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Biomedical subjects

D D Curl

Publications and source records attributed to D D Curl.

10 recordsLinked to original sources

Chiropractic manipulation of anteriorly displaced temporomandibular disc with adhesion.

OBJECTIVE: This AB, single-subject case study was conducted to investigate the capability of chiropractic manipulation of the temporomandibular joint (TMJ) in treating unilateral anterior displacement of the articular disc with adhesion to the articular eminence. A specific joint manipulation was designed to reduce the anteriorly displaced and adhered TMJ disc. CLINICAL FEATURES: A 21-yr-old woman suffered from a four year history of right-sided temporomandibular joint pain and clicking, with limitation of mandibular opening. The patient reported previous unsuccessful treatments for her condition. An exhaustive history, a complete review of systems and a physical examination (including, but not limited to, eyes, ears, nose, throat and motor, sensory and reflex neurological tests) were obtained. Relevant or contributory findings are extracted for this article. A clinical diagnosis of left-sided anteriorly displaced TMJ disc with adhesion to the articular eminence was made. INTERVENTION AND OUTCOME: Patient's pain level, presence of joint clicking upon mandibular opening and the amount of mandibular opening were used as outcome measures for capability of treatments. An AB, single-subject study was used where A was the baseline period and B the therapeutic intervention period. The patient was treated twice a week for a total of 19 visits. During the baseline period no treatment was given to the TMJ (3 visits) where the patient received cervical manipulation alone. During the experimental period the patient received both cervical spine manipulation and a specific manipulation to the left mandible. There were no physical therapeutic modalities applied to the jaw. The specific TMJ manipulation used requires a very low-amplitude high velocity thrust parallel to the slope of the articular eminence. The results of this study show mandibular opening distance was returned to normal in addition to the abolition of the patient's TMJ pain and clicking. During the three baseline visits mandibular opening showed no significant change, with an average of 25.3 mm (range 25-26 mm). There was also no change in the patient's TMJ pain or clicking during this baseline period. The patient's TMJ clicking was absent following the third treatment and the patient reported significant subjective pain relief as well. Temporomandibular pain was again reported during the fifth, sixth and seventh post-treatment visits due to exacerbations caused by daily activities. There was no pain reported from the beginning of the eighth post-treatment visit to the end of the study. CONCLUSION: The findings of this study show this specific manipulation of the TMJ may be appropriate for the conservative treatment of adhered anteriorly dislocated disc.

Adult↗

Chiropractic management of capsulitis and synovitis of the temporomandibular joint.

Localized inflammatory conditions (eg, synovitis and capsulitis) of the temporomandibular joint are commonly seen in clinical practice. Regardless of their frequency of occurrence, these conditions must be differentially diagnosed from conditions that also may cause pain in the temporomandibular joint region. Capsulitis or synovitis should be considered if such pain is present and historical, physical, and laboratory findings do not indicate a referred pain phenomena or systemic, tumorous, or infectious involvement. This article reviews the clinical characteristics, etiology, physical examination methods, treatment, and prognosis for capsulitis and synovitis, and three cases that illustrate these conditions are reported.

Adult↗

The visual range of motion scale: analysis of mandibular gait in a chiropractic setting.

The study of skeletal motion is not new to chiropractic. Many methods have been utilized within the chiropractic profession to study or detect aberrant motion. Notably absent in these chiropractic methodologies is motion analysis of the mandible and its bilateral articulations, the temporomandibular joints. The issue of adapting a uniform method of recording mandibular gait becomes especially significant in light of the fact that increasing numbers of patients with temporomandibular disorders are being treated in a chiropractic setting. Chiropractic has traditionally applied or followed carefully described motion analysis routines when investigating the spine or extremities. The purpose of this article, therefore, is to present a method of analyzing mandibular gait (visual range of motion scale) in a chiropractic setting consistent with what is known of the biomechanics and pathomechanics of the mandible and its articulations. Incorporating the visual range of motion scale into the chiropractic examination brings the evaluation of mandibular gait into line with other accepted chiropractic examination procedures.

Chiropractic↗

Addressing the issue of cataloging and making chiropractic literature accessible: Part I: Defining the problem.

Health science journals are a principle source of new knowledge for chiropractors, chiropractic faculty and students. Regrettably, clinically or educationally relevant articles (appearing in the nearly 20,000 journals annually) are often overlooked due to access difficulties. Innovations are needed to assist the reader to select articles relevant to chiropractic and reduce the time spent sorting through the volumes of literature. A review of the literature shows there is a trend toward database management for cataloging and accessibility of other, nonchiropractic, literature. Most notable of these is an endeavor by National Technical Information Service, commonly referred to as MEDLARS (Medline). It is interesting to note that a computer-assisted library database program does not exist on any chiropractic campus. This is in contrast with the trend on campuses of other health care fields. Manual search strategies within the chiropractic literature are time consuming, subject to a high failure rate, and even if the search produces citations, there is no assurance the journal can be accessed unless a chiropractic campus is nearby. Furthermore, difficulties exist when a chiropractic literature search is attempted in any computerized database, e.g., MEDLARS (Medline). Journals/articles that are unique to chiropractic (national, international or on the state level) are not specifically included in these computerized databases. Aside from these difficulties, there exists the problem of finding those articles that contain valid and relevant information from among those that are less valid or informative.

Cataloging↗

Addressing the issue of cataloging and making accessible chiropractic literature: Part II. Pilot software development program.

Health science journals are a principle source of new knowledge for chiropractors, chiropractic faculty, and students. Regrettably, clinically or educationally relevant articles (appearing in the nearly 20,000 journals annually) are often overlooked due to access difficulties. Innovations are needed to assist the reader to select articles relevant to chiropractic and reduce the time spent sorting through the volumes of literature. A solution to those problems of accessing, obtaining, and storing article citations from the chiropractic literature come from a pilot computerized program developed for use on the Los Angeles College of Chiropractic (LACC) campus. The Chiropractic Literature Archive and Search Program (CLASP) is dedicated to chiropractic literature. It provides rapid access to the literature and directs the user to one of the participating chiropractic campuses where the article can be found. Because of its ease of operation, the program is a useful tool for nearly all areas of chiropractic, ranging from education and research to clinical patient management. The program would be inexpensive to fully implement, and the hardware needed is minimal. Important protocols have been developed for database input, use and maintenance. Testing of this program on the LACC campus reveals that such a program is capable of making citations of the chiropractic literature available within days of their publication.

Abstracting and Indexing↗