{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T13:38:45Z","timestamp":1649165925702},"reference-count":33,"publisher":"Walter de Gruyter GmbH","issue":"6","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jaoa.2019.063_s_001\">\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Occlusal splints are widely used in clinical practice as a noninvasive treatment for patients with temporomandibular disorders (TMDs) and for reduction of TMD-related symptoms. A force diagram allows a health care professional to evaluate the interactions of loads caused by muscular effort, which are sensed by the teeth and the temporomandibular joint during the protrusive movement of the mandible.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.063_s_002\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the efficacy of occlusal splints combined with occlusal adjustment (OA) based on a force diagram in the management of joint sounds (clicking and crepitation).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.063_s_003\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients were examined clinically and administered a questionnaire for the diagnosis of TMD and orofacial pain. Patients were then assigned to 1 of 2 splint therapies: (1) an anterior bite plane of the front-plateau type (FP) or (2) a maxillary muscle relaxation appliance (MRA), both combined with OA based on a force diagram performed at 6 visits, with an interval of 24 to 48 hours between each visit. To measure the effects of treatment, at each of the 6 visits, patients also rated the severity of their TMD-related symptoms on a visual analog scale. Data were dichotomized into presence and absence of symptoms and compared using the McNemar test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.063_s_004\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 199 patients were included in the study. At baseline, 38 patients (19.1%) had crepitation and 161 (80.9%) had clicking. A total of 150 patients were treated with FP+OA, with a statistically significant reduction in the number of patients reporting clicking (42.6%, <jats:italic>P<\/jats:italic>&lt;.001) and crepitation (42.9%, <jats:italic>P<\/jats:italic>&lt;.001). Among patients treated with MRA+OA (n=49), there was a statistically significant reduction in the number of patients reporting clicking (50%, <jats:italic>P<\/jats:italic>&lt;.001). All 3 patients with crepitation in the MRA+OA group reported total remission (<jats:italic>P<\/jats:italic>&gt;.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.063_s_005\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The 2 treatment strategies, FP+OA and MRA+OA, improved both clicking and crepitation. Both strategies prioritize the concept of mutually protected occlusion, in which all jaw and temporomandibular joint movements must synchronize, which may be conveniently done using the force diagram.<\/jats:p>\n               <\/jats:sec>","DOI":"10.7556\/jaoa.2019.063","type":"journal-article","created":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T13:01:25Z","timestamp":1559048485000},"page":"349-356","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the Use of a Force Diagram in the Management of Temporomandibular Joint Sounds: A Prospective Cross-sectional Study"],"prefix":"10.1515","volume":"119","author":[{"given":"Nilton Sodi","family":"Saueressig","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline Cristina","family":"Saueressig Hickert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilberto","family":"Keller de Andrade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9lio Radke","family":"Bittencourt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D\u00e9lcio","family":"Basso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilton Gustavo","family":"Saueressig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2019,6,1]]},"reference":[{"key":"2022022616524578307_j_jaoa.2019.063_ref_001","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1007\/BF02962508","article-title":"H\u00e4ufigkeit, bedeutung und behandlungsbedarf kraniomandibul\u00e4rer dysfunktionen (CMD)","volume":"9","author":"John","year":"2001","journal-title":"Z Gesundh Wiss"},{"issue":"3","key":"2022022616524578307_j_jaoa.2019.063_ref_002","first-page":"218","article-title":"Relationship between overbite\/overjet and clicking or crepitus of the temporomandibular joint","volume":"19","author":"Hirsch","year":"2005","journal-title":"J Orofac Pain"},{"issue":"8","key":"2022022616524578307_j_jaoa.2019.063_ref_003","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1046\/j.1365-2842.2001.00705.x","article-title":"Impact of balancing-side tooth contact on clenching induced mandibular displacements in humans","volume":"28","author":"Baba","year":"2001","journal-title":"J Oral Rehabil"},{"issue":"7","key":"2022022616524578307_j_jaoa.2019.063_ref_004","first-page":"571","article-title":"Disc derangements of the temporomandibular joint","volume":"36","author":"Holmlund","year":"2007","journal-title":"a tissue-based characterization and implications for surgical treatment [review]. 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