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Biomedical subjects

Y Le Bell

Publications and source records attributed to Y Le Bell.

At least 19 recordsLinked to original sources
PubMed2005

Headache children with temporomandibular disorders have several types of pain and other symptoms.

The aim was to investigate the association between temporomandibular disorders (TMD) and overall muscle tenderness, depressive symptoms, sleep difficulties, headache frequency and related symptoms in children with primary headache in comparison with controls. Based on an unselected population sample of 1135 Finnish schoolchildren classified according to the type of headache at age 12, altogether 297 children aged 13-14 from different headache groups and healthy controls were randomly selected for an interview and clinical examinations. Children with migraine had more TMD signs than children with nonmigrainous headaches or healthy controls. High TMD total scores were associated with palpation tenderness in other parts of the body and with frequent headache attacks. We conclude that children with overall headache, migraine in particular, and high total TMD scores showed an increased overall tenderness to muscle palpation and multiply manifested hypersensitivity pain.

Adolescent↗
PubMed2001

Signs and symptoms of temporomandibular disorders in children with different types of headache.

Headache is a common symptom among children and teenagers. Both bruxism and muscle and joint tenderness have been found in children with headache. Children with migraine headache report more temporomandibular disorder (TMD) symptoms than do those with tension-type headache. The aim of the present study was to investigate the association of different types of headache with TMD and sex in children. Altogether 297 randomly selected schoolchildren aged 13-14 years participated in a blind study setting. There were no statistically significant differences between the headache groups with regard to TMD signs, although the migraine and migraine-type headache groups had the highest percentage of subjects with more severe TMD signs. Nor were there any statistical differences between sexes or between the headache groups with regard to subjective symptoms of TMD. The present results with children differed from earlier results with adults. First, no association was found between tension headache and TMD, and, second, no sex difference in TMD children was observed at this age.

Adolescent↗
PubMed1999

Aural symptoms and signs of temporomandibular disorder in association with treatment need and visits to a physician.

OBJECTIVES: To analyze associations between aural symptoms and clinical signs of and treatment need for temporomandibular disorders, as well as visits to a physician, in a Finnish population. STUDY DESIGN: A longitudinal study of a random sample of adults. METHODS: Four hundred eleven subjects (203 men and 208 women aged 25, 35, 45, 55, or 65 years at baseline) were examined and interviewed at three consecutive examinations at 12-month intervals, and a questionnaire on visits to physician during the preceding 12 months was completed. RESULTS: The aural symptoms were common. The prevalence of otalgia without infection varied between 12% and 16%, while the prevalence of tinnitus and fullness of ears was 12% to 17% and 5% to 9%, respectively. Women had more aural symptoms than men. When compared with the other subjects, the subjects with aural symptoms more often had masticatory muscles that were tender to palpation or temporomandibular joint signs. Subjects with obvious treatment need for temporomandibular disorders had more aural symptoms than subjects in the other treatment need subgroups. They also visited a physician more often because of otalgia than the subjects with otalgia in the other treatment need subgroups. CONCLUSIONS: In patients with otalgia, infectious otolaryngologic diseases should be ruled out. Then the patients without infection should be remitted to a dentist with stomatognathic experience. In the absence of temporomandibular disorders, further medical consultations (e.g., otorhinolaryngological, neurological, physiatric, and psychiatric) are indicated.

Adult↗
PubMed1998

TMD treatment need in relation to age, gender, stress, and diagnostic subgroup.

Associations between treatment need for temporomandibular disorders (TMD) and age, gender, stress, and diagnostic subgroup were analyzed in an adult Finnish population sample of 506 subjects. When analyzed separately, the association between TMD treatment need and all the studied factors was statistically significant. This finding is in accordance with earlier results. When the studied factors were included into an explanatory model, however, the picture changed. The logistic regression analysis revealed that diagnostic subgroup was the strongest predictor for the TMD treatment need. Total stress score significantly added to the explanatory power of the model, but age and gender did not. The commonplace observation that women show more signs and symptoms of TMD seems to be explainable by their higher stress scores and by the type of symptoms.

Adult↗
PubMed1997

Fluctuation of treatment need for temporomandibular disorders and age, gender, stress, and diagnostic subgroup.

Associations between fluctuation of treatment need for temporomandibular disorders (TMD) and age, gender, stress, and diagnostic subgrouping were analyzed in a 2-year follow-up of 391 subjects. All the studied factors were significantly associated with the treatment need for TMD at all examinations. The diagnostic subgroup (TMD arthro, TMD myo, TMD comb, or non-classified) at base line was significantly associated with the fluctuation of the treatment need for TMD also during the follow-up, but age, gender, and stress score were not. In the subgroup needing active treatment for TMD at least once during the follow-up (n = 65), the stress score did not show statistically significant covariation with the treatment need. The diagnostic subgrouping of these 65 subjects at the second and third examination at 12-month intervals did not show any association with the subgrouping at base line or with any studied variable. Detailed descriptive diagnostics may serve well in treatment planning but do not necessarily help us in understanding the nature of TMD.

Adult↗
PubMed1997

Fluctuation of temporomandibular disorders in accordance with two classifications: the Helkimo dysfunction index and treatment need grouping.

We studied the fluctuation of temporomandibular disorders, applying two classifications systems, in a 2-year follow-up study of 411 subjects. In general, the fluctuation was not large. There were no major differences between the two classifications. In our opinion, a decision to treat a patient on the basis of the treatment need grouping would not lead to overtreatment. The study design suffered from the fact that it is not possible to separate the fluctuation of the TMD itself and the fluctuation of its signs and symptoms from each other, owing to the descriptive nature of the diagnosis 'temporomandibular disorder'.

Adult↗
PubMed1997

Prevention of temporomandibular disorder-related signs and symptoms in orthodontically treated adolescents. A 3-year follow-up of a prospective randomized trial.

Recommendations about the need for occlusal adjustment after malocclusion therapy are inconclusive. A total of 123 orthodontically treated healthy adolescents (88 girls, 35 boys; 14.8 +/- 1.7 years old) agreed to participate in the present study. The subjects were interviewed and examined for signs and symptoms related to temporomandibular disorder (TMD) and were randomly allocated to intervention (n = 63) and control (n = 60) groups. At base line, occlusal adjustment was carried out for the intervention group and repeated every 6 months thereafter as needed. Mock adjustments were performed for the control group. At the end of the 3rd year 118 subjects (96%) turned up for re-examination. The number of subjects with palpatory pain of the masticatory muscles, and with occlusal centric slides decreased significantly in the intervention group but not in the control group (P < 0.001). In conclusion, occlusal adjustment therapy may prevent the occurrence of TMD signs in orthodontically treated healthy adolescents.

Adolescent↗
PubMed1997

Association between TMD treatment need, sick leaves, and use of health care services for adults.

The objective of this study was to analyze the relationship between need for treatment of temporomandibular disorders, sick leaves, and use of health care services in a study population of 441 adults born between 1927 and 1967. The findings indicated that these were strongly associated. The results were in agreement with earlier studies suggesting that stomatognathic disorders are one link between medicine and dentistry in health care. Subjects with temporomandibular disorders were significantly more often on sick leave, visited a physician more often, and had more physiotherapy and massage than subjects who did not need treatment for temporomandibular disorders. Intervention studies are needed to improve cooperation between different specialties, to eliminate unnecessary examinations as well as ineffective treatment modalities, and to decrease the cost of health care.

Adult↗
PubMed1996

The concepts prevalence, need for treatment, and prevention of temporomandibular disorders: a suggestion for terminology.

The concepts active and passive treatment need and active and passive prevention need are suggested, to systematize some concepts used in discussions about temporomandibular disorders (TMD), to separate the treatment need figures from the prevalence figures, and to understand the great variation among TMD prevalence studies. On the basis of a summary of recently published papers and on a clinical 2-year follow-up study of 411 subjects, the suggestions seem to provide a reasonably good fit with clinical experience and earlier epidemiologic studies of TMD.

Adult↗
PubMed1993

Self-reported symptoms of stress in Finnish patients with craniomandibular disorders.

This study compared the stress reports of Finnish craniomandibular disorder patients and nonpatients by using the Symptoms of Stress Inventory as a screening device. A comparison of Finnish and American craniomandibular disorder patients' stress reports was made in the same manner. The overall stress level of craniomandibular disorder patients was higher than that of nonpatients. The patients had elevated scores on somatic subscales, with muscle tension symptoms being the most characteristic. These results are in accordance with American results. However, statistically significant differences were not found for emotional symptoms.

Adult↗
PubMed1993

Function of masticatory system after surgical-orthodontic correction of maxillomandibular discrepancies.

Thirty-two subjects were interviewed about their pre- and post-treatment symptoms of craniomandibular disorders (CMD) and examined for signs of CMD at follow up 2-5 years after surgical-orthodontic treatment for maxillomandibular discrepancies. Symptoms of CMD were among the main reasons for seeking treatment in 31% of the patients. Patients with retrognathic mandibles had significantly more severe symptoms than patients with mandibular prognathism before treatment. After treatment, the severity of subjective symptoms had decreased for the patients as a whole, and significantly in the subjects with originally severe symptoms. Ten subjects out of 12 reported a decrease in the occurrence of headache. The clinical findings of CMD after surgery were usually mild. The importance of occlusal adjustment and rehabilitation as final steps after surgical-orthodontic treatment is stressed.

Adolescent↗
PubMed1993

A two-year follow-up of temporomandibular joint disk displacement without reduction in 22 subjects.

Twenty-two subjects with clinically diagnosed unilateral anterior disk displacement were followed up for two years. Seventeen of the patients were women and five were men, with ages ranging from 17 to 68 years (median 27 years). In 20 cases the duration of locking at the time of the examination was less than 6 months; the other two cases had experienced locking for more than 6 months but less than one year. Case histories were recorded and clinical examinations performed according to accepted principles, followed by calculation of Helkimo's anamnestic dysfunction index Ai and clinical dysfunction index Di. The patients were treated using full coverage splints combined with occlusal adjustment. Follow-up examinations were made after 6 months, one year and two years. At the time of the first visit, 17 patients had severe subjective symptoms such as difficulty in opening the mouth wide and pain on movement of the mandible, while five experienced locking without subjective symptoms. All patients apart from one belonged to Di III and had a maximal mouth opening capacity ranging from 24 to 38 mm. During follow-up, one patient was treated surgically because of continuous severe symptoms; in one case, spontaneous disk reduction was confirmed by MR imaging. At the last examination the rest of the patients (n = 20) had a mouth opening capacity ranging from 31 to 60 mm and belonged to Di II. However, eight patients were completely symptom free and 12 had only mild symptoms. All patients regarded their condition and good as were able to manage well.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Effect of repeated sampling and prestimulation on saliva buffer capacity and flow rate values in children.

Great variations reported in the frequency distribution of buffer capacity values may partly be due to methodological differences in saliva sampling. In this study we wanted to see to what extent these variations are due to repetition and prestimulation. 9-yr-old schoolchildren (n: 41, 23 girls and 18 boys), who had never had saliva samples taken before, participated in the present study. The repetition tests were carried out between 9 and 11 a.m. on three subsequent days. The effect of prestimulation was tested 4 days later with the same subjects. The buffer capacity of the samples was determined electrometrically immediately after sampling using the commercial Dentobuff-test. The intraindividual analysis revealed a significant increase in flow rate but not in buffer capacity along with repetition of the sampling. The analysis further showed that the buffer capacity of children accustomed to saliva sampling increased significantly through prestimulation of 1 min. The use of prestimulation resulted in substantial changes also in the frequency distribution of the buffer capacity values. Our results emphasize the importance of proper sampling conditions in saliva collection when screening children for high caries risk.

Buffers↗
PubMed1990

Treatment of reciprocal clicking of the temporomandibular joint with a repositioning appliance and occlusal adjustment--results after four and six years.

A follow-up study was performed on 12 subjects with unilateral and five subjects with bilateral reciprocal clicking and symptoms of craniomandibular disorders. After treatment for, on average, three months with a repositioning appliance, followed by occlusal adjustment, patients were examined every six months initially and, after the first two years, once a year. During the follow-up period, occlusal stability was maintained by readjustment and use of full occlusal splints at night, when needed. After four years there was a 57% success rate with regard to treated joints. After six years, the success rate had decreased to 41%. However, even the eight unsuccessful cases, with persistent clicking and adjusted occlusion, managed well with regard to other clinical findings and subjective symptoms. It is concluded that repositioning splint therapy followed by occlusal adjustment seems appropriate for elimination of subjective symptoms and clinical signs even though repositioning may subsequently fail. Results seem to remain relatively unchanged for several years but some decline in the success rate may occur with time.

Adolescent↗