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Herrero Babiloni A, Provost C, Charlebois-Plante C, De Koninck BP, Apinis-Deshaies A, Lavigne GJ, Martel MO, De Beaumont L. One session of repetitive transcranial magnetic stimulation induces mild and transient analgesic effects among female individuals with painful temporomandibular disorders. J Oral Rehabil 2024; 51:827-839. [PMID: 38225806 DOI: 10.1111/joor.13655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/11/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE Temporomandibular disorders (TMD) are characterised by chronic pain and dysfunction in the jaw joint and masticatory muscles. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential non-invasive treatment for chronic pain; however, its effectiveness in individuals with TMD has not been thoroughly investigated. This study aimed to evaluate the immediate and sustained (over seven consecutive days) effects of a single session of active rTMS compared to sham stimulation on pain intensity and pain unpleasantness in individuals with TMD. METHODS A randomised, double-blind, sham-controlled trial enrolled 41 female participants with chronic TMD. Pain intensity and pain unpleasantness were assessed immediately pre- and post-intervention, as well as twice daily for 21 days using electronic diaries. Secondary outcomes included pain interference, sleep quality, positive and negative affect and pain catastrophizing. Adverse effects were monitored. Repeated measures ANOVA and multilevel modelling regression analyses were employed for data analysis. RESULT Active rTMS demonstrated a significant immediate mild reduction in pain intensity and pain unpleasantness compared to sham stimulation. However, these effects were not sustained over the 7-day post-intervention period. No significant differences were observed between interventions for pain interference, sleep quality and negative affect. A minority of participants reported minor and transient side effects, including headaches and fatigue. CONCLUSION A single session of active rTMS was safe and led to immediate mild analgesic effects in individuals with TMD compared to sham stimulation. However, no significant differences were observed between interventions over the 7-day post-intervention period. Based on this study, rTMS stimulation appears to be a promising safe approach to be tested in TMD patients with longer stimulation protocols.
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Affiliation(s)
- Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Catherine Provost
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Camille Charlebois-Plante
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Beatrice P De Koninck
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Amelie Apinis-Deshaies
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Gilles J Lavigne
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Marc O Martel
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada
| | - Louis De Beaumont
- Sacre-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
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Jenabzadeh T, Bohner L, Köppe J, Kleinheinz J, Hanisch M, Oelerich O. Temporomandibular disorders in individuals with Marfan syndrome: an exploratory analysis. Head Face Med 2024; 20:26. [PMID: 38659050 PMCID: PMC11040890 DOI: 10.1186/s13005-024-00427-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/05/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This study aims to analyze to what extent patients with Marfan syndrome (MFS) are affected by temporomandibular disorders (TMD) and its impact on oral health-related quality of life (OHRQoL). To collect data, an online questionnaire was created to recruit participants from Germany, Austria, and Switzerland through social media and support groups. The questionnaire consists of free-text questions, the German versions of the Oral Health Impact Profile (OHIP-G14), the Depression Anxiety Stress Scale (DASS), and the Graded Chronic Pain Status (GCPS). RESULTS A total of 76 participants with diagnosed MFS were included. Of these, 65.8% showed TMD symptoms, the most common being pain or stiffness of the masticatory muscles in the jaw angle (50.0%). Only 14.5% of the participants were already diagnosed with TMD. Of the participants with an increased likelihood of a depression disorder, 76.9% showed TMD symptoms. Of those with a critical score for an anxiety disorder, 90.9% showed TMD symptoms. 73.3% of participants with TMD symptoms reached the critical score for a stress disorder. TMD symptoms were associated with a higher risk for chronic pain. In the median, participants with TMD showed statistically notably higher OHIP-G14 scores than participants without TMD (11.5 [IQR 17] vs. 1 [IQR 3] points, p ≤ 0.001). CONCLUSION TMD symptoms had a noticeable impact on OHRQoL in patients with MFS, i.e., chronic pain and psychological impairment. TMD seems underdiagnosed, and more research is needed to prevent the associated chronification of pain and psychological burden to improve the OHRQoL.
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Affiliation(s)
- Termeh Jenabzadeh
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Lauren Bohner
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Jeanette Köppe
- Institute of Biostatistics and Clinical Research, University of Münster, Schmeddingstraße 56, D-48149, Münster, Germany
| | - Johannes Kleinheinz
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Marcel Hanisch
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Ole Oelerich
- Department of Prosthodontics, University Hospital Münster, D-48149, Münster, Germany.
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Costello A, Twilt M, Lerman MA. Provider assessment of the temporomandibular joint in Juvenile idiopathic arthritis: a retrospective analysis from the CARRA database. Pediatr Rheumatol Online J 2024; 22:41. [PMID: 38589909 PMCID: PMC11000332 DOI: 10.1186/s12969-024-00968-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Temporomandibular joint (TMJ) involvement is an often underrecognized complication of juvenile idiopathic arthritis (JIA) that can cause decreased mandibular growth, altered facial morphology, and orofacial pain. It is estimated that the TMJ is affected in 30-45% of children with JIA. Standardized physical examination and imaging evaluations are important in accurately assessing active TMJ arthritis and sequalae. Little is known about the rate at which providers evaluate TMJ involvement in their clinical practice. METHODS Data were obtained from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. Data fields related to assessment for TMJ arthritis were added in 2019. Patients were included in the study if they had a diagnosis of JIA and had data recorded between January 2020 and August 2021. Standard descriptive statistics were used to describe demographic and clinical features. RESULTS A total of 17,761 visits were reviewed for a total of 7473 patients with JIA. A total of 52.7% of patients had maximal mouth opening (MMO) recorded as finger breadths or total incisal distance (TID). Only 8% had TID measured. A total of 5.0% had MRI with contrast performed. A total of 939 patients had a diagnosis of TMJ arthritis. Of these, 28.5% had an MRI documented, 83% had an MMO documented, and 40% had TID measured. Few patient-level characteristics were statistically related to having MMO assessed. MRI was more likely to be obtained in older and in female patients. MMO was recorded at a given visit > 80% of the time at 17 sites, and it was recorded < 1% of the time at 8 sites. MRIs were infrequently performed at all sites, with 27 sites having no MRIs obtained and only 7 sites having an MRI obtained at > 10% of visits. CONCLUSIONS MMO is not consistently measured in patients with JIA, and it is rarely measured quantitatively. Similarly, TMJ MRIs are rarely obtained in patients with JIA. Site of care is more associated with TMJ assessments than patient-level characteristics. These data suggest that provider education is needed to improve the assessment of the TMJ in patients with JIA to enable earlier recognition and prevent long-term complications.
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Affiliation(s)
- Anna Costello
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| | - Marinka Twilt
- Department of Pediatrics, Division of Rheumatology, Cumming School of Medicine, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Melissa A Lerman
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
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Ananth K, Majumdar A, Singh T. Inflammatory arthritis post-COVID-19 infection affecting the temporomandibular joint. Br Dent J 2024; 236:615. [PMID: 38671113 DOI: 10.1038/s41415-024-7356-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 03/04/2024] [Indexed: 04/28/2024]
Affiliation(s)
- K Ananth
- Waikato Hospital, Hamilton, New Zealand.
| | - A Majumdar
- Waikato Hospital, Hamilton, New Zealand.
| | - T Singh
- Waikato Hospital, Hamilton, New Zealand.
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Oelerich O, Daume L, Yekkalam N, Hanisch M, Menne MC. Temporomandibular disorders among Ehlers-Danlos syndromes: a narrative review. J Int Med Res 2024; 52:3000605241242582. [PMID: 38603608 PMCID: PMC11010766 DOI: 10.1177/03000605241242582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/10/2024] [Indexed: 04/13/2024] Open
Abstract
This narrative review aims to demonstrate and summarize the complex relationship between Ehlers-Danlos syndromes (EDS) and temporomandibular disorders (TMD) by reviewing the results of observational studies and case reports. EDS are a set of hereditary connective tissue disorders, where generalized joint hypermobility (GJH), especially in the hypermobile subtype (hEDS), is a key symptom. Mutations have been identified in genes that impact the production or assembly of collagen for all subtypes except hEDS. While the correlation between GJH and TMD has been analysed in various studies, fewer studies have examined TMD in patients with EDS, with most showing an increased prevalence of TMD. In case-control studies, an elevated prevalence of myalgia, arthralgia and disc-related disorders was found in individuals with EDS. Various therapeutic interventions have been reported within the literature in the form of case reports and observational studies, but there are no long-term clinical trials with results on the efficacy of different therapeutic approaches to date. This review demonstrates the high prevalence of different TMDs in different subtypes of EDS, but also shows that little is known about the success of treatment thus far. Further clinical research is necessary to provide adequate guidance on targeted treatment.
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Affiliation(s)
- Ole Oelerich
- Department of Prosthodontics, University Hospital Münster, Münster, Germany
| | - Linda Daume
- Department of Oral and Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations (RDOM), University Hospital Münster, Münster, Germany
| | - Negin Yekkalam
- Department of Clinical Oral Physiology, School of Dentistry, Umeå University, Umeå, Sweden
| | - Marcel Hanisch
- Department of Oral and Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations (RDOM), University Hospital Münster, Münster, Germany
| | - Max C. Menne
- Department of Prosthodontics, University Hospital Münster, Münster, Germany
- Department of Oral and Maxillofacial Surgery, Fachklinik Hornheide, Münster, Germany
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Affiliation(s)
- Paul Hellyer
- Retired GDP/Clinical Teacher, Bexhill-on-Sea, East Sussex, UK.
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Rangel M, Ferreira MV, dos Santos MTBR, da Silva CBG, Romano MM, Guaré RO. Temporomandibular disorder in individuals with spinal cord injuries. J Spinal Cord Med 2024; 47:270-276. [PMID: 35349395 PMCID: PMC10885762 DOI: 10.1080/10790268.2022.2046421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE This study evaluated Temporomandibular Disorder (TMD) in individuals with Spinal Cord Injuries (SCI) compared to individuals without physical disabilities. DESIGN Cross-sectional. SETTING International Fair of Technologies in Rehabilitation and Accessibility (REATECH) and School of Dentistry at the University of São Paulo (USP), Brazil. PARTICIPANTS In total, 19 patients with SCI and 19 patients without SCI (36.9 ± 11.4 years old) were examined by a calibrated examiner. METHODS using the following parameters: cervical spine mobility, palpation of muscle groups of the head and neck, functional manipulation of the lateral and medial pterygoids, and joint palpation (Diagnostic Criteria). The pattern and amplitude of mandibular movements were determined during screening using the Helkimo index. STATISTICAL ANALYSES Student's t-test, chi-square, Fisher's exact and Shapiro-Wilk test were used. RESULTS The groups did not differ in the presence of noise, pain, temporomandibular joint palpation, locking, dislocation, jaw pain, muscle sensitivity, or in pain, mobility of the cervical spine and functional manipulation. With respect to the jaw mobility index, the groups differed in range of movement (P = 0.020) and maximum right lateral movement (P = 0.007), with the worst values in the SCI group. The groups also differed in relation to lateral flexion in cervical mobility, in which the group without SCI presented better results (P = 0.046). CONCLUSION The Spinal Cord Injuries group showed higher levels of TMD in terms of range of movement, lateral flexion, and maximum right lateral movement, than the individuals without physical disabilities, demonstrating a clinical significance between cervical and mandibular disability in this group.
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Affiliation(s)
- Mayara Rangel
- Graduate Program in Dentistry, Cruzeiro do Sul University - UNICSUL, São Paulo, Brazil
| | | | | | | | | | - Renata Oliveira Guaré
- Graduate Program in Dentistry, Cruzeiro do Sul University - UNICSUL, São Paulo, Brazil
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Mélou C, Leroux L, Bonnesoeur M, Le Padellec C, Bertaud V, Chauvel-Lebret D. Relationship between natural or iatrogenic malocclusions and temporomandibular disorders: A case control study. Cranio 2024; 42:206-214. [PMID: 34061714 DOI: 10.1080/08869634.2021.1933307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate the link between malocclusions and temporomandibular disorders (TMD) with a focus on iatrogenic malocclusion. Other etiologies of TMD (oral parafunctions) were also assessed. METHODS The prevalence of malocclusions was correlated in two groups: patients with TMD (case group) and patients without TMD (control group). Malocclusions involving dental care were specified. Parafunctions in the case group were assessed. RESULTS A statistically significant association between TMD and overbite >4 mm, interferences in laterotrusion, and absence of Angle Class I was shown. A potential deleterious effect of iatrogenic malocclusions was highlighted. CONCLUSION The multifactorial etiology of TMD was confirmed because an association between TMD and three malocclusions was found, and all case patients had parafunction(s). Current recommendations advising first a reversible treatment, TMD care should start with a behavioral re-education to remove parafunctions. However, it is essential to avoid creating iatrogenic malocclusion during dental care.
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Affiliation(s)
- Caroline Mélou
- Odontology Department, Rennes, France, Training and Research Unit of Odontology, University of Rennes, University Hospital Center of Rennes, Rennes, France
| | | | | | | | - Valérie Bertaud
- Odontology Department, Rennes, France, Training and Research Unit of Odontology, University of Rennes, Inserm, LTSI (Signal and Image Processing Laboratory), Rennes, France, University Hospital Center of Rennes, Rennes, France
| | - Dominique Chauvel-Lebret
- Odontology Department, Rennes, France, Training and Research Unit of Odontology, University of Rennes, CNRS, ISCR (Institute of Chemical Sciences of Rennes), University Hospital Center of Rennes, Rennes, France
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Uzunçıbuk H, Marrapodi MM, Meto A, Ronsivalle V, Cicciù M, Minervini G. 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. J Oral Rehabil 2024; 51:500-509. [PMID: 38041596 DOI: 10.1111/joor.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 12/03/2023]
Abstract
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.
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Affiliation(s)
- Hande Uzunçıbuk
- Department of Orthodontics, Dentistry Faculty, Trakya University, Edirne, Turkey
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, Tirana, Albania
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Jayaprakash S, Prasad CB, Dhir V, Jain S. Temporomandibular joint ankylosis in ankylosing spondylitis. Rheumatology (Oxford) 2024; 63:e77-e78. [PMID: 37632772 DOI: 10.1093/rheumatology/kead452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 08/28/2023] Open
Affiliation(s)
- Sankar Jayaprakash
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Chandra Bhushan Prasad
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Varun Dhir
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Jain
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Maranini B, Mandrioli S, Ciancio G, Fabbian F, Galiè M, Govoni M. Temporomandibular joint involvement in psoriatic arthritis: a prospective clinical and ultrasonographic study. Clin Exp Rheumatol 2024; 42:39-47. [PMID: 37534684 DOI: 10.55563/clinexprheumatol/pfi2ql] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/15/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES To evaluate the prevalence of temporomandibular disorders (TMD) in a monocentric cohort of patients affected by psoriatic arthritis (PsA), and to investigate the accuracy of temporomandibular joint (TMJ) ultrasound (US) compared with clinical evaluation and clinimetric composite index in assessing TMJ involvement. METHODS We conducted a prospective cohort study of patients diagnosed with PsA who underwent at least one TMJ US examination and maxillofacial surgeon's evaluation between 2018 and 2021. The rheumatology physician's interpretation of each TMJ US exam (presence/absence of TMD) was compared with psoriatic arthritis disease activity indexes and maxillofacial surgeon's clinical judgement (presence/absence of TMD signs and/or symptoms). RESULTS 142 psoriatic arthritis patients were included. 111 patients were totally asymptomatic for TMD, but 58.5% of them already showed TMJ US changes; moreover, 103 patients passed the maxillofacial surgeon's examination in the absence of any relevant findings but again, of these, 55.3% already presented US signs of TMD. Univariate analysis of subgroups with and without TMJ synovitis and with and without active power Doppler signal showed a significant prevalence of peripheral enthesitic involvement in patients affected by TMD (95.7% vs. 4.3%, p=0.001; and 72.2% vs. 27.3%, p=0.007, respectively). Multivariate regression analysis confirmed the results (p=0.01 and p=0.013, respectively). CONCLUSIONS Peripheral enthesitic involvement may represent a potential risk factor for the development of TMJ synovitis in PsA patients. Since TMD often develops asymptomatically, TMJ US may detect early signs of TMD, ensuring precocious and adequate management.
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Affiliation(s)
- Beatrice Maranini
- Division of Rheumatology, Department of Medical Sciences, University of Ferrara, Italy.
| | - Stefano Mandrioli
- Department of Cranio-Maxillofacial Surgery, Unit of Cranio-Maxillofacial Surgery, University of Ferrara, Italy
| | - Giovanni Ciancio
- Division of Rheumatology, Department of Medical Sciences, University of Ferrara, Italy
| | - Fabio Fabbian
- Department of Medical Science, University of Ferrara, Italy
| | - Manlio Galiè
- Department of Cranio-Maxillofacial Surgery, Unit of Cranio-Maxillofacial Surgery, University of Ferrara, Italy
| | - Marcello Govoni
- Division of Rheumatology, Department of Medical Sciences, University of Ferrara, Italy
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Korkmaz YN, Buyuk SK, Becet N. Does childhood maltreatment play a role in temporomandibular disorders? Br J Oral Maxillofac Surg 2023; 61:691-695. [PMID: 37925310 DOI: 10.1016/j.bjoms.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/23/2023] [Accepted: 10/04/2023] [Indexed: 11/06/2023]
Abstract
The aim of this study was to find out if experiences of maltreatment in childhood have an effect on the occurrence of temporomandibular joint disorders (TMD). The study was conducted on 380 volunteer adults (252 females and 128 males), with a mean (SD) age of 27.63 (9.06) years. The level of TMD was assessed using the Fonseca Anamnestic Index (FAI). Childhood Trauma Questionnaires (CTQ) were completed by the participants and their marital status and educational level were recorded. FAI scores were significantly higher in females than in males. There was no statistically significant difference between gender and total CTQ score. Moreover, there was no statistically significant difference between educational status, marital status, and total CTQ score. FAI scores correlated positively with total CTQ scores in all individuals. Similarly FAI scores correlated positively with total CTQ scores in males and females. Childhood maltreatment is associated with TMDs. Dentists should be aware that possible collaboration with psychiatrists and/or psychologists when treating patients with TMD could increase the success of their treatment.
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Affiliation(s)
- Yasemin Nur Korkmaz
- Department of Orthodontics, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkiye
| | | | - Nursu Becet
- Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkiye
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Chappuis L, Barthelemy I, Pham Dang N. Persistent foramen of Huschke: Clinical manifestations and complications, systematic review. J Stomatol Oral Maxillofac Surg 2023; 124:101455. [PMID: 36965816 DOI: 10.1016/j.jormas.2023.101455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Foramen of Huschke is a bone defect with wide clinical symptoms which ca can be responsible for severe complications. Clinical history and imaging are unspecific, it is therefore essential to recognize and treat the pathology related to the persistence of this foramen, to avoid destruction of the TMJ, chronic pain or OBJECTIVE: The aim of this review was to summarise the clinical manifestations and complications of persistent foramen of Huschke in adult patients, through a review of the cases reported in the literature. METHODS & MATERIALS A literature search of the PubMed, Cochrane Library, ScienceDirect and Embase databases was conducted for all articles published up to November 2022 to identify studies and case reports concerning clinical manifestations and complications of persistent foramen of Huschke in adult patients, with the key words "foramen of Huschke" or "foramen tympanicum". RESULTS 74 papers where firstly identify, and 21 were selected. This correspond to 46 patients with the additional case from our department. Symptoms mostly reported consisted of otitis (63%, 29/46), otorrhea (28.26%, 13/46), and masticatory tinnitus (19.57%, 9/46). Diagnosis was priority made by CT-scan (95.65%, 44/46). Surgery was the most performed treatment (28.26%, 13/46). In our case, the use of FLUOBEAM® NIR camera was help-full for TMJ surgery. CONCLUSION Persistent foramen of Huschke should be suspected in the presence of otitis, otorrhea and masticatory tinnitus. Knowledge of this anatomical variation could help to treat certain pathology like TMJ disorders or TMJ septic arthritis.
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Affiliation(s)
- Louis Chappuis
- Oral and Maxillofacial Department, Estaing Hospital, CHU Clermont-Ferrand, F-63003, Clermont-Ferrand, France; Université d'Auvergne, Faculty of Medicine, F- 63001, Clermont-Ferrand cedex 1, France.
| | - Isabelle Barthelemy
- Oral and Maxillofacial Department, Estaing Hospital, CHU Clermont-Ferrand, F-63003, Clermont-Ferrand, France; Université d'Auvergne, Faculty of Medicine, F- 63001, Clermont-Ferrand cedex 1, France; Inserm U1107 Neuro-Dol, Trigeminal Pain and Migraine, Faculty of Dental Surgery, F-63100 Clermont-Ferrand, France
| | - Nathalie Pham Dang
- Oral and Maxillofacial Department, Estaing Hospital, CHU Clermont-Ferrand, F-63003, Clermont-Ferrand, France; Université d'Auvergne, Faculty of Medicine, F- 63001, Clermont-Ferrand cedex 1, France; Inserm U1107 Neuro-Dol, Trigeminal Pain and Migraine, Faculty of Dental Surgery, F-63100 Clermont-Ferrand, France
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14
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Ogundipe OK. RE: A Nonsurgical Treatment Strategy for Longstanding, Nonreducible, Bilateral Temporomandibular Joint Dislocation: A Case Report. J Oral Maxillofac Surg 2023; 81:1453-1454. [PMID: 38044011 DOI: 10.1016/j.joms.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 09/10/2023] [Indexed: 12/05/2023]
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15
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Sadrzadeh‐Afshar M, Salari B, shobeiri A, HafeziMotlagh K. Investigating the effect of obsessive-compulsive disorder on clinical symptoms of temporomandibular joint disorders. Clin Exp Dent Res 2023; 9:1191-1199. [PMID: 37840225 PMCID: PMC10728531 DOI: 10.1002/cre2.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES Temporomandibular disorders (TMD) are a group of clinical conditions involving muscles of mastication, temporomandibular joint (TMJ), and related structures or both. TMD is characterized by facial pain in TMJ and muscles of mastication, limitation or deviation of jaw movement, and TMJ sounds during jaw movement and function. The highest risk of TMD prevalence is between 18 and 24 years, and a relationship is between chronic TMD and psychological disorders such as stress and depression. The knowledge of the function of this joint and those with TMD symptoms when visiting the dentist will help to provide an ideal treatment plan for the patient. Therefore, if the therapist is familiar with the various etiological factors of this disorder, he will provide better treatment, especially if the simultaneous effect of psychological factors such as stress and obsessive-compulsive disorder (OCD) along with occlusal factors such as posterior cross-bite, overjet, and overbite is measured, it can be a valuable guide for clinicians. METHODS AND MATERIALS In this study, 385 patients were examined by DASS42 and Maudsley's test and classified into normal, with stress, and stress plus OCD groups. TMJ was examined for each of them by the TMD-RDC test. The presence or absence of TMD was noted in their file. RESULTS The prevalence of TMD was 20.7% in the normal group, 30.70% in the stress group, and 44.68% in the stress and OCD group. After analyzing the data by SPSS 24 and performing analysis of variance and Duncan tests, no significant difference was found between the probability of TMD in normal and stressed groups, but the stress and OCD group has a higher chance of TMD. CONCLUSION Although the co-occurrence of stress and OCD is associated with the prevalence of TMD, it cannot be considered a cause of TMD.
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Affiliation(s)
| | - Behzad Salari
- Orthodontics Department, Faculty of Dentistry, Tehran Medical SciencesIslamic Azad UniversityTehranIran
| | - Ali shobeiri
- Department of Oral and Maxillofacial Medicine, Faculty of DentistryAJA University of Medical SciencesTehranIran
| | - Kimia HafeziMotlagh
- Department of Oral Medicine, School of DentistryTehran University of Medical SciencesTehranIran
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16
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Gao W, Lu J, Gao X, Zhou J, Dai H, Sun M, Xu J. Biomechanical effects of joint disc perforation on the temporomandibular joint: a 3D finite element study. BMC Oral Health 2023; 23:943. [PMID: 38031042 PMCID: PMC10685656 DOI: 10.1186/s12903-023-03521-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Disc perforation (DP) is a severe type of Temporomandibular Disorder (TMD). DP may induce changes in the internal stresses of the temporomandibular joint (TMJ). Herein, this study attempts to investigate the biomechanical effects of different positions and sizes of DP on the TMJ using a biomechanical approach, to explore the mechanical pathogenesis of TMD. METHODS Eleven three-dimensional finite element (FE)models of the TMJ were constructed based on CBCT imaging files of a patient with DP on the left side. These models included the disc with anterior displacement and discs with different locations and sizes of perforations on the affected disc. FE methods were conducted on these models. RESULTS Anterior displacement of the disc leads to a significant increase in the maxim von Mises stress (MVMS) in both TMJs, with the affected side exhibiting a more pronounced effect. DP occurring at the posterior band and the junction between the disc and the bilaminar region has a greater impact on the MVMS of both TMJs compared to perforations at other locations. As the size of the perforation increases, both sides of the TMJs exhibit an increase in the magnitude of MVMS. CONCLUSIONS Unilateral disc anterior displacement results in an increased stress on both TMJs. Unilateral DP further affects the stress on both sides of the TMJs. TMD is a progressive condition, and timely intervention is necessary in the early stages to prevent the worsening of the condition.
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Affiliation(s)
- Wentong Gao
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Lu
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiang Gao
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jianping Zhou
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hongwei Dai
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Min Sun
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Department of Knee Joint Sports Injury, Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan Province, China.
| | - Jie Xu
- Stomatological Hospital of Chongqing Medical University, No. 426 Songshi North Road, Chongqing, China.
- Chongqing Key Laboratory for Oral Diseases and Biomedical Science, Chongqing, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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17
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Rozenblyum EV, Chan MO, Gakhal NK. Chew on This: The Afterbite of Temporomandibular Joint Involvement in Adults With Juvenile Idiopathic Arthritis. J Rheumatol 2023; 50:1364-1366. [PMID: 37714549 DOI: 10.3899/jrheum.2023-0776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Affiliation(s)
- Evelyn Victoria Rozenblyum
- E.V. Rozenblyum, MD, Division of Pediatrics, Pediatric Rheumatology, Unity Health Toronto-St. Michael's Hospital, Hospital for Sick Children, Women's College Hospital, Toronto, Ontario;
| | - Mercedes Olivia Chan
- M.O. Chan, MBBS, MHPE, Department of Pediatrics, University of British Columbia, Pediatric Rheumatology, BC Children's Hospital, Vancouver, British Columbia
| | - Natasha Kaur Gakhal
- N.K. Gakhal, MD, MSc, Department of Medicine, Rheumatology, University of Toronto, Women's College Hospital, Toronto, Ontario, Canada
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18
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Seneldir L, Celep S, Yildiz S, Verim A, Zer Toros S, Ozcan Z. A severe headache due to pigmented villonodular synovitis in a rare location: facial nerve on temporomandibular joint. A case report. Cranio 2023; 41:565-568. [PMID: 33834955 DOI: 10.1080/08869634.2021.1911501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pigmented villonodular synovitis (PVNS) is an infrequent benign tumor-like proliferative lesion developing from the synovial membranes of the joint, tendon sheath, and bursa. CLINICAL PRESENTATION A 44-year-old woman with numbness on the right side of her face, severe headaches, and swelling in temporomandibular region is presented. On head and neck magnetic resonance imaging, an encapsulated mass approximately 2 cm was detected. The fine-needle aspiration biopsy resulted as suspicion of mesenchymal tumor. A complete resection with the capsule was performed over the temporal branch by monitoring of the facial nerve. The final histopathologic examination resulted as a giant cell tendon sheath tumor. CONCLUSION Headache is not the main symptom in PVNS, but in severe pain spreading from the temporomandibular region, physical examination should be done carefully for slight swelling, and the possibility of pigmented villonodular synovitis should be considered. Because of the high recurrence rate, en bloc resection is necessary.
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Affiliation(s)
- Lutfu Seneldir
- ENT Department, Haydarpa#şa Numune Training and Research Hospital, Istanbul, Turkey
| | - Sinan Celep
- ENT Department, Tuzla State Hospital, Istanbul, Turkey
| | - Selçuk Yildiz
- ENT Department, Haydarpa#şa Numune Training and Research Hospital, Istanbul, Turkey
| | - Aysegul Verim
- ENT Department, Haydarpa#şa Numune Training and Research Hospital, Istanbul, Turkey
| | - Sema Zer Toros
- ENT Department, Haydarpa#şa Numune Training and Research Hospital, Istanbul, Turkey
| | - Zuhal Ozcan
- Pathology Department, Haydarpa#şa Numune Training and Research Hospital, Istanbul, Turkey
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19
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Vassis S, Resnick CM, Nørgaard M, Strawn KM, Grove H, Noeldeke B, Herlin T, Pedersen TK, Stoustrup PB. Impact of physiotherapy on orofacial manifestations of juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2023; 21:116. [PMID: 37828517 PMCID: PMC10571390 DOI: 10.1186/s12969-023-00900-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Physiotherapy appears as a promising therapy option for patients with Juvenile Idiopathic Arthritis (JIA) [1, 2], but the effects of physiotherapy and jaw exercises on JIA-related orofacial symptoms remain unknown [3]. The aim of this proof-of-concept study was to assess the impact of orofacial physiotherapy and home-exercise programs in patients with JIA and temporomandibular joint (TMJ) involvement. METHODS Twelve patients with JIA and TMJ involvement received a treatment of physiotherapy, complemented by prescribed home exercises spanning over eight weeks. Orofacial symptoms and dysfunction were monitored pre-treatment, during treatment, after treatment, and at a three-months follow-up. RESULTS Orofacial pain frequency and intensity significantly decreased during the course of the treatment (p = 0.009 and p = 0.006), with further reductions observed at the three-month follow-up (p = 0.007 and p = 0.002). During treatment, the mandibular function improved significantly in terms of maximal mouth opening capacity, laterotrusion, and protrusion. CONCLUSIONS This proof-of-concept study shows favourable effects of physiotherapy and home excercises in the management of JIA-related orofacial symptoms and dysfunctions.
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Affiliation(s)
- Stratos Vassis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark.
| | - Cory M Resnick
- Department of Oral and Maxillofacial Surgery, Harvard Medical School, 188 Longwood Avenue, Boston, MA, 02115, United States of America
| | - Mette Nørgaard
- Department of Physiotherapy, Aarhus University Hospital, Skejby, Denmark, Palle Juul- Jensens Boulevard 103, Aarhus N, 8200, Denmark
| | - Kathleen M Strawn
- Department of Physical and Occupational Therapy, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, United States of America
| | - Helle Grove
- Mårslet Fysioterapi & Traeningscenter, Hørretvej 16 C, Mårslet, 8320, Denmark
| | - Beatrice Noeldeke
- Leibniz University Hannover, Welfengarten 1, 30167, Hannover, Germany
| | - Troels Herlin
- Department of Clinical Medicine, Department of Paediatrics, Aarhus University, Palle Juul- Jensens Boulevard 103, Aarhus N, 8200, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark
| | - Peter Bangsgaard Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Blvd. 9, Aarhus C, DK-8000, Denmark
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20
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Jiang N, Zhu SS. [Orthognathic surgery and temporomandibular joint]. Zhonghua Kou Qiang Yi Xue Za Zhi 2023; 58:991-995. [PMID: 37818533 DOI: 10.3760/cma.j.cn112144-20230807-00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Orthognathic surgery changes the jaw position and occlusion, and also affects the original structure and function of the temporomandibular joint (TMJ). With the widespread development of orthognathic surgery, the impact of orthognathic surgery on the structure and function of the TMJ is increasingly valued, and the importance of the TMJ in orthognathic surgery is gradually recognized. Proper understanding the relationship between orthognathic surgery and TMJ not only helps to elucidate how the orthognathic surgery affects the condyle and causes temporomandibular disorders (TMD), but also has significant clinical significance in preventing and treating TMD in patients underwent orthognathic surgery.
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Affiliation(s)
- N Jiang
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - S S Zhu
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
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21
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Kulkarni R, Akintoye S. A Patient with Juvenile Idiopathic Arthritis Presents for Dental Extraction. Dent Clin North Am 2023; 67:625-628. [PMID: 37714610 DOI: 10.1016/j.cden.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Patients with JIA, specifically the polyarticular subtype, may present with temporomandibular joint arthritis. Given the pain typically present in the joint, limitations in opening may be noted. As such, oral health and hygiene practices may be compromised in this patient population. Dental management considerations during treatment include shorter visits, safe measures to maintain mouth opening, frequent breaks during procedures, and counselling on condition management to reduce risks in the future. In dental extractions, bite blocks or props may be used to complete the procedure safely and reduce pain.
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Affiliation(s)
- Roopali Kulkarni
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.
| | - Sunday Akintoye
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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22
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Lerman MA. Opening Wide: Advances in Understanding Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis. Arthritis Rheumatol 2023; 75:1509-1511. [PMID: 37096578 DOI: 10.1002/art.42539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/10/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Melissa A Lerman
- Division of Rheumatology, The Children's Hospital of Philadelphia, and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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23
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Glerup M, Tagkli A, Küseler A, Christensen AE, Verna C, Bilgrau AE, Nørholt SE, Herlin T, Pedersen TK, Stoustrup P. Incidence of Orofacial Manifestations of Juvenile Idiopathic Arthritis From Diagnosis to Adult Care Transition: A Population-Based Cohort Study. Arthritis Rheumatol 2023; 75:1658-1667. [PMID: 36806745 DOI: 10.1002/art.42481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/29/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To estimate the cumulative incidences of orofacial conditions related to temporomandibular joint (TMJ) juvenile idiopathic arthritis (JIA) between diagnosis in childhood to transition into adult care, and to identify features in JIA associated with TMJ involvement. METHODS A population-based cohort analysis was conducted of patients with JIA involving longitudinal data on orofacial health from 2000 to 2018. Regardless of TMJ status, the patients were referred to the Regional Specialist Craniofacial Clinic of Western Denmark for routine orofacial examinations. Data collection included information about disease-specific background characteristics, TMJ involvement, JIA-induced dentofacial deformity, and orofacial symptoms and dysfunction. RESULTS A total of 613 patients were followed up with a mean clinical TMJ observation time of 4.0 years. From JIA onset to transition into adult care, the cumulative incidence of patients with JIA involvement of the TMJ was 30.1%. Furthermore, 20.6% of the cohort had developed arthritis-induced dentofacial deformity. A substantial proportion of the cohort experienced several events with orofacial symptoms (23.5%) and dentofacial dysfunction (52%). Young age at diagnosis (<9 years), female gender, and antinuclear antibody positivity were significantly associated with TMJ involvement. CONCLUSION Orofacial signs and symptoms were frequent findings in children and adolescents with JIA. TMJ involvement was seen in 30.1% of the cohort; and 20.6% of the total cohort developed JIA-related dentofacial deformity before transition into adult care. This is the first population-based study in the era of available biologic treatments to document these frequent orofacial complications in children with JIA.
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Affiliation(s)
- Mia Glerup
- Pediatric Rheumatology Clinic, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, UZB University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Anders E Bilgrau
- Department of Mathematical Sciences, Aalborg University, Aalborg, Denmark
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Troels Herlin
- Pediatric Rheumatology Clinic, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas K Pedersen
- Section of Orthodontics, Aarhus University, and Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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24
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Arnold SH, Harmon KA, Jazayeri HE, Figueroa AA, Tragos C. TMJ Ankylosis Following Mandibular Distraction Osteogenesis: Management With Simultaneous Midface External Distraction and Bilateral Temporomandibular Joint Replacement. J Craniofac Surg 2023; 34:e587-e589. [PMID: 37246290 DOI: 10.1097/scs.0000000000009444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/16/2023] [Indexed: 05/30/2023] Open
Abstract
Early mandibular distraction osteogenesis (MDO) can decrease upper airway and feeding complications in pediatric patients with micrognathia; however, temporomandibular joint (TMJ) complications like TMJ ankylosis (TMJA) may occur. TMJA can disturb pediatric patients' function and craniofacial growth, resulting in significant physical and psychosocial consequences. Additional surgical procedures may also be required, increasing the burden of care on patients and their families. CMF surgeons must discuss the potential complications of early MDO surgery with families as well as potential solutions should these problems occur. This report presents the case of a 17-year-old male with a severe craniofacial anomaly with features of Treacher-Collins syndrome (TCS) and a surgical history of tracheostomy, cleft palate repair, mandibular reconstruction with harvested costochondral grafts, and MDO with resultant bilateral TMJA and limited mouth opening. The patient Was treated with bilateral custom alloplastic TMJ replacements and simultaneous maxillary DO using a Rigid External Distraction (RED) device.
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Affiliation(s)
- Sydney H Arnold
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL
| | - Kelly A Harmon
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL
| | - Hossein E Jazayeri
- Section of Oral and Maxillofacial Surgery, Department of Surgery, Michigan Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - Alvaro A Figueroa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL
| | - Christina Tragos
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL
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25
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Montemurro N, Trilli I, Bordea IR, Ferrara E, Francesco MD, Caccamo F, Malcangi G, Rapone B. Are Whiplash-Associated Disorders and Temporomandibular Disorders in a Trauma Related Cause and Effect Relationship? A Review. Medicina (Kaunas) 2023; 59:1482. [PMID: 37629772 PMCID: PMC10456620 DOI: 10.3390/medicina59081482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Background: Whiplash is associated with a wide variety of clinical manifestations, including headache, neck pain, cervical rigidity, shoulder and back pain, paresthesia, vertigo, and temporomandibular disorders (TMDs). Previous studies reported that TMDs are more common in individuals with chronic whiplash-associated disorders (WAD) than in the general population; however, the pathophysiology and mechanism of this relationship are still not well understood. Methods: A PubMed and Ovid EMBASE review was performed to identify all studies addressing the trauma related cause and effect relationship between WAD and TMDs from January 2003 to March 2023. Results: After screening for eligibility and inclusion criteria, a total of 16 articles met the selection criteria. The various included studies discussed different aspects of the association between WDA and TMDs, including changes in the coordination and amplitude of jaw opening, the severity of the associated symptoms/signs in cases of WAD, the degree of fatigue and psychological stress, difficulty in feeding, cervical and myofascial pain, changes in the MRI signal at various muscle points, muscle tenderness, and quality of life. Conclusions: In this review, we summarized the clinical evidence of any trauma related cause and effect relationship between whiplash and TMDs. An accurate screening of the previous literature showed that, in conclusion, the relationship between whiplash and TMDs is still unclear.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy;
| | - Irma Trilli
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, 400012 Cluj-Napoca, Romania
| | - Elisabetta Ferrara
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio, 66100 Chieti, Italy;
| | - Maurizio De Francesco
- Department of Neurosciences, Institute of Clinical Dentistry, University of Padua, 35128 Padua, Italy;
| | | | - Giuseppina Malcangi
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Biagio Rapone
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
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Hysa E, Lercara A, Cere A, Gotelli E, Gerli V, Paolino S, Pizzorni C, Sulli A, Smith V, Cutolo M. Temporomandibular disorders in immune-mediated rheumatic diseases of the adult: A systematic review. Semin Arthritis Rheum 2023; 61:152215. [PMID: 37167773 DOI: 10.1016/j.semarthrit.2023.152215] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/24/2022] [Accepted: 04/26/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To systematically review the literature concerning temporomandibular disorders (TMDs) in immune-mediated rheumatic diseases (IMRDs) of the adult. The temporomandibular joint (TMJ) outcomes used in clinical studies, the prevalence of TMDs in IMRDs and the risk factors for their development were qualitatively synthetized. METHODS A literature search on PubMed Central, Embase and Cochrane Library databases was performed for studies including TMJ outcomes in IMRDs patients compared with healthy controls, other rheumatic diseases or in the assessed IMRDs patients after follow-up and treatment. Among the IMRDs of the adult, original articles investigating TMJ involvement in inflammatory polyarthritides and/or autoimmune connective tissue diseases were considered. The quality of the studies was scored using the Newcastle-Ottawa scale (NOS). RESULTS Of the 3259 screened abstracts, 56 papers were included in the systematic review. Most of the papers (77%) investigated TMDs in rheumatoid arthritis (RA) with a prevalence of signs and symptoms varying from 8% to 70%. The risk factors for TMDs development in RA were female sex, younger age, anti-citrulline peptide autoantibodies (ACPA) positivity, higher disease activity, cervical spine involvement, cardiovascular and neuropsychiatric comorbidities. Ten papers (18%) evaluated TMDs in spondylarthritides (SpA) reporting a prevalence of symptoms and signs in 12%-80% of patients with higher TMDs prevalence in patients with radiographic spine involvement, skin psoriasis and HLADRB1×01 positivity. Among autoimmune connective tissue diseases (CTDs), systemic sclerosis (SSc) displayed the highest evidence of TMDs patient-reported outcomes (PROs) and clinical findings (20-93%), followed by systemic lupus erythematosus (SLE) in 18-85%, primary Sjogren's syndrome (24-54%) and idiopathic inflammatory myopathies (4-26%). In SSc and SLE, TMDs were more frequent in patients with higher disease activity and duration, correlating with the extent of skin fibrosis in SSc and with renal involvement in SLE. CONCLUSION TMDs in IMRDs display a significant relevance in the rheumatological clinical practice even if often misdiagnosed. This burden is epidemiologically important in terms of PROs and clinical findings which correlate with disease activity in RA, SpA, SSc and SLE. The early recognition and multidisciplinary management of TMDs is warranted and should be aimed at hindering the TMJ structural damage maximizing the quality of life of patients.
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Affiliation(s)
- Elvis Hysa
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Adriano Lercara
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Andrea Cere
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Emanuele Gotelli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Veronica Gerli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Sabrina Paolino
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Carmen Pizzorni
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Alberto Sulli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Vanessa Smith
- Department of Internal Medicine, Department of Rheumatology, Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy.
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Sangalli L, Eli B, Mehrotra S, Sabagh S, Fricton J. Calcitonin Gene-Related Peptide-Mediated Trigeminal Ganglionitis: The Biomolecular Link between Temporomandibular Disorders and Chronic Headaches. Int J Mol Sci 2023; 24:12200. [PMID: 37569575 PMCID: PMC10418780 DOI: 10.3390/ijms241512200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
A bidirectional causal relationship has been established between temporomandibular disorders (TMDs) and chronic headaches. Recent advances in the neurobiology of chronic pain offer a framework for understanding the comorbidity between these two conditions that might reside in the shared biomolecular mechanisms of peripheral and central sensitization. The initiation of these processes is inflammatory in nature and is most likely mediated by key molecules, including calcitonin gene-related peptide (CGRP). This scoping review proposes that CGRP-mediated neuroinflammation in the trigeminal ganglion may partly explain the biomolecular bidirectional link between TMDs and chronic headaches. Finally, clinical implications of this neuropathologic process are briefly discussed.
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Affiliation(s)
- Linda Sangalli
- College of Dental Medicine—Illinois, Midwestern University, Downers Grove, IL 60515, USA
| | - Bradley Eli
- Facial Pain Specialists, San Diego, CA 92121,USA; (B.E.); (S.M.); (S.S.)
| | - Sachi Mehrotra
- Facial Pain Specialists, San Diego, CA 92121,USA; (B.E.); (S.M.); (S.S.)
| | - Suzan Sabagh
- Facial Pain Specialists, San Diego, CA 92121,USA; (B.E.); (S.M.); (S.S.)
| | - James Fricton
- Division of TMD and Orofacial Pain, University of Minnesota Schoof of Dentistry, Minneapolis, MN 55455, USA
- Minnesota Head and Neck Pain Clinic, Plymouth, MN 55447, USA
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Liu Y, Yin T, He M, Fang C, Peng S. The association of severely worn dentition resulting from betel nut chewing with temporomandibular disorders: a cross-sectional study. BMC Oral Health 2023; 23:459. [PMID: 37420243 PMCID: PMC10327273 DOI: 10.1186/s12903-023-03160-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Most studies support parafunctions play an important role in temporomandibular disorders (TMD), whereas the association between tooth wear and TMD remains controversial. Betel nut chewing as a parafunction is popular in South and Southeast Asia. We therefore investigated the association of severely worn dentition resulting from betel nut chewing with TMD. METHODS A cross-sectional analysis of 408 control participants (male: 380, female: 28, 43.62 ± 9.54 years) and 408 participants with betel nut chewing related severely worn dentition (male: 380, female: 28, 43.73 ± 8.93 years) who received dental and TMD checkup according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in Health Management Center, Xiangya Hospital was performed. Betel nut chewing related severely worn dentition meant all the natural teeth had moderate to severe tooth wear [Tooth Wear Index (TWI) ≥ 2)] including ≥ 2 severe wear teeth (TWI ≥ 3) due to betel nut chewing. Multivariable logistic regression analysis was used. RESULTS After adjusting for age, gender, betel nut chewing related severely worn dentition, oral submucosal fibrosis, number of missing teeth, number of dental quadrants with missing teeth, visible third molar and orthodontic history, variables of age, gender and betel nut chewing related severely worn dentition were significant for overall TMD. Multivariable analysis showed betel nut chewing related severely worn dentition was significantly associated with intra-articular TMD [odds ratio and 95% confidence intervals: 1.689 (1.271-2.244), P = 0.001] in a betel nut chewing dose-dependent manner. CONCLUSION Betel nut chewing related severely worn dentition was associated with intra-articular TMD.
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Affiliation(s)
- Yundong Liu
- Health Management Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, China.
| | - Tao Yin
- Changsha Health Vocational College, Changsha, Hunan, 410605, China
| | - Mi He
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Changyun Fang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Shifang Peng
- Department of Infectious Diseases, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, China.
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Cini MA, Avelino MD, Machado JGLA, Junior RLDR, Santos AD. Chondromatosis of the temporomandibular joint as a cause of reflex otalgia. Braz J Otorhinolaryngol 2023; 89:101284. [PMID: 37421832 PMCID: PMC10344662 DOI: 10.1016/j.bjorl.2023.101284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/10/2023] Open
Affiliation(s)
| | | | | | | | - Alan Dos Santos
- Universidade do Oeste Paulista (UNOESTE), Guarujá, SP, Brazil
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30
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Zheng H, Liu Z, Wang H. Research progress in effect of chewing-side preference on temporomandibular joint and its relationship with temporo-mandibular disorders. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:386-397. [PMID: 37476950 PMCID: PMC10409910 DOI: 10.3724/zdxbyxb-2023-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/15/2023] [Indexed: 07/22/2023]
Abstract
Chewing-side preference is one of the risk factors for temporomandibular disorders (TMD), and people with chewing-side preference is more prone to have short and displaced condyles, increased articular eminence inclination and glenoid fossa depth. The proportion of TMD patients with chewing-side preference is often higher than that of the normal subjects. Clinical studies have shown a strong correlation between chewing-side preference and TMD symptoms and signs; and animal studies have shown that chewing-side preference can affect the growth, development, damage and repair of the mandible. After long-term unilateral mastication, changes in the stress within the joint cause the imbalance of temporomandibular joint (TMJ) structural reconstruction, the transformation and even destruction of the fiber structure of masticatory muscle, resulting in uncoordinated movement of bilateral muscles. The joint neurogenic diseases caused by the increase of neuropeptide substance P and calcitonin-gene-related-peptide (CGRP) released locally by TMJ may be the mechanism of TMD. This article reviews the research progress of the influence of chewing-side preference on the structure of TMJ, the relationship between chewing-side preference and TMD, and the related mechanisms.
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Affiliation(s)
- Huiyun Zheng
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Cancer Center of Zhejiang University, Hangzhou 310006, China.
| | - Zhichao Liu
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Huiming Wang
- The Stomatology Hospital, Zhejiang University School of Medicine, Zhejiang University School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Provincial Key Laboratory of Oral Biomedical Research, Cancer Center of Zhejiang University, Hangzhou 310006, China.
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Thirumoorthy S, Gopal S. Association between orthodontic treatment and the occurrence of temporomandibular disorders: smoke and mirrors in the form of a systematic review? Evid Based Dent 2023; 24:85-88. [PMID: 37225868 DOI: 10.1038/s41432-023-00893-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 05/26/2023]
Abstract
QUESTION To investigate the association between orthodontic treatment and incidence of temporomandibular joint disorders (TMD) as a revision to the existing literature. DATA SOURCES Electronic searches were performed in the following databases: PubMed/Medline, Scopus, Scielo, Google Scholar and Web of Science. Hand search of the references of the included studies was also conducted. STUDY SELECTION Two authors performed database search independently using the keywords to include case control and cohort studies in English or Spanish language. Systematic reviews and Randomized controlled trials (RCTs) were excluded. DATA EXTRACTION AND SYNTHESIS From the studies that met the inclusion criteria, investigators extracted the following data: authors, year, study title, number of patients, male/female ratio, mean age (range), follow up time, groups, number of patients per group, country and results. The Newcastle Ottawa scale was used for risk of bias assessment. All disagreements were resolved by consulting with a third reviewer. RESULTS A total of 686 articles were found in the search and 28 duplicates were removed. After title and abstract screening, 648 articles remained. Ten articles were analyzed for full text and four studies were excluded in the process, leaving six articles that met all inclusion and exclusion criteria. Out of six studies, four were case control, one cohort and one prospective cohort. Authors found good quality on all categories of risk of bias assessment in the selected studies. For the meta-analysis, they considered Odds Ratio (OR) because of its presence in every included study. An association between orthodontic treatment and the occurrence of TMD was demonstrated with an odds ratio of 1.84. CONCLUSIONS The review authors conclude that the results of their systematic review indicate association between the orthodontic treatment and incidence of TMJ disorders.
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Affiliation(s)
- Soumya Thirumoorthy
- Board Certified Orthodontist, Smilelife Orthodontics, Corpus Christi, TX, USA.
| | - Saumiya Gopal
- Reader, Department of Periodontics, KMCT Dental College, Kozhikode, Kerala, India
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32
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Stoustrup P, Resnick CM, Abramowicz S, Pedersen TK, Michelotti A, Küseler A, Koos B, Verna C, Nordal EB, Granquist EJ, Halbig JM, Kristensen KD, Kaban LB, Arvidsson LZ, Spiegel L, Stoll ML, Lerman MA, Glerup M, Defabianis P, Frid P, Alstergren P, Cron RQ, Ringold S, Nørholt SE, Peltomaki T, Larheim TA, Herlin T, Peacock ZS, Kellenberger CJ, Twilt M. Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus-Based Recommendations. Arthritis Rheumatol 2023; 75:4-14. [PMID: 36041065 PMCID: PMC10100353 DOI: 10.1002/art.42338] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 08/08/2022] [Accepted: 08/19/2022] [Indexed: 02/04/2023]
Abstract
Involvement of the temporomandibular joint (TMJ) is common in juvenile idiopathic arthritis (JIA). TMJ arthritis can lead to orofacial symptoms, orofacial dysfunction, and dentofacial deformity with negative impact on quality of life. Management involves interdisciplinary collaboration. No current recommendations exist to guide clinical management. We undertook this study to develop consensus-based interdisciplinary recommendations for management of orofacial manifestations of JIA, and to create a future research agenda related to management of TMJ arthritis in children with JIA. Recommendations were developed using online surveying of relevant stakeholders, systematic literature review, evidence-informed generation of recommendations during 2 consensus meetings, and Delphi study iterations involving external experts. The process included disciplines involved in the care of orofacial manifestations of JIA: pediatric rheumatology, radiology, orthodontics, oral and maxillofacial surgery, orofacial pain specialists, and pediatric dentistry. Recommendations were accepted if agreement was >80% during a final Delphi study. Three overarching management principles and 12 recommendations for interdisciplinary management of orofacial manifestations of JIA were outlined. The 12 recommendations pertained to diagnosis (n = 4), treatment of TMJ arthritis (active TMJ inflammation) (n = 2), treatment of TMJ dysfunction and symptoms (n = 3), treatment of arthritis-related dentofacial deformity (n = 2), and other aspects related to JIA (n = 1). Additionally, a future interdisciplinary research agenda was developed. These are the first interdisciplinary recommendations to guide clinical management of TMJ JIA. The 3 overarching principles and 12 recommendations fill an important gap in current clinical practice. They emphasize the importance of an interdisciplinary approach to diagnosis and management of orofacial manifestations of JIA.
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Affiliation(s)
| | - Cory M. Resnick
- Department of Plastic and Oral SurgeryBoston Children's HospitalBostonMassachusetts
| | - Shelly Abramowicz
- Division of Oral and Maxillofacial Surgery, Departments of Surgery and PediatricsEmory University School of MedicineAtlantaGeorgia
| | - Thomas K. Pedersen
- Section of Orthodontics and Department of Oral and Maxillofacial SurgeryAarhus University HospitalAarhusDenmark
| | | | - Annelise Küseler
- Section of Orthodontics and Department of Oral and Maxillofacial SurgeryAarhus University HospitalAarhusDenmark
| | - Bernd Koos
- Department of OrthodonticsUniversity Hospital TübingenTübingenGermany
| | - Carlalberta Verna
- Department of Pediatric Oral Health and OrthodonticsUZB University Center for Dentistry Basel, University of BaselBaselSwitzerland
| | - Ellen B. Nordal
- Department of Pediatrics, University Hospital of North Norway and the Pediatric Research Group, Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Eric J. Granquist
- Department of Oral and Maxillofacial Surgery, School of Dental MedicineUniversity of PennsylvaniaPhiladelphia
| | - Josefine Mareile Halbig
- The Public Dental Health Competence Centre of North Norway, and the Department of Clinical Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
| | | | - Leonard B. Kaban
- Massachusetts General Hospital, Harvard School of Dental MedicineBostonMassachusetts
| | - Linda Z. Arvidsson
- Department of Maxillofacial RadiologyInstitute of Clinical Dentistry, University of OsloOsloNorway
| | - Lynn Spiegel
- The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | | | - Melissa A. Lerman
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania
| | - Mia Glerup
- Department of Pediatrics and Adolescent MedicineAarhus University HospitalAarhusDenmark
| | | | - Paula Frid
- Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Public Dental Service Competence Centre of North Norway, and Department of Clinical DentistryUiT The Arctic University of NorwayTromsøNorway
| | - Per Alstergren
- Faculty of Odontology, Orofacial Pain UnitMalmö UniversityMalmöSweden
| | | | | | - Sven Erik Nørholt
- Section of Orthodontics and Department of Oral and Maxillofacial SurgeryAarhus University HospitalAarhusDenmark
| | - Timo Peltomaki
- Faculty of Medicine and Health Technology, and Department of Ear and Oral Diseases, Tampere University, Tampere, Finland, and Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland and Department of Oral and Maxillofacial Diseases, Kuopio University HospitalKuopioFinland
| | - Tore A. Larheim
- Department of Maxillofacial RadiologyInstitute of Clinical Dentistry, University of OsloOsloNorway
| | - Troels Herlin
- Department of Pediatrics and Adolescent MedicineAarhus University HospitalAarhusDenmark
| | - Zachary S. Peacock
- Massachusetts General Hospital, Harvard School of Dental MedicineBostonMassachusetts
| | | | - Marinka Twilt
- Alberta Children's Hospital and University of CalgaryCalgaryAlbertaCanada
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Barry F, Chai F, Chijcheapaza-Flores H, Garcia-Fernandez MJ, Blanchemain N, Nicot R. Comparison of chemical-induced temporomandibular osteoarthritis rat models (monosodium iodoacetate versus collagenase type II) for the study of prolonged drug delivery systems. PLoS One 2023; 18:e0281135. [PMID: 36719872 PMCID: PMC9888674 DOI: 10.1371/journal.pone.0281135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/13/2023] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To compare two agents that can induce a rat model of temporomandibular joint osteoarthritis (TMJOA) by chemical induction: monosodium iodoacetate (MIA) and collagenase type 2 (Col-2). We wished to ascertain the best agent for assessing drug-delivery systems (DDSs). METHOD Male Wistar rats underwent intra-articular injection with MIA or Col-2. They were manipulated for 30 days. The head withdrawal threshold (HWT), immunohistological assessment, and positron emission tomography (PET) were used to evaluate the relevance of our models. RESULTS For both the MIA and Col-2 groups, pain persisted for 30 days after injection. Change in the HWT showed that Col-2 elicited a strong action initially that decreased progressively. MIA had a constant action upon pain behavior. Histology of TMJ tissue from both groups showed progressive degradation of TMJ components. CONCLUSIONS MIA and Col-2 induced orofacial pain by their local chemical action on TMJs. However, based on a prolonged and greater sustained effect on the pain threshold, persistent histological changes, and imaging results, MIA appeared to be more suitable for creation of a rat model of TMJOA for the study of DDSs.
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Affiliation(s)
- Florent Barry
- INSERM, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, University of Lille, Lille, France
- * E-mail:
| | - Feng Chai
- INSERM, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, University of Lille, Lille, France
| | - Henry Chijcheapaza-Flores
- INSERM, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, University of Lille, Lille, France
| | - Maria José Garcia-Fernandez
- INSERM, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, University of Lille, Lille, France
| | - Nicolas Blanchemain
- INSERM, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, University of Lille, Lille, France
| | - Romain Nicot
- INSERM, CHU Lille, Department of Oral and Maxillofacial Surgery, University of Lille, Lille, France
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García Martín I, Cariati P, Martínez-Sauquillo Rico A, Cabello Serrano A, García Medina B. Arthroscopic osteoplasty of the medial and anteromedial wall of temporomandibular joint: surgical technique and anatomical considerations. Br J Oral Maxillofac Surg 2023; 61:72-77. [PMID: 36535863 DOI: 10.1016/j.bjoms.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/19/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
The anterior displacement of the articular disc is the most frequent cause of pathological alterations in the TMJ. Although it is an extremely common pathology, there is no certainty about the aetiopathogenesis of this disease. The main aim of the present report is to describe new anatomical findings that could help clarifying the aetiopathogenesis of this disease and determine a typology of treatment based on the cause of the disease. All the operative records of patients who underwent arthroscopic osteoplasty of the medial TMJ wall in our centre from January 2021 to September 2021 were reviewed and analysed to identify specific anatomical features observed in every procedure. Fifty-two joints were included for analysis in this study. Twenty-two joints were classified as Wilkes stages II-III and 30 as Wilkes stages IV-V. The most common complication observed in our sample was the dysaesthesias found in the temporal and preauricular regions. Other complications observed were frontal branch paresis (n = 2), intraoperative bleeding (n = 1), and postoperative malocclusion (n = 1). The compression of the superior head of pterygoid lateral muscle (SPLM) on the medial bony wall and the consequent muscle atrophy could be key for the aetiology of the anterior TMJ disc displacement. Therapeutic actions on the osseous and muscular component in this anatomical area could improve the outcomes of patients affected by TMJ internal derangement. A meticulous dissection of the fascia of the superior fascicle of the lateral pterygoid muscle allows a remodelling of the bone surfaces with minimal complications.
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Affiliation(s)
- Irene García Martín
- Department of Oral and Maxillofacial Surgery, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Paolo Cariati
- Hospital General Universitario de Albacete, Departamento de Cirugía Oral y Maxilofacial, Albacete, Spain.
| | | | - Almudena Cabello Serrano
- Hospital Universitario Virgen de las Nieves de Granada, Departamento de Cirugía Oral y Maxilofacial, Granada, Spain
| | - Blas García Medina
- Hospital Universitario Virgen de las Nieves de Granada, Departamento de Cirugía Oral y Maxilofacial, Granada, Spain
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Kamdem B, Broome M, May L, Blatter J. [Temporomandibular joint disorders: current concepts for conservative management]. Rev Med Suisse 2022; 18:1860-1863. [PMID: 36200964 DOI: 10.53738/revmed.2022.18.798.1860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The temporomandibular joint is subject to repeated stress. The overloading of the compensation system leads to dysfunction, which manifests itself in the form of muscular and articular damage. Pain, joint noises and limitation of mouth opening are the most frequent reasons for a temporomandibular dysfunction (TMD) consultation. The diagnosis is mainly clinical. The therapeutic concepts are still controversial. The aim of this article is to offer a management strategy based on evidence through the analysis of literature reviews.
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Affiliation(s)
- Benedikta Kamdem
- Service de chirurgie orale et maxillo-faciale, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Martin Broome
- Service de chirurgie orale et maxillo-faciale, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Laurence May
- Service de chirurgie orale et maxillo-faciale, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Jeannine Blatter
- Service de chirurgie orale et maxillo-faciale, Centre hospitalier universitaire vaudois, 1011 Lausanne
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Kvaratskhelia S, Nemsadze T. THE INFLUENCE OF THE ORTHODONTIC TREATMENT ON THE DEVELOPMENT OF THE TEMPOROMANDIBULAR JOINT DISORDER - LITERATURE REVIEW. Georgian Med News 2022:22-26. [PMID: 36539125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
TMJ is highly prevalent stomatognathic disease affecting all age groups. Frequently, malocclusion can be the reason of the development of TMJ disorders. However, in addition to this, in the course of orthodontic treatment there may be some complaints about the pain and discomfort in temporomandibular joint, which is caused by orthodontic appliances that aimed to change the condition of malocclusion and mandibles. TMJ disorders are characterized with more complexity in case disorders are chronic or persistent. Orthodontic treatment has a potential role for the possible recovery as a consequence of correction of malocclusion. Pre-orthodontic preparation frequently is a necessary stage of orthodontic treatment. Orthodontists and general dentists must be aware of the multifactorial etiology of TMD and should accept recommendations about controlling the process before or after any dental or orthodontic interventions. The aim of this literature review is to show the effect of the orthodontic treatment in the development of temporomandibular joint disorders. The research may be an important factor for orthodontic patients for better assessment in order to avoid the post treatment complications. In the electronic database of PubMed, Google Scholar, Web of Science and Scopus using the key words the studies held before 2022 were searched and analyzed in addition to the data from the books related to temporomandibular joint and complications of orthodontic treatment. Orthodontic treatment in combined treatment of TMJ disorders has a potential role for the possible recovery. For the successful recovery it is essential clinicists to be informed about TMJ clinical signs and symptoms, have appropriate knowledge about all possible treatment means and detailed assessment of TMJ myofunctional condition before and after the orthodontic treatment. As a result of the correct control of the treatment process amongst the patients with the signs of TMJ dysfunction, the structure of temporomandibular joint is adapted to a new functional positioned that improves clinical condition in the surroundings. On the basis of this research and experience, it must be emphasized one more time that TMJ diagnosis must be a crucial criterion at a pre-orthodontic preparation stage in order to assess the treatment quality and avoid the post treatment complications.
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Affiliation(s)
| | - T Nemsadze
- Ivane Javakhishvili Tbilisi State University, Georgia
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Abstract
The presentation of patients with symptoms associated with temporomandibular disorders (TMDs) is a common finding in general dental practice. The management of patients with TMDs is often complicated by its multifactorial aetiology. This paper aims to provide a guide for dental practitioners to the clinical examination, diagnosis, and recognition of red flags in relation to TMDs and inform the busy practitioner when to refer patients presenting with TMDs for specialist/secondary care management.
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Affiliation(s)
- Aneesha Shah
- Consultant Oral Surgeon, Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Ambareen Naqvi
- Specialty dentist in Oral Surgery, Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK
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Vega-Cauich JI, Gutierrez-Solis AL. Temporomandibular disorders and bullying: The mediating role of anxiety in young adults. Community Dent Health 2022; 39:118-122. [PMID: 35080816 DOI: 10.1922/cdh_00198vega-cauich05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Bullying is a major social issue. Individuals who experience bullying victimization may develop stress-related health disorders, such as anxiety and temporomandibular disorders (TMDs). As school bullying can enhance or trigger stress and anxiety, individuals who experience bullying victimization are prone to develop TMD. However, it is still unclear whether this relationship is mediated by anxiety. OBJECTIVE The aim of this study was to investigate the role of anxiety in the relationship between bullying victimization and TMD among young adults. METHODS A cross-sectional study among 578 students aged 18 to 25 years in Yucatan, Mexico. A mediation model was used to identify whether anxiety mediated the relationship between bullying victimization and the development of TMD. RESULTS Our results showed that 14.2% of the students self-identified as victims of bullying, and 43.7% reported having a type of TMD. The indirect effect of the pathway "victimization → anxiety → TMD" was significant (β= 0.660; p ⟨0.001). There was also an effect, not mediated by anxiety (β= 0.31; p= 0.026). This means that the relationship between victimization caused by bullying and TMD is mostly mediated by anxiety. CONCLUSION This study presents the first evidence of the role of anxiety as a mediator of the relationship between bullying victimization and TMD among young adults in Mexico.
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Affiliation(s)
- J I Vega-Cauich
- Unidad de Posgrado e Investigacion, School of Education, Autonomus University of Yucatan, Mexico
| | - A L Gutierrez-Solis
- Research Unit, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Mexico
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Memis S, Can M. Bilateral Temporomandibular Joint Dislocation Following Arthrocentesis Plus Hyaluronic Acid Injection. J Coll Physicians Surg Pak 2022; 32:677-679. [PMID: 35546711 DOI: 10.29271/jcpsp.2022.05.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 05/04/2021] [Indexed: 06/15/2023]
Abstract
Arthrocentesis plus intra-articular hyaluronic acid (HA) injection for temporomandibular joint (TMJ) disorders is known to be a safe and minimally invasive surgical procedure. Arthrocentesis plus HA injection has a pain-reducing effect on TMJ disorders. It is also a palliative treatment that yields positive results in terms of clinical findings such as clicking and mouth opening. Even though some complications have been reported after the performance of this highly successful procedure, the development of bilateral TMJ dislocation after arthrocentesis plus intra-articular HA injection has not been reported to date. This case report presents bilateral TMJ dislocation following arthrocentesis plus intra-articular HA injection that developed within a few hours and resisted manual Hippocrates manoeuvre in a 21-year male. Herein, his treatment with systemic corticosteroid therapy, myorelaxant and anti-inflammatory drugs is also presented. Key Words: Arthrocentesis, Hyaluronic acid, Joint dislocation, Temporomandibular joint, Steroids.
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Affiliation(s)
- Sadi Memis
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Mert Can
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Kalladka M, Young A, Thomas D, Heir GM, Quek SYP, Khan J. The relation of temporomandibular disorders and dental occlusion: a narrative review. Quintessence Int 2022; 53:450-459. [PMID: 35274511 DOI: 10.3290/j.qi.b2793201] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The term temporomandibular disorders (TMDs) encompasses a variety of disorders of the temporomandibular joint (TMJD) and the associated musculature (MMD). Occlusion and its role in the genesis of TMDs is one of the most controversial topics in this arena. The objective of the narrative review was to summarize the implications of TMDs and its relationship to dental occlusion in two scenarios: 1) TMD as an etiologic factor in dental occlusal changes; 2) The role of dental occlusion as a causative factor in the genesis of TMDs. DATA SOURCES Indexed databases were searched from January 1951 to August 2021 using the terms TMJ, TMD, temporomandibular disorders, temporomandibular joint, and dental occlusion. CONCLUSION There is lack of good primary research evaluating true association and showing the cause-and-effect relationship between dental occlusion and TMD. Systematic reviews suggest that the role of occlusion as a primary factor in the genesis of TMDs is low to very low. However, a variety of TMDs can lead to secondary changes in dental occlusion. Distinction between the two is paramount for successful management.
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Ding L, Chen R, Liu J, Wang Y, Chang Q, Ren L. The effect of functional mandibular advancement for adolescent patients with skeletal class II malocclusion on the TMJ: a systematic review and meta-analysis. BMC Oral Health 2022; 22:51. [PMID: 35241050 PMCID: PMC8895665 DOI: 10.1186/s12903-022-02075-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/08/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This study aimed to assess whether functional mandibular advancement (FMA) will cause temporomandibular joint disorders (TMD) or have side effects on temporomandibular joint (TMJ) in adolescent patients. METHODS All searched databases, including PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trails and Scopus were searched. Gray literature and unpublished literature was also searched. Randomized controlled trails (RCT) and non-randomized studies of the effects of interventions (NRSI) directly observe the condition of adolescent patients' TMJ after finishing treatment will be considered to include in our study. According to Cochrane Handbook, Cochrane Collaboration risk of bias tool was used to assess the quality of included RCTs, and Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool was used to assess the quality of included NRSIs. RESULT Finally 18 researches were evaluated as eligible to include in this study. 5 of the studies were RCTs, 8 were NRSIs and 5 were systematic reviews. The data of RCTs and NRSIs were statistically pooled in meta-analysis. The number of samples under investigated among primary studies was 579 individuals,there were 80 patients who developed temporomandibular symptoms during or after treatment. But all the subjective symptoms disappeared during follow-up time. The statistical outcomes proved that patients received FMA didn't show more tendency to develop temporomandibular symptoms [I2 = 27%, OR = 0.54, 95%CI (0.33,0.87), p = 0.01]. CONCLUSION (1) TMJ symptoms may occur during the functional oral appliance wearing, but the symptoms will release or disappear after treatment or during the follow-up period. (2) Less convincing evidence indicates that slightly previous TMD and condyle-glenoid fossa relationship will be improved after treatment. (3) There is TMJ disc anterior displacement observed during treatment, but most of them will return to the normal position later. (4) Moderate evidence support that FMA will not have side effects on TMJ of adolescent patients.
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Affiliation(s)
- Lan Ding
- Department of Orthodontics, School of Stomology, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000 Gansu Province China
| | - Rui Chen
- Department of Orthodontics, School of Stomology, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000 Gansu Province China
| | - Jiaxin Liu
- Department of Orthodontics, School of Stomology, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000 Gansu Province China
| | - Yuan Wang
- Department of Orthodontics, School of Stomology, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000 Gansu Province China
| | - Qian Chang
- Department of Orthodontics, School of Stomology, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000 Gansu Province China
| | - Liling Ren
- Department of Orthodontics, School of Stomology, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000 Gansu Province China
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Sahni J, Lamberghini F. Dental Management in Juvenile Idiopathic Arthritis. J Dent Child (Chic) 2022; 89:18-23. [PMID: 35337395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease. It can involve the temporomandibular joint (TMJ) at onset; however, this is frequently overlooked until later stages when pain and dysfunction occur. The purpose of this paper is to discuss the case of a 14-year-old female with malocclusion and TMJ pain who presented for orthodontic treatment. The orthodontist referred her to the orofacial pain specialist to rule out TMJ dysfunction before starting care. After a comprehensive evaluation, the patient was diagnosed with JIA. Dentists can play a key role in the initial detection of systemic diseases causing TMJ pathology. This case report outlines the main orofacial signs and symptoms a dentist needs to be familiar with for the prompt identification of JIA, further reiterating the importance of an early diagnosis for a better prognosis and quality of life of a young patient with JIA.
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Affiliation(s)
- Jasjot Sahni
- Dr. Sahni, Assistant Professor, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University ofIllinois Chicago, Chicago,Ill., USA
| | - Flavia Lamberghini
- Dr. Lamberghini, Assistant Professor, Department of Pediatric Dentistry, College of Dentistry, University ofIllinois Chicago, Chicago,Ill., USA
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Yin K, Pang H, Guo Z, Guo H, Qi X, Che X. A comparative study of audiology and cone beam computed tomography in TMD patients with otological symptoms through occlusal splint therapy. Ann Ital Chir 2022; 93:210-216. [PMID: 34290153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION To investigate the changes of audiological tests and the cone beam computed tomography (CBCT) measurements of temporomandibular joint (TMJ) and middle-inner ear structure after occlusal splint therapy in temporomandibular disorders (TMD) patients with otological symptoms, and explore the etiological mechanism between TMD and otological symptoms. METHODS The 25 subjects aged 18 to 40 years who diagnosed with TMD combined the otological symptoms enrolled in the study.They all had received orthodontic treatment in the outpatient clinic of the orthodontic department in Beijing Stomatological Hospital. All the subjects underwent the audiological tests of pure tone audiometry (PTA) and CBCT before and after the occlusal splint therapy. RESULTS After the stabilization occlusal splint therapy, subjects with improvement or complete remission in TMD and otological symptoms accounted for 84% and 80% in all subjects respectively. There were statistically differences in the distances between condylar center (CoC) and sella (S) in sagittal and vertical directions before and after treatment, and statistically difference between ATM and S in sagittal direction. The threshold of PTA at 8000Hz were negatively correlated with the sagittal displacement of condyle and positively correlated with the coronal displacement of condyle. The thickness of top 1/3 of anterior wall of tympanum in sagittal were positively correlated with the threshold of PTA at 4000Hz. CONCLUSION The changes in the TMJ position through occlusal splint therapy might cause the changes in structure of middle-inner ear, which might be one of the reasons for the improvement in otological symptoms. KEY WORDS Audiology, CBCT, Otological symptoms, TMD.
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Voronina EA, Nurieva NS, Delec AV. [A clinical case of a growing patient with juvenile rheumatoid arthritis of the temporomandibular joint]. Stomatologiia (Mosk) 2022; 101:74-79. [PMID: 35362707 DOI: 10.17116/stomat202210102174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Treatment of patients with temporomandibular joint pathology in the presence of systemic diseases should include a number of additional methods. OBJECTIVE The aim of the study to consider an algorithm for providing care to a growing patient with TMJ arthritis on the background of juvenile rheumatoid arthritis complicated by distalization of the mandible. MATERIAL AND METHODS A growing patient with temporomandibular joint pathology and juvenile rheumatoid arthritis is undergoing complex treatment by a rheumatologist and dentist in order to prevent pronounced degenerative changes in the TMJ bone structures, significant asymmetries of the facial skeleton and the postural component of the patient's body. RESULTS The patient underwent rehabilitation in order to activate the growth zones, reduce the skeletal asymmetry of the maxillofacial region due to directed growth using conservative techniques. The growth of the branches of the lower jaw was obtained, the optical density of the cortical bone of both condyles improved to the age norm. CONCLUSION A significant improvement in the prognosis of TMJ rheumatoid arthritis disease in growing patients is possible while creating conditions for adequate interaction of all structures of the maxillofacial region.
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Affiliation(s)
- E A Voronina
- South-Urals State Medical University, Chelyabinsk, Russia
| | - N S Nurieva
- South-Urals State Medical University, Chelyabinsk, Russia
| | - A V Delec
- South-Urals State Medical University, Chelyabinsk, Russia
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Zaitsu T, Inoue Y, Oshiro A, Nishiyama A, Kawaguchi Y, Aida J. Association of visual display terminal time with prevalence of temporomandibular disorder among Japanese workers. J Occup Health 2022; 64:e12370. [PMID: 36350045 PMCID: PMC9644922 DOI: 10.1002/1348-9585.12370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 10/11/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Visual display terminal (VDT) time has been reported to affect the development of temporomandibular disorders (TMDs). However, no study has investigated the association between VDT time at and outside of work with TMDs Adjusting for known TMJ risk factors. This study aimed to investigate whether TMDs were associated with VDT time at and outside of work after adjusting for various working conditions in Japanese workers. METHODS This cross-sectional study was based on an internet survey of 3930 workers (2057 men and 1873 women), The TMD Screening Questionnaire (SQ-TMD), occupational factors, VDT time at and outside of work, psychosocial factors, and habits were assessed. We applied logistic regression to estimate the odds ratio (OR) of VDT time on SQ-TMD with adjustment for confounders. RESULTS The mean age of the respondents was 43.3 ± 11.7 years, and 778 (19.8%) and 3152 (80.2%) subjects were at high and low TMD-related symptoms (TRS). Logistic regression analysis adjusting for all covariates (Model 2), the prevalence of high TRS was significantly higher among those with VDT time at work of 60-179 min (OR = 1.52, 95% CI 1.18-1.94), 180-359 min (OR = 1.27, 95% CI 1.00-1.62), and more than 360 min (OR = 1.44, 95% CI 1.10-1.88) compared to those with 0-59 min. However, there was no significant difference in the prevalence of high TRS for VDT time outside of work. CONCLUSION VDT time at work, but not VDT time outside of work, influences the prevalence of TRS. Since the association between VDT time at work and the prevalence of TRS was found even after adjusting for sociopsychological factors and habits generally associated with TMD, further investigation of other factors is needed.
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Affiliation(s)
- Takashi Zaitsu
- Department of Oral Health Promotion, Graduate School of Medical and Dental ScienceTokyo Medical and Dental UniversityTokyoJapan
| | - Yuko Inoue
- Department of Oral Health Promotion, Graduate School of Medical and Dental ScienceTokyo Medical and Dental UniversityTokyoJapan
| | - Akiko Oshiro
- Department of Oral Health Promotion, Graduate School of Medical and Dental ScienceTokyo Medical and Dental UniversityTokyoJapan
| | - Akira Nishiyama
- Department of General Dentistry, Graduate School of Medical and Dental ScienceTokyo Medical and Dental UniversityTokyoJapan
| | - Yoko Kawaguchi
- Department of Oral Health Promotion, Graduate School of Medical and Dental ScienceTokyo Medical and Dental UniversityTokyoJapan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental ScienceTokyo Medical and Dental UniversityTokyoJapan
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Alqanatish JT, Alrewaithi BS, Alsewairi WM, Khan AH, Alsalman MJ, Alrasheed AA. Temporomandibular joint involvement in children with juvenile idiopathic arthritis: A single tertiary-center experience. Saudi Med J 2021; 42:399-404. [PMID: 33795495 PMCID: PMC8128629 DOI: 10.15537/smj.2021.42.4.20200470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/10/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To describe the clinical and laboratory characteristic, state the treatment and outcome of patients with juvenile idiopathic arthritis (JIA), and describe temporomandibular joint (TMJ) involvement as observed in a large tertiary center. METHODS A retrospective cross-sectional study of children diagnosed with JIA was assessed at King Abdullah Specialist Children's Hospital, Riyadh, Saudi Arabia (2015-2019), which included a descriptive analysis of children who had TMJ involvement among our study group. Subjects diagnosed with the TMJ arthritis were based either on clinical musculoskeletal examination or using contrast-enhanced MRI. RESULTS We reviewed 123 cases with different JIA subtypes (57% females). The most frequent subtype is the oligoarticular (36%). TMJ involvement was found in 16% (n=20/123) of the patients, of whom 45% had Polyarticular JIA. The rheumatoid factor was positive in 25%; antinuclear antibody (ANA) in 45% and none showed positivity to HLAB27. Treatment resulted in complete resolution in 95% of cases, while Micrognathia and obstructive sleep apnea were the complications reported in 5% of cases. CONCLUSION TMJ involvement in JIA is not uncommon. Females with polyarticular disease were more frequently affected with TMJ arthritis. Positive ANA could be a risk factor for TMJ involvement, while positive HLAB27 might have some protective effects. Early treatment for TMJ arthritis is essential to avoid possible complications.
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Affiliation(s)
- Jubran T Alqanatish
- From King Saud bin Abdulaziz University for Health Sciences (Alqanatish, Alrewaithi, Alsewairi, Alsalman, Alrasheed); from King Abdullah International Medical Research Center (Alqanatish, Alsewairi, Khan, Alsalman, Alrasheed); from King Abdullah Specialist Children's Hospital (Alqanatish, Alsewairi, Alrasheed); and from King Abdulaziz Medical City (Alsalman), Riyadh, Kingdom of Saudi Arabia
| | - Banan S Alrewaithi
- From King Saud bin Abdulaziz University for Health Sciences (Alqanatish, Alrewaithi, Alsewairi, Alsalman, Alrasheed); from King Abdullah International Medical Research Center (Alqanatish, Alsewairi, Khan, Alsalman, Alrasheed); from King Abdullah Specialist Children's Hospital (Alqanatish, Alsewairi, Alrasheed); and from King Abdulaziz Medical City (Alsalman), Riyadh, Kingdom of Saudi Arabia
| | - Wafaa M Alsewairi
- From King Saud bin Abdulaziz University for Health Sciences (Alqanatish, Alrewaithi, Alsewairi, Alsalman, Alrasheed); from King Abdullah International Medical Research Center (Alqanatish, Alsewairi, Khan, Alsalman, Alrasheed); from King Abdullah Specialist Children's Hospital (Alqanatish, Alsewairi, Alrasheed); and from King Abdulaziz Medical City (Alsalman), Riyadh, Kingdom of Saudi Arabia
| | - Altaf H Khan
- From King Saud bin Abdulaziz University for Health Sciences (Alqanatish, Alrewaithi, Alsewairi, Alsalman, Alrasheed); from King Abdullah International Medical Research Center (Alqanatish, Alsewairi, Khan, Alsalman, Alrasheed); from King Abdullah Specialist Children's Hospital (Alqanatish, Alsewairi, Alrasheed); and from King Abdulaziz Medical City (Alsalman), Riyadh, Kingdom of Saudi Arabia
| | - Mohammed J Alsalman
- From King Saud bin Abdulaziz University for Health Sciences (Alqanatish, Alrewaithi, Alsewairi, Alsalman, Alrasheed); from King Abdullah International Medical Research Center (Alqanatish, Alsewairi, Khan, Alsalman, Alrasheed); from King Abdullah Specialist Children's Hospital (Alqanatish, Alsewairi, Alrasheed); and from King Abdulaziz Medical City (Alsalman), Riyadh, Kingdom of Saudi Arabia
| | - Abdulrhman A Alrasheed
- From King Saud bin Abdulaziz University for Health Sciences (Alqanatish, Alrewaithi, Alsewairi, Alsalman, Alrasheed); from King Abdullah International Medical Research Center (Alqanatish, Alsewairi, Khan, Alsalman, Alrasheed); from King Abdullah Specialist Children's Hospital (Alqanatish, Alsewairi, Alrasheed); and from King Abdulaziz Medical City (Alsalman), Riyadh, Kingdom of Saudi Arabia
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Zhang L, Shi W, Lu S, Cai B, Fan S, Yang Y, Xu L. Prognostic factor analysis in patients with temporomandibular disorders after reversible treatment: study protocol for a prospective cohort study in China. BMJ Open 2021; 11:e048011. [PMID: 34215608 PMCID: PMC8256761 DOI: 10.1136/bmjopen-2020-048011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/09/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Temporomandibular disorders (TMDs) are complex multifactorial disorders. Reversible treatment has been suggested for the initial management of TMD; however, comparable therapeutic effects of different reversible intervention modalities remain controversial. Various biopsychosocial factors, which may be putative prognostic factors that influence the response to reversible treatment for TMD, have been reported to increase the risk of developing first-onset TMD. However, there is a paucity of research that aims to identify prognostic factors associated with the clinical outcomes of reversible treatment in people with TMD. The objective of this prospective cohort study is to identify prognostic factors that are associated with clinical outcomes of reversible treatment in patients with TMD and to analyse the risk factors that influence the development of chronic TMD. METHODS AND ANALYSIS We plan to recruit 834 patients with TMD who meet the inclusion criteria. Once informed consent is obtained, baseline data, including anamnestic data, physical assessments and self-report questionnaires, will be collected from participants at their first clinic visit; subsequently, they will receive 1-4 weeks of reversible treatment. The primary treatment outcome measures will be a change in the anterior maximum mouth opening, worsening of TMD pain scores assessed using a visual analogue scale (VAS) and a reduction in characteristic pain intensity. A good outcome will be defined as an anterior maximal opening ≥35 mm and at least a 30% reduction in VAS scores 3 months after baseline. The association between candidate prognostic factors and clinical outcomes of reversible TMD treatment will be analysed. ETHICS AND DISSEMINATION The protocol has been approved by the Ethics Committee of Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, based on the guidelines outlined in the Declaration of Helsinki (SH9H-2019-T316-4). The results of this study will be reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement. The authors intend to publish the results in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ChiCTR2000033328.
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Affiliation(s)
- Ling Zhang
- Department of Rehabilitation, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
| | - Wentao Shi
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
| | - Shenji Lu
- Department of Rehabilitation, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
| | - Bin Cai
- Department of Rehabilitation, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
| | - Shuai Fan
- Department of Rehabilitation, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
| | - Yang Yang
- Department of Rehabilitation, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
| | - Lili Xu
- Department of Rehabilitation, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
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Linsen SS, Schön A, Teschke M, Mercuri LG. Does Maximum Voluntary Clenching Force Pose a Risk to Overloading Alloplastic Temporomandibular Joint Replacement?-A Prospective Cohort Study. J Oral Maxillofac Surg 2021; 79:2433-2443. [PMID: 34280358 DOI: 10.1016/j.joms.2021.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/04/2021] [Accepted: 06/13/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE The amount of maximum voluntary clenching (MVC) force may influence functional loading at the polyethylene/metal bearing surfaces in alloplastic total temporomandibular joint replacement (TMJR). The aim of this study was to measure ipsilateral MVC and estimate the risk for revision due to overloading of the TMJR. METHODS A prospective cohort study design was used to study patients who underwent alloplastic TMJR. The primary predictor was time after TMJR, the secondary predictors were age at TMJR placement, coronoidectomy, prior ipsilateral TMJ surgeries, TMJR design (custom, stock), and bite location. The primary outcome variable was MVC, the secondary outcome was need for TMJR revision. Data were collected preoperatively (T0), and 1 year (T1), 2 to 3 years (T2) and ≥4 years postoperatively (T3). Analysis of variance (ANOVA) with post hoc Tukey-HSD and regression analysis was used for statistical analysis. P < .05 was considered significant. RESULTS Thirty-seven patients (58 TMJR) with unilateral (n = 16) and bilateral (n = 21) TMJR were enrolled; 8 males (12 TMJR) and 29 females (46 TMJR). Average age was 46.4 ± 14.9 years. MVC increased significantly over the observation period (P = .000). At all observation time points, age at TMJR placement and bite location significantly influenced MVC (P = .000). Coronoidectomy and prior ipsilateral TMJ surgeries did not demonstrate a significant influence on MVC. TMJR design influenced MVC significantly at T3 (P = .006). Regression analysis identified age as a significant factor for higher MVC. No TMJR required revision or replacement. CONCLUSIONS Based on this study, ipsilateral MVC increases significantly after TMJR. However, since MVC is significantly lower than in healthy test-patients, a considerably lower functional loading at the polyethylene/metal bearing surfaces can be assumed. Lower loading at the TMJR bearing surfaces and at the cortical screw fixation sites suggest a potential longer lifespan compared to other artificial joints like hip and knee prostheses.
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Affiliation(s)
- Sabine S Linsen
- Priv.-Doz., Dr. med. dent., MSc, Assistant Professor, Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany.
| | - Andreas Schön
- Dr. med., Dr. med. dent., Assistant Professor, Department of Oral- and Maxillofacial Plastic Surgery, University Hospital Bonn, Bonn, Germany
| | - Marcus Teschke
- Dr. med., Dr. med. dent., Private Practice, Praxis fuer Gesichtschirurgie und Kiefergelenkschirurgie, Hamburg, Germany
| | - Louis G Mercuri
- Visiting Professor, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL; Adjunct Professor, Department of Bioengineering, University of Illinois Chicago, Chicago, IL; Clinical Consultant, TMJ Concepts, Ventura, CA
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Yap AU, Chen C, Wong HC, Yow M, Tan E. Temporomandibular disorders in prospective orthodontic patients. Angle Orthod 2021; 91:377-383. [PMID: 33534890 DOI: 10.2319/010720-863.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To determine the prevalence and severity of temporomandibular disorders (TMDs) in prospective orthodontic patients. The association between TMDs and malocclusion severity as well as the impact of TMDs on oral health-related quality of life (OHRQoL) were also examined. MATERIALS AND METHODS A total of 350 consecutive patients seeking orthodontic treatment were invited to participate in the study. The presence of TMDs was established with the Fonseca Anamnestic Index (FAI), while malocclusion severity and OHRQoL were evaluated using the Peer Assessment Rating (PAR) index and Oral Health Impact Profile-14 (OHIP-14), respectively. Data were analyzed using chi-square, Kruskal-Wallis, and Mann-Whitney U tests and Spearman's correlation (P < .05). RESULTS Of the 350 patients, 164 consented to participation. Data from 26 participants were excluded because of incomplete entries, and that from 138 subjects (mean age 21.02 ± 5.45 years) were examined. TMD-related symptoms were present in two-thirds of the subjects, with 20.3% experiencing moderate/severe TMDs. While no significant difference in PAR scores were observed between the group with no TMDs and those with TMDs, subjects with TMDs had significantly higher OHIP-14 summary/domain scores than those without TMDs. Although a moderately strong correlation was observed between the FAI and summary OHIP-14 scores (rs = 0.57), no association was observed between FAI and PAR index scores. CONCLUSIONS The prevalence of TMD-related symptoms in prospective orthodontic patients was high, emphasizing the importance of screening the masticatory system before initiating orthodontic therapy. Although the presence of TMDs was not associated with malocclusion severity, it had a significant negative impact on OHRQoL.
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Delgado-Delgado R, Iriarte-Álvarez N, Valera-Calero JA, Centenera-Centenera MB, Garnacho-Garnacho VE, Gallego-Sendarrubias GM. Association between temporomandibular disorders with clinical and sociodemographic features: An observational study. Int J Clin Pract 2021; 75:e13961. [PMID: 33387380 DOI: 10.1111/ijcp.13961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are the most common orofacial impairment, but the relevance of certain clinical features in TMD is not clear. OBJECTIVE The main objective of this study was to analyse if temporomandibular disorders (TMD) are associated with sociodemographic (eg age, height, weight, body mass index and gender), psychological (eg anxiety and depression) and clinical features (eg use of dental splints, orthodontics, retainers, bruxism, sleep disturbance, familiar prior history of TMD and dental occlusion). METHODS An observational study was conducted to calculate the correlation of TMD, as assessed with DC/TMD criteria, with sociodemographic, psychological and clinical features on 59 voluntary subjects with TMD (n = 45) and without TMD (n = 14). Sex, height, weight, body mass index, age, use of dental splint, orthodontics, retainers, parafunctional disorders, sleep disturbance, familiar history of TMD, bruxism, anxiety, stress and dental occlusion class data were included in a multivariable correlation analysis to determine which variables are associated with TMD and bruxism. RESULTS TMD was found to be correlated with none of the features assessed (P > .05), but a negative correlation with the use of dental splint (P < .05). Dental occlusion class showed no statistically significant correlation with any assessed feature (P > .05). CONCLUSION The etiology of TMD is not clear and considering certain clinical features including dental occlusion are not justified in the evidence-based TMD practice for making irreversible occlusal treatment decisions.
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Affiliation(s)
- Raquel Delgado-Delgado
- Department of Physical Therapy, Faculty of Health, Universidad Camilo José Cela, Madrid, Spain
- Escuela Internacional de Doctorado, Universidad Camilo José Cela, Madrid, Spain
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