tests in distinguishing between persons with or without craniomandibular or cervical spinal pain complaints.

The recognition of a craniomandibular or cervical spinal pain is usually based upon the pain complaint of the patient, reported during an oral history, and the pain responses provoked in a clinical examination. Often used clinical tests are palpation, and function tests like dynamic/static tests or active movements. The relative importance of these tests for the recognition of the musculoskeletal pain is important. Therefore, it was the aim of the present study to determine which test, or combination of tests, best discriminates between persons with or without craniomandibular and/or cervical spinal pain complaints. Two hundred and fifty persons participated. From each person, a standardized oral history was taken. Then, in a randomized order and using a blind design, physical examinations of the craniomandibular system and of the neck were performed. Forward stepwise logistic regression analyses showed that the dynamic/static tests discriminated better between persons with and without pain complaints than the other tests did. In conclusion, in studies to the coexistence of craniomandibular and cervical spinal pain, it may be a good choice to base the recognition of these disorders on the pain complaints reported in the oral history which are verified by the pain response of the dynamic/static tests.

Adult↗

PubMed2000

Kinematics of the human mandible for different head postures.

The influence of head posture on movement paths of the incisal point (IP) and of the mandibular condyles during free open-close movements was studied. Ten persons, without craniomandibular or cervical spine disorders, participated in the study. Open close mandibular movements were recorded with the head in five postures, viz., natural head posture, forward head posture, military posture, and lateroflexion to the right and to the left side, using the Oral Kinesiologic Analysis System (OKAS-3D). This study showed that in a military head posture, the opening movement path of the incisal point is shifted anteriorly relative to the path in a natural head posture. In a forward head posture, the movement path is shifted posteriorly whereas during lateroflexion, it deviates to the side the head has moved to. Moreover, the intra-articular distance in the temporomandibular joint during closing is smaller with the head in military posture and greater in forward head posture, as compared to the natural head posture. During lateroflexion, the intra-articular distance on the ipsilateral side is smaller. The influence of head posture upon the kinematics of the mandible is probably a manifestation of differences in mandibular loading in the different head postures.

Adult↗

PubMed2000

[Treatment protocol for craniomandibular disorder 1. Diagnosis].

In two essays the treatment strategy of the department of Oral Function of the Academic Center of Dentistry Amsterdam for treating craniomandibular disorder (CMD) patients will be presented. This first essay starts with a short description of the symptomatology, classification and etiology of CMD. Then it is described how to diagnose a CMD with the use of a standardized diagnostic protocol. Some important aspects of the differential diagnosis of CMD are discussed. Furthermore it is discussed when a CMD-patient can be treated by the dentist or when referral to a CMD specialist or oral surgeon is necessary.

Craniomandibular Disorders↗

PubMed2000

[Treatment protocol for craniomandibular dysfunction 2. Treatment].

In two essays the treatment strategy of the department of Oral Function of the Academic Center of Dentistry Amsterdam for treating craniomandibular disorder (CMD) patients is described. In this second essay a description is given of several dental, physiotherapeutical and psychological treatment modalities for CMD. Then treatment strategies for the different categories of CMD are described. It is also indicated which aspects of the treatment strategy are based upon 'evidence based care' and which aspects are more based upon principles of 'common sense' and 'clinical prudence'.

Analgesics↗

PubMed2000

[Multidisciplinary diagnosis and treatment of craniomandibular disorders].

Treatment of craniomandibular disorders (CMD) requires a multidisciplinary approach. The CMD-team of the Academic Centre for Dentistry Amsterdam (ACTA) therefore consists not only of specialists in CMD and orofacial pain, but also of physiotherapists and a psychologist. Possible CMD-patients are referred to this team by the dentist-general practitioner, either directly or upon request of a family physician or a medical specialist; the many rules of such referrals are outlined in the article. The CMD-team regularly consults other disciplines for diagnosis and/or treatment of their patients. For instance, internal referrals are sometimes made to the departments of Oral radiology, Endontology, Periodontology, Orthodontics, or Oral and maxillofacial surgery. External referrals to, for example, a speech therapist or a medical specialist (e.g., a pain specialist) are arranged by the family physician upon request of the CMD-team.

Craniomandibular Disorders↗

PubMed2000

[Treatment of bruxism: physiotherapeutic approach].

Epidemiological and experimental studies suggest that there is a relationship between bruxism and pain in the orofacial region, and between bruxism and restricted mandibular movements. However, the exact nature of this relationship remains unclear. Therefore, up till now, the following working hypothesis is used: bruxism can lead to (chronic) pain complaints and restricted mandibular movements, when its intensity exceeds the adaptation capacity of the musculoskeletal structures. In that case, the aims of physical therapy treatment are twofold: to decrease symptoms, such as pain ('symptom therapy'), and to teach the patient to recognise and reduce the bruxism ('behavioral therapy'). Techniques used for symptom treatment are massage and stretching exercises. For the behavioral therapy exercises and myofeedback are often used.

Biofeedback, Psychology↗

PubMed1999

The intra-articular distance within the TMJ during free and loaded closing movements.

Previous studies on free opening and closing movements of the mandible have demonstrated that the opening movement traces of the condylar kinematic center (i.e., the condylar point for which the protrusive and the opening movement traces coincide) lie closer to the articular eminence than the closing traces. This indicates the presence of an intra-articular distance within the joint during free closing. Since the mandible behaves like a class III biomechanical lever, a counteracting mechanical load on the mandible during closing will press the condyle-disc complex against the articular eminence. Therefore, in this study the hypothesis was tested that the difference between opening and closing movement traces of the kinematic center is reduced when the closing movements are counteracted by a mechanical load. From 10 healthy participants, 20-second movement recordings were obtained by a six-degrees-of-freedom opto-electronic jaw movement recording system (OKAS-3D) for three types of movements: (1) free opening and closing movements, (2) free opening and loaded closing movements (i.e., the participants closed against a small or high manually applied downward-directed force to the chin), and (3) gum chewing. Off-line, the opening and closing movement traces of the kinematic center were reconstructed, and the average difference between the traces (the intra-articular distance) was calculated. The average intraarticular distance was significantly smaller during loaded closing than during free closing, whereas no significant differences were found in the intra-articular distances between the loaded situations of low and high manual loading and contralateral chewing (ANOVA and post hoc Bonferroni multiple comparisons of means test, p<0.005). In conclusion, loading of the mandible during closing movements reduces the intra-articular distance within the temporomandibular joint.

Adult↗

PubMedDate not supplied

The relationship between posture and curvature of the cervical spine.

OBJECTIVE: To study the relationship between posture and curvature of the cervical spine in healthy subjects. SUBJECTS: The study was composed of 54 healthy students (25 men and 29 women) aged 20-31 yr with a mean age of 24.7 yr. METHODS: Lateral radiographs were taken of the head and cervical spine of the subjects while standing in a neutral position. Cervical spine posture was quantified by the angle of a reference line, composed of reference points of the upper six cervical vertebrae, with the horizontal axis. The curvature of the cervical spine was classified visually as lordotic, straight or reversed. RESULTS: A relationship was found between posture and curvature of the cervical spine (p = .006); a more forward posture of the cervical spine was related to a partly reversed curvature; and a more upright posture was related to a lordotic curvature. Moreover, men more often exhibited a straight curvature, and women more often exhibited a partly reversed curvature. CONCLUSION: The curvature of the cervical spine is related to the subject's posture and gender.

Adult↗