Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults

Prevalence of temporomandibular disorders and their associated factors in Confucian heritage cultures: A systematic review and meta-analysis

BACKGROUND

Temporomandibular disorders (TMDs) may be an 'idiom' of psychological distress in Confucian heritage cultures (CHCs).

OBJECTIVES

This systematic review/meta-analysis estimated the prevalence of TMDs in CHCs and compared the differences in TMD occurrence between time periods and age groups. Additionally, the associated biopsychosocial risk factors were also examined.

METHODS

The study protocol was developed a priori following the PRISMA guidelines and Joanna Briggs Institute systematic review methodology (CRD42021245526). Electronic searches of seven databases were conducted from January 2002 to Dec 2021. Reference lists of identified studies were hand-searched for additional articles. Study selection, quality assessment, and data extraction were done. Meta-analysis was performed using the RevMan 5.4 software.

RESULTS

Forty-eight articles were included in the systematic review. Overall prevalences were: TMDs-15% (95% CI: 15-16%); TMD pain-8% (95% CI: 7-9%); TMJ sounds-24% (95% CI: 21-27%); and TMJ locking-7% (95% CI: 1-13%). While TMD prevalence appeared to have declined from 2002 to 2011 to 2012-2021, the occurrence of TMD pain, TMJ sounds, and locking increased marginally or remained constant. TMD prevalence in children/adolescents was 18% (95% CI: 14-22%) and 17% (95% CI: 16-18%) among adults. Significant associations between TMDs and bruxism/psychological distress/education levels were specified by 73%/90%/88% of the relevant studies.

CONCLUSIONS

TMDs are prevalent in CHCs and a slight increase in TMD pain (2%) and TMJ sounds (8%) were discerned over the past two decades. TMDs are related to a myriad of biopsychosocial variables, particularly psychological distress, and these factors must be addressed within the cultural context of patients.

Associations between temporomandibular disorders and tinnitus - a systematic review

OBJECTIVES

Temporomandibular disorders (TMD) and tinnitus are highly prevalent conditions, that affects about 10-30% of the adult population and seem to co-exist. The primary objective of this systematic review was to investigate any associations between TMD and tinnitus. The secondary objective was to investigate if the associations differ between painful and non-painful TMDs.

METHODS

An electronic literature search in five databases was performed, from the inception of the databases until 26th of October 2022. This was to identify clinical trials with prevalence numbers of patients with TMD, with and without tinnitus and vice versa. From 1240 studies, a total number of 32 studies were included in the meta-analysis. A risk of bias analysis was made using the Methodological Evaluation of Observational Research (MORE).

RESULTS

Seventeen studies showed low risk of bias, while fifteen studies showed some risk of bias. Among patients with TMD, 57.5% also displayed tinnitus. In contrast, among patients with tinnitus, 92.9% also suffered from TMD. There was a strong association between patients with TMD that also had tinnitus, and patients with tinnitus that also had TMD (p's < 0.001). The odds ratio for TMD-patients also having tinnitus was 1.556 (p < .05), while it for tinnitus-patients also having TMD was 2.859 (p < .05). Six studies examined the psychological status, and there was a higher degree of psychosocial distress among patients with TMD and TMD/tinnitus.

CONCLUSIONS

There is a strong significant association between TMD and tinnitus, but further research is needed to unravel the nature of this association and its clinical implication.

Perspective on Temporomandibular Joint Disorder: Foramen Tympanicum Defect

BACKGROUND

Foramen tympanicum (FT) is a defect located anterior-inferior to the external acoustic meatus. We evaluated its prevalence, location, size, and relationship with temporomandibular joint (TMJ) disorders.

METHODS

Cone beam computed tomography was performed for 200 patients who presented to the Karamanoğlu Mehmetbey University Ahmet Keleşoğlu Faculty of Dentistry Hospital. The location and size of the FT in the axial and sagittal planes were evaluated. Descriptive statistics were used to compare the study parameters among age and sex groups. Patients with FT were reevaluated by two maxillofacial surgeons at the study centre.

RESULTS

In total, 200 images from 400 joints were examined. Unilateral and bilateral FT (19 [9.5%] and 8 [4%], respectively) was detected in 35 (17.5%) images from 27 (13.5%) patients. Examinations were performed for TMJ disorders in 24 patients. Participants with bilateral defects had the highest rates of presence of sounds and ear pain on the left and right sides (p < .05).

CONCLUSION

Foramen tympanicum can lead to TMJ disorders and spread of tumours or infections from the external auditory canal to the infratemporal fossa. The increased prevalence of such disorders in patients with bilateral FT suggests an association between them.

Temporomandibular treatments are significantly efficient in improving otologic symptoms

Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient's parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs.

Evaluation of the relationship between temporomandibular joint disorders and tinnitus with computed tomography

PURPOSE

This study aimed to radiographically determine tinnitus and joint disorders by evaluating glenoid fossa depth and the horizontal angle of the ramus mandible in patients with isolated temporomandibular joint disorder and temporomandibular joint disorder with tinnitus by computed tomography (CT).

METHODS

In total, eighty two patients with temporomandibular disorders (TMDs) (forty two patients with tinnitus; forty patients without tinnitus) were evaluated using CT. CT images were analysed according to glenoid fossa depth and the horizontal angle of the ramus.

RESULTS

A total of 82 cases 43 (52.4%) female and 39 (47.6%) male were included. The distribution of gender was not significantly different between the TMD patients and the TMD-tinnitus patients (p >0.05). The mean age of the patients with isolated TMD was 31.70 ± 9.68 years, and the mean age of the patients with TMD-tinnitus was 34.07 ± 11.72 years. Comparisons were made of the right and left glenoid fossa depths of the patients with TMD and TMD-tinnitus, respectively. There was a statistically significant difference between the right glenoid fossa depths (p = 0.016) also there was also a statistically significant difference between the left glenoid fossa depths (p = 0.049).

CONCLUSION

Our study revealed that decreased glenoid fossa depth may be associated with an increased incidence of tinnitus in TMD patients by the way temporomandibular joint and ear can affect each other in diseases such as tinnitus due to their close anatomical relationship.

Association of temporomandibular disorders severity with otologic and concomitant pain symptoms in Asian youths

OBJECTIVE

To investigate the presence/severity of TMDs among Asian youths and examine the associations between TMD severity, otologic, and concomitant pain symptoms.

METHODS

Youths (17-24 years old) were recruited from a local polytechnic. The presence/severity of TMDs was determined with the Fonseca Anamnestic Index (FAI), while otologic/concomitant pain symptoms were appraised with the Maciel's Symptoms Checklist (MSC). Demographic, FAI, and MSC data were evaluated using Kruskal Wallis, chi-square, and relevant post-hoc tests (α = 0.05).

RESULTS

Among the participants (n = 200) enrolled, 40.5% had no TMD, whereas mild, moderate, and severe TMD were present in 43.5%, 12.5%, and 3.5%, respectively. Participants with moderate/severe TMDs had significantly more otalgia, tinnitus, vertigo, dizziness, ear pruritus, hearing loss, ear fullness, headache, eye, neck, and back pain than those with no TMDs (p < 0.001).

CONCLUSION

Otologic and concomitant pain symptoms were associated with TMDs and appear to increase with progressive TMD severity.

Is there a comorbid relationship between temporomandibular disorders and otologic signs/symptoms?: An umbrella review

OBJECTIVE

This umbrella review (UR) explored the possible associations between temporomandibular disorders (TMDs) and otologic signs/symptoms (OSs) and established the potential impact of TMD interventions on OSs.

METHODS

A systematic review of systematic reviews (SRs)/meta-analyses (MAs) was conducted according to the PRISMA guidelines and Joanna Briggs Institute UR protocol. Electronic search of the PubMed, Scopus, Web of Science, and Open Grey databases was conducted and the quality of the identified studies was assessed using the AMSTAR2 criteria.

RESULTS

Out of 923 and 157 articles screened for the first and second focus questions respectively, a total of 8 SRs/MAs fulfilled the eligibility criteria. The prevalence of OSs in TMD patients and contrariwise varied substantially up to 85.0-95.0%. Available evidence indicates that TMDs are associated with OSs, and TMD treatment reduced OSs.

CONCLUSION

Findings suggest that a comorbid relationship between TMDs and OSs exists, and therapeutic TMD interventions improve OSs.

Association between primary headaches and temporomandibular disorders: A systematic review and meta-analysis

BACKGROUND

The primary objective of this systematic review was to answer the following question systematically: Is there any association between primary headaches (PHs) and temporomandibular disorders (TMDs) in adults?

TYPES OF STUDIES REVIEWED

The protocol was registered with the International Prospective Register of Systematic Reviews. The authors performed the search in 7 main databases and 3 gray literature sources. The included articles had to have adult samples. PHs must have been diagnosed using the International Classification of Headache Disorders, and TMDs must have been diagnosed using Research Diagnostic Criteria for Temporomandibular Disorders, Diagnostic Criteria for Temporomandibular Disorders, or International Classification of Orofacial Pain. Risk of bias was evaluated using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tools. The meta-analysis was performed using Review Manager software, Version 5.4. Certainty of evidence was screened according to Grading of Recommendations Assessment, Development and Evaluation.

RESULTS

Eight of 2,574 articles reviewed met the inclusion criteria for qualitative analysis and, of these, 6 met the inclusion criteria for quantitative analysis. Odds ratios (ORs) for painful TMD and tension-type headache (OR, 3.16; 95% CI, 1.80 to 5.54 to OR, 13.06; 95% CI, 2.79 to 61.12), migraines (OR, 5.35; 95% CI, 3.04 to 9.40 to OR, 6.22; 95% CI, 3.81 to 10.14), and chronic headaches (OR, 40.40; 95% CI, 8.67 to 188.15 to OR, 95.93; 95% CI, 12.53 to 734.27) were calculated. Articular TMDs without pain were evaluated in only 1 article, in which ORs of 1.78 (95% CI, 0.90 to 3.51) for migraines and 1.04 (95% CI, 0.53 to 2.06) for tension-type headache were reported. Three studies were classified as moderate risk of bias and 5 as low risk of bias. The certainty of evidence varied between very low and low.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Recognizing the positive association between painful TMD and PHs can help dentists and physicians treat the pain and avoid it, or recommend the patient to a specialist.

Ear symptoms in patients with orofacial pain and dysfunction - An explorative study on different TMD symptoms, occlusion and habits

Objectives

Ear symptoms coincident with TMD symptoms have been noticed for a long time. The aim was to investigate the relationship between reported ear symptoms in TMD patients and different TMD symptoms, dental occlusion, oral parafunction and habits.

Material and methods

Consecutive patients, ≥18 years of age and referred to a specialist clinic for orofacial pain and dysfunction during a three‐month period, were considered for the study. Patients with poor general or psychiatric health were excluded. One hundred thirty‐two patients were included and studied with regard to reported ear symptoms in relation to clinical dysfunction, occlusion, habits and subjective rating of their symptoms. A clinical examination was performed according to RDC/TMD and extended with occlusal factors, parafunctions and habits.

Results

Ear symptoms were reported by 72% of the TMD patients, with ear fullness in 49% as the most frequent symptom. The patients with ear symptoms were significantly older and proportionally more often females. Ear symptoms were significantly correlated to the subjective index, to myalgia (p = 0.003), decreased opening capacity (p = 0.01), TMJ pain (p = 0.02), parafunctions (p = 0.007), and some occlusal factor (p = 0.018–0.003). Muscle pain on palpation was significantly associated with ear fullness, and changed hearing and sensitivity to sound, on the same side (p < 0.005).

Conclusions

Ear symptoms are frequently reported by TMD patients. Concomitant ear symptoms are associated with oral parafunction and muscle pain on palpation on the same side as the ear symptoms.

The "hype" of hydrops in classifying vestibular disorders: a narrative review

Background

Classifying and diagnosing peripheral vestibular disorders based on their symptoms is challenging due to possible symptom overlap or atypical clinical presentation. To improve the diagnostic trajectory, gadolinium-based contrast-enhanced magnetic resonance imaging of the inner ear is nowadays frequently used for the in vivo confirmation of endolymphatic hydrops in humans. However, hydrops is visualized in both healthy subjects and patients with vestibular disorders, which might make the clinical value of hydrops detection on MRI questionable.

Objective

To investigate the diagnostic value of clinical and radiological features, including the in vivo visualization of endolymphatic hydrops, for the classification and diagnosis of vestibular disorders.

Methods

A literature search was performed in February and March 2019 to estimate the prevalence of various features in healthy subjects and in common vestibular disorders to make a graphical comparison between healthy and abnormal.

Results

Of the features studied, hydrops was found to be a highly prevalent feature in Menière’s disease (99.4%). Though, hydrops has also a relatively high prevalence in patients with vestibular schwannoma (48.2%) and in healthy temporal bones (12.5%) as well. In patients diagnosed with (definite or probable) Menière’s disease, hydrops is less frequently diagnosed by magnetic resonance imaging compared to the histological confirmation (82.3% versus 99.4%). The mean prevalence of radiologically diagnosed hydrops was 31% in healthy subjects, 28.1% in patients with vestibular migraine, and 25.9% in patients with vestibular schwannoma. An interesting finding was an absolute difference in hydrops prevalence between the two diagnostic techniques (histology and radiology) of 25.2% in patients with Menière’s disease and 29% in patients with vestibular schwannoma.

Conclusions

Although the visualization of hydrops has a high diagnostic value in patients with definite Menière’s disease, it is important to appreciate the relatively high prevalence of hydrops in healthy populations and other vestibular disorders. Endolymphatic hydrops is not a pathognomic phenomenon, and detecting hydrops should not directly indicate a diagnosis of Menière’s disease. Both symptom-driven and hydrops-based classification systems have disadvantages. Therefore, it might be worth to explore features “beyond” hydrops. New analysis techniques, such as Radiomics, might play an essential role in (re)classifying vestibular disorders in the future.

Electronic supplementary material

The online version of this article (10.1007/s00415-020-10278-8) contains supplementary material, which is available to authorized users.

Effect of occlusal splint and therapeutic exercises on postural balance of patients with signs and symptoms of temporomandibular disorder

The aim of this study was to investigate the effects of the use of an occlusal splint on postural balance considering the occlusal splint as a device for treating temporomandibular joint disorder. A randomized, controlled, prospective clinical trial was conducted. The research group consisted of 49 patients (36 as test group and 13 as control group) between 18 and 75 years old, both genders, diagnosed as temporomandibular disorder by Research Diagnostic Criteria/Temporomandibular Disorders questionnaire and magnetic resonance imaging of the temporomandibular joints. Test group was treated with orientations for physiotherapeutic exercises and occlusal splint, whereas control group received orientation for physiotherapeutic exercises only. Postural equilibrium was evaluated by means of a force plate. After 12 weeks, the groups were re-evaluated. Patients from both groups presented a significant increase in antero-posterior speed with eyes closed, test group (P < 0.001) and control group (P = 0.046). Only patients of the test group presented a significant increase in antero-posterior speed with eyes opened (P = 0.023). We concluded that the use of occlusal splint affected the postural balance.

Association Between Subjective Tinnitus and Cervical Spine or Temporomandibular Disorders: A Systematic Review

Movements of the neck and jaw may modulate the loudness and pitch of tinnitus. The aim of the present study was to systematically analyze the strength of associations between subjective tinnitus, cervical spine disorders (CSD), and temporomandibular disorders (TMD). A systematic literature search of the Medline, Embase, and Pedro databases was carried out on articles published up to September 2017. This covered studies in which tinnitus and CSD or TMD were studied as a primary or a secondary outcome and in which outcomes were compared with a control group. Included articles were evaluated on nine methodological quality criteria. Associations between tinnitus and CSD or TMD were expressed as odds ratios. In total, 2,139 articles were identified, of which 24 studies met the inclusion criteria. Twice, two studies were based on the same data set; consequently, 22 studies were included in the meta-analysis. Methodological quality was generally limited by a lack of blinding, comparability of groups, and nonvalidated instruments for assessing CSD. Results indicated that patients with tinnitus more frequently reported CSD than subjects without tinnitus. The odds ratio was 2.6 (95% CI [1.1, 6.4]). For TMD, a bidirectional association with tinnitus was found; odds ratios ranged from 2.3 (95%CI [1.5, 3.6]) for arthrogenous TMD to 6.7 (95%CI [2.4, 18.8]) for unspecified TMD. Funnel plots suggested a publication bias. After adjusting for this, the odds ratios decreased, but associations persisted. There is weak evidence for an association between subjective tinnitus and CSD and a bidirectional association between tinnitus and TMD.

Tinnitus as a comorbidity to temporomandibular disorders-A systematic review

The aim of this systematic review was to evaluate the prevalence of tinnitus in patients with temporomandibular disorders (TMD) and the possible effects of TMD treatment on tinnitus symptoms. A search of the PubMed, Web of Science and Cochrane databases from inception of each database up to January 2017 found 222 articles. After independent screening of abstracts by two of the authors, we assessed 46 articles in full text. The inclusion and exclusion criteria reduced these to 25 articles of which 22 studies reported prevalence based on 13 358 patients and 33 876 controls, and eight studies reported effect of TMD treatment on tinnitus based on 536 patients and 18 controls. The prevalence of tinnitus in patients with TMD varied from 3.7% to 70% (median 42.3%) whereas the prevalence in control groups without TMD varied between 1.7% and 26% (median 12%). The eight treatment studies indicated that treatment of TMD symptoms may have a beneficial effect on severity of tinnitus. However, only one treatment study included a control group, meaning that the overall level of evidence is low. The finding that tinnitus is more common in patients with TMD means that it can be regarded as a comorbidity to TMD. However, in view of the lack of evidence currently available, further well-designed and randomised studies with control groups are needed to investigate whether possible mechanisms common to tinnitus and TMD do exist and whether TMD treatment can be justified to try to alleviate tinnitus in patients with TMD and comorbidity of tinnitus.

The efficacy of oral habit modification on headache

Objectives

Headache is the most common complaint of patients suffering from temporomandibular joint disorders (TMDs). Thus, temporomandibular joint (TMJ) examinations maybe necessary in patients with headache. Considering the high prevalence of bruxism and TMDs in patients with headache the effects of conservative TMD treatment on headache should be assessed.

Materials and Methods

Patients were questioned about headaches in the past three months. Those responding affirmatively to this question were examined for TMD and bruxism. After the examinations, 219 patients remained in the study and received self-management instructions. Patients were requested to modify oral habits except when eating or sleeping. The degree of pain (visual analogue scale), headache disability index (HDI), frequency of headaches (FH) per month and TMD intensity were evaluated.

Results

The median levels of pain, HDI, FH, and TMD intensity were 8, 44, 8, and 7, respectively, before modifying oral habits and decreased to 4, 24, 2, and 3, respectively, after intervention. These decreases were statistically significant.

Conclusion

Having patients maintain free space between the teeth and relax muscles can be an efficient method to treat headache and TMD, especially when repeated frequently.

Temporomandibular Joint Disorders as a Cause of Aural Fullness

OBJECTIVES

Temporomandibular joint disorders (TMD) are often associated with aural manifestations. However, it is not clear whether aural fullness could be induced by TMD. The purpose was to investigate the TMD and effectiveness of TMD treatments in patients with mainly or exclusively aural fullness complaint.

METHODS

One hundred and twelve patients, who had aural fullness as the main or sole complaint, presented to the Otolaryngology Department, PLA Army General Hospital, Beijing, China, between January 2010 and January 2015. Patients' medical history indicated that they had previously been diagnosed and treated for otitis media or sensorineural hearing loss but without positive results. Patients were subjected to pure tone audiometry and acoustic immittance screening using GSI-61 clinical audiometer and GSI TympStar middle ear analyzer respectively. Patients were examined by questionnaire, X-ray and/or computed tomography scan of temporomandibular joint. TMD was categorized according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients were then treated for TMD.

RESULTS

All the patients showed normal eardrum and type A tympanogram. The patients of 60.7% (68/112) were classified as group I TMD disorders (muscle disorders), 34.8% (39/112) were group II (disc displacements), and 4.5% (5/112) were group III (arthralgia, osteoarthritis, and osteoarthrosis). Aural fullness was completely resolved or significantly improved in 67 and 34 patients respectively following treatments aimed at improving TMD, with a combined effectiveness of 90.2% (101/112). TMD treatments are especially effective (94.1%) in group I TMD.

CONCLUSION

TMD as a potential cause of aural fullness should be considered in otolaryngology practice.

[Tinnitus and temporomandibular joint: State of the art]

Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus.

Assessment of risk factors for oro-facial pain and recent developments in classification: implications for management

Oro-facial pain research has during the last decades provided important novel insights into the basic underlying mechanisms, the need for standardised diagnostic procedures and classification systems, and multiple treatment options for successful rehabilitation of the patient in pain. Notwithstanding the significant progress in our knowledge spanning from molecules to chair, there may also be limitations in our ability to integrate and interpret the tremendous amount of new data and information, in particular in terms of the clinical implications and overriding conceptual models for oro-facial pain. The aim of the present narrative review is to briefly summarise some of the current thoughts on oro-facial pain mechanisms and recent attempts to identify biomarkers and risk factors leading to the proposal of a new risk assessment diagram for oro-facial pain (RADOP) and a provocative new concept based on stochastic variation between multiple risk factors. Finally, the implications for novel management strategies will briefly be discussed.

Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey

Background

Associations between temporomandibular disorder (TMD) and psychological variables, pain conditions, and daily activities have been reported more commonly in middle-aged individuals than in children. However, to determine factor-specific preventive programs for TMD, it is important to evaluate the associations between multiple factors and TMD symptoms during childhood. The aim of this study was to assess the relationship between TMD symptoms and other orofacial pain conditions, daily activities, and trait anxiety in a population-based cross-sectional survey of Japanese children and adolescents.

Methods

A total of 1,415 subjects (11–15 years old) self-reported their TMD symptoms, headache, neck pain, and toothache, and completed questionnaire scales that assessed 15 daily activities. Trait anxiety was assessed using the State Trait Anxiety Inventory for Children-Trait (STAIC-T) scale. Subjects were dichotomized into a TMD group or control group, based on whether they reported at least 1 TMD symptom: the TMD group (≥1 TMD symptom, n = 182) and the control group (no TMD symptoms, n = 1,233). Data were analyzed using the chi-square test and multivariate logistic regression analysis.

Results

The prevalence rates for headache and neck pain were significantly higher in the TMD group than in the control group (44.0% vs. 24.7% and 54.4% vs. 30.0%, respectively; both P < 0.001). The odds ratios for TMD symptoms in subjects with neck pain and frequent diurnal clenching were 2.08 (P < 0.001) and 3.69 (P = 0.011), respectively. Moreover, high STAIC-T scores were weakly associated with TMD symptoms.

Conclusions

In this young Japanese population, TMD symptoms were associated with other orofacial pain conditions, particularly neck pain, although they were only weakly associated with trait anxiety. Diurnal clenching was strongly associated with TMD symptoms. Health professionals should carefully consider these factors when developing appropriate management strategies for TMD in children and adolescents.

Myofunctional orofacial examination: comparative analysis in young adults with and without complaints

PURPOSE

To verify myofunctional orofacial characteristics in young adults and to compare data on individuals with and without myofunctional complaints, aiming to identify the main myofunctional problems and differentiating them from characteristics that are common for this population, as well as to list items for myofunctional evaluation in this population.

METHODS

Cross-sectional study with 85 adult participants, aged between 19 and 39 years, selected through consecutive sampling at the Department of Speech, Language and Hearing Sciences of Universidade Veiga de Almeida. The participants were divided into two groups: G1 (comprising 50 individuals referred for orofacial myofunctional disorders) and G2 (comprising 35 volunteers without complaints). Descriptive evaluation of craniofacial structures of hard and soft tissues, kinesiology and mandible range of motion and functional patterns of breathing, chewing, and swallowing was applied. Three expert Speech-Language pathologists assessed all participants. Statistical analysis was done using χ2-test, Student's t-test, or Mann-Whitney test. The reliability level was 99%.

RESULTS

A predominance of Angle Class I pattern of occlusions for G2 (p<0.0001) was found. G1 showed (p<0.0001) mandible movements with deviations and joint noises, amplitude reduction in lateral and protrusive movements, unilateral chewing, nonexpected muscle contraction, temporomandibular joint noises, swallowing with excessive contraction of the orbicularis oris muscle, loud noise, and residues (p=0.006).

CONCLUSION

The main myofunctional orofacial alterations in young adults with complaints refer to changes of the mandibular movements and patterns of chewing or of swallowing, reflecting the main items of the clinical evaluation. Many items of assessment and characterization do not differ between the groups, and these should be analyzed regarding their relevance.

[Temporomandibular disorders: Evaluation of the usefulness of a self-test questionnaire]

BACKGROUND

A self-test questionnaire has been provided in the internet and in some dental offices for some time now. By using this questionnaire, interested individuals may assess whether they have a temporomandibular disorder (TMD) which might require therapy. It is the aim of this article to examine whether the 11 questions are apt to reliably identify patients with suspected TMDs within a given population.

METHODS

Each question has been examined for its relevance by resorting to the current literature. Accordingly, the inclusion of each question into the self-test questionnaire has been rated as suitable or unsuitable.

RESULTS

Only 2½ of the 11 questions are useful to detect individuals with as-yet undiagnosed TMDs.

CONCLUSIONS

Due to its missing content validity, the questionnaire cannot be recommended.