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Use of complementary and alternative medicine for temporomandibular disorders
REVIEWS AND ABSTRACTS
Book reviews and article abstracts Alex Jacobson, DMD, MS, PhD Birmingham, Ala
ARTICLE REVIEWS
Constant versus dissipating forces in orthodontics: the effect on initial tooth movements and root resorption F. Weiland European Journal of Orthodontics 2003;25:335-42
Use of complementary and alternative medicine for temporomandibular disorders L. L. De Bar, N. Vuckovic, J. Schneider, and C. Ritenbaugh Journal of Orofacial Pain 2003;17:224-36
Stainless steel orthodontic wires generate a rapidly declining force during deactivation. Superelastic wires, on the other hand, deliver a constant force over an extended portion of the deactivation range. The type and level of force have a bearing on the occurrence of root resorption during orthodontic treatment. The aim of this investigation was to study root resorption resulting from the 2 regimens. Ninety premolars from 27 patients (10 boys and 17 girls) aged 10.2-14.5 years (mean age 12.5 years) were used in the study. The children had been referred for orthodontic treatment and had malocclusions requiring premolar extractions. The scheduled extractions were postponed to use the teeth as test and control teeth for the experiment. In the split-mouth experimental design, the premolar on 1 side was activated with a stainless steel wire with a buccal offset of 1 mm and activated every 4 weeks. The contralateral premolar was moved with a superelastic wire with a force plateau of 0.8-1.0 N. The latter wire had an initial activation of 4.5 mm and was not activated during the 12-week experimental period. In all, 84 teeth were actively moved, and 6 teeth were used as controls and extracted before the experiment started. The depth, perimeter, area, and volume of the resorption lacunae were measured by using 3-dimensional digital images with a confocal scanning microscope, and the resorbed portions of the root were mathematically “reconstructed.” The results of the study showed that teeth with the superelastic wires moved significantly more and tipped buccally to a larger degree during the 12-week experimental period than those moved with stainless steel wires. The depth of the resorption lacunae did not differ significantly between the 2 groups; however, the perimeters of the superelastic group were 140% greater than those of the teeth of the stainless steel group. The author concluded that tooth movement will go faster with superelastic wires offering a force level of 0.8-1.0 N compared with stainless steel wires with initially higher, but rapidly declining, forces. The negative side effect is an increase in the severity of root resorption. Alex Jacobson
Alternative treatments are often sought in conjunction with conventional medical care, not in place of it. The most commonly used therapies are relaxation techniques, herbal medicine, massage, and chiropractic. This article is a report of a survey investigating the use and effectiveness of complementary and alternative medicine (CAM) in patients with temporomandibular disorder (TMD) and other medical conditions. The investigators surveyed 192 patients with documented TMD as part of a larger project on the effectiveness of various CAM modalities for TMD patients. The survey questioned attitudes toward specific CAM therapies for treating TMD and other patient-identified health conditions. Also measured were the subjects’ physical health, health behavior, and psychological functioning. Overall, nearly two-thirds of the respondents (62.5%; n ⫽ 120) reported using CAM therapies for TMD or a related condition. Of all the CAM therapies reportedly used for TMD, massage was rated as the most frequent and the most satisfactory, and among the most helpful CAM treatments received. In general, respondents reported being most satisfied with the “hands-on” CAM therapies (massage, acupuncture, and chiropractic care). Those reporting CAM therapies for TMD in the study thought that they only modestly helped their condition. Respondents appeared to use CAM therapies simultaneously with conventional care. Those using CAM for TMD tended to be older, had a history of multiple medical problems, and reported more positive psychological functioning. Respondents who most often reported CAM treatments as “very helpful” for their TMD were likely to be healthier (ie, reporting higher levels of exercise and fewer sleep disturbances). Given the frequent use of CAM treatments by their respondents, the authors suggest that allopathic providers might want to inquire about the adjunctive use of CAM among their TMD patients. Alex Jacobson
Am J Orthod Dentofacial Orthop 2004;125:122 0889-5406/$30.00 Copyright © 2004 by the American Association of Orthodontists. doi:10.1016/j.ajodo.2003.10.013
Am J Orthod Dentofacial Orthop 2004;125:122 0889-5406/$30.00 Copyright © 2004 by the American Association of Orthodontists. doi:10.1016/j.ajodo.2003.10.014
122
American Journal of Orthodontics and Dentofacial Orthopedics /January 2004
Book reviews and article abstracts Alex Jacobson, DMD, MS, PhD Birmingham, Ala
ARTICLE REVIEWS
Constant versus dissipating forces in orthodontics: the effect on initial tooth movements and root resorption F. Weiland European Journal of Orthodontics 2003;25:335-42
Use of complementary and alternative medicine for temporomandibular disorders L. L. De Bar, N. Vuckovic, J. Schneider, and C. Ritenbaugh Journal of Orofacial Pain 2003;17:224-36
Stainless steel orthodontic wires generate a rapidly declining force during deactivation. Superelastic wires, on the other hand, deliver a constant force over an extended portion of the deactivation range. The type and level of force have a bearing on the occurrence of root resorption during orthodontic treatment. The aim of this investigation was to study root resorption resulting from the 2 regimens. Ninety premolars from 27 patients (10 boys and 17 girls) aged 10.2-14.5 years (mean age 12.5 years) were used in the study. The children had been referred for orthodontic treatment and had malocclusions requiring premolar extractions. The scheduled extractions were postponed to use the teeth as test and control teeth for the experiment. In the split-mouth experimental design, the premolar on 1 side was activated with a stainless steel wire with a buccal offset of 1 mm and activated every 4 weeks. The contralateral premolar was moved with a superelastic wire with a force plateau of 0.8-1.0 N. The latter wire had an initial activation of 4.5 mm and was not activated during the 12-week experimental period. In all, 84 teeth were actively moved, and 6 teeth were used as controls and extracted before the experiment started. The depth, perimeter, area, and volume of the resorption lacunae were measured by using 3-dimensional digital images with a confocal scanning microscope, and the resorbed portions of the root were mathematically “reconstructed.” The results of the study showed that teeth with the superelastic wires moved significantly more and tipped buccally to a larger degree during the 12-week experimental period than those moved with stainless steel wires. The depth of the resorption lacunae did not differ significantly between the 2 groups; however, the perimeters of the superelastic group were 140% greater than those of the teeth of the stainless steel group. The author concluded that tooth movement will go faster with superelastic wires offering a force level of 0.8-1.0 N compared with stainless steel wires with initially higher, but rapidly declining, forces. The negative side effect is an increase in the severity of root resorption. Alex Jacobson
Alternative treatments are often sought in conjunction with conventional medical care, not in place of it. The most commonly used therapies are relaxation techniques, herbal medicine, massage, and chiropractic. This article is a report of a survey investigating the use and effectiveness of complementary and alternative medicine (CAM) in patients with temporomandibular disorder (TMD) and other medical conditions. The investigators surveyed 192 patients with documented TMD as part of a larger project on the effectiveness of various CAM modalities for TMD patients. The survey questioned attitudes toward specific CAM therapies for treating TMD and other patient-identified health conditions. Also measured were the subjects’ physical health, health behavior, and psychological functioning. Overall, nearly two-thirds of the respondents (62.5%; n ⫽ 120) reported using CAM therapies for TMD or a related condition. Of all the CAM therapies reportedly used for TMD, massage was rated as the most frequent and the most satisfactory, and among the most helpful CAM treatments received. In general, respondents reported being most satisfied with the “hands-on” CAM therapies (massage, acupuncture, and chiropractic care). Those reporting CAM therapies for TMD in the study thought that they only modestly helped their condition. Respondents appeared to use CAM therapies simultaneously with conventional care. Those using CAM for TMD tended to be older, had a history of multiple medical problems, and reported more positive psychological functioning. Respondents who most often reported CAM treatments as “very helpful” for their TMD were likely to be healthier (ie, reporting higher levels of exercise and fewer sleep disturbances). Given the frequent use of CAM treatments by their respondents, the authors suggest that allopathic providers might want to inquire about the adjunctive use of CAM among their TMD patients. Alex Jacobson
Am J Orthod Dentofacial Orthop 2004;125:122 0889-5406/$30.00 Copyright © 2004 by the American Association of Orthodontists. doi:10.1016/j.ajodo.2003.10.013
Am J Orthod Dentofacial Orthop 2004;125:122 0889-5406/$30.00 Copyright © 2004 by the American Association of Orthodontists. doi:10.1016/j.ajodo.2003.10.014
122
American Journal of Orthodontics and Dentofacial Orthopedics /January 2004