Clinical Dysfunction Index Research Articles

ASSESSMENT OF TEMPOROMANDIBULAR DYSFUNCTION AND MANDIBULAR FUNCTIONAL IMPAIRMENT IN DENTISTRY ACADEMICS

Introduction: Temporomandibular dysfunction (TMD) is a collective term adding up the entire problems related to temporomandibular joint (TMJ) and the mandibular functional impairment is one of the symptoms of TMD. It is known that the posture influences the onset of TMD, thus, as in the appearance of mandibular functional impairment. Dentists remain in inadequate positions during their workday, thus presenting an important risk factor for the onset of TMD. Objective: To classify temporomandibular dysfunction and mandibular functional impairment in undergraduates of the 8th period of the Dentistry course in the “Centro Universitário do Triângulo-UNITRI”, in Uberlândia, MG, Brazil. Methodology: This is a cross-sectional, practical, exploratory with a quantitative approach, epidemiological study carried out through application of two questionnaires: Mandibular Functional Impairment Index (MFIQ) and Clinical Dysfunction Index (IDCCM or Helkimo Index). Results: The results found in the present study showed a higher prevalence of moderate TMD (70,83%), followed by mild TMD (16.67%) and severe TMD (12,50%) and all participants were classified with mandibular functional impairment of low severity. Conclusion: The results of this research showed a high prevalence of moderate TMD in dentistry students and that there is no correlation between TMD and mandibular functional impairment. It was observed that many students had pain in the neck and/or shoulder.

Evaluation of Oral Dysfunction in Completely Edentulous Denture Wearing Patients

Background: Oral dysfunction is the difficulties faced by the complete denture wearers during speech mastication, pain and esthetics. By knowing this oral dysfunction we can make a satisfactory complete denture to the patient. Aim: The aim of the study is to evaluate oral dysfunction in complete denture wearers using a Clinical Dysfunction Index. Materials and Methods: Potential study participants were interviewed regarding their satisfaction with their complete denture after minimum three months of denture wear. The first twenty satisfied and unsatisfied complete denture wearers were recruited for the study. The data collection was done using a questionnaire and clinical examination was carried out to ascertain the quality of the denture based on stability, occlusion, articulation, oral mucosa and resilience. Clinical Dysfunction Index by Helkimo [1974] was used to assess the functional health of the Temporo-Mandibular joint. Results: According to the results of our study fewer participants reported difficulty in chewing among those with correct articulation, correct occlusion and good retention of their dentures and more participants reported difficulty in chewing with dentures having incorrect articulation, incorrect occlusion and minimum retention Conclusion: Knowledge about oral dysfunction in complete denture wearers can motivate us to pay careful attention to factors that may influence the satisfaction of complete denture wearers as observed from this study.

Outcome of eminectomy combined with discectomy and silastic interpositional graft for temporomandibular joint dysfunction: a retrospective study of 20 years.

Internal derangement of the temporomandibular joint (TMJ) is usually treated conservatively, but about 5% require surgical treatment. We designed a retrospective study to assess the long-term outcomes of eminectomy combined with discectomy and silastic interpositional graft in 44 patients who had chronic TMJ dysfunction that had not responded to traditional conservative treatment and arthrocentesis. The maximum mouth opening, pain score, Wilkes stage, and clinical dysfunction index were measured before, and two years after, operation. All the patients showed significant improvement in mouth opening and reduced pain scores (p<0.0001 in each case). There were no long-term operative complications, and postoperative magnetic resonance scans showed that the silastic interpositional graft was in a stable position with no evidence of degenerative changes on the surfaces of the joint and no lymphadenopathy.

Does TMJ Function and Imaging Tools Help Differentiate Between Condylar Resorption and Mandibular Hypoplasia?

Differentiating between bilateral condylar resorption (CR) and mandibular hypoplasia (MH) can be challenging owing to the difficulty in chronological observation and establishing standardized measurements. The purpose of the present study was to assess whether temporomandibular joint (TMJ) function can distinguish between CR and MH and clarify the essential diagnostic imaging tools for CR. We performed a cross-sectional study of patients with mandibular retrognathia. The primary predictor variables were a clinical dysfunction score for the TMJ, mandibular plane angle (MPA), SNA angle, SNB angle, and cortical erosion score in the condylar heads. The demographic variables were age, anterior disc displacement, and previous orthodontic treatment. The anatomic variable was the condylar height (CH). The primary outcome variable was the disease status (CR or MH). The patients were divided into the CR group and MH group. The patients with CR were selected on the basis of a CH value of less than 22mm. TMJ function was assessed using the Helkimo clinical dysfunction index. The CH on panoramic radiographs was measured using the Kjellberg method. The MPA, SNA angle, and SNB angle were analyzed using cephalometric analysis. Cortical erosion in the condylar head was assessed using computed tomography and magnetic resonance imaging. A total of 23 female participants were enrolled in the present study. The average clinical dysfunction score for the TMJ was 4.4 in the CR group and 0.4 in the MH group (P<.05). The average MPA was 41.2° in the CR group and 35.5° in the MH group (P<.05). The present investigation has shown that assessing TMJ function and analyzing MPA using a cephalometric radiograph can differentiate CR from MH.

Efficiency of treatment of patients with muscular and joint dysfunction of the temporomandibular joints

The prevalence of dysfunction of the temporomandibular joint, especially in people aged 18-60 years, reached 95-98 % among all dental applications. The course of the pathology is usually hidden, with periodic recurrences and has a long nature, which is accompanied by a decrease in overall quality of life. Treatment of this pathology of the temporomandibular joint is a set of complex therapeutic, orthopedic and psychological measures. The literature describes many ways to treat temporomandibular joint dysfunction, one of the modem ones is the use of occlusal splints, which allow to change the position of the mandible, diagnose and eliminate musculoskeletal dysfunction of the temporomandibular joint. The aim of the study was to determine the effectiveness of treatment of musculoskeletal dysfunction of the temporomandibular joint with occlusal splints according to axiography. 274 patients aged 18 to 65 years were diagnosed with temporomandibular joint pain syndrome before and after treatment. All patients with signs of temporomandibular joint dysfunction before treatment had a violation of the trajectory of the mandible (deviation is 68.7 %, dyslexia is 31.3 %). When opening and closing the mouth, asymmetrical shifts of the lower jaw to the sides of more than 2 mm (deviation from the midline is more than 2 mm) were observed. After treatment with occlusal splints there was an improvement in the trajectory of opening and closing the mouth: the number of patients with a violation of the trajectory decreased by 89.1 %, and the displacement of the mandible during opening and closing the mouth in 92.4 % of patients decreased on average to 0.9 mm. When analyzing the movements of the mandible in the sagittal plane in 79 % of cases, deviations of the trajectory of the mandible were detected. After treatment with occlusive muscle relaxation splints, elimination of violations of the trajectory of the mandible in the transverse plane was noted in 93.4 % of cases, reduction of displacement to 0.9 mm in 78.1 % of patients. The trajectory of the mandible in the sagittal plane improved in 80.1 % of patients, normalization of the position of the mandible relative to the neuromuscular trajectory was achieved in 93.4 % of clinical cases. According to the analysis of parameters, such treatment should be considered effective. Keywords: musculoskeletal dysfunction, temporomandibular joint, clinical dysfunction index, axiography, sagittal articular pathway angle, sagittal incisor pathway angle, Bennett’s angle (movement), duration.

Comprehensive Assessment of Orofacial Health and Disease Related Parameters in Adolescents with Juvenile Idiopathic Arthritis-A Cross-Sectional Study.

Background: The aim of this cross-sectional study was to investigate oral health and functional status of adolescents with juvenile idiopathic arthritis (JIA) and its possible link to disease specific parameters. Methods: Patients with JIA were recruited (November 2012–October 2014) and disease specific information was extracted from patients’ records. Oral examination included: dental findings (decayed-, missing- and filled-teeth-index (dmf-t/DMF-T)), gingival inflammation (papilla-bleeding-index (PBI)) and periodontal screening index (PSI). Functional examination followed Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Additionally, modified Helkimo’s Clinical Dysfunction Index and radiographic scoring were recorded. Results: 59 JIA patients were included. The mean dmf-t/DMF-T was 2.6. Only one patient showed no signs of gingival inflammation, while 57.6% had a maximum PSI of 2 or less. Positive functional findings were assessed clinically in more than half of the patients. Major diagnosis by RDC/TMD was osteoarthrosis. Patients with at least one positive anamnestic or clinical functional finding revealed significantly higher radiographic scores (CI = 0.440, p = 0.022). Patients with increased c-reactive-protein had a significantly higher PBI (Z = –2.118, p = 0.034) and increased radiographic scores (CI = 0.408, p = 0.043). Conclusions: Adolescents suffering from JIA show high levels of caries experience and gingival inflammation. Temporomandibular joint dysfunction is often seen in JIA patients. Consequently, special dental care programs would be recommendable.

Correlation between mandibular condylar position and clinical dysfunction index after bilateral sagittal split osteotomies

Correlation between mandibular condylar position and clinical dysfunction index after bilateral sagittal split osteotomies

Temporomandibular Dysfunction After Surgery of Mandibular Fractures Not Involving the Mandibular Condyle: A Prospective Follow-Up Study

Facial trauma can lead to temporomandibular dysfunction (TMD). The aim of this study was to clarify the occurrence and characteristics of TMD in patients surgically treated for mandibular fractures not involving the mandibular condyle. This prospective single-center follow-up study was composed of patients who underwent surgery for non-condylar mandibular fracture. Patients were evaluated at presentation and 6months after surgery to assess the function of the masticatory system using the Helkimo index. Specifically, this index incorporates 2 complementary subindices: the subjective symptomatic (anamnestic) index (Ai) and the objective clinical dysfunction index (Di). The Ai score was recorded at presentation and 6-month follow-up. The Di score was recorded at 6-month follow-up. Thirty-one patients completed the study. All patients were men (mean age, 26.2yr; range, 18 to 47yr). Four (12.9%) developed severe symptoms of dysfunction during the study period according to the Ai. Clinical findings (Di) were observed in 25 patients (80.6%), but these were not associated with symptoms of dysfunction. TMD is common 6months after surgery in patients with non-condylar mandibular fractures. Patients with such fractures should be evaluated for dysfunction during follow-ups and referred for further treatment if necessary.

Assessment of the impact of temporomandibular disorders on maximum bite force.

Temporomandibular disorders (TMD) refer to functional disorders of the masticatory system, temporomandibular joint (TMJ) and masticatory muscles. The main objective of this study was to determine whether and to what extent temporomandibular disorders (TMD) affect the maximum bite force (MBF). The present study included subjects with and without temporomandibular disorder. The presence of TMD was assessed by means of the Helkimo clinical dysfunction index analysis. We measured the maximum bite pressure (MBP) and occlusal contact area (OCA) by means of a Fuji Prescale Pressure measurement film. Based on the MBP and OCA values obtained, MBF values were determined. The MBF values were significantly lower in patients with TMD compared to subjects without TMD (P Conclusion: TMDs have a significant impact on MBF and masticatory muscle action potential. More research is needed to determine the impact of reduced maximum bite force on the functional efficiency of the masticatory system.

Investigating possible correlation between condylar asymmetry and clinical dysfunction indices in patients with temporomandibular dysfunction using Cone-beam computed tomographic

PurposeTemporomandibular disorder (TMD) is a common problem in modern societies. Causes of TMD, as a consequence of condylar asymmetry index (CAI), are still a subject of controversy. The aim of the present study was to determine the possible correlations between the degree of condylar asymmetry and clinical dysfunction indices. Materials and methodsIn this cross-sectional study, we used the Habets method to measure the CAI in 42 TMD patients. The participants' age and sex were matched in the control group. Patients were divided into mild, moderate and severe dysfunction groups based on Helkimo's clinical Di. The data were analyzed using Mann–Whitney U and Kruskal–Wallis tests. Also, the study attempted to assess the possibility of correlation between age and CAI. ResultsThe CAI values of TMD patients were significantly higher than those of the control group (P = 0.001). However, CAI was not significantly different among TMD patients with different dysfunction index. There was no significant correlation between CAI and age (Spearman r = 0.655, P = 0.23). ConclusionBased on the findings of the present study, patients with condylar asymmetry index are more susceptible to TMD. However, degree of the condylar asymmetry is not a criterion for TMD signs and symptoms.

Evaluation of Functional Therapy Vs Intermaxillary Fixation in Condylar Fracture Treatment

Purpose: To compare the outcomes after rigid intermaxillary fixation (IMF) versus functional therapy (FT) in patients with mandibular condylar fractures (CFs). Patients and Methods: A prospective comparative study with 3 follow-ups (FU) at 1, 3 and 6 months was undertaken in 2 groups, which exclusively privileged either surgical or conservative treatment due to different therapeutic agendas. Patients from Group1 (GI) received IMF for 10 days, followed by physiotherapy, whereas those in Group2 (GII) had undergone FT for 21 days via guiding elastics. In both groups, all concomitant fractures (if present) were treated by open reduction and internal fixation (ORIF). Patients with unilateral CFs, with or without concomitant mandibular fractures showing one or more of the following conditions were included: adult patients (>18 years of age) indicated for closed treatment, and sufficient dentition for arch bars application. Previous history of tempromandibular joint (TMJ) dysfunction, severe pre-traumatic skeletal dysgnathia, and mid face fractures was excluded. Results: 12 patients (6 in GI and 6 in GII) were included. The clinical TMJ Dysfunction Index of Helkimo (CTDI-H) was equal in both groups at 1 month FU, it became worse in GI than in the GII at 3 month FU, corresponding to better function on the short-term. At the 6 month FU, there were better values in the GII. The Magnetic Resonance Imaging (MRI) scans revealed that the trauma caused disc displacement for 33.3% of GI and 66.7 % of GII. At 6 months FU, 33.3% of GI had improvement in the degree of the disc displacement, but they still had internal derangement with reduction. In GII, 2 out of 4 retained the normal position of the disc and the others had improvement in the disc displacement degree only. Conclusion: Both treatment options may yield acceptable results, however, FT seems to be the appropriate treatment for rapid recovery of range of mandibular motion (ROMM), relief of pain during palpation of masticatory muscles, and recovery of disc position during FU. Its success depends on the passive maneuver of physiotherapy if there is no restricted maximum interincisal opening (MIO) and it should be in a forcible manner in case of restricted MIO.

Clinical Outcome of Sodium Hyaluronate Injection into the Superior and Inferior Joint Space for Osteoarthritis of the Temporomandibular Joint Evaluated by Cone-Beam Computed Tomography: A Retrospective Study of 51 Patients and 56 Joints.

BackgroundThe aim of this study was to determine the clinical effects of sodium hyaluronate injection into the superior and inferior joint space for osteoarthritis of the temporomandibular joint (TMJ) and to evaluate the joint changes using cone-beam computed tomography (CBCT).Material/MethodsA retrospective observational clinical study included 51 patients and 56 TMJs, with a diagnosis of osteoarthritis. All patients received sodium hyaluronate injections into the superior and inferior TMJ joint spaces (articular cavities). At baseline and post-treatment the condylar bony changes were evaluated by CBCT. To evaluate TMJ function, maximum mouth opening (MMO), and Helkimo’s index was used, which included an anamnestic index (Ai) and a clinical dysfunction index (Di). Patients were divided into short-term (<one year) and long-term (>one year) follow-up groups.ResultsIn both patient follow-up groups, sodium hyaluronate injection of the superior and inferior TMJ space significantly improved MMO, the Ai, and the Di (P<0.05). There were no significant differences between the two groups in condylar bony changes of the TMJ seen by CBCT (sclerosis, erosion, hyperplasia, and flattening) (P>0.05). CBCT showed a good predictive ability on post-treatment symptom relief following sodium hyaluronate injection into the superior and inferior TMJ space in patients with osteoarthritis of the TMJ (P=0.024).ConclusionsThe findings of this clinical and CBCT imaging study showed that sodium hyaluronate injection into the superior and inferior TMJ space in patients with osteoarthritis improved clinical symptoms, but did not control the progression of osteoarthritic joint destruction.

Postoperative temporomandibular dysfunction in patients with fractures of the zygomatic complex: a prospective follow-up study

The aim of this prospective follow-up study was to clarify the incidence and characteristics of dysfunction of the temporomandibular joint (TMJ) in patients treated surgically for fractures of the zygomatic complex. Patients were evaluated on presentation and six months after injury to assess the function of the masticatory system using the Helkimo index, which incorporates two complementary subindices: the subjective symptomatic (anamnestic) index (Ai) and the objective clinical dysfunction index (Di). Forty-five patients (12 women and 33 men, mean (range) age 44 (21-83)years) completed the study. Six patients developed subjective symptoms of dysfunction of the TMJ during follow-up, in four of whom they were severe. Clinical findings were noted in 38 patients but without significant association with subjective symptoms.Dysfunction of the TMJ is common six months after surgical treatment of a fracture of the zygomatic complex, and patients with such fractures should be evaluated for temporomandibular dysfunction during follow-up and referred for treatment when necessary.

OZONE THERAPY AS A TREATMENT MODALITY FOR TEMPORO-MANDIBULAR JOINT DYSFUNCTION

Temporo-mandibular (TMJ) disorders are of multi-factorial etiology. Numerous attempts have been made to identify the causes however, a great controversy still exists. Emotional stress, malocclusion and bruxism of the teeth are thought to be important factors in TMJ disorders. The limitations of mouth opening, deviation of the mandible on opening, joint noises and pain are among the common signs and symptoms of TMJ disorders. Concerning the treatment, different surgical and non- surgical techniques have been tied by several clinicians. In the recent years, ozone therapy is tried as a new treatment modality for many diseases particularly joint affection. So this study was carried out to assess the clinical outcome of ozone therapy in TMJ disorders. Twenty five patients (16 Females, 9 Males) complaining of TMJ disorders were selected for this study.Every affected joint received 2 ml of ozone gas in concentration of 10 ?g/ml by direct injection of the gas into the joint cavity. The injection was repeated two times per week for tree weeks.The clinical signs &amp; symptoms before and after treatment were assessed according to Helkimo's clinical dysfunction index. The results showed that, 84% of the patients became symptoms free or improved while; only 16% showed unchanged signs and symptoms after completion of the treatment protocol.

Temporomandibular dysfunction and functional mandibular limitation

Background: The temporomandibular dysfunction (TMD) is one of the most complex disorders of the body, capable of triggering changes in mandibular function and speech articulation. In the case of teachers, probably due to long periods of speech, since it is known that most of them work in classrooms with too many students, end up making use of the voice incorrectly and may lead to changes in the function of the stomatognathic system. Objective: To investigate the association between TMD and mandibular functional limitation in teachers of an elementary school in the city of Uberlandia. Methods: The study was carried out in 49 teachers. The data were collected through Helkimo’s Clinical Dysfunction Index (IDCCM) and Mandibular Function Impairment Questionnaire (MFIQ). Results: It was observed that all teachers in both genders showed some degree of TMD and, consequently, the higher the TMD degree the greater is the changing the jaw function. Conclusions: Based on the data and through studies carried out with this group of teachers, it is concluded that as the TMD degree increases, it causes alteration of the mandibular function and can lead to a decreased in the mandibular amplitude and to limit movement.

Comparison of temporomandibular disorders between menopausal and non-menopausal women.

ObjectivesHormonal changes during menopause alter a woman's susceptibility to some disorders. Information regarding the prevalence of temporomandibular disorder (TMD) in menopausal women is limited in the literature. In this study, the prevalence and severity of TMDs were compared between menopausal and non-menopausal women.Materials and MethodsThe study included 140 women (69 premenopausal and 71 postmenopausal) 45 to 55 years of age that were examined in Shiraz Dental School, Shiraz in Iran. The Helkimo clinical dysfunction index (Di) was used to evaluate temporomandibular joint (TMJ) dysfunction. The data were analyzed using chi-square and Fisher's exact tests.ResultsOccurrence of TMD was significantly higher in menopausal than non-menopausal women (P<0.001). All the TMD criteria based on Helkimo Di except range of mandibular movement were significantly more common in menopausal women. The range of mandibular movement was not significantly different between menopausal and non-menopausal women (P=0.178).ConclusionThe results from this study show that TMD can be considered more common and severe in menopausal than non-menopausal women. This finding indicates that, similar to other conditions in menopausal women such as arthritis and osteoporosis, TMD should be taken into consideration by dental and medical professionals.

Correlations between the Helkimo indices and the maximal mandibular excursion capacities of patients with temporomandibular joint disorders

Temporomandibular disorders (TMD) may present with diverse signs and symptoms, and one very significant is the limitation of mandibular movements. Additionally, the Helkimo indices allow for the reliable quantification of the signs and symptoms of TMD. The purpose of this study was to ascertain whether there are any correlations between the Helkimo indices and the maximal mandibular excursion capacity in a group of patients with TMD. Eighty patients (72 women and 8 men, mean age 33.6 years) with diagnosis of TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were evaluated to obtain the Helkimo indices and their maximal mandibular excursion capacities. Normal or decreased maximum mandibular movements, i.e., opening, lateral and protrusion were compared with the anamnestic index, muscular pain symptoms, joint pain symptoms and the dysfunction index. Chi-squared analysis was used to compare normal and decreased movement capacities in terms of the Helkimo indices, and the muscle and temporomandibular joint (TMJ) pain. The statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 19.0. There were statistically significant differences in the clinical dysfunction index with the maximum opening (p = .011) and lateral movements (p = .024) but not with the maximum protrusion. There were no significant differences in the anamnestic index or the muscle pain and TMJ pain items of the clinical dysfunction index according to the mandibular excursions. The occurrences of limitations in the maximum opening and lateral movements are indications of greater TMD intensity.

Discectomy without replacement improves function in patients with internal derangement of the temporomandibular joint

PurposeTreatment of internal derangement is controversial. This study assessed the effectiveness of discectomy without replacement in improving jaw function and decreasing pain. Materials and methodsA retrospective cohort study sample of subjects with internal derangement underwent discectomy without replacement by one surgeon at a single academic medical center. The primary predictor variables were preoperative maximal incisal opening (MIO) and Helkimo Clinical Dysfunction Index (CDI) score. The primary outcome variable was postoperative MIO and CDI score. A paired student's t-test assessed the difference between pre- and post-operative MIO and CDI scores. ResultsPreoperatively, all patients had a clinical dysfunction index of DiIII, indicating severe dysfunction. Postoperatively 14 of 17 subjects (82%) showed marked improvement in mandibular function, and reduction in pain characterized as clinically symptom-free or only small dysfunction (DiO or DiI). One subject improved to DiII and two remained DiIII due to poor compliance. Preoperatively all subjects had an anamnestic index of AiII, representing TMJ locking or severe TMJ or muscle pain. Postoperatively 15 of 17 patients (88%) improved to AiO or AiI, and the two patients with poor compliance remained at AiII, but with marked pain reduction. Of the 17 subjects, the mean pre- and post-operative MIO was 24.2 mm and 34.9 mm, respectively (p < 0.001). There was a significant difference in pre- and post-operative MIO in subjects with Wilkes III (p = 0.005) and Wilkes IV (p = 0.008), but not Wilkes V (p = 0.7). Mean pre- and post-CDI scores were 17.3 and 3.8, respectively (p < 0.001). When stratifying by Wilkes stage, there was a significant difference in pre- and post-operative CDI in subjects with Wilkes III (p < 0.001) and Wilkes IV (p < 0.001), but not Wilkes V (p = 0.1). ConclusionsIn Wilkes III and IV subjects, discectomy without replacement is effective in improving MIO based upon improvement in objective and subjective assessments.

The association between condylar bone changes revealed in cone beam computed tomography and clinical dysfunction index in patients with or without temporomandibular joint disorders

The aim of the present study was to compare cone beam computed tomography (CBCT) findings pertinent to patients with temporomandibular disorder (TMD) and patients without TMD (non-TMD), as well as to investigate the correlation between these findings and the clinical dysfunction index (Di). In this cross-sectional study, CBCT images of temporomandibular joints (TMJs) were evaluated for condylar bone changes in 84 patients with TMD. The patients were assigned a score using Helkimo's clinical Di, ranging from 1 to 25, and were thereafter subdivided into 3 groups based on the degree of Helkimo's Di. CBCT and clinical records of sex- and age-matched non-TMD patients were used as the control group. There was a significant difference in the prevalence of all types of bone changes between TMD and non-TMD groups (all P<.05), except for loose joint bodies. Furthermore, there was a significant correlation between the total amount of bone change and the Helkimo Di score (P<.001). Evaluation of CBCT images in the present study revealed significant differences between TMD and non-TMD condyles. There was also a significant relationship between the Helkimo clinical Di and the total amount of condylar bone change in patients with TMD.

Assessment of the Relationship Between Clinicophysiologic and Magnetic Resonance Imaging Findings of the Temporomandibular Disorder Patients.

Temporomandibular joint disorders (TMJDs) are a complex group of disorders that comprise dysfunctions of the temporomandibular joint (TMJ). In this study, we analyzed the objective and subjective findings of the TMJD patients by using Helkimo anamnesis (Ai) and clinical dysfunction (Di) indices, and tried to document a relation between these findings and magnetic resonance imaging (MRI) results.Ninety-eight patients who were admitted to our clinic were included in the study. The clinical evaluation was performed by using Ai, an 8-question-survey based on the objective symptoms of patients; Di, concluded as the score of 5 objective measurements of physical examination. The morphology of the TMJ was evaluated by MRI, and the findings were analyzed and statistically compared with respect to the Di.The most commonly seen symptoms were noise during mandibular movement (58%), pain around the joint (42.5%), and pain with mandibular movements (40%). Seventeen patients (17.3%) were Di0, 47 (48%) were DiI, 24 (24.5%) were DiII, and 10 (10.2%) were DiIII. Thirty-seven patients (37.8%) had abnormal MRI findings, whereas 61 patients (62.2%) had normal MRI. The most commonly encountered pathology was anterior disc displacement with reduction, which was reported in 15 patients. Increased TMJ Di, which points a more progressed TMJD, was found to be significantly related with the pathological MRI findings (P < 0.05).MRI is especially effective in particularly those with high Di; therefore, the results of the study may give a prospect in which types of patients does MRI give a valuable data toward diagnosis, in which stages of the TMJD should we expect pathological findings, and thereby preventing unnecessary use of MRI in patients with symptoms of TMJD.