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Biomedical subjects

M Helkimo

Publications and source records attributed to M Helkimo.

At least 19 recordsLinked to original sources
PubMed1995

Self-assessment of pain and discomfort in patients with temporomandibular disorders: a comparison of five different scales with respect to their precision and sensitivity as well as their capacity to register memory of pain and discomfort.

Five different scales of self-assessment of pain were tested in patients with temporomandibular disorders. The precision and sensitivity and the capacity to register memory of pain and discomfort were compared for each of the five scales. The behaviour rating scale was found to be superior to the other four scales in respect of precision and sensitivity to pain and discomfort and when recording the memory of these two variables. This scale was also considered by the patients to be the most relevant and the simplest to understand. From these results, the behaviour rating scale can be recommended when measuring pain and discomfort in patients with temporomandibular disorders.

Adolescent↗
PubMed1995

A scale for measuring the activities of daily living (ADL) of patients with craniomandibular disorders.

A rating scale based on methods used in medical and behavioral science was modified for specific assessment of the function of the masticatory system. Eleven common activities of daily living were recorded on a scale rated from 0 to 10. Thirty-one patients (23 women and 8 men) who had exhibited facial pain and/or headache for a duration of at least one year participated. Test-retest coefficients of reliability for the patients' assessment of pain and discomfort on two different occasions two weeks apart were high and varied (with the exception of one question) between r = 0.67 and r = 0.92. The correlations between the patients' own estimations and that which one member of the family made were high and varied (with the exception of one question) between r = 0.78 and r = 0.92.

Activities of Daily Living↗
PubMed1994

Craniomandibular disorders in children--a critical review of the literature.

Reports of prevalences of craniomandibular disorders (CMD) in children and adolescents differ markedly from one study to another. Therefore it is almost impossible to get a clear picture of the magnitude of the disorder in a child population. The aim of this study was to critically compare and analyse the results presented in recent publications in order to get a comprehensive view of the prevalence of CMD in children and adolescents. Fourty epidemiological studies on CMD symptomatology and headache in the age group three to 25 years were included. Eight symptoms and eight signs were chosen for further comparisons and analyses. The prevalences of these signs and symptoms were evaluated and classified according to a set of criteria, in either frequency of "greater clinical relevance" or frequency of "lesser clinical relevance". The evaluation was based on the presented examination methods, definitions and symptom criteria used in the studies. The reported frequencies for the sixteen signs and symptoms are presented graphically. The diagram clearly show great variation in the reported frequencies for most signs and symptoms. If only reported frequencies of "greater clinical relevance" are considered, these variations are less pronounced but still considerable. One major reason for this is inter- and intraindividual variation among the examiners. Another plausible and often overlooked reason is the fact that examination methods designed for adults uncritically have been applied on children without consideration of age and cognitive development of the child.

Adolescent↗
PubMed1993

Pressure pain thresholds in patients with craniomandibular disorders before and after treatment with acupuncture and occlusal splint therapy: a controlled clinical study.

Fifty-five patients (46 women and 9 men) with craniomandibular disorders and a history of pain of at least 6 months' duration participated in this trial. The patients were randomly assigned to three groups: one group to receive acupuncture; one group to receive occlusal splint therapy; and one group to act as controls. Pressure pain threshold, clinical dysfunction score, and visual analog scale measures were used to evaluate patients before, immediately after, and 6 months after treatment. A moderate, but statistically significant, correlation was found between pressure pain threshold and the number of tender spots in the masticatory muscles (tau = -.43; P < .001), degree of tenderness in the masticatory muscles (tau = -.43; P < .001), clinical dysfunction score (tau = .32; P < .001), and the visual analog scale (tau = -.25; P < .01). The short-term results showed a statistically significant improvement in all evaluations for both treatment groups. No significant differences were found in the control group. The improvements resulted in significant differences between the control and each treatment group immediately after treatment. At the 6-month follow-up, no significant differences in pressure pain threshold or clinical dysfunction score were found in the two treatment groups compared with the short-term results.

Acupuncture Analgesia↗
PubMed1992

Adverse events of acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders.

Occlusal splint therapy and acupuncture have been found to provide positive treatment in a number of studies. As with other therapies, adverse events may occur. In this paper, adverse event refers to any reaction to a treatment besides the intended treatment effect--irrespective of any correlation between the treatment and the reaction. This reaction can be positive, as well as negative, to the patient. In the present study, 61 patients with craniomandibular dysfunction (CMD) were treated with acupuncture or occlusal splint therapy and the adverse events were carefully recorded. The results show that the profile of the adverse events differed between the two treatment modes. Acupuncture seemed to have adverse events of a more general nature, e.g., relaxed feeling, improved sleep, temporarily increased pain; whereas, adverse events of occlusal splint therapy seemed to be more locally related to the orofacial region, e.g., increased/decreased salivation and tension in the teeth. The majority of the patients responded positively to both treatment modalities. Only in a few cases did the patients consider the treatment uncomfortable. No serious adverse event or complication was observed in this study.

Acupuncture Therapy↗
PubMed1992

Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. II. A 1-year follow-up study.

Eighty patients, of whom 22 were men and 58 women, participated in a 1-year follow-up study. All participants in the study showed signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than 6 months at treatment start. The patients were randomly assigned to either acupuncture or occlusal splint therapy. Those patients who did not respond to either of the treatment modes were offered various additional therapies. The result showed that 57% of the patients who received acupuncture and 68% of the patients treated with occlusal splint therapy benefited subjectively (p < 0.01) and clinically (p < 0.001) from the treatment over a 12-month period. No statistically significant difference was found between the two groups as to the assessment variables. Those patients who received various additional therapies after acupuncture and/or occlusal splint therapy responded favorably to additional treatment in only a few instances. The study showed that acupuncture gave positive results similar to those of occlusal splint therapy in patients with primarily myogenic CMD symptoms over a 1-year follow-up period.

Activities of Daily Living↗
PubMed1992

Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. Part I. A comparative study.

One hundred and ten patients, 23 males and 87 females, participated in a comparative study of the effect of acupuncture and occlusal splint therapy. All the patients exhibited signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than six months. The participants were randomly assigned to three groups; acupuncture treatment, occlusal splint therapy or control. The patients were evaluated before and immediately after treatment/control time. Ten different subjective and/or clinical assessment variables were used in the evaluation of the treatment effects. Both acupuncture and occlusal splint therapy reduced the symptoms as compared with the control group in which the symptoms remained essentially unchanged. In this short-term study, acupuncture gave better subjective results (p < 0.001) than the occlusal splint therapy.

Acetaminophen↗
PubMed1991

Influence of pressure rates on the reliability of a pressure threshold meter.

The relationship between the rate of pressure applied over the masseter muscle and the pressure pain threshold was studied with the aid of an algometer (pressure threshold meter, PTM) connected to a stopwatch. Twenty consecutive patients with various degrees of craniomandibular dysfunction were included in the study. In 10 of the patients, the belly of the right superficial masseter muscle was recorded with the algometer 10 times using different pressure rates arbitrarily and unsystematically ranging from low to high values. The correlation between pressure rate and the PTM value was high. An increased pressure rate increased the PTM value (mean regression coefficient b = 0.70). A PTM value range of 0.5 kg/cm2 was found to correspond to a pressure rate range of 0.50 kg/cm2/s. In the remaining 10 patients, repeated recordings of the same site with a constant pressure rate did not influence the PTM value significantly.

Adult↗
PubMed1991

Craniomandibular function in juvenile chronic arthritis. A clinical and radiographic study.

Craniomandibular function was studied in 70 subjects with juvenile chronic arthritis (JCA). The subjects represented the total group of children and adolescents with the diagnosis JCA in a Swedish county. At examination, the median age of the subjects was 11.9 years and the median duration of the disease was 2.6 years. The most important finding of the study was the high prevalence (41%) of radiographic signs of temporomandibular joint (TMJ) pathology. Few subjects showed the typical craniofacial abnormalities associated with JCA, like mandibular micrognathia, facial asymmetries and open bite. Subjective symptoms of dysfunction were almost absent in subjects younger than seven years but were reported by 56% of the older subjects. TMJ sounds and pain on jaw movements were the most frequent symptoms reported. At the clinical examination, TMJ crepitations and restricted horizontal jaw movements were noted in 26% and 32% respectively. The high prevalence of TMJ involvement found in this study underlines the importance that dentists become part of the medical team responsible for the treatment of children and adolescents with JCA.

Adolescent↗
PubMed1990

An individual tooth wear index and an analysis of factors correlated to incisal and occlusal wear in an adult Swedish population.

The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.

Adult↗
PubMed1990

Background factors in craniomandibular disorders with special reference to general joint hypermobility, parafunction, and trauma.

Seventy-four female patients referred to a CMD clinic were randomly selected for an examination of general joint mobility according to Beighton. Thirty of the patients (41%) were classified as hypermobile. Eighty-three percent of the patients with generally lax joints had TMJ involvement in comparison to 41% of the patients with no joint laxity. The difference between these groups was statistically significant (P less than 0.001). Parafunctions and trauma were associated with increased symptoms and signs in individuals with lax joints. In nonlax joint patients, trauma to the head and jaw was significantly correlated to TMJ disorders. The results indicate that general joint hypermobility should be taken into consideration in the diagnosis and treatment of CMD.

Adolescent↗
PubMed1989

Reliability and validity of a pressure threshold meter in recording tenderness in the masseter muscle and the anterior temporalis muscle.

The reliability and validity of an algometer pressure threshold meter (PTM) was evaluated on 45 individuals, 25 healthy volunteers and 20 patients with craniomandibular dysfunction. Tenderness upon palpation was measured at six points located on the masseter muscle, the anterior temporal muscle, and on the zygomatic arch. The validity of the PTM was evaluated by comparison of the PTM values obtained by one examiner with the finger palpation score obtained by another examiner (Part 1). A statistically significant correlation between PTM values and finger-palpation scores was found at all of the points recorded (p less than 0.05). A statistically significant difference between PTM values was obtained for the symptom-free group and the patient group. The reliability of the PTM was evaluated at six points by repeated recordings at each marked point (Part 2). High reliability coefficients (r = 0.79-0.94) were found at all the points. The study also showed that if the points were located with a certain inaccuracy (1.0 mm less than x less than 2.6 mm), the reliability coefficients were still of the same magnitude. The PTM can be recommended for evaluation of pressure pain thresholds in the masticatory system in clinical and experimental studies.

Adult↗
PubMed1988

Prevalence and severity of incisal and occlusal tooth wear in an adult Swedish population.

The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year-olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition.

Adult↗
PubMed1987

Acupuncture in the treatment of patients with chronic facial pain and mandibular dysfunction.

Ten patients with chronic facial pain and long lasting mandibular dysfunction symptoms were treated with acupuncture. All patients, two men and eight women aged between 39 and 71 years (mean = 51.0 years), exhibited a complex pain symptomatology with, basically, daily constant pain with an average duration of 13 years. The patients had resisted all previous conventional stomatognathic treatment. The symptoms and signs were evaluated before and immediately after treatment and at follow-ups three and seven months later. Four methods were used for evaluating the effect of the treatment. Subjective evaluation according to a 6-graded verbal scale. Clinical dysfunction index according to Helkimo (1974). Intensity of pain according to a visual analogue scale (VAS-scale, Pilowsky & Kaufman, 1965). Medicine consumption. Six to eight acupuncture treatments were given at one week intervals. The acupuncture points were stimulated both manually and electrically for 30 minutes with a frequency of approximately 2-3 Hz and 20-30 mA. All patients reported some degree of subjectively experienced improvement. Four felt much better and six somewhat better. At the follow-ups the same reports were given with the exception for one patient who reported unchanged discomfort. The objective criteria used for assessment of a favourable response to treatment were fulfilled by three patients immediately after treatment and at 3, 7 and 14 months after treatment. No significant negative effects of the treatment were recorded. It is concluded that acupuncture may be a realistic alternative to other, conventional stomatognathic treatment for some patients with long lasting chronic facial pain.

Acupuncture Therapy↗