Research Diagnostic Criteria For Temporomandibular Disorders Research Articles

Prevalence of Temporomandibular Disorders and its Correlation with Stress and Salivary Cortisol Levels among Students

Objective: To evaluate the prevalence of temporomandibular disorders (TMD) in students and to evaluate if any relationship existed between the stress levels, salivary cortisol levels, and TMD. Material and Methods: A total of 348 students, 187 female, and 161 male students, participated in this cross-sectional study. Students were evaluated based on the Research Diagnostic Criteria for TMD. The stress levels were evaluated using the Perceived Stress Scale. The students were divided into the control and TMD groups. Salivary cortisol levels in the salivary samples were analyzed. Results: The prevalence rate of TMDs was 30.7% in the study population. Of the female students, 61% had TMD compared with 46% of male students. Muscle disorders were the most predominant disorder in 14.2% of the students with TMD. The TMD group showed significantly higher salivary cortisol and stress levels than the control group. The TMD group also showed a moderate positive correlation between cortisol and stress levels (p=0.01). Conclusion: The study showed a strong association between salivary cortisol levels, stress, and temporomandibular disorders. Salivary cortisol could be used as a prognostic biomarker for stress while assessing the severity of TMJ problems in stressed individuals.

Individuals requiring orthognathic surgery have more depression and pain than controls.

The objective of this study was to evaluate if individuals with dentofacial deformities (DFD) who require orthognathic surgery are affected more by depression and pain. A case-control study was performed with 195 individuals. In the DFD group, 145 individuals with Class II and III malocclusion requiring orthognathic surgery were selected. The control group was composed of 50 individuals with no DFD. All patients were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Data were analyzed with a significance level of 0.05. The DFD group more often presented severe depression (p = 0.020) and chronic pain (p = 0.017). They also presented higher prevalence of Nonspecific Physical Symptoms Including Pain (P = 0.002) and Nonspecific Physical Symptoms Excluding Pain (p = 0.002). Concerning TMD symptoms, the DFD group had more myofascial (p = 0.002) and articular pain (p = 0.041). Therefore, the results of this study suggest that depression and pain are more common in individuals with DFD requiring orthognathic surgery compared with individuals without DFD.

PREVALENCE OF OTOLARYNGOLOGICAL SYMPTOMS IN PATIENTS WITH TEMPOROMANDIBULAR DISORDERS- A CROSS-SECTIONAL STUDY

Aim:To investigate the prevalence of otolaryngological symptoms with Temporomandibular Disorders (TMD) in TMD patients. Materials and Methods: In this cross sectional study, the sample consisted of 172 TMD patients, both males and females of 18-59 years. Diagnosis of TMD was based on Research Diagnostic Criteria for TMD (RDC-TMD) Axis 1. The prevalence of otolaryngological symptoms was determined using questionnaire. Results: Of the 172 TMD patients evaluated, 81 patients were having Muscular disorder alone or combined with Intracapsular disorder. Out of the 81 patients having muscular disorder, 74 had ear symptoms (91.4%). Conclusion: A high prevalence (91.4%) of Otolaryngological symptoms with TMD was found in the present study. Ruling out causes of ear symptoms other than TMD by an ENT specialist is essential before proceeding with the treatment of these category of patients for a better prognosis.

Changes in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders.

Menstrual cycle may contribute to experimental pain measures in healthy women and women with chronic pain. The present study aimed to investigate variation in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders (TMD) and to explore the effect of TMD pain and psychosocial variables on the pulp response. This longitudinal study involved 47 regularly menstruating women aged 20-45, 24 healthy and 23 with diagnosed painful TMD. The electric and cold stimuli were performed by electric pulp tester and refrigerant spray, respectively, on mandibular lateral incisors, in five menstrual phases (menstrual, follicular, periovulatory, luteal and premenstrual). Research Diagnostic Criteria for TMD were used to assess TMD, chronic pain, depression and somatisation. Regression analysis was performed to investigate the effect of the predictor variables on the pulp sensitivity. Significant phase-related differences were observed for pain intensity to cold stimuli. Higher pain sensitivity was reported in menstrual in comparison with luteal phase (P=.019) among healthy women, and in menstrual in comparison with follicular (P=.033), periovulatory (P=.003) and luteal (P=.007) phases in TMD women. No significant differences were recorded for electric stimuli. Regression analysis identified depression as the determinant of cold and electric response in menstrual phase, regardless of age and presence of TMD. Menstrual phase in healthy and TMD women with regular menstrual cycle is characterised with higher pulp sensitivity to cold stimuli. Depressive symptoms independently influence pulp response in this phase.

TMD diagnosis: Sensitivity and specificity of the Fonseca Anamnestic Index

ABSTRACT Objective To verify whether the Fonseca Anamnestic Index (FAI) has adequate sensitivity and specificity to be used in the diagnosis of temporomandibular disorder (TMD). Methods Two hundred-sixty-five participants with symptoms of TMDs were assessed through the FAI and through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and then classified as sick or non-sick. The sensitivity, specificity, and predictive values of the FAI in relation to the RDC/TMD were calculated using the STATA 14.0 software. Results Most of the patients were female, white, without a steady job, and the average age was 37.57 years. The FAI showed high sensitivity (97.21%) but obtained a low specificity (26.00%). The positive and negative predictive values were 84.96% and 68.42%, respectively. Conclusion The FAI is very sensitive in identifying patients who actually have TMD but not very specific in identifying non-TMD patients, being indicated only for initial screening of patients.

High-resolution ultrasound imaging compared to magnetic resonance imaging for temporomandibular joint disorders: An in vivo study

PurposeThe study aims to determine the diagnostic value of high-resolution ultrasonography (US) compared with magnetic resonance imaging (MRI) for the evaluation of temporomandibular disorders (TMD). MethodsFifty consecutive patients (42 female and 8 male) with signs and symptoms of TMD according to the Research Diagnostic Criteria for TMD were enrolled in the study. Each patient underwent US (13 and 20 MHz) and MRI examination of both TMJs, 1–7 days following clinical examination. All MRI examinations were performed by another radiologist using an 1.5 T MRI device. Sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV, NPV) and diagnostic accuracy were computed along with 95% confidence intervals. ResultsFor overall disc displacements, 13 MHz US showed a Se of 72.58%, Sp of 86.84%, PPV of 90%, NPV of 66% and diagnostic accuracy of 78%, while 20 MHz US showed a Se of 75.81%, Sp of 86.84%, PPV of 90.38%, NPV of 68.75% and a diagnostic accuracy of 80%. For degenerative changes, 13 MHz US revealed a Se of 58.33%, Sp of 92.11%, PPV of 70%, NPV of 87.5% and a diagnostic accuracy of 84%, whereas 20 MHz US indicated the same Se of 58.33%, Sp of 93.42%, PPV of 73.68%, NPV of 87.65% and a diagnostic accuracy of 85%. The Cohen's Kappa coefficient for the intra- and inter-observer agreement was 0.822 and 0.836 for disc displacement, respectively 0.813 and 0.788 for degenerative disorders (p < 0.001). ConclusionsHigh-resolution US could be a useful imaging technique in diagnosing TMJ disc displacements.

Effects of arthrocentesis and low-level laser therapy on patients with osteoarthritis of the temporomandibular joint

This retrospective study examined whether arthrocentesis combined with 10 sessions of low-level laser therapy (LLLT) improved the clinical outcomes of patients with temporomandibular joint osteoarthritis (TMJ-OA) compared with arthrocentesis alone. Data from two groups of patients (total: n=36) with unilateral TMJ-OA were evaluated. The groups were established according to their treatment regimens: Group 1 (arthrocentesis alone; n=19) and Group 2 (arthrocentesis plus LLLT; n=17). All patients had been diagnosed in accordance with the Research Diagnostic Criteria for Temporomandibular Joint Disorders (RDC/TMD) (Axis I Group IIIb) protocol. They all underwent the same arthrocentesis protocol, but those in Group 2 also received 10 sessions of LLLT immediately afterwards. The outcome variables were the visual analogue scale scores (VAS 1, VAS 2) for various treatment outcomes and millimetric measurements of mandibular movements over both the short and long term. Intra-group comparisons showed significant short and long-term improvements for both groups, but outcomes were better over the long term than the short term in both. In addition, greater improvements in muscle palpation scores and mandibular movements were achieved in Group 2 than in Group 1. In conclusion, although both techniques improved joint pain and function, a combination with LLLT seemed to have an additional benefit for myofascial components.

PREVALENCE OF BURNOUT SYNDROME AND ITS ASSOCIATION TO TEMPOROMANDIBULAR DYSFUNCTION (TMD) IN DENTAL STUDENTS

Objective: To verify the prevalence of burnout syndrome and to associate it with temporomandibular dysfunction (TMD) in a sample of dental students from a public university. Study Design: A cross-sectional study with a sample of 108 volunteers. Data was collected by evaluating the signs and symptoms of TMD using the Fonseca index (DMF) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I and II; for burnout syndrome, a sociodemographic questionnaire and the Maslach Burnout Inventory (student version) were used. Data were analyzed using chi-square and Fisher exact test (P< .05). Results: Burnout prevalence was 12.1%, and it was associated with “thought of giving up the course” (P = .01), but there was no association with TMD, sex, sociodemographic characteristics, the need for TMD treatment, depression, and emotional tension. TMD prevalence was 84.1%, by DMF index, and 50.9%, by RDC/TMD. The most prevalent clinical diagnoses were arthralgia (26.9%) followed by myofascial pain (14.8%) and disc displacement with reduction (13%). A total of 47.2% of the students presented with depression, 30.6% moderate and 17.6% severe. TMD was associated with the year of the course (P = .015). Conclusion: There was no significant association between burnout and TMD, however, more studies are necessary in order to understand the risk factors and avoid the repercussions of the syndrome in the student’s life. Objective: To verify the prevalence of burnout syndrome and to associate it with temporomandibular dysfunction (TMD) in a sample of dental students from a public university. Study Design: A cross-sectional study with a sample of 108 volunteers. Data was collected by evaluating the signs and symptoms of TMD using the Fonseca index (DMF) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I and II; for burnout syndrome, a sociodemographic questionnaire and the Maslach Burnout Inventory (student version) were used. Data were analyzed using chi-square and Fisher exact test (P< .05). Results: Burnout prevalence was 12.1%, and it was associated with “thought of giving up the course” (P = .01), but there was no association with TMD, sex, sociodemographic characteristics, the need for TMD treatment, depression, and emotional tension. TMD prevalence was 84.1%, by DMF index, and 50.9%, by RDC/TMD. The most prevalent clinical diagnoses were arthralgia (26.9%) followed by myofascial pain (14.8%) and disc displacement with reduction (13%). A total of 47.2% of the students presented with depression, 30.6% moderate and 17.6% severe. TMD was associated with the year of the course (P = .015). Conclusion: There was no significant association between burnout and TMD, however, more studies are necessary in order to understand the risk factors and avoid the repercussions of the syndrome in the student’s life.

Study on the association between sleep disorders versus oral health related variables

Background To study the association between sleep quality and oral health related variables, which still have conflicts in the literature. Material and Methods This was a population-based case-control study between subjects with versus without sleep disorders from the Brazilian Public Health System (SUS), city of Maringá (N=1,643). Subjects answered self-reported questionnaires: a) Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), b) Sleep Assessment Questionnaire (SAQ) and c) North York Dental Health Survey (NYDHS). Results No significant difference was found for gender, marital status, or income; however, non-Caucasians, people with lower levels of education, and those between 20 to 50 years old had worse scores of sleep disorders in the SAQ. Self-perceived oral health, masticatory capacity to eat foods, and gingival bleeding was significantly worse among subjects with self-reported sleep disorders. Self-reported tooth loss, edentulism and use of removable partial dentures (with clasps) or complete dentures showed no significant difference between groups. Self-reported sleep disorder subjects presented significantly higher prevalence of both self-reported tooth and TMJ pain. Conclusions It can be concluded that individuals with self-reported sleep disorders presented worse self-perceived oral health for most studied variables. Key words:Oral health, case control study, sleep; review, gingivitis, periodontitis, tooth loss.

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.

Conservative therapies to treat pain and anxiety associated with temporomandibular disorders: a randomized clinical trial

Temporomandibular dysfunction (TMD) is a condition that affects the stomatognathic system. To determine the effect of treatment with an occlusal splint (OS), manual therapy (MT), counselling (CS) and the combination of an occlusal splint and counselling (OSCS) on pain and anxiety in patients with TMD. A randomised clinical trial was conducted with 89 patients diagnosed with TMD through RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders) and divided into four groups of treatment: OSCS (n=25); OS (n=24); MT (n=21); and CS (n=19). Participants were assessed before and after 1month of therapy for pain, anxiety and TMD diagnosis. Pain was measured by a visual analogue scale. To assess anxiety, Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI-S and T) were used. The data were analysed using SPSS (Statistical Package for Social Science) 22.0. The four groups obtained a significant reduction (P<0.001) in the pain after 1month of treatment. Treatment in all groups promoted a significant reduction in anxiety symptoms 1 month after completion, HADS (P<0.001), BAI (P<0.001), STAI-T (P=0.006). Thus, no group was superior to the other in reducing the studied variables. The therapies used were effective in reducing pain and anxiety in patients diagnosed with TMD. However, no treatment was superior to the other in reducing the studied variables.

Acupuncture for pain, mandibular function and oral health-related quality of life in patients with masticatory myofascial pain: A randomised controlled trial.

Masticatory myofascial pain is the most prevalent muscular temporomandibular disorders (TMD). It primarily affects masseter and temporal muscles. Several treatments, including acupuncture, have been recommended. However, systematic reviews have highlighted gaps in studies and absence of conclusive results. We performed a randomised controlled clinical trial to evaluate the effectiveness of acupuncture in improving pain, mandibular function and oral health-related quality of life in women with masticatory myofascial pain. Thirty-six patients diagnosed with masticatory myofascial pain according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were divided into the following two groups: acupuncture and control (non-penetrating acupuncture).Treatment was performed weekly for 5weeks, and pain, mandibular function and oral health-related quality of life were evaluated one week before treatment, one week after treatment and one month after treatment. Non-parametric and parametric tests were used for comparisons between times and treatment groups (significance level of P≤.05). The acupuncture group showed a significant reduction in pain (P≤.01), which was not observed in the control group. Pain intensity was reduced by 61% and 84% at 1week and 1month after treatment, respectively. Both groups showed significant improvements in mandibular function and oral health-related quality of life over time (P≤.01). Statistical analysis did not show a significant difference between the groups for any other evaluated outcome (P>.05). Although acupuncture was effective in pain reduction, non-specific factors may have influenced mandibular function and oral health-related quality of life improvements in both groups, and this needs to be further addressed.

Pain threshold in the masticatory and cervical muscles in different types of temporomandibular disorders

Introduction: Given the intimate connection of the temporomandibular joint in the cervical region and its functions of chewing, speech and swallowing, patients with temporomandibular disorders (TMD) have most painful condition in stomathognatic muscles. Objective: Check for differences in pressure pain threshold of the masseter (MS), temporalis (TM), upper trapezius (UT) and sternocleidomastoid (SCM) muscles in different types of TMD. Method: Participated in the research 97 subjects, classified according to “The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)”: myofascial pain (TMD IA), myofascial pain with limited opening (TMD IB), disc displacement with reduction (TMD IIA), disc displacement without reduction and with limited opening (TMD IIB), disc displacement without reduction and without limited opening (TMD IIC). For measurement of the pressure pain threshold (PPT) was used the pressure algometry program (Kratos) of the TM, MS, UT and SCM muscles. For statistical analysis was used the Graphpad Instat program with the Kruskal-Wallis test. Results: The sample consisted of 67 women and 30 men with an average age of 22.09 ± 5.45 years. Of these subjects, 40 were classified as “with TMD”, 57 as “without TMD”, 34 as “TMD IA”, 16 as “TMD IB”, 14 as “TMD IIA” and nobody as “TMD IIB” and “TMD IIC”. The MS, TM and UT muscles showed decreased threshold in myogenic groups of TMD with relation to the group without TMD. Only the masseter muscle showed statistical significance when compared to the myogenic groups with each other, demonstrating that the IB group has lower PPT. Individuals with TMD IB showed lower PPT of MS, TM and UT muscles when compared to TMD IIA. Conclusion: There is a significant difference comparing the PTT of MS, TM and UT muscles of myofascial pain subgroup to the subgroup without TMD. There were differences between the groups myogenic in PPT of MS. TMD IB showed lower threshold in TMD IB group than in TMD IIA group. Controversially, it was not observed when comparing the SCM muscle and disc displacement subgroup with the subgroup without TMD.

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

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

Efficacy of occlusal splints in the treatment of temporomandibular disorders: a systematic review of randomized controlled trials

Objective This systematic review aimed to assess the efficacy of occlusal splints in the treatment of temporomandibular disorders (TMDs). Material and Methods This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Four databases (Medline via Pubmed, Web of Science, Embase and Scopus) were searched, the last search was conducted on April 2020. Randomised controlled trials (RCTs) employing the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) as diagnostic criteria and including occlusal splint as one of the experimental groups were included in the present study. The data from the included studies were extracted and assessed for risk of bias. Results Eleven studies were included. The sample size ranged from 12 to 96 subjects. The male to female ratio was 0 to 25%. The mean length of follow-up was 4 months. Occlusal splint had a positive effect on mandibular movements in all included studies. Seven studies showed a positive effect of occlusal splint on chronic pain reduction and pain intensity, while two others showed improvement of temporomandibular joint clicking sounds and locking of the jaws. Moreover, improvements in mouth opening, depression, and anxiety symptoms, were reported in four studies. Conclusions An occlusal splint can be considered as a non-invasive treatment approach for patients with TMD, especially those with signs and symptoms of restriction of mandibular movement and pain. Moreover, the present findings highlighted an urgent need of a standardised consensus regarding the prognostic evaluation of TMD.

Evaluación de la eficacia a corto plazo de la terapia manual ortopédica en signos y síntomas de dolor miofascial: un ensayo clínico controlado

To evaluate the short-term effectiveness of orthopedic manual therapy (OMT) in signs and symptoms of myofascial pain (MFP) in young adults. Materials and Methods: An experimental controlled clinical study was performed in young adults between 19 and 24 years old. Thirty-one patients with MFP according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were divided into two groups. Group A: Orthopedic Manual Therapy (n=16; 10 females, 6 males; 21.6 ± 1.70 years old), and Group B: Control group (n=15; 10 females, 5 males; 20.9 ± 2.00 years old). The participants of group A were treated for a period of 6 weeks; Six therapeutic interventions were performed. Degree of dysfunction (Helkimo index), pain level (VAS scale), and range of mandibular movements (opening and lateral movements) were taken at baseline (T0) and immediately at post-treatment (T1). The data were analyzed with chi-square test and t-test; p&lt;0.05 was considered significant. Result: After the OMT, there were no significant changes in diagnosis of MFP according to RDC/TMD (p=0.41); however, there was a statistically significant improvement in the Helkimo index (p=0.0083) and the level of pain according to the VAS scale (p=0.0004). Mandibular movements did not show significant differences (p&gt;0.05). Conclusion: This study suggested that a 6-week period of OMT treatment has a clinically significant effect in pain level and degree of dysfunction in patients with MFP. A longer follow-up study is required to better assess the effects of manual therapy.

Effects on the Facial Growth of Rapid Palatal Expansion in Growing Patients Affected by Juvenile Idiopathic Arthritis with Monolateral Involvement of the Temporomandibular Joints: A Case-Control Study on Posteroanterior and Lateral Cephalograms.

Background: Juvenile idiopathic arthritis (JIA) affecting temporomandibular joints (TMJ) in growing patients results in maxillofacial deformities, especially if only one condyle has been affected by the rheumatic disease. Mandibular hypoplasia is the most common issue and it may be associated with maxillary hypoplasia. The aim of this retrospective case-control study is to evaluate the effects of rapid maxillary expansion (RME) in these patients. Methods: 25 growing patients affected by maxillary hypoplasia, currently in a quiescent phase of JIA for at least one year and monolateral involvement of the TMJs, were treated with RME. Data gathered from posteroanterior and lateral cephalograms before and after 1 year from RME were compared to those of 25 non-JIA controls. Results: Nasal cavity width, maxillary width and upper and lower intermolar width statistically increased. Maxillary and mandibular symmetry indexes presented a statistically significant increase, so did the skeletal class. No signs or symptoms of TMJ activity of JIA occurred according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) criteria. No difference was found when comparing JIA and non-JIA patients apart from the better improvement of several mandibular symmetry indexes in the affected TMJ side of JIA patients. This event is allegedly due to a worse baseline asymmetry in JIA patients that underwent a bigger relative improvement after treatment. Conclusions: Results suggest that solving maxillary hypoplasia and, therefore, premature contacts are likely to have allowed mandibular repositioning and condylar growth. RME is a safe and effective solution that can substantially improve maxillary and mandibular symmetry in growing patients affected by JIA with TMJ involvement.

Depression and Resting Masticatory Muscle Activity.

Background: The aim of this study was to determine the influence of moderate depression determined based on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs) Axis II on the bioelectrical resting activity of temporal muscles and masseter muscles. Methods: The research participants were 68 healthy adult women. Of these, 46 people h (mean age: 22 ± 1 year) who had no temporomandibular disorders were selected for the research. They were divided based on results from RDC/TMDs (Axis II: scale’s measurement) into the study group with a moderate level of depression (23 people), rest of participants without symptoms of depression were classified to control group (23 people). The resting activity of temporal muscles and masseter muscles was examined by using BioEMGIII electromyograph. Two statistical analyses were used: Shapiro–Wilk test and Mann–Whitney U test. Results: Despite higher mean tensions of temporal muscles and masseter muscles in the group with depression, results findings were not statistically significant (p > 0.05). Conclusions: Moderate depression determined based on the RDC/TMDs II axis questionnaire is not related to the resting activity of selected masticatory muscles. Further research should be continued on a larger group of respondents in order to establish the relationship between psychological factors and bioelectrical parameters of the masticatory muscles.

Association Between -1607 1G/2G Polymorphism of MMP1 and Temporomandibular Joint Anterior Disc Displacement with Reduction

Anterior disc displacement with reduction (DDWR) is considered one of the most common disorders within the temporomandibular joint (TMJ), with a prevalence of 41% in adults. Matrix metalloproteinases play an important role in the degradation of the TMJ and the matrix metalloproteinase 1 (MMP1) 1607 1G/2G polymorphism increases the local expression of MMP1 thus leading to accelerated degradation of the extracellular matrix. The objective of this study was to evaluate the association between the 1607 1G/2G polymorphism of MMP1 gene and DDWR in a group of Mexican individuals from western Mexico. A total of 67 unrelated individuals, between the ages of 18 and 36 years, of both genders, were included in this study. Study participants with DDWR were required to meet the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), while a second control group of 90 individuals without DDWR were also included. Both groups were required to have paternal and maternal ancestry (grandparents) of the same geographic and ethnic region. Genotypes were determined using the nested PCR technique. The 1G/2G polymorphism was found in 68.7%, followed by 2G/2G in 25.4% and 1G/1G in 6.0% of the cases group. While the prevalence in the control group was 55.5% for the 1G/2G polymorphism, 26.6% for 1G/1G and 17.7% for 2G/2G. An association was found between the 2G allele of the 1607 1G/2G polymorphism of MMP1 gene and the presence of DDWR in the patients of western Mexico.

TMJ related short-term outcomes comparing two different osteosynthesis techniques for bilateral sagittal split osteotomy

ObjectivesBilateral sagittal split osteotomy (BSSO) is a morpho-functional surgery and post-surgical osteosynthesis may influence temporomandibular joint (TMJ) health. Our objective was to evaluate temporomandibular disorders (TMD) and TMJ symptoms after orthognathic surgery according to the type of osteosynthesis used in a population of patients with dentofacial deformities. Materials and methodsOne hundred and eighty-three consecutive patients undergoing orthodontic and maxillofacial surgery treatment for correction of their malocclusion were recruited for a two-year period at Lille University Hospital. All patients had at least a mandibular BSSO using Epker's technique. Each patient was examined before and one year after orthognathic surgery. We compared osteosynthesis by miniplates fixed with monocortical screws (n=42) and the hybrid fixation with bicortical retro-molar screws used with miniplates (n=141). TMJ health was assessed by monitoring TMD signs and symptoms according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and scores obtained from the “Jaw Pain Function” questionnaire. ResultsThere was no significant difference in pre-operative and one year post-operative RDC/TMD assessments (p≥0.91) or JPF score (p≥0.29) between the two types of osteosynthesis. ConclusionThere was no difference in TMJ health between the two techniques of osteosynthesis after BSSO. Clinical relevanceIn our experience the hybrid technique fixation affords many advantages and does not influence postoperative TMD compared with osteosynthesis by miniplates.