non-TMD Group Research Articles

Investigation of glenoid fossa roof thickness in patients with and without TMJ disorders in a Turkish Subpopulation

The aim of this study was to evaluate the minimum thickness of the glenoid fossa (GFMT), the discontinuity of the roof of the glenoid fossa, and degenerative bone changes (DBC) using cone-beam computed tomography (CBCT), and to compare these findings between the patients with temporomandibular joint dysfunction (TMD) and patients witout TMD. CBCT images of 72 patients with TMD and 72 patients with non-TMD were evaluated for DBC and GMFC in the TMJ. The obtained data were compared between TMD group and non-TMD group, between DBC group and non-DBC group and between genders. Chi-square, fisher exact, and Mann-Whitney U tests were used to compare the data. The frequency of DBC was statistically different between the TMD group (79.2%) and non-TMD group (55.6%) (p=0.000). There was no statistical difference in the GFMT between in the TMD group (0.873 mm) and non-TMD group (0.853 mm). GFMT was statistically higher in DBC group (0.92 mm) compared to non-DBC group (0.738 mm) (p<0.05). There were no statistical differences between all groups for fossa discontuniuty and nutrition canal (p>0.05). The mean GFMT was found to be statistically higher in males than in females (p<0.05). Moreover, in the TMD group, the mean GFMT was found to be statistically higher in males than in females (p<0.05). The frequency of DBC was higher in TMD group than in non-TMD group. While TMD status had no effect on GFMT, it was found that GFMT increased in the presence of DBC. It was found that TMD and DBC had no effect on glenoid fossa discontinuity.

Associations between oral behaviors, temporomandibular disorder subtypes and psychological distress in adult women: a retrospective case-control study

Oral behaviors and psychological distress are known to be related to temporomandibular disorders (TMDs). However, the relationship between various oral behaviors and specific TMD subgroups in adult women experiencing psychological distress is still unclear. To investigate the relationship between various oral behaviors and different TMD subgroups with different psychological distress states. A total of 210 female TMD patients were divided into 3 subgroups according to their symptoms: pain-related (PT), intra-articular (IT) and combined pain-related and intra-articular (CT). Another 70 participants without TMDs were recruited as the non-TMD (NT) control group. We used reduced Chinese versions of the Oral Behavior Checklist (OBC-Ch 8), including awake (OBC-Ch 6) and sleep-related activities, the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) to assess oral behaviors and psychological distress. Differences in OBC scores among TMD subgroups were analyzed using Chi-square, Kruskal-Wallis H and post hoc tests, with significance set at p < 0.05. Oral behavior subscale scores significantly differed among TMD subgroups (p < 0.01). The OBC-Ch 8 scores of PT, IT and CT subjects were significantly higher than the NT group. PT and CT groups also had significantly higher GAD-7 and PHQ-9 scores. Sleep-related OBC scores of the PT, IT and CT groups were higher than those in the NT group, regardless of psychological states (p < 0.001). In psychologically distressed subjects, OBC-Ch 8 scores for PT and CT subgroups were significantly higher than those in the NT group. Oral behaviors are differentially associated with various TMD subgroups in female adults, and a correlation exists between individual psychological status and OBC scores.

Surface electromyography in the assessment of masticatory muscle activity in patients with pain-related temporomandibular disorders: a systematic review.

Temporomandibular disorders (TMD) are a set of painful conditions affecting the orofacial region that are prevalent and constitute the most frequent type of non-dental pain complaint in the maxillofacial area. Pain-related TMD (TMD-P) is characterized by ongoing pain in the masticatory muscles, the temporomandibular joint, or surrounding structures. Due to the multiple factors that contribute to the development of this condition, it can be challenging to accurately diagnose. One of the useful method for assessing patients with TMD-P is surface electromyography (sEMG). The aim of this systematic review was to provide a comprehensive overview of the current scientific literature on the evaluation of masticatory muscle activity (MMA) in individuals diagnosed with TMD-P, through the utilization of sEMG. To gather relevant information, electronic databases such as PubMed, Web of Science, Scopus, and Embase were searched using specific keywords including: "pain" AND ("temporomandibular disorder*" OR "temporomandibular dysfunction*") AND "surface electromyography" AND "masticatory muscle activity." The inclusion criteria were studies assessing MMA in patients with TMD-P using sEMG. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was utilized to evaluate the quality of the studies that were included in the review. The search strategy identified 450 potential articles. Fourteen papers met the inclusion criteria. Global quality rating for significant part of the articles was weak. Most studies showed greater sEMG activity of the masseter (MM) and temporal anterior (TA) muscles at rest in TMD-P subjects than in the asymptomatic controls, while the MM and TA muscles were less active in the pain-related TMD group compared to the non-TMD group during maximal voluntary clenching (MVC). There were differences in MMA in the TMD-pain population compared to a healthy control group during various tasks. The diagnostic efficacy of surface electromyography in assessing individuals with TMD-P remains unclear.

Dimensional and Positional Characteristics of the Temporomandibular Joint of Skeletal Class II Malocclusion with and without Temporomandibular Disorders.

This study sought to evaluate dimensional and positional temporomandibular joint (TMJ) features in three-dimensions in skeletal class II malocclusion with and without temporomandibular disorders (TMDs). A total of 91 (182 joints) adult patients were divided into the following two groups: (1) Group I - TMD (n = 56; 112 joints) and (2) group II - non-TMD (n = 35; 70 joints). Dimensional and positional TMJ characteristics including glenoid fossae, mandibular condyles, and joint spaces were assessed using cone-beam computed tomography (CBCT). The mandibular fossa in the TMD group was significantly more lateral than in the non-TMD group, and the mandibular fossa anterior wall inclination to the horizontal plane showed a significantly more vertically inclined wall in the TMD group compared to the non-TMD group. Significantly vertical mandibular condylar changes in the form of less vertical inclination, more vertical position, and lower vertical dimension (height) in addition to more upward position within the joint space were found. The TMD group showed significantly decreased superior and posterior joint spaces in addition to significantly increased medial joint spaces. Patients with TMDs are associated with laterally positioned mandibular fossa with the more vertically inclined anterior wall. They are characterized by vertical mandibular condylar changes in the form of less vertical inclination, more vertical position, and lower vertical dimension (height) in addition to more upward positioning within the joint space is accompanied by a decrease in superior and posterior and an increase in medial joint spaces. The TMJ characteristics of skeletal class II make it more susceptible to TMDs and any orthodontic and/or surgical interventions in a direction possibly change these characteristics are to be considered.

Masticatory Myoelectric Side Modular Ratio Asymmetry during Maximal Biting in Women with and without Temporomandibular Disorders

There is no consensus on the role of electromyographic analysis in detecting and characterizing the asymmetries of jaw muscle excitation in patients with temporomandibular disorders (TMD). To analyze the TMD patients (n = 72) in comparison with the healthy controls (n = 30), the surface electromyography (sEMG) of the temporalis anterior muscle (TA) and masseter muscle (M) was recorded while a maximal biting task was performed. The differences in the asymmetry of the relationship between the masseter muscles were assessed in a module to determine the sensitivity (Sn) of binomial logistic models, based on the dominance of the TA or the M muscle, in accurately predicting the presence of TMD. All assumptions were met, and comparisons between the groups showed significant differences for the TA muscle ratio (p = 0.007), but not for the M muscle ratio (p = 0.13). The left side was predominant over the right side in the TMD group for both the TA (p = 0.02) and M muscles (p = 0.001), while the non-TMD group had a higher frequency of the right side. Binary logistic regression showed a significant model (χ2 = 9.53; p = 0.002) for the TA muscle with Sn = 0.843. The model for the M muscle also showed significance (χ2 = 8.03; p = 0.005) with Sn = 0.837. The TMD patients showed an increased TA muscle ratio and asymmetry of left dominance, compared to the healthy subjects. Both of the binomial logistic models, based on muscle dominance TA or M, were moderately sensitive for predicting the presence of TMD.

Relationship between oral health status and oral health-related quality of life among patients with temporomandibular disorders in Bengaluru City: A cross-sectional comparative study

Background: Most of the oral diseases have consequences that can affect the quality of life (QoL). Temporomandibular disorders (TMDs) constitute a series of clinical problems that affect muscles of mastication, the temporomandibular joint, along with their associated structures. The perception and feelings of these patients regarding their oral health are often ignored. Objective: The aim is to assess the relationship between oral health status and oral health-related QoL (OHRQoL) in participants with TMD compared to the Non-TMD group. Materials and Methods: A cross-sectional comparative study was conducted among 320 participants (TMD 160 and Non-TMD 160 participants, respectively) in various hospitals of Bengaluru city. The Oral Health Impact Profile for TMDs (OHIP) questionnaire was administered for evaluating the OHRQoL. Oral health status was assessed using World Health Organization Oral Health Assessment Form for Adults, 2013. Chi-square tests, Pearson's correlation tests, and one-way ANOVA were applied for statistical analysis. The value of P < 0.05 was considered statistically significant. Results: TMD patients exhibited worse OHIP-TMDs scores when compared to the Non-TMD group (63.2 ± 3.78 vs. 2.15 ± 3.21). The mean Decayed, Missing, and Filled Teeth (P < 0.001), gingival bleeding (P < 0.001), pockets P < 0.001), and loss of attachment (P = 0.677) was significantly higher in the TMD group when compared to the non-TMD group. TMDs negatively affected the OHRQoL in the TMD group when compared to the non-TMD group. Conclusions: OHRQoL and oral health status are found to be poor among the TMD group when compared to the non-TMD group. There was a relationship between OHRQoL and oral health status among the TMD group and non-TMD group.

Assessments of Muscle Thickness and Tonicity of the Masseter and Sternocleidomastoid Muscles and Maximum Mouth Opening in Patients with Temporomandibular Disorder.

The purpose of this study was to compare the muscle thickness and tone of the masseter and sternocleidomastoid (SCM) muscles and maximum mouth opening (MMO) in subjects with and without temporomandibular disorders (TMD), and perform a correlation comparison on the results of the TMD group. Sixty patients were allocated to the TMD group (n = 30) or the non-TMD group (n = 30). Ultrasound imaging, myotonometer, and vernier calipers were used to determine the related changes in muscle thickness and muscle tone in masseter and SCM, and MMO, respectively. The TMD group revealed a significant decrease than the non-TMD group in the muscle thickness of masseter and SCM, respectively (p < 0.001), with a significant increase in frequency (p < 0.001) and stiffness (p < 0.001) in the masseter muscle tone, with a significant increase in frequency (p < 0.001) and stiffness (p = 0.005) in the SCM muscle tone, a significant decrease in the MMO (p < 0.001). There was a moderate negative correlation between the relaxed state of masseter muscle thickness and stiffness of SCM muscle tone (r = −0.40, p = 0.002), and a moderate negative correlation between the relaxed state of SCM muscle thickness and frequency of SCM muscle tone (r = −0.42, p = 0.001). There was a moderate negative correlation between the clenching state of SCM muscle thickness and the frequency of SCM muscle tone (r = −0.47, p < 0.001). In addition, a moderate negative correlation between MMO and frequency of SCM muscle tone (r = −0.44, p < 0.001). The muscle thickness was decreased, and the muscle tone was increased in the masseter and SCM muscle, respectively. Additionally, MMO was decreased in patients with TMD compared with non-TMD.

Association between waking-state oral behaviours, according to the oral behaviors checklist, and TMD subgroups.

ObjectivesTo assess the association between waking‐state oral behaviours and temporomandibular disorder (TMD) subgroups and to develop new scoring methods for the Oral Behavior Checklist (OBC).MethodsPatients with any TMD diagnosis, according to the diagnostic criteria for TMD (DC/TMD), were divided into subgroups: ‘Dysfunctional‐TMD’ (n = 70), only mechanical dysfunction; ‘Painful‐TMD’ (n = 204), only myalgia, arthralgia or both; and ‘Painful‐Dysfunctional TMD’ (n = 95), combined pain and dysfunction. A group of individuals without TMD, ‘Non‐TMD’ (n = 374), was used for testing associations. Participants completed the OBC. An exploratory factor analysis, followed by a confirmatory factor analysis of the OBC responses, identified 2 major factors, named non‐functional activities (NFA) and functional activities (FA). Component total scores were computed. Differences among subgroups for OBC‐MS (mean score) and NFA and FA factor scores were estimated using one‐way ANOVA and Tukey post hoc tests. Significance was set at p < .05.ResultsThe OBC‐MS in Non‐TMD, Painful‐TMD and Painful‐Dysfunctional TMD subgroups was higher than in the Dysfunctional‐TMD subgroup (p ≤ .001). NFA in Painful‐TMD and Painful‐Dysfunctional TMD subgroups were higher than in the Non‐TMD group (p < .05); NFA in the Dysfunctional‐TMD subgroup were lower than in the Painful‐TMD subgroup (p = .034). In contrast, FA in Painful‐TMD, Dysfunctional‐TMD and Painful‐Dysfunctional TMD subgroups were lower than in the Non‐TMD group (p < .0001).ConclusionsA new scoring method for the OBC results in item reduction and creation of meaningful subscales for functional and non‐functional behaviours, which are differentially associated with painful and dysfunctional TMDs. This may help clinicians to better tailor treatment for the management of subtypes of TMD patients.

Comparison of Condylar Bone Density in Cone-Beam Computed Tomographic Images of Patients with and without Temporomandibular Joint Disorders

Introduction: Temporomandibular disorders (TMDs) are the main source of orofacial pain of nondental origin. Density changes in mandibular condyles of patients with TMD have not been well documented. The aim of this study was to compare condylar head bone density values in patient with and without TMD in cone-beam computed tomographic (CBCT) images. Materials and Methods: CBCT images of 70 patients with TMD and 70 age- and sex-controlled individuals were studied. Density of the cancellous bone in the left and right condylar heads was measured on a CBCT slice with the widest mediolateral dimension. Moreover, absence of at least one maxillary or mandibular posterior tooth (except for third molars) was recorded. Interclass correlation, t test, and Chi-squared test were used for statistical analysis. Results: Bone density in the condylar head significantly increased in patients with TMD compared with the non-TMD group (P &lt; 0.001). The difference between males and females in each group was not significant (P = 0.182). Condylar head bone density in patients with TMD with posterior missing teeth was significantly less than individuals without missing teeth (P = 0.002). Conclusion: Increased density of condylar head must be regarded as a potential diagnostic tool for TMD when interpreting CBCT images of the joints.

Electromyography as a Means of Assessing Masticatory Muscle Activity in Patients with Pain-Related Temporomandibular Disorders.

Aim The aim of this study was to evaluate masticatory muscle electrical activity in patients with pain-related and pain-free temporomandibular disorders (TMDs) as well as in subjects with no TMD. Methods Ninety children with mixed dentition were recruited to the study. Of this total, 30 subjects were diagnosed with pain-related TMD (TMD-P), 30 with pain-free TMD (TMD-PF), and 30 without TMD. We used Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD) to assess the presence of TMD in the examined children. The electromyographical (EMG) potentials of the temporalis and masseter muscles were measured with a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) at rest and during maximum voluntary clenching (MVC). Results An analysis of the EMG recordings showed statistically significant intergroup differences in masticatory muscle electrical activity at rest and during MVC. Significantly higher rest temporalis muscle activity was noted in pain-related TMD subjects compared with that children from the pain-free TMD and non-TMD groups, as well as in TMD-PF children in relation to those without TMD. The EMG potentials of the temporalis muscle during MVC were much lower in patients with TMD-P than in pain-free TMD and non-TMD subjects. Masseter muscle activity at rest in the TMD-pain group was significantly greater, and masseter muscle EMG potentials during clenching were markedly lower than in patients with no TMD diagnosis. Conclusion The use of electromyography to assess masticatory muscle function revealed alterations in the pattern of temporalis and masseter muscle activity in patients with pain-related TMD compared with the pain-free subjects.

Frequency distribution of temporomandibular disorders according to occlusal factors: A cross-sectional study

Temporomandibular disorder (TMD) is a common condition affecting the temporomandibular joint and causes pain and discomfort. However, the role of factors contributing to this problem is still controversial. The purpose of this cross-sectional study was to determine the correlation of occlusal factors and parafunctional habits with TMD and The determination of TMD prevalence among patients referring to Isfahan Dental School in 2017. In this cross-sectional study, A total of 200 patients between 20 and 50 years were examined and questioned based on the Research Diagnostic Criteria for Temporomandibular Disorders assessment instrument. The association of occlusal factors (dental relationship, lateral occlusal scheme, horizontal differences between centric occlusion and Maximum intercuspation (MI), difference between MI and mandibular resting position) and parafunctional habits (bruxism/clenching and habits) with TMD was analyzed using Chi-square tests and independent sample t-test (α = 0.05). Binomial logistic regression analysis was performed with respect to confounding variables. The prevalence of TMD in the studied sample was 58.9%. Only bruxism showed a significant difference between TMD and non-TMD groups (P < 0.05). Other parafunctional and occlusal factors did not act as influential factors for TMD. Parafunction may play an important role in the initiation of TMD, although other habits and occlusal factors are considered as noninfluential factors. However, larger sample size and multicenter sampling are recommended for the future studies.

Comparison between Glenoid Fossa Roof Thickness in TMD and non-TMD Patients, a CBCT Study.

Statement of the Problem: Various pathologic conditions can affect the thickness of the roof of glenoid fossa (RGF). The relationship between the RGF thickness and temporomandibular joint disorder (TMD) is not explicitly investigated. Considering the changes in RGF thickness, as a radiographic sign for TMD diagnosis, the phenomenon may necessitate specific treatment and may influence the treatment course and results. Purpose:This research was designed to examine the relationship between TMD and RGF thickness changes compared to non-TMD group. Materials and Method: In this cross sectional analytic research CBCT images of 70 TMD patients (140 joints) and 70 non-TMD individuals (140 joints) as control group were evaluated for thickness of RGF and presence of discontinuity in RGF. The distance between superior and inferior cortex of glenoid fossa was measured as RGF thickness. Inability to follow the course of cortex in any given image was considered as discontinuity. T-test, Chi-square and odds ratio (OR) were used for statistical analysis. In this study, p< 0.05 was considered meaningful. Results:The mean thickness of RGF in our non-TMD samples was 1.12 mm. RGF thickness was significantly increased in TMD patients compared non-TMD group (p= 0.00). This value was also greater in males. On the other hand, TMD patient showed a higher incidence of discontinuity in RGF, in comparison with non-TMD patients (p= 0.006). Conclusion:The increased thickness of RGF can be considered as a sign of TMD, which may help in diagnosis of TMD. It seems that there is a direct relationship between TMD and discontinuity of RGF.

Clinical jaw-muscle symptoms in a group of probable sleep bruxers

ObjectivesTo investigate, in a sample of probable sleep bruxers with and without temporomandibular disorder (TMD) pain, the presence and relationships between clinical jaw-muscle symptoms, and test their associations with jaw-muscle electromyographic (EMG) activity during sleep. MethodsPain, unpleasantness, tiredness, tension, soreness, and stiffness were scored on a 0–10 numerical rating scale (NRS) in 50 probable sleep bruxers. The sample was subdivided into two groups, i.e., with and without TMD pain. Multiple-night, single-channel EMG recordings were performed. Descriptive data, correlations between the six symptoms, and correlations between symptoms and EMG measures, i.e. EMG events/recording, EMG events/hour, and night-to-night variability in EMG events, were calculated. ResultsIn the total sample, 90% of the participants reported at least one symptom. Tiredness and tension were the most prevalent symptoms (both 78%), and pain the least (30%). In the TMD pain group, pain remained the least reported symptom (57%). Intensity of symptoms was low to moderate, with tension presenting the highest median in the total sample (NRS 4), the TMD pain group (NRS 5), and non-TMD group (NRS 3). Significant correlations between all symptoms were found in the total sample, but not in the two subgroups. No significant associations between EMG measures and muscle symptoms emerged. ConclusionJaw-muscle symptoms other than pain were highly prevalent in a sample of probable sleep bruxers. There were no associations between these symptoms and EMG measures of jaw-muscle activity during sleep. These findings challenge the concept of simple relationships between jaw-muscle activity during sleep and clinical muscle symptoms.

Using the child behavior checklist to determine associations between psychosocial aspects and TMD-related pain in children and adolescents

BackgroundSince children and adolescents are frequently experiencing emotional and behavioral consequences due to pain, their parents should be aware of this emotional and behavioral status. Therefore, the aim of this study was to analyze and describe the parents’ reports of the emotional and behavioral status of children and adolescents with different types of temporomandibular disorders using the Child Behavior Checklist.MethodsThis Cross-sectional study comprises of 386 randomly selected children and adolescents that ages between 10 and 18 years in Jeddah. One day prior the clinical examination according to Research Diagnostic Criteria for temporomandibular disorders (TMD) Axis I and II, Arabic version of the Child Behavior Checklist scale was distributed to the parents of participant. According to the diagnosis, the participants were divided into three groups; non-TMD group, TMD-pain group, and TMD-painfree group.ResultsIn regard to internalizing problems, the parents to the children and adolescents in the TMD-pain group rated a higher frequency of anxiety, depression and somatic complaints in their children than the parents of children in the non-TMD group (p < 0.05). Only one significant association regarding the externalizing problems was found for the aggressive behavior in the TMD-pain group.ConclusionThe parents rated that their children with TMD-pain suffer from emotional, somatic and aggressive behavior to a higher degree than healthy control subjects. Also, the parents believed that TMD-pain influenced their children’s physical activities but not social activities.

Temporomandibular disorders and mandibular vertical asymmetry

Objective To analyze the association between mandibular vertical asymmetry and the presence of TMD in adult patients.Methods This case-control study recruited patients from the orthodontic clinic at FEBUAP. Patients were classified on the basis of diagnostic criteria for temporomandibular disorders (DC/TMD). Panoramic radiographs were measured to determine mandibular vertical asymmetry indices according to criteria described by Kjellberg and Habets. Both methods (DC/TMD and index criteria) were standardized a priori.Results A total of 56 patients were analyzed, of whom 25 (44.6%) met the inclusion criteria and were divided into two groups (TMD group, n = 15; non-TMD group, n = 10). The highest asymmetry index was observed in the condylar neck, followed by the total condylar asymmetry index, but without significant differences between groups (p > .05).Conclusion There is no association (p > .05) between temporomandibular disorders and mandibular vertical asymmetry.

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.

The associations between psychosocial aspects and TMD-pain related aspects in children and adolescents.

BackgroundTemporomandibular disorders (TMD) in children and adolescents is prevalent with pain as a common component, and has a comorbidity with psychosocial problems such as stress, depression, anxiety as well as somatic complaints. Therefore, the aim of the study was to investigate if psychosocial problems in children and adolescents are associated with TMD with pain (TMD-pain) and TMD without pain (TMD-painfree) when compared to children and adolescents without TMD.MethodsThis cross-sectional study consisted of 456 randomly selected children and adolescents, enrolled from 10 boy’s- and 10 girl’s- schools in Jeddah, between 10 and 18 years of age. On the examination day, prior to the clinical examination according to Research Diagnostic Criteria for TMD Axis I and II, the participants first answered two validated questions about TMD pain, and after that the Arabic version of the Youth Self Report scale. According to their clinical examination and diagnosis the participants were divided into three groups; non-TMD group, TMD-pain group, and TMD-painfree group.ResultsThe TMD-pain group presents a higher frequency of the internalizing problems anxiety, depression and somatic complaints than non-TMD group (p < 0.05). Regarding externalizing problems the only significant association found was for aggressive behavior in the TMD-pain group (p < 0.05). The TMD-pain group also shows a higher frequency of social problems than the non-TMD group. However, no such difference was found when compared to the TMD-painfree group. There was also a significant association with a higher frequency of thought problems in the TMD-pain group (p < 0.05). The children’s and adolescents’ physical activities were within border line clinical range for all three groups, whereas the social competence was within the normal range. There were no significant associations between any of the groups in this respect.ConclusionsTMD-pain in children and adolescents does not seem to affect the social activities. However, TMD-pain seem to have a strong association to emotional, behavior and somatic functioning, with higher frequencies of anxiety, depression, somatic problems, aggressive behavior and thought problems, than children and adolescents without TMD-pain. With respect to the biopsychosocial model the present study indicates that there are significant associations to psychosocial, somatic and behavioral comorbidities and TMD-pain in children and adolescents in the Middle East region.

Comparative study of the prevalence of temporomandibular joint osteoarthritic changes in cone beam computed tomograms of patients with or without temporomandibular disorder

To compare the prevalence of temporomandibular joint (TMJ) osteoarthritic changes in cone beam computed tomography (CBCT) images of temporomandibular disorder (TMD) and non-TMD patients. A retrospective analysis of CBCT images of the joints of TMD and non-TMD patients was performed. The presence or absence of osteoarthritic changes (condylar erosion, osteophyte, subcortical cyst, or generalized sclerosis) in each TMJ was evaluated. The prevalence within the two study groups were compared by using Chi-square statistics. At least one type of osteoarthritic change was present in78.6% of joints in the TMD group and 79.7% in the non-TMD group. No significant difference was found in prevalence of osteoarthritic changes between the TMD and non-TMD groups in the overall study sample or within the subsets of gender and age in the groups. The lack of a significant difference in prevalence of TMJ osteoarthritic changes in TMD and non-TMD patients highlights the equivocal relationship between osseous TMJ morphology and degenerative bone disease.

Relationship of Occlusal Schemes with the Occurrence of Temporomandibular Disorders

Masticatory system is a complex functional unit of the body responsible for mastication, speech, and deglutition process. Temporomandibular disorders (TMD) is used to describe all functional disturbances of the masticatory system. The etiology of TMD is multifactorial, such as occlusal disharmony and emotional stress. The relationship between occlusion and TMD has been highly debated in dentistry, one of the occlusal factors is the occlusal scheme. Occlusal schemes are defined as bilateral canine guidance, unilateral canine guidance, group function and balanced occlusion. However, studies about the relationship of occlusal schemes and the occurrence of the TMD are still limited and remained controversial. Objective: To investigate the relationship of occlusal schemes witht he occurrence of TMD. Methods: A cross-sectional study was conducted at the Faculty of Dentistry, Uniiversitas Indonesia. A total of 127 students were included in this study. Subjects were examined based on Clinical Helkimo Index and divided into TMD and non-TMD groups. Subjects were categorized as non-TMD groups if the value of the clinical Helkimo index was 0 and as TMD group when the value ranged between 1-25. Results: Balanced occlusion schemes has a greater risk of TMD occurrence with odds ratio value 5.6 and 95% confidence interval 1.188 to 26.331 (p=0.021). Conclusion: Balanced occlusion has a significant relationship with the occurrence of TMD.

Association between condylar asymmetry and Temporo- mandibular disorders using 3D-CT

Objectives: Using reconstructed three-dimensional computed tomography (3D-CT) models, the purpose of this study was to analyze and compare mandibular condyle morphology in patients with and without temporomandibular disorder (TMD). Study Design: Thirty-two patients were divided into two groups: the first comprised those with TMD (n=18), and the second those who did not have TMD (n=14). A CT of each patient was obtained and reconstructed as a 3D model. The 64 resulting 3D condylar models were evaluated for possible TMD-associated length, width and height asymmetries of the condylar process. Descriptive statistics were used to assess the results and student’s t tests applied to compare the two groups. Results: Statistically significant (p<0.05) vertical, mediolateral and sagittal asymmetries of the condylar process were observed between TMD and non-TMD groups. TMD patients showed less condylar height (p<0.05) in comparison with their asymptomatic counterparts. Conclusions: Using 3D-CT, it was shown that condylar width, height and length asymmetries were a common feature of TMD. Key words:Condilar asymmetry, 3D-computed tomography, X-ray diagnosis , maxillofacial surgery, orthodontics.