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Patel K, Eley KA, Cascarini L, Watt-Smith S, Larkin M, Lloyd T, Maddocks C, McLaren E, Stovell R, McMillan R. Temporomandibular disorders-review of evidence-based management and a proposed multidisciplinary care pathway. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:54-69. [PMID: 36990844 DOI: 10.1016/j.oooo.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 01/28/2023] [Accepted: 02/05/2023] [Indexed: 02/14/2023]
Abstract
Temporomandibular disorders (TMDs) are a prevalent but complex group of conditions that cause orofacial pain. Temporomandibular disorders are recognized as one of the most common chronic pain conditions, alongside back pain and headache disorders. Given the competing theories surrounding what causes TMDs and limited high-equality evidence on optimally treating TMDs, clinicians often encounter challenges in developing an effective management plan for patients. Furthermore, patients will often seek advice from multiple health care providers from varying specialties, seeking curative management, often resulting in inappropriate treatments and no improvement in pain symptoms. Throughout this review, we explore the existing evidence base surrounding the pathophysiology, diagnosis, and management of TMDs. An existing United Kingdom-based multidisciplinary care pathway for the management of TMDs is described herein, highlighting the benefits of a multidisciplinary approach to patient care for TMDs.
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Affiliation(s)
- Krupali Patel
- Department of Facial Pain, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK; University College London Eastman Dental Institute, London, UK
| | - Karen A Eley
- Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | | | - Maeve Larkin
- Department of Facial Pain, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK
| | - Tim Lloyd
- Department of Facial Pain, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK
| | - Clare Maddocks
- Department of Facial Pain, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK
| | - Elenor McLaren
- Department of Facial Pain, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK
| | - Rachel Stovell
- Department of Facial Pain, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK
| | - Roddy McMillan
- Department of Facial Pain, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK; University College London Eastman Dental Institute, London, UK.
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Pauli N, Grinups M, Folkestad L, Gudnadottir G. Patient-Reported Symptoms after Midfacial Trauma. Surg J (N Y) 2022; 8:e22-e27. [PMID: 35059499 PMCID: PMC8763470 DOI: 10.1055/s-0041-1742174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background
The aim of this study was to assess patient-reported symptoms and health-related quality of life, 12 to 24 months after injury in patients with midfacial fractures.
Methods
Patients diagnosed with midfacial fractures were assessed regarding symptoms related to the fracture as well as assessment of the patients overall health-related quality of life using the Gothenburg Trismus Questionnaire (GTQ), the Folkestad facial trauma questionnaire, and EuroQol five-dimensional (EQ-5D). Questionnaires were distributed to the study patients 12 to 24 months after the trauma. Medical records were retrospectively surveyed for age, gender, trauma etiology, date of injury, fracture classification, treatment regimen, and time of surgery.
Results
Sixty-seven percent of the study group reports sensibility disturbance in the face 12 to 24 months after trauma and 52% reported cosmetic consequences related to the trauma. Numbness in the face was the symptom reported to be most disturbing for the patients. Few of the patients reported severe jaw-related problems, problems with muscular tension, or eating limitation according to the validated questionnaire GTQ.
Conclusion
Sensibility disturbance remains a significant and common symptom 12 to 24 months after midfacial trauma. There is a need for a validated patient-reported outcome instrument for facial trauma that covers multiple aspects of facial trauma such as vision disturbance and diplopia, jaw-related problems, and facial pain as well as sensibility disturbance and cosmetic consequences.
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Affiliation(s)
- Nina Pauli
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martina Grinups
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena Folkestad
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnhildur Gudnadottir
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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Ku JK, Baik SH, Kim JY, Huh JK. Follow-up evaluation of temporomandibular joints using magnetic resonance imaging after mandibular trauma: Case series analysis of young adult males. Dent Traumatol 2021; 38:136-142. [PMID: 34808038 DOI: 10.1111/edt.12719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIMS A relationship between mandibular fractures and traumatic temporomandibular joint (TMJ) conditions has been suggested in many studies. Although magnetic resonance imaging (MRI) is the best option for a TMJ evaluation, few studies have evaluated the TMJ condition after a mandibular fracture using MRI follow-up. The aim of this study was to evaluate the TMJ for post-traumatic conditions following a mandibular fracture using follow-up MRI. MATERIALS AND METHODS Fourteen TMJs of seven young adult males (aged 19-21 years) with mandibular fractures were analyzed by MRI, and 12 TMJs of six patients were evaluated by follow-up MRI after the trauma. Regarding the intensity of MRI, the pathologic condition of TMJ was classified into acute joint inflammation, marrow edema, and joint space widening. RESULTS Thirteen joints (92.9%) showed pathologic conditions, including 11 with acute joint inflammation (84.6%), 10 with joint space widening (76.9%), and six with marrow edema (46.2%). Five out of 12 evaluated joints were injected with dexamethasone. Among these, four joints healed within one week, and one healed within one month. Among the seven untreated TMJs, four and one joint healed within one week and one month, respectively, but two joints of one patient did not improve until one month. Although that patient received arthrocentesis, the right joint showed osteoarthritis six months after the trauma. CONCLUSIONS Most TMJs were acutely damaged due to mandibular trauma and healed within one week to one month. A follow-up examination could be considered at one month after the injury to confirm the possibility of traumatic TMJ disorder, such as osteoarthritis.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Lee KM, Jang WH, You MS, Lee BK. An additional lysis procedure during arthrocentesis of the temporomandibular joint. Maxillofac Plast Reconstr Surg 2021; 43:38. [PMID: 34636971 PMCID: PMC8511201 DOI: 10.1186/s40902-021-00324-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Arthrocentesis of the temporomandibular joint (TMJ) is an easy, highly efficient, minimally invasive procedure for treating temporomandibular joint disorders (TMDs). However, in some cases of mouth opening limitation (MOL), routine arthrocentesis is ineffective due to severe fibrotic adhesion in the superior joint space of the TMJ. In this condition, mechanical lysis of the adhesions might be needed to resolve the MOL, as well as other symptoms, such as chronic pain. Currently, this can be achieved by arthroscopic surgery or open TMJ surgery. The objective of this study was to introduce and evaluate our trial of the adhesion lysis procedure during arthrocentesis of the TMJ using normal 18-gauge needles. RESULTS In this study, 40 patients with MOL due to disc derangement underwent conventional arthrocentesis at first and then physical detachment was conducted using the same needle. The change in maximum mouth opening (MMO) and the pain at the TMJ were recorded before, during, and after treatment according to our protocol. The mean increase in MMO after conventional arthrocentesis was 6.6 ± 4.2mm. The mean increase in MMO after the detachment procedure with the same needle was 4.2 ± 2.0 mm. The MMO in ten patients was significantly increased after the detachment procedure than after arthrocentesis alone. In all cases, the pain intensity in the TMJ significantly decreased over time, whereas the MMO increased over time. No adverse effect was observed in all joints during our observation periods. CONCLUSION We confirmed that our simple lysis procedure with the same needle of the arthrocentesis of the TMJ could not only improve the MMO more than after a conventional arthrocentesis but also resolve severe adhesion of the joint space that was ineffective by conventional arthrocentesis. Although this additional lysis procedure is simple, it might reduce the number of cases of more invasive procedures such as arthroscopic surgery or open TMJ surgery.
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Affiliation(s)
- Keon-Mo Lee
- Department of Oral and Maxillofacial Surgery, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Wan-Hee Jang
- Department of Oral and Maxillofacial Surgery, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Myoung-Sang You
- Department of Oral and Maxillofacial Surgery, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Bu-Kyu Lee
- Department of Oral and Maxillofacial Surgery, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. .,College of Medicine, University of Ulsan, Seoul, Republic of Korea.
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Figueiredo C, Afonso A, Caramelo F, Corte-Real A. Temporomandibular joint trauma and disability assessment - A longitudinal exploratory study. J Forensic Leg Med 2021; 82:102230. [PMID: 34385019 DOI: 10.1016/j.jflm.2021.102230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Orofacial trauma can encompass, isolated or not, several anatomical regions, namely facial, dental and temporomandibular joint (TMJ), one of the most complex joints in the human body. Evidence-based knowledge in the field of TMJ trauma and in temporomandibular joint disorders (TMD) diagnosis and treatment, provides the necessary data for medico-legal assessment. OBJECTIVE The aim of this study is to bring up epidemiological data referring to TMJ injuries and sequelae, in order to present a medico-legal approach of TMJ disability. METHODS An observational longitudinal exploratory study was performed in the database of the National Institute of Legal Medicine and Forensic Sciences, Portugal, between 2000 and 2017, regarding inclusion and exclusion criteria.Statistical significance was set as P‹0.05, Fisher's exact test, Binomial test and Goodman and Kruskal's test were used. RESULTS Post-traumatic orofacial reports (n = 2622) included 234 TMJ-injury and 149 TMJ-sequelae.Epidemiological data was presented regarding age,gender, professional status and etiology. There was a statistically significant association between TMJ injury and TMJ sequela, despite a weak relation (ƛ = 0.170). No statistically significant association was identified between TMJ-injury/TMJ-sequelae and the professional status, etiology. CONCLUSION The TMJ sequela group is smaller than the TMJ-injury, reflecting that 2/3 of the injuries have been cured without a monetary compensation value and without Health costs. The association between TMJ injury and TMJ sequelae reinforces the necessity of preventive measures in TMJ trauma, namely in physical violence context and in medico-legal impairment.
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Affiliation(s)
- Cristina Figueiredo
- Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Viseu, Portugal.
| | | | - Francisco Caramelo
- Faculty of Medicine, Biostatistics and Medical Informatics Laboratory, Coimbra University, Portugal.
| | - Ana Corte-Real
- Faculty of Medicine, Forensic Dentistry Laboratory, Coimbra University, Portugal.
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Lee HM, Kang DW, Yun PY, Kim IH, Kim YK. Associations between mandibular torus and types of temporomandibular disorders, and the clinical usefulness of temporary splint for checking bruxism. BMC Oral Health 2021; 21:182. [PMID: 33836733 PMCID: PMC8033698 DOI: 10.1186/s12903-021-01550-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/05/2021] [Indexed: 02/08/2023] Open
Abstract
Background Occlusal stress from oral parafunctional habits is one of the causes of temporomandibular disorders (TMD) and mandibular torus (MT). Although some studies have investigated the correlation between TMD and MT, understanding of the relationships between types of TMD and MT is insufficient. Therefore, we conducted this study to investigate the associations between presence of MT and TMD types. Methods This study included 77 patients diagnosed with TMD who first visited our clinic for TMD between March 2019 and July 2020. Among them, 30 (38.9%) had MT, and 54 (70.1%) had oral parafunction. Parafunctional activity during sleep was confirmed using a temporary splint for checking bruxism (TSCB). Results The relationship between prevalence of MT and oral parafunction in TMD patients was not statistically significant (P = 0.131), but the odds ratio was relatively high at 2.267. An analysis of TMD type revealed that Type I, which is classified as myalgia of the masticatory muscles, and MT had a significant association (P = 0.011). We fabricated a TSCB for 27 patients to wear during sleep and confirmed that 23 (85.2%) had nocturnal bruxism. The TSCB results and presence of MT showed a significant relationship (P = 0.047). Conclusion Through the results of this study, clinicians may consider the hyperactivity of masticatory muscles in the presence of MT when treating TMD patients. In addition, TSCB has a great diagnostic value as it can be easily manufactured and be useful for discovering pre-existing oral parafunctions that patients are not aware of.
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Affiliation(s)
- Hee-Min Lee
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Dong-Woo Kang
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea
| | - Il-Hyung Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea. .,Office of Human Resources Development, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea.
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, Korea. .,School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.
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Bhargava D, Sharma Y, Beena S, Koneru G, Pandey A. Effects of distal mandibular skeletal injury on temporomandibular joint soft tissue without bony injury to the joint: An arthroscopic screening survey. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_168_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Figueiredo CP, Teixeira HM, Afonso AS, Corte‐Real A. Prevalence of, and disability approaches to, temporomandibular joint trauma: A 17‐year cross‐sectional study. Dent Traumatol 2020; 36:624-631. [DOI: 10.1111/edt.12587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Cristina Paiva Figueiredo
- Faculty of Dental Medicine Portuguese Catholic University Center for Interdisciplinary Research in Health (CIIS) Viseu Portugal
| | - Helena M. Teixeira
- Faculty of Medicine National Institute of Legal Medicine and Forensic Sciences Coimbra University Coimbra Portugal
| | | | - Ana Corte‐Real
- Faculty of Medicine Forensic Dentistry Laboratory Coimbra University Coimbra Portugal
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Park JY, Lee JH. Efficacy of arthrocentesis and lavage for treatment of post-traumatic arthritis in temporomandibular joints. J Korean Assoc Oral Maxillofac Surg 2020; 46:174-182. [PMID: 32606278 PMCID: PMC7338635 DOI: 10.5125/jkaoms.2020.46.3.174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 posttrauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.
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Affiliation(s)
- Joo-Young Park
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.,Oral Cancer Center, Seoul National University Dental Hospital, Seoul, Korea
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Stone JH, Nelson GC, Fitzpatrick SM. Temporomandibular joint osteoarthritis at Chelechol ra Orrak, Palau. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 28:20-31. [PMID: 31902741 DOI: 10.1016/j.ijpp.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 12/04/2019] [Accepted: 12/07/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the frequency and severity of temporomandibular joint osteoarthritis (TMJ-OA) and its causative factors in a skeletal assemblage from the prehistoric site of Chelechol ra Orrak, Palau, western Micronesia. MATERIALS 50 temporomandibular joint surfaces (mandibular condyles and articular eminences), representing a minimum of 22 adult individuals, 17 of which retain teeth. METHODS Joint surfaces were macroscopically evaluated for characteristics associated with TMJ-OA and joint morphology. Dental remains were scored for tooth wear and staining. RESULTS Nine individuals (40.1 %) displayed lesions typical of TMJ-OA. The strongest associations were between tooth wear and TMJ-OA. CONCLUSIONS Indirect effects of parafunctional dental activity appear to be a factor in TMJ-OA frequency at Chelechol ra Orrak. While betel nut chewing may be one of those activities, it does not appear to be solely driving the presence of TMJ-OA. SIGNIFICANCE This study highlights the association between a specific parafunctional use of the temporomandibular joint and the potential pathological consequences. It also reinforces the need to carefully evaluate the archaeological context of skeletal remains in order to evaluate specific etiological factors in the presence of TMJ-OA in present and past populations. LIMITATIONS Sample sizes are limited in this study. This will increase as excavations continue. SUGGESTIONS FOR FURTHER RESEARCH Because dental occlusion appears to be associated with TMJ-OA, focus on dental conditions affecting occlusal patterns, such as third molar agenesis, antemortem tooth loss, and malocclusion, and their relationship to TMJ-OA frequency, are recommended.
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Affiliation(s)
- Jessica H Stone
- Department of Anthropology, University of Oregon, Eugene, OR, United States.
| | - Greg C Nelson
- Department of Anthropology, University of Oregon, Eugene, OR, United States; Museum of Natural and Cultural History, University of Oregon, Eugene, OR, United States
| | - Scott M Fitzpatrick
- Department of Anthropology, University of Oregon, Eugene, OR, United States; Museum of Natural and Cultural History, University of Oregon, Eugene, OR, United States
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Kumar N, Choudhary RS, Malhotra K, Kathariya R. Maxillofacial Nursing: Assessing the Knowledge and Awareness of Nurses in Handling Maxillofacial Injuries Through a Comprehensive Survey. J Maxillofac Oral Surg 2020; 19:136-142. [PMID: 31988577 PMCID: PMC6954928 DOI: 10.1007/s12663-019-01240-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/13/2019] [Indexed: 11/26/2022] Open
Abstract
Aim To assess the knowledge and awareness of nurses in handling maxillofacial injuries. Method A cross-sectional questionnaire study was conducted among the staff nurses of the multi-specialty Gokul Newtech Hospital, Jamnagar, Gujarat. Forty nursing staff were included in the study. Kruskal–Wallis ANOVA, Spearman’s correlation and Mann–Whitney U tests were applied for statistical analysis. Result There was no statistically significant difference between the mean knowledge score concerning the study participant’s age, work experience, and education. According to the survey, a majority of the nurses either did not know the answer or answered incorrectly. Conclusion It can be concluded that there is a requirement of new guidelines and recommendations in the existing teaching and training modules being followed by the nursing schools across the country. Electronic supplementary material The online version of this article (10.1007/s12663-019-01240-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nishit Kumar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Jamnagar, Gujarat India
| | | | - Kamal Malhotra
- Dr. Malhotra’s Nuface Clinic, 1813 Maharaja Nagar, Ludhiana, Punjab India
| | - Rahul Kathariya
- Dental Galaxy, 201, 1st floor, 1443 Kaustubh Apts, Bajirao Road, Pune, Maharashtra 411002 India
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Prathap V, Tarun S, S LS, Balasubramanian S, Panneerselvam E, Vb KR. Do Splints Play a Role in the Management of Condylar Postfracture Syndrome After Mandibular Angle Fractures?-A Randomized Controlled Clinical Trial. J Oral Maxillofac Surg 2019; 78:241-247. [PMID: 31704268 DOI: 10.1016/j.joms.2019.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Fractures of the mandibular angle can result in condylar postfracture syndrome (CPFS) due to indirect injury to the condylar region. Studies evaluating early intervention for CPFS are lacking. In the present study, we evaluated the efficacy of interocclusal splint therapy for the prevention and early management of CPFS. PATIENTS AND METHODS A prospective randomized controlled clinical trial was designed and included patients who required open reduction and internal fixation for a unilateral angle fracture. The patients were divided into 2 groups. The study group received interocclusal splints postoperatively and the control group did not receive such splints. The patients were followed up at 2 weeks and 1, 2, and 3 months. The primary outcome measure was the presence or absence of CPFS after 3 months. CPFS was defined as the presence of any 1 of the clinical signs of temporomandibular joint dysfunction. The secondary outcomes included the mean pain scores and degree of mouth opening, which were evaluated at each follow-up visit. RESULTS The study included 40 patients, with 20 patients each randomized to the study and control groups. At the end of 3 months, CPFS was present in 2 patients in the study group and in all 20 patients in the control group. The mean pain scores were significantly lower in the study group than in the control group, and the mean mouth opening was significantly greater. CONCLUSIONS The use of interocclusal splints was found to be effective in the prevention and early management of CPFS. The use of splints also resulted in decreased pain and an improved mandibular mouth opening.
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Affiliation(s)
- Vikranth Prathap
- Consultant and Private Practitioner, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Swetha Tarun
- Postgraduate Trainee, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Logitha Sri S
- Postgraduate Trainee, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Sasikala Balasubramanian
- Reader, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India.
| | - Elavenil Panneerselvam
- Reader, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Krishnakumar Raja Vb
- Professor and Head, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
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Figueiredo C, Coelho J, Pedrosa D, Caetano C, Corte-Real F, Vieira DN, Corte-Real A. Dental evaluation specificity in orofacial damage assessment: A serial case study. J Forensic Leg Med 2019; 68:101861. [DOI: 10.1016/j.jflm.2019.101861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 10/26/2022]
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Temporomandibular Dysfunction After Surgery of Mandibular Fractures Not Involving the Mandibular Condyle: A Prospective Follow-Up Study. J Oral Maxillofac Surg 2019; 77:1657-1662. [DOI: 10.1016/j.joms.2019.03.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 11/19/2022]
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Junjie Y, Weidong L, Ren L, Min Y. Incidence and risk factors of the temporomandibular joint disorders in the patients without condylar fractures. Med Sci (Paris) 2018; 34 Focus issue F1:39-42. [PMID: 30403173 DOI: 10.1051/medsci/201834f107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To evaluate the incidence and risk factors of the temporomandibular joint disorders (TMD) in the patients suffering from maxillo-facial injury without condylar fractures. METHODS sixty patients without condylar fractures were recruited from Feb 2014 to Nov 2015 in the department of stomatology, Lishui people's hospital. The incidence of TMD was recorded at 1, 3, 6, 9 and 12 months after injury through MRI examination. The risk factors for TMD were evaluated by logistic regression analysis. RESULTS the TMD incidence rates were 25.0%, 30.0%, 35.0%, 41.7% and 48.3% at 1, 3, 6, 9 and 12 months after injury with no statistical difference between male and female (P>0.05). Logistic regression indicated that disorder of occlusal relationship (OR=1.84,95%CI:1.36-2.78) and hemi-mastication (OR=1.56, 95% CI:1.23- 2.24) were independent risk factors for the development of TMD. CONCLUSION there was a high incidence of temporomandibular joint disorders in the patients suffering from maxillo-facial injury without condylar fractures. The disorder of occlusal relationship and hemi-mastication were independent risk factors for the development of post-injury TMD.
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Affiliation(s)
- Yan Junjie
- Department of stomatology, Lishui people's hospital (6th affiliated hospital of Wenzhou medical university) Zhejian Lishui, No.15 Dazhong Road, Liandu District, Lishui City, Zhejiang Province 323000 PR China
| | - Liu Weidong
- Department of stomatology, Lishui people's hospital (6th affiliated hospital of Wenzhou medical university) Zhejian Lishui, No.15 Dazhong Road, Liandu District, Lishui City, Zhejiang Province 323000 PR China
| | - Lin Ren
- Department of stomatology, Lishui people's hospital (6th affiliated hospital of Wenzhou medical university) Zhejian Lishui, No.15 Dazhong Road, Liandu District, Lishui City, Zhejiang Province 323000 PR China
| | - Ye Min
- Department of stomatology, Lishui people's hospital (6th affiliated hospital of Wenzhou medical university) Zhejian Lishui, No.15 Dazhong Road, Liandu District, Lishui City, Zhejiang Province 323000 PR China
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Figueroba S, Groppo M, Faibish D, Groppo F. The action of anti-inflammatory agents in healthy temporomandibular joint synovial tissues is sex-dependent. Int J Oral Maxillofac Surg 2018; 47:205-213. [DOI: 10.1016/j.ijom.2017.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 08/08/2017] [Accepted: 08/11/2017] [Indexed: 10/18/2022]
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Vrbanović E, Alajbeg IZ. A Young Patient with Temporomandibular Joint Osteoarthritis: Case Report. Acta Stomatol Croat 2017; 51:232-239. [PMID: 29225364 PMCID: PMC5708329 DOI: 10.15644/asc51/3/7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
This paper describes a case of a young patient who sought help because of pain in the right temporomandibular joint (TMJ). She also reported increasing of pain during chewing. Clinical examination revealed limited mouth opening with uncorrected deviation to the ipsilateral side. Palpation of the lateral pole of the right condyle discovered crepitus, and maximum assisted opening elicited a report of "familiar pain". The diagnosis of osteoarthritis of the TMJ (RDC / TMD criteria, Axis I, Group III) was confirmed by CBCT of TMJ. There is no "gold standard" for the management of TMD, but the need for TMD treatment has to be based on precise indications related to the presence of pain, limitation in function of the lower jaw and signs of degenerative joint disease. Conservative, reversible therapeutic procedures are considered as the first choice for TMD treatment and their task is to improve the function of the entire masticatory system. In this case patient was treated with the combination of physical therapy and stabilization splint, in order to reduce the pain and restore the normal function of the lower jaw. At 6 months’ follow-up symptoms have almost completely disappeared, while 3 years later, the patient still has no significant subjective symptoms. In the present case non-invasive therapy was sufficient to bring, otherwise recurrent nature of osteoarthritis, in complete remission and keep it like that for years.
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Affiliation(s)
- Ema Vrbanović
- PhD student, School of Dental Medicine, University of Zagreb, Croatia
| | - Iva Z Alajbeg
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
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Ghurye S, McMillan R. Pain-Related Temporomandibular Disorder - Current Perspectives and Evidence-Based Management. ACTA ACUST UNITED AC 2015; 42:533-6, 539-42, 545-6. [PMID: 26506809 DOI: 10.12968/denu.2015.42.6.533] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Pain-related temporomandibular disorder (TMD) is one of the top three most common chronic pain conditions, along with headaches and back pain. TMD has complex pathophysiology and significant associations with a variety of other chronic pain conditions, eg fibromyalgia, irritable bowel syndrome and migraine. Chronic TMD is associated with a negative impact upon quality of life and high levels of healthcare utility. It is important that clinicians are able to diagnose TMD correctly, provide appropriate management in keeping with current evidence-based practice, and identify when to refer patients to specialist care. The presence of risk factors, eg anxiety, depression, pain-related disability and chronic pain conditions elsewhere in the body, may help to identify which TMD patients require referral for multidisciplinary management. TMD should be managed using a holistic approach, incorporating patient education and encouragement towards self-management. TMD care pathways should consider using the three'pillars'of pain management: physical therapies, pharmacotherapy and clinical psychology.
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An SY, Jung JK. Fracture of the articular disc in the temporomandibular joint: two case reports. Dentomaxillofac Radiol 2014; 44:20140218. [PMID: 25308829 DOI: 10.1259/dmfr.20140218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Disc fracture of the temporomandibular joint (TMJ) is a little-known pathological condition owing to its extreme rarity. We report two cases of elderly patients who were diagnosed with disc fracture of the TMJ based on MRI, and we review related reports. On physical examination, an incomplete bite and mild joint pain were observed on the affected side in both patients. An MRI showed a complete fracture in the intermediate zone of the articular disc in the TMJ; the posterior fragment was displaced posteriorly, causing occlusal change in the closed position of the condyle and an incomplete bite. Conservative treatment including manual manipulation, physical therapy and oral appliance had no effect on the occlusal abnormality. Although the inciting cause of the disc fracture remained unclear, the degenerative changes in the joint may have been a factor by increasing the brittleness and reducing the elasticity of the disc.
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Affiliation(s)
- S-Y An
- 1 Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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20
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Figueroba S, Desjardins M, Nani B, Ferreira L, Rossi A, Santos F, Venâncio P, Aguiar F, Groppo F. Effect of diazepam on temporomandibular joints in rats with increased occlusal vertical dimension. Br J Oral Maxillofac Surg 2014; 52:438-44. [DOI: 10.1016/j.bjoms.2014.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
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Attallah MM, Visscher CM, van Selms MKA, Lobbezoo F. Is there an association between temporomandibular disorders and playing a musical instrument? A review of literature. J Oral Rehabil 2014; 41:532-41. [PMID: 24702514 DOI: 10.1111/joor.12166] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2014] [Indexed: 11/28/2022]
Abstract
Temporomandibular disorders (TMDs) have a multifactorial etiology. Among others, parafunctions and oral habits have been suggested as important initiating and perpetuating factors. Playing a musical instrument that loads the masticatory system, like wind instruments and the violin or viola, has been suggested to be part of this group of etiological factors. However, the evidence base for this suggestion is lacking. Therefore, the aim of this study was to review the literature on the possible association between playing a musical instrument and developing and/or having a TMD. A PubMed search, using the query ['Music'(Mesh) AND 'Craniomandibular Disorders'(Mesh)], yielded 19 articles, 14 of which were included in this review. Six of 14 papers had a case-control or pre-test-post-test design; the remaining eight papers were case reports of expert opinions. The former papers were analysed and tabulated according to the PICO (Patient/population-Intervention-Control/comparison-Outcome/results) system; the latter ones were only summarised and tabulated. All articles with a case-control or pre-test-post-test design suggested a possible association between TMD and playing a musical instrument, especially the violin and viola. However, no clear-cut conclusion could be drawn as to whether playing a musical instrument is directly associated with TMD, or only in combination with other factors. More and better research on this topic is needed, as to enable a better counselling and possibly even a better treatment of the suffering musician.
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Affiliation(s)
- M M Attallah
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
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Is the Frequency of Temporomandibular Dysfunction Different in Various Mandibular Fractures? J Oral Maxillofac Surg 2014; 72:755-61. [DOI: 10.1016/j.joms.2013.10.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/16/2013] [Accepted: 10/24/2013] [Indexed: 11/19/2022]
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Kim YK. Temporomandibular disorder in the oral and maxillofacial fields. J Korean Assoc Oral Maxillofac Surg 2014; 39:1-2. [PMID: 24471009 PMCID: PMC3858157 DOI: 10.5125/jkaoms.2013.39.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
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24
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Lee JY, Kim YK, Kim SG, Yun PY. Evaluation of Korean teenagers with temporomandibular joint disorders. J Korean Assoc Oral Maxillofac Surg 2013; 39:231-7. [PMID: 24471050 PMCID: PMC3858142 DOI: 10.5125/jkaoms.2013.39.5.231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 08/28/2013] [Accepted: 09/13/2013] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES This study aims to evaluate the severity and pattern of symptoms exhibited by teenage Korean temporomandibular disorder (TMD) patients. MATERIALS AND METHODS Among patients with an association of TMDs, teenage patients (11-19 years) who answered the questionnaire on the research diagnostic criteria for TMD (RDC/TMD) were recruited. RESULTS The ratio of patients who visited our clinic with a chief complaint of clicking sound (34.5%) or temporomandibular pain (36.6%) at the initial diagnosis (examination) was the highest. In the evaluation of the depression index, 75.8% of the subjects were normal, 12.9% were moderate, and 11.3% were severe. With regard to non-specific physical symptoms (including pain), 66.5% of the subjects were normal, 17.0% were moderate, and 16.5% were severe. Concerning non-specific physical symptoms (excluding pain), 70.6% of the subjects were normal, 14.4% were moderate, and 15.0% were severe. In terms of the graded chronic pain score, high disability (grade III, IV) was found in 9.3% of the subjects. CONCLUSION Among teenage TMD patients, a portion have clinical symptoms and experience severe psychological pressure; hence requiring attention and treatment, as well as understanding the psychological pressure and appropriate treatments for dysfunction.
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Affiliation(s)
- Ji-Young Lee
- Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Su-Gwan Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Robin O. [Course of action in front of children or adolescent suffering from temporomandibular disorders]. Orthod Fr 2013; 84:87-96. [PMID: 23531293 DOI: 10.1051/orthodfr/2013035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Temporomandibular disorders are described in children from the age of 4. Their prevalence and severity increase strongly during the second decade, which corresponds to the period of orthodontic treatments. At this age the most common symptoms are joint clicking sounds (more than 70% of the cases), sometimes accompanied by episodes of intermittent locking. They would be favored by oral parafunctional activities (gum chewing, biting habits, bruxism...), ligamentous hyperlaxity and modification of the intra-articular space relations during growth. The questioning of the patient and his parents and clinical examination (muscular, articular and occlusal) are essential and very often sufficient for establishing the diagnosis. Even more than in the adult, the therapeutic attitude must rely on conservative and non-irreversible methods (explanations, suppression of the parafunctions, occlusal splints in the case of severe bruxism). These considerations are illustrated by the presentation of two representative clinical cases of temporomandibular disorders frequently encountered in children and adolescents.
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26
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Effects of soft tissue injury to the temporomandibular joint: report of 8 cases. Br J Oral Maxillofac Surg 2012; 51:58-62. [PMID: 22465223 DOI: 10.1016/j.bjoms.2012.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 02/10/2012] [Indexed: 11/22/2022]
Abstract
Our aim was to describe the effects of soft tissue injury to the temporomandibular joint (TMJ), to analyse possible reasons for it, and to evaluate the results of treatment. Eight patients (12 joints) who developed disorders of the TMJ after trauma to the mandible without fracture of the condyle were treated in our department from 2009 to 2010. Magnetic resonance imaging (MRI) and computed tomography (CT) were used to check the condition of the joint. Five patients had their joints explored to relieve pain and improve mouth opening. MRI showed all 12 joints had displaced discs. CT showed that the surface of the condylar bone was "intact" immediately after injury but destroyed later in 8 joints. Exploration showed fibrous ankylosis in 5, osteoarthritis with intra-articular adhesions in 2, and internal derangement in 1. Four were treated by costochondral graft (CCG) with 7 symptomatic joints. The disc was repositioned in 1 case with 1 affected joint. The mean maximal incision opening at follow-up were significantly better than the one before treatment (mean 34 compared with 23 mm, p=0.02). Pain in the TMJ was relieved by operation in all patients so treated. The other 3 patients (4 joints) had no treatment because their symptoms were minor and mouth opening was not restricted. Soft tissue injuries of the TMJ can potentially lead to internal derangement, osteoarthrosis, and possibly fibrous ankylosis, which should be considered during follow-up. Displacement of the disc and damage to the condylar cartilage seem to be the causes of these complications. Surgical management is effective in the short term.
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Al-Hashmi A, Al-Azri A, Al-Ismaily M, Goss A. Temporomandibular disorders in patients with mandibular fractures: a preliminary comparative case–control study between South Australia and Oman. Int J Oral Maxillofac Surg 2011; 40:1369-72. [DOI: 10.1016/j.ijom.2011.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 02/07/2011] [Accepted: 04/01/2011] [Indexed: 11/15/2022]
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Prevalence of risk factors for temporomandibular disorders: a retrospective survey from 300 consecutive patients seeking care for TMD in a French dental school. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2011. [DOI: 10.1007/s12548-011-0066-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Okeson JP, de Leeuw R. Differential diagnosis of temporomandibular disorders and other orofacial pain disorders. Dent Clin North Am 2011; 55:105-20. [PMID: 21094721 DOI: 10.1016/j.cden.2010.08.007] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
There are many types of pain conditions that are felt in the orofacial structures. Most of the conditions treated by the dentist are associated with the teeth, periodontal structures, and associated mucosal tissues. This article focuses on the differential diagnosis of other common pain conditions the dentist will likely face, such as temporomandibular disorders, neuropathic pain disorders, and common headaches; and the clinical presentation of each. Controlling or reducing pain can be accomplished by controlling perpetuating factors such as parafunctional habits and by some simple behavioral modifications. Finally, this article offers some simple treatment considerations.
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Affiliation(s)
- Jeffrey P Okeson
- Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY 40536-0297, USA.
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30
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Gebeile-Chauty S, Robin O, Messaoudi Y, Aknin JJ. [Can orthodontic treatment generate temporomandibular disorders and pain? A review]. Orthod Fr 2010; 81:85-93. [PMID: 20359451 DOI: 10.1051/orthodfr/2010009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
While considered for years to play the primary role in the etiology of temporo-mandibular joint disturbances (TMD), occlusal discrepancies are now considered to be just one causative factor among many. Recent studies, literature reviews or meta-analyses, and longitudinal studies with follow-up of children treated for many years all conclude that there is no risk of orthodontic treatment giving rise to episodes of temporo-mandibular disorders. The signs of TMD appearing during the course of orthodontic treatment should be considered in the context of the epidemiology of the disorder, which is characterized by a strong increase in its occurrence during adolescence. In conclusion, it should be stated that if orthodontic treatment can no longer be considered as one of the etiopathogenic factors in the TMD complex, there are no scientific arguments to justify the converse, that there are indications for orthodontic treatment whose sole goal would be the treatment of TMD.
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Affiliation(s)
- Sarah Gebeile-Chauty
- Département d'Orthopédie Dento-Faciale, Faculté d'Odontologie, 11 rue Guillaume Paradin, 69372 Lyon Cedex 08, France.
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31
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Giannakopoulos HE, Quinn PD, Granquist E, Chou JC. Posttraumatic temporomandibular joint disorders. Craniomaxillofac Trauma Reconstr 2009; 2:91-101. [PMID: 22110802 PMCID: PMC3052671 DOI: 10.1055/s-0029-1215872] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding, and with opposing approaches. The following article explores various treatment options for problems presenting as a result of a history of trauma to the TMJ.
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Affiliation(s)
- Helen E. Giannakopoulos
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Peter D. Quinn
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Eric Granquist
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Joli C. Chou
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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32
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Alons K, Naphausen MT, Von den Hoff JW, van der Kraan PM, Maltha JC, Veltien AA, Heerschap A, Van Damme PA. Induction of haemarthrosis in the TMJ of rats: Validation by MR imaging (MRI) and histology. J Craniomaxillofac Surg 2009; 37:140-4. [DOI: 10.1016/j.jcms.2008.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 09/11/2008] [Accepted: 10/13/2008] [Indexed: 11/29/2022] Open
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Okeson JP. Joint intracapsular disorders: diagnostic and nonsurgical management considerations. Dent Clin North Am 2007; 51:85-103, vi. [PMID: 17185061 DOI: 10.1016/j.cden.2006.09.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This article reviews common intracapsular temporomandibular disorders encountered in the dental practice. It begins with a brief review of normal temporomandibular joint anatomy and function followed by a description of the common types of disorders known as internal derangements. The etiology, history, and clinical presentation of each are reviewed. Nonsurgical management is presented based on current long-term scientific evidence.
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Affiliation(s)
- Jeffrey P Okeson
- Department of Oral Health Science, Orofacial Pain Program, D-530 University of Kentucky, College of Dentistry, Lexington, KY 40536-0297, USA.
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34
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Bibliography. Current world literature. Head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2006; 14:289-91. [PMID: 16832188 DOI: 10.1097/01.moo.0000233602.37541.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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