Common Temporomandibular Disorders Research Articles

Temporomandibular Disorders and Orthodontics: how to conduct a screening examination?

Common Temporomandibular Disorders (TMD) involve the masticatory muscles, temporomandibular joints, and/or their associated structures. Clinical manifestations can vary, including sounds (cracking, crepitus), pain, and/or dyskinesias, often corresponding to a limitation of mandibular movements. Signs or symptoms of muscular or joint disorders of the masticatory system may be present before the initiation of orthodontic treatment, emerge during treatment, or worsen to the point of stopping treatment. How do you screen for common TMD in orthodontic treatment? The main elements of the interview and clinical examination for screening common TMD in the context of orthodontic treatment are clarified and illustrated with photographs. Moreover, complementary examinations are also detailed. A clinical screening form for common TMD is proposed. A synthetic decision tree helping in the screening of TMD is also presented. In the context of an orthodontic treatment, the screening examination for common TMD includes gathering information (interview), a clinical evaluation, and possibly complementary investigations. The orthodontist is supported in this approach through the development of a clinical form and a dedicated synthetic decision tree for the screening of TMDs. Systematically screening for common TMD before initiating orthodontic treatment allows the orthodontist to suggest additional diagnostic measures, implement appropriate therapeutic interventions, and/or refer to a specialist in the field if necessary.

Age distribution of East Asian TMD patients and age-related differences in DC/TMD axis I findings.

The pattern of age distribution in East Asian temporomandibular disorder (TMD) patients and age-related differences in DC/TMD diagnostic subtypes/categories were evaluated. TMD patients from two University-based centers in China and South Korea were enrolled. Axis I physical diagnoses were rendered according to DC/TMD. Patients were categorized into six age groups (15-24, 25-34, 35-44, 45-54, 55-64, and 65-84 years; Groups A-F respectively). Youths/young adults (Groups A-C) formed 74.1% of TMD patients. TMJ disc displacements (74.9%), arthralgia (49.2%), and degenerative joint disease [DJD] (36.8%) were the most common TMD subtypes. The majority had combined (54.0%) and chronic (58.5%) TMDs. Youths/young adults and middle-aged/old adults had substantially lower frequencies of merely pain-related (6.2-14.5%) and intra-articular (13.8-16.8%) TMDs correspondingly. "Being female" increased the prospects of pain-related/combined TMDs by 96%/49%, respectively. East Asian TMD patients comprised mostly of youths/young adults who had an alarmingly high prevalence of TMJ DJD.

A Bibliometric Analysis of Research on Temporomandibular Joint Disc Displacement from 1992 to 2022.

The temporomandibular joint (TMJ) disc displacement is the most common temporomandibular disorders (TMD) condition. It causes clicking, pain, limited mandibular movements, and even masticatory difficulties in many people. The aim of this study is showcasing hotspots and frontiers in the field and providing a reference for the future research by a bibliometric analysis. Studies published from 1992 to 2022 were retrieved from Web of Science Core Collection on 23 April 2023. A total of 1882 studies (1739 articles and 143 reviews) were included in the bibliometric analysis. From 1992 to 2022, the annual number of publications and citations greatly increased. The United States of America (USA) contributed the most publications about TMJ disc displacement. Shanghai Jiao Tong University was the most productive institution; meanwhile, Yang, C. from this institution was the most prolific author. The University of Washington was the most influential institution, and Brooks, S. was the most influential author. Diagnostic criteria and management of TMJ disc displacement, as well as TMJ disc displacement-associated conditions, might be a hotspot for current global research. We provided an objective and valuable reference for future research on TMJ disc displacement.

A Study to Assess Etiology and Prevalence of Signs and Symptoms of Temporomandibular Disorder.

The purpose of this epidemiological research was to determine how common temporomandibular disorder (TMD) symptoms are. Among the outpatient population, a sample of 100 people was chosen at random. A patient survey was presented to each person, and points were allotted based on their responses. Participants were categorized as having no symptoms of TMD, mild TMD, moderate TMD, or severe TMD based on their total score. One hundred adults aged 18 and above were selected from the general public to take part in the research. Temporomandibular disorder was present in no more than 30% of those studied, in the mild range in 50%, in the moderate range in 15%, and in the severe range in 5%. 0.602 was determined to be the dependability of Fonseca's questionnaire. The Fonseca questionnaire is a useful instrument for gauging the extent to which TMD symptoms are present in a given population. The screening questionnaire may be received in a short amount of time and for little money, making it a good option for public health services.

Relationships between tooth wear, bruxism and temporomandibular disorders.

This article will provide an overview of the diagnosis of common temporomandibular disorders (TMDs) and bruxism, along with their relevance in management of tooth wear. When assessing and managing a tooth wear case, the teeth should not be considered in isolation, but as part of the articulatory system, which has three inter-related elements: the teeth, the temporomandibular joints and the masticatory muscles. The presence/absence of bruxism and TMD are highly relevant, although there may not be a causal relationship between these. A consideration of TMD and bruxism, together with the potential impact these may have on the patient during and after any management of tooth wear, will form part of patient education and the informed consent process.

Arthroscopic Disc Suturing and Repositioning Technique for Treating Anteriorly Displaced Disc in Temporomandibular Joint Disorders: A Posterior Anchorage Technique

Several treatment modalities have been reported for patients with arthrogenous temporomandibular disorders. The most common temporomandibular disorder is internal derangement, usually accompanied by displacement of the articular disc. Most often anteriorly and medially displaced, patients may develop clicking, impaired jaw function, and pain. Articular disc repositioning has been described as an effective method to eliminate interference during mandibular translation, improving mandibular range of motion, and eliminating pain. In this article, we present a new, simple, and reproducible technique without requiring specific instruments for repositioning and suturing the articular disc with posterior anchorage fixed to the tragus cartilage. It has the advantages of a better anteroposterior vector of traction force, without adverse effects as lateralization of the articular disc and skin depression, commonly presented in other techniques.

THE VOICE OF THE PATIENT IN OROFACIAL PAIN MANAGEMENT.

As pain cannot be measured objectively, the use of patient reported outcomes (PROs), and specifically dental PROs (dPROs), is essential for adequate assessment and management of the patient with orofacial pain. For orofacial pain conditions, some of the suitable PROs are specific to dentistry and hence can be labelled dPROs, whereas others are not. There is also a need to understand which outcomes and domains are most relevant to the patient with pain complaints within the context of the biopsychosocial model. Acute pain in the orofacial area is most often related to toothache, whereas the most common chronic orofacial pain are temporomandibular disorders. Other chronic pains in the orofacial area include neuropathic pain and unknown or idiopathic pain. PROs have been fundamental in the development of both screening procedures and diagnostic criteria in temporomandibular disorders. PROs are now often a prerequisite for the most common temporomandibular disorder pain diagnoses. Furthermore, PROs form the basis for decision-making with regard to treatment, prognostics, and referrals. Future areas of development include the standardized use of PROs in the screening and diagnostics of the less common orofacial pain conditions, together with development of core outcomes sets and standardized protocols for the use of PROs in evaluation of treatment including efficacy, compliance, adherence, and side-effects.

Acute arthritis of the right temporomandibular joint due to Lyme disease: a case report and literature review

BackgroundLyme disease is the most frequent tick-borne infectious disease in Europe. It often presents with a wide variety of symptoms. For this reason, affection of the temporomandibular joint (TMJ) caused by Lyme disease (LD) can be misdiagnosed as a common temporomandibular disorder (TMD).Case presentationThe purpose of this case report of a 25-year-old woman presenting to the Departments of Orthodontics and Oral and Maxillofacial Surgery with extensive symptoms of temporomandibular disorder is to illustrate the delayed diagnosis of Lyme disease which was only made after extensive therapy of the temporomandibular joint. The specialist literature only reports a few cases of patients suffering from Lyme disease with TMJ manifestations.ConclusionThis case report and the relevant literature review aim to emphasize the importance of accurate request of medical history and differential diagnosis of acute TMJ arthritis and arthralgia. Early interdisciplinary diagnosis of Lyme disease and early antibiotic therapy are essential to avoid misdiagnosis and unnecessary, sometimes invasive, therapies.

Temporomandibular Disorders and Its Management in Dentistry: A Review

Temporomandibular disorders (TMD) is a collective term for a group of musculoskeletal conditions involvingpain and/or dysfunction in the masticatory muscles, temporomandibular joints (TMJ) and associatedstructures. It is the most common type of non-odontogenic orofacial pain and patients can present with painaffecting the face/head, TMJ and/or teeth, limitations in jaw movement and sounds in the TMJ during jawmovements. Comorbid painful and non-painful conditions are also common among individuals with TMD.The diagnosis of TMD have significantly improved over time with the recent Diagnostic Criteria for TMD(DC/TMD) being reliable and valid for most common diagnoses, and an efficient way to communicate inmultidisciplinary settings. This classification covers 12 most common TMD, including painful (myalgia,arthralgia and headache attributed to TMD) as well as the non-painful (disc displacements, degenerativejoint disease and subluxation) TMD diagnoses. Recent studies have demonstrated that the pathophysiologyof common painful TMD is biopsychosocial and multifactorial, where no one factor is responsible for itsdevelopment.Importantly, research has suggested different predisposing, initiating and perpetuating factors, includingboth peripheral and central mechanisms. This is an active field of investigation and future studies will notonly seek to clarify specific causal pathways but translate this knowledge into mechanism-directed diagnosisand treatment. In accordance with this complex aetiology, current evidence supports primarily conservativemultidisciplinary treatment including self-management strategies, behavioural therapy, physical therapy andpharmacotherapy. The aim of this review is to present an overview of most recent developments in aetiology,pathophysiology, diagnosis and management of TMD.

Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders.

Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of the contracted skeletal muscle fibers. A correct clinical treatment of myofascial pain has the potential to modify the functional activation of cerebral networks associated with pain and unconscious teeth clenching, specifically the pain network (PN) and default mode network (DMN). In this study, research is presented as a case series of five patients with myofascial pain: three were diagnosed with intra- and extra-articular disorders, and two were diagnosed with only extra-articular disorders. All five patients received gnathological therapy consisting of passive splints and biofeedback exercises for tongue–palatal vault coordination. Before and after treatment, patients underwent pain assessments (through measures of visual analog scales and muscular palpation tests), nuclear magnetic resonance of the temporomandibular joint, and functional nuclear magnetic resonance of the brain. In each patient, temporomandibular joint nuclear magnetic resonance results were similar before and after the gnathological treatment. However, the treatment resulted in a considerable reduction in pain for all patients, according to the visual analog scales and the palpation test. Furthermore, functional nuclear magnetic resonance of the brain clearly showed a homogeneous modification in cerebral networks associated with pain (i.e., PN and DMN), in all patients. In conclusion, gnathological therapy consisting of passive aligners and biofeedback exercises improved myofascial pain in all five patients. Most importantly, this study showed that all five patients had a homogeneous functional modification of pain and default mode networks. Using passive splints in combination with jaw exercises may be an effective treatment option for patients with TMD. This research could be a starting point for future investigations and for clinicians who want to approach similar situations.

Temporomandibular disorders: a review of current concepts in aetiology, diagnosis and management.

Temporomandibular disorders (TMD) is a collective term for a group of musculoskeletal conditions involving pain and/or dysfunction in the masticatory muscles, temporomandibular joints (TMJ) and associated structures. It is the most common type of non-odontogenic orofacial pain and patients can present with pain affecting the face/head, TMJ and or teeth, limitations in jaw movement, and sounds in the TMJ during jaw movements. Comorbid painful and non-painful conditions are also common among individuals with TMD. The diagnosis of TMD have significantly improved over time with the recent Diagnostic Criteria for TMD (DC/TMD) being reliable and valid for most common diagnoses, and an efficient way to communicate in multidisciplinary settings. This classification covers 12 most common TMD, including painful (myalgia, arthralgia and headache attributed to TMD) as well as the non-painful (disc displacements, degenerative joint disease and subluxation) TMD diagnoses. Recent studies have demonstrated that the pathophysiology of common painful TMD is biopsychosocial and multifactorial, where no one factor is responsible for its development. Importantly, research has suggested different predisposing, initiating and perpetuating factors, including both peripheral and central mechanisms. This is an active field of investigation and future studies will not only seek to clarify specific causal pathways but translate this knowledge into mechanism-directed diagnosis and treatment. In accordance with this complex aetiology, current evidence supports primarily conservative multidisciplinary treatment including self-management strategies, behavioural therapy, physical therapy and pharmacotherapy. The aim of this review is to present an overview of most recent developments in aetiology, pathophysiology, diagnosis and management of TMD.

Prevalence of Temporomandibular Disorders and Anxiety State Levels in Ballet Dancers A Cross-Sectional Study.

This study evaluated the prevalence of temporomandibular disorders (TMDs) in ballet dancers and explored their association with levels of anxiety. Participants were 51 male and female ballet dancers with a mean age of 31.5 ± 12.6 years. The diagnosis of TMDs was made in accordance with Research Diagnostic Criteria for Temporomandibular Joint Disorders (RDC/TMD). All subjects completed the state part of an anxiety questionnaire (STAI). Data were gathered and analyzed using the R statistical software (version: 3.4.0.) with level of significance set at 5%. The prevalence of all TMDs in the sample was 78%; that is, of the 51 participants, 39 had at least one positive diagnosis. The two most prevalence diagnoses were disk displacement with reduction and arthralgia. Individuals with TMD had a mean anxiety score of 42.55 ± 9.92 on the STAI, whereas for those without TMD it was 44.27 ± 11.89, with no statistically significant difference (p = 0.53). It is concluded that the general prevalence of TMDs in ballet dancer is higher than in the population at large. Disk displacement with reduction and arthralgia are the most common TMDs, and the presence of TMDs does not seem to affect anxiety state levels in this population.

Headache Attributed to Temporomandibular Disorders. Case Report

The goal of this article was to review the most common temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular disorders (DC/TMD) emphasizing in the criteria for headache attributed to TMD. By presenting a clinical case that shows the characteristics of a patient with masticatory myofascial pain, arthralgia of the temporomandibular joint and headache attributed to TMD. A case of a 34-year-old female patient is presented, the diagnostic process and its approach: self-care, modification of parafunctional habits and behaviors, physical therapy and pharmacological support.

Plasma rich in growth factors injection effectiveness for myofascial pain treatment in masticatory muscles. Randomised controlled trial.

Myofascial pain in masticatory muscles is one of the most common temporomandibular disorder. Nowadays, the most usable treatment methods are based on the muscle taut band cell membrane disruption, which releases the taut band. Platelet-rich plasma, made with PRGF Endoret® method, gives an opportunity to use platelet-derived growth factors in treatment processes. It has been proven that platelet-derived growth factors can relief pain and activate muscle regeneration. To test a hypothesis that PRGF injections can be effective for treating myofascial pain in masticatory muscles. Fifty adult patients participated in the study. Participants were randomly divided into two groups. The first group received 1-mL lidocaine injections to trigger point in their masseter muscle. The second group of patients received 1-mL PRGF injections. The patients' pain was measured by using visual analogue scale (VAS). Statistically significant difference in pain levels before the procedure and 4weeks after it was found in both groups. There was no statistically significant difference between groups in pain levels before the procedure (P=.063) and 2weeks after it (P=.123); however, statistically significant difference was noticed 4weeks after the procedure (P<.001). Four weeks after the procedure, patients' average pain in lidocaine group was 3.4 on VAS, and it was 0.9 in PRGF group. PRGF injections in masseter muscle affected by myofascial pain syndrome are an effective treatment method. PRGF injections more effectively relief myofascial pain in masseter muscle than lidocaine injections.

The prevalence of temporomandibular disorders in chronic hemodialysis patients: a cross-sectional study

ABSTRACT Objective: This study aimed to investigate the prevalence of temporomandibular disorders (TMD) in patients with chronic hemodialysis and evaluate the risk factors of developing TMD. Methods: One hundred forty-six subjects were included in the study. The examination for TMD was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. Axis I protocol was used to evaluate the prevalence of TMD sub-diagnoses. Results: The prevalence of TMD was 41.5% in hemodialysis patients and significantly higher than in the control group. The most common symptom was TMJ pain, and the most common TMD subtype was muscular type. Female patients had significantly higher TMD than males. C-reactive protein, hemoglobin, parathyroid hormone, and albumin were significantly associated with TMD. Conclusion: There was an elevated prevalence of TMD in hemodialysis patients.

Knowledge and management of temporomandibular joint disorders by general dentists in Spain.

BackgroundGiven the importance of temporomandibular disorders (TMD), we tried to assess general dentists’ knowledge regarding etiology, diagnosis, and treatment in order to understand their attitude.Material and MethodsA sample of 130 general dentists answered a 16-item questionnaire on three areas – etiology, diagnosis, and management of common temporomandibular disorders – as well as a question on the need for continuous education regarding TMD management in common clinical practice in Spain. Given that the descriptive statistics achieved reflect significantly different values among means in each area, a variance analysis for repeated measurements was applied in order to contrast differences among etiology, diagnosis, and management knowledge levels.ResultsThe contrast test was based on Wilks’ Lambda, which assumed a value of 0.120 (F = 467.28; p<.001), demonstrating statistically significant differences among knowledge levels in the three dimensions. The effect size for these differences, measured by partial eta squared, was very high (η2p = 0.88). Such parameters were also analyzed to search for potential differences according to professional experience, with differences being exposed as non-significant at the 0.05 level: etiology (T = 1.60; p = 0.113), diagnosis (T = - 0.17; p = 0.868), and treatment (T = 1.10; p = 0.273).ConclusionsOur study found that, even though clinicians are generally skilled regarding the knowledge of the etiologic that explain the diagnosis of TMD, they have room for improvement in terms of TMD management compared to the other two areas studied. General dentists could benefit from specific educational programs enhancing TMD management skills. Key words:Temporomandibular disorders (TMD), knowledge and management. Clinical competence, postgraduate, continuing professional development. Surveys, education,orofacial pain.

Prevalence of temporomandibular disorders (TMD) among Finnish prisoners: cross-sectional clinical study

Objective: The aim of the present study was to evaluate the prevalence of self-reported temporomandibular disorders (TMD) symptoms and clinically diagnosed TMD among Finnish prisoners.Material and methods: Altogether 100 prisoners from the Pelso Prison, Vaala, Finland, underwent dental and TMD clinical examinations performed by a calibrated and well-trained dentist. Symptom Questionnaire and clinical examination according to a Finnish pre-final version of the DC/TMD (Diagnostic Criteria for Temporomandibular Disorders) Axis I protocol were used to evaluate the prevalence of TMD sub-diagnoses.Results: The most common TMD symptoms were facial pain (54.0%), temporomandibular joint noises (43.0%) and headache (37.0%). The prevalence of joint-related TMD diagnoses was four and a half times higher than diagnoses attributed with pain (76.0% vs. 17.0%). The most common TMD diagnoses were degenerative joint disease (33.0%) and disc displacement with reduction (33.0%).Conclusions: The prevalence of self-reported TMD symptoms and clinical assessed TMD, especially join-related TMD diagnoses, is high among Finnish prisoners. Examination and treatment of TMD should become a common practice also in prison dental care.

Prevalencia de los trastornos temporomandibulares y factores asociados más comunes presentados en las clínicas de la Universidad Santo Tomás en el segundo periodo del año 2016

Objetivo: Establecer la prevalencia de los trastornos temporomandibulares (TTM) presentados por los pacientes que acudieron a las clínicas odontológicas de noveno y décimo semestre de la Universidad Santo Tomás en el segundo período de 2016.&#x0D; Materiales y Métodos: Se realizó un estudio observacional descriptivo de corte transversal, con una muestra de 113 historias clínicas, se recolectó la muestra de historias clínicas ya diligenciadas de las clínicas de noveno y décimo semestre de la Universidad Santo Tomás en el segundo periodo del año 2016. Usando estadística descriptiva para el análisis Univariado. En el análisis bivariado, se estableció relación entre TTM y las variables de interés mediante la prueba t-student y Chi-cuadrado donde un valor de p≤0,05 fue considerado estadísticamente significativo.&#x0D; &#x0D; Resultados: De las 113 historias clínicas se obtuvieron 131 diagnósticos, la prevalencia de uno o más TTM fue del 55,7%, de los cuales el 30,1% fueron mujeres diagnosticadas con TTM; el TTM más prevalente fue la subluxación unilateral en el 11,4% de los casos. De los factores asociados, predominó el ruido articular con 43,4% donde el tipo predominante de ruido fue el clic con 91,8%, seguido por el dolor muscular.&#x0D; Conclusiones: La prevalencia de TTM fue alta, representada en el 55,7% de la población. El TTM más común fue la Subluxación unilateral con un 11,4%. Se encontró asociación estadísticamente significativa entre al menos un factor de tipo signo y síntoma, los factores dentales y uno o más TTM.&#x0D;

Prevalence of temporomandibular disorders among a cohort of university undergraduates in Australia.

The aim of the present study was to determine the prevalence of temporomandibular disorder (TMD) symptoms among dentistry students at James Cook University in Australia, and to determine the associations of TMD symptoms with demographic parameters and compare the prevalence to that of the Australian general population. The study was conducted at the School of Dentistry, James Cook University. Axis I symptom questionnaire of diagnostic criteria for TMD was used to assess the prevalence of TMD symptoms. Additional questions were included to gather demographic information on the participants. Data were collected anonymously via the online survey tool, SurveyMonkey. The overall prevalence of TMD symptoms in this cohort was 77.2%. The most common TMD symptoms were pain (48.5%) and joint noises (48.5%). Females reported a significantly higher prevalence of TMD symptoms than males, with 73 of 88 female respondents (83%) and 32 of 48 male respondents (66.7%) reporting at least one symptom of TMD (P=.030). The overall prevalence of TMD symptoms in the population studied was 77.2%, with female preponderance of TMD symptoms (83%). This is higher than the estimated prevalence (23%) in the Australian general population.

Common symptoms of temporomandibular disorders do not mean same treatment plans: A case series

Temporomandibular disorders (TMDs) present several risks and different contributing factors with consequently diverse treatment approaches. It is important to recognize what patients' characteristics may benefit from orthodontics, from physiotherapy, from other treatment modalities or even from a combined approach. We present three cases of patients with common TMDs signs and/or symptoms and different treatment approaches and outcomes, and our aim is to understand what might explain the different outcomes observed and also provide a rationale about the skeletal, muscular, facial and occlusal characteristics that may be indicative of a particular intervention benefit. It has been shown that orthodontics plays an important role solving occlusal problems as well as changes in the vertical dimension. On the other hand, physiotherapy was effective in pain management and range improvement, when musculoskeletal changes were clearly found. Finally, it has also been shown that a multidisciplinary approach may be crucial, and the clinician should be aware of a comprehensive assessment, valuing all the contributing factors, namely the psychological ones.