Temporomandibular disorders and parafunctional oral habits: an anamnestic study

Effectiveness of conservative approaches on otologic signs and symptoms in patients with temporomandibular disorders and Meniere's disease: A systematic review

OBJECTIVE

This systematic review aimed to evaluate the effectiveness of conservative approaches on otologic signs and symptoms in patients affected by Menière's Disease (MD) and temporomandibular disorders (TMD).

METHODS

PubMed, Scopus, and Web of Science were systematically searched to identify studies presenting participants with a diagnosis of MD associated with TMD, conservative approaches as interventions, and modification of the otological signs and symptoms as outcome.

RESULTS

Out of 627 articles assessed for eligibility, two studies were included. Both studies showed a significant reduction of Situational Vertigo Questionnaire after treatment, number of vertigo spells, Functional Level Scale, Dizziness Hearing Inventory, and Tinnitus Handicap Inventory, after occlusal splint therapy. No significant differences were found in terms of pure-tone audiometry average.

CONCLUSION

Findings of this systematic review suggested that conservative approaches might improve vertigo in patients affected by MD and TMD. However, the low number of included studies makes difficult to draw strong conclusions.

Temporomandibular disorder prevalence and its association with oral parafunctions, neck pain, and neck function in healthcare students: A cross-sectional study

OBJECTIVE

To determine the temporomandibular disorder (TMD) prevalence in female students and to assess its association with oral parafunctions, neck pain, and function.

METHODS

One hundred forty-four participants were included. The severity of TMD was assessed with Fonseca's Anamnestic Index (FAI). The oral parafunctions were self-reported with the Oral Behaviors Checklist (OBC). Neck pain and neck function were recorded with the Core Outcome Measure Index (COMI). The Spearman correlation analysis was used for statistical analysis.

RESULTS

Seventy participants (48.6%) had mild TMD. All participants had a positive OBC score, which indicated an oral parafunction. A moderate correlation between TMD and oral parafunctions (p < 0.001) was detected.

DISCUSSION

TMD is common in female healthcare students, and its presence is associated with oral parafunctions, neck pain, and function. It is recommended to evaluate oral health habits and neck pain and function in females with TMD.

Malocclusion trait and the parafunctional effect among young female school students

Extraneous activities of either the mouth, tongue or the jaw comprise the oral parafunctional habits of the stomatognathic system. This denominated habit is expressed through bruxism, digit sucking, nail biting to name a few, have led to hypothesizing the possible relationship of evolution of occluso-facial abnormalities such as malocclusion thereby hindering the conventional developmental process. Hence, the present study aimed to determine the prevalence and the possible relationship of parafunctional oral habits with the types of malocclusions among 12–16 years old females in Jeddah, Saudi Arabia. This cross-sectional study was conducted through questionnaire and clinical examinations, where the sagittal abnormalities within a randomly selected 672 participants who met the eligibility criteria were tabulated and analyzed. A positive history of the presence of parafunctional habit was recorded among all the participants with nasal and mouth breathing [46.6%], nail biting [39.6%] being predominant. 36.4% presented with significantly higher prevalence of bi-maxillary protrusion in mouth breathers while 17.1% with moderate overbite in participants with nail biting habit. Therefore, within the limitations of the present study, the findings do support the literature on the prevalence and the possible association of these habits with the malocclusion development thereby emphasizing on the importance of early recognition, management and prevention of them.

Prevalence of malocclusion, oral parafunctions and temporomandibular disorder-pain in Italian schoolchildren: An epidemiological study

BACKGROUND

The prevalence of malocclusion, temporomandibular disorders (TMD) and oral parafunctions is highly debated in children population.

OBJECTIVES

To investigate the prevalence of malocclusion, self-reported oral parafunctions and TMD-pain in Italian schoolchildren and to assess the association between the examined factors.

METHODS

A total of 700 children aged 9-11 years were selected among six public schools in Campania region (Italy). Molar relationship, overjet, overbite and cross-bite were assessed through a clinical examination. Furthermore, the subjects were demanded to fill in a validated questionnaire for TMD-pain screening and the short form of the Oral Behaviours Checklist. Descriptive statistics were used to report the frequencies. The associations between occlusal traits, oral parafunctions and TMD-pain were analysed with a Pearson chi-square test, as expressed by odds ratio and 95% confidence intervals. The significance level was set at P < 0.05.

RESULTS

Molar Class I was the most frequently encountered molar relationship, followed by molar Class II, subdivision and molar Class III. Increased overjet was more common than negative overjet. Posterior cross-bite was observed in 12% of children. TMD-pain was recorded in 14.7% of subjects. High frequency of oral parafunctions was reported in 21.3% of subjects. A significant association was found between TMD-pain and negative overbite. Cross-bite and high frequency of oral parafunctions were associated with TMD-pain.

CONCLUSION

The current results show that malocclusion, self-reported oral parafunctions and TMD-pain are frequent findings among Italian schoolchildren and that some occlusal factors and high frequency of oral parafunctions might be associated with TMD-pain.

Temporomandibular disorder: otologic implications and its relationship to sleep bruxism

Introduction

Temporomandibular disorder is an umbrella term for various clinical problems affecting the muscles of mastication, temporomandibular joint and associated structures. This disorder has a multifactor etiology, with oral parafunctional habits considered an important co-factor. Among such habits, sleep bruxism is considered a causal agent involved in the initiation and/or perpetuation of temporomandibular disorder. That condition can result in pain otologic symptoms.

Objective

The aim of the present study was to investigate the relationship between temporomandibular disorder and both otologic symptoms and bruxism.

Methods

A total of 776 individuals aged 15 years or older from urban areas in the city of Recife (Brazil) registered at Family Health Units were examined. The diagnosis of temporomandibular disorder was determined using Axis I of the Research Diagnostic Criteria for temporomandibular disorders, addressing questions concerning myofascial pain and joint problems (disk displacement, arthralgia, osteoarthritis and osteoarthrosis). Four examiners had previously undergone training and calibration exercises for the administration of the instrument. Intra-examiner and inter-examiner agreement was determined using the Kappa statistic. Individuals with a diagnosis of at least one of these conditions were classified as having temporomandibular disorder. The diagnosis of otologic symptoms and bruxism was defined using the same instrument and a clinical exam.

Results

Among the individuals with temporomandibular disorder, 58.2% had at least one otologic symptom and 52% exhibited bruxism. Statistically significant associations were found between the disorder and both otologic symptoms and bruxism (p < 0.01 for both conditions; OR = 2.12 and 2.3 respectively). Otologic symptoms and bruxism maintained statistical significance in the binary logistic regression analysis, which demonstrated a 1.7 fold and twofold greater chance of such individuals have temporomandibular disorder, respectively.

Conclusion

The logistic regression analysis demonstrated strong associations between the disorder and both otologic symptoms and bruxism when analyzed simultaneously, independently of patient age and gender.

Treatment of frictional dental hypersensitivity (FDH) with computer-guided occlusal adjustments

OBJECTIVE

To verify the efficacy of treating dentin/dental hypersensitivity (DH) to Cold Ice Water Swish testing before and after subjects undergo the Immediate Complete Anterior Guidance Development (ICAGD) computer-guided occlusal adjustment.

METHODS

One hundred chronically dysfunctional patients with known cold sensitivity swished ice water intraorally to elicit a DH response scored on a Visual Analog Scale (VAS). The subjects then underwent the ICAGD coronoplasty, which was followed by a second ice water swish scored with a second VAS. The pre to post ICAGD Disclusion Time values and VAS scores were statistically evaluated by the Wilcoxon Signed Rank for Paired Difference test. The subjects were divided into subgroups with DH sensitivities <4 and ≥4, and analyzed. Limitations were as follows: abfractions were not quantified, dysfunctional symptom resolution was not determined, each subject was their own control, one clinician administered all ice water tests, and protrusive excursions were not included.

RESULTS

Disclusion Time reductions from ICAGD were significant (2.11-0.55 s. p = 0.0000). The DH score changes showed highly significant decreases from pre to post ICAGD (p < 0.0001).

CONCLUSIONS

A partial etiology for cold tooth sensitivity exists, resultant from prolonged occlusal surface excursive movement frictional contacts. This cold sensitivity can be lessened with measured, computer-guided occlusal adjustments.