Signs Of Temporomandibular Joint Dysfunction Research Articles

EFFICACY OF BOTULINUM TOXIN TYPE A IN REDUCING CHRONIC TENSION HEADACHE IN PATIENTS WITH TEMPOROMANDIBULAR JOINT DYSFUNCTION

There is a notable prevalence of temporomandibular joint dysfunction, reaching approximately 34% in the general population according to the recent studies. Individuals with such dysfunction often experience tension headaches due to increased tension in the masticatory muscles, a key symptom of temporomandibular joint dysfunction. Botulinum toxin type A injections into these muscles are utilized to alleviate the dysfunction, as this drug inhibits neuromuscular impulses, thereby reducing muscle tension. This study aimed to assess the efficacy of alleviating chronic tension headaches in patients with temporomandibular joint dysfunction through botulinum toxin type A injections into trigger points of the masticatory muscles. Sixty patients exhibiting signs of temporomandibular joint dysfunction and chronic tension headaches participated in the study. They were randomly assigned to either an experimental group receiving botulinum toxin type A injections or a control group receiving saline injections into the masticatory muscles. Injections were administered at sites with the highest muscle tension in the masseter and temporalis muscles. The reduction in chronic tension-type headaches was evaluated using a visual analogue pain scale. The results indicated a statistically significant decrease in headache intensity in the experimental group compared to the control group (P<0.001). Furthermore, the experimental group demonstrated significant treatment efficacy based on headache intensity before and after 12 weeks from the drug administration date (P<0.001).

Prevalence of Temporomandibular disorders in Orthognathic Surgery patients: A systematic review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

Orthognathic surgery is done to treat a variety of dentofacial abnormalities, but a wide gap still remains on how it can result in temporomandibular joint dysfunction (TMD). The primary goal of this review was to assess the effects of various orthognathic surgical techniques on the emergence or exacerbation of TMJ dysfunction. A comprehensive search was conducted across several databases using Boolean operators and MeSH keywords related to temporomandibular joint disorders (TMDs) and orthognathic surgical interventions, with no limitation on the year of publication. Two independent reviewers screened the identified studies based on predetermined inclusion and exclusion criteria, followed by a risk of bias assessment using a standardized tool. Five articles were considered for inclusion in this review. A greater number of females opted for surgical options than their male cohorts. 3 studies were of prospective design, 1 of retrospective and 1 of observational type. Mobility on lateral excursion, tenderness on palpation, arthralgia and popping sounds were the TMD characteristics that showed significant differences. Overall, orthognathic surgical intervention did not show an increase in TMD signs and symptoms as compared to non-surgical counterparts. Though orthognathic surgery reported greater cases of some TMD symptoms and signs as compared to the non-surgical cohorts in four studies, the conclusive evidence is debatable. Further studies are recommended with longer follow up period and greater sample size to determine the impact of orthognathic surgery on TMJ.

Clinical Signs of Temporomandibular Joint Dysfunction in Students of a University in Hanoi

Abstract: Temporomandibular joint dysfunction (TMD) is a common disease, especially increasing in young people, and affects the quality of life. Clinical signs of TMDs are various and complex. Diagnosis of symptoms and prognosis is essential. Therefore, we conducted a cross-sectional descriptive study on 61 patients aged 19-23 who participated voluntarily from February to June 2022 at the Odonto-Stomatology clinic at the University of Medicine and Pharmacy, Vietnam National University. The results showed that the proportion of women with symptoms was higher than that of men. For the clinical symptoms, percentages of the limited range of mandibular movements and mouth gap deviation were quite high (77.0% and 68.9%, respectively). Joint sounds and arthralgia took 31.1% and 24.6%, while myalgia accounted for only 11.5%. In the joint, the pain was detected mainly on the outer surface of the joint (24.6%). In both genders, the masseter muscle was the most painful muscle group. Clinical symptoms are very important in diagnosis, treatment, and prognosis.
 Keywords: Clinical signs, temporomandibular joint dysfunction, students. 
 

СПОСОБ ДИАГНОСТИКИ МЫШЕЧНО-СУСТАВНОЙ ДИСФУНКЦИИ ВНЧС У ПАЦИЕНТОВ С ЗУБОЧЕЛЮСТНЫМИ АНОМАЛИЯМИ

Subject. Anomalies of the dentition and deformities of the dentition in adult patients are often accompanied by disorders in the temporomandibular joint (TMJ). At present, the possibilities of diagnosing TMJ diseases have increased significantly due to the emergence and use of modern instrumental and technical methods. However, data on the optimal choice of research methods, their scope and sequence of execution in patients with TMJ diseases are not presented in the literature. The treatment of patients with dentoalveolar anomalies (DA), combined with functional disorders of the TMJ, according to many authors, presents significant difficulties. Currently, the problem of effective diagnosis of patients with AF and functional disorders of the TMJ remains an urgent problem in dentistry.
 The aim of the study to develop a method for diagnosing patients with AF and functional disorders of the TMJ based on the method of M. Helkimo.
 Methodology. Questioning and clinical examination of 150 patients aged 18–44 years with dentoalveolar anomalies and symptoms of temporomandibular joint dysfunction were carried out. According to the proposed diagnostic method, signs of TMJ dysfunction were determined: articular, muscular, neurological and occlusive. When identifying occlusal and muscle signs of dysfunction, an in-depth study was carried out according to the proposed scheme.
 Results. Own observations and studies have shown that the system of signs of dysfunction of the temporomandibular joint can be used as a scheme for the initial examination of a patient with dento-maxillary anomalies and functional disorders of the TMJ at the dentist's appointment.
 Conclusions. The proposed diagnostic method allows the dentist at the initial appointment, without using additional instrumental diagnostic methods, to determine the amount of necessary research for patients with dento-maxillary anomalies and functional disorders of the TMJ.

Prevalence of signs of temporomandibular joint dysfunction in asymptomatic edentulous subjects visiting department of prosthodontics government dental college, Srinagar: A cross-sectional study

Patients having complete dentures with reduced vertical dimension generally do not manifest Temporomandibular Joint problems. It is not understood as to why the closure of jaws in dentulous individuals can predispose to Temporomandibular Joint problems, while the same etiology in edentulous subjects does not cause any concern. This study was planned to find out the prevalence of various Temporomandibular Joint dysfunction signs in subjects who were edentulous for a period of 6 months to 2 year. The various signs were obtained from a population of 40 healthy asymptomatic edentulous subjects by a questionnaire and then were clinically examined for the presence or absence of signs of Temporomandibular Joint dysfunction. 55% of the subjects exhibited one or more signs of Temporomandibular Joint dysfunction, 45% of the subjects did not show any signs of Temporomandibular Joint dysfunction. 25% of males reported signs of Temporomandibular Joint dysfunction when compared with females which was 30%. 35% of males did not show any signs of Temporomandibular Joint dysfunction when compared with those of the females which was 10%. The number of subjects who showed two signs was 22%, subjects who had only one sign was 59%. It was found that dysfunction was prevalent among both men and women in more than half of the asymptomatic subjects examined. The most commonly seen Joint dysfunction was the joint sounds which was 45%.

Assessment of occlusion and temporomandibular joint after placing preformed metal crowns on all primary molars in children.

Placing preformed metal crowns (PMCs) on all eight primary molars at one single clinical visit may disrupt a child's occlusion; the literature regarding the effects on occlusion and temporomandibular joint (TMJ) is scarce. This study aimed to quantify the changes in occlusion using T-Scan III and to investigate whether there was TMJ dysfunction after placing eight PMCs at the same time. In this study, we enrolled children with severe early childhood caries (S-ECC) and dental phobia, who needed eight PMCs to be placed under general anesthesia. The participants underwent occlusal examinations with a computed occlusal analysis system. The vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge, TMJ dysfunction signs were recorded by the clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using a questionnaire. The data were collected before treatment (T0 ), 1 week after treatment (T1 ), and 1 month (T2 ) and 3 months (T3 ) after treatment during follow-up visits. Repeated-measures analysis of variance and Friedman's test were used for occlusal data analysis. In addition, the Di and symptoms were compared over time using McNemar's test. Forty patients (mean age=4.25 ± 0.63 years, age range=3-5 years, 21 boys and 19 girls) were followed up for 3 months. The occlusal contact area 3 months after treatment did not return to the pretreatment status (p=.03). The total of force at the 3-month follow-up visit increased significantly (p=.009) compared with that at the pretreatment. The asymmetric ratio of occlusal force at the 1-month follow-up visit was restored to pretreatment. Concerning the occlusion time, no significant changes were observed for any time intervals (p=.069). The VDO was recovered at the 1-month follow-up visit. The statistical analysis of TMJ dysfunction showed no significant differences in the Di and TMJ dysfunction symptoms before and after treatment (p > .05). After undergoing eight PMC restorations under general anesthesia, occlusal re-equilibration was attained approximately after 1 month. There were no significant signs and symptoms of TMJ dysfunction after treatment.

Effects of Prosthetic Rehabilitation on Temporomandibular Disorders: Protocol for a Randomized Controlled Trial

BackgroundLoss of teeth or occlusal imbalance is one of the proposed dental risk factors for temporomandibular disorders (TMDs). Losing some non–free-end teeth cause the original occluding tooth/teeth to supraerupt from the original upright position and causes neighboring tooth/teeth to shift in an angle, causing biomechanical imbalance on the mandible. Based on these sequelae, rehabilitation of missing teeth is the first step in managing TMD in edentulous patients. Even though the prevalence of TMD in association with edentulism and in rehabilitated patients has been increasing, proper guidelines for the management of such cases have not been established. This study describes the protocol to analyze the effect of prosthetic rehabilitation on patients with TMD.ObjectiveThis study aims to determine the effectiveness of prosthetic rehabilitation in the reduction of pain in edentulous patients with TMD and to determine the effect of the span of edentulism, the number of quadrants involved, pathological migration, the type of Kennedy classification, and the prosthetic status on temporomandibular joint dysfunction signs and symptoms.MethodsIn this randomized controlled trial, 300 patients diagnosed with TMD will be grouped into one of the three interventional groups based on the type of their edentulous state. The interventional groups are (1) partially edentulous arch: Kennedy Class I and II (prosthetic rehabilitation without splint); (2) partially edentulous arch: Kennedy Class III and IV (prosthetic rehabilitation with a splint); and (3) completely edentulous arches (prosthetic rehabilitation without splint). All three of the mentioned interventional groups have corresponding control groups that will receive symptomatic treatment and comprehensive counseling. The measured primary outcomes are pain and electromyogram, and the secondary outcomes include pain drawing, Graded Chronic Pain Scale, Jaw Functional Limitation Scale, Oral Behaviours Checklist, depression, physical symptoms, and anxiety. The outcome measurements will be recorded at baseline and at the end of 24 hours, 7 days, 28 days, and 3 months.ResultsEthical approval was obtained from the Institutional Review Board of Amrita Institute of Medical Sciences, Kochi, India. Study participants’ recruitment began in May 2021 and is expected to conclude in March 2023. This clinical trial protocol was developed based on the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 Statement.ConclusionsThe purpose of this study is to gather data on prosthetic rehabilitation as a treatment for TMD. Obtaining this goal will aid in the development of evidence-based therapy protocols for prosthetic rehabilitation in TMD management.Trial RegistrationClinical Trials Registry - India CTRI/2020/06/026169; http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=42381International Registered Report Identifier (IRRID)DERR1-10.2196/33104

Signs of temporomandibular joint dysfunction in individuals with different dentition defects and unequal preservation of antagonist pairs of teeth

As a result of examination and questionnaire of 143 patients who applied for orthopedic treatment of defects of teeth and dental rows, it was found that signs of dysfunction of temporomandibular joint with preserved dental rows are diagnosed in 36—55% cases, and with defects of dental rows — in 45—90% cases. The absence of eighth teeth in the dental row does not significantly change the functional state of the dental-jaw system. A statistically significant frequency of signs of EHS dysfunction has been identified among individuals having terminal dentition defects.In patients with terminal dentition defects, each 3rd patient is diagnosed with cochleovestibular syndrome, and in each 2nd, sounds are determined in the area of VNHS when the lower jaw moves. It has been found that if 15—13 and 12—11 pairs of antagonist teeth are preserved, the signs of dysfunction are determined in 55—45% cases, if the number of teeth having antagonists is reduced to 10—5 (in 90.0% these are patients with preserved 7—8 pairs of antagonist teeth), then the frequency of dysfunction signs increases to 75.0% (t1-3=1.33; t2-3=2.00), in such patients significantly more often — in 75.0% of cases, mandibular deviation is diagnosed when opening and closing the mouth than in persons with a large number of preserved antagonist teeth, respectively 55.0% (t=2.66) and 45.0% (t=3.93) in 1 and 2 groups. Thus, the identification of such signs as crunching, clicking in the joints, hearing loss or tinnitus, suggests the presence of intra-articular disorders in such patients. The deviation of the jaw from its main trajectory when opening the mouth indicates the possible involvement of the masticators muscles in the pathological process. All this requires the dentist to carry out early diagnosis and timely orthopedic treatment.

Efficiency of treatment of patients with muscular and joint dysfunction of the TMJ

The prevalence of dysfunction of the temporomandibular joint (TMJ), especially in people aged 18-65 years, reached 95-98% among all dental applications. The course of the pathology is usually hidden, with periodic recurrences, and has a long nature, which is accompanied by a decrease in overall quality of life. Treatment of this pathology of the TMJ is a set of complex therapeutic, orthopedic and psychological measures. The literature describes many ways to treat TMJ dysfunction, and one of the modern ones is the use of occlusal splints, which enables to change the position of the mandible, diagnose and eliminate musculoskeletal dysfunction of the TMJ. The aim of the study was to determine the effectiveness of treatment of musculoskeletal dysfunction of the TMJ with occlusal splints according to axiography. Material and methods. 274 patients aged 18 to 65 years were diagnosed with temporomandibular joint (TMJ) pain syndrome before and after treatment.Results. All patients with signs of TMJ dysfunction before treatment had a violation of the trajectory of the mandible (deviation – 68.7%, dyslexia – 31.3%). When opening and closing the mouth, asymmetrical shifts of the lower jaw to the sides of more than 2 mm (deviation from the midline – more than 2 mm) were observed. After treatment with occlusal splints there was an improvement in the trajectory of opening and closing the mouth: the number of patients with a violation of the trajectory decreased by 89.1%, and the displacement of the mandible during opening and closing the mouth in 92.4% of patients decreased on average to 0, 9 mm. When analyzing the movements of the mandible in the sagittal plane in 79 % of cases, deviations of the trajectory of the mandible were detected. After treatment with occlusive muscle relaxation splints, elimination of violations of the trajectory of the mandible in the transverse plane was noted in 93.4% of cases, reduction of displacement to 0.9 mm in 78.1% of patients. Сonclusions. The trajectory of the mandible in the sagittal plane improved in 80.1% of patients, normalization of the position of the mandible relative to the neuromuscular trajectory was achieved in 93.4% of clinical cases. According to the analysis of parameters, such treatment should be considered effective.

Assessment of structural body imbalances in patients with temporomandibular joint dysfunction

Introduction. Temporomandibular joint (TMJ) dysfunction is the second most common musculoskeletal disease, affecting up to 33 % of people during their lifetime. The multicomponent etiopathogenesis of the disease actualizes the use of diagnostic criteria for the early symptoms of developing functional disorders. The algorithm for preclinical examination of the TMJ must be used already in the dentist′s office, which will allow to avoid the unpredictable results of dental rehabilitation and in time to attract other specialists to the complex therapy of the patient. The etiopathogenesis of TMJ dysfunction indicates the need for a closer study of the mutual infl uence of structural imbalances in the body and dentition, the determination of the primary disorder, which will help to develop a system for the prevention of TMJ dysfunctions, and may also affect the sequence, volume and nature of the treatment for this pathology.The goal of research — to identify the relationship of structural imbalances in the body and temporomandibular joint dysfunction.Materials and methods. From September to December 2019, a prospective study of 70 volunteers among university students was conducted at the Department of Orthopedic Dentistry of Omsk State Medical University. During the processing of clinical material, 6 people retired in accordance with exclusion criteria. All subjects underwent an assessment of the state of the dentofacial system, primarily the TMJ (using a short Hamburg test) and structural imbalances of the body (using the Notch Interfaces Inc. motion capture and reconstruction system). To assess the cervical-cranial relationship in the subjects who had 3–6 points according to the results of the Hamburg test, a head X-ray was make in lateral projection, and cephalometric analyzes were performed according to Rocabado and Sassuni. The presence and strength of the linear relationship between the phenomena was determined using the Pearson coefficient.Results. According to the results of the Hamburg test, a functional norm was revealed in only 12,5 % of the examined; TMJ dysfunction was revealed in the vast majority of volunteers (57,9 %). Structural imbalances of the body were detected in 82,8 % of cases. Patients with established by the results of the Hamburg test TMJ dysfunction were underwent cephalometric analysis. Structural changes in the TMJ were not found in the subjects according to the X-ray studies results. There was a high positive relationship between functional TMJ dysfunction and pelvic hyperfl exion (ρ=0,72, p<0,05), and an average positive relationship (ρ=0,55, p<0,05) between the head and neck forward tilting. A positive weak relationship was observed between the risk of TMJ dysfunction developing (2 points according to the Hamburg test) and pelvic hyperfl exion (ρ=0,31, p<0,05).Conclusion. The study showed a strong positive relationship between pelvic hyperfl exion and TMJ dysfunction signs; an average positive relationship between TMJ functional impairment and head and neck forward tilting. It was also found that in individuals with TMJ dysfunction signs there were no radiological signs of structural changes in the joint, which indicates the potential reversibility of the revealed disorders and the need for their timely detection and correction. This study is pilot and will be continued in a broader format.

Efficiency of treatment of patients with muscular and joint dysfunction of the temporomandibular joints

The prevalence of dysfunction of the temporomandibular joint, especially in people aged 18-60 years, reached 95-98 % among all dental applications. The course of the pathology is usually hidden, with periodic recurrences and has a long nature, which is accompanied by a decrease in overall quality of life. Treatment of this pathology of the temporomandibular joint is a set of complex therapeutic, orthopedic and psychological measures. The literature describes many ways to treat temporomandibular joint dysfunction, one of the modem ones is the use of occlusal splints, which allow to change the position of the mandible, diagnose and eliminate musculoskeletal dysfunction of the temporomandibular joint. The aim of the study was to determine the effectiveness of treatment of musculoskeletal dysfunction of the temporomandibular joint with occlusal splints according to axiography. 274 patients aged 18 to 65 years were diagnosed with temporomandibular joint pain syndrome before and after treatment. All patients with signs of temporomandibular joint dysfunction before treatment had a violation of the trajectory of the mandible (deviation is 68.7 %, dyslexia is 31.3 %). When opening and closing the mouth, asymmetrical shifts of the lower jaw to the sides of more than 2 mm (deviation from the midline is more than 2 mm) were observed. After treatment with occlusal splints there was an improvement in the trajectory of opening and closing the mouth: the number of patients with a violation of the trajectory decreased by 89.1 %, and the displacement of the mandible during opening and closing the mouth in 92.4 % of patients decreased on average to 0.9 mm. When analyzing the movements of the mandible in the sagittal plane in 79 % of cases, deviations of the trajectory of the mandible were detected. After treatment with occlusive muscle relaxation splints, elimination of violations of the trajectory of the mandible in the transverse plane was noted in 93.4 % of cases, reduction of displacement to 0.9 mm in 78.1 % of patients. The trajectory of the mandible in the sagittal plane improved in 80.1 % of patients, normalization of the position of the mandible relative to the neuromuscular trajectory was achieved in 93.4 % of clinical cases. According to the analysis of parameters, such treatment should be considered effective. Keywords: musculoskeletal dysfunction, temporomandibular joint, clinical dysfunction index, axiography, sagittal articular pathway angle, sagittal incisor pathway angle, Bennett’s angle (movement), duration.

Patient myofunctional adaptation to orthodontic treatment

Myofunctional condition of the temporomandibular joint (TMJ) in everyday orthodontic practice is an important diagnostic criterion for evaluating the quality of orthodontic treatment. Pre-orthodontic preparation is often a necessary stage of orthodontic treatment. To evaluate and compare the adaptation of the masticatory muscles of patients during pre-orthodontic preparation based on interference electromyography of the masticatory and temporal muscles with the data of patients after orthodontic treatment without preparation and with the indicators in the control group. Electromyography indicators of the masticatory and temporal muscles of 82 patients aged 18 to 35 were obtained. Patients were divided into 3groups: 1st - with signs of TMJ dysfunction at the stage of pre-orthodontic preparation and orthodontic treatment; 2nd - patients after orthodontic treatment, having dissatisfaction with the state of the dentition; 3rd - a control group was compared composed of patients without signs of myofunctional dysfunction. Patients who have complaints after orthodontic treatment have different electromyography of the masticatory and temporal muscles in comparison with the control group. In patients with signs of TMJ dysfunction at the stage of preorthodontic preparation, after using a device of their own design, the structures of the temporomandibular joint were adapted to a new functional position. After using the device of its own design, myofunctional adaptation to a new functional position was obtained, which is confirmed by electromyographic studies.

Do Splints Play a Role in the Management of Condylar Postfracture Syndrome After Mandibular Angle Fractures?—A Randomized Controlled Clinical Trial

Fractures of the mandibular angle can result in condylar postfracture syndrome (CPFS) due to indirect injury to the condylar region. Studies evaluating early intervention for CPFS are lacking. In the present study, we evaluated the efficacy of interocclusal splint therapy for the prevention and early management of CPFS. A prospective randomized controlled clinical trial was designed and included patients who required open reduction and internal fixation for a unilateral angle fracture. The patients were divided into 2 groups. The study group received interocclusal splints postoperatively and the control group did not receive such splints. The patients were followed up at 2weeks and 1, 2, and 3months. The primary outcome measure was the presence or absence of CPFS after 3months. CPFS was defined as the presence of any 1 of the clinical signs of temporomandibular joint dysfunction. The secondary outcomes included the mean pain scores and degree of mouth opening, which were evaluated at each follow-up visit. The study included 40 patients, with 20 patients each randomized to the study and control groups. At the end of 3months, CPFS was present in 2 patients in the study group and in all 20 patients in the control group. The mean pain scores were significantly lower in the study group than in the control group, and the mean mouth opening was significantly greater. The use of interocclusal splints was found to be effective in the prevention and early management of CPFS. The use of splints also resulted in decreased pain and an improved mandibular mouth opening.

Comparative evaluation of signs of temporomandibular joint dysfunction and occlusal discrepancies in asymptomatic men and women: A cross-sectional study

Context: Temporomandibular joint (TMJ) disorders represent a multifactorial disease process manifesting with various combination of signs and symptoms. Several studies have shown that there is an increased prevalence of TMJ dysfunction among females; however, there has been no conclusive explanation for this increased occurrence. Occlusal discrepancies have been identified as a causative factor in several cases. Aims: The present study was designed to identify the presence of three signs of occlusal discrepancy, namely the presence of anterior and/or lateral slide from centric relation to centric occlusion, occlusal contact on the nonworking side, and disclusive contact distal to canine on working side on purposeful lateral movement of mandible, in among the population with no signs of TMJ dysfunction. Methods and Materials: A sample population of 620 patients consisting of 313 females and 307 males with no signs of TMJ dysfunction were included in this study. Individual patients were examined for maximum inter-incisal opening, deviation of mandible on opening and closing, presence of joint sounds, and the three abovementioned signs of occlusal discrepancies. Results and Conclusion: The results revealed that there was no statistically significant difference in the occurrence of signs of TMJ dysfunction and of occlusal discrepancies among symptom-free men and women.

Dental Angle class asymmetry and temporomandibular disorders.

The aim of this study was to determine whether there is an association between the presence of asymmetric molar or canine Angle classes on the two sides and the presence of temporomandibular joint dysfunction (TMD). Participants to the study were divided into two groups: TMD group (90 patients) or a control group (58 patients). In the TMD group, clinical assessment for TMD was performed according to the Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines by the same two trained examiners. In both groups, all subjects underwent an assessment of dental occlusion, focusing on the assessment of bilateral canine and molar Angle class relationship. The study protocol was reviewed and approved by the Institutional Review Board of the University of Padova, and each participant gave written consent to take part in the investigation. TMJ pain was diagnosed in 58, disk displacement in 96, arthrosis in 17, and muscle pain in 46 individuals. Molar Angle class was symmetrical in 86 individuals and asymmetrical in 62 subjects. Molar Angle class was not correlated with any of the TMD diagnoses. Canine Angle class was correlated with TMJ arthrosis. Correlation values with the other TMD diagnoses were low and were not significant. It can be suggested that an association between dental Angle class asymmetry and TMDs does not exist and that the role of dental asymmetries as a factor correlated with the presence of TMD signs and symptoms is minimal.

Prevalence of temporomandibular dysfunction in edentulous patients of Saudi Arabia

Aim: This study aimed to determine the prevalence of various temporomandibular joint dysfunction (TMD) signs in healthy asymptomatic edentulous individuals and denture wearers. Materials and Methods: Four hundred completely edentulous individuals in the age group of 45–75 years, who did not complain of any TMD and were denture bearers with varied denture-wearing span, were examined for the existence of TMD signs and symptoms. Statistical analyses were carried out with Chi-square test. Statistical significance was set at P < 0.05. Results: The total prevalence of TMD in the group was 60.5% (58.75% in males and 63.12% in females). It has been observed that more number of females (63.21%) reported signs of TMD and majority of them (23.25%) reported with two signs of TMD. The most common finding was limitation on mouth opening and the least common finding was joint sounds (crepitus and clicking). The occurrence of findings was not statistically related to edentulous span. Conclusion: The present study showed a high prevalence of signs of TMD in healthy asymptomatic completely edentulous individuals. However, the gender difference was not statistically significant.

Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series

ObjectiveThe purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). MethodsThis is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles. ResultsAll pre- and postadjustment assessments were recorded using a numeric pain scale. The resulting average showed a reduction in the patients’ pain scores from the initial visit of 8.3±1.6 to the last visit at 1.4±1.1 with an 80.9%±15.4% improvement. The average number of visits was 13.6±8.2. ConclusionAll patients selected for this case series showed a reduction of temporomandibular dysfunction symptoms.

Temporomandibular joint dysfunction due to benign joint hypermobility syndrome

Aim. To mark out the main features of temporomandibular joint dysfunction in patients with benign joint hypermobility syndrome. Methods. 90 patients with temporomandibular joint dysfunction were examined. The first group included 53 (58.89%) patients with benign joint hypermobility syndrome, the second group - 37 patients with temporomandibular joint dysfunction without any signs of benign joint hypermobility syndrome. Functional joint examination including clinical examination, examination of jaw diagnostic models in articulators, X-ray and magnetic resonance imaging, was performed. The diagnosis of benign joint hypermobility syndrome was set up by clinical findings according to national recommendations of Russian Society of Cardiology. Results. Two main trends were found in patients with benign joint hypermobility syndrome. Joint hypermobility was present in 27 (50.94%) out of 53 patients aged 30 years and older. Temporomandibular joint dysfunction in those patients was quite severe, associated with pain and limited range of mandibular movement. In 49.06% of cases in patients with benign joint hypermobility syndrome aged younger than 30 years, bone symptoms were present. Those patients were complaining of joint noises. In 38.46% of cases, gothic palate or frontal teeth crowding were observed. According to magnetic resonance imaging, there was a condylar processes asymmetry at occlusion in 41 (77.36%) patients with benign joint hypermobility syndrome. Conclusion. Clinical and morphologic signs of temporomandibular joint dysfunction in patients with benign joint hypermobility syndrome are associated with predisposed changes in temporomandibular joint capsule and ligaments. Temporomandibular joint dysfunction is a typical and regular feature of benign joint hypermobility syndrome.

Prevalence of temporomandibular joint dysfunction and its signs among the partially edentulous patients in a village of North Gujarat.

There is disagreement about the association between missing teeth and the presence of temporomandibular disorder (TMD). To investigate whether, the span of edentulousness, gender, number of quadrants involved, pathological migration and the type of kennedy's classification are related to the temporomandibular joint (TMJ) dysfunction signs. Clinical examination of 250 patients (males 99 and females 151) was done among the age group of 35 to 45 years. The patients were partially edentulous for 6 months or more and did not wear any kind of prosthesis. Among 250 subjects, females showed more TMJ dysfunction signs. Clicking sounds were present in 46.5%, mandibular deviation was present in 40% of individuals, TMJ tenderness was observed in 32% and masseter was involved in 32% of individual. Temporomandibular joint dysfunction signs in relation to pathologic migration of teeth show that clicking and mandibular deviation was present in 54.5 and 49.2% and among muscles masseter muscle tenderness 41.9% was more commonly present. Masseter muscle tenderness 64.1% was seen in individuals who were edentulous for more than 5 years. Females subjects had a significantly higher prevalence of TMJ dysfunction signs then male subjects. As the span and time of edentulousness, the number of missing teeth and the number of quadrant involved increased, the signs of dysfunction became more prevalent. Among the TMJ dysfunction signs deviation and clicking sound were most frequently observed. The masseter muscle was most commonly affected and demonstrated muscle tenderness.

Esthetic orthodontic treatment with a double J retractor and temporary anchorage devices

This clinical article reports an esthetic treatment option for managing a Class II malocclusion in an adult. The patient, a woman aged 24 years 2 months, had crowding and a convex profile. She was treated with maxillary first premolar extractions, a double J retractor, and temporary skeletal anchorage devices in the maxillary arch. Posttreatment records after 2 years showed excellent results with good occlusion and long-term stability.