Retrospektive multivariate Datenanalyse der CMD-Patienten der Universitätsmedizin Göttingen zur Diagnostik, Therapie und Heilungswahrscheinlichkeit im Zeitraum 2011 - 2014
Retrospective multivariate data analysis of TMD-patients at the University of Göttingen regarding diagnosis, therapy and healing process from 2011 - 2014
by Jana Jessica Wendelstein
Date of Examination:2017-01-11
Date of issue:2017-01-09
Advisor:Prof. Dr. Nikolaus Gersdorff
Referee:Prof. Dr. Dr. Wilfried Engelke
Referee:Prof. Dr. Margarete Schön
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Abstract
English
BACKGROUND: TMD is a frequently occurring disorder of the mandibular joint that can be the cause of discomfort by creating symptoms such as pain, lockjaw or joint-popping, which often drives patients to seek treatment from their dental practitioner. The most common method to treat the joint dysfunction is an occlusal splint therapy. In the modern day, dentists can choose from a wide array of splints with different pros and cons. Additionally, physiotherapy can be used to treat the symptoms. OBJECTIVE: The purpose of this study was to retrospectively assess different therapeutic concepts in the treatment of TMD–patients with a focus on the reduction or even absence of pain. DESIGN: From 2011 until 2014, 358 patients received TMD treatment in the form of different splints and physiotherapy. A total of 52 parameters were recorded for a statistical analysis. Patients were split into two groups, with or without physiotherapy, and further divided into subgroups based on their type of splints. The main targets were the differences in influence on pain relief and absence thereof. RESULTS: The evaluation in this study showed no significant difference in pain reduction between patients with and without physiotherapy. Nor is there any difference between patients with a pure bimaxillary calotte splint therapy, a pure maxillar (equilibrated/centric) splint therapy, or a pure mandibular (equilibrated/centric) splint therapy. In patients who were treated only by bimaxillary calotte splints, due to their TMD, the chance of being free of pain was approx. 0.3 times that of patients who were treated only with maxillar splints. In patients who were treated exclusively by a bimaxillary calotte splint, the chance of painlessness was approx. 0.4 times that of patients who were treated with mandibular splints. The evaluation showed no significant difference between the patients with and without physiotherapy with regard to painlessness. There is no significant difference between combined splint therapy and pure bimaxillary calotte splint therapy, maxillar splint therapy, or mandibular splint therapy. There was also no difference between maxilla and mandibular splint therapy in relation to painlessness. Male patients in the investigated treatment period were 3.3 times as likely to have an absence of pain compared to female patients. CONCLUSION: The current observations warrant further analysis, depending on the set-up, taking into account the relevant parameters.
Keywords: TMD; occlusal splint; physiotherapy TMD