Research Diagnostic Criteria For Temporomandibular Disorders Research Articles

Is malocclusion a predictor of pain in patients suffering from TMD pain?

Temporomandibular disorders (TMD) affect the masticatory muscles, temporomandibular joints (TMJs) and associated structures. The relationship between occlusion and TMD is a contentious issue in the dental field. Although there is a strong argument against invasive and irreversible therapeutic TMD procedures, the TMD biopsychosocial model is still not accepted by some clinicians. Hence, this study aimed to verify whether malocclusions are related to TMD pain. The study included 49 adult patients with one or multiple TMD diagnoses and without any other diseases that could mimic TMD. A reliable investigator diagnosed the patients using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) protocol. The sample was divided into pain and non-pain TMD groups, and the predictor of malocclusion was categorized as the dependent variable. There were 33 patients in the TMD pain group and 16 patients in the non-pain TMD group. Analyses were conducted at a significance level of 0.05. The χ2 test (with Yates' correction for 2 × 2 matrix) was used to compare qualitative variables between the groups. Malocclusion was present in 13 patients in the pain group and 7 patients in the non-pain group. According to our study, there is no correlation between malocclusion and TMD pain.

Academic Stress contributes to Temporomandibular Joint Disorders (TMDs) among Dental Students of the Universiti Teknologi MARA Malaysia, not the Social Stress: An Institutional Study

Objectives: The objectives of this study were to determine the prevalence of TMD in dental students in Universiti Teknologi MARA, and to identify risk factors that may contribute (social vs academic) to TMD in dental students. Methods: In a cross-sectional study, 202 dental undergraduate students, aged 19 to 25 years from year 1 to year 5 were recruited in our study. The respondents have undergone an assessment using a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and Dental Environment Stress (DES) questionnaires. TMD was diagnosed by using RDC/TMD axis I and II. The DES questionnaire was based on five-point Likert scale, from a range of not pertinent to very stressful. Stress scores were measured from seven stressor domains. Statistical analysis was performed using Fisher-exact test using SPSS 20.0. Significance level was set at P≤0.05. Result: 13.3% of the students were diagnosed with TMD, The higher prevalence of TMD was detected among female students. Present study demonstrated that academic stress is significantly higher than social stress among all dental students. Among the domains in the academic stress, performance pressure found to be the highest to effect the students. Conclusion: The significant association between TMD and academic stress observed in our present study warrants further investigation to examine the underlying molecular mechanism of academic stress in TMD initiation and progression.

Etiologic Factors of Temporomandibular Disorders: A Systematic Review of Literature Containing Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) from 2018 to 2022.

This study aims to conduct a systematic analysis of literature published between 1 January 2018 and 1 September 2022, exploring factors influencing the progression or development of temporomandibular disorders (TMD), diagnosed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Three electronic databases were reviewed to identify papers that examined TMD factors using DC/TMD or RDC/TMD. Inclusion criteria encompassed original research published in English between 1 January 2018 and 1 October 2022, online, and complete DC/TMD or RDC/TMD studies on human participants aged 18 or older. Two authors independently assessed the risk of bias using The Joanna Briggs Institute (JBI) Analytical cross-sectional studies' Critical Appraisal Tool. Of 1478 articles, 11 were included. The studies revealed strong associations between TMD and factors such as female, poor sleep quality, depression, oral parafunction, anxiety, somatization, and anatomical features. However, variables such as education, living conditions, socioeconomic status, marital status, chronic pain, and stress did not exhibit statistically significant correlations. Based on the obtained data, it can be concluded that the causes of TMD are largely related to psychological factors, which supports the biopsychosocial theory of the disorder.

Cannabidiol Intervention for Muscular Tension, Pain, and Sleep Bruxism Intensity-A Randomized, Double-Blind Clinical Trial.

Background: Temporomandibular disorders (TMDs) are the most prevalent non-dental pain issues in the maxillofacial region. Despite advancements, diagnosing and managing TMDs continues to pose challenges. This study aimed to assess the efficacy of cannabidiol (CBD) formulations, with different concentrations, in patients experiencing sleep bruxism and muscle-related TMDs, with a particular emphasis on their myorelaxant, pain-relieving, and bruxism-reducing properties. Methods: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs) was utilized as the diagnostic framework. Sixty patients completed the study, which followed a parallel-group, three-arm, randomized, double-blind clinical trial design, with a 1:1:1 allocation ratio across three groups: 1a, 1b, and 2. Groups 1a and 1b received CBD formulations at concentrations of 10% and 5%, respectively, while Group 2 received a placebo formulation. The trial consisted of four main visits, namely screening, baseline, first follow-up after 14 days, and second follow-up after 30 days, during which surface electromyography (sEMG), the visual analogue scale (VAS) for pain assessment, and Bruxoff examinations were conducted. Results: The reduction in pain, as measured by the visual analogue scale (VAS), among patients using the 10% CBD formulation was 57.4% (p < 0.05), accompanied by a decrease in sEMG activity by 42.1% (p < 0.05). Conversely, individuals using the 5% CBD formulation experienced a 40.8% (p < 0.05) decrease in pain. Regarding the decrease in the sleep bruxism index, users of the 10% CBD formulation saw the highest reduction of 51% (p < 0.05). These findings underscore the efficacy of the proposed treatment in both experimental groups, with a notable advantage observed in Group 1a. Conversely, the outcomes of the selected variables for the control group did not exhibit significant differences throughout the study. Conclusions: The intraoral use of CBD formulations in patients with TMDs have proven to be a successful treatment for reducing pain, muscle tension, and bruxing activity in individuals with sleep bruxism and muscle-related TMDs. Specifically, a concentration of 10% CBD has demonstrated superior results compared to 5% CBD.

Disclosure orthodontic and TMD-new study.

Cooperative analysis of participants and controls. Wiley Online Library, National Institute of Health, ResearchGate, ScienceDirect, Google Scholar. Human clinical trials age 18-30 years old, a case-control study included 291 individuals, 192 TMDs and 99 controls. All patients underwent assessment based on a questionnaire and a clinical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients who underwent orthodontic treatment were compared to those who did not, regarding their trauma history, bruxism, aggressive teeth brushing, level of oral hygiene, pain scores, muscle tenderness scores and subjective sleep quality. Medical and/or dental emergencies, subjects with a history of drug, alcohol or medication abuse, fibromyalgia, being pregnant or lactating, having a coexisting mental, psychiatric, or physical disability, cancerous or significant medical problems and the consumption of drugs and/or medications that affect the nervous system including narcotics, TCA (tricyclic antidepressants), anticonvulsant, muscle relaxants and medication overuse headache. To identify differences between groups, categorical independent variables were analysed using the chi-square test or likelihood ratio, while numeric independent variables were analysed using independent t-tests and analysis of variance (ANOVA). A two-tailed level of statistical significance (α) was established at 0.05. Analysis of multicollinearity was performed following the univariate analyses to examine the collinearity among the independent variables and select independent variables with minimal correlation. Among the highly correlated variables, only one was selected for inclusion in the multivariate model, with the specific variable chosen based on contextual considerations. The research comprised a total of 291 individuals, consisting of two distinct groups: the TMD group (192 participants, 66%) and the control group (99 participants, 34%). Within the TMD group, further subcategorization was conducted, including MMP (masticatory muscle pain) with 44 individuals (15%); TMJD with 26 individuals (9%); and TMP (both MMP and TMJ) with 122 individuals (42%). Using a "holistic" and a "collinearity statistical approach and the utilization of a multivariate model" the conclusion is that TMD is not associated with orthodontics.

Effectiveness of an 8-week neck exercise training on pain, jaw function, and oral health-related quality of life in women with chronic temporomandibular disorders: a randomized controlled trial

To test the effectiveness of an 8-week exercise program targeted to the neck muscles compared to manual therapy, and placebo treatments on orofacial pain intensity, jaw function, oral health-related quality of life (OHRQoL), and jaw range of motion (ROM) in women with Temporomandibular Disorders (TMD). In this randomized controlled trial, fifty-four women (between 18–45 years old) with a diagnosis of myofascial or mixed TMD according to the Research Diagnostic Criteria for TMD (RDC/TMD) were randomized into three groups: Neck motor control training (NTG), Manual Therapy Group (MTG), and Placebo Group (PG). All patients were evaluated with the Visual Analog Scale, Mandibular Function Impairment Questionnaire, Oral Health Impact Profile-14, and jaw Range of Motion (ROM) at baseline, immediately after treatment (after 8 weeks of treatment), one month, and three-month follow-up. For all outcomes, a mixed analysis of variance (ANOVA) with repeated measures was conducted with a Bonferroni post hoc test. NTG was significantly better than the PG group on pain and jaw function at the end of treatment, one- and three-month follow-up (Effect Size (ES) &gt;0.7). For OHRQoL, NTG was significantly better than MTG and PG at the end of treatment and at three-month follow-up (ES &gt;0.7). The results of this project are encouraging, and they could be used to guide clinical practice in this field. Exercises targeted to the neck (which require low therapeutic supervision) could be a simple and conservative way to improve pain and disability for women with TMD with neck involvement.

The association between orthodontic treatment and temporomandibular disorders diagnosis and disease characteristics.

The association between orthodontic treatment and temporomandibular disorders (TMD) has been contentious in the literature. To analyse the associations between orthodontic treatment and TMD diagnosis and diseases characteristics. This case-control study included 291 individuals, 192 TMDs and 99 controls. All patients underwent assessment based on a questionnaire and a clinical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Differences in orthodontic treatment between TMDs and controls, as well as across different TMD diagnoses within the TMD group were analysed. Patients who underwent orthodontic treatment were compared to those who did not, regarding their trauma history, bruxism, aggressive teeth brushing, level of oral hygiene, pain scores, muscle tenderness scores and subjective sleep quality. Of the 291 participants, 119 (40.9%) underwent orthodontic treatment and 172 (59.1%) had no orthodontics experience. Orthodontic treatment included: mandibular orthodontic treatment (102 subjects) and maxillary orthodontic treatment (113 subjects) of those 47 used a headgear. Following multivariate analysis among TMDs, orthodontic treatment was associated with a good level of oral hygiene versus poor (Odds ratio [OR]: 5.17 [1.04-25.59]), lower number of tender muscles [OR = 0.84 (0.74-0.96)] and lower (better) Pittsburgh Sleep Quality Index (PSQI) scores (OR = 0.86 [0.76-0.97]). None of the studied parameters maintained a statistically significant association with orthodontic treatment in the multivariate analysis among the entire study population. Utilising a holistic approach, this study supports the main hypothesis that orthodontic treatment is not associated with TMD diagnosis and disease characteristics.

Association between depressive symptoms and temporomandibular disorders among students

To evaluate the association between depressive symptoms and the severity of temporomandibular disorders (TMD). This cross-sectional study (763 students) used the Fonseca Anamnestic Index and Axis II of the Research Diagnostic Criteria for TMD. Pearson’s correlation test was applied to evaluate associations of sociodemographic and clinical characteristics with TMD (p ≤ 0.05). Multinomial logistic regression was performed to adjust for confounding variables. The prevalence of signs and symptoms of TMD among the participants was 63.8% (47.6% had signs and symptoms of depression). Students with moderate depressive symptoms were 5.11 times more likely to develop severe TMD symptoms (p &lt; 0.001). Students with severe depressive symptoms were 12.51 times more likely to develop signs and symptoms of TMD (p &lt; 0.001). There was a significant association between depressive symptoms and signs and symptoms of TMD. The greater the severity of symptoms of depression, the higher the risk of developing signs and symptoms of TMD.

Qualitative and quantitative assessment of headaches in people with temporomandibular joint disorders: A pilot study.

Headaches (HAs) and temporomandibular joint dysfunction (TMD) are common comorbidities, and the presence of one of them in a patient increases the incidence of the other. The relationship between these 2 conditions may involve common pathophysiological processes. Considering the topicality of the problem, it is justified to conduct research in this field. In this study, we assessed HA type and severity in people with TMD. The aim of the study was to conduct qualitative and quantitative assessments of HAs in people with temporomandibular joint (TMJ) disorders. The study group consisted of 51 subjects of both sexes with a TMD diagnosed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) test. A self-report questionnaire was utilized to self-assess the presence of TMD symptoms, while the standardized Short-Form of the McGill Pain Questionnaire was used to qualitatively and quantitatively assess HAs. People with TMD were significantly more likely to report HA occurrences (p < 0.001). Pain intensity was statistically significantly higher among individuals with TMD compared to those without TMD symptoms (p < 0.001). Most often, the HA was associated with a pressing pain (r = 0.82) and least often, it was described as cutting (r = 0.30). Neck and shoulder girdle pain (p = 0.059; 82.9%) and clenching and/or grinding of teeth (p = 0.021; 92.7%) were significantly more common among patients who declared HAs than among those without HAs. The results obtained so far may indicate a significant relationship between HA and TMD. We have described the relationship between the occurrence of HAs and TMD. Headaches are more frequent and more severe in people with TMD.

Prevalence of temporomandibular disorders (TMD) in bleeding disorders: A systematic review with meta-analysis.

Haemophilia A, B and von Willebrand disease are the most common bleeding disorders. There is an increased tendency of spontaneous bleeding into joints resulting in intra-articular infection. It is believed that Temporomandibular Joint (TMJ) can be affected in a similar manner which can further lead to limited mouth opening and ankylosis. The association between bleeding disorders (BD) and development of temporomandibular disorders (TMD) is poorly understood. This systematic review intends to evaluate the association of TMD in individuals with inherited bleeding disorders as compared to healthy controls. PubMed, Ovid SP and Google Scholar were searched for articles published between the times of inception to 1 May 2023. All the articles were subjected to Population, Exposure, Comparison and Outcome model (PECO) based on which inclusion and exclusion criteria were applied. Participants (P) is children, adults or adolescents; Exposure (E) is children, adults or adolescents with a diagnosis of Haemophilia or bleeding disorder (BD); Comparator (C) is age and gender-matched healthy controls who do not have Haemophilia or bleeding disorder; Outcome (O) is prevalence of any signs or symptoms (clinical, radiographic) that is suggestive of temporomandibular disorder (TMD). Studies showing the prevalence of TMD are included for qualitative analysis. Only the studies which provided data of the prevalence of TMD in both the groups (BD and healthy controls) were included in the quantitative analysis. TMD diagnosis can be by clinical signs and symptoms, radiographic criteria, Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or any other imaging criteria (MRI). We have set the exclusion criteria as articles without a control group, diagnostic sensitivity studies, case reports and systematic reviews and narrative reviews. The software Review Manager version 5.4 (Cochrane Collaboration) was used to perform the pooled analysis. We measured the risk ratio (RR) between the two groups (BD and healthy controls) for the outcome TMD. A total of seven studies are included for qualitative analysis of data. The age of the population (BD and control) in the included studies ranged between 2 and 57 years. The prevalence of TMD in individual studies varied from 2% to 77%, and controls in the individual studies varied from 2% to 14%. Among the included studies, only clinical signs, symptoms and history were taken into consideration in four studies. Four studies were included for meta-analysis, the pooled result of the four studies suggests there is no significant difference in the prevalence of TMD in BD and control group (p value = .11, RR 2.19; 95% CI [0.84, 5.73]). This systematic review and meta-analysis elicits no association between bleeding disorders and increased prevalence of TMD.

Association of Catechol-O-Methyl-Transferase and Estrogen Receptors polymorphism with Severity of Temporomandibular Disorder in Iranian Patients

Background: There are many studies which strongly suggest that the pathophysiology of Temporomandibular joint Disorder (TMD) may also be influenced by genetic conditions. The current study was aimed to evaluate the hypothesis that the polymorphism of estrogen receptor genes, estrogen receptor 1 and 2 (ESR1 and ESR2), and the gene Catechol -O-Methyl-Transferase (COMT) could be Predisposing factor for TMD.&#x0D; Methods: In this case-control study, blood sample were taken from 100 TMD diagnosed patients based on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and 103 healthy individuals as the control group. Tetra ARMS-PCR method was used to amplify and identify COMT rs4680, ESR1 rs1643821, and ESR2 rs1676303 gene polymorphism.&#x0D; Results: ESR1 genotype AA and GA showed significantly increase probability (OR= 4.80, OR=2.98, respectively) of TMD. ESR2 T/T homozygosity was associated with decreased risk for TMD (OR=0.41). The relationship between COMT and TMD was not statistically significant (p&gt;00.05). The relationship between the severity of TMD and ESR1 was significant (p=0.003). According to the inheritance pattern the COMT and ESR1 gene, in the dominant pattern can be susceptible to TMD and in ESR2 gene, in the recessive pattern can be protective to TMD.&#x0D; Conclusion: It seems that SNPs of ESR1 rs1643821 has a susceptible role and ESR2 rs1676303 has a protective role against TMD. Also, we add evidences that various genotype of COMT rs4680 were not statistically different between case and control, but allele A in the dominant inherence pattern can be susceptible to TMD.&#x0D;

Wear Management of Colored Foils for the Assessment of Sleep Bruxism Patterns-A Prospective, Randomized Crossover Study.

The assessment of bruxism relies on clinical examinations, questionnaires, and polysomnography. The additional use of colored foils (BruxChecker®) could enable a more precise evaluation of bruxing patterns. To assess differences between use of the foils during stress periods or just on consecutive nights and to determine a reasonable duration of using the foils, 28 patients were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and were randomly assigned to wearing the 12 foils for six consecutive nights (alternately in the upper and lower jaw; "consecutive") or six nights within one month following days of high stress ("stress") in a crossover design. The sizes of the attrition areas were measured with ImageJ. Stress was evaluated using the Perceived Stress Scale. The Stress Coping Questionnaire (SVF-120) was used for assessing habitual stress coping strategies. Areas of attrition increased significantly from day 1/2 to 5/6, both for the upper and lower jaw. Molars in the mandible had significantly larger attrition areas than in the maxilla. No significant differences were detected between "consecutive" and "stress" phases. The foils were suitable for differentiating teeth more or less affected by bruxism and were able to show that areas of attrition increased with days, indicating that some adaptation takes place and several days of wearing the foils are required to show the full picture. However, no differences between low/moderate- and high-stress phases were detected.

The role of pain-related disability on treatment outcome and psychosocial symptoms in patients with temporomandibular disorders – a pilot study

Objective The aim of the pilot study was to investigate the association of pain-related disability with the outcome of conservative treatment of temporomandibular disorders (TMD) and with depressive and non-specific physical symptoms among TMD pain patients utilizing Graded Chronic Pain Scale 1.0 (GCPS1.0) as a screening instrument. Material and methods The study included 80 adult patients who were referred to the Oral and Maxillofacial Department, Oulu University Hospital, Finland, due to TMD pain. At baseline, pain-related disability was assessed by using the GCPS1.0 according to the Research Diagnostic Criteria for TMD (RDC/TMD), and the patients were categorized into three TMD subtypes, 1–3. Patients were given conservative TMD treatment. At follow-up visits (1, 3, 6, and 12 months), patients evaluated the pain intensity on an NRS and described the treatment outcome and the severity of the TMD symptoms on a numerical scale. Results and conclusions Patients with TMD subtype 3 (moderate/severe disability) had the highest NRS scores and described their symptoms as most severe at each time point, statistically significantly so at 1-month and 6-month follow-up (p < .05). The highest proportion of depressive symptoms was found in TMD subtype 3 (p < .05). The current pilot study showed that moderate/severe TMD-related disability, based on the GCPS 1.0 as a screening tool, may be linked with poor treatment outcome and depressive symptoms. Studies with larger samples are needed to confirm the results.

Occlusal Splint Therapy Combined with Cranio-Temporomandibular Kinesiotherapy in Patients with Temporomandibular Disorders-A CBCT Study.

Occlusal splints are used as a non-invasive treatment for patients diagnosed with temporomandibular disorders (TMD). Another non-invasive treatment option for TMD patients is kinesiotherapy, which may be used alone or in conjunction with occlusal splint therapy. The aim of this study was to evaluate the changes in the intra-articular spaces of the temporomandibular joint (TMJ) after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients. Twenty-four patients (N = 24) diagnosed with TMD according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were included. Cone beam computed tomography (CBCT) images were taken before and after treatment. The anterior, superior, posterior, and medial joint spaces were measured on the CBCT images, and the condylar ratio was calculated using Pullinger and Hollender's formula. Additionally, the thickness of the glenoid fossa (GFT), condylar medio-lateral widths (MLW), and condylar height (HCo) were measured. The condylar ratio was significantly higher after treatment (p = 0.049). The changes in dimensions of the anterior, superior, posterior and medial joint spaces were not statistically significant after treatment. No statistically significant differences were found in the dimensions of the GFT, MLW, and HCo post treatment. The condylar position did not shift anteriorly in a statistically significant way after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients.

Effectiveness of conservative therapeutic modalities for temporomandibular disorders-related pain: a systematic review

Purpose The aim of this systematic review was to evaluate the effectiveness of conservative different therapeutic modalities for temporomandibular disorders (TMD) pain. Materials and methods An electronic systematic search was conducted in the MEDLINE (PubMed) database to identify the randomized clinical trials (RCTs) published between 2001 and 2021. The following, simple or multiple conjunctions, search keywords were selected: TMD pain, TMD management or conservative treatment or treatment strategies and TMD pain, therapeutic modalities or interventions and TMD. Studies included must have patients older than 18 years, with painful TMD, which diagnosis was performed by Research Diagnostic Criteria for TMD or Diagnostic Criteria for TMD. Outcome variables were pain relief and post treatment pain intensity reduction. Data were analysed with non-parametric tests and the level of significance was set at p<.05. Results Out of 1599 articles obtained, 28 RCTs fulfilled all selection criteria and were included. The results of this study show that there was a significant decrease in short-term post-treatment TMD pain with the use of occlusal splint alone or in combination with other therapeutic modalities when compared with the control group. Statistically significant differences were also detected between laser and photobiomodulation group and the control, in short-term treatment TMD-related pain. Conclusions The primary findings of the present systematic review showed that the occlusal splint alone or combined with other therapeutic intervention presented positive effect on short-term TMD pain reduction. Secondary outcome suggests that laser and photobiomodulation therapy had, also, a significant role in short term pain relief.

Prevalence of temporomandibular disorders in people with multiple sclerosis: A systematic review and meta-analysis

ABSTRACT Objective To explore the prevalence of temporomandibular disorders (TMD) in patients affected by multiple sclerosis (MS) and whether there is a correlation between TMD prevalence and MS severity. Methods PubMed, Web of Science, and Lilacs were systematically searched until July 30 2022, to identify studies presenting patients affected by MS and whether there is a correlation between TMD prevalence and MS severity. Results Out of 292 papers, 8 studies were included with 1312 study participants. Among the 8 studies, 5 had a control group; 5 used the RDC/TMD criteria, 1 used the NOT-S instrument, and 2 did not define a standardized method to define TMD symptoms. Meta-analysis revealed that the MS group had a higher rate than the control group, showing an association between MS and TMD (RR 2.10; 95% CI: 1.21–3.65). Conclusion These findings show an association between TMD and MS. Abbreviations Australian Longitudinal Study of MS (AMSLS); Computed Tomography (CT); Community Periodontal Index of Treatment Needs (CPITN); Central Nervous System (CNS); Decayed, Missing, and Filled (DMF); Decayed, Missing, or Filled Teeth Index (DMFT); Expanded Disability Status Scale (EDSS); European Academy of Craniomandibular Disorders (EACD); Healthy Controls (HC); International Prospective Register of Systematic Reviews (PROSPERO); Multiple Sclerosis (MS); Nordic Orofacial Test-Screening (NOT-S); Participants, model of Intervention, Comparison and Outcome (PICO); Preferred Reporting Items for Systematic Reviews (PRISMA); Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD); Temporomandibular Joint (TMJ); Temporomandibular Disorders (TMD); World Health Organization (WHO)

Association between chronic pain, depression, somatization and temporomandibular disorders in a southern brazilian population

Introduction: Temporomandibular disorder (TMD) is defined as a set of pathological clinical conditions involving the masticatory muscles, the temporomandibular joint, or both, and the associated structures. It is often associated with chronic headaches, cervical pain, otologic symptoms and may be accompanied by some degree of physical or psychological disability in patients. Objective: To investigate the association of chronic pain-related disability, depression, and somatization with temporomandibular disorders. Methods: It was a transversal study with 275 patients evaluated using the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders). The variables of Axis I (myofascial pain, disc displacement and other joint conditions) and Axis II (chronic pain-related disability, depression and somatization) were crossed using Fischer’s Exact Test (p &lt;0.05). Results: Statistically significant association was found among factors of chronic pain-related disability, depression and somatization with myofascial pain diagnosis (p =0.000, p =0.001, p =0.000, respectively), as well as joint conditions (arthralgia, osteoarthritis and osteoarthrosis) (p =0.000, p =0.008, p =0.003, respectively). Conclusion: There is a positive association between chronic pain, depression and somatization (Axis II variables) with and myofascial pain and other joint conditions (Axis I). Disc displacements were not associated to variables of Axis II.

Temporomandibular disorder in construction workers associated with ANKK1 and DRD2 genes.

The study aimed to explore the influence of genetic polymorphisms in ANKK1 and DRD2 on the signs and symptoms of temporomandibular disorder (TMD) in construction workers. This cross-sectional study included only male subjects. All construction workers were healthy and over 18 years age. Illiterate workers and functionally illiterate workers were excluded. The diagnosis of TMD was established according to the Research Diagnostic Criteria for TMD (RDC/TMD). Genomic DNA was used to evaluate the genetic polymorphisms ANKK1 (rs1800497) and DRD2 (rs6275; rs6276) using Real-Time PCR. Chi-square or Fisher exact tests were used to evaluate genotypes and allele distribution among the studied phenotypes. The established alpha of this study was 5%. The sample included a total of 115 patients. The age of the patients ranged from 19 to 70 years (mean age 38.2; standard deviation 11.7). Chronic pain (87.7%), disc displacement (38.2%), and joint inflammation (26.9%) were the most frequently observed signs and symptoms. The genetic polymorphism rs6276 in DRD2 was associated with chronic pain (p=0.033). In conclusion, our study suggests that genetic polymorphisms in DRD2 and ANKK1 may influence TMD signs and symptoms in a group of male construction workers.

Back and neck pain: A comparison between acute and chronic pain–related Temporomandibular Disorders

ABSTRACT Background Temporomandibular disorders (TMDs) are common and cause persistent pain. Comorbidities are associated with TMDs and can affect the effectiveness of their treatments. The literature is lacking enough evidence on the difference between acute and chronic pain, particularly in TMDs. Investigating this difference could highlight potential risk factors for the transition from acute to chronic pain–related TMDs. Aim To compare the likelihood of back and neck pain (BP, NP) between acute and chronic pain–related TMDs (AP-TMD, CP-TMD) as defined by pain duration and pain-related disability.‎ Methods Participants with AP-TMDs (≤3 months) and CP-TMDs (>3 months) were recruited according to the diagnostic criteria and research diagnostic criteria of TMD. BP and NP were assessed using a self-reported checklist. CP-TMDs defined by disability (chronic disability) and depression and anxiety symptoms were assessed using validated instruments. Logistic regression analyses were employed. Results This study enrolled 487 adults with AP-TMD (n = 118) and CP-TMD (n = 369). Relative to AP-TMD, participants with CP-TMD had twice the odds of reporting NP (odds ratio [OR] = 2.17‎, 95% CI 1.27–3.71) but not BP ‎‎(OR = 0.96, 95% CI 0.57–1.64). Participants with chronic disability were twice as likely to report NP ‎(OR = 1.95‎, 95% CI 1.20–3.17‎) but not BP (OR = 1.13, 95% CI 0.69–1.82)‎ compared to those without. All analyses were adjusted for age, sex, and anxiety and depression symptoms. Conclusions Within the limitations of this study, results suggest that central dysregulation or trigeminocervical convergence mechanisms are implicated in the process of pain-related TMD chronification and highlight the relevance of considering disability when defining CP-TMDs.

Relationship between cervical angle and temporomandibular disorders in young and middle-aged population

ABSTRACT Objective To verify temporomandibular disorders (TMDs) and cervical angles in a young and middle-aged population. Methods Ninety participants were included, 45 of whom had TMDs. The participants were diagnosed according to the Research Diagnostic Criteria for TMDs. Lateral cervical radiographs were taken, and relevant cervical angles were measured. The general characteristics of the TMD group and control group were analyzed using chi-square analysis, and the relationship between cervical angles and TMDs was evaluated using the unpaired t-test. Results The decrease in C2–C7 Cobb and increase in the posterior occipitocervical angle (POCA) were associated with the incidence of TMDs (p < 0.0001). Conclusion This study revealed that the cervical angle was related to TMDs. People with a long-time habit of head bending posture had a decrease in C2–C7 Cobb and an increase in the POCA. This group of people was more likely to develop TMDs.