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J van der Zaag

Publications and source records attributed to J van der Zaag.

8 recordsLinked to original sources
PubMed2001

Prevalence of cervical spinal pain in craniomandibular pain patients.

It has often been suggested that patients with a craniomandibular disorder (CMD) more often suffer from a cervical spine disorder (CSD) than persons without a CMD. However, in most studies no controlled, blind design was used, and conclusions were based on differing signs and symptoms. In this study, the recognition of CMD and CSD was based upon the presence of pain. The aim of this study was to determine the prevalence of cervical spinal pain in persons with or without craniomandibular pain, using a controlled, single-blind design. From 250 persons, a standardised oral history was taken, and a physical examination of the masticatory system and the neck was performed. Three classification models were used: one based on symptoms only; a second on signs only; and a third one based on a combination of symptoms and signs. The CMD patients were also subdivided in three subgroups: patients with mainly myogenous pain; mainly arthrogenous pain; and both myogenous and arthrogenous pain. Craniomandibular pain patients more often showed cervical spinal pain than persons without craniomandibular pain, independent of the classification model used. No difference in the prevalence of cervical spinal pain was found between the three subgroups of craniomandibular pain patients.

Adult↗
PubMed2000

Clinical tests in distinguishing between persons with or without craniomandibular or cervical spinal pain complaints.

The recognition of a craniomandibular or cervical spinal pain is usually based upon the pain complaint of the patient, reported during an oral history, and the pain responses provoked in a clinical examination. Often used clinical tests are palpation, and function tests like dynamic/static tests or active movements. The relative importance of these tests for the recognition of the musculoskeletal pain is important. Therefore, it was the aim of the present study to determine which test, or combination of tests, best discriminates between persons with or without craniomandibular and/or cervical spinal pain complaints. Two hundred and fifty persons participated. From each person, a standardized oral history was taken. Then, in a randomized order and using a blind design, physical examinations of the craniomandibular system and of the neck were performed. Forward stepwise logistic regression analyses showed that the dynamic/static tests discriminated better between persons with and without pain complaints than the other tests did. In conclusion, in studies to the coexistence of craniomandibular and cervical spinal pain, it may be a good choice to base the recognition of these disorders on the pain complaints reported in the oral history which are verified by the pain response of the dynamic/static tests.

Adult↗
PubMed2000

[Treatment protocol for craniomandibular disorder 1. Diagnosis].

In two essays the treatment strategy of the department of Oral Function of the Academic Center of Dentistry Amsterdam for treating craniomandibular disorder (CMD) patients will be presented. This first essay starts with a short description of the symptomatology, classification and etiology of CMD. Then it is described how to diagnose a CMD with the use of a standardized diagnostic protocol. Some important aspects of the differential diagnosis of CMD are discussed. Furthermore it is discussed when a CMD-patient can be treated by the dentist or when referral to a CMD specialist or oral surgeon is necessary.

Craniomandibular Disorders↗
PubMed2000

[Treatment protocol for craniomandibular dysfunction 2. Treatment].

In two essays the treatment strategy of the department of Oral Function of the Academic Center of Dentistry Amsterdam for treating craniomandibular disorder (CMD) patients is described. In this second essay a description is given of several dental, physiotherapeutical and psychological treatment modalities for CMD. Then treatment strategies for the different categories of CMD are described. It is also indicated which aspects of the treatment strategy are based upon 'evidence based care' and which aspects are more based upon principles of 'common sense' and 'clinical prudence'.

Analgesics↗
PubMed2000

[Multidisciplinary diagnosis and treatment of craniomandibular disorders].

Treatment of craniomandibular disorders (CMD) requires a multidisciplinary approach. The CMD-team of the Academic Centre for Dentistry Amsterdam (ACTA) therefore consists not only of specialists in CMD and orofacial pain, but also of physiotherapists and a psychologist. Possible CMD-patients are referred to this team by the dentist-general practitioner, either directly or upon request of a family physician or a medical specialist; the many rules of such referrals are outlined in the article. The CMD-team regularly consults other disciplines for diagnosis and/or treatment of their patients. For instance, internal referrals are sometimes made to the departments of Oral radiology, Endontology, Periodontology, Orthodontics, or Oral and maxillofacial surgery. External referrals to, for example, a speech therapist or a medical specialist (e.g., a pain specialist) are arranged by the family physician upon request of the CMD-team.

Craniomandibular Disorders↗
PubMed2000

[Dental and pharmacological treatment options for bruxism].

Bruxism has a multifactorial etiology. The consequences of bruxism, abrasion of teeth and a possible craniomandibular disorder, present themselves periferal. So, treatment can have divers points of action. Counseling seems to be useful in all cases. Treatment with a hard acrylic occlusal appliance (oral splint) is especially useful in those situations where the patient has a lot of abrasion or suffers from a craniomandibular disorder with pain. Pharmacological treatment will have a more central effect. Some drugs are effective on bruxism. However, the real pharmacological mechanisms have not yet been discovered. In the absence of data from double-blind, polysomnographic, controlled studies, pharmacotherapy treatment is only indicated in severe cases on a short-term base. Until new data come available, the dentist has to use conventional therapies only.

Bruxism↗
PubMed1994

The reliability of clinical methods for recording temporomandibular joint sounds.

Measurement errors in recording temporomandibular joint sounds may originate from variation between observers and from variation in the phenomenon. Laboratory settings enable various procedures to be used to minimize both sources of variation. These procedures yield some excellent intra- and inter-examiner reliabilities, but this does not imply that dentists in a clinical setting are likely to evaluate temporomandibular joint sounds in a comparable way. This study was designed to evaluate clinical joint sound assessment methods (palpation and stethoscopy) without using special precautions to minimize variance. An attempt was made to quantify the signal variance. Within- and between-examiners agreement is estimated for both methods in a sample of 44 non-patients. The results show that two clinically experienced craniomandibular disorders specialists were able to reach fair to good agreement on the identification of (the number of) temporomandibular joint sounds. There was some disagreement with respect to the number of reciprocal clicks. Compared with the palpation technique, stethoscopy is more sensitive, especially with regard to crepitation. Based on the electronically recorded sounds, both examiners appeared to be overconsistent. It is concluded that the use of both palpation and stethoscopy in clinical settings can be justified but that both methods have limitations. When, in a given clinical setting, these limitations are acceptable, there appears to be no need for extra-sensitive but expensive electronic recording devices.

Auscultation↗