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Biomedical subjects

E L Gaudet

Publications and source records attributed to E L Gaudet.

4 recordsLinked to original sources
PubMed2000

Temporomandibular disorder treatment outcomes: first report of a large-scale prospective clinical study.

The diagnosis and treatment of temporomandibular disorders (TMD) has been surrounded by considerable controversy. Clinical research in the field to date has been inconsistent and methodologically limited and has not firmly established the role of treatment interventions. This large scale, multisite study attempts to answer some of the questions regarding TMD diagnosis and treatment. More than 6,500 patients are currently being analyzed and 1,212 have completed TMD therapy, providing the basis for comparison with 198 untreated patients. A wide variety of treatments have been administered from 60 practice sites, whose practitioners were carefully calibrated to maximize inter-rater reliability. A validated symptom measurement system, the TMJ Scale, was employed to assure uniform assessment of treatment outcomes. Treated patients reported statistically and clinically significant symptom improvement, while untreated patients reported unchanged symptom levels. Data presented here do not support the hypothesis that TMD patients improve spontaneously without treatment.

Adult↗
PubMed1994

Changes in vertical tooth position and face height related to long term anterior repositioning splint therapy.

This study evaluates whether extended full-time wear of a partial coverage mandibular anterior repositioning splint (MORA) causes intrusion of posterior teeth and determines the effect on jaw position. Sixty-four patients from two private orthodontic practices were studied using cephalometric radiographs to measure vertical change in position of the anterior and posterior teeth and the mandible. The splint wear time ranged from a minimum of one half year to a maximum of 4.8 years, with a mean of 1.33 years. No significant change was recorded in the distance from the mandibular molar to the mandibular plane. On average, the maxillary incisor and maxillary molar extruded about 1 mm, while the mandibular molar was unchanged and the mandibular incisor intruded about 0.6 mm. Posterior face height increased an average of 1.6 mm, and anterior face height increased an average of 2.7 mms. In 20% of the patients, intrusion of the mandibular molars of 1 mm or more occurred. In 41%, extrusion of the maxillary incisors of 1 mm or more was noted. Intrusion of the upper molars or extrusion of the lower incisors occurred in only 5% of the patients. The data indicates that only a very small proportion of patients having long term splint therapy using the MORA have clinically significant molar intrusion. Change in mandibular position was expressed in a vertical increase in posterior and anterior face height. Only very small changes occurred in antero-posterior position.

Adolescent↗
PubMed1994

Outcome measurement for treated and untreated TMD patients using the TMJ scale.

Changes in symptom profiles of two groups of treated and untreated temporomandibular disorders (TMD) patients were measured using the TMJ Scale. Forty-nine consecutive TMD patients were included in the study. Of these, 29 patients were treated using splint therapy, physical therapy, counseling, and non-steroidal anti-inflammatory (NSAID) medications. Patients completed the TMJ Scale questionnaire prior to treatment and at completion of the TMD therapy. Sixty-five patients were not treated in any manner, having completed the questionnaire during an initial diagnostic study and having declined treatment. They were contacted by mail at least four months later and asked to complete the second questionnaire if they had not received any treatment. Twenty untreated patients returned the completed questionnaire. The initial scale scores for the two groups were similar. Comparison of the two tests of both groups revealed the treated group improved significantly, while the untreated group remained unchanged, except for a statistically non-significant increase of scale scores (increased symptom severity) for joint dysfunction and range of motion limitation. Younger patients responded more favorably to therapy than older patients. The findings do not support the conclusions of the few previous studies that found TMD are often self-limiting and rarely progress to chronic intracapsular derangement. The findings strongly support the hypothesis that symptom improvement was related to treatment and not solely to the passage of time.

Adolescent↗