Temporomandibular Disorders Research Articles

Revised consensus guidelines for the use of cone-beam computed tomography/ digital volume tomography.

Cone beam computed tomography (CBCT) is established in dentistry for about 20 years. Technique evolved and indications clarified since then and since the Swiss consensus guidelines regarding CBCT were published in 2014 and 2015. Therefore, the Swiss association of dentomaxillofacial radiology decided to initiate the process of updating these guidelines by forming a consensus group divided into a core group responsible for the whole process and an approval group responsible for specific clinical matters. The manuscript outlines the revised guidelines in a practical way and is divided along the different specialties and clinical fields of dentistry. In result the guidelines are updated regarding reconstructive dentistry, orthodontics, geriatric dentistry, temporomandibular joint disorders, maxillofacial traumatology, benign and malignant tumors, assessment and detection of dental foci and endodontic infections and apical surgery. Overall, it can be stated that CBCT is utilized more consistently and somewhat broader than ten years ago. Today CBCT is well established and has proven benefits if indicated and analyzed precisely. Therefore, it might very well become more and more standard in dental radiology.

Resistant and refractory migraine – two different entities with different comorbidities? Results from the REFINE study

BackgroundResistant and refractory migraine are commonly encountered in specialized headache centers. Several comorbidities, mostly psychiatric conditions, have been linked to migraine worsening; however, there is little knowledge of the comorbidity profile of individuals with resistant and refractory migraine.MethodsREFINE is a prospective observational multicenter international study involving individuals with migraine from 15 headache centers. Participants were categorized into three groups based on the European Headache Federation criteria: non-resistant and non-refractory (NRNRM), resistant (ResM), and refractory (RefM). We explored the prevalence of 20 comorbidities at baseline in the three groups.ResultsOf the 689 included patients (82.8% women), 262 (38.0%) had ResM, 73 (10.4%) had RefM and 354 (51.4%) NRNRM. A higher prevalence of psychiatric comorbidities, trigger points, temporomandibular joint disorders, thyroiditis, and cerebrovascular diseases was observed in the RefM group, followed by ResM and NRNRM. Multiple comorbidities were more common in the RefM group, followed by the ResM group and by the NRNRM group (41.6% vs. 24.5% vs. 14.1% respectively; p < 0.001). At the sensitivity analysis, exploring participants with chronic migraine, significant differences among the NRNRM, ResM, and RefM groups were found in the prevalence of anxiety (p < 0.001), asthma and rhinitis (p = 0.013), bipolar and other psychiatric disorders (p = 0.049), cerebrovascular diseases (p < 0.001), depression (p < 0.001), obesity (p = 0.002), thyroiditis (p < 0.001), and trigger points (p = 0.008).ConclusionREFINE data indicate that individuals with ResM and RefM have a higher burden of comorbidities than those with NRNRM. It can be postulated that those comorbidities may have an impact on the progression of migraine from a form that is easy to treat to a form that is resistant or refractory to treatments. Longitudinal studies are needed to understand the direction of the association between ResM or RefM and those comorbidities and if proper treatment of comorbidities might help overcome treatment resistance or refractoriness.

Association Between Temporomandibular Disorders and Irritable Bowel Syndrome: A Scoping Review

Temporomandibular disorders (TMDs) encompass various clinical conditions associated with the temporomandibular joint (TMJ) and the masticatory muscles. TMD symptoms include pain in the orofacial region, restricted or altered mandibular movement, and sounds associated with the temporomandibular joint (TMJ). This condition adversely affects quality of life, social functioning, and daily activities, and may also contribute to widespread pain syndromes and comorbidities, including irritable bowel syndrome (IBS). IBS is a common chronic functional disorder of the lower gastrointestinal tract, characterized by recurrent abdominal pain associated with impaired bowel symptoms. Previous studies indicate an association between TMD and IBS. This scoping review examined the correlation between TMD and IBS concerning their pathology, frequency, and severity, and the potential similarities in how the nervous and endocrine systems influence them. PubMed, SCOPUS, Web of Science, and Google Scholar search engines were utilized to identify suitable studies for this article. Following the application of selection criteria, a total of 58 clinical papers met the eligibility requirements for inclusion in the systematic review. Research showed that both conditions significantly enhance the development of one another and have mutual comorbidities. Both ailments were proven to modify central nervous system processing, leading to high comorbidity in patients. Combining dental and gastroenterological treatments, including a simultaneous therapeutic approach, can significantly enhance patients’ quality of life, but further research is needed for a holistic approach.

The Coexistence of Tinnitus and Temporomandibular Disorder: A Narrative Review on the Importance of an Interdisciplinary Approach

This review focuses on the coexistence of tinnitus and temporomandibular disorders in terms of epidemiological data, etiology, differential diagnosis, treatment, and interaction between the two disorders. PubMed, Google Scholar, and ClinicalKey digital databases were used to search for publications covering the years 2009–2024. Finally, 77 publications were used. The review followed recommendations of the Scale for the Assessment of Narrative Review Articles. The prevalence of tinnitus in individuals with TMD amounted to 2–59% and was reported as the main concomitant symptom. Several studies reported that tinnitus was eight times more common in TMD sufferers. Among patients with tinnitus, TMJ disorders were observed at a frequency of 19%, while in the group presenting with a high severity of the condition, TMJ disorders were observed more frequently (36%). Based on this review, in order to facilitate the diagnosis and future treatment of tinnitus and TMD patients, a proposal for a multidisciplinary diagnostic algorithm is presented in the article. The cooperation of an otolaryngologist, audiologist, neurologist, psychiatrist, dentist, and physiotherapist may be considered in clinical settings.

Understanding Occlusion and Temporomandibular Joint Function Using Deep Learning and Predictive Modeling.

Advancements in artificial intelligence (AI)-driven predictive modeling in dentistry are outpacing the clinical translation of research findings. Predictive modeling uses statistical methods to anticipate norms related to TMJ dynamics, complementing imaging modalities like cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). Deep learning, a subset of AI, helps quantify and analyze complex hierarchical relationships in occlusion and TMJ function. This narrative review explores the application of predictive modeling and deep learning to identify clinical trends and associations related to occlusion and TMJ function. Debates persist regarding best practices for managing occlusal factors in temporomandibular joint (TMJ) function analysis while interpreting and quantifying findings related to the TMJ and occlusion and mitigating biases remain challenging. Data generated from noninvasive chairside tools such as jaw trackers, video tracking, and 3D scanners with virtual articulators offer unique insights by predicting variations in dynamic jaw movement, TMJ, and occlusion. The predictions help us understand the highly individualized norms surrounding TMJ function that are often required to address temporomandibular disorders (TMDs) in general practice. Normal TMJ function, occlusion, and the appropriate management of TMDs are complex and continue to attract ongoing debate. This review examines how predictive modeling and artificial intelligence aid in understanding occlusion and TMJ function and provides insights into complex dental conditions such as TMDs that may improve diagnosis and treatment outcomes with noninvasive techniques.

MiR-374 family is a key regulator of chronic primary pain onset.

Chronic primary pain conditions (CPPCs) are linked to catecholamine activation of peripheral adrenergic receptors. Yet, catecholamine-dependent epigenetic mechanisms, such as microRNA (miRNA) regulation of mRNA transcripts, remain largely unknown. We sought to identify RNA species correlated with case status in 3 pain cohorts, to validate RNAs found to be dysregulated in a mouse model of CPPC onset, and to directly test the role of adrenergic receptors in miRNA regulation. Furthermore, we tested antinociceptive effects of miR-374 overexpression. We used RNA-seq and quantitative reverse transcription polymerase chain reaction to measure RNA expression in 3 pain cohorts. Next, we validated identified RNAs with quantitative reverse transcription polymerase chain reaction in a mouse model of CPPC onset, measuring expression in plasma, peripheral (adipose, muscle, dorsal root ganglia [DRG]), and central (spinal cord) tissues. Then, we stimulated adrenergic receptors in primary adipocyte and DRG cultures to directly test regulation of microRNAs by adrenergic signaling. Furthermore, we used in vitro calcium imaging to measure the antinociceptive effects of miR-374 overexpression. We found that one miRNA family, miR-374, was downregulated in the plasma of individuals with temporomandibular disorder, fibromyalgia syndrome, or widespread pain following a motor vehicle collision. miR-374 was also downregulated in plasma, white adipose tissue, and spinal cord from mice with multisite mechanical sensitivity. miR-374 downregulation in plasma and spinal cord was female specific. Norepinephrine stimulation of primary adipocytes, but not DRG, led to decreased miR-374 expression. Furthermore, we identified tissue-specific and sex-specific changes in the expression of predicted miR-374 mRNA targets, including known (HIF1A, NUMB, TGFBR2) and new (ATXN7, CRK-II) pain targets. Finally, we demonstrated that miR-374 overexpression in DRG neurons reduced capsaicin-induced nociceptor activity. Downregulation of miR-374 occurs between adrenergic receptor activation and mechanical hypersensitivity, and its adipocyte source implicates adipose signaling in nociception. Further study of miR-374 may inform therapeutic strategies for the millions worldwide who experience CPPCs.

Sleep and circadian rhythm disturbances as risk and progression factors for multiple chronic overlapping pain conditions: a protocol for a longitudinal study.

Chronic overlapping pain conditions (COPCs), such as chronic low back pain (cLBP) and fibromyalgia, frequently cooccur and incur substantial healthcare costs. However, to date, much focus has been placed on individual anatomically based chronic pain conditions, whereas little is known about the mechanisms underlying progression to multiple (more than 1) COPCs. This study aims to address the gap by investigating the role of common and modifiable risk factors, specifically sleep and circadian rhythm disturbances, in the development of multiple COPCs. The study will enroll 300 participants with cLBP, including 200 with cLBP only and 100 with cLBP plus other COPCs (ie, fibromyalgia, temporomandibular disorders, irritable bowel syndrome, and chronic headaches) and follow them up for 12 months. Sleep and circadian rhythms will be assessed using wireless sleep electroencephalography, 24-hour evaluation of the rhythm of urinary 6-sulfatoxymelatonin, actigraphy, and sleep diaries. Pain amplification using quantitative sensory testing, psychological distress using validated self-report measures, and the number of pain sites using a pain body map will also be assessed. This research aims to (1) comprehensively characterize sleep/circadian disturbances in individuals with single and multiple COPCs using multimodal in-home assessments; (2) examine the associations between sleep/circadian disturbances, changes in pain amplification, and psychological distress; and (3) investigate the relationship among these factors and the progression in the number of pain sites, a proxy for multiple COPCs. The findings will provide insights into the mechanisms leading to multiple COPCs, potentially informing treatment and prevention strategies for these complex conditions.

A Commentary on “Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population” [Letter

A Commentary on “Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population” [Letter

Temporomandibular Disorders in Children and Adolescents

Temporomandibular disorder (TMD) is characterized by pain, dysfunction, and distress in the masticatory muscles and/or temporomandibular joints and associated structures. Despite its high prevalence in children and adolescents, exceeding 20%, TMD has not been extensively studied. Therefore, this review aimed to establish an overview of TMD in children and adolescents and describe its diagnosis and treatment. TMD more predominantly occurs in girls and has multifactorial etiologies, with several risk factors interacting differently at the individual level. TMD is associated with poor oral health-related quality of life and abnormal facial growth. The Diagnostic Criteria for TMD (DC/TMD) assessment protocol is used to diagnose TMD in young patients, and TMD can be effectively managed with conservative therapies such as patient education, home care, physical therapy, occlusal appliance therapy, and pharmacotherapy. During routine dental checkups, pediatric dentists can identify TMD in children and adolescents to reduce the occurrence of complications due to its chronic progression.

Recovery of hearing loss in atypical Meniere’s disease after treatment with orofacial and neck massage: A case report

BACKGROUND A 48-year-old female presented with sudden-onset right-sided aural fullness, low-frequency hearing loss, and tinnitus. Medical history included right-sided temporomandibular joint disorder (TMJD) with crepitation, and retro-orbital headaches. The patient was diagnosed with atypical Meniere’s disease (MD) and received intratympanic steroids, prednisone, betahistine, and began a low-sodium diet; however, the patient’s symptoms worsened. CASE SUMMARY The patient sought physical therapy for TMJD; testing revealed reduced motion and dysfunction with vertical opening, lateral excursion of the mandible to the right, and tenderness to palpation. Treatment included soft tissue mobilization of right facial structures and temporal fossa, intraoral massage of the right pterygoid musculature, and massage of right neck structures. After 4 weeks, the patient noticed subjective improvement in hearing and decreased headaches. After 11 weeks, an audiogram showed that the hearing loss had recovered. The patient has continued the daily at-home intraoral/neck massage therapy and maintained normal hearing over 4 years to date. The temporal relationship between physical therapy and recovery of hearing loss suggests muscular or inflammatory etiology as at least partially causative of this patient’s symptoms. The mechanism of healing may have been due to decreased inflammation, improved blood flow, restored function of cranial nerves, or some combination of these and other unknown factors. CONCLUSION This report suggests that orofacial physical and massage therapy may be an effective treatment for the cochlear symptoms associated with MD.

Pain Relief and Efficacy of Surgical vs Nonsurgical Management of TMJ Disorders: A Systematic Review

Pain Relief and Efficacy of Surgical vs Nonsurgical Management of TMJ Disorders: A Systematic Review

Temporomandibular Disorders and the Singing Voice: A Summary of the Research

ABSTRACT Temporomandibular Disorders are a prevalent group of disorders affecting the temporomandibular joints and surrounding structures. The purpose of this article is to summarize and integrate medical research regarding TMDs with research regarding the singing voice. Its intent is to provide practical information for voice teachers or other professionals who may work with singers experiencing a TMD. This article will draw from medical and voice-related literature, with the author summarizing the relationship between the TMJ function and the speaking and singing voice. Since TMDs are shown to be prevalent within the singer population, associations between TMDs and the voice will also be discussed, as well as the impact that the experience of TMDs may have on the singer. While research does not support the claim that singing causes TMDs, certain predisposing and precipitating factors in its development and progression exist commonly within the singer population. The article will conclude with a discussion of limitations within the literature and suggestions for future research.

Evaluation of temporomandibular joint osteoarthritis using a new FRACTURE sequence of 3.0T magnetic resonance imaging.

The purpose of this study was to determine the usefulness of a new MRI sequence, CT-like fast field echo with limited echo-spacing (FRACTURE), in diagnosing temporomandibular joint osteoarthritis compared with routine MRI temporomandibular joint (TMJ) sequences. The study sample comprised 76 patients (152 joints) who underwent MRI and CT examinations to diagnose TMJ disorders. Two specialists in oral and maxillofacial radiology assessed the bony changes of the TMJ on FRACTURE, proton density-weighted (PDw), and fat-suppression T2-weighted (T2wFS) sequences. Receiver operating characteristic curves were plotted for each sequence, and the accuracy, sensitivity, specificity, and area under the curve (AUC) were calculated. Additionally, the interobserver agreement (Cohen's kappa value) and sensitivity in assessing each osteoarthritis finding were calculated for each sequence. The FRACTURE sequence had the highest diagnostic performance, with an accuracy of 0.85, sensitivity of 0.85, specificity of 0.84, and AUC of 0.84. These values were 0.84, 0.72, 0.91, and 0.80, respectively, for the PDw sequence, and 0.83, 0.72, 0.91, and 0.79, respectively, for the T2wFS sequence. The AUC did not significantly differ between the FRACTURE and PDw sequences (Delong test, p > 0.05), but did significantly differ between the FRACTURE and T2wFS sequences (p < 0.05). For all osteoarthritis findings, the FRACTURE sequence had the highest kappa values and the highest sensitivity. FRACTURE sequencing may be a promising tool for the diagnosis of TMJ osteoarthritis compared with other conventional sequences.

Immediate Effects of the Mandibular Muscle Energy Technique in Adults with Chronic Temporomandibular Disorder

Background/Objectives: Temporomandibular disorders affect the muscles used for chewing, the temporomandibular joint, and other related tissues, resulting in pain, limited mobility, and dysfunction of the masticatory muscles. Physical therapy plays a critical role in treatment. Manual therapy can trigger neurophysiological mechanisms that contribute to pain relief and a reduction in muscle activation. Evaluations of different manual therapy techniques are needed on this topic. The main objective of this study was to evaluate the effects of a specific manual therapy technique (the mandibular muscle energy technique) in adults with temporomandibular disorders. Methods: A randomized, parallel clinical trial was conducted, and 31 participants were recruited into an experimental group and 30 were recruited into a control group in order to analyze its effects on outcomes such as pain, pain threshold to pressure, mandibular mobility, and kinesiophobia. Pre- and post-intervention assessments were performed, followed by statistical analyses to verify the intra- and intergroup changes. Results: The results showed that the mandibular muscle energy technique produced positive effects with significant differences in the intra- and intergroup comparisons for pain threshold to pressure, mandibular mobility, and kinesiophobia, demonstrating its efficacy and safety as a treatment option for adults with temporomandibular disorders, with proven effects in the short term. Conclusions: The effects obtained and the absence of side effects showed that this technique can be integrated into multimodal treatment along with other types of interventions in patients with temporomandibular disorders.

Efficacy of combination treatment in a patient with temporomandibular joint dysfunction

Background: Muscle and joint dysfunction is a common complication, particularly in females over 40 years. It is strongly associated with age-related hormonal changes in the bones, as well as concomitant dentoalveolar deformities and tooth loss. Case description: The efficacy of combination treatment of dentoalveolar abnormalities and deformities complicated by temporomandibular joint (TMJ) dysfunction was demonstrated. The efficacy of combination treatment in patients with missing teeth, as well as dentoalveolar abnormalities and deformities complicated by TMJ dysfunction, was confirmed. To ensure a representative before-and-after comparison, the restoration of masticatory efficiency following orthodontic and orthopedic rehabilitation was assessed. A physical examination in patient M. revealed hypertonia of masticatory muscles, restricted mouth opening, jaw shifting to the left, partially absent dentition in distal sections, and prosthetic restoration failure. On MRI, there were signs of deforming arthrosis of both TMJs. The following observation methods were used to assess the efficacy of rehabilitation: questioning to identify symptoms of TMJ pain; follow-up examination for joint clicking when opening the mouth; palpation of the external pterygoid muscle, masticatory muscle, and internal pterygoid muscle; X-ray examination (TMJ CT and MRI) following treatment; masticatory efficiency assessment using a masticatory performance test (according to Trezubov) before and after treatment. Diagnostic testing following combination orthodontic and orthopedic treatment revealed that the patient’s left TMJ no longer felt heavy, and she could open her mouth easily; moreover, jaw shifting resolved, and masticatory muscle rigidity decreased. Conclusion: This clinical case demonstrates why orthopedic surgeons and orthodontists must collaborate in the diagnosis and treatment of TMJ dysfunction. The authors present a well-established approach to the treatment of patients with TMJ dysfunction that has been used successfully in clinical practice for several years.

Clinical Features of Temporomandibular Disorders: Validity and Reliability of the Fonseca Anamnestic Index in Persian

Background: Temporomandibular Disorders (TMDs) are a group of disorders associated with masticatory dysfunction. TMDs are usually diagnosed late which leads to complicated treatments. Early diagnosis and treatment of TMDs are essential. Methods: A valid and reliable version of Fonseca’s Anamnestic Index (FAI) was prepared in Persian from the English version. It was used to assess TMD in 350 patients. Clinical signs of TMD were also recorded based on examination. Results: FAI scores showed 161(46%) people had TMD. There was no significant difference between occlusion classes in terms of the frequency of TMD. There was no significant difference between the mean maximum mouth opening and severity of TMD. Conclusion: In this study the validity and reliability of the FAI in Persian language, as a simple tool for TMD screening in health centers, was confirmed. Based on results, there is a relationship between clinical findings and the severity of TMD by using FAI and it can be used for screening TMD patients.

Jaw exercise in head and neck cancer patients for prevention of temporomandibular disorders: a randomized controlled trial.

To prospectively evaluate the effect of a preventive jaw-training intervention program on the development of temporomandibular disorders (TMD) in patients treated for head and neck cancer (HNC). We randomized 58 consecutive patients with squamous cell carcinoma in the head and neck area into two groups before initiation of a curatively intended oncologic treatment: training with a jaw mobilizer once a day or a control group without active exercise. A comprehensive examination according to diagnostic criteria for temporomandibular disorders (DC/TMD) was conducted at baseline (before oncologic treatment) 6 and 12months after completed radiation therapy (RT). The patients recorded training frequency in a diary. There were significant differences in the changes of maximal incisal opening (MIO) between the intervention and control groups at 6 and 12months compared to baseline (p = 0.010 and p = 0.012, respectively) with more deterioration in the control group. The control group had a higher prevalence of TMD diagnosis at the 6-month follow-up (p = 0.010) and a close to significant level at the 12-month follow-up (p = 0.055). This unique study, which evaluates the effect of a preventive jaw-training program for prevention of TMD in patients with HNC undergoing high dose RT, found that the preventive jaw-training program could prevent the deterioration of MIO and development of TMD. This preventive exercise program could prevent the deterioration in MIO and the development of TMD in HNC patients, leading to less pain and better jaw function.

Long-Term Stability in Temporomandibular Joint Replacement: A Review of Related Variables.

Background: The temporomandibular joint (TMJ) is a key component of the stomatognathic system, playing a major role in maintaining mandibular stability and function. Temporomandibular disorders (TMDs) are a prevalent disease in the world, with surgical treatment being reserved for complex cases or end-stage TMJ disease. A narrative review was conducted to describe the quantitative and qualitative factors that affect TMJ prosthesis stability. Methods: Studies with a sample size equal to or greater than 10 subjects who underwent surgical procedures for joint replacement using stock or customized ATM prostheses were included. This narrative review examined some variables that may influence in terms of the longevity of the TMJ prosthesis, highlighting issues to be considered in future research. Results: The current development of TMJ prostheses is benefiting from technological advances, offering a suitable adaptation to the patient's anatomy and superior results in functionality and patient satisfaction. However, the biomechanical complexity of the TMJ shows unique challenges compared to other joints in the body, where anatomical, biomechanical, and functional requirements are high. The stability of the TMJ prosthesis is affected by multiple variables, including the selection of biocompatible materials that resist corrosion and wear, the design of the prosthesis, the diagnosis and indication for its use, and the surgeon's experience. The success of TMJ replacement can be measured by improving the patient's quality of life, reducing pain, restoring mandibular functionality, and recovering suitable facial morphology for the patient's conditions. Conclusion: There is a need for training of maxillofacial surgeons in TMJ surgery and replacement, as well as a greater focus on the research and development of systems to simplify surgical design and procedures and to optimize the results of TMJ replacement.

Evaluating Surgical Approaches for Hemimandibular Hyperplasia Associated with Osteochondroma: A Systematic Literature Review.

Background/Objectives: Hemimandibular hyperplasia (HH) associated with osteochondroma presents complex challenges in maxillofacial surgery, including facial asymmetry, occlusal instability, and temporomandibular joint (TMJ) dysfunction. Surgical interventions vary widely in approach and outcomes, underscoring the need for a systematic evaluation of effectiveness. This systematic review assesses the effectiveness of surgical approaches for managing HH associated with osteochondroma, focusing on techniques including condylectomy, orthognathic surgery, distraction osteogenesis, total joint replacement (TJR), and genioplasty. Methods: Following PRISMA 2020 guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science for studies published from 2000 to 2023. Eligibility criteria were based on the PICO framework, with primary outcomes evaluated for facial symmetry, occlusal correction, mandibular function, and recurrence rates. The Cochrane Risk of Bias Tool assessed study quality, while the GRADE framework evaluated the certainty of evidence. This review was not registered due to exclusion criteria for certain dental topics in PROSPERO. Results: Of 145 studies identified, 18 met inclusion criteria, totaling 214 patients. High and low condylectomy both effectively corrected asymmetry, with high condylectomy reducing recurrence risk but often requiring reconstruction. Orthognathic surgery, combined with condylectomy, significantly enhanced facial symmetry and occlusal function. Distraction osteogenesis proved valuable for mandibular lengthening in cases of severe deformities, while TJR offered definitive solutions for extensive joint involvement. Genioplasty corrected chin asymmetry, contributing to improved facial balance. Limitations included small sample sizes and variable follow-up durations. Conclusions: Surgical approaches tailored to individual patient needs show effectiveness in treating HH associated with osteochondroma, achieving functional and esthetic outcomes. Future studies should prioritize larger cohorts and standardized follow-up protocols to better assess long-term efficacy. Advances in 3D surgical planning and individualized treatment strategies show promise for optimized patient-specific care.

Investigating the Relationship Between Orthodontic Treatment and Temporomandibular Joint Disorders in Adolescents

ABSTRACT Background: Orthodontic treatment is widely utilized to correct malocclusions and improve dental aesthetics in adolescents. However, its potential association with the development of temporomandibular joint disorders (TMDs) remains controversial. Materials and Methods: A prospective cohort study was conducted involving 200 adolescents aged 12–18 years undergoing orthodontic treatment. Participants were divided into two groups: those receiving fixed appliances (n = 150) and those undergoing aligner therapy (n = 50). The presence and severity of TMDs were assessed using the Research Diagnostic Criteria for Temporomandibular Disorders at baseline, 6 months, and 12 months post-treatment initiation. Data were analyzed using the Chi-square tests and multivariate logistic regression to identify potential risk factors. Results: At baseline, 10% of the total cohort exhibited mild TMD symptoms. After 12 months, 25% of the fixed appliance group showed an increase in TMD symptoms, compared to 15% in the aligner group. The logistic regression analysis revealed a significant association between the duration of treatment with fixed appliances and the development of TMDs (OR = 2.5; 95% CI: 1.2–5.1; P = 0.02). However, no significant correlation was found between aligner therapy and TMD incidence (OR = 1.1; 95% CI: 0.5–2.3; P = 0.67). Conclusion: The findings suggest that prolonged orthodontic treatment with fixed appliances may increase the risk of developing TMDs in adolescents, whereas aligner therapy appears to have a minimal impact on TMJ function.