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Biomedical subjects

E F Wright

Publications and source records attributed to E F Wright.

At least 19 recordsLinked to original sources

Usefulness of posture training for patients with temporomandibular disorders.

BACKGROUND: Many practitioners have found that posture training has a positive impact on temporomandibular, or TMD, symptoms. The authors conducted a study to evaluate its effectiveness. METHODS: Sixty patients with TMD and a primary muscle disorder were randomized into two groups: one group received posture training and TMD self-management instructions while the control group received TMD self-management instructions only. Four weeks after the study began, the authors reexamined the subjects for changes in symptoms, pain-free opening and pressure algometer pain thresholds. In addition, pretreatment and posttreatment posture measurements were recorded for subjects in the treatment group. RESULTS: Statistically significant improvement was demonstrated by the modified symptom severity index, maximum pain-free opening and pressure algometer threshold measurements, as well as by the subjects' perceived TMD and neck symptoms. Subjects in the treatment group reported having experienced a mean reduction in TMD and neck symptoms of 41.9 and 38.2 percent, respectively, while subjects in the control group reported a mean reduction in these symptoms of 8.1 and 9.3 percent. Within the treatment group, the authors found significant correlations between improvements in TMD symptoms and improvements in neck symptoms (P < .005) as well as between TMD symptom improvement and the difference between head and shoulder posture measurements at the outset of treatment (P < .05). CONCLUSIONS: Posture training and TMD self-management instructions are significantly more effective than TMD self-management instructions alone for patients with TMD who have a primary muscle disorder. PRACTICE IMPLICATIONS: Patients with TMD who hold their heads farther forward relative to the shoulders have a high probability of experiencing symptom improvement as a result of posture training and being provided with selfmanagement instructions.

Adolescent↗

Referred craniofacial pain patterns in patients with temporomandibular disorder.

BACKGROUND: Referred pain is prevalent in the craniofacial region, and it would be helpful for dental practitioners to have drawings delineating regions with a high probability for a patient's referred pain source. METHODS: The author applied firm pressure for approximately five seconds to trigger points, nodules of spot tenderness, and selected masticatory structures within the head and neck region on 230 patients with temporomandibular disorder, or TMD. As firm pressure was being applied, subjects were asked whether pain was developing or intensifying in a location different than that being palpated. RESULTS: One hundred ninety-six subjects (85 percent) reported that referred pain was being generated. The cheek area, ear and forehead were the most frequently reported sites of referred pain generation; palpation over the trapezius muscle, lateral pterygoid area and masseter muscle were the most common sources of referred pain to the craniofacial region. The author provides figures displaying common referred pain sites and their sources. CONCLUSIONS: Patients with TMD often report referred craniofacial pain arising from palpation of the head and neck region. The author found that the pattern between referred pain source and site was consistent and predictable. PRACTICE IMPLICATIONS: Practitioners should consider craniofacial pain's propensity for referral when treating patients with TMD. Practitioners can use the figures presented to determine regions of high probability for a patient's referred pain source.

Adolescent↗

Tinnitus, dizziness, and nonotologic otalgia improvement through temporomandibular disorder therapy.

U.S. Air Force otologic patients seeking care at Wilford Hall Medical Center for tinnitus, dizziness, and/or nonotologic otalgia without an identifiable cause and presenting with temporomandibular disorder (TMD) symptoms in the temple, jaw, or preauricular area or with otalgia at least once a month were referred to a TMD specialty clinic. The patients were provided a dental orthotic and TMD self-care instructions. After 3 months of orthotic wear, the percentages of patients reporting at least moderate symptom improvement of their tinnitus, dizziness, otalgia, and/or TMD were 64, 91, 87, and 92%, respectively. Follow-up telephone calls 6 months after completion of TMD therapy revealed that all patients maintained their symptom improvements. These findings imply that TMD was affecting the patients' otologic symptoms. Patients seeking care for tinnitus, dizziness, and/or nonotologic otalgia without an identifiable cause may have TMD, and their otologic symptoms may benefit from conservative reversible TMD therapy.

Adult↗

Tinnitus improvement through TMD therapy.

Many patients with temporomandibular disorder and coexisting tinnitus find that therapy improves or resolves their tinnitus in conjunction with their TMD symptoms. Ninety-three patients with TMD who reported having coexisting tinnitus were questioned and given clinical tests. These assessment instruments were then evaluated for their ability to suggest tinnitus improvement as a result of TMD therapy. This study suggests that asking targeted questions and performing a clinical test could be of significant value in helping practitioners identify which patients with TMD and coexisting tinnitus will experience improvement in, or resolution of, their tinnitus when TMD symptoms have improved significantly.

Analysis of Variance↗

Identifying undiagnosed rheumatic disorders among patients with TMD.

If a patient with TMD has a coexisting rheumatic disorder, it may adversely affect the TMD symptoms and treatment outcome. A clinic that specializes in TMD treatment asked symptom-related questions of 104 patients with TMD, and a rheumatology clinic then performed rheumatologic evaluations. The authors review the results of the rheumatologic evaluations and the predictive probability for the questions. The findings of this study suggest questions that practitioners can ask to help identify patients with TMD who have a high probability of being diagnosed with a coexisting rheumatic disorder.

Adolescent↗

Identifying acute pulpalgia as a factor in TMD pain.

An acute pulpalgia and temporomandibular disorders can produce many of the same symptoms. To illustrate identification of an acute pulpalgia as a component in TMD, the authors review the evaluation of 11 patients at a clinic that specializes in TMD treatment. During the evaluation, thermal testing and periodontal ligament anesthesia were used to identify the offending tooth. After receiving endodontic treatment or having the tooth extracted, patients reported either complete or partial relief of TMD symptoms. The authors provide questions that may help practitioners identify a tooth with an acute pulpalgia as a contributing factor to TMD symptoms and suggest a technique to confirm this diagnosis.

Acute Disease↗

Dental pulpalgia contributing to bilateral preauricular pain and tinnitus.

The case of a patient with bilateral preauricular pain and tinnitus is reported. Minimal relief was obtained with traditional temporomandibular disorders therapy, and complete relief was obtained after endodontic therapy. Pulpal conditions that can refer pain are discussed, and recommendations are made to help practitioners identify a possible pulpal etiology for symptoms and tests of temporomandibular disorders.

Dental Pulp Diseases↗

Treatment alternatives for patients with masticatory myofascial pain.

Alternative therapies are used by many people, and the dental literature has reported that some alternative therapies are comparable to splint therapy in the effective treatment of masticatory myofascial pain. The authors review the efficacy of alternative therapies and discuss their clinical implications. This review is intended to help dental practitioners to select alternative therapies they can use with or instead of splint therapy for treating patients who have a primary diagnosis of myofascial pain.

Acupuncture Analgesia↗

A simple questionnaire and clinical examination to help identify possible non-craniomandibular disorders that may influence a patient's CMD symptoms.

A patient with craniomandibular disorder (CMD) symptoms may have CMD, a local or systemic disorder that mimics CMD, or CMD superimposed with a local or systemic disorder that exacerbates the CMD symptoms. When evaluating a patient with CMD symptoms, the practitioner needs to determine whether local or systemic problems contribute to the patient's symptoms. The author presents a simple questionnaire that can help identify some non-CMD problems that may contribute to the patient's symptoms. A discussion of each question and examples of possible non-CMD disorders are provided. The author also describes a clinical examination that may be used in conjunction with the questionnaire to help identify some non-CMD conditions.

Cervical Vertebrae↗

Using removable partial denture framework as matrix for pin-retained restoration.

A quick and easy method can restore a broken-down partial denture abutment with a pin-retained amalgam restoration. It has a high degree of patient acceptance as only one appointment is required, eliminating the need for the patient to leave a partial denture for adaptation to a wax pattern. The cost can be minimal. This technique can be used for Class II restorations; however, the practitioner must ensure sufficient clearance for the condenser to pass between the tooth and the partial denture, so all areas can be properly condensed.

Dental Abutments↗

An easily fabricated occlusal splint.

An easy and inexpensive method for fabrication of an occlusal splint has been described. It has a high degree of patient acceptance and is effective in treating TMJ dysfunction symptoms. If a hard acrylic occlusal splint is preferred, the aforementioned method can be used as an interim appliance until necessary appointments can be scheduled.

Dental Occlusion↗

Atypical presentation of odontogenic pain.

Pain referral patterns in the head and neck regions can be complex and frustrating for practitioners to diagnose and treat. This clinical case report involves a patient who did not respond to initial medical treatment for headache pain. The pain was found to be referred from a carious and pulpally involved mandibular molar that interestingly responded normal to pulp vitality testing.

Adult↗

Using soft splints in your dental practice.

A significant number of soft splints are fabricated by U.S. dentists every year. The efficacy of these splints is discussed, reported indications and contraindications are defined, and favorable and unfavorable characteristics reported by patients are presented. Maxillary and mandibular soft splint designs that have been found to be clinically acceptable are illustrated and an easy and rapid technique for adjusting and polishing a soft splint is proposed.

Bruxism↗