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Yap AU, Lai YC, Ho HCW. Prevalence of temporomandibular disorders and their associated factors in Confucian heritage cultures: A systematic review and meta-analysis. J Oral Rehabil 2024. [PMID: 38873743 DOI: 10.1111/joor.13779] [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: 04/16/2023] [Revised: 05/12/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Temporomandibular disorders (TMDs) may be an 'idiom' of psychological distress in Confucian heritage cultures (CHCs). OBJECTIVES This systematic review/meta-analysis estimated the prevalence of TMDs in CHCs and compared the differences in TMD occurrence between time periods and age groups. Additionally, the associated biopsychosocial risk factors were also examined. METHODS The study protocol was developed a priori following the PRISMA guidelines and Joanna Briggs Institute systematic review methodology (CRD42021245526). Electronic searches of seven databases were conducted from January 2002 to Dec 2021. Reference lists of identified studies were hand-searched for additional articles. Study selection, quality assessment, and data extraction were done. Meta-analysis was performed using the RevMan 5.4 software. RESULTS Forty-eight articles were included in the systematic review. Overall prevalences were: TMDs-15% (95% CI: 15-16%); TMD pain-8% (95% CI: 7-9%); TMJ sounds-24% (95% CI: 21-27%); and TMJ locking-7% (95% CI: 1-13%). While TMD prevalence appeared to have declined from 2002 to 2011 to 2012-2021, the occurrence of TMD pain, TMJ sounds, and locking increased marginally or remained constant. TMD prevalence in children/adolescents was 18% (95% CI: 14-22%) and 17% (95% CI: 16-18%) among adults. Significant associations between TMDs and bruxism/psychological distress/education levels were specified by 73%/90%/88% of the relevant studies. CONCLUSIONS TMDs are prevalent in CHCs and a slight increase in TMD pain (2%) and TMJ sounds (8%) were discerned over the past two decades. TMDs are related to a myriad of biopsychosocial variables, particularly psychological distress, and these factors must be addressed within the cultural context of patients.
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
| | - Ye Choung Lai
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
| | - Henry Chee Wai Ho
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
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Leal MDCF, Castro MML, Sosthenes MCK. Updating The General Practitioner on The Association Between Teeth Loss and Temporomandibular Disorders: A Systematic Review. Eur J Dent 2023; 17:296-309. [PMID: 36574784 PMCID: PMC10424267 DOI: 10.1055/s-0042-1757209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The belief about a possible association between the absence of one or more teeth and the presence of temporomandibular disorders (TMD), although old, is still present among the dental class. Although evidence points to a lack of association between loss of posterior support and the presence of TMD, we do not have critical studies on the extent, quantity, or location of these losses. In this sense, this systematic review aims to investigate the association between tooth loss and the presence of TMD signs or diagnostic subgroups. Search strategies using a combination of keywords tooth loss and TMDs were performed in six databases (PubMed, Embase, Web of Science, Livivo, Lilacs, and Scopus) and gray literature from August to September 2020. Observational studies that investigated the association between tooth loss in TMD were considered. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Assessment Checklist for cross-sectional analytical studies, case-control, and cohort studies. Finally, the level of certainty measured by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was assessed. Six articles were included in the review according to the eligibility criteria. Of these, five had a high risk of bias and one had a moderate risk. Only one study showed an association between the loss of posterior teeth and the presence of joint sounds and joint pain, the others found no significant association with sign or TMD subgroups diagnostic.There is no scientific evidence to support the association between one or more tooth loss and the presence of TMD signs and symptoms or diagnostic subgroups.
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Affiliation(s)
- Marília da Cunha Feio Leal
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de
Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal
do Pará, Belém, Brazil
| | - Micaele Maria Lopes Castro
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de
Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal
do Pará, Belém, Brazil
| | - Márcia Consentino Kronka Sosthenes
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de
Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal
do Pará, Belém, Brazil
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Fan Y, Shu X, Leung KCM, Lo ECM. Association between masticatory performance and oral conditions in adults: A systematic review and meta-analysis. J Dent 2023; 129:104395. [PMID: 36563840 DOI: 10.1016/j.jdent.2022.104395] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/25/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To give an overview of the evidence on the associations between oral condition factors and masticatory performance of adults, and to evaluate the direction and level of the associations. DATA/SOURCES Medline (PubMed), Embase (Ovid) and CINAHL Plus (EBSCOhost) were searched up to May 2022 for cross-sectional studies on oral conditions and masticatory performance in adults. Methodological quality of the included studies was independently evaluated based on the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between oral condition factors and masticatory performance were extracted. Meta-analysis was conducted on correlation coefficients. STUDY SELECTION Of the 8,035 records identified, 97 articles (88 studies) were included in the qualitative synthesis, and 18 studies were included in the meta-analyses. Among the oral condition factors that had associations with masticatory performance, the number of natural/remaining teeth or functional tooth pairs was reported by the largest number of studies, followed by perioral muscle status, dental prosthetic status, oral moisture status and periodontal status. Results of the meta-analyses showed that the positive association with the number of natural/remaining teeth was the strongest (pooled correlation coefficient: 0.51, 95%CI: 0.48 to 0.54), followed by the number of functional tooth pairs, maximum tongue force/pressure, while the association with the oral moisture status was the weakest. CONCLUSIONS Number of natural/remaining teeth and functional tooth pairs, perioral muscle status, oral moisture status, dental prosthetic status and periodontal status are the main oral condition factors influencing masticatory performance. Based on the limited evidence available, among these factors, the number of natural/remaining teeth has the strongest positive association, with a very low quality of evidence. CLINICAL SIGNIFICANCE This study provides valuable information on the oral condition factors associated with masticatory performance, which would be important for policymakers and clinical practitioners when deciding on the strategies for improving the masticatory performance of adults. This review highlights the need for standardization of measures and classifications of masticatory performance and oral conditions. REGISTRATION PROSPERO (registration number: CRD42021256824).
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Affiliation(s)
- Yanpin Fan
- Faculty of Dentistry, Prince Philip Dental Hospital, the University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Xin Shu
- Faculty of Dentistry, Prince Philip Dental Hospital, the University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, Prince Philip Dental Hospital, the University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Edward Chin Man Lo
- Faculty of Dentistry, Prince Philip Dental Hospital, the University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong.
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Da D, Ge S, Zhang H, Zeng X, Jiang Y, Yu J, Wang H, Wu W, Xiao Z, Liang X, Zhao Q, Ding D, Zhang Y. Association between occlusal support and cognitive impairment in older Chinese adults: a community-based study. Front Aging Neurosci 2023; 15:1146335. [PMID: 37139086 PMCID: PMC10149703 DOI: 10.3389/fnagi.2023.1146335] [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: 01/17/2023] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction The loss of occlusal support due to tooth loss is associated with systemic diseases. However, there was little about the association between occlusal support and cognitive impairment. The cross-sectional study aimed to investigate their association. Methods Cognitive function was assessed and diagnosed in 1,225 community-dwelling adults aged 60 years or older in Jing'an District, Shanghai. Participants were diagnosed with mild cognitive impairment (MCI) by Peterson's criteria, or dementia, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. We determined the number of functional occlusal supporting areas according to Eichner classifications. We used multivariate logistic regression models to analyze the relationship between occlusal support and cognitive impairment and mediation effect models to analyze the mediation effect of age. Results Six hundred sixty participants were diagnosed with cognitive impairment, averaging 79.92 years old. After adjusting age, sex, education level, cigarette smoking, alcohol drinking, cardiovascular disease, and diabetes, individuals with poor occlusal support had an OR of 3.674 (95%CI 1.141-11.829) for cognitive impairment compared to those with good occlusal support. Age mediated 66.53% of the association between the number of functional occlusal supporting areas and cognitive impairment. Discussion In this study, cognitive impairment was significantly associated with the number of missing teeth, functional occlusal areas, and Eichner classifications with older community residents. Occlusal support should be a significant concern for people with cognitive impairment.
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Affiliation(s)
- Dongxin Da
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Suyu Ge
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Hao Zhang
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Xiaoli Zeng
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Yiwei Jiang
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Jin Yu
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Huning Wang
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Wanqing Wu
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Ding Ding,
| | - Ying Zhang
- Department of Preventive Dentistry, Shanghai Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
- *Correspondence: Ying Zhang,
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Relationship between Knowledge and Attitude toward Oral Function in Middle-Aged and Older Adults. Int J Dent 2022; 2022:3503644. [PMID: 36034477 PMCID: PMC9410982 DOI: 10.1155/2022/3503644] [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: 04/04/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
Oral hypofunction is the stage at which recovery can be expected with proper diagnosis, management, and motivation before oral dysfunction occurs. The knowledge and attitude toward oral function can influence the maintenance and improvement of oral function. However, whether middle-aged and older adults with declining oral function have knowledge of their oral function and how this knowledge and their attitude affect their oral function are unclear. Therefore, we aimed to examine (1) the relationship between knowledge and attitude toward oral function and hypofunction in individuals with suspected oral hypofunction and (2) changes in knowledge and attitude toward oral function through evaluation and education. Participants aged ≥50 years were enrolled during their first community dental clinic visit. A questionnaire assessment of knowledge and attitudes before and after oral function evaluation was performed. The oral function was initially assessed with seven criteria: oral hygiene; oral dryness; occlusal force; tongue pressure; tongue-lip motor, masticatory, and swallowing function. Associations between knowledge and attitudes and their changes were statistically analyzed. Fifty-nine participants (93.7%) were unaware of “oral hypofunction.” Associations between knowledge and attitudes and their changes in the negative to positive response groups, from 86.4% and 61.0% to 6.8% and 25.4%, respectively, after oral function evaluation, indicated that participants understood their oral function and the need for training. Middle-aged and older individuals with poor knowledge and attitudes were more likely to have a worse oral function; however, their knowledge and attitudes toward oral function could be improved through oral function assessment and education.
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Greenbaum T, Pitance L, Kedem R, Emodi-Perlman A. The mouth-opening muscular performance in adults with and without temporomandibular disorders: A systematic review. J Oral Rehabil 2022; 49:476-494. [PMID: 35020217 PMCID: PMC9303535 DOI: 10.1111/joor.13303] [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: 08/14/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
Background The mouth‐opening muscular performance in patients with temporomandibular disorders (TMDs) is unclear. Understanding the impairments of this muscle group within specific TMDs is important to develop proper management strategies. Objective To characterise the mouth‐opening muscular performance in adults with and without TMDs. Methods PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane databases were searched from inception to 12 November 2020. Bibliographies were searched for additional articles, including grey literature. Case‐control, cross‐sectional and interventional studies reporting mouth‐opening muscular strength and/or endurance were included. Risk of bias was assessed by the SIGN checklist for case‐control studies and by the NIH quality assessment tool for cross‐sectional studies. Results were pooled with a random‐effects model. Confidence in cumulative evidence was determined by means of the GRADE guidelines. Results Fourteen studies were included; most were rated as having a moderate risk of bias. Only three studies assessed patients with TMDs and the other 11 assessed healthy adults. Significant sex differences in muscular performance were found for healthy adults in the review (strength deficit for females versus males). There was a significant reduction in maximal mouth opening performance (strength and endurance) in the three studies that assessed patients with temporomandibular disorders. Conclusion Sex plays a significant role in maximal mouth opening strength. There is a lack of reliable data on the normal mouth‐opening strength and endurance of healthy adults as well as for patients with TMDs. Implications Lack of reliable TMDs patient data and comparable healthy adult data highlight future direction for research.
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Affiliation(s)
- Tzvika Greenbaum
- Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Laurent Pitance
- Institute of Experimental and Clinical Research, Health Sciences division, Neuro-Musculo-Skeletal-Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium
| | - Ron Kedem
- Academic Branch, Medical Corps, IDF, Tel Aviv, Israel
| | - Alona Emodi-Perlman
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Nguyen MS, Saag M, Jagomägi T, Nguyen QH, Voog-Oras Ü. The impact of occlusal support on temporomandibular disorders: a literature review. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/20101058211023779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Temporomandibular disorders are a multifactorial disease. Occlusal support and the number of teeth in dentition have significant effects on the masticatory system. The current study aims to review the role of occlusal support in association with findings of temporomandibular disorders. Data sources were PubMed, Web of Science and Google Scholar, with 1411 citations published over the period 1992–2019. The selection criteria stipulated that articles must have reported the association between the number of teeth, occlusal unit, occlusal support and temporomandibular disorders. A total of 15 full-text articles was finally accessed for eligibility in the current review. The studies on temporomandibular disorders were collected from various sources, including articles reporting temporomandibular disorder symptoms ( n=1), temporomandibular disorder signs ( n=5), temporomandibular joint osseous changes ( n=1), temporomandibular joint dysfunction using the Helkimo index ( n=2), and temporomandibular disorder classification ( n=6). Of these articles, significant associations were found between: the number of missing teeth and temporomandibular disorders ( n=5); the number of occlusal units and occlusal supports and temporomandibular disorders ( n=3); the position of the lost occlusal units and temporomandibular disorders ( n=1). Loss of the occlusal unit has more impact on temporomandibular disorders than the loss of posterior teeth. The total loss of unilateral occlusal support seems to be an aetiological factor for temporomandibular disorders, and maintenance of balanced posterior occlusal support has a role in the prevention and management of temporomandibular disorders.
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Affiliation(s)
- Minh Son Nguyen
- Faculty of Dentistry, Danang University of Medical Technology and Pharmacy, Vietnam
| | - Mare Saag
- Institute of Dentistry, University of Tartu, Estonia
| | | | - Quang Hai Nguyen
- Department of Surgery – Anesthesia and Resuscitation, Danang Hospital of Odonto-Stomatology, Vietnam
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Dumbuya A, Gomes AF, Marchini L, Zeng E, Comnick CL, Melo SLS. Bone changes in the temporomandibular joints of older adults: A cone-beam computed tomography study. SPECIAL CARE IN DENTISTRY 2019; 40:84-89. [PMID: 31799710 DOI: 10.1111/scd.12441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/05/2019] [Accepted: 11/22/2019] [Indexed: 12/14/2022]
Abstract
AIMS To assess the prevalence of degenerative bone changes in the temporomandibular joint (TMJ) of older adults using cone-beam computed tomography (CBCT), and to verify possible associations between these findings and patient health history. METHODS CBCT scans comprising both TMJs were acquired for 137 patients aged 65+, regardless of TMD status. Images were assessed by two oral radiologists and evaluated for the presence of flattening, erosion, sclerosis, subchondral cysts, and osteophytes in the TMJ bony components, and self-reported patient systemic health histories were retrieved from records. RESULTS There were 59 males, and the mean age was 73.35 ± 6.28. A total of 31.4% had bone changes in both TMJs, and 65.7% had bone changes in at least one side. Bone changes were more prevalent in females, with subchondral cysts (63.3%) and osteophytes (60%) the most common findings. There was a higher prevalence of osteoporosis/osteopenia (38.5%) and connective tissue disorders (39.8%) in patients with TMJ bone changes than in those with normal TMJs. CONCLUSION Degenerative bone changes of TMJ were prevalent among older adults, and females were more affected. There was a greater prevalence of osteoporosis/osteopenia and connective tissue disorders in patients with TMJ bone changes than in subjects with normal TMJs.
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Affiliation(s)
- Aminata Dumbuya
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | | | - Leonardo Marchini
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | - Erliang Zeng
- Department of Preventive & Community Dentistry, Division of Biostatistics and Computational Biology, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa.,Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa.,Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa
| | - Carissa L Comnick
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical and Diagnostic Sciences, School of Dentistry, Oregon Health and Science University, Portland, Oregon
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Saueressig NS, Saueressig Hickert AC, Keller de Andrade G, Bittencourt HR, Basso D, Saueressig NG. Evaluation of the Use of a Force Diagram in the Management of Temporomandibular Joint Sounds: A Prospective Cross-sectional Study. J Osteopath Med 2019; 119:349-356. [PMID: 31135862 DOI: 10.7556/jaoa.2019.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Context Occlusal splints are widely used in clinical practice as a noninvasive treatment for patients with temporomandibular disorders (TMDs) and for reduction of TMD-related symptoms. A force diagram allows a health care professional to evaluate the interactions of loads caused by muscular effort, which are sensed by the teeth and the temporomandibular joint during the protrusive movement of the mandible. Objective To evaluate the efficacy of occlusal splints combined with occlusal adjustment (OA) based on a force diagram in the management of joint sounds (clicking and crepitation). Methods Patients were examined clinically and administered a questionnaire for the diagnosis of TMD and orofacial pain. Patients were then assigned to 1 of 2 splint therapies: (1) an anterior bite plane of the front-plateau type (FP) or (2) a maxillary muscle relaxation appliance (MRA), both combined with OA based on a force diagram performed at 6 visits, with an interval of 24 to 48 hours between each visit. To measure the effects of treatment, at each of the 6 visits, patients also rated the severity of their TMD-related symptoms on a visual analog scale. Data were dichotomized into presence and absence of symptoms and compared using the McNemar test. Results A total of 199 patients were included in the study. At baseline, 38 patients (19.1%) had crepitation and 161 (80.9%) had clicking. A total of 150 patients were treated with FP+OA, with a statistically significant reduction in the number of patients reporting clicking (42.6%, P<.001) and crepitation (42.9%, P<.001). Among patients treated with MRA+OA (n=49), there was a statistically significant reduction in the number of patients reporting clicking (50%, P<.001). All 3 patients with crepitation in the MRA+OA group reported total remission (P>.05). Conclusion The 2 treatment strategies, FP+OA and MRA+OA, improved both clicking and crepitation. Both strategies prioritize the concept of mutually protected occlusion, in which all jaw and temporomandibular joint movements must synchronize, which may be conveniently done using the force diagram.
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Todic J, Martinovic B, Pavlovic J, Tabakovic S, Staletovic M. Assessment of the impact of temporomandibular disorders on maximum bite force. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:274-278. [PMID: 30631208 DOI: 10.5507/bp.2019.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 01/03/2019] [Indexed: 11/23/2022] Open
Abstract
AIM Temporomandibular disorders (TMD) refer to functional disorders of the masticatory system, temporomandibular joint (TMJ) and masticatory muscles. The main objective of this study was to determine whether and to what extent temporomandibular disorders (TMD) affect the maximum bite force (MBF). METHODS The present study included subjects with and without temporomandibular disorder. The presence of TMD was assessed by means of the Helkimo clinical dysfunction index analysis. We measured the maximum bite pressure (MBP) and occlusal contact area (OCA) by means of a Fuji Prescale Pressure measurement film. Based on the MBP and OCA values obtained, MBF values were determined. RESULTS The MBF values were significantly lower in patients with TMD compared to subjects without TMD (P Conclusion: TMDs have a significant impact on MBF and masticatory muscle action potential. More research is needed to determine the impact of reduced maximum bite force on the functional efficiency of the masticatory system.
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Affiliation(s)
- Jelena Todic
- Department of Prosthodontics, Medical Faculty Pristina in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Brankica Martinovic
- Department of Pediatric and Preventive Dentistry, Medical Faculty Pristina in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Jasna Pavlovic
- Department of Orthodontics, Medical Faculty Pristina in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Sasa Tabakovic
- Department of Maxillofacial Surgery, Medical Faculty Pristina in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Milos Staletovic
- Department of Prosthodontics, Medical Faculty Pristina in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
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Reissmann DR, Anderson GC, Heydecke G, Schiffman EL. Effect of Shortened Dental Arch on Temporomandibular Joint Intra-articular Disorders. J Oral Facial Pain Headache 2018; 32:329-337. [PMID: 30036887 DOI: 10.11607/ofph.1910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS To investigate whether a shortened dental arch (SDA), as identified by reduced posterior occlusal contacts, is a risk factor for the progression of temporomandibular joint (TMJ) intra-articular disorders (ID), as identified using imaging techniques. METHODS This multisite, prospective observational study with a mean follow-up period of 7.9 years had a sample of 345 participants with at least 1 temporomandibular disorder (TMD) diagnosis at baseline. SDA was defined as reduced occlusal posterior support due to lack of occlusal intercuspal contacts in the molar region on the left and/or right side. SDA was assessed at baseline and at follow-up with metalized Mylar Tape. The presence or absence of a TMJ ID and the specific TMJ ID diagnoses for baseline and follow-up images were established by a calibrated, blinded radiologist at each of three sites by using bilateral magnetic resonance imaging for soft tissue imaging for disc displacement and by bilateral multidetector computed tomography or cone beam computed tomography for hard tissue imaging for degenerative joint diseases. Wilcoxon rank sum test and linear regression analyses were used to test for an impact of SDA on TMJ ID status. RESULTS At baseline, TMJ ID status of either side was not significantly affected by the presence of SDA on the ipsilateral or contralateral side of the jaw (all P > .05). Furthermore, the presence or absence of SDA at baseline was also not a significant predictor for progression of the TMJ ID status between baseline and follow-up (all P > .05). CONCLUSION The findings of this study suggest that there is no significant effect of SDA on progression of TMJ ID.
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Gupta D, Sheikh S, Pallagatti S, Singh R, Aggarwal A. Correlation of Condylar Translation During Maximal Mouth Opening with Presence of Signs of Temporomandibular Joint Disorders in an Asymptomatic Population of 18-25 Years Age Group of Northern India. Open Dent J 2018; 12:770-781. [PMID: 30369987 PMCID: PMC6182881 DOI: 10.2174/1745017901814010770] [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: 04/30/2018] [Revised: 07/18/2018] [Accepted: 09/11/2018] [Indexed: 11/22/2022] Open
Abstract
Objective(s): The objective of this study was to determine the frequency of “subluxation” and presence of clinical signs of Temporomandibular Joint Disorder (TMD) in asymptomatic individuals and its distribution according to age and sex. Materials and Methods: The material investigated comprised of 200 asymptomatic subjects with 400 joints. The subjects were divided into two groups of 18-25 years and 50-60 years of age consisting of equal number of males and females. Clinical examination involved measurement of maximal inter-incisal distance, joint sounds and deviation. For radiological examination, Temporomandibular Joint (TMJ) open mouth close mouth view option (TMJ1/2) was used on a Digital Panoramic Machine. All the radiographs were traced to assess subluxation and anterior translation of the condyle. The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, version 15.0 for Windows). Results: The prevalence of the signs of TMDs in the asymptomatic population was found to be very high and more predominant in females as compared to males. Furthermore, the older age group had comparatively less signs of TMDs. It was of interest that the subjects presenting with clinical signs of TMD were significantly less as compared to the subjects presenting with subluxation. The value of anterior translation was found to be more in females in the younger age group as compared to the males. Similarly, it was more in males as compared to females in older age group. But the mean anterior translation difference in females in 18-25 years and 50-60 years showed a statistically significant difference with P-value 0.017. Conclusion: Subluxation is a very common feature found in almost all the subjects in this study with a high prevalence. Hence, we may assume that the increased incidence of TMDs could be a direct result of the phenomena of subluxation. The decrease in mandibular length could be the cause of decreased mouth opening and increased subluxation.
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Affiliation(s)
- Deepak Gupta
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Soheyl Sheikh
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Shambulingappa Pallagatti
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Ravinder Singh
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Amit Aggarwal
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
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Nguyen MS, Saag M, Voog-Oras Ü, Nguyen T, Jagomägi T. Temporomandibular Disorder Signs, Occlusal Support, and Craniofacial Structure Changes Among the Elderly Vietnamese. J Maxillofac Oral Surg 2018; 17:362-371. [PMID: 30034156 DOI: 10.1007/s12663-017-1057-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 11/20/2017] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of study was to determine the association between signs of temporomandibular disorders (TMD), occlusal support, and alterations in the craniofacial structure of elderly Vietnamese by using cephalometric analysis. Methods The cross-sectional study consisted of 244 participants aged 65-74 years. Participants were examined for signs of TMD, including limited mouth opening, temporomandibular joint (TMJ) crepitus, TMJ tenderness, and muscle tenderness. Dentition was divided into four occlusal support zones based on occluding pairs of posterior teeth by using Eichner's classification: Class A = 4 support zones; Class B = 1-3 support zones or only contact in anterior teeth; Class C = 0 support zones. Fifteen angular and seven linear parameters were used for sagittal craniofacial skeleton analysis. Results 10.3% of participants had limited mouth opening, 49.6% TMJ crepitus, 16.3% TMJ tenderness, and 24.2% muscle tenderness; 45.5% had Class A occlusal support, 38.5% Class B, and 16.0% Class C. Those with Class C had significantly smaller ramus inclination, articular angle, and angles formed by the mandibular plane and shorter facial height compared to Class A and Class B (P < .001). TMD signs were significantly associated with: angles formed by mandibular plane, gonial angle, cranial base angle, effective mandibular length, and anterior facial height (P < .05). Conclusions The alteration of craniofacial structures was significantly associated with TMD signs among elderly Vietnamese. The higher number of lost occlusal support zones, the more significant the changes to craniofacial structures.
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Affiliation(s)
- Minh Son Nguyen
- 1Institute of Dentistry, University of Tartu, 6 Raekoja Plats, 51003 Tartu, Estonia
- 2Department of Prosthodontics, Danang University of Medical Technology and Pharmacy, 99 Hung Vuong, Danang, 550000 Vietnam
| | - Mare Saag
- 1Institute of Dentistry, University of Tartu, 6 Raekoja Plats, 51003 Tartu, Estonia
| | - Ülle Voog-Oras
- 1Institute of Dentistry, University of Tartu, 6 Raekoja Plats, 51003 Tartu, Estonia
| | - Toai Nguyen
- 3Hue University of Medicine and Pharmacy, 06 Ngo Quyen, Hue, 530000 Vietnam
| | - Triin Jagomägi
- 1Institute of Dentistry, University of Tartu, 6 Raekoja Plats, 51003 Tartu, Estonia
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Nguyen MS, Jagomägi T, Nguyen T, Saag M, Voog-Oras Ü. Symptoms and signs of temporomandibular disorders among elderly Vietnamese. PROCEEDINGS OF SINGAPORE HEALTHCARE 2017. [DOI: 10.1177/2010105817694907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: To assess the prevalence of the symptoms and signs of temporomandibular disorders (TMDs) and determine the prevalence of TMDs among elderly Vietnamese aged 65–74 years old. Methods: A cross-sectional study was conducted among 258 participants aged 65–74 years old (128 females and 130 males) using two strategies for TMD diagnosis: a clinical examination of the temporomandibular joint and its associated structures using the Diagnostic Criteria for Temporomandibular Disorders Axis I; and a set of 14 questions regarding TMD symptoms to obtain anamnestic data. Results: The prevalence of TMD symptoms was: headache 49.6%; temporomandibular joint noise 28.0%; orofacial pain 25.2%; jaw locking 3.1%; 62.5% of participants had at least one TMD symptom. Headaches were more prevalent in females than males ( p=0.009) and rural than urban residents ( p<0.001). The most frequent signs were temporomandibular joint crepitus (50.4%), clicking (48.1%) and mouth-opening deviation (37.6%). Temporomandibular joint crepitus and mouth-opening deviation were more frequent among rural than urban ( p=0.024 and p<0.001, respectively). TMD was found in 56.6% of the total sample. Of the TMD sufferers, 37.6% were diagnosed with disc displacement, 34.9% with degenerative joint disease, 3.5% with myalgia and 1.2% with arthralgia. Conclusions: More than half of elderly Vietnamese have at least one TMD symptom. TMD sounds were the most common clinical sign of TMD. There were no differences between the genders or place of residence and TMD diagnosis. Disc displacement and degenerative joint disease were most prevalent among elderly Vietnamese.
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Affiliation(s)
- Minh Son Nguyen
- Department of Prosthodontics, Danang University of Medical Technology and Pharmacy, Vietnam
- Institute of Dentistry, University of Tartu, Estonia
| | | | - Toai Nguyen
- Faculty of Stomatology, Hue University of Medicine and Pharmacy, Vietnam
| | - Mare Saag
- Institute of Dentistry, University of Tartu, Estonia
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Sampaio NDM, Oliveira MC, Ortega ADO, Santos LDB, Alves TDB. Temporomandibular disorders in elderly individuals: the influence of institutionalization and sociodemographic factors. Codas 2017; 29:e20160114. [DOI: 10.1590/2317-1782/20162016114] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/24/2016] [Indexed: 11/21/2022] Open
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Huang B, Takahashi K, Goto T, Kiso H, Sugai M, Shimizu A, Kosugi S, Bessho K. ANKH Polymorphisms and Clicking of the Temporomandibular Joint in Dental Residents. J Maxillofac Oral Surg 2015; 14:247-51. [PMID: 26028843 DOI: 10.1007/s12663-014-0622-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 02/24/2014] [Indexed: 11/30/2022] Open
Abstract
AIM This study aimed to carry out a case-control research study to assess occurrence of clicking of the temporomandibular joint (TMJ) in order to establish the relationship between TMJ clicking and the genotype of "ANKH inorganic pyrophosphate transport regulator" (ANKH) polymorphisms. MATERIALS AND METHOD A sample of 41 first-year dental residents was selected. Each was examined using standard clinical procedures and genotyping techniques. RESULTS The participation rate was 91.8 %. The prevalence of TMJ clicking was 51.2 % (95 % CI: 35.7-66.7 %). Occurrence of TMJ clicking was not related to age, gender and genotypes of ANKH-OR as well as ANKH-TR polymorphisms (p ≥ 0.165). CONCLUSION A similar distribution of ANKH genotypes in TMJ clicking and asymptomatic individuals has been demonstrated by this study. A high percentage of TMJ clicking has been confirmed. Future investigations are indicated.
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Affiliation(s)
- Boyen Huang
- Department of Paediatric Dentistry, School of Medicine and Dentistry, James Cook University, Cairns, Australia
| | - Katsu Takahashi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
| | - Tomoko Goto
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
| | - Honoka Kiso
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
| | - Manabu Sugai
- Translational Research Center, Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Akira Shimizu
- Translational Research Center, Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Shinji Kosugi
- Department of Biomedical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuhisa Bessho
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 Japan
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Yoshino K, Kariya N, Namura D, Noji I, Mitsuhashi K, Kimura H, Fukuda A, Kikukawa I, Hayashi T, Yamazaki N, Kimura M, Tsukiyama K, Yamamoto K, Fukuyama A, Hidaka D, Shinoda J, Mibu H, Shimakura Y, Saito A, Ikumi S, Umehara K, Kamei F, Fukuda H, Toake T, Takahashi Y, Miyata Y, Shioji S, Toyoda M, Hattori N, Nishihara H, Matsushima R, Nishibori M, Hokkedo O, Nojima M, Kimura T, Fujiseki M, Okudaira S, Tanabe K, Nakano M, Ito K, Kuroda M, Matsukubo T. Comparison of prognosis of separated and non-separated tooth autotransplantation. J Oral Rehabil 2012; 40:33-42. [DOI: 10.1111/joor.12003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2012] [Indexed: 11/28/2022]
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Sipilä K, Näpänkangas R, Könönen M, Alanen P, Suominen AL. The role of dental loss and denture status on clinical signs of temporomandibular disorders. J Oral Rehabil 2012; 40:15-23. [DOI: 10.1111/j.1365-2842.2012.02345.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2012] [Indexed: 01/01/2023]
Affiliation(s)
- K Sipilä
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Oulu, Oulu, Finland.
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Yoshino K, Kikukawa I, Yoda Y, Watanabe H, Fukai K, Sugihara N, Matsukubo T. Relationship between Eichner Index and Number of Present Teeth. THE BULLETIN OF TOKYO DENTAL COLLEGE 2012; 53:37-40. [DOI: 10.2209/tdcpublication.53.37] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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