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Minervini G, Marrapodi MM, Siurkel Y, Cicciù M, Ronsivalle V. Accuracy of temporomandibular disorders diagnosis evaluated through the diagnostic criteria for temporomandibular disorder (DC/TDM) Axis II compared to the Axis I evaluations: a systematic review and meta-analysis. BMC Oral Health 2024; 24:299. [PMID: 38431574 PMCID: PMC10909276 DOI: 10.1186/s12903-024-03983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/04/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The temporomandibular joint (TMJ) is a complex joint that facilitates mandibular movements during speech, chewing, and swallowing activities. The Axis I evaluation of the DC/TMD focuses on assessing physical diagnoses related to TMDs. It includes an assessment of pain and functional limitations, such as jaw opening range, joint sounds, and joint tenderness. The Axis II evaluation of the DC/TMD provides information on the patient's psychological status and quality of life. This Systematic Review with Meta-Analysis aimed to evaluate the accuracy of Temporomandibular Disorders diagnosis considered through the Diagnostic Criteria for Temporomandibular Disorder (DC/TDM) axis II compared to the Axis I evaluations. METHODS A search was made in PubMed, Web of Science and Lilacs for articles published from the inception until 20 January 2023. We applied the Population, Exposure, Comparator, and Outcomes (PECO) model [1] to assess document eligibility. Only studies that evaluated patients by DC/TMD Axis I and Axis II were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (Axis I and Axis II). RESULTS Fifty-one articles were selected because of the search. Four papers were excluded before the screening: 2 pieces were not in English, and two were reviewed. The remaining 47 articles were selected for the title and abstract screening to evaluate whether they met the PECO criteria. Among these, four papers were established; the overall effect showed that there was no difference in TMD diagnosis between Axis I and Axis II (RR 1.17; 95% CI: 0.80- 1.71; Z:0.82; P = .41), suggesting that there is no difference between Axis I and Axis II. CONCLUSION In conclusion, DC/TMD is an effective tool for the diagnosis of TMD. It improves the accuracy of TMD diagnosis, allows for the classification of subtypes, and assesses psychosocial factors that may impact the development or maintenance of TMD symptoms.
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Affiliation(s)
- Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, Caserta, 81100, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania, Luigi Vanvitelli, Naples, 80121, Italy.
| | - Yuliia Siurkel
- International European University School of Medicine, Akademika Hlushkova Ave, 42В, Kyiv, 03187, Ukraine.
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
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Luo YX, Chen ZH, Wang JN. Changes of Temporomandibular Joint Morphology and Symptoms in Class II Malocclusion Patients With Bilateral Sagittal Split Ramous Osteotomy. J Craniofac Surg 2023; 34:e655-e660. [PMID: 37801718 DOI: 10.1097/scs.0000000000009505] [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: 01/16/2023] [Accepted: 05/16/2023] [Indexed: 10/08/2023] Open
Abstract
This study included 46 patients with class II malocclusion ranging in age from 19 to 39 years old treated with bilateral sagittal split ramous osteotomy (BSSRO). Left and right temporomandibular joints (TMJs) of each subject were evaluated independently with cone-beam computed tomography (CBCT) before operation (T1), 1 week after operation (T2), and 1 year after operation (T3) and assessed the effects of orthognathic surgery (OGS) on the temporomandibular joint disease (TMD) symptoms. Temporomandibular joint morphology evaluation included condylar volume, condylar area, cortical bone thickness, depth of the mandibular fossa, fossa thickness, joint nodule angle, joint space, and condyle-fossa relationship, which were calculated by using the Mimics software and 3-matic software. Data were statistically analyzed with SPSS software (P <0.05 means statistically significant). In our study, bilateral TMJs have no difference in T3. Bilateral sagittal split ramous osteotomy had no significant effect on the articular fossa. The condyle volume and surface area decreased from T1 to T3, but the cortical thickness of the bone did not change significantly. More anterior condyle positions in T1 and more posterior in T3.21 patients had at least 1 sign or symptom of TMD in T1 and 27 patients in T3. Four patients who were asymptomatic in T1 developed pain after surgery, 10 developed noises, 12 showed limited mouth opening, and 8 had abnormal opening patterns. It is concluded that more condylar posterior position after BSSRO and the reduction of condyle may be related to the enlargement of anterior space. The number of patients with joint symptoms increased postoperative, and the impact of BSSRO on TMD may be negative.
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Affiliation(s)
- Yang-Xin Luo
- Guangdong Provincial Key Laboratory of Stomatology, Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong Province, P.R. China
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Uetanabaro LC, Gerber JT, Dos Santos KM, Meger MN, da Costa DJ, Küchler EC, Sebastiani AM, Scariot R. Prevalence and associated factors of myofascial pain in orthognathic patients with skeletal class II malocclusion. Oral Maxillofac Surg 2023; 27:25-31. [PMID: 35262814 DOI: 10.1007/s10006-022-01046-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
UNLABELLED Orthognathic patients with skeletal class II malocclusion frequently suffer from myofascial pain (MP). PURPOSE This study aimed to evaluate the prevalence and associated factors of MP in these patients. METHODS This cross-sectional study was performed in adult patients with skeletal Class II malocclusion requiring orthognathic surgery. They were divided according to the presence or absence of MP. The predictor variables were craniofacial morphology, sex, temporomandibular disorders, chronic pain, depression, and polymorphisms of dopamine receptors DRD2 (rs6275 and rs6276) and ANKK1 (rs1800497) genes. Data were submitted to statistical analyses using the linear regression model and Poisson regression with a significance level of 0.05. RESULTS Sixty-five individuals were selected, of which 50 (76.92%) were females. A total of 21 (32.3%) patients had MP. Individuals with MP showed a decrease in the mandible gonial angle (p = 0.042) and an increased risk of having temporomandibular joint (TMJ) disc displacement (p = 0.003), TMJ pain (p = 0.030), chronic pain (p = 0.001), and severe depression (p = 0.015). Additionally, individuals carrying AA and AG genotypes in rs6275, and CC genotype in rs6276, were more likely to have MP (p < 0.05). CONCLUSION In this study, 32.3% of skeletal class II orthognathic patients had MP, which was associated with a decreased gonial angle, TMJ disc displacement, TMJ pain, chronic pain, depression, and polymorphisms in the DRD2 gene.
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Affiliation(s)
| | | | | | | | - Delson João da Costa
- Department of Stomatology, Federal University of Parana, 632 Prefeito Lothário Meissner Avenue, Curitiba, PR, 80210-170, Brazil
| | - Erika Calvano Küchler
- Department of Pediatric Dentistry, Ribeirão Preto Dental School, University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Aline Monise Sebastiani
- Department of Stomatology, Federal University of Parana, 632 Prefeito Lothário Meissner Avenue, Curitiba, PR, 80210-170, Brazil.
| | - Rafaela Scariot
- Department of Stomatology, Federal University of Parana, 632 Prefeito Lothário Meissner Avenue, Curitiba, PR, 80210-170, Brazil
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Bergamaschi IP, Cavalcante RC, Fanderuff M, Gerber JT, Petinati MFP, Sebastiani AM, da Costa DJ, Scariot R. Orthognathic surgery in class II patients: a longitudinal study on quality of life, TMD, and psychological aspects. Clin Oral Investig 2021; 25:3801-3808. [PMID: 33415380 DOI: 10.1007/s00784-020-03709-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate, longitudinally, the impacts of orthognathic surgery in patients with skeletal class II malocclusion on oral health-related quality of life (OHRQoL), temporomandibular disorders (TMD) and psychological symptoms. MATERIALS AND METHODS Forty-three patients with skeletal class II malocclusion who were submitted to orthognathic surgery were evaluated during their preoperative and postoperative periods. They answered the short version of the Oral Health Impact Profile (OHIP-14) and were also diagnosed according to Axes I and II of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The evolution of OHRQoL and TMD before and after surgery was verified, and the relationships among these variables were found through statistical analysis using Wilcoxon, McNemar, chi-square, and Mann-Whitney tests, with a 5% significance level. RESULTS The median of the overall OHIP-14 score and five domains decreased after orthognathic surgery (p < 0.05), the functional limitation domain increased (p = 0.014), and the physical disability domain did not show an association (p = 0.133). There were improvements in articular pain (p = 0.016), chronic pain (p = 0.019), and nonspecific physical symptoms excluding pain (p = 0.013). In addition, an association was found between poorer OHRQoL (overall scale and domains) and the Axis II variables of the RDC/TMD (p < 0.05). CONCLUSION Orthognathic surgery improved perceived OHRQoL, articular pain, and chronic pain. The conditions of Axis II of the RDC/TMD interfered with OHRQoL postoperatively. CLINICAL RELEVANCE Although orthognathic surgery improves QoL and some TMD conditions in skeletal class II patients, poorer postoperative outcomes are observed when psychological conditions are present.
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Affiliation(s)
- Isabela Polesi Bergamaschi
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Rafael Correia Cavalcante
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Marina Fanderuff
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Jennifer Tsi Gerber
- School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil
| | - Maria Fernanda Pivetta Petinati
- School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil
| | - Aline Monise Sebastiani
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil. .,School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil.
| | - Delson João da Costa
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Rafaela Scariot
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil.,School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil
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