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      The Application of Radiofrequency Waves in Supportive Treatment of Temporomandibular Disorders

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          Abstract

          In recent years, the number of patients applying for prosthetic treatment due to temporomandibular joint disorders (TMD) has been increasing. The main methods for treating disorders are the use of occlusal splints and physiotherapeutic rehabilitation as supportive treatment. Radio waves are electromagnetic waves with radiation frequency between 3 Hz and 3 THz, used for physiotherapeutic treatment of skeletal muscle relaxation in the range of 3 to 6 MHz. The rehabilitation effect of these waves is based on diathermy by means of high-voltage quick alternating current. Aim. The aim of the study was to evaluate the influence of radiofrequency waves on the pain of the masticatory muscles in the course of TMD and the usefulness of these procedures in the supporting treatment of these disorders. Materials and Methods. Patients aged 19 to 45 years, of both sexes, reported to the Consulting Room of TMD at the Institute of Dentistry in Krakow to undertake prosthetic treatment of TMD (I a—according to RDC/TMD). Study group (SG) consists of 20 patients who had 10 supportive treatments with radiofrequency currents. In the case of application of radiation to the muscle area, the energy was 20 J to the area of the masticatory muscles, the frequency was 3 MHz, bipolar technique, the duration of the procedure was 10 minutes, and the coupling substance was a gel for ultrasound examinations. The control group (CG) consisted of 20 patients who had 10 supportive treatments with sonophoresis procedures. For the area of masticatory muscles, 0.9 W/cm 2 treatments were applied, the duty factor was 80%, the treatment time was 10 minutes, and the medical substance was 25% Voltaren gel. Results. Analysis of the results of the first clinical examinations (axis I) conducted in both groups shows a homogeneous clinical material and similar results. The second clinical examination revealed improved clinical parameters, but it showed a greater improvement in the SG. In the SG, the mean level of VAS was 6.25, and the extreme values were 5.9–0.14, the median was 2.15, and the standard deviation was 1.54. In the CG, the average value of VAS was 6.20 (peak of 5.2–0.7), the median was 2.4, and the standard deviation was 1.87. Summary. The search for new methods of supportive treatment of TMD is an important research direction due to the complex etiology of this disease and the lack of an explicit treatment algorithm. Conclusion. The results of our own research clearly indicate that the use of the radiofrequency waves brings pain relief and improvement of clinical parameters to a greater extent than in sonophoresis. It can be a very important new method in supportive treatment of TMD. Research needs to be continued.

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          Most cited references 25

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          Psychological factors associated with development of TMD: the OPPERA prospective cohort study.

          Case-control studies have consistently associated psychological factors with chronic pain in general and with temporomandibular disorder (TMD) specifically. However, only a handful of prospective studies have explored whether preexisting psychological characteristics represent risk factors for first-onset TMD. The current findings derive from the prospective cohort study of the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) cooperative agreement. For this study, 3,263 TMD-free participants completed a battery of psychological instruments assessing general psychological adjustment and personality, affective distress, psychosocial stress, somatic symptoms, and pain coping and catastrophizing. Study participants were then followed prospectively for an average of 2.8 years to ascertain cases of first-onset of TMD, and 2,737 provided follow-up data and were considered in the analyses of TMD onset. In bivariate and demographically adjusted analyses, several psychological variables predicted increased risk of first-onset TMD, including reported somatic symptoms, psychosocial stress, and affective distress. Principal component analysis of 26 psychological scores was used to identify latent constructs, revealing 4 components: stress and negative affectivity, global psychological and somatic symptoms, passive pain coping, and active pain coping. In multivariable analyses, global psychological and somatic symptoms emerged as the most robust risk factor for incident TMD. These findings provide evidence that measures of psychological functioning can predict first onset of TMD. Future analyses in the OPPERA cohort will determine whether these psychological factors interact with other variables to increase risk for TMD onset and persistence.
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            Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial.

            Chronic osteoarthritis (OA) pain of the knee is often not effectively managed with current non-pharmacological or pharmacological treatments. Radiofrequency (RF) neurotomy is a therapeutic alternative for chronic pain. We investigated whether RF neurotomy applied to articular nerve branches (genicular nerves) was effective in relieving chronic OA knee joint pain. The study involved 38 elderly patients with (a) severe knee OA pain lasting more than 3 months, (b) positive response to a diagnostic genicular nerve block and (c) no response to conservative treatments. Patients were randomly assigned to receive percutaneous RF genicular neurotomy under fluoroscopic guidance (RF group; n=19) or the same procedure without effective neurotomy (control group; n=19). Visual analogue scale (VAS), Oxford knee scores, and global perceived effect on a 7-point scale were measured at baseline and at 1, 4, and 12weeks post-procedure. VAS scores showed that the RF group had less knee joint pain at 4 (p<0.001) and 12 (p<0.001) weeks compared with the control group. Oxford knee scores showed similar findings (p<0.001). In the RF group, 10/17 (59%), 11/17 (65%) and 10/17 (59%) achieved at least 50% knee pain relief at 1, 4, and 12 weeks, respectively. No patient reported a post-procedure adverse event during the follow-up period. RF neurotomy of genicular nerves leads to significant pain reduction and functional improvement in a subset of elderly chronic knee OA pain, and thus may be an effective treatment in such cases. Further trials with larger sample size and longer follow-up are warranted. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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              Epidemiology, diagnosis, and treatment of temporomandibular disorders.

              Temporomandibular disorder (TMD) is a multifactorial disease process caused by muscle hyperfunction or parafunction, traumatic injuries, hormonal influences, and articular changes. Symptoms of TMD include decreased mandibular range of motion, muscle and joint pain, joint crepitus, and functional limitation or deviation of jaw opening. Only after failure of noninvasive options should more invasive and nonreversible treatments be initiated. Treatment can be divided into noninvasive, minimally invasive, and invasive options. Temporomandibular joint replacement is reserved for severely damaged joints with end-stage disease that has failed all other more conservative treatment modalities. Copyright © 2013 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Pain Res Manag
                Pain Res Manag
                PRM
                Pain Research & Management
                Hindawi
                1203-6765
                1918-1523
                2020
                6 May 2020
                : 2020
                Affiliations
                1Prosthodontics Department, Consulting Room of Temporomandibular Disorders, Jagiellonian University Medical Collage, 4 Montelupich Str., 31-155 Krakow, Poland
                2Doctoral Studies, Jagiellonian University Medical College, 12 Św Anny Str., 31-008 Krakow, Poland
                Author notes

                Academic Editor: Marina De Tommaso

                Article
                10.1155/2020/6195601
                7225847
                Copyright © 2020 M. Pihut et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Research Article

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