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Mitro V, Caso AR, Sacchi F, Gilli M, Lombardo G, Monarchi G, Pagano S, Tullio A. Fonseca's Questionnaire Is a Useful Tool for Carrying Out the Initial Evaluation of Temporomandibular Disorders in Dental Students. Clin Pract 2024; 14:1650-1668. [PMID: 39311282 PMCID: PMC11417721 DOI: 10.3390/clinpract14050132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/15/2024] [Accepted: 08/22/2024] [Indexed: 09/26/2024] Open
Abstract
Background: Temporomandibular disorders (TMDs) represent a prevalent multifactorial condition that impacts a significant portion of the global population. The objective of this study was to employ Fonseca's questionnaire for an initial assessment of TMDs. Methods: A cross-sectional study was conducted on a sample of 250 undergraduates from the Dental School of the University of Perugia, Italy. The chi-square test, with a significance level set at p < 0.05, was used to evaluate a statistically significant relationship between TMDs and several variables such as gender, age, employed/unemployed, and physically active or not. Results: The data obtained through the questionnaire indicated that a considerable percentage of students (78%) exhibited signs consistent with TMDs. The most frequently reported signs and symptoms included psychological stress (49.6%), dental clenching and grinding (34%), joint clicking (33.6%), frequent headaches (15.2%), and neck pain (23.2%). Notably, when considering moderate to severe symptoms of TMDs, females were more significantly affected than males. Furthermore, factors such as age, employment status, and physical activity did not appear to influence the prevalence of TMDs. Conclusions: The high prevalence of TMDs identified within this young population (university students), as measured by this questionnaire (albeit warranting validation through more rigorous methodologies) underscores the necessity for the implementation of new preventive strategies that specifically address this demographic.
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Affiliation(s)
- Valeria Mitro
- Department of Maxillo-Facial Surgery, Hospital of Perugia, Sant’Andrea Delle Fratte, 06132 Perugia, Italy; (V.M.)
| | - Angela Rosa Caso
- Department of Medicine, Section of Maxillofacial Surgery, University of Siena, Viale Bracci, 53100 Siena, Italy (G.M.)
| | - Federica Sacchi
- Department of Medicine, Section of Maxillofacial Surgery, University of Siena, Viale Bracci, 53100 Siena, Italy (G.M.)
| | - Massimiliano Gilli
- Department of Maxillo-Facial Surgery, Hospital of Perugia, Sant’Andrea Delle Fratte, 06132 Perugia, Italy; (V.M.)
| | - Guido Lombardo
- Unit of Paediatric Dentistry, Department of Surgical and Biomedical Sciences, University of Perugia, 06132 Perugia, Italy
| | - Gabriele Monarchi
- Department of Medicine, Section of Maxillofacial Surgery, University of Siena, Viale Bracci, 53100 Siena, Italy (G.M.)
| | - Stefano Pagano
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, Sant Andrea delle Fratte, 06156 Perugia, Italy
| | - Antonio Tullio
- Department of Surgical and Biomedical Sciences, Section of Maxillo-Facial Surgery, University of Perugia, Piazzale Gambuli 1, 06129 Perugia, Italy
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Al-Khatieeb MM, Nissan LM, Al-Labban YR, Abid M. Occlusal Features and Temporomandibular Joint Disorder: A Cross-Sectional Study. Int J Dent 2024; 2024:8715166. [PMID: 38798761 PMCID: PMC11127760 DOI: 10.1155/2024/8715166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/01/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Background Understanding the correlation between temporomandibular joint disorder (TMD) parameters and various occlusal features can play a significant role in diagnosing and treating occlusal problems and their potential consequences on TMD. Objectives To investigate the relationship of occlusal features and some of the TMD parameters. Study Design and Sampling. The current cross-sectional study was conducted on 200 TMD patients seeking dental treatment at different dental centers in Baghdad city, aged 18-35 years. All participants underwent assessment for occlusal features, which were molar and canine classifications, overjet, posterior buccal or lingual crossbites, and overbites, and TMD parameters (muscle pain, TMJ pain, and clicking) using the Chi-square test for statistical analysis. Results Regarding molar classification, there were strong positive correlations between subjects with TMD and having different molar classifications (class I, II, and III) bilaterally or unilaterally; furthermore, there were strong positive correlations between subjects with TMD and having different canine classifications. Moreover, there were significant correlations between subjects with increased, normal, or decreased overjet and the TMD parameters. In addition, there were weak positive correlations between TMD occurrence and buccal or lingual posterior crossbite. On the other hand, there were significant correlations between subjects with a decreased overbite and the presence of TMD parameters. Conclusion TMD had a multifactorial background rather than dependability on a specific molar or canine classification type. There was also a correlation between overjet and TMD muscle pain, while decreased overbite was correlated to muscle and TMJ pain. Conversely, there is no vital correlation between posterior buccal or lingual crossbite occurrence and TMD parameters.
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Affiliation(s)
| | - Layth M. Nissan
- Orthodontic Department, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Yasir R. Al-Labban
- Orthodontic Department, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Mushriq Abid
- Orthodontic Department, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Lekaviciute R, Kriauciunas A. Relationship Between Occlusal Factors and Temporomandibular Disorders: A Systematic Literature Review. Cureus 2024; 16:e54130. [PMID: 38487145 PMCID: PMC10939299 DOI: 10.7759/cureus.54130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Temporomandibular disorders (TMD) originate from various components within the temporomandibular joint (TMJ), causing an impact on the masticatory muscles, the joint itself, and associated structures. They are a widely prevalent issue across the world. According to epidemiological research, up to 50% of adults in the population have TMD-related symptoms. The objective of this work was to analyze the existing scientific literature regarding the association between malocclusion classes, bruxism, and tooth loss in relation to the etiology of TMD. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 analysis protocol. For the development of the question focus, the population, intervention, control, and outcomes (PICO) study design protocol was used. The question in focus according to the PICO format was: "Do malocclusion, tooth loss, and bruxism contribute to temporomandibular disorders?". The review was performed with articles from PubMed, Web of Science, and Google Scholar databases according to the specified inclusion and exclusion criteria. The included articles were not older than five years. The risk of bias was assessed in the included studies by using the Cochrane Risk-of-bias 2 (RoB-2) tool. Out of a total of 32 results received, 21 articles were chosen according to the established criteria after conducting a review and analysis of their full texts. The article search sequence was presented in the PRISMA 2020 flow diagram, and the outcomes of the chosen articles were presented. The literature results revealed a relationship between occlusion and the development of TMD. The influence of occlusal factors on the TMJ was explained by an examination of joint anatomy and symptoms related to TMD. This study revealed variations in TMJ factors across different malocclusion classes. Additionally, it was observed that the occurrence and attributes of TMD are influenced by the number of tooth loss quadrants and the frequency of missing teeth. Furthermore, a correlation was found between bruxism and the symptoms of TMD, including myofascial pain, disc displacement, arthralgia, and muscle disorders. This literature review provides comprehensive information on the relationship between malocclusion classes, bruxism, tooth loss, and TMDs. This prompts healthcare professionals to prioritize patients' occlusal assessment and TMJ condition.
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Affiliation(s)
- Roberta Lekaviciute
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Albertas Kriauciunas
- Faculty of Odontology, Clinic of Dental and Maxillofacial Orthopaedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
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Manfredini D, Ercoli C, Poggio CE, Carboncini F, Ferrari M. Centric relation-A biological perspective of a technical concept. J Oral Rehabil 2023; 50:1355-1361. [PMID: 37394665 DOI: 10.1111/joor.13553] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Few terms and concepts have been so extensively debated in dentistry as the words 'centric relation' (CR). Debates involve its biological, diagnostic and therapeutic usefulness. METHODS A review of the literature on the current concepts on CR as a diagnostic or therapeutic aid in dentistry was provided. Clinical trials assessing the superiority of one CR recording method over the others to identify patients with temporomandibular disorders (diagnostic use) or to manage patients with prosthodontic or orthodontic needs (therapeutic use) were tentatively included. RESULTS Due to the absence of literature addressing either of the above targets, a comprehensive overview was provided. The diagnostic use of CR as a reference position to identify the correct position of the temporomandibular joint condyle within the glenoid fossa is not supported and lacks anatomical support. From a therapeutic standpoint, the use of CR can be pragmatically useful in prosthodontics as a maxillo-mandibular reference position when occlusal re-organization is warranted and/or when the position of maximum intercuspation is no longer available. CONCLUSIONS The derived occlusal goals from a diagnostic misuse of CR are generally the result of circular reasoning, that is a technique is based on the recording of a certain condylar position that is believed to be 'ideal' and the treatment is considered successful when such position is shown by the specific instrument that was manufactured for that purpose. The term 'Centric Relation' might be replaced with the term 'Maxillo-Mandibular Utility Position'.
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Affiliation(s)
- Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Carlo Ercoli
- Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Carlo E Poggio
- Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Fabio Carboncini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Marco Ferrari
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
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Tervahauta E, Närhi L, Pirttiniemi P, Sipilä K, Näpänkangas R, Tolvanen M, Vuollo V, Silvola AS. Prevalence of sagittal molar and canine relationships, asymmetries and midline shift in relation to temporomandibular disorders (TMD) in a Finnish adult population. Acta Odontol Scand 2022; 80:470-480. [PMID: 35148484 DOI: 10.1080/00016357.2022.2036364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To examine the prevalence of sagittal relationships, asymmetries and midline shift, and their associations with temporomandibular disorders (TMD) in the Northern Finland Birth Cohort 1966 (NFBC1966). MATERIALS AND METHODS 1845 subjects participated in a clinical examination at the age of 46. Occlusal measurements were performed using 3D models. Symptoms of TMD were screened using validated questions, and signs and diagnoses of TMD were assessed using a modified protocol of the Diagnostic Criteria for TMD (DC/TMD) and questionnaires. Associations between variables of occlusion and TMD were evaluated with χ2-test and Fisher's exact test and using logistic regression analyses, adjusted for self-reported general health, mental health, bruxism, and rheumatoid arthritis. RESULTS The most common sagittal relationships were Class I and normal canine relationship. Half-cusp Class II and post-normal canine relationship were more frequent in females, and Class III and pre-normal canine relationship in males. Deviations from normal cuspid or molar relationships showed a weak but statistically significant association with TMD, especially in females. Half-cusp Class II and Class II relationships were more frequent in relation to joint-related TMD signs and diagnoses while missing canines were associated with pain-related TMD diagnoses. CONCLUSIONS The present study findings gave some indications that canine relationships are associated with pain-related TMD, whereas Angle II sagittal occlusal relations may associate with joint-related TMD. Occlusal characteristics should therefore be taken into account as one possible associating factor in subjects with TMD.
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Affiliation(s)
- Elisa Tervahauta
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Linnea Närhi
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Pertti Pirttiniemi
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kirsi Sipilä
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Ritva Näpänkangas
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mimmi Tolvanen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Finland
| | - Ville Vuollo
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna-Sofia Silvola
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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Evaluation of Growth and Development of Adolescents' Dental Arch Asymmetry with Normal Occlusion Using Three-Dimensional Digital Models. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8872022. [PMID: 34188792 PMCID: PMC8195658 DOI: 10.1155/2021/8872022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/23/2021] [Accepted: 05/21/2021] [Indexed: 11/18/2022]
Abstract
Objective The purpose of this study was to observe the dental arch asymmetry in 12-year-olds with normal occlusion during the early permanent dentition stage. Methods Ninety-two 12-year-old students (46 males and 46 females) who had normal occlusion during early permanent dentition were selected from a junior high school in Tangshan, China. Once per year for three consecutive years, a dental cast was obtained from each subject, and the cast was scanned with a 3D digital scanner (R700 3D). The median palatal plane (MPP) and transverse palatal plane (TPP) were used as the reference plane for the transverse and anteroposterior measurements, respectively. Results Most of the dental arch asymmetry indicators decreased with age, but these differences were not statistically significant. The values of the midincisal edge of the upper central incisors (U1), midincisal edge of the upper lateral incisors (U2), upper canine cusp tip (U3), upper first premolar buccal cusp tip (U4), upper second premolar buccal cusp tip (U5), upper first molar mesiobuccal cusp tip (U6MB), and upper first molar distobuccal cusp tip (U6DB) to the TPP were 0.019 mm, 0.279 mm, 0.017 mm, 0.016 mm, 0.016 mm, 0.027 mm, and 0.200 mm, respectively; these values were larger in males than in females (P < 0.05). The values of 2–5, 6MB, and 6DB-TPP were 0.154 mm, 0.102 mm, 0.119 mm, 0.259 mm, 0.206 mm, and 0.123 mm, respectively, larger in the mandibular than in the maxillary dental arch (P < 0.05). The values of the midincisal edge of the lower central incisors (L1), midincisal edge of the lower lateral incisors (L2), lower canine cusp tip (L3), lower first premolar buccal cusp tip (L4), lower second premolar buccal cusp tip (L5), lower first molar mesiobuccal cusp tip (L6MB), and lower first molar distobuccal cusp tip (L6DB) to the MPP were 0.399 mm, 0.197 mm, 0.258 mm, 0.248 mm, 0.214 mm, 0.575 mm, and 0.531 mm, respectively, larger than L1-5, L6MB, and L6DB-TPP (P < 0.05). Conclusion The asymmetry of the dental arch in 12-to-15-year-olds with normal occlusion did not change significantly with age. The anteroposterior asymmetry of the maxillary dental arch is larger in males than in females. With the exception of the central incisor, the anteroposterior asymmetry of the mandibular dental arch is larger than that of the maxillary dental arch. The transverse asymmetry of the mandibular dental arch is larger than the anteroposterior asymmetry.
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Knowledge and beliefs regarding temporomandibular disorders among orthodontists. Am J Orthod Dentofacial Orthop 2019; 156:475-484. [DOI: 10.1016/j.ajodo.2018.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 11/18/2022]
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Vozzi F, Favero L, Peretta R, Guarda‐Nardini L, Cocilovo F, Manfredini D. Indexes of jaw muscle function in asymptomatic individuals with different occlusal features. Clin Exp Dent Res 2018; 4:263-267. [PMID: 30603108 PMCID: PMC6305926 DOI: 10.1002/cre2.140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/24/2018] [Accepted: 09/30/2018] [Indexed: 11/11/2022] Open
Abstract
This study aims to assess the correlation between indexes of jaw muscle function and dento-skeletal morphology. A sample of 35 temporomandibular disorders-free healthy individuals (10 males, mean age 26.7 ± 9.8 years) underwent surface electromyographic (sEMG) assessment of bilateral masseter and temporalis muscles, to evaluate sEMG activity during maximum voluntary clenching (MVC) with a dedicated device (Easymyo®, T.F.R. Technology, Udine, Italy). Four outcome parameters were assessed for each individual: MCV on cotton rolls; MVC on teeth; chewing on right and left sides; clench/relax test. Electromyographic recordings were assessed based on five standardized indexes of muscle function, to evaluate the degree of muscle asymmetry during static and dynamic function (i.e., percentage overlapping coefficient [POC], Impact, Asymmetry, Activation, and Torque). For each individual, the presence of a number of occlusal and skeletal features was assessed: asymmetry of molar class; deviated incisor midline; deep bite; open bite; and crossbite. Skeletal class and vertical dimension of occlusion were also evaluated. Based on normality distribution of data, t test and analysis of variance, when needed, were used to compare muscle function indexes between individuals with and without the different dento-skeletal features. None of the muscle function indexes (POC, Impact, Asymmetry, Activation, and Torque) was significantly different between individuals with or without the various dental and skeletal features. Gender differences were also not significant (p > 0.05). Despite some minor differences were observed, none of them was significant. Thus, the interaction between form and function is too complex for hypothesizing a simple one-to-one relationship between interarch tooth relationship and muscle function patterns.
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Affiliation(s)
| | | | | | | | | | - Daniele Manfredini
- School of DentistryUniversity of PadovaItaly
- School of DentistryUniversity of SienaItaly
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Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? J Oral Rehabil 2017; 44:908-923. [DOI: 10.1111/joor.12531] [Citation(s) in RCA: 128] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2017] [Indexed: 12/26/2022]
Affiliation(s)
- D. Manfredini
- Post-graduate School in Orthodontics; University of Ferrara; Ferrara Italy
| | - L. Lombardo
- Post-graduate School in Orthodontics; University of Ferrara; Ferrara Italy
| | - G. Siciliani
- Post-graduate School in Orthodontics; University of Ferrara; Ferrara Italy
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