Severe Temporomandibular Joint Disorders Research Articles

Temporomandibular joint disorder among Peruvian music students of different instrumental specialties

Background Music, a profound human expression, can have physical implications for its practitioners. Musicians face various physical challenges that can impact their well-being, with craniofacial and temporomandibular pain being prevalent yet understudied. Temporomandibular joint disorder (TMJD) affects up to one-third of the population, though prevalence varies by study. While musculoskeletal issues like carpal tunnel syndrome are well-documented in musicians, craniofacial and temporomandibular pain is less explored. This study aims to determine the differences in TMJD frequency among music students of different instrumental specialties. Methods The sample was composed of students between 12 and 25 years of age from the National University of Music of Peru. A stratified random probability sample was chosen. Data were collected using a structured instrument covering general data, academic information, dental malocclusion, the Fonseca Simplified Anamnestic Index, and the Global Stress Perception Scale. Statistical analysis included Pearson's Chi-square test and a generalized linear model regression. Results The sample included 71.4% males with a median age of 23 years. Class II dental occlusion was most common (51.4%). TMJD prevalence was: 14.3% no TMJD, 60.0% mild TMJD, 22.9% moderate TMJD, and 2.9% severe TMJD. Metal wind (PR=0.04, 95%CI [0.00; 50.04], p=0.002) and woodwind players (PR=0.03, 95%CI [0.00; 0.56], p=0.018) had lower TMJD prevalence compared to plucked string and percussion players. Post-regression analysis indicated significant differences between metal wind and percussion students (p=0.030) and between percussion and woodwind students (p=0.025). These results are supported by the adjusted ratio of proportions analysis, which maintains statistical significance. Conclusion We found significant differences in TMJD prevalence among music students based on their instrumental specialty, with lower rates in metal wind and woodwind players compared to plucked string and percussion players.

Examination-Related Stress Leads to Temporomandibular Joint Disorders in Medical and Dental Students - An Institutional-Based Study

<p><strong>Background and Objective:</strong> Stress-related behaviors such as challenging academic atmosphere and rigorous examinations exert a negative impact on the normal function of temporomandibular joint. This study aimed to determine the prevalence and severity of temporomandibular joint disorders (TMDs) and their association with examination-related stress among medical (Bachelor of Medicine and Bachelor of Surgery) and dental (Bachelor of Dental Surgery) students.</p>
 <p><strong>Methods:</strong> This cross-sectional survey was conducted at Fatima Memorial Hospital, College of Medicine and Dentistry, Lahore, Pakistan, from June 2022 to November 2022 using the Fonseca’s Questionnaire. A total of 198 medical and dental students were included as study participants. They were required to select just 1 response for each of the 10 items mentioned in the adopted but customized and validated questionnaire. TMD was categorized as mild, moderate, severe, or no TMD based on the sum of these responses. The data were analysed using statistical software and a p-value less than or equal to 0.05 was set as significant.</p>
 <p><strong>Results:</strong> There were 52 (26.2%) males and 146 (73.7%) females with a mean age of 24.2 +1.22 years. Among 198 students, 104 were dental students while 94 were medical students. The prevalence of TMD was found to be 63.6% among all students. There was no TMD in 36.4% of students while 42.9% of students had mild TMD, and moderate and severe TMD was found in 14.1% and 6.6% of students, respectively. Mild (74%) and severe (6.7%) TMD were more prevalent in dental students than in medical students while moderate TMD was found more in medical students (16%). However, these differences were statistically not significant between dental and medical students (p > 0.005).</p>
 <p><strong>Conclusion:</strong> TMD was found in both medical and dental students with no significant difference in severity between them. The study indicates the need to take on certain preventive and therapeutic strategies to address this disorder among anxiety-prone medical and dental students.</p>

Muscle and joint mechanics during maximum force biting following total temporomandibular joint replacement surgery

Total temporomandibular joint replacement (TMJR) surgery is the established treatment for severe temporomandibular joint disorders. While TMJR surgery is known to increase mouth-opening capacity, reduce pain and improve quality of life, little is known about post-surgical jaw function during activities of daily living such as biting and chewing. The aim of this study was to use subject-specific 3D bite force measurements to evaluate the magnitude and direction of joint loading in unilateral total TMJR patients and compare these data to those in healthy control subjects. An optoelectronic tracking system was used to measure jaw kinematics while biting a rubber sample for 5 unilateral total TMJR patients and 8 controls. Finite element simulations driven by the measured kinematics were employed to calculate the resultant bite force generated when compressing the rubber between teeth during biting tasks. Subject-specific musculoskeletal models were subsequently used to calculate muscle and TMJ loading. Unilateral total TMJR patients generated a bite force of 249.6 ± 24.4 N and 164.2 ± 62.3 N when biting on the contralateral and ipsilateral molars, respectively. In contrast, controls generated a bite force of 317.1 ± 206.6 N. Unilateral total TMJR patients biting on the contralateral molars had a significantly higher lateral TMJ force direction (median difference: 63.6°, p = 0.028) and a significantly lower ratio of working TMJ force to bite force (median difference: 0.17, p = 0.049) than controls. Results of this study may guide TMJ prosthesis design and evaluation of dental implants.

Temporomandibular joint disorders prevalence and health-seeking preferences among Al-Madinah community: A prospective cross sectional study

Background: Painful temporomandibular joint disorders (TMDs) are of musculoskeletal origin and are considered the most common cause of non-odontogenic pain in the orofacial region. The purpose of this study was to investigate the prevalence and awareness of temporomandibular joint (TMJ) disorders in Almadinah Almunawwarah community. Methods: A prospective observational cross-sectional study with convenience sampling was conducted. The patients were selected from the dental college and the hospital at Taibah University in Al-Madinah, Saudi Arabia. A translated Arabic version of Fonseca's questionnaire was employed. The questionnaire asked about the participant's personal information, if they thought they had TMDs, and who to visit for therapy if necessary. These were followed by 10 items from Fonseca's questionnaire, each with a three-point scale. Results: The questionnaire was completed by 518 people. Females made up 57.1% of the participants. TMDs were present in 61% of the population, with varying degrees of severity. Males (44.3%) were less affected than females (55.7%). The difference, however, was not statistically significant (P = 0.354). Out of the 61% TMDs Positive patients, 74.1% had mild TMDs symptoms, while 20.8% and 5.1%, respectively, had moderate and severe TMDs symptoms (P = 0.05). The severity of the symptoms was unaffected by demographic data (P > 0.05). Only 40% seek care, with 64.6% selecting for a dentist or orofacial pain specialists for their management and 24.6% preferring for an orthopaedic specialist (P= 0.008). Conclusions: Participants from Al-Madinah had a greater prevalence of mild TMDs. The majority of the participants had no idea who to go to for treatment. The findings of this study highlight the importance of educational activities to enhance public awareness

Focus Groups to Inform the Development of a Patient-Reported Outcome Measure (PROM) for Temporomandibular Joint Disorders (TMDs).

Understanding symptoms of temporomandibular joint disorders (TMDs) can help doctors and patients document, monitor, and manage the disease and help researchers evaluate interventions. Patients with TMDs experience symptoms ranging from mild to severe, primarily in the head and neck region. This study describes findings from formative patient focus groups to capture, categorize, and prioritize symptoms of TMDs towards the development of a patient-reported outcome measure (PROM). We conducted ten focus groups with 40 men and women with mild, moderate, and severe TMD. Focus groups elicited descriptions of symptoms and asked participants to review a list of existing patient-reported outcomes (PROs) from the literature and patient advisor input and speak to how those PROs reflect their own experience, including rating their importance. We identified 52 distinct concepts across six domains: somatic, physical, social, sexual, affective, and sleep. Focus groups identified the ability to chew and eat; clicking, popping, and other jaw noises; jaw pain and headaches; jaw misalignment or dislocation; grinding, clenching, or chewing, including at night; and ear sensations as most important. Participants with severe TMDs more often reported affective concepts like depression and shame than did participants with mild or moderate TMDs. Findings support PROM item development for TMDs, including selecting existing PROMs or developing new ones that reflect patients' lived experiences, priorities, and preferred terminology. Such measures are needed to increase understanding of TMDs, promote accurate diagnosis and effective treatment, and help advance research on TMDs.

Modified minimally invasive surgery in reconstructing the temporomandibular joint disk by transplantation of the temporalis myofascial flap

ObjectiveThe transplantation of temporalis myofascial flap (TMF) is an indispensable method to treat severe temporomandibular joint disorders with disk failure. How to select the indication and the ways of transplantation is still a challenging topic for achieving the ideal effect. We reported the new methods and follow-up results of the patients treated with pedicled TMF transplantation.MethodsRetrospective case series was performed at Temporomandibular Joint Specialist Clinic, the First Affiliated Hospital of Xinjiang Medical University, from December 2014 to August 2022. 39 patients (50 sides) included anterior disk displacement without reduction and disk perforation who underwent discectomy and immediate reconstruction with pedicled TMF. The initial and postoperative maximum mouth opening (MMO), and pain visual analogue scale (VAS) were compared via paired t-test and Wilcoxon signed-rank sum test, respectively.ResultsThe average of follow-up time was 30.07 months. The reconstructed temporomandibular joints basically achieved stable occlusion, good function, and satisfactory effect. The patients displayed a remarkable reduction of VAS score of pain, and improvement of the MMO compared with that before operation (P < 0.001). MR scanning revealed the grafts in joint space showed band-shaped soft tissue density of medium signal and had the clear edges, without interruption and fragment.ConclusionReconstruction of the temporomandibular joint disk by transplantation of the TMF applying modified minimally invasive surgery was a feasible method, which could improve the function of joints and prevent adhesion, without obvious complications in donor region.

A hiperboloide não influencia a atividade eletromiográfica dos músculos mastigatórios durante movimentos mandibulares em indivíduos com disturbiotemporomandibular

Abstract Introduction The hyperboloid is a masticatory device made of silicone with an hourglass (hyperbolic) shape that has been used as an aid to jaw functional orthopedic therapy. Objective To evaluate whether the hyperboloid device affects electromyographic (EMG) activity of the masticatory muscles during jaw movements in individuals with temporomandibular joint disorders (TMD) compared to controls. Methods The study sample consisted of 49 participants divided into two groups: mild, moderate and severe TMD (TMD group; n = 25) and a control group (n = 24). We evaluated EMG activities of temporal and masseter muscles bilaterally during jaw protraction and retraction, and left and right lateralization with and without the use of the hyperboloid device. Statistical analyses were performed using two-way ANOVA with two factors: group (healthy and TMD) and situation (with or without the use of the hyperboloid). Results We found higher EMG activity in the left temporal in the TMD group and no difference in EMG activities with the use of the hyperboloid device. Conclusion The use of the hyperboloid device did not affect EMG activity of the muscles evaluated in the groups studied. We found higher EMG activity of the left temporal muscle in participants with TMD. Long-term randomized studies should be conducted in individuals with TMD to investigate the effects of functional orthopedic therapy using the hyperboloid device with visual and quantitative feedback.

Correlation between Temporomandibular Joint Disorders, Sleep Quality and Stress among Dental Students: A Cross-sectional Study

Introduction: Dental students are subjected to high levels of stress during their academic performance. The quality of sleep could also be affected in those with increased stress levels. Stress and sleep quality could be considered as risk factors in Temporomandibular Joint Disorders (TMD). Identification of the risk factors in TMD at the initial stages can lead to minimising the long term effects. Aim: To investigate the relationship between TMD symptoms, sleep quality and stress among dental students. Materials and Methods: A cross-sectional questionnairebased survey was conducted in the Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India, from November 2021 to December 2021 among 255 dental students. Fonseca Anamnestic Index (FAI) questionnaire was used for evaluation of TMD, while Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess stress scores and sleep quality, respectively. The students were surveyed to categorise them, if they were showing any symptoms of mild, moderate or severe TMD. Similarly the sleep quality and stress scores were assessed. The relationship between TMD with stress and sleep quality was also evaluated. Data analysis was done using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) version 26.0. Comparison of frequencies of scores of PSS, PSQI and FAI within groups was done using Chi-square test. Bivariate correlation between PSS/PSQI, PSS/ FAI ad FAI/PSQI was assessed using correlation coefficient. Results: Out of 255 participants, 182 were females and 73 were males. It was observed that 221 (86.7%) students reported moderate stress levels, 21 (8.2%) students showed mild and 13 (5.1%) subjects showed high stress levels. Temporomandibular symptoms were reported as mild, moderate and severe in 130 (51%), 21 (8.2%) and 9 (3.5%) students, respectively. A total of 229 (89.8%) students showed poor sleep quality and 26 (10.2%) students showed good sleep quality. Moderate stress was correlated with poor sleep quality and mild TMD. Conclusion: The stress levels were significantly correlated with sleep quality and TMD symptoms. Thus, increased stress and poor sleep may be considered as risk factors of TMD. However, longitudinal studies in large samples are required to determine the cause and effect relationships between sleep quality, stress levels and TMD.

Comparative Evaluation and Correlation of Pain Pattern in Neck Musculature Observed in Mild, Moderate, and Severe Temporomandibular Joint Disorder Cases as Compared to Non-temporomandibular Joint Disorder Cases

Introduction Temporomandibular disorder (TMD) is a broad term used to describe several interlinked disorders affecting the temporomandibular joint (TMJ), muscles of the craniofacial region, and associated structures, all of which have common symptoms such as pain and reduced jaw opening. Along with these, extra-craniofacial symptoms may also be present, which need to be assessed for early diagnosis of TMD. Considering the extra-craniofacial symptoms of TMD, this observational study aimed to evaluate the severity of pain in the neck musculature of patients with TMD and correlate it with the severity of the disorder. Material and methods A total of 44 patients were included in the study who were graded for severity of TMD based on the amnestic and dysfunctional components of the Helkimo index separately. The pain was evaluated bilaterally in five groups of neck muscles in all cases using manual palpation. The severity of pain in these neck muscles was then correlated with the severity of both subjective and objective symptoms of TMD and compared with patients without TMD. Results The Chi-square test revealed a statistically significant association between the severity of pain in all five groups of neck muscles and the severity of TMD. The severity of pain increased with the increasing severity of TMD, with atotal of 59.09% of TMD patients presenting with varying degrees of pain in the neck musculature and a p-value of 0.0001%which was significant. Negligible pain in the neck musculature was present in patients without TMD. Conclusion Based on the results, it was observed that the severity of TMD directly correlated with pain in various groups of neck muscles. 59.09% of patients with TMD reported varying degrees of pain in the neck musculature. The severity and distribution of pain in the neck muscles increased with the increasing severity of TMD.

Temporomandibular joint disorders prevalence and awareness of appropriate clinical practices, among Al-Madinah community: A prospective cross sectional study

Background: Painful temporomandibular joint disorders (TMDs) are of musculoskeletal origin and are considered the most common cause of non-odontogenic pain in the orofacial region. The purpose of this study was to investigate the prevalence and awareness of temporomandibular joint (TMJ) disorders in Almadinah Almunawwarah community. Methods: A prospective observational cross-sectional study with convenience sampling was conducted. A translated Arabic version of Fonseca's questionnaire was employed. The questionnaire asked about the participant's personal information, if they thought they had TMDs, and who to visit for therapy if necessary. These were followed by 10 items from Fonseca's questionnaire, each with a three-point scale. Results: The questionnaire was completed by 598 people. Females made up 57.1% of the participants. TMDs were present in 61% of the population, with varying degrees of severity. Males (44.3%) were less affected than females (55.7%). The difference, however, was not statistically significant (P = 0.354). Out of the 61% TMDs Positive patients, 74.1% had mild TMDs symptoms, while 20.8% and 5.1%, respectively, had moderate and severe TMDs symptoms (P = 0.05). The severity of the symptoms was unaffected by demographic data (P &gt; 0.05). Only 40% seek care, with 64.6% selecting for a dentist and 24.6% preferring for an orthopaedic specialist (P= 0.008). Conclusions: Participants from Al-Madinah had a greater prevalence of mild TMDs. The majority of the participants had no idea who to go to for treatment. The findings of this study highlight the importance of educational activities to enhance public awareness

The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study

BackgroundPatients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. Therefore, this study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data.MethodsA total of 12,375 TMD patients from the Korean National Health Insurance Review and Assessment database were analyzed. Controls were selected using propensity score-matching. The McNemar test, chi-square test, and paired t-test were used to compare the prevalence and severity of spinal pain between cases and matched controls. Logistic regression and linear regression models were used to analyze factors affecting the prevalence and severity of spinal pain in patients with TMD.ResultsThe annual period prevalence of TMD was 1.1%. The prevalence was higher in younger individuals than in individuals of other ages and was higher in women than in men. The medical expenditure for TMD per person was $86. Among TMD patients, 2.5% underwent surgical procedures and 0.3% were hospitalized. The prevalence of spinal pain in patients with TMD was 48%, whereas that in the control group was 34%. Increased severity of TMD was associated with an increased probability of spinal pain. The medical expenditure, mean number of visits, and lengths of treatment for spinal pain were greater for patients with TMD than for controls ($136 vs. $81, 4.8 days vs. 2.7 days, 5.5 days vs. 3.3 days). Higher TMD grade was associated with greater differences in average medical expenditure, number of visits, and lengths of treatment for spinal pain between cases and controls. Additionally, for women, living in a rural area and having an older age and more severe TMD were associated with a greater probability of spinal pain and higher medical expenditure related to spinal pain.ConclusionA strong association was observed between the presence of TMD and the presence of spinal pain. The association became stronger as the severity of TMD increased, indicating a positive correlation between the severity of TMD and spinal pain.

Oral health and orofacial function in patients with rheumatoid arthritis

The aim of the study was to describe the oral health and orofacial function of Mexican patients with rheumatoid arthritis (RA) and their association with clinical and radiological aspects of the disease. Patients with RA received a complete odontological exam, which also included a clinical and radiographic assessment of the temporomandibular joint (TMJ). The rheumatologic assessment included detailed profiling of the disease and serological and radiographic parameters. The study included 62 RA patients; the median (min-max) age was 51 (18-72) years old and 8.5 (1-39) years of disease duration. The 63.6% of the patients had DAS28 ≥ 3.2, and a median (min-max) of Sharp/van der Heijde score (SvdHS) of 41 (0-214). 98.3% of the patients presented caries, which were severe in 53.3% of the cases. The 73.8% of the patients were missing teeth due to caries, with a median (min-max) of 4 (0-32) teeth missing per patient. Oral hygiene was classified as bad in 49.1% of patients and only 15.3% of them had a healthy periodontium. The TMJ function was abnormal in 98.4% of the patients and 62.9% of them presented moderate or severe TMJ disorder (TMD). The radiographic damage of the TMJ correlated positively with the SvdHS. No correlations were found between disease activity or structural progression and orofacial variables, including periodontitis. There are severe oral and orofacial health problems in RA patients despite having medical attention for their disease. Multidisciplinary management remains an area of opportunity for both the medical specialists and the health system in our country.

Tissue Engineering for the Temporomandibular Joint.

Tissue engineering potentially offers new treatments for disorders of the temporomandibular joint which frequently afflict patients. Damage or disease in this area adversely affects masticatory function and speaking, reducing patients' quality of life. Effective treatment options for patients suffering from severe temporomandibular joint disorders are in high demand because surgical options are restricted to removal of damaged tissue or complete replacement of the joint with prosthetics. Tissue engineering approaches for the temporomandibular joint are a promising alternative to the limited clinical treatment options. However, tissue engineering is still a developing field and only in its formative years for the temporomandibular joint. This review outlines the anatomical and physiological characteristics of the temporomandibular joint, clinical management of temporomandibular joint disorder, and current perspectives in the tissue engineering approach for the temporomandibular joint disorder. The tissue engineering perspectives have been categorized according to the primary structures of the temporomandibular joint: the disc, the mandibular condyle, and the glenoid fossa. In each section, contemporary approaches in cellularization, growth factor selection, and scaffold fabrication strategies are reviewed in detail along with their achievements and challenges.

Improved anchoring nails: design and analysis of resistance ability

BackgroundAnchorage is one of the most important treatments for severe temporomandibular joint disorder (TMD). Anchoring nails have shown great success in clinical trials; however, they can break under pressure and are difficult to remove. In this study, we aimed to evaluate an improved anchoring nail and its mechanical stability.MethodsThe experiment consisted of two parts: a tensile test and finite element analysis (FEA). First, traditional and improved anchoring nails were implanted into the condylar cortical bone and their tensile strength was measured using a tension meter. Second, a three-dimensional finite element model of the condyles with implants was established and FEA was performed with forces from three different directions.ResultsThe FEA results showed that the total force of the traditional and improved anchoring nails is 48.2 N and 200 N, respectively. The mean (±s.d.) maximum tensile strength of the traditional anchoring nail with a 3–0 suture was 27.53 ± 5.47 N. For the improved anchoring nail with a 3–0 suture it was 25.89 ± 2.64 N and with a 2–0 suture it was above 50 N. The tensile strengths of the traditional and improved anchoring nails with a 3–0 suture was significantly different (P = 0.033–< 0.05). Furthermore, the difference between the traditional anchoring nail with a 3–0 suture and the improved anchoring nail with a 2–0 suture was also significantly different (P = 0.000–< 0.01).ConclusionThe improved anchoring nail, especially when combined with a 2–0 suture, showed better resistance ability compared with the traditional anchoring nail.

Bioengineered Temporomandibular Joint Disk Implants: Study Protocol for a Two-Phase Exploratory Randomized Preclinical Pilot Trial in 18 Black Merino Sheep (TEMPOJIMS).

BackgroundPreclinical trials are essential to test efficacious options to substitute the temporomandibular joint (TMJ) disk. The contemporary absence of an ideal treatment for patients with severe TMJ disorders can be related to difficulties concerning the appropriate study design to conduct preclinical trials in the TMJ field. These difficulties can be associated with the use of heterogeneous animal models, the use of the contralateral TMJ as control, the absence of rigorous randomized controlled preclinical trials with blinded outcomes assessors, and difficulties involving multidisciplinary teams.ObjectiveThis study aims to develop a new, reproducible, and effective study design for preclinical research in the TMJ domain, obtaining rigorous data related to (1) identify the impact of bilateral discectomy in black Merino sheep, (2) identify the impact of bilateral discopexy in black Merino sheep, and (3) identify the impact of three different bioengineering TMJ discs in black Merino sheep.MethodsA two-phase exploratory randomized controlled preclinical trial with blinded outcomes is proposed. In the first phase, nine sheep are randomized into three different surgical bilateral procedures: bilateral discectomy, bilateral discopexy, and sham surgery. In the second phase, nine sheep are randomized to bilaterally test three different TMJ bioengineering disk implants. The primary outcome is the histological gradation of TMJ. Secondary outcomes are imaging changes, absolute masticatory time, ruminant time per cycle, ruminant kinetics, ruminant area, and sheep weight.ResultsPrevious preclinical studies in this field have used the contralateral unoperated side as a control, different animal models ranging from mice to a canine model, with nonrandomized, nonblinded and uncontrolled study designs and limited outcomes measures. The main goal of this exploratory preclinical protocol is to set a new standard for future preclinical trials in oromaxillofacial surgery, particularly in the TMJ field, by proposing a rigorous design in black Merino sheep. The authors also intend to test the feasibility of pilot outcomes. The authors expect to increase the quality of further studies in this field and to progress in future treatment options for patients undergoing surgery for TMJ disk replacement.ConclusionsThe study has commenced, but it is too early to provide results or conclusions.

Prevalence and Severity of Temporomandibular Disorders among Undergraduate Medical Students in Association with Khat Chewing.

The aim of this study was to assess the prevalence and severity of temporomandibular joint disorders (TMDs) among undergraduate medical students in the presence of khat chewing over a period of time. Totally, 186 medical college students (age < 20 years) were randomly selected for the present study. The study subjects were divided into two groups according to age, under 20 and above 20 years. The study was based on Fonseca's anamnestic index and its questionnaire, which is composed of 10 questions and classifies the severity of TMDs. The obtained data were coded and entered into Statistical Package for the Social Sciences (SPSS) program for analysis using chi-square test at significance level of 5%. Most of the participants were male (68.8%) students and older than 20 years (63%). Those who reported with khat chewing comprised 31.7%. From the total samples, only 38.0% was classified as having mild TMD and 0.50% were classified as having severe TMD. Poor dental articulation, grinding of teeth, headaches, tense personalities, and temporomandibular joint (TMJ) clicking were the most common clinical findings. The mean scores showed no significant difference among gender (p < 0.29) and the khat chewing (p < 0.531) groups for the 10 questions. However, it showed significant difference among age groups (p < 0.025). The majority of subjects complained of mild TMD, while only a few cases showed a moderate TMD among different age groups. The most frequently reported dysfunctions were related to poor dental articulation and grinding of the teeth, frequent headaches, the clicking of joint, and tense personalities. No significant difference was found between gender and khat and nonkhat chewing groups. Khat chewing is a parafunctional habit and affects dental occlusion (especially cuspal wear) in terms of anterior guidance. Such alterations in occlusion are known to be one of the causative (predisposing) factors of TMD.

Poly(ɛ-caprolactone) and Polyethylene Glycol Diacrylate-based Scaffolds for TMJ Bioengineered Disc Implants

The temporomandibular joint (TMJ), articulation between the mandibular condyle and the temporal bone, is divided into two compartments (superior and inferior) by a fibrocartilaginous disc. The TMJ disc consists on an avascular and non-innervated tissue, with viscoelastic behavior. Mechanically, the TMJ disc experiences tensile, compressive and shear forces. TMJ disc displacement or degeneration could lead to severe intra-articular temporomandibular joint disorders (TMD). Despite the large number of current therapies/treatments, there is limited treatment options for severe intra-articular TMD. A strategy to solve this problem could be the use of an interposal material to substitute the damaged TMJ disc, which will gradually degrade and give rise to new tissue. In this work three options were used and tested, one using a thermoplastic material, poly(ɛ-caprolactone) (PCL), another using an photopolymerized hydrogel, polyethylene glycol diacrilate (PEGDA) and the third using the combination of the two materials. Obtained results demonstrated that that the combination of different materials could represent a significant advantage in the TMJ disc TE and in the cartilage TE in general.

Prevalence of Temporomandibular Dysfunction and its Association with Malocclusion in Children: An Epidemiologic Study.

Malocclusion is one etiological factor of temporomandibular joint disorder (TMD). This study investigates the prevalence of TMD and the relationship between TMD and the type of occlusion. A sample of 923 children (463 girls and 460 boys, ages 7-12 years old) was grouped not only by chronological age but also by gender. The information was collected on functional occlusion (anterior and lateral sliding, interferences), dental wear, mandibular mobility (maximal opening, deflection, deviation), and temporomandibular joint and muscular pain recorded by palpation. Headache was the only symptom of temporomandibular dysfunction (TMD) reported by the children. The results showed that one or more clinical signs were recorded in 25% of the subjects, most of which were mild in character. The prevalence increased during the developmental stages. Girls were in general more affected than boys. In this study, many subjects with TMD had malocclusions. Early treatment may be important in the prevention of severe TMD. Significant associations were found between different signs, and TMD was associated with posterior crossbite, anterior open bite, Angle Class II and III malocclusions, and extreme maxillary overjet.

Prevalence and Severity of Temporomandibular Joint Disorders among Populations in Najran Province, Kingdom of Saudi Arabia

ABSTRACT Aim This study assessed the prevalence and severity of temporomandibular joint disorders (TMDs) in the absence or presence of teeth of participants in Najran region in comparison with other adult participants in other regions with respect to gender differences and age. Furthermore, it investigates the frequency of symptoms of temporomandibular joint (TMJ) by clinical examination. Materials and methods The total number of participants was 318 of both genders randomly selected for this study. The participants were divided into three age groups: 14 to 20, 21 to 40, and ≥41 years. The study was based on Fonseca's Anamnestic Index and its questionnaire, which is composed of 10 questions and classifies the severity of TMD. Clinical examination was performed for the patients to investigate the sign of TMJ dysfunctions. The obtained data were coded and entered into Statistical Package for the Social Sciences program for analysis using Chi-square test at significance level of 5%. Results The participants with mild TMD dysfunction were 35.5%, whereas 18.6 and 3.5% were classified as moderate and severe TMD dysfunction respectively. The most reported TMD problems were related to poor articulation of teeth (23.9 and 25.5%), followed by frequent headache (15.1 and 33.6%), then grinding of teeth (15.4 and 34.9%) in “Yes” and “sometimes” answers respectively. The highest TMJ disorder was a frequent headache at 55.3%, followed by TMJ clicking at 21.1%. The remaining TMJ dysfunctions ranged between 11 and 13%. There was no significant difference between TMDs and gender (p ≤0.306). However, the severity of TMDs increased with increasing age (p ≤0.001) and was associated with tooth loss (p ≤ 0.000). Conclusion The majority of the participants had mild-tomoderate TMDs and they were found among the middle-age group. The severity of TMDs increased with age and was associated with tooth loss. No significant difference between males and females was found. The most reported TMD problems were related to the poor articulation of teeth, frequent headache, and grinding of teeth, while a headache followed by clicking of TMJ was the highest clinical TMJ disorder. How to cite this article Aldhalai MA, Alyami YAS, Al Haider YMB, Aldhili MK, Alyami DAS, Alyami SAS, Al-Moaleem MM, Alghazali N. Prevalence and Severity of Temporomandibular Joint Disorders among Populations in Najran Province, Kingdom of Saudi Arabia. World World J Dent 2017;8(2):90-95.

Association between headache and temporomandibular joint disorders in children and adolescents

The aim of the present study was to assess the relationship between temporomandibular joint disorder (TMJD) and headache in children and adolescents. A prospective cross-sectional cohort study was carried out involving 93 children and adolescents (6 to 14 years of age) at the outpatient service of a dental school. All participants underwent a clinical examination involving Axis 1 of the Research Diagnostic Criteria for Temporomandibular Disorders, along with a characterization of headache and an anthropometric evaluation. Statistical analysis involved the chi-squared test for quantitative variables and the Student's t-test, ANOVA and Tukey's test for quantitative data. An adjusted logistic regression model was used to determine significant associations among gender, age, TMJD and headache. Mild TMJD was identified in 35.8% of the sample and was not associated the presence of headache. Moderate TMJD was found in 25.8% of patients and severe TMJD was found in 11.8%; both forms of TMJD were associated with headache. A significant correlation was found between the intensity of TMJD and the risk of headache. The present findings demonstrate a positive correlation between TMJD and headache in children and adolescents, independently of gender and age.