A comparative clinical study of arthrogenous versus myogenous temporomandibular disorder in patients presenting with Costen's syndrome

Ultrasonographic examination of masticatory muscles in patients with TMJ arthralgia and headache attributed to temporomandibular disorders

This study used ultrasonography to compare the thickness and cross-sectional area of the masticatory muscles in patients with temporomandibular joint arthralgia and investigated the differences according to sex and the co-occurrence of headache attributed to temporomandibular disorders (HATMD). The observational study comprised 100 consecutive patients with TMJ arthralgia (71 females and 29 males; mean age, 40.01 ± 17.67 years) divided into two groups: Group 1, including 86 patients with arthralgia alone (60 females; 41.15 ± 17.65 years); and Group 2, including 14 patients with concurrent arthralgia and HATMD (11 females; 33.00 ± 16.72 years). The diagnosis of TMJ arthralgia was based on the diagnostic criteria for temporomandibular disorders. The parameters of the masticatory muscles examined by ultrasonography were subjected to statistical analysis. The pain area (2.23 ± 1.75 vs. 5.79 ± 2.39, p-value = 0.002) and visual analog scale (VAS) score (3.41 ± 1.82 vs. 5.57 ± 12.14, p-value = 0.002) were significantly higher in Group 2 than in Group 1. Muscle thickness (12.58 ± 4.24 mm) and cross-sectional area (4.46 ± 2.57 cm2) were larger in the masseter muscle than in the other three masticatory muscles (p-value < 0.001). When examining sex-based differences, the thickness and area of the masseter and lower temporalis muscles were significantly larger in males (all p-value < 0.05). The area of the masseter muscle (4.67 ± 2.69 vs. 3.18 ± 0.92, p-value = 0.004) and lower temporalis muscle (3.76 ± 0.95 vs. 3.21 ± 1.02, p-value = 0.049) was significantly smaller in Group 2 than in Group 1. An increase in VAS was significantly negatively correlated with the thickness of the masseter (r =  - 0.268) and lower temporalis (r =  - 0.215), and the cross-sectional area of the masseter (r =  - 0.329) and lower temporalis (r =  - 0.293). The masseter and lower temporalis muscles were significantly thinner in females than in males, and their volumes were smaller in patients with TMJ arthralgia and HATMD than in those with TMJ arthralgia alone. HATMD and decreased masseter and lower temporalis muscle volume were associated with increased pain intensity.

Otological symptoms in patients with rheumatoid arthritis of the temporomandibular joint

OBJECTIVE

The aim of the current study was to describe the pattern of otological symptoms in patients with rheumatoid arthritis (RA), having clinical temporomandibular joint (TMJ) involvement. This issue had not been previously addressed.

METHODS

A questionnaire and examination findings protocol was applied for 141 patients with RA and 141 control subjects.

RESULTS

Otological symptoms (otalgia, hearing loss, tinnitus, and vertigo), all had a significantly higher incidence in RA patients, compared to control subjects (P = .001).

CONCLUSION

The onset and maintenance of otological symptoms in patients with TMJ involvement by RA probably result from peripheral, as well as central nervous system alterations in sensory stimuli programming.

Temporomandibular disorder: A previously unreported complication of chronic suppurative otitis media

OBJECTIVE

The aim of the current clinical study was to test the hypothesis that chronic suppurative otitis media (CSOM) might be significantly associated with signs of temporomandibular joint (TMJ) internal derangement.

METHODS

The study involved 79 patients with CSOM and 79 control subjects. The TMJ was clinically examined in both groups.

RESULTS

Signs of internal derangement of the TMJ(s) were found in 67.1% of CSOM patients versus 26.6% of control subjects (p = .001).

CONCLUSION

CSOM may be associated with the extension of the inflammatory process into the TMJ, thereby predisposing to internal derangement of the joint.

Chronic craniomandibular pain after craniotomy: A long-term clinical study

OBJECTIVE

Chronic craniomandibular/cervical pain and temporomandibular disorders have not been studied in patients who had a craniotomy several years previously. The aim of the current clinical work was to address these issues.

METHODS

A total group of 150 ambulant patients who had a previous craniotomy was subclassified according to whether or not the temporalis muscle was manipulated.

RESULTS

The average incidence of multiple subsite regional head and neck pain was 69.3% a number of years after a craniotomy. Evidence of internal derangement of the temporomandibular joint was significantly higher in the group that required manipulation of the temporalis muscle during the procedure.

CONCLUSION

The pattern of chronic craniomandibular/cervical pain experienced years after a craniotomy supports the brain neuromatrix theory of pain.

A clinical study on the incidence of internal derangement of the temporomandibular joint following harvesting of temporalis fascia

OBJECTIVE

The aim of the current clinical study was to reveal whether harvesting of a temporalis fascia graft would be associated with a higher incidence of temporomandibular joint (TMJ) internal derangement.

METHODS

The study group involved 104 patients who had middle-ear operations, 67 of which involved harvesting of temporalis fascia and 37 that did not. The TMJs were clinically examined in each group.

RESULTS

The total incidence of internal derangement of the TMJ was significantly higher in the group that had temporalis fascia harvesting (79.1%), compared to the group that did not have temporalis fascia harvesting (29.7%), (p= 0.001).

CONCLUSION

Harvesting of temporalis fascia probably alters mandibular kinematics and predisposes to internal derangement of the TMJs.