OU College of Dentistry Surgeon Wins ‘Best Paper’ for Research on Jaw Joint Disorder

A research article by Fabio G. Ritto, DDS, M.D., MS, Ph.D., an oral and maxillofacial surgeon and assistant professor at the University of Oklahoma College of Dentistry at OU Health Sciences, has been named Best Paper in the surgery section of the journal Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology.

The article details the results of a pivotal clinical trial that compared treatments for temporomandibular disorder (TMD), which causes pain in the jaw joints (TMJ, or temporomandibular joints) and difficulty opening the mouth.

“It was very gratifying for me to be honored with the Best Paper award and to now have evidence for the approaches that the field of dentistry uses in treating TMDs,” Ritto said. “I am also grateful for my fellow authors and contributors.”

TMDs are either muscular (the result of tension or spasm in the muscles that move the jaw) or articular (dysfunction in the actual joint of the jaw). Ritto’s clinical trial filled a gap in knowledge about the best initial treatment for the articular type of TMD. Because the condition can be treated with both invasive and non-invasive techniques, Ritto sought evidence for which approach would be most appropriate to use first.

In the study, the non-invasive approach to treating TMDs involved anti-inflammatory medications and physical therapy, in which the therapist helped patients stretch the muscles that allow the mouth to open more fully. The more invasive procedure, called arthrocentesis, used needles to flush the joint with saline in order to clear out inflammatory substances that have accumulated, as well as fibrous attachments that limit joint movement and range of motion. Existing research supports both treatments, but until now, they had not been compared in the same group of patients.

In the clinical trial, Ritto and his team discovered that both the medication/physical therapy and arthrocentesis achieved the same level of pain reduction and increase of mouth opening — meaning the non-invasive approach should be used first.

“The main takeaway of our study is that we should start conservatively, and if that doesn’t work, we can move to more invasive treatments,” Ritto said.

TMDs are the second most frequent musculoskeletal condition after low back pain, affecting between 10% and 30% of the world’s population. In addition, 80% of people with TMD have some degree of problem with the joint that connects the jawbone to the skull. Because the disorder causes pain in the jaw and difficulty chewing, among other symptoms, it affects quality of life. Ritto said its cause remains unclear — possibilities include trauma, grinding or clenching the teeth, and missing teeth, but no clear connection has yet to be shown.

Ritto said he enjoys practicing oral surgery in an academic setting because he can also train the next generation of dental surgeons and conduct research. “Without research, we cannot advance knowledge and the standard of care,” he said. “That is rewarding — advancing science and training my future peers.”

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About the OU College of Dentistry
The OU College of Dentistry is home to the state’s only Doctor of Dental Surgery program and baccalaureate degree program in dental hygiene. More than 70% of the state of Oklahoma’s dentists are graduates of the OU College of Dentistry. The college provides general dental care and specialty care to Oklahomans through student, resident and faculty practice clinics. The OU College of Dentistry has established a reputation of training its students to provide the highest quality of clinical care available.

About The University of Oklahoma Health Sciences
The University of Oklahoma Health Sciences is one of the nation’s few academic health centers with all health professions colleges — Allied Health, Dentistry, Medicine, Nursing, Pharmacy, Public Health, Graduate Studies and School of Community Medicine. OU Health Sciences serves approximately 4,000 students in more than 70 undergraduate and graduate degree programs on campuses in Oklahoma City and Tulsa and is the academic and research partner of OU Health, the state’s only comprehensive academic healthcare system. The OU Health Sciences is ranked 129 out of over 2,849 institutions in funding received from the National Institutes of Health, according to the Blue Ridge Institute for Medical Research. For more information, visit ouhsc.edu.