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Nikolaos Z, Marcus G, Dimitrios N, Michail T, Dimitrios MD, Vasileios P. Instrumental Occlusal Analysis in Migraine Patients: A Quantitative Cross Sectional Study. Clin Exp Dent Res 2024; 10:e938. [PMID: 39039942 PMCID: PMC11263750 DOI: 10.1002/cre2.938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/01/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVES This study aimed to investigate possible differences of functional occlusal variables between a group of migraine patients (MG) and a control group (CG). MATERIALS AND METHODS Each group included 50 individuals. Instrumental functional analysis and digital occlusal analysis were performed. Variables examined were condylar displacement from a reference position to maximum intercuspation; angular difference between the steepness of the articular eminence and the contra-lateral canine guidance; and angular difference between the steepness of the articular eminence and the ipsilateral central incisor guidance and occlusal plane inclination. Self-reported grinding and occlusal index were also investigated. RESULTS There were statistically significant differences in the extent of retral condylar displacement assessed both clinically [MG: 0.49 mm (SD 0.67 mm), CG: 0.29 mm (SD 0.27 mm), p = 0.012] and digital-mechanically [MG: 1.53 mm (SD 0.95 mm), CG: 0.9 mm (SD 0.66 mm), p = 0.001], the angular difference between the steepness of the articular eminence and the contra-lateral canine guidance [MG: 13.11° (SD 8.33°), CG: 9.47° (SD 7.08°), p = 0.021 and MG: 12.94° (SD 8.71°), CG: 9.44° (SD 8.70°), p = 0.017], and the occlusal plane inclination [MG: 11.16° (SD 4.66°), CG: 9.09° (SD 4.37°), p = 0.024]. Self-reported grinding (MG: 39/50, CG: 12/50, p < 0.001) and occlusal index [MG: 1.92 (SD 0.46), CG: 0.21 (SD 0.66), p < 0.001] were also significantly higher in migraineurs. CONCLUSIONS Articular and occlusal structures could play a role in migraine and thus should be considered in an interdisciplinary approach.
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Affiliation(s)
- Zokaris Nikolaos
- 251 Hellenic Air Force and VA Hospital, Department of ProsthodonticsAthensGreece
| | - Greven Marcus
- Medical University of Vienna, University Clinic of DentistryViennaAustria
| | | | - Tzakis Michail
- School of Dentistry, Department of Orofacial PainNational and Kapodistrian University of AthensAthensGreece
| | - Mitsikostas Dimos Dimitrios
- School of Medicine, First Department of Neurology, Aeginition HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Psarras Vasileios
- School of Dentistry, Department of Orofacial PainNational and Kapodistrian University of AthensAthensGreece
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Lee YH, Bae H, Chun YH, Lee JW, Kim HJ. Ultrasonographic examination of masticatory muscles in patients with TMJ arthralgia and headache attributed to temporomandibular disorders. Sci Rep 2024; 14:8967. [PMID: 38637633 PMCID: PMC11026518 DOI: 10.1038/s41598-024-59316-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024] Open
Abstract
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.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Hyungkyu Bae
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Yang-Hyun Chun
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, 02447, South Korea.
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
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Yelken Kendirci M, Ertürk AF, Özcan I, Kendirci AŞ, Akgül T. The role of scoliosis on temporomandibular joint disease: a cross-sectional study based on ultrasonography. Clin Radiol 2024; 79:e417-e423. [PMID: 38143227 DOI: 10.1016/j.crad.2023.11.023] [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: 07/22/2023] [Revised: 10/05/2023] [Accepted: 11/19/2023] [Indexed: 12/26/2023]
Abstract
AIM To investigate the relationship between temporomandibular disorders (TMD) and the stomatognathic system and spine through a multidisciplinary approach, utilising ultrasound to assess the temporomandibular joint. MATERIALS AND METHODS Between October 2020 and January 2021, 50 patients aged 12-18 years with adolescent idiopathic scoliosis and 50 healthy individuals were enrolled. All participants underwent clinical examinations based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. Additionally, ultrasound evaluations were performed of the temporomandibular joint and masseter muscles. Subsequently, the data from both groups were compared and analysed. RESULTS The mean age of participants was 14.69 ± 2.73 years in the scoliosis group (SG) and 14.68 ± 1.81 years in the control group (CG). Among scoliosis patients, a moderate negative correlation was observed between the Cobb angle (indicative of curvature severity) and mouth opening (p=0.023; r=-0.320). Furthermore, the incidence of TMD was significantly higher in the scoliosis group compared to the control group (p<0.001). Additionally, it was found that a 1-unit increase in joint space elastography value led to a 4.81-fold higher likelihood of diagnosing disc displacement with reduction (p=0.009; 95% CI: 1.47-15.73). CONCLUSION This pioneering study, the first of its kind to explore the connection between scoliosis and ultrasound-based temporomandibular joint screening, suggests that scoliosis may be a predisposing factor for TMD. Moreover, the present findings underscore the importance of joint elastography as a valuable quantitative tool in TMD diagnosis.
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Affiliation(s)
- M Yelken Kendirci
- Biruni University Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, İstanbul, Turkey.
| | - A F Ertürk
- Biruni University Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, İstanbul, Turkey
| | - I Özcan
- Biruni University Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, İstanbul, Turkey
| | - A Ş Kendirci
- Istanbul University, Istanbul Medical Faculty, Orthopaedics and Traumatology Department, İstanbul, Turkey
| | - T Akgül
- Istanbul University, Istanbul Medical Faculty, Orthopaedics and Traumatology Department, İstanbul, Turkey
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Busse JW, Casassus R, Carrasco-Labra A, Durham J, Mock D, Zakrzewska JM, Palmer C, Samer CF, Coen M, Guevremont B, Hoppe T, Guyatt GH, Crandon HN, Yao L, Sadeghirad B, Vandvik PO, Siemieniuk RAC, Lytvyn L, Hunskaar BS, Agoritsas T. Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline. BMJ 2023; 383:e076227. [PMID: 38101929 DOI: 10.1136/bmj-2023-076227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
CLINICAL QUESTION What is the comparative effectiveness of available therapies for chronic pain associated with temporomandibular disorders (TMD)? CURRENT PRACTICE TMD are the second most common musculoskeletal chronic pain disorder after low back pain, affecting 6-9% of adults globally. TMD are associated with pain affecting the jaw and associated structures and may present with headaches, earache, clicking, popping, or crackling sounds in the temporomandibular joint, and impaired mandibular function. Current clinical practice guidelines are largely consensus-based and provide inconsistent recommendations. RECOMMENDATIONS For patients living with chronic pain (≥3 months) associated with TMD, and compared with placebo or sham procedures, the guideline panel issued: (1) strong recommendations in favour of cognitive behavioural therapy (CBT) with or without biofeedback or relaxation therapy, therapist-assisted mobilisation, manual trigger point therapy, supervised postural exercise, supervised jaw exercise and stretching with or without manual trigger point therapy, and usual care (such as home exercises, stretching, reassurance, and education); (2) conditional recommendations in favour of manipulation, supervised jaw exercise with mobilisation, CBT with non-steroidal anti-inflammatory drugs (NSAIDS), manipulation with postural exercise, and acupuncture; (3) conditional recommendations against reversible occlusal splints (alone or in combination with other interventions), arthrocentesis (alone or in combination with other interventions), cartilage supplement with or without hyaluronic acid injection, low level laser therapy (alone or in combination with other interventions), transcutaneous electrical nerve stimulation, gabapentin, botulinum toxin injection, hyaluronic acid injection, relaxation therapy, trigger point injection, acetaminophen (with or without muscle relaxants or NSAIDS), topical capsaicin, biofeedback, corticosteroid injection (with or without NSAIDS), benzodiazepines, and β blockers; and (4) strong recommendations against irreversible oral splints, discectomy, and NSAIDS with opioids. HOW THIS GUIDELINE WAS CREATED An international guideline development panel including patients, clinicians with content expertise, and methodologists produced these recommendations in adherence with standards for trustworthy guidelines using the GRADE approach. The MAGIC Evidence Ecosystem Foundation (MAGIC) provided methodological support. The panel approached the formulation of recommendations from the perspective of patients, rather than a population or health system perspective. THE EVIDENCE Recommendations are informed by a linked systematic review and network meta-analysis summarising the current body of evidence for benefits and harms of conservative, pharmacologic, and invasive interventions for chronic pain secondary to TMD. UNDERSTANDING THE RECOMMENDATION These recommendations apply to patients living with chronic pain (≥3 months duration) associated with TMD as a group of conditions, and do not apply to the management of acute TMD pain. When considering management options, clinicians and patients should first consider strongly recommended interventions, then those conditionally recommended in favour, then conditionally against. In doing so, shared decision making is essential to ensure patients make choices that reflect their values and preference, availability of interventions, and what they may have already tried. Further research is warranted and may alter recommendations in the future.
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Affiliation(s)
- Jason W Busse
- Michael G DeGroote National Pain Centre, McMaster University, Hamilton ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada
- Department of Anesthesia, McMaster University, Hamilton ON, Canada
| | - Rodrigo Casassus
- Orofacial Pain Unit, Maxillo-Facial Department, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Alonso Carrasco-Labra
- Center for Integrative Global Oral Health, University of Pennsylvania, School of Dental Medicine, Philadelphia PA, USA
| | | | - David Mock
- Faculty of Dentistry and Mount Sinai Hospital, University of Toronto, Canada
| | - Joanna M Zakrzewska
- Royal National ENT &Eastman Dental Hospitals University College London Hospitals, London, UK
| | | | - Caroline F Samer
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals
- Faculty of Medicine, University of Geneva, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Department of Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Bruno Guevremont
- The Canadian Veterans Chronic Pain Centre of Excellence, Hamilton, ON, Canada
| | - Thomas Hoppe
- The Canadian Veterans Chronic Pain Centre of Excellence, Hamilton, ON, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada
| | - Holly N Crandon
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada
| | - Behnam Sadeghirad
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada
- Department of Anesthesia, McMaster University, Hamilton ON, Canada
| | - Per O Vandvik
- Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
| | - Reed A C Siemieniuk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada
| | - Lyuba Lytvyn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada
| | | | - Thomas Agoritsas
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton ON, Canada
- Division of General Internal Medicine, Department of Medicine, University Hospitals of Geneva, Geneva, Switzerland
- The MAGIC Evidence Ecosystem Foundation, Oslo, Norway
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Chattrattrai T, Aarab G, Su N, Blanken TF, Mitrirattanakul S, Lobbezoo F. The association of self-reported awake bruxism and sleep bruxism with temporomandibular pain and dysfunction in adult patients with temporomandibular disorders. Clin Oral Investig 2023; 27:7501-7511. [PMID: 37864603 DOI: 10.1007/s00784-023-05338-y] [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: 06/14/2023] [Accepted: 10/11/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To investigate the association of the severity of temporomandibular disorders (TMD) pain and dysfunction with the frequency of self-reported awake bruxism (AB), sleep bruxism (SB), and stress in an adult TMD-patient population. MATERIALS AND METHODS This cross-sectional study included 237 TMD patients based on the Diagnostic Criteria for TMD. Age, sex, frequency of self-reported AB and SB, and stress were included as independent variables. TMD pain and TMD dysfunction were included as dependent variables in regression analyses. Univariate and multivariable linear regression analyses were used to predict TMD pain and TMD dysfunction in two separate models. Finally, network analysis was performed to investigate the associations between all variables. RESULTS In the univariate analyses, TMD pain was significantly associated with self-reported AB-frequent (unstandardized coefficient (B) = 3.196, 95%CI 1.198-5.195, p = 0.002). TMD dysfunction was significantly associated with AB-frequent (B = 2.208, 95%CI 0.177-4.238, p = 0.033) and SB-sometimes (B = 1.698, 95%CI 0.001-3.394, p = 0.050). In the multivariable analyses, TMD pain was significantly associated with TMD dysfunction (B = 0.370, p < 0.001), stress (B=0.102, p < 0.001). TMD dysfunction was significantly associated with TMD pain (B = 0.410, p < 0.001) only. Network analysis showed that TMD pain is a bridge factor between AB, stress, and TMD dysfunction. CONCLUSIONS TMD pain is directly associated with AB, stress, and TMD dysfunction, while TMD dysfunction is only associated with TMD pain. CLINICAL RELEVANCE Reducing pain may improve pain-related dysfunction, and the management of AB and stress may improve TMD pain and dysfunction, and vice versa.
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Affiliation(s)
- Thiprawee Chattrattrai
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Tessa F Blanken
- Department of Psychological Methods, University of Amsterdam, Amsterdam, the Netherlands
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Demir MG. Comparison of symptoms, signs and magnetic resonance imaging in children aged 5-18 years with temporomandibular joint disease. Cranio 2023:1-5. [PMID: 37982425 DOI: 10.1080/08869634.2023.2281203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Temporomandibular joint diseases (TMD) are an important clinical condition in childhood as in adults. There is variation in the frequency and distribution of complaints in children about this disorder. MATERIALS AND METHODS This study was conducted on 407 children aged 5-18 years. Patients with dentofacial function problems, trauma, history of surgery, and malignancy were excluded from the study. Patients with temporomandibular magnetic resonance imaging in their records were classified as normal, reduction disc displacement and non-reduction disc displacement. RESULTS Patients symptoms were click (77.2%), pain (71.5%), headache (61.2%), bruxism (31.9%), locking (28%), difficulty in mouth opening (24.3%). The most common clinical findings are normal mouth opening (62.2%) and deviation (44.9%). When the MR results were examined, 55.1% of female and 66.6% of male were observed to be normal, and this statistically shows that males have more normal MR findings. CONCLUSION TMD are also observed in children. Clinical history and findings are helpful in diagnosis, but the contribution of imaging methods may be limited. If head and neck pain is detected in children, TMD should be kept in mind.
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Affiliation(s)
- Mehmet Gökhan Demir
- Istanbul Medical School, Department Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
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Verghese RS, Jose R, Ramachandran A, Shanmugham AM, Nair PK, Kumar KS, Varma BR. Comparison of Pre- and Posttreatment Airway Volume in Patients with Temporomandibular Joint Disorders Treated with Ultra-Low Frequency Transcutaneous Electrical Nerve Stimulation Using Cone Beam Computed Tomography. Int Arch Otorhinolaryngol 2023; 27:e593-e601. [PMID: 37876693 PMCID: PMC10593537 DOI: 10.1055/s-0042-1758207] [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: 10/15/2021] [Accepted: 07/19/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Temporomandibular joint disorders (TMD) present with a multitude of symptoms that can range from headaches to shoulder pain. Patients frequently present with pain in the ear, dizziness, and vertigo. It is noted that some patients who report TMDs also have a history of sleep disturbances, which is noted in cone beam computed tomography (CBCT) as a reduction in the oropharyngeal airway volume. Objective To evaluate the airway volume in pre- and posttreatment of TMD with the use of neuromuscular orthotics made with ultra-low frequency transcutaneous electrical nerve stimulation (ULF-TENS). Methods A total of 15 patients were evaluated for TMDs using the related criteria. Those included were treated with ULF-TENS with evaluation of the airway volume both pre- and posttreatment using CBCT and the Dolphin 3D volume analysis software. Results While the symptoms were shown to be significantly reduced in patients who were treated with this particular modality, the airway volume varied in those who reported a reduction after a period of 3 months and those that reported after a period of 6 months. Conclusion Posttreatment evaluation of the airway should be done after a period of 6 months for a more objective evaluation. A multidisciplinary evaluation of the patient is required in such cases.
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Affiliation(s)
- Rhea Susan Verghese
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
| | - Renju Jose
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
| | - Anu Ramachandran
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
| | - Aravind M. Shanmugham
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
| | - Priya K. Nair
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
| | - Krishna S. Kumar
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
| | - Beena R. Varma
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
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Piekartz HV, van der Meer H, Olivo SA. Craniofacial disorders and headaches. A narrative review. Musculoskelet Sci Pract 2023; 66:102815. [PMID: 37419842 DOI: 10.1016/j.msksp.2023.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVES Craniofacial- and headache disorders are common co-morbid disorders. The aim of this review is to provide an overview of the research discussing craniofacial pain, especially temporomandibular disorders, and its relationship and impact on headaches, as well as suggestions for diagnostic assessment tools and physical therapeutic management strategies. METHOD A narrative structured review was performed. A search was conducted in MEDLINE using terms related to craniofacial pain and headaches. Additionally, papers regarding this topic were also extracted from the authors' personal libraries. Any study design (i.e., RCT, observational studies, systematic review, narrative review) that reported the concepts of interest was included, using Covidence. Results were narratively synthesized and described. RESULTS From an epidemiological perspective, craniofacial pain and headaches are strongly related and often co-existing. This may be due to the neuroanatomical connection with the trigeminal cervical complex, or due to shared predisposing factors such as age, gender, and psychosocial factors. Pain drawings, questionnaires, and physical tests can be used to determine the cause of pain, as well as other perpetuating factors in patients with headaches and craniofacial pain. The evidence supports different forms of exercise and a combination of hands-on and hands-off strategies aimed at both the craniofacial pain as well as the headache. CONCLUSION Headaches may be caused or aggravated by different disorders in the craniofacial region. Proper use of terminology and classification may help in understanding these complaints. Future research should look into the specific craniofacial areas and how headaches may arise from problems from those regions. (249 words).
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Affiliation(s)
- Harry von Piekartz
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Cranial Facial Therapy Academy (CRAFTA), Hamburg, Germany.
| | - Hedwig van der Meer
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, the Netherlands; SOMT University of Physiotherapy, Amersfoort, Netherlands
| | - Susan Armijo Olivo
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Faculty of Rehabilitation Medicine, Faculty of Medicine and Dentistry Rehabilitation Research Center, University of Alberta, Edmonton, Canada
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Akbulut AS, Akca Karpuzoglu AH. Evaluation of Temporomandibular Joint in Patients with Parkinson's Disease: A Comparative Study. Diagnostics (Basel) 2023; 13:2482. [PMID: 37568844 PMCID: PMC10416915 DOI: 10.3390/diagnostics13152482] [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: 05/31/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
(1) The aim of this study was to perform an evaluation of the temporomandibular joint (TMJ) in patients with Parkinson's disease (PD) and present the morphological differences of the TMJ between healthy subjects and patients with PD. (2) A total of 102 Caucasian subjects were divided equally into two groups. The study group consisted of patients with PD, while the control group comprised healthy subjects. Ten parameters, including anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), condyle head length (CHL), condylar neck width (CNW), minor axis of the condyle (MAC), long axis of the condyle (LAC), condylar axis inclination (CI), medial joint space (MJS), and lateral joint space (LJS), were measured using magnetic resonance images. The data were statistically analyzed using paired samples t-test and Student's t-test, with a significance level set at p < 0.05. (3) In the PD group, all TMJ parameters showed a statistically significant difference between both sides of the face (p < 0.05). However, in the control group, AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS did not show a statistically significant difference between both sides of the face (p > 0.05), except for LAC (p < 0.05). The asymmetry index values of AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS demonstrated a statistically significant difference between the study and control groups (p < 0.05), except for LAC (p > 0.05). (4) Within the limitations of this retrospective study, the findings suggest that TMJ morphology and asymmetry could be associated with PD.
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Lam AC, Liddle LJ, MacLellan CL. The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis. Arch Rehabil Res Clin Transl 2023; 5:100242. [PMID: 36968167 PMCID: PMC10036235 DOI: 10.1016/j.arrct.2022.100242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective To evaluate the efficacy of upper cervical joint mobilization and/or manipulation on reducing pain and improving maximal mouth opening (MMO) and pressure pain thresholds (PPTs) in adults with temporomandibular joint (TMJ) dysfunction compared with sham or other intervention. Data Sources MEDLINE, CINAHL, EMBASE, and Cochrane Library from inception to June 3, 2022, were searched. Study Selection Eight randomized controlled trials with 437 participants evaluating manual therapy (MT) vs sham and MT vs other intervention were included. Two reviewers independently extracted data and assessed risk of bias. Data Extraction Two independent reviewers extracted information about origin, number of study participants, eligibility criteria, type of intervention, and outcome measures. Data Synthesis Manual therapy was statistically significant in reducing pain compared with sham (mean difference [MD]: -1.93 points, 95% confidence interval [CI]: -3.61 to -0.24, P=.03), and other intervention (MD: -1.03 points, 95% CI: -1.73 to -0.33, P=.004), improved MMO compared with sham (MD: 2.11 mm, 95% CI: 0.26 to 3.96, P=.03), and other intervention (MD: 2.25 mm, 95% CI: 1.01 to 3.48, P<.001), but not statistically significant in improving PPT of masseter compared with sham (MD: 0.45 kg/cm2, 95% CI: -0.21 to 1.11, P=.18), and other intervention (MD: 0.42 kg/cm2, 95% CI: -0.19 to 1.03, P=.18), or the PPT of temporalis compared with sham (MD: 0.37 kg/cm2, 95% CI: -0.03 to 0.77, P=.07), and other intervention (MD: 0.43 kg/cm2, 95% CI: -0.60 to 1.45, P=.42). Conclusion There appears to be limited benefit of upper cervical spine MT on TMJ dysfunction, but definitive conclusions cannot be made because of heterogeneity and imprecision of treatment effects.
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Affiliation(s)
- Alan C. Lam
- Department of Physical Therapy, St. John's University, Queens, NY
| | - Lane J. Liddle
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
| | - Crystal L. MacLellan
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Chung MK, Wang S, Alshanqiti I, Hu J, Ro JY. The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models. FRONTIERS IN PAIN RESEARCH 2023; 4:1038808. [PMID: 36846071 PMCID: PMC9947567 DOI: 10.3389/fpain.2023.1038808] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions involving the temporomandibular joints (TMJ), the masticatory muscles and associated structures. Painful TMD are highly prevalent and conditions afflict 4% of US adults annually. TMD include heterogenous musculoskeletal pain conditions, such as myalgia, arthralgia, and myofascial pain. A subpopulations of TMD patients show structural changes in TMJ, including disc displacement or degenerative joint diseases (DJD). DJD is a slowly progressing, degenerative disease of the TMJ characterized by cartilage degradation and subchondral bone remodeling. Patients with DJD often develop pain (TMJ osteoarthritis; TMJ OA), but do not always have pain (TMJ osteoarthrosis). Therefore, pain symptoms are not always associated with altered TMJ structures, which suggests that a causal relationship between TMJ degeneration and pain is unclear. Multiple animal models have been developed for determining altered joint structure and pain phenotypes in response to various TMJ injuries. Rodent models of TMJOA and pain include injections to induce inflammation or cartilage destruction, sustained opening of the oral cavity, surgical resection of the articular disc, transgenic approaches to knockout or overexpress key genes, and an integrative approach with superimposed emotional stress or comorbidities. In rodents, TMJ pain and degeneration occur during partially overlapping time periods in these models, which suggests that common biological factors may mediate TMJ pain and degeneration over different time courses. While substances such as intra-articular pro-inflammatory cytokines commonly cause pain and joint degeneration, it remains unclear whether pain or nociceptive activities are causally associated with structural degeneration of TMJ and whether structural degeneration of TMJ is necessary for producing persistent pain. A thorough understanding of the determining factors of pain-structure relationships of TMJ during the onset, progression, and chronification by adopting novel approaches and models should improve the ability to simultaneously treat TMJ pain and TMJ degeneration.
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Affiliation(s)
- Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, Program in Neuroscience, Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
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Aetiology and management options for secondary referred otalgia: a systematic review and meta-analyses. Eur Arch Otorhinolaryngol 2023; 280:47-59. [PMID: 36163556 DOI: 10.1007/s00405-022-07638-7] [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: 05/18/2022] [Accepted: 08/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES OF REVIEW To review the literature for the evidence base for the aetiology and management of referred otalgia, looking particularly at non-malignant, neuralgic, structural and functional issues. TYPE OF REVIEW Systematic review. SEARCH STRATEGY A systematic literature search was undertaken from the databases of EMBASE, CINAHL, MEDLINE®, BNI, and Cochrane Library according to predefined inclusion and exclusion criteria. EVALUATION METHOD All relevant titles, abstracts and full text articles were reviewed by three authors who resolved any differences by discussion and consultation with senior author. RESULTS 44 articles were included in our review. The overall quality of evidence was low, with the vast majority of the studies being case-series with three cohort and four randomised-controlled trials included. The prime causes and management strategies were focussed on temporomandibular joint dysfunction (TMJD), Eagle syndrome and neuralgia. Our meta-analyses found no difference on the management strategies for the interventions found. CONCLUSIONS Referred otalgia is common and treatment should be aimed at the underlying pathology. Potential aetiologies are vast given the extensive sensory innervation of the ear. An understanding of this and a structured approach to patient assessment is important for optimal patient management.
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Demir MG. Comparison of symptoms, signs, gender, and magnetic resonance images of temporomandibular joint disorder patients. Cranio 2022:1-5. [PMID: 36170015 DOI: 10.1080/08869634.2022.2128591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To compare patients' complaints, clinician's examination findings, and magnetic resonance imaging (MRI) findings by considering gender. METHODS Temporomandibular joint (TMJ) pain, difficulty in mouth opening, masseter tenderness, deviation, clicking sound, bruxism, restriction, normal occlusion and normal mouth opening symptoms, and findings of temporomandibular disorder (TMD) patients who came to the author's outpatient clinic were recorded. These recordings were compared with MRI. RESULTS In the study, symptoms, signs, and MRIs of 276 TMD patients were analyzed, including gender. No difference was observed in terms of symptoms, signs, or MRI results for either gender. MRI findings were correlated with restriction and normal mouth opening in both groups (p < 0.05). Normal MRI findings were observed in 52.5% of the MRI results. CONCLUSION Except for normal mouth opening and limitation, MRI findings did not provide a significant result. Therefore, careful detection of symptoms and signs rather than MRI helps in diagnosis.
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Affiliation(s)
- Mehmet Gökhan Demir
- Istanbul Medical School, Department Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
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14
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Garcia E, Flores RE, Doherty JK. Temporomandibular Joint Syndrome from an Ear Versus Dental-Related Standpoint. Otolaryngol Clin North Am 2022; 55:649-658. [PMID: 35490046 DOI: 10.1016/j.otc.2022.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Temporomandibular disorders (TMDs) are a prominent reason for visits to medical providers. The presentation of headaches within this population remains a challenging diagnosis, given the prevalence and overlap of symptomatology of both conditions. The literature demonstrates an undeniable association between headaches and TMD. Regardless of causality and etiology, the literature supports that prompt diagnosis and treatment results in improvement or resolution of symptoms, including headaches. Treatment of TMD headaches should begin with conservative measures, including medical management with NSAIDs, heat therapy, and muscle-stretching exercises.
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Affiliation(s)
- Erick Garcia
- Rick and Tina Caruso Department of Otolaryngology - Head & Neck Surgery, Keck Medicine of University of Southern California, Los Angeles, CA, USA.
| | - Ryan E Flores
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joni K Doherty
- Rick and Tina Caruso Department of Otolaryngology - Head & Neck Surgery, Keck Medicine of University of Southern California, Los Angeles, CA, USA
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Zhang X, Rahman M, Bereiter DA. Estrogen Status and Trigeminal Ganglion Responses to Jaw Movement. J Dent Res 2022; 101:1075-1081. [PMID: 35259995 PMCID: PMC9305844 DOI: 10.1177/00220345221077951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic temporomandibular joint disorders (TMDs) present with pain in the temporomandibular joint (TMJ) and muscles of mastication. Risk factors for TMD include localized joint/muscle inflammation and estrogen status. This study determined whether mild tissue inflammation and estrogen status influenced the responses of trigeminal ganglion neurons to jaw palpation or jaw movement, 2 key diagnostic features of clinical TMD, in adult rats. Neuronal activity was recorded from male rats, ovariectomized (OvX) female rats, and OvX female rats injected with 17β-estradiol 24 h prior to testing (OvXE). Neurons were tested for responses to deep press over the TMJ region and jaw movement in 3 directions (open, protrusion, lateral) 10 d after intra-TMJ injection of a low dose of complete Freund's adjuvant (CFA) or vehicle (sham). Deep press evoked similar responses in all treatment groups. The response magnitude to jaw opening and protrusion was significantly greater for neurons recorded from OvXE CFA-treated rats than from OvX CFA-treated or OvXE sham rats. The responses to lateral movement of the jaw were similar across all treatment groups. Most neurons (70% to 90%) displayed a static response pattern to jaw movement independent of direction. Estradiol treatment also increased the proportion of neurons that were excited by jaw movement in >1 direction as compared with untreated OvX females or males. These results suggest that mild localized inflammation in the TMJ region during periods of elevated estrogen were sufficient to increase the peripheral driving force for jaw movement-evoked hyperalgesia.
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Affiliation(s)
- X Zhang
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - M Rahman
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - D A Bereiter
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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Patients' perceptions on temporomandibular disorder treatment with hydrostatic oral splints - a pilot study. BDJ Open 2022; 8:4. [PMID: 35124698 PMCID: PMC8818047 DOI: 10.1038/s41405-022-00096-7] [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: 10/18/2021] [Revised: 12/29/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate temporomandibular disorder (TMD) treatment with a prefabricated, hydrostatic oral splint (HOS) based on self-reported patient’s symptoms using a standardized questionnaire. Methods Two hundred fifty-eight questionnaires from patients diagnosed with TMD and subsequently treated with HOS were collected from two independent private practices. Based on patient’s comfort the questionnaire recorded TMD symptoms and symptom regression. Descriptive and comparative statistics was carried out using SPSS. Results A total of 221 questionnaires were analyzed. Patients reported TMD symptoms such as pain (93.2%), TMJ clicking (66.1%), headache (25.8%), cervical spine disorders (23.5%), restricted mouth opening (22.6%) and tinnitus (11.8%). For most symptoms, improvement was reported mostly after two weeks, except for tinnitus, where positive effects were usually reported after four weeks. Conclusion HOS seem to be effective for immediate treatment of pain and other TMD symptoms. Based on the available data, a treatment period of four weeks can be recommended.
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Olivencia O, Kaplan K, Dreger M, Veloz M, Kais A, Marlowe K. Postrehabilitation Considerations for Individuals With Temporomandibular Disorders. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abdrabuh A, Baljon K, Alyami Y. Impact of estrogen therapy on temporomandibular joints of rats: Histological and hormone analytical study. Saudi Dent J 2021; 33:608-613. [PMID: 34803308 PMCID: PMC8589588 DOI: 10.1016/j.sdentj.2020.07.006] [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: 11/11/2019] [Revised: 07/11/2020] [Accepted: 07/23/2020] [Indexed: 11/08/2022] Open
Abstract
Objectives This research aims to evaluate the effects of estrogen deficiency and replacement on the TMJ structures of rats. The considerable similarities in the anatomical features of rats and humans make rats a suitable model for human scientific studies. Methods A clinical trial was conducted on 18 female Sprague-Dawley rats grouped into three categories. The GI group included 6 female rats labelled as the control group, the GII group consisted of 6 females that received ovariectomies, and the GIII group had 6 ovariectomised females that were injected with estrogen replacement therapy in a science laboratory at King Abdulaziz University. ANOVA and Tukey HSD post hoc tests were used to determine any significant differences between the levels of estrogen among the three groups. Results The results indicate that some TMJ structures, including the articular disc and condylar cartilaginous layer, were degraded after estrogen deficiency. However, there was a slight improvement in the cartilaginous layer thickness and proliferation of chondroid cells after estrogen replacement therapy. Estrogen level was reduced in the ovariectomized rats, and while estrogen injections increased blood hormone levels, the levels did not reach those of the control group. Conclusion Estrogen deficiency degraded some TMJ structures, and there is only a slight recovery after estrogen replacement therapy.
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Affiliation(s)
- Abrar Abdrabuh
- College of Dentistry, Al Farabi Private Collage, Jeddah, Saudi Arabia
| | - Kamilya Baljon
- Nursing Collage, Um AL Qura University, Makkah, Saudi Arabia
| | - Yagoub Alyami
- Department of Oral and Maxillofacial Surgery, Al Farabi Private Collage, Jeddah, Saudi Arabia
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Lee E, Crowder HR, Tummala N, Goodman JF, Abbott J, Zapanta PE. Temporomandibular disorder treatment algorithm for otolaryngologists. Am J Otolaryngol 2021; 42:103155. [PMID: 34214714 DOI: 10.1016/j.amjoto.2021.103155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/20/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To review current literature describing the management of temporomandibular disorder (TMD) and to propose an evidence-based algorithm for otolaryngologists. DATA SOURCES A literature review using PubMed and Scopus was conducted to identify manuscripts that describe TMJ disorder etiology, diagnostic methods, and management across the fields of otolaryngology, general practice medicine, physical therapy, dentistry, and maxillofacial surgery. REVIEW METHODS Two reviewers subjectively evaluated the studies based on the inclusion criteria, incorporating them into a comprehensive algorithm. CONCLUSIONS TMD is one of the most common conditions presenting to otolaryngology outpatient clinics. Etiologies of TMD vary widely, including myofascial, intraarticular, neurologic, traumatic, or psychiatric in origin. When conservative measures fail to produce symptom relief, alternative treatments and referral to outside specialists including psychiatry, physical therapy, dentistry, and maxillofacial surgery may be indicated. Premature or inappropriate referrals may lead to patients suffering TMD for extended periods of time, with alternating referrals between various specialists. Thus, we present a TMD treatment algorithm for otolaryngologists to aid in the decision-making process in managing TMD. IMPLICATIONS FOR PRACTICE Patients frequently present to otolaryngology outpatient clinics for symptoms of TMD. Multidisciplinary practice may be necessary to effectively treat TMD of varying etiology and severity. Following conservative treatment, appropriate referrals and treatment plans will reduce ineffective use of resources, deferral of treatment, and patient suffering. For this reason, a comprehensive algorithm for otolaryngologists will improve resource utilization and efficiency of treatment to ultimately provide improved treatment outcomes for patients.
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Ahmed F, Rahman M, Thompson R, Bereiter DA. Role of Connexin 43 in an Inflammatory Model for TMJ Hyperalgesia. FRONTIERS IN PAIN RESEARCH 2021; 2:715871. [PMID: 35295418 PMCID: PMC8915650 DOI: 10.3389/fpain.2021.715871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/08/2021] [Indexed: 12/27/2022] Open
Abstract
Temporomandibular joint disorders (TMD) consist of a heterogeneous group of conditions that present with pain in the temporomandibular joint (TMJ) region and muscles of mastication. This project assessed the role of connexin 43 (Cx43), a gap junction protein, in the trigeminal ganglion (TG) in an animal model for persistent inflammatory TMJ hyperalgesia. Experiments were performed in male and female rats to determine if sex differences influence the expression and/or function of Cx43 in persistent TMJ hyperalgesia. Intra-TMJ injection of Complete Freund's Adjuvant (CFA) caused a significant increase in Cx43 expression in the TG at 4 days and 10 days post-injection in ovariectomized (OvX) female rats and OvX females treated with estradiol (OvXE), while TG samples in males revealed only marginal increases. Intra-TG injection of interference RNA for Cx43 (siRNA Cx43) 3 days prior to recording, markedly reduced TMJ-evoked masseter muscle electromyographic (MMemg) activity in all CFA-inflamed rats, while activity in sham animals was not affected. Western blot analysis revealed that at 3 days after intra-TG injection of siRNA Cx43 protein levels for Cx43 were significantly reduced in TG samples of all CFA-inflamed rats. Intra-TG injection of the mimetic peptide GAP19, which inhibits Cx43 hemichannel formation, greatly reduced TMJ-evoked MMemg activity in all CFA-inflamed groups, while activity in sham groups was not affected. These results revealed that TMJ inflammation caused a persistent increase in Cx43 protein in the TG in a sex-dependent manner. However, intra-TG blockade of Cx43 by siRNA or by GAP19 significantly reduced TMJ-evoked MMemg activity in both males and females following TMJ inflammation. These results indicated that Cx43 was necessary for enhanced jaw muscle activity after TMJ inflammation in males and females, a result that could not be predicted on the basis of TG expression of Cx43 alone.
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Tanhan A, Ozer AY, Polat MG. Efficacy of different combinations of physiotherapy techniques compared to exercise and patient education in temporomandibular disorders: A randomized controlled study. Cranio 2021:1-13. [PMID: 33818314 DOI: 10.1080/08869634.2021.1909454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aims to investigate the efficacy of different types of physiotherapy approaches in individuals with cervical myofascial painful temporomandibular disorders (TMDs). METHODS Seventy-five participants with myofascial pain of jaw muscles and cervical myofascial pain were randomized into three groups: exercise group (E), low-level laser therapy group (LLLT), and manual pressure release group (MPR). All patients were assessed before treatment and after 12 sessions of treatment. RESULTS Significant improvement was seen in all groups' pressure pain threshold (PPT) values (p < 0.01). Some masticatory and neck muscles' PPT changes in MRP and LLLT groups were significantly higher than the exercise group (p < 0.05). CONCLUSION Exercise therapy is an effective approach for treatment of TMDs. Additionally, LLLT combined with exercise and MPR combined with exercise have better effects than only exercise therapy. Multimodal treatment approaches should include exercise to achieve better results in clinical practice.
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Affiliation(s)
- Abdurrahman Tanhan
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
| | - Aysel Yildiz Ozer
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
| | - Mine Gulden Polat
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
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Prevalence of signs and symptoms of temporo-mandibular disorder in patients with sleep apnea. Sleep Breath 2021; 25:2001-2006. [PMID: 33674964 DOI: 10.1007/s11325-021-02337-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/01/2021] [Accepted: 02/19/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of the present study was to detect the prevalence of temporomandibular disorders (TMD) in patients with untreated obstructive sleep apnea (OSA) and to compare the results with healthy controls, matched for sex and age. METHODS Forty-one consecutive patients with OSA were prospectively recruited from the Department of Otorhinolaryngology at the A. Gemelli Hospital prior to undergoing any treatment for OSA and independently of OSA severity. All patients underwent a complete TMD examination according to the diagnostic criteria for temporomandibular disorders (DC/TMD) protocol. The same examination was performed on 41 healthy controls matched for sex and age. Chi-squared test was used to compare results between the two groups. RESULTS Of the 41 patients with OSA, 21 (51%) presented signs and/or symptoms of TMD compared to 13 of 41 subjects (32%) from the control group. Headache attributed to TMD and disc displacement with reduction were the most common diagnoses, with a statistically significant difference between the two groups (p<0.05). CONCLUSIONS The prevalence of TMD signs and symptoms is significantly higher in untreated patients with OSA compared to healthy controls.
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Karaman A, Sapan Z. Evaluation of temporomandibular disorders, quality of life, and oral habits among dentistry students. Cranio 2020:1-7. [PMID: 33325334 DOI: 10.1080/08869634.2020.1857615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To evaluate temporomandibular disorders (TMD), quality of life, and oral habits in dentistry students.Methods: The study was performed with 480 students (287 females, 193 males). The Fonseca Questionnaire, Oral Health Impact Profile-14 (OHIP-14), and Oral Behaviors Checklist (OBC) were used.Results: The mean scores of the fifth-year students from Fonseca TMD, OHIP-14, and OBC were statistically significantly higher than those of the students in other years of study. The mean Fonseca score of female students was higher than those of the males. There was a statistically significant difference regarding the OHIP-14 scores based on the Fonseca TMD scores. A statistically significant difference regarding OBC was present based on the Fonseca TMD scores.Conclusion: The prevalence of TMDs was higher among the senior dentistry students. Necessary measures should be taken in the dentistry educational system to raise students' quality of life, improve joint disorders, and eliminate current oral habits.
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Affiliation(s)
- Ahmet Karaman
- Department of Orthodontics, Istanbul Aydın University, Istanbul, Turkey
| | - Zeynep Sapan
- Department of Orthodontics, Istanbul Aydın University, Istanbul, Turkey
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Di Paolo C, Falisi G, Panti F, Di Giacomo P, Rampello A. "RA.DI.CA." Splint for the Management of the Mandibular Functional Limitation: A Retrospective Study on Patients with Anterior Disc Displacement without Reduction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9057. [PMID: 33291679 PMCID: PMC7730108 DOI: 10.3390/ijerph17239057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
The study aimed at assessing the effectiveness of the RA.DI.CA. splint in the management of temporomandibular joint disc displacement without reduction (ADDwoR) and jaw functional limitation. The authors developed a retrospective clinical study. A total of 2739 medical records were screened. One hundred and forty-one patients with chronic unilateral disc displacement without reduction and jaw limitation, treated with a multifunctional RA.DI.CA. splint, were enrolled. Temporomandibular pain, headache, familiar pain, neck pain, and emotional strain, maximum spontaneous mouth opening, and lateral excursions were evaluated at baseline (T0), after therapy (T1), and during the follow-up (T2). Descriptive statistical analysis was performed. Wilcoxon test assessed changes in symptomatology and functional aspects before and after treatment and between T1 and T2, with p < 0.05. Ninety-nine patients (70%) declared themselves "healed" from jaw functional limitation with no residual painful symptoms, 31 (22%) improved their symptoms and jaw function, 11 (8%) reported no changes compared to T0 and no one worsened. As for all parameters analyzed, the comparison between the ones before and after treatment was statistically significant (p < 0.05). The RA.DI.CA. splint proved to be highly performing and promoting functional and symptomatologic recovery, also in the medium and long term, through the restoration of the functional disc-condyle relationship and the healing of joint tissues.
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Affiliation(s)
| | | | | | - Paola Di Giacomo
- Gnathologic Division, Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (C.D.P.); (G.F.); (F.P.); (A.R.)
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Catastrophizing Has a Better Prediction for TMD Than Other Psychometric and Experimental Pain Variables. Pain Res Manag 2020; 2020:7893023. [PMID: 33273993 PMCID: PMC7676933 DOI: 10.1155/2020/7893023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/21/2020] [Accepted: 10/24/2020] [Indexed: 01/11/2023]
Abstract
Temporomandibular disorders (TMDs) are characterized by moderate to severe pain in the masticatory muscles and/or the temporomandibular joint (TMJ). The present study is a part of a multidisciplinary project, initiated by the Norwegian Ministry of Health. The main purpose of this study is to compare a cohort of TMD patients to healthy individuals regarding experimental pain, the degree of disability caused by living with pain and psychometric variables, and to investigate which of these variables is the best predictor for TMD patients. We hypothesised that TMD patients have more disability when living with pain and lower pain thresholds than healthy controls, and those psychometric variables are stronger predictors than pain thresholds provoked by experimental pain. Sixty TMD patients were matched by sex and age to sixty healthy individuals without TMD symptoms or other musculoskeletal symptoms in the head and neck region. All subjects completed a questionnaire that included psychometric characteristics, that is, a one- and two-item version of the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale (HADS), and the Roland Morris Scale (RMS), which measures disability when living with pain. They also underwent a clinical examination including the measurement of pain thresholds with electrical and pressure stimuli. The TMD patients had lower pain thresholds for experimental electrical and pressure stimuli compared with the controls (P < 0.05 and <0.001, respectively). They also scored higher than healthy individuals with disability living with pain (P < 0.001), anxiety (P < 0.001), depression (P < 0.001), and catastrophizing (P < 0.001). The results for anxiety, depression, and catastrophizing have been published earlier, and the reused data in this study are compared with RMS and pain thresholds. The conditional logistic regression model identified catastrophizing (OR = 2.42, CI 1.22–4.79) as a significant predictor of TMD patients. The results support this hypothesis and indicate that TMD patients have lower pain thresholds and more disability when living with pain compared to healthy individuals, where the strongest prediction for TMD was catastrophizing. Awareness of psychometric disabilities in TMD patients is of importance when considering the choice of treatment.
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Chaurasia A, Ishrat S, Katheriya G, Chaudhary PK, Dhingra K, Nagar A. Temporomandibular disorders in North Indian population visiting a tertiary care dental hospital. Natl J Maxillofac Surg 2020; 11:106-109. [PMID: 33041586 PMCID: PMC7518477 DOI: 10.4103/njms.njms_73_17] [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: 11/30/2017] [Revised: 01/12/2018] [Accepted: 02/17/2018] [Indexed: 11/06/2022] Open
Abstract
Background: The terminology “temporomandibular disorders” (TMDs) encompasses a wide spectrum of conditions. Several hypothesized causes are occlusal disharmony, muscle hyperactivity, central pain mechanisms, psychological distress, and trauma. In day-to-day practice, TMDs had become more prevalent in Indian population due to changed dietary pattern and food habits, excessive stress of modern life, and other environmental causes. This study is an attempt to find the prevalence of TMDs in North Indian population. Aims: The present study is taken into account to determine the prevalence of TMDs on the basis of signs and symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Materials and Methods: The present cross-sectional study was conducted in the Department of Oral Medicine and Radiology. A total of 1009 patients aged between 6 and 80 years with a mean age of 42.04 ± 16.8 years seeking dental treatment from January 2016 to June 2017 were included in the study. All the patients were screened for TMD sign and symptoms. The demographic data and the signs and symptoms of TMDs were recorded in designed structured questionnaires which were based on the RDC/TMD criteria. Results: The study population consisted of 1009 patients aged between 6 and 80 years. In the present study population, based on RDC/TMD criteria, the incidence of clicking sound (42.5%) was highest in TMD joint followed by deviation of mandible on mouth opening (40.8%), internal derangement (36.8%), myofacial pain dysfunction syndrome (33.7%), osteoarthritis (29.5%), crepitus (25.8%), joint tenderness (5.8%), and pain on mouth opening (4.8%). Conclusion: Clicking sound was the most common sign of TMD disorders in Indian population.
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Affiliation(s)
| | - Saman Ishrat
- Department of Oral Medicine and Radiology, Rama Dental College Kanpur, Kanpur, Uttar Pradesh, India
| | - Gaurav Katheriya
- Department of Oral Medicine and Radiology KGMU, Lucknow, Uttar Pradesh, India
| | | | - Kunal Dhingra
- Department of Orthodontics, CDER, AIIMS, New Delhi, India
| | - Amit Nagar
- Department Of Orthodontics, KGMU, Lucknow, Uttar Pradesh, India
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YILMAZ B, SOMAY E. Temporomandibular eklem bozukluğu tanısının manyetik rezonans görüntüleme ile doğrulanması. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.687196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Gilheaney Ó, Stassen LF, Walshe M. The epidemiology, nature, and impact of eating and swallowing problems in adults presenting with temporomandibular disorders. Cranio 2020; 40:476-484. [PMID: 32564703 DOI: 10.1080/08869634.2020.1781453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Temporomandibular disorders (TMDs) are the most common non-dental orofacial pain disorders. Research suggests that patients with TMDs experience eating and swallowing problems, although information is sparse, impacting effectiveness of management. Research aims were to investigate the epidemiology and impact of TMD-related eating and swallowing problems. METHODS A cross-sectional study was completed in two national Irish specialist centers, with 126 participants with TMDs assessed using a specifically-devised protocol. Descriptive and statistical analyses were completed. RESULTS Masticatory issues (95%), swallowing difficulties (53%), and weight loss (50%) were prevalent. Participants reported moderately severe eating and swallowing problems impacting participation and well-being across daily and social activities. DISCUSSION A variety of eating and swallowing problems are reported by adults with TMDs, which impact functioning and psychosocial well-being. The need to improve clinical practice and research is argued. Future research should refine the original assessment protocol developed in this study.
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Affiliation(s)
- Órla Gilheaney
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Leo Fa Stassen
- Oral and Maxillofacial Surgery TCD, Dublin Dental University Hospital, Dublin, Ireland
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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Zwiri A, Al-Hatamleh MAI, W. Ahmad WMA, Ahmed Asif J, Khoo SP, Husein A, Ab-Ghani Z, Kassim NK. Biomarkers for Temporomandibular Disorders: Current Status and Future Directions. Diagnostics (Basel) 2020; 10:E303. [PMID: 32429070 PMCID: PMC7277983 DOI: 10.3390/diagnostics10050303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/08/2020] [Indexed: 12/17/2022] Open
Abstract
Numerous studies have been conducted in the previous years with an objective to determine the ideal biomarker or set of biomarkers in temporomandibular disorders (TMDs). It was recorded that tumour necrosis factor (TNF), interleukin 8 (IL-8), IL-6, and IL-1 were the most common biomarkers of TMDs. As of recently, although the research on TMDs biomarkers still aims to find more diagnostic agents, no recent study employs the biomarker as a targeting point of pharmacotherapy to suppress the inflammatory responses. This article represents an explicit review on the biomarkers of TMDs that have been discovered so far and provides possible future directions towards further research on these biomarkers. The potential implementation of the interactions of TNF with its receptor 2 (TNFR2) in the inflammatory process has been interpreted, and thus, this review presents a new hypothesis towards suppression of the inflammatory response using TNFR2-agonist. Subsequently, this hypothesis could be explored as a potential pain elimination approach in patients with TMDs.
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Affiliation(s)
- Abdalwhab Zwiri
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.Z.); (W.M.A.W.A.); (J.A.A.); (A.H.)
| | - Mohammad A. I. Al-Hatamleh
- Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Wan Muhamad Amir W. Ahmad
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.Z.); (W.M.A.W.A.); (J.A.A.); (A.H.)
| | - Jawaad Ahmed Asif
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.Z.); (W.M.A.W.A.); (J.A.A.); (A.H.)
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Suan Phaik Khoo
- Department of Oral Diagnostic and Surgical Sciences, School of Dentistry, International Medical University, Bukit Jalil 57000, Kuala Lumpur, Malaysia;
| | - Adam Husein
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.Z.); (W.M.A.W.A.); (J.A.A.); (A.H.)
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Zuryati Ab-Ghani
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.Z.); (W.M.A.W.A.); (J.A.A.); (A.H.)
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Nur Karyatee Kassim
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.Z.); (W.M.A.W.A.); (J.A.A.); (A.H.)
- Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Shoohanizad E, Garajei A, Enamzadeh A, Yari A. Nonsurgical management of temporomandibular joint autoimmune disorders. AIMS Public Health 2019; 6:554-567. [PMID: 31909075 PMCID: PMC6940567 DOI: 10.3934/publichealth.2019.4.554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/24/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction Temporomandibular disorders (TMD) are observed in a number of autoimmune diseases but limited studies have assessed the effect of autoimmune diseases on TMD. Therefore, the present review article was conducted to determine the effect of autoimmune diseases on TMD. Methods International databases, including Web of Sciences, PubMed and Scopus, were searched in order to find related articles. The search key words were; temporomandibular joint (TMJ) autoimmune disorders, TMJ, TMD, medical therapy and non-invasive, local and systemic management. Published articles from June, 2010 to June, 2019 were included in the review. Results A total of 11 related articles including rheumatoid arthritis (RA), lupus erythematosus and systemic sclerosis were found. All articles noted that TMJ has unique features that distinguishes it from other human body joints. Cases of TMJ injury and TMD require specific treatments. Therefore, early diagnosis of TMD is essential. It was also mentioned in the articles that the collagen-induced arthritis (CIA) method is a suitable method for investigating TMD and its relationship with RA. Treatment methods included oral steroids, Disease-modifying antirheumatic drugs, nonsteroidal anti-inflammatory drugs, methotrexate 75 mg, and combination therapy with methotrexate. Conclusion Based on the results of this study, TMD exists in some autoimmune diseases, including RA, lupus erythematosus and systemic sclerosis. Therefore, there should be an interdisciplinary collaboration between physicians and dentists in order to choose the best conservative treatment and medication therapy for TMD to reduce the progression and pain associated with this type of disorder.
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Affiliation(s)
- Ehsan Shoohanizad
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ata Garajei
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Enamzadeh
- DMD, Private Practice, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Yari
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry and Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Karaman A, Sadry S. Evaluation of temporomandibular disorders and oral health-related quality of life with obese patients. Cranio 2019; 39:510-517. [PMID: 31747866 DOI: 10.1080/08869634.2019.1694777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: The aim of this study was to investigate the relationship between temporomandibular disorders and oral health impact profile in healthy, overweight, and obese patients.Methods: This study was carried out on 1528 individuals divided into three groups as healthy, overweight, and obese patients. Diagnostic Criteria for Temporomandibular Disorders, Fonseca's questionnaire, and Oral Health Impact Profile-14 (OHIP-14) forms were used.Results: Gender, classification, pain, temporomandibular joint noise, and open-lock of the jaw of healthy, overweight, and obese groups were found to be related. The differences in the Fonseca and the OHIP-14 total scores according to the groups were found to be statistically significant. The correlation between the Fonseca total score and age was positive and significant.Conclusion: In the obese patients, both total Fonseca and OHIP-14 values were found to be higher. Also, the presence of pain in the obese patients was found to be higher.
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Affiliation(s)
- Ahmet Karaman
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey
| | - Sanaz Sadry
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey
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Cooper BC. An orofacial pain specialty: An asset or liability to dentistry and the public. Cranio 2019; 37:344-346. [PMID: 31581939 DOI: 10.1080/08869634.2019.1664813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Barry C Cooper
- CRANIO Editorial Board, Department of Oral Biology and Pathology, State University of New York, Stony Brook School of Dental Medicine, Past International President, International College of CranioMandibular Orthopedics, Past Chairman Alliance of TMD organizations
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Lee YH, Lee KM, Auh QS, Hong JP. Sex-related differences in symptoms of temporomandibular disorders and structural changes in the lateral pterygoid muscle after whiplash injury. J Oral Rehabil 2019; 46:1107-1120. [PMID: 31228222 DOI: 10.1111/joor.12845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 05/28/2019] [Accepted: 06/17/2019] [Indexed: 12/31/2022]
Abstract
Whiplash injury is an initiating or aggravating factor of temporomandibular disorder (TMD). Although there are sex-related differences in the mechanism of pain perception and pain control, there is a lack of research on differences in TMD after whiplash injury. We aimed to evaluate sex-related differences in the clinical symptoms and magnetic resonance imaging (MRI) findings of patients with TMD attributed to whiplash injury. This retrospective, cross-sectional study included 100 patients (50 women; 50 men; mean age, 37.60 years) who visited our oro-facial pain clinic with symptoms of TMD after whiplash injury. All patients underwent detailed evaluations for history of trauma, and their clinical and MRI findings were comprehensively assessed. Women with TMD after whiplash injury perceived more pain and presented more tenderness upon palpation than did men with TMD. In addition, women showed higher volume (58% vs 26%) and signal changes (54% vs 20%) in the lateral pterygoid muscle (LPM) and more anterior disc displacement without reduction (ADDWoR) (40% vs 20%) than did men. The presence of ADDWoR (odds ratio, 10.58; P = 0.007) and condylar degeneration (odds ratio, 9.30; P = 0.015) predicted LPM volume; stressful conditions (beta = 1.34; P = 0.011) correlated with increased visual analogue scale scores, and sleep problem was associated with an increased palpation index (PI) (beta = 0.42; P < 0.001) and neck PI (beta = 0.49; P < 0.001) scores only in women. Our results showed sex-specific differences in pain intensity, distribution of clinical and abnormal MRI findings, and their relationships, and these differences should be considered when treating patients with TMD.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Dongdaemun-gu, Seoul, Korea
| | - Kyung Mi Lee
- Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Dongdaemun-gu, Seoul, Korea
| | - Q-Schick Auh
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Dongdaemun-gu, Seoul, Korea
| | - Jyung-Pyo Hong
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Dongdaemun-gu, Seoul, Korea
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Chen YY, Fan HC, Tung MC, Chang YK. The association between Parkinson's disease and temporomandibular disorder. PLoS One 2019; 14:e0217763. [PMID: 31199837 PMCID: PMC6568392 DOI: 10.1371/journal.pone.0217763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 05/19/2019] [Indexed: 12/31/2022] Open
Abstract
The prevalence of temporomandibular disorder (TMD) among elderly people with Parkinson’s disease (PD) is relatively high, but a population-based study of the relationship between PD and TMD is still lacking. This study, therefore, sought to investigate the association between TMD and PD by using data for one million randomly sampled beneficiaries of Taiwan’s National Health Insurance program, including 6,185 PD patients who were matched through propensity score matching with 18,555 non-PD patients. Both the PD and non-PD cohorts were followed until death, any diagnosis of TMD, or December 31, 2013, whichever occurred first. Each diagnosis of TMD was made by a qualified physician according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), using the diagnosis codes 524.60, 524.62, 524.63, and 524.69 while excluding tooth abscess, wisdom tooth eruption, herpes zoster and postherpetic neuralgia, mastoiditis, otitis externa, otitis media, parotitis, sialadenitis, and trigeminal neuralgia. We used Cox proportional hazard regression models to calculate the relative risk of TMD and found a 2.11-fold (95% CI: 1.35–3.30) increased risk of TMD overall in the PD group compared with the non-PD group. Stratified by follow-up period, there was a 4.25-fold (95% CI: 1.51–11.93) increased risk in the PD group in the first year after the initial PD diagnosis and a 3.88-fold (95% CI: 1.33–11.28) increased risk in the second year. Over the long-term (>5 years), PD was significantly associated with an increased risk of TMD. These findings suggest that it is important to closely monitor the temporomandibular joint health of PD patients.
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Affiliation(s)
- Ya-Yi Chen
- Department of Stomatology, Tungs’ Taichung MetroHarbor Hospital, Wuchi, Taichung, Taiwan, Republic of China
- Institute of Genomics and Bioinformatics, College of Life Sciences, National of Chung Hsing University, Taichung, Taiwan, Republic of China
| | - Hueng-Chuen Fan
- Department of Pediatrics, Tungs’ Taichung MetroHarbor Hospital, Wuchi, Taichung, Taiwan, Republic of China
- Department of Medical Research, Tungs’ Taichung MetroHarbor Hospital, Wuchi, Taichung, Taiwan, Republic of China
- Department of Rehabilitation, Jen-Teh Junior College of Medicine and Management, Hou-Loung Town, Miaoli, Taiwan, Republic of China
| | - Min-Che Tung
- Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Wuchi, Taichung, Taiwan, Republic of China
| | - Yu-Kang Chang
- Department of Medical Research, Tungs’ Taichung MetroHarbor Hospital, Wuchi, Taichung, Taiwan, Republic of China
- Department of Nursing, Jen-Teh Junior College of Medicine and Management, Hou-Loung Town, Miaoli, Taiwan, Republic of China
- * E-mail:
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Çebi AT. Batı Karadeniz Bölgesi Karabük İli ve Çevresinde Temporomandibular Eklem Disfonksiyon Prevalansının Değerlendirilmesi. ACTA MEDICA ALANYA 2019. [DOI: 10.30565/medalanya.448660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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[Assessment of postural control and balance in persons with temporomandibular disorders: A systematic review]. Rehabilitacion (Madr) 2019; 53:28-42. [PMID: 30929830 DOI: 10.1016/j.rh.2018.10.004] [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: 05/01/2018] [Revised: 10/10/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022]
Abstract
The stomatognathic system is the anatomo-functional unit of the cranio-cervico-facial region. Some dysfunctions affect its motor control. The aim of this study was to analyse the clinical usefulness of the various scales and instruments used in the assessment of postural control in people with temporomandibular disorders. A systematic review was carried out by 2independent reviewers in the PubMed, Medline, Ebsco, Science Direct and PEDro databases, selecting observational studies published between January 2006 and March 2017. The risk of bias and methodological quality was analysed following Cochrane indications and the Downs and Black quality scale. Ten studies were included, of which 9used computerised platforms, one added photogrammetry and one used electromyography. Seven studies were classified as moderate quality and 3as low quality. Posturography was the most widely used assessment instrument. Methodological differences did not allow determination of their clinical implications or the relationship between balance and the presence of temporomandibular disorders.
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Bereiter DA, Thompson R, Rahman M. Sex Differences in Estradiol Secretion by Trigeminal Brainstem Neurons. Front Integr Neurosci 2019; 13:3. [PMID: 30809134 PMCID: PMC6379465 DOI: 10.3389/fnint.2019.00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/22/2019] [Indexed: 12/01/2022] Open
Abstract
Estrogen status is a significant risk factor in the development of temporomandibular joint disorders (TMD). Classically, estrogen status is thought to derive mainly from ovarian sources; however, it is well known that estradiol (E2) also is synthesized by neurons in the brain. This study tested the hypothesis that E2 is produced by neurons in trigeminal subnucleus caudalis (Vc), the principal site of termination for sensory afferents that supply the temporomandibular joint (TMJ), to modify evoked responses in a model of TMJ nociception in male and female rats. Intra-TMJ injection of the small fiber excitant, allyl isothiocyanate (AIC), increased the levels of E2 collected from microdialysis probes sites at Vc of ovariectomized (OvX) female rats, ipsilateral to the stimulus, whereas males displayed no change. Dialysate levels of E2 collected from probe sites in the contralateral Vc or cerebellum in OvX rats were not affected by TMJ stimulation. Reverse dialysis of anastrozole, an aromatase (ARO) inhibitor, via the probe reduced perfusate levels of E2 in Vc. Systemic administration of letrozole, a non-steroid ARO inhibitor, for 4 days prevented TMJ-evoked increases in masseter muscle electromyography (MMemg) activity. ARO-positive neurons were distributed mainly in superficial laminae (I-III) at Vc and cell counts revealed no significant difference between OvX and male rats. Intra-TMJ injection of AIC revealed similar numbers of ARO/Fos dual-labeled neurons in OvX and male rats. By contrast, the percentage of ARO neurons co-labeled for glutamic acid decarboxylase (GAD), the biosynthetic enzyme for GABA, was greater in OvX (35%) than male rats (14%). Few ARO-positive neurons were co-labeled for estrogen receptor alpha. These data indicate that E2 is secreted continuously by Vc neurons and that acute stimulation of TMJ nociceptors evokes further secretion in a sex-dependent manner. Reduced TMJ-evoked MMemg activity after ARO inhibition suggests that locally produced E2 by Vc neurons acts via paracrine mechanisms to modify TMJ nociception in female rats.
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Affiliation(s)
- David A Bereiter
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, MN, United States
| | - Randall Thompson
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, MN, United States
| | - Mostafeezur Rahman
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, MN, United States
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Al Hayek SO, Al‐Thunayan MF, AlGhaihab AM, AlReshaid RM, Omair A. Assessing stress associated with temporomandibular joint disorder through Fonseca's anamnestic index among the Saudi physicians. Clin Exp Dent Res 2019; 5:52-58. [PMID: 30847233 PMCID: PMC6392863 DOI: 10.1002/cre2.157] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/19/2018] [Accepted: 11/28/2018] [Indexed: 12/03/2022] Open
Abstract
The study aims to investigate signs and symptoms of temporomandibular disorders (TMD) among physicians in a tertiary health-care center. It has estimated the level of symptomatology, determined the association with demographic data, and identified the related occupational risk factors. A cross-sectional survey was used, and physicians of genders, all age groups, and nationalities from King Abdulaziz Medical City in Riyadh, Saudi Arabia, were recruited. Subjects who had rheumatic arthritis, osteoarthritis, trigeminal neuralgia, or temporomandibular joint (TMJ) trauma were excluded. The data were collected through a self-administered questionnaire that measured TMD severity and oral parafunctional behaviors. Fonseca's anamnestic index (FAI) and an oral validated behavior checklist were used to assess the signs and symptoms of TMD. A total of 282 physicians participated in the study, and the prevalence of TMD signs among physicians was 37% (106); among them, 88 (83%) were within the light dysfunction category. Female physicians reported significantly higher FAI than males for side-to-side mandibular movement (12% vs. 5%, P = 0.04), reporting ear pain (18% vs. 10%, P = 0.04), and noticing clicking when chewing or opening the mouth (35% vs. 20%, P = 0.006). Younger practitioners (28-31 years old) who reported clicking while chewing or opening the mouth tended to have reported higher TMD dysfunction (35%) than those aged 40 and above (13%; P = 0.007). Self-reported signs of TMD were 37% among our population. Information collected from FAI is useful in early diagnosis and prevention of TMD.
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Affiliation(s)
- Samar O. Al Hayek
- College of DentistryKing Saud bin Abdulaziz University for Health Sciences, National Guard HospitalRiyadhSaudi Arabia
| | - Mashael F. Al‐Thunayan
- College of DentistryKing Saud bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
| | - Amjad M. AlGhaihab
- College of DentistryKing Saud bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
| | | | - Aamir Omair
- College of MedicineKing Saud bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
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Abstract
This review examines gender prevalence in orofacial pain to elucidate underlying factors that can explain such differences. This review highlights how gender affects (1) the association of hormonal factors and pain modulation; (2) the genetic aspects influencing pain sensitivity and pain perception; (3) the role of resting blood pressure and pain threshold; and (4) the impact of sociocultural, environmental, and psychological factors on pain.
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Affiliation(s)
- Jeffry Rowland Shaefer
- Division of Oral and Maxillofacial Pain, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, 55 Fruit Street, Boston, MA 02114, USA.
| | - Shehryar Nasir Khawaja
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital, 7A Block R-3 M.A. Johar Town, Lahore, Punjab, Pakistan
| | - Paula Furlan Bavia
- Division of Oral and Maxillofacial Pain, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Gilheaney Ó, Béchet S, Kerr P, Kenny C, Smith S, Kouider R, Kidd R, Walshe M. The prevalence of oral stage dysphagia in adults presenting with temporomandibular disorders: a systematic review and meta-analysis. Acta Odontol Scand 2018; 76:448-458. [PMID: 29320883 DOI: 10.1080/00016357.2018.1424936] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Temporomandibular disorders (TMDs) are the most commonly experienced non-dental orofacial pain disorders, with pain and dysfunction potentially resulting in oral stage dysphagia (OD). However, limited research has been conducted on this condition, with potential negative effects on clinical practice. Therefore, the aim of this study was to determine the prevalence of OD in adults presenting with TMDs, diagnosed as per the Research Diagnostic Criteria for Temporomandibular Disorders or the Diagnostic Criteria for Temporomandibular Disorders protocols. MATERIAL AND METHODS A systematic review of the literature was completed. Nine electronic databases were searched from inception to January 2017, with no date/language restriction applied. Grey literature, conference proceedings, and reference lists were also searched. Studies presenting original data regarding OD prevalence in adults presenting with TMDs were included if they investigated impaired swallowing, mastication, masticatory pain or fatigue, or weight loss. Study eligibility and quality were assessed by two independent reviewers. Methodological quality was assessed using the Down's and Black tool. RESULTS AND CONCLUSIONS This search yielded 20 eligible studies. Swallowing itself was impaired in only 9.3% of patients with TMDs. A range of additional OD signs and symptoms were also commonly reported (e.g. masticatory pain (87.4%) and fatigue (62%)). Study limitations included the small number of studies which were eligible for inclusion. As signs and symptoms of OD are frequently reported by patients with TMDs, psychometrically robust prospective research is warranted to determine current and optimal management of this condition.
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Affiliation(s)
- Órla Gilheaney
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Sibylle Béchet
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Patrick Kerr
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Ciaran Kenny
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Shauna Smith
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Rita Kouider
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Rachel Kidd
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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Gilheaney Ó, Stassen LF, Walshe M. Prevalence, Nature, and Management of Oral Stage Dysphagia in Adults With Temporomandibular Joint Disorders: Findings From an Irish Cohort. J Oral Maxillofac Surg 2018; 76:1665-1676. [PMID: 29549021 DOI: 10.1016/j.joms.2018.01.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 01/18/2018] [Accepted: 01/31/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Temporomandibular disorders (TMDs) are caused by changes in the structure and/or function of the temporomandibular joint, masticatory muscles, and/or osseous components. TMDs can result in oral stage dysphagia (OD) with potential effects on function and patient well-being. Little is known about the prevalence, nature, and management of TMD-related OD. The aims of the present study were to estimate the prevalence and nature of OD in adult TMD patients and to identify the common management techniques used to manage the signs and symptoms of TMD-related OD. PATIENTS AND METHODS An 18-item subjective questionnaire was adapted from existing tools and used to investigate TMD etiology, the symptoms and signs of TMD-related OD, and the intervention techniques used to manage these symptoms. This was disseminated to 178 TMD patients consecutively recruited over 6 months in 2016. Descriptive and statistical methods were used to analyze the data. RESULTS Of the 178 TMD participants, 99% reported at least one symptom or sign of OD. Individuals presenting with subluxation of the jaw (80%), degenerative joint disorder (67%), and myofascial pain disorder (40%) reported OD most frequently. Common symptoms included painful mastication (90%), masticatory fatigue (78%), difficulties swallowing (33%), and difficulties drinking liquids (28%). The use of a broad range of management techniques was reported, with these including both OD-specific techniques (eg, diet modifications [81%]), and non-OD specific techniques (eg, analgesia [79%] and oral splints [75%]). CONCLUSIONS OD is prevalent, and difficulties with mastication are common in those with TMDs. The interventions used were diverse, with varying objectives and disparate levels of evidence supporting their efficacy within this cohort. Further research should address the epidemiology of TMD-related OD, evidence-based interventions, and the promotion of collaboration across the disciplines responsible for managing TMD-related OD (eg, speech and language therapy, oral and maxillofacial surgery, dentistry, restorative dentistry, orthodontics, oral medicine).
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Affiliation(s)
- Órla Gilheaney
- PhD Student, Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland.
| | - Leo Fa Stassen
- Professor and Chair, Department of Oral and Maxillofacial Surgery, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Margaret Walshe
- Associate Professor and Department Head, Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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Chatzopoulos GS, Sanchez M, Cisneros A, Wolff LF. Prevalence of temporomandibular symptoms and parafunctional habits in a university dental clinic and association with gender, age, and missing teeth. Cranio 2017; 37:159-167. [PMID: 29143569 DOI: 10.1080/08869634.2017.1399649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective To assess the prevalence of symptoms of temporomandibular disorder (TMD) and parafunctional habits as well as to investigate their association with age, gender, and number of missing teeth. Methods This retrospective study is based on 4204 randomly selected patients who were examined to determine their symptoms of TMD, such as clicking, difficulty chewing, difficulty opening/closing, as well self-reported joint pain and parafunctional habits. Results Clenching/grinding was reported by 26.5% of the examined population, clicking by 14.8%, and difficulty chewing and closing by 3.6%. Significant associations between the number of missing teeth with clenching/grinding (p = 0.05) and difficulty chewing (p < 0.001) were detected. Age and gender showed significant effects on the examined parameters (p < 0.05). Discussion Understanding the TMD subjective symptoms in relation to age, gender, and tooth loss would be of great value for treatment planning and could provide other perspectives to establish preventive measures.
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Affiliation(s)
- Georgios S Chatzopoulos
- a Department of Developmental and Surgical Sciences, Division of Periodontology, School of Dentistry , University of Minnesota , Minneapolis , MN , USA
| | - Miguel Sanchez
- b School of Dentistry , University of Minnesota , Minneapolis , MN , USA
| | - Alejandro Cisneros
- b School of Dentistry , University of Minnesota , Minneapolis , MN , USA
| | - Larry F Wolff
- a Department of Developmental and Surgical Sciences, Division of Periodontology, School of Dentistry , University of Minnesota , Minneapolis , MN , USA
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Maciejewska-Szaniec Z, Maciejewska B, Mehr K, Piotrowski P, Michalak M, Wiskirska-Woźnica B, Klatkiewicz T, Czajka-Jakubowska A. Incidence of Otologic Symptoms and Evaluation of the Organ of Hearing in Patients with Temporomandibular Disorders (TDM). Med Sci Monit 2017; 23:5123-5129. [PMID: 29077689 PMCID: PMC5673028 DOI: 10.12659/msm.905510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Numerous studies have discussed cases of concomitant temporomandibular disorders (TMD) and otologic symptoms (OS). However, attempts to determine the true origin of these symptoms combined with assessments of the condition of the organ of hearing are relatively rare. This study aimed to evaluate the frequency and type of OS in patients with TMD, and attempted to determine the origin of the OS in the studied group of patients. Material/Methods 246 patients, aged 40.08±11.12 years (F=147, M=99) with TMD, from the Department of Oral Rehabilitation of Poznan University of Medical Sciences. Methods: dental history interviews and clinical examinations. There were 2 groups–G1 and G2–selected on the basis of the presence or absence of OS in the medical history stage. After audiological evaluation, 2 subgroups were identified: G1.1 and G1.2. Results OS were observed in 36.18% (G1). In 48 patients (53.93%), the audiological evaluation found there was no impairment of the organ of hearing (G1.2). Audiological abnormalities were found in 46.07% (n=41) of the patients (G1.1). The OS which differentiated the 2 groups were a plugging sensation as well as otalgia (more frequent in group G1.2) and hearing impairment (more frequent in group G1.1). Conclusions 1. The OS which most frequently accompany with TMD were fullness and otalgia. 2. It is recommended that a subjective assessment of hearing loss in patients with TMD and concomitant OS should be included in the medical history stage. 3. Clicking and popping are significantly more frequent in patients without concomitant hearing impairment.
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Affiliation(s)
- Zofia Maciejewska-Szaniec
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Barbara Maciejewska
- Department and Clinic of Phoniatrics and Audiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Katarzyna Mehr
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł Piotrowski
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics , Poznań University of Medical Sciences, Poznań, Poland
| | - Bożena Wiskirska-Woźnica
- Department and Clinic of Phoniatrics and Audiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Tomasz Klatkiewicz
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Agata Czajka-Jakubowska
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
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Zwiri AMA, Al-Omiri MK. Prevalence of temporomandibular joint disorder among North Saudi University students. Cranio 2017; 34:176-81. [PMID: 25832332 DOI: 10.1179/2151090315y.0000000007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The aim of the current investigation was to study the prevalence of temporomandibular disorder (TMD) among university students of North Saudi Arabia. METHODS A specifically constructed questionnaire was distributed to 489 university students to investigate the prevalence of temporomandibular joint (TMJ) findings among them. The study sample consisted of 346 males and 143 females (age range was 18-25 years). The data were analyzed, and probability values were set at p ≤ 0.05. RESULTS A total of 49.7% of participants had at least one sign or symptom of TMD. Clicking was the most reported finding. Pain in or about the ears/cheeks was the second most common finding. In all, 24.3% of the participants reported one TMJ finding; meanwhile, 0.4% reported the presence of five concurrent TMJ signs and symptoms. Females reported more TMJ signs and symptoms than males (p < 0.05). Science and health students reported more TMD findings than humanitarian college students (p < 0.05). DISCUSSION University students in north Saudi Arabia reported high prevalence of TMD. Also, students from science and health colleges reported higher prevalence of TMD findings than humanitarian college students. Clicking and pain are the most prevalent findings of TMD among university students. The results of this investigation highlight the need for additional research to shed more light on the risk factors and findings related to TMD. This will facilitate drawing adequate guidelines for prevention and management of TMD.
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Affiliation(s)
- Abdalwhab M A Zwiri
- a Department of Oral Medicine and Periodontics, Faculty of Dentistry , Aljouf University , Sakaka , KSA
| | - Mahmoud K Al-Omiri
- b Department of Prosthodontics, Faculty of Dentistry , University of Jordan , Amman , Jordan.,c The City of London School of Dentistry , London , UK
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Butts R, Dunning J, Perreault T, Mettille J, Escaloni J. Pathoanatomical characteristics of temporomandibular dysfunction: Where do we stand? (Narrative review part 1). J Bodyw Mov Ther 2017; 21:534-540. [DOI: 10.1016/j.jbmt.2017.05.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Losert-Bruggner B, Hülse M, Hülse R. Fibromyalgia in patients with chronic CCD and CMD - A retrospective study of 555 patients. Cranio 2017; 36:318-326. [PMID: 28580880 DOI: 10.1080/08869634.2017.1334376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Craniomandibular dysfunction (CMD) and craniocervical dysfunction (CCD) are clearly defined musculoskeletal pain syndromes. Relationships with fibromyalgia syndrome (FMS) have not yet been investigated. The aim of the present study is to establish possible relationships between FMS and CMD/ CCD. METHODS In a retrospective study, 555 patients with CCD and CMD were investigated with respect to the diagnostic criteria of FMS. In addition to otolaryngologic and dental examination, an instrumental functional analysis for the diagnosis of CMD/CCD was performed. RESULTS Three hundred fifty-one (63%) of the 555 patients evaluated met the diagnostic criteria for FMS. Seventy-two percent of the patients had a widespread pain index of at least 7 and a severity scale score of at least 5. Twenty-nine percent had a widespread pain index of 3-6 and a severity scale score of at least 9. Using myocentric bite splint therapy and therapy with oral orthesis in combination with neuromuscular relaxation measures, a good to very good improvement of physical symptoms was seen in 84% of CMD-FMS patients, and an improvement of the symptoms in the jaw was achieved in 77% of cases. DISCUSSION The substantial proportion of CMD and CCD patients who meet the criteria for FMS emphasizes the complexity of the two diseases. It must be assumed that FMS is a crucial factor for the formation of CMD and CCD. Conversely, CMD/ CCD could also be responsible for diverse clinical pictures of the FMS. FMS patients with synchronous CCD/CMD benefit from an interdisciplinary CMD/CCD treatment.
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Affiliation(s)
| | - Manfred Hülse
- b Section of Phoniatrics, Pedaudiology and Neurootology, Department of Otorhinolaryngology, Head and Neck Surgery , University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg , Mannheim , Germany
| | - Roland Hülse
- b Section of Phoniatrics, Pedaudiology and Neurootology, Department of Otorhinolaryngology, Head and Neck Surgery , University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg , Mannheim , Germany
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Diagnostic uncertainty and epistemologic humility. Clin Rheumatol 2017; 36:1211-1214. [DOI: 10.1007/s10067-017-3631-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 10/19/2022]
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Câmara-Souza MB, Figueredo OMC, Maia PRL, Dantas IDS, Barbosa GAS. Cervical posture analysis in dental students and its correlation with temporomandibular disorder. Cranio 2017; 36:85-90. [DOI: 10.1080/08869634.2017.1298226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mariana Barbosa Câmara-Souza
- Department of Prosthesis and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Olívia Maria Costa Figueredo
- Department of Prosthesis and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Heres Diddens A, Kraaijenga S, Coupé V, Hilgers F, van der Molen L, Smeele L, Retèl V. The cost-effectiveness of TheraBite® as treatment for acute myogenic temporomandibular disorder. Cranio 2016; 35:290-297. [PMID: 27630036 DOI: 10.1080/08869634.2016.1232344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Temporomandibular disorder (TMD) is a very common and costly pain problem concerning the temporomandibular joint. A previous study has shown that for the treatment of acute myogenic TMD, TheraBite® (TB) offers a faster and greater effect than usual care consisting of physical therapy (PT). This study estimates the cost-effectiveness of TB compared to PT. METHODS Differences in costs and quality-adjusted life-years (QALYs) between TB and PT are analyzed using a decision model. RESULTS The point estimate for the incremental cost-effectiveness ratio is -28,068 EUR (-30,191 USD) per QALY (dominant) for TB versus PT. At the willingness-to-pay ratio of 20,000 EUR (21,513 USD) per QALY, TB has a 97% probability of being cost-effective compared to PT. CONCLUSION TB is expected to be cost-effective compared to PT for the treatment of acute myogenic TMD, offering faster recovery of quality of life for patients, at a lower cost to society.
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Affiliation(s)
- Andreas Heres Diddens
- a Department of Head and Neck Oncology and Surgery , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Sophie Kraaijenga
- a Department of Head and Neck Oncology and Surgery , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Veerle Coupé
- b Department of Epidemiology and Biostatistics , VU University Medical Center , Amsterdam , The Netherlands
| | - Frans Hilgers
- a Department of Head and Neck Oncology and Surgery , The Netherlands Cancer Institute , Amsterdam , The Netherlands.,c Institute of Phonetic Sciences, University of Amsterdam , Amsterdam , The Netherlands
| | - Lisette van der Molen
- a Department of Head and Neck Oncology and Surgery , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Ludi Smeele
- a Department of Head and Neck Oncology and Surgery , The Netherlands Cancer Institute , Amsterdam , The Netherlands.,d Department of Maxillofacial Surgery , Academic Medical Center , Amsterdam , The Netherlands
| | - Valesca Retèl
- e Department of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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Occlusal force characteristics of masseteric muscles after intramuscular injection of botulinum toxin A(BTX – A)for treatment of temporomandibular disorder. Br J Oral Maxillofac Surg 2016; 54:736-40. [DOI: 10.1016/j.bjoms.2016.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 04/11/2016] [Indexed: 11/19/2022]
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