Association between orthodontic treatment and the occurrence of temporomandibular disorders: A systematic review and meta-analysis

The association between orthodontic treatment and temporomandibular disorders diagnosis and disease characteristics

BACKGROUND

The association between orthodontic treatment and temporomandibular disorders (TMD) has been contentious in the literature.

OBJECTIVES

To analyse the associations between orthodontic treatment and TMD diagnosis and diseases characteristics.

METHODS

This case-control study included 291 individuals, 192 TMDs and 99 controls. All patients underwent assessment based on a questionnaire and a clinical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Differences in orthodontic treatment between TMDs and controls, as well as across different TMD diagnoses within the TMD group were analysed. Patients who underwent orthodontic treatment were compared to those who did not, regarding their trauma history, bruxism, aggressive teeth brushing, level of oral hygiene, pain scores, muscle tenderness scores and subjective sleep quality.

RESULTS

Of the 291 participants, 119 (40.9%) underwent orthodontic treatment and 172 (59.1%) had no orthodontics experience. Orthodontic treatment included: mandibular orthodontic treatment (102 subjects) and maxillary orthodontic treatment (113 subjects) of those 47 used a headgear. Following multivariate analysis among TMDs, orthodontic treatment was associated with a good level of oral hygiene versus poor (Odds ratio [OR]: 5.17 [1.04-25.59]), lower number of tender muscles [OR = 0.84 (0.74-0.96)] and lower (better) Pittsburgh Sleep Quality Index (PSQI) scores (OR = 0.86 [0.76-0.97]). None of the studied parameters maintained a statistically significant association with orthodontic treatment in the multivariate analysis among the entire study population.

CONCLUSIONS

Utilising a holistic approach, this study supports the main hypothesis that orthodontic treatment is not associated with TMD diagnosis and disease characteristics.

Effect of conventional and self-ligating brackets on periodontal health. Systematic review and meta-analysis

Background

To compare the effect of conventional brackets and self-ligating brackets on periodontal health.

Material and Methods

A search of information up to October 2022 was carried out in the following electronic databases: PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science (WoS), EMBASE, SciELO and Google Scholar. We included studies that were randomised clinical trials, dealing with conventional brackets and self-ligating brackets and their effect on periodontal health, with no language restriction and no time limit. The Risk of Bias 2 (Rob 2.0) tool was used to determine the risk of bias of the included studies. The information selected from the studies was entered and analysed with RevMan 5.3, using the mean and standard deviation with a 95% confidence interval as a measure. Finally, an analysis was performed using the GRADE system to classify the quality of the evidence and grade the strength of the recommendation.

Results

The preliminary search yielded a total of 399 articles, discarding those that did not meet the selection criteria, leaving only 13 articles. The effect of conventional and self-ligating brackets on periodontal health was determined using periodontal probing depth (PPD), plaque index (PI), gingival index (GI) and bleeding index (BI), showing advantages of self-ligating brackets in PI and BI, and no differences compared to self-ligating brackets in PPD and GI.

Conclusions

Self-ligating brackets probably better preserve periodontal health compared to conventional brackets regarding plaque accumulation and bleeding on probing. Key words:Conventional brackets, self-ligating brackets, periodontal health, orthodontic treatment, systematic review, meta-analysis.

Evaluation of IL-1β and CRP mRNA expression levels by RT-PCR in postorthodontic treatment patients with temporomandibular joint disorders: a cross-sectional Study

Aim

Temporomandibular joint disorder (TMD), which affects the masticatory muscles, temporomandibular joint, and surrounding tissues, can manifest as inflammation. This study aims to explore the expression levels of the inflammatory biomarkers, interleukin (IL)-1β and C-reactive protein (CRP), in TMD patients who have undergone orthodontic treatment.

Materials and Methods

Buccal swabs from 105 postorthodontic treatment patients were analyzed using real-time polymerase chain reaction to assess the expression levels of IL-1β and CRP in each group after messenger ribonucleic acid extraction. Patients were also examined using the Diagnostic Criteria for TMD (DC/TMD) to determine if they met the criteria for a TMD diagnosis. The TMD group was subdivided into three categories based on the DC/TMD.

Results

The study included 37 patients who did not develop TMD (group 0) and 68 participants who developed TMD after orthodontic treatment, including 17 with pain-related TMDs (group 1), 29 with intra-articular TMDs (Group 2), and 22 with combined pain-related and intra-articular TMDs (group 3). CRP expression was higher than IL-1β in groups 1 and 2, and IL-1β expression was higher than CRP in group 3. The Kruskal-Wallis test showed that IL-1β and CRP expression levels in groups 1, 2, and 3 were not statistically different. Sex and adult age had considerable effects on the occurrence of TMD in patients after orthodontic treatment.

Conclusions

Higher IL-1β expression was found in postorthodontic treatment patients with more complex TMD. This study strengthens the evidence of inflammation through IL-1β and CRP expression in individuals with TMD, especially after orthodontic treatment.

Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study

BACKGROUND

The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms.

METHODS

This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests.

RESULTS

The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05).

CONCLUSIONS

Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.

Three-dimensional evaluation of condylar morphology after orthodontic treatment in adult patients with Class II malocclusion by cone-beam computed tomography

BACKGROUND

The aim of this study was to evaluate the condylar morphological changes after orthodontic treatment in adult patients with Class II malocclusion using a Cone-beam computed tomography (CBCT).

METHODS

Images of twenty-eight adult patients with Class II malocclusion who have no temporomandibular symptoms were involved in this study. To analyze the post-treatment changes in condylar morphology, mimics 17.0 software was used to measure several values and reconstruct the three-dimensional condyle, including height of the condyle, area and bone mineral density of the maximum axial and sagittal section, volume and bone mineral density of the three-dimensional condyle and condylar head before and after orthodontic treatment. Using SPSS 19.0 software package Paired t-test was applied for comparison of condylar morphology analysis between pre-treatment and post-treatment.

RESULTS

Height of condylar head increase significant (P < .05). Bone mineral density showed a decrease in the maximum axial and sagittal section, three-dimensional condyle and condylar head (P < .01). Evaluation of volume revealed that volume of both condyle and condylar head decrease considerably (P < .05). No significant difference was detected in other values ((P > .05).

CONCLUSION

Condylar volume decreased and height of condylar head have changed, so we speculated that adaptive bone remodeling of the condyle occurs.