ASSOCIATION OF VITAMIN D SUPPLEMENTS IN PAIN MANAGEMENT OF PATIENTS WITH TMD – A CROSS-SECTIONAL STUDY
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Keywords
Temporomandibular disorders (TMDs), Vitamin D, TMJ
Abstract
Background: Temporomandibular disorder (TMD) is characterized by pain and dysfunction in the temporomandibular joint (TMJ) and the masticatory apparatus. Associations with autoimmune diseases, inflammatory conditions, and nutrition deficiencies have been reported in previous studies of TMD patients. Typical signs and symptoms of TMDs are facial pain, clicking or crepitus of the TMJs, limited jaw movement capacity, and a deviation in the movement patterns of the mandible. Various studies have shown that reduced serum levels of vitamin D are associated with musculoskeletal disorders and data about vitamin D status and TMDs are limited. Serum vitamin D levels are a reliable qualitative and quantitative tool to assess bone metabolism and health. The objective of this study was to evaluate the Vitamin D supplements in the pain management of TMD Patients.
Material and Methods: In this study, 500 patients diagnosed with TMDs were included. VAS scale, inter incisal opening, Clicking of TMJ, and Serum calcium were evaluated before and after Vitamin D supplements.
Result: Post-treatment Mean SD is 4.21 (1.67) compared to the Pre-treatment Mean SD is 7.12 (2.87) found a highly significant statistical difference between pre and post-treatment with Vitamin D supplementation for relief of pain. The significant statistical difference found in other parameters
Discussion: Temporomandibular disorders are a collective cause of craniofacial pain. The most collective symptom recounted by patients with TMD is unilateral facial pain. Patients suffering from TMD who have low Vitamin D may benefit from this treatment.
Conclusion: Our study revealed that TMD patients with deficit Vitamin D levels benefitted more with supplementation of the same whereas those with normal/almost normal Vitamin D levels had little benefit from supplementation
References
2. Holick, M.F. Vitamin D deficiency. N. Engl. J. Med. 2007, 357, 266–281.Rosen, C.J.; Adams, J.S.; Bikle, D.D.; Black, D.M.; Demay, M.B.; Manson, J.E.; Murad, M.H.; Kovacs, C.S. The nonskeletal effects of vitamin D: An Endocrine Society scientific statement. Endocr. Rev. 2012, 33, 456–492.
3. Pludowski, P.; Holick, M.F.; Pilz, S.; Wagner, C.L.; Hollis, B.W.; Grant, W.B.; Shoenfeld, Y.; Lerchbaum, E.; Llewellyn, D.J.; Kienreich, K.; et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility,pregnancy, dementia and mortality-a review of recent evidence. Autoimmun. Rev. 2013, 12, 976–989.
4. Zakeri, M.; Parsian, H.; Bijani, A.; Shirzad, A.; Neamati, N. Serum levels of vitamin D in patients with recurrent aphthous stomatitis. Dent. Med. Probl. 2021, 58, 27–30
5. Krawiec, M.; Dominiak, M. Prospective evaluation of vitamin D levels in dental treated patients: A screening study. Dent. Med. Probl. 2021, 58, 321–326.
6. Schiffman, E.; Ohrbach, R.; Truelove, E.; Look, J.; Anderson, G.; Goulet, J.P.; List, T.; Svensson, P.; Gonzalez, Y.; Lobbezoo, F.; et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: Recommendations of the international RDC/TMD consortium network* and orofacial pain special interest group†. J. Oral Facial Pain Headache 2014, 28,6–27.
7. Okeson, J.P. Bell’s Oral and Facial Pain, 7th ed.; Quintessence Publishing: Hannover, Germany, 2014.
8. de Souza, R.F.; Lovato da Silva, C.H.; Nasser, M.; Fedorowicz, Z.; Al-Muharraqi, M.A. Interventions for the management of temporomandibular joint osteoarthritis. Cochrane Database Syst. Rev. 2012, 2012, Cd007261.
9. Kavuncu, V.; Sahin, S.; Kamanli, A.; Karan, A.; Aksoy, C. The role of systemic hypermobility and condylar hypermobility in temporomandibular joint dysfunction syndrome. Rheumatol. Int. 2006, 26, 257–260.
10. Wongwatana, S.; Kronman, J.H.; Clark, R.E.; Kabani, S.; Mehta, N. Anatomic basis for disk displacement in temporomandibular joint (TMJ) dysfunction. Am. J. Orthod. Dentofac. Orthop. 1994, 105, 257–264
11. Bizzarro, M.; Generali, C.; Maietta, S.; Martorelli, M.; Ferrillo, M.; Flores-Mir, C.; Perillo, L. Association between 3D palatal morphology and upper arch dimensions in buccally displaced maxillary canines early in mixed dentition. Eur. J. Orthod. 2018, 40,592–596.
12. Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews. 2018 Mar;2(3)
13. Rattan V, Chauhan D, Sahoo GR, Rai SK, Bhadada S. Does vitamin D has a role in causation and management of temporomandibular disorders? Int J Oral Maxillofac Surg 2015;44:280‑2.
14. De Leeuw R, Klasser GD. American Academy of Orofacial Pain. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. 5th ed. Chicago, Ill.: Quintessence Publ. 2013
15. O’Connor A. An Overview of the Role of Diet in the Treatment of Rheumatoid Arthritis. Nutrition Bulletin.; 39: 74-88 (2013)
16. Adegboye AR, Christensen LB, HolmPedersen P, Avlund K, Boucher L, and Heitmann BL. Intakes of Calcium, Vitamin D, and Dairy Servings and Dental Plaque in Older Danish adults. Nutrition Journal, 12:61:1-5 (2013)
17. Boonstra A, Barrat FJ, Crain C, Heath VL, Savelkoul HF, et al. 1-Alpha, 25-Dihydroxyvitamin D3 Has a Direct Effect on Naive CD4(+) T Cells to Enhance the Development of Th2 Cells. J Immunol.; 167: 4974-4980 (2011)
18. Kui A, Buduru S, Labunet A, Balhuc S, Negucioiu M. Vitamin D and temporomandibular disorders: What do we know so far? Nutrients 2021;13:1286.
19. Khanna, S.S.; Parulekar, N.R.; Dhaimade, P.A. The influence of vitamin D on the temporomandibular joint and the activities of daily living. J. Clin. Diagn. Res. 2017, 11, 31–34
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Manzoor Mohd Dar
Research Scholar, Pacific Academy of Higher Education & Research University, Udaipur
Dr. A. Bhagavandas Rai
Professor, Pacific Dental College and Hospital, Pacific Academy of Higher Education & Research University, Udaipur