Symptoms Of Temporomandibular Disorders Research Articles

Fonseca's Questionnaire Is a Useful Tool for Carrying Out the Initial Evaluation of Temporomandibular Disorders in Dental Students.

Background: Temporomandibular disorders (TMDs) represent a prevalent multifactorial condition that impacts a significant portion of the global population. The objective of this study was to employ Fonseca's questionnaire for an initial assessment of TMDs. Methods: A cross-sectional study was conducted on a sample of 250 undergraduates from the Dental School of the University of Perugia, Italy. The chi-square test, with a significance level set at p < 0.05, was used to evaluate a statistically significant relationship between TMDs and several variables such as gender, age, employed/unemployed, and physically active or not. Results: The data obtained through the questionnaire indicated that a considerable percentage of students (78%) exhibited signs consistent with TMDs. The most frequently reported signs and symptoms included psychological stress (49.6%), dental clenching and grinding (34%), joint clicking (33.6%), frequent headaches (15.2%), and neck pain (23.2%). Notably, when considering moderate to severe symptoms of TMDs, females were more significantly affected than males. Furthermore, factors such as age, employment status, and physical activity did not appear to influence the prevalence of TMDs. Conclusions: The high prevalence of TMDs identified within this young population (university students), as measured by this questionnaire (albeit warranting validation through more rigorous methodologies) underscores the necessity for the implementation of new preventive strategies that specifically address this demographic.

Impact of temporomandibular disorder symptoms among 15-year-old girls.

Many adolescents, especially girls, report temporomandibular disorder (TMD) symptoms that may impact their daily life. At 19 different schools participating in the preventive program with dental nurses of FRAMM (Fluoride, Advise, Arena, Motivation, Food), at the Västra Götaland Region in Sweden, 15-year-old girls were invited to a cohort study about symptoms of TMD that also included headaches. Three hundred twenty-nine girls attended the study and answered a questionnaire regarding TMD symptoms and their consequences such as sick leave from school and consumption of analgesics. The girls were asked about the symptom's influence on their daily life, about their general health, use of regular medication, physical activity, and they answered the PHQ4 regarding experienced symptoms of anxiety and depression. There was a significant correlation between TMD symptoms and sick leave with 31% of the girls having stayed home due to symptoms. Of the girls who answered affirmative in the screening questions (3QTMD), nearly half the group had stayed at home due to their symptoms, 24% had consulted a physician, 42% had used analgesics weekly and 59% reported that they felt the symptoms negatively affected their school performance. The girls who had regular medication had more TMD symptoms. Anxiety and depression were associated with TMD symptoms. The study showed that TMD symptoms had a negative impact on the 15-year-old girls' daily life resulting in sick leave from school, consumption of analgesics, and experiences of negative impacts on their behavior and performance at school.

TEMPOROMANDIBULAR DISORDER, BODY PAIN, AND OTOLOGIC AND PSYCHOLOGIC SYMPTOMS: THEIR INTERRELATIONSHIPS IN ASIAN YOUTHS.

To establish the interrelationships between temporomandibular disorders (TMDs), pain, and otologic and psychologic comorbidities in Asian youths. Youths from a local polytechnic, aged 17 to 24 years old, were enrolled and an electronic survey encompassing demographic variables-the DC/TMD TMD pain screener (TPS), Short- form Fonseca Anamnestic Index (SFAI), modified Maciel's Otologic/Pain Symptom Inventory, and Patient Health Questionnaire-4-was administered. Par.cipants were subsequently categorized into groups: no TMD pain (NP), with TMD pain (WP), no TMDs (NT), and with any TMDs (WT). Data were evaluated with chi-square test, nonparametric, and logistic regression analyses (α &#61; .05). Among the 198 participants (mean age 18.8 ± 1.7 years), 11.1% had painful TMDs and 18.2% experienced TMD pain or dysfunction. Significant differences in total-otologic symptoms (total-OS), vertigo, and dizziness plus otalgia, tinnitus, and hearing loss scores were observed between the WP-NP and WT-NT groups correspondingly. While total-comorbid pain (total-CP) and psychologic distress (total-PD) scores varied substanally between the WT-NT group, only a significant difference in total-PD scores was discerned between the WP-NP group. Total-OS scores were moderately correlated to TPS/SFAI, total-CP, and total-PD scores, and psychologic distress was a risk factor for painful TMDs. Otologic and pain comorbidities were prevalent among Asian youths with TMDs and appear to be interrelated. The complex interaction of TMDs with pain, otologic, and psychologic comorbidities must be considered when caring for youths with multiple somatic complaints.

Role of transcutaneous electrical nerve stimulation in temporomandibular joint disorders.

To co mpare the e ffica cy of transcutaneous elec trica l ner ve stimulation with commercially ava ilab le analgesics in alleviating symptoms of temporomandibular disorders. The cross-sectional, interventional study was conducted from March 11, 2020, to August 31, 2023, at the Oral and Maxillofa cial S urger y Department of the Armed Forces Institute o f Den tist r y, Rawalpindi, Pakistan, and comprised patients aged 18-65 years who were experiencing pain or distress in the temporomandibular joint region. The par ticipants were divided into intervention group A and control group B. Group A treatment involved applying electrodes near the temporomandibular joint, with parameters adjusted as per the treatment guidelines. Group B subjects received only analgesics along with basic care recommendations. Pain intensit y was assessed using visual analogue scale, while functional impairment and adverse effects were monitored. Data was analysed using SPSS 24. Of the 130 patients initially assessed, 100(77%) were included; 50(50%) in each group. In group A, there were 33(66.0%) fema les and 17(34.0 %) male s wit h overal l mean age 42.8±10.12 years. In group B, there were 30(60%) females and 20(40%) males with overall mean age 46.98±14.09 years. Pain intensity was significantly lower in group A compared to group B post-inter vention (p=0.009). Group A sub jec ts also showed significant post-intervention improvement in terms of mouth opening compared to group B patients (p<0.05). There was no significant intergroup difference with respect to adverse effects (p>0.05). Transcutaneous electrical nerve stimulation was significantly more effective than commercially available analgesics in alleviating symptoms of temporomandibular disorders.

The Link Between Temporomandibular Disorders and Jaw Functional Limitations Among Chinese Adolescents

BackgroundCurrently, there is still controversy surrounding the relationship between temporomandibular disorders (TMDs) symptoms and jaw functional limitations. We investigated the distribution of TMDs in senior high school students, including both the number and types of symptoms, and assessed their association with jaw functional limitations. Furthermore, we explored sex differences in these associations. MethodsThis study was conducted at a public high school in Hefei, Anhui Province, China, with data collected from September to October 2022. All subjects completed questionnaires assessing the anamnestic symptoms of TMDs and the Jaw Functional Limitation Scale (JFLS), and examinations were performed by trained dentists according to the Diagnostic Criteria for TMD. Data were analysed using the Kruskal–Wallis, Mann–Whitney U, and Chi-square tests. ResultsThe mean age of the participants (N = 2890) was 17.2 ± 0.14 years and 38.9% were females (61.1% were males). Limitations in self-assessed jaw function were associated with the presence of TMDs (P < .05). Participants with more symptoms reported significantly high levels of functional limitations (P < .05). Compared to male adolescents, female adolescents more commonly experienced TMDs pain and tended to have more symptoms (P < .05). However, no sex differences were observed in most associations between TMDs and jaw functional limitations. ConclusionTMDs-positive symptoms are common in adolescents. Female adolescents were more affected by TMDs symptoms than male adolescents. Individuals with more TMDs symptoms have greater jaw functional limitations.

Treatment decisions of patients with Class II Division 2 malocclusion and severe tooth wear: a systematic review

BackgroundThe treatment strategy for patients with severe tooth wear associated with Class II Division 2 malocclusion remains a major challenge for dental practitioners.ObjectivesTo systematically review and summarize the literature on treatment strategies, restoration procedures and clinical outcomes for Class II Division 2 malocclusion patients with severe tooth wear.MethodsA literature review was conducted using Pubmed, Embase, the Cochrane Library, and Web of Science to identify eligible articles. Publications until October 16th, 2023 were searched independently and cross-checked by two researchers.ResultsOf 1513 articles screened, 10 reports detailed treatment processes, including six males and four females aged 34–68 years old. Four articles recorded pre-treatment freeway space (FWS) values ranging from 5 to 9 mm. All ten cases had significant occlusal vertical dimension (OVD) loss and the increase in OVD after treatment ranged from 1 to 7 mm. Pre-prosthetic orthodontic treatment was performed in two cases, in one of which only the maxillary region was orthodontically treated. The most common restorations provided were full coverage restorations. In most cases, temporary restorations were applied before the permanent restorations for eight weeks to six months. Four different sequences of final restoration were proposed. Follow-up ranged from four months to six years and included seven patients, one of them showed symptoms of temporomandibular disorder (TMD).ConclusionsA multidisciplinary team (MDT) approach to treatment is recommended. Consideration of pre-prosthetic orthodontic treatment is essential. Commonly used cephalometric measurements for anterior teeth include the interincisal angle and collum angle. The increases in OVD ranging from 1 to 7 mm can be effectively accommodated. Temporary restorations are recommended to accommodate the OVD, and the transition periods of 8 weeks to 6 months help the patients adapted well. Four different sequences for final rehabilitation have demonstrated positive clinical outcomes. Full crown restorations have emerged as the preferred choice for the ultimate restoration of these patients.

Association between mental health and temporomandibular disorders symptoms of users of a Family health unit in the contexto of Covid-19

The research consisted of carrying out a descriptive cross-sectional study with the aim of evaluating the correlation between mental health and symptoms of temporomandibular disorders (TMD). The study was carried out in a unit of the SUS primary care network. The research involved users of a Family Health Unit, Tangará II and a sample population of 223 patients. Data collection was carried out by applying questionnaires representing demographic data, the anamnestic – anamnestic index, and the DASS-21. The data were transcribed into spreadsheets using the Microsoft® Excel program and statistical analyzes were carried out using the SPSS 22.0 program. Descriptive statistics were used to characterize the sample. Qualitative variables were presented in simple and relative frequencies. To verify associations between variables, non-parametric tests were performed: Pearson's Chi-square test and Spearman's correlation test for the significance level p &lt; 0.05. The results demonstrated alignment with results already obtained in the literature. It concluded that healthcare professionals dealing with patients with TMD should integrate regular assessments of anxiety and stress into their treatment plans.

Conceptualising TMD symptom burden in youths: Symptom duration, frequency, intensity and interference.

This study aimed to conceptualise Temporomandibular disorder (TMD) symptom burden and severity and explored their interrelationships with somatic symptoms and psychological distress. Participants were recruited from a local polytechnic. The quintessential five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) were appraised and extended to evaluate the duration, frequency, intensity and interference of discrete TMD symptoms. Global TMD severity (GS) was computed by totaling the points for all TMD symptoms and dimensions. TMD (TS) and somatic symptom (SS) burden were assessed based on the Somatic Symptoms Scale-8, while psychological distress was measured with the Depression, Anxiety and Stress Scales-21. Statistical analyses were performed using Kruskal-Wallis/Dunn tests and Spearman's correlation (α = .05). Of the 366 eligible participants (mean age 19.1 ± 2.3 years), 51.4% were 5Ts-negative and 48.6% were 5Ts-positive. Among the 5Ts-positive individuals, 25.3%/64.0% were 'bothered a little' whereas 4.5%/10.7% were 'bothered a lot' by TMD pain/headache. Correspondingly, 32.6%/12.4%/5.1% were 'bothered a little' while 2.8%/2.8%/1.1% were 'bothered a lot' by TMJ sounds/closed/open locking. TS burden was moderate-to-strongly correlated to aggregate symptom duration, frequency, intensity, interference, GS and SS burden (rs = .50-.88). While TS burden and GS were weakly associated with psychological distress (rs = .18-.36), SS burden was moderately related to depression, anxiety and stress (rs = .47-.53). TS burden can serve as a proxy for global TMD severity and may be more meaningful than the mere presence of TMD symptoms in clinical and research settings.

Exploring the Association Between Physical Fitness (High Intensity and Low Intensity) and the Incidence of Temporomandibular Disorders: A Comparative Study.

Temporomandibular joint disorders affect the temporomandibular joint (TMJ), masticatory muscles, and associated structures. Symptoms include TMJ pain, limited jaw movement, muscle tenderness, and referred pain. Physical activity can alleviate musculoskeletal pain. This study explored the link between physical fitness (high and low intensity) and temporomandibular disorder (TMD) incidence. Sixty patients were divided into three groups in this comparative study. Group I underwent 30 minutes of high-intensity aerobic training. Group II had 30 minutes of low-intensity yoga sessions weekly. Group III received health education. TMD was diagnosed using the Fonseca Anamnestic Index (FAI). Pain intensity was measured using the Visual Analogue Scale (VAS) and the Pain Self-Efficacy Questionnaire (PSEQ). Of the participants, 38.1% were males and 61.9% were females. TMD severity was mild (25.0%), moderate (55.0%), and severe (20.0%). High-intensity training groups had higher TMD symptom severity than low-intensity groups (p = 0.001). VAS scores increased in group I and decreased in group II (significant). PSEQ scores decreased in group I and increased significantly in group II. Group III showed no significant differences in PSEQ scores. High-intensity training resulted in moderate TMD symptoms. Low-intensity training was beneficial for TMD pain. The study recommends combining low-intensity physical workouts with medications to alleviate TMD.

Prevalence and impact of signs and symptoms of temporomandibular disorders in dental students and faculty.

Temporomandibular disorders (TMD) affect individuals undergoing increased stress, for example, dental professionals. No study to date has compared dental students and faculty in TMD manifestation. This cross-sectional study compared prevalence, risk factors, and impact on daily activities of self-reported TMD signs/symptoms between dental students and faculty at a predoctoral dental school, and between preclinical (first- to second-year) and clinical (third- to fourth-year) students. A REDCap survey was sent to dental students and faculty, assessing TMD signs/symptoms (TMD Symptom Questionnaire), pain intensity (Chronic Graded Pain Scale), jaw function (Jaw Function Limitation Scale), parafunctions (Oral Behavioral Checklist), previous TMD treatments, anxiety/depression symptoms (Patient Health Questionnaire), perceived stress (Perceived Stress Scale), and sleep quality (RU-SATED Scale). Outcomes were compared between groups using chi-square and t-tests, adjusting for covariates with analyses of covariance (ANCOVA). Data derived from N=145 participants (N=108 students, N=37 faculty). Dental students reported significantly higher prevalence (90.1% vs. 75.7%, p=0.020) and greater number of TMD signs/symptoms (5.3±3.5 vs. 3.0±2.7, p<0.001) compared to faculty. Students reported significantly more parafunctional activities (p=0.000), jaw-strain episodes (prolonged mouth opening, p=0.007), higher stress level (p=0.008), and lower sleep quality (p=0.002) than faculty. Difference in number of TMD signs/symptoms was maintained after adjusting for stress, sleep quality, and parafunctional/jaw-strain activities. Clinical students utilized significantly more often evidence-based TMD treatment compared to preclinical students. High prevalence of self-reported TMD was observed among dental students and faculty, with students reporting higher prevalence and impairment despite working in the same environment. Findings underscore the importance of education on preventive measures early in dental training to address contributing factors and TMD management.

Genetic change investigation in DOCK1 gene in an Iranian family with sign and symptoms of temporomandibular joint disorder (TMD).

Temporomandibular joint disorder (TMD) is a complex condition with pain and dysfunction in the temporomandibular joint and related muscles. Scientific evidence indicates both genetic and environmental factors play a crucial role in TMD. In this study, we aimed to discover the genetic changes in individuals from 4 generations of an Iranian family with signs and symptoms of TMD and malocclusion Class III. Whole Exome Sequencing (WES) was performed in 4 patients (IV-8, IV-9, V-4, and V-6) with TMD according to (DC/TMD), along with skeletal Class III malocclusion. Then, PCR sequencing was performed on 23 family members to confirm the WES. In the present study, WES results analysis detected 6 heterozygous non-synonymous Single Nucleotide Variants (SNVs) in 5 genes, including CRLF3, DNAH17, DOCK1, SEPT9, and VWDE. A heterozygous variant, c.2012T > A (p.F671Y), in Exon 20 of the DOCK1 (NM_001290223.2) gene was identified. Then, this variant was investigated in 19 other members of the same family. PCR-Sequencing results showed that 7/19 had heterozygous TA genotype, all of whom were accompanied by malocclusion and TMD symptoms and 12/19 individuals had homozygous TT genotype, 9 of whom had no temporomandibular joint problems or malocclusion. The remaining 3 showed mild TMD clinical symptoms. The 5 other non-synonymous SNVs of CRLF3, DNAH17, SEPT9, and VWDE were not considered plausible candidates for TMD. The present study identified a heterozygous nonsynonymous c.2012T > A (p.F671Y) variant of the DOCK1 gene is significantly associated with skeletal class III malocclusion, TMD, and its severity in affected individuals in the Iranian pedigree. The role of genetic factors in the development of TMD has been described. The present study identified a nonsynonymous variant of the DOCK1 gene as a candidate for TMD and skeletal class III malocclusion in affected individuals in the Iranian pedigree.

What has a year of social isolation due to the COVID-19 pandemic influenced oral parafunctional habits and temporomandibular disorders? A case-control study.

Few studies investigated the influence of oral parafunctional habits during the COVID-19 pandemic. Since some studies have demonstrated that signs and symptoms of temporomandibular disorder (TMD), as well as psychological alterations, increased during the COVID-19 pandemic lockdown, the aim of this study was to investigate whether social isolation is a situation that increases the prevalence of oral parafunctional habits. This was an observational case-control study. An online survey with questions about TMD symptoms (Diagnostic Criteria Symptom Questionnaire) and oral parafunctional habits (Oral Behaviours Checklist [OBC]) was administered to Brazilian residents at two different times (2020 and 2021). The participants were divided according to social isolation practices into study groups (GI: 2020, n = 507; GIII: 2021, n = 282) and control groups (GII: 2020, n = 98; GIV: 2021, n = 202). In each group, we evaluated the association of the frequency of oral parafunctional habits with the symptoms of TMD, and we observed that individuals with a greater presence of painful TMD present a greater number of oral parafunctional habits. Despite the literature showing that individuals who practiced social isolation developed more oral parafunctional habits, when analysing the association of the OBC questions in Groups GI × GII and GIII × GIV, only 'sustained talking' (p = .0022) and 'hold telephone between your hand and shoulders' (p = .0124) showed a significant difference in GI × GII. Kendall's coefficient of concordance revealed that there was a very strong concordance (GI × GII 0.9515 (p = .0087) and GIII × GIV 0.9655 (p = .0074)) between the ranks of the analysed oral parafunctional habits in all groups. We can state that Individuals who practiced social isolation did not present more oral parafunctional habits than individuals who did not.

The Role of Malocclusion and Oral Parafunctions in Predicting Signs and Symptoms of Temporomandibular Disorders-A Cross-Sectional Study.

The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years. TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth. At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom. Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment.

Effects of Mask Usage During the COVID-19 Pandemic on Sign and Symptoms of Temporomandibular Joint Disorder: A Survey Study.

To evaluate possible temporomandibular disorders (TMD) symptoms that may occur due to mask use in dentists during the coronavirus disease-2019 pandemic period and identify potentially effective factors. An online questionnaire consisting of three parts was sent to dentists and clinical dental students. The first part included questions regarding sociodemographic information. In the second part, questions were asked to evaluate stress levels, TMD symptoms, and treatment of TMD, if any, before (T0) and during the pandemic (T1). In the last part, professional mask choice, mask-related parafunctional movements, and breathing patterns while wearing a mask were evaluated. TMD symptoms and stress levels were significantly higher at T1. An increase in mouth breathing and mask-related parafunctional movements was reported during the use of N95 masks compared with daily life in dentists whose professional mask selection was an N95 respirator. The change in temporomandibular joints pain and muscle pain at rest between T0 and T1 was higher in those whose professional mask choice was N95 respirators than in those who chose to wear one surgical mask. The increase in mouth breathing and mask-related parafunctional movements during the use of N95 respirators may increase TMD.

Evaluation of the contribution of different groups of teeth to occlusion of patients with symptoms of temporomandibular disorders

AbstractPurposeThe purpose of this study was to analyse the distribution of occlusal forces in the dental arches released during tooth clenching in patients with symptoms of temporomandibular disorders, and to analyse the age and gender structure of the patients in the study group and the control group.Materials and methodThe study was carried out on a group of 58 patients, of both genders, aged 18–40 years, with full dental arches, who presented for treatment at the Prosthodontics Clinic of the University Dental Clinic in Kraków due to symptoms of temporomandibular disorders. The patients were divided into two groups. The first group (study group) comprised 26 patients with painful temporomandibular disorders, while the second group (control group) comprised 32 patients without pain. The study only included patients over 18 years of age, with full dental arches with symptoms of temporomandibular disorders. All patients underwent a basic dental examination and a specialized functional examination of the masticatory organ. A T‐Scan III‐Novus instrument with electronic occlusal articulation paper was used to assess the distribution of occlusal contacts.ResultsIn the study, women (43) were a larger group than men (15). Statistically significant values for the percentage distribution of occlusal contacts were obtained in group of women in the study group on the right and left side, in the area of molars and premolars. In the analysis of the percentage distribution of occlusal contacts in both the study and control groups, it can be seen that the first molars (teeth 16 and 26) showed a larger percentage range of values than the other teeth. The smallest values can be observed on the second incisal teeth and on the canines.ConclusionsThe first molars are, in the majority of patients, the teeth on which the strongest occlusal contacts are generated. Excessive participation of incisal teeth in occlusion might influence the development of the pain form of TMD. In order to determine whether there is a correlation between an uneven distribution of occlusal contacts and TMD pain, studies on larger numbers of patients are needed. © 2024 Australian Dental Association.

Locus coeruleus activation contributes to masseter muscle overactivity induced by chronic restraint stress in mice.

It is commonly accepted that exposure to stress may cause overactivity in the orofacial muscles, leading to consistent muscle pain, which is the main symptom of temporomandibular disorders. The central neural mechanism underlying this process, however, remains unclear. The locus coeruleus is considered to play an important role in stress-related behavioral changes. Therefore, the present study was designed to examine the role of locus coeruleus neurons in masseter overactivity induced by stress. C57BL/6 mice were subjected to chronic restraint stress for 14 days to establish an animal model. The behavioral changes and the electromyography of the masseter muscle in mice were measured. The expression of Fos in locus coeruleus was observed by immunofluorescence staining to assess neuronal activation. A chemogenetic test was used to inhibit locus coeruleus neuronal activity, and the behavioral changes and electromyography of the masseter muscle were observed again. The results exhibited that chronic restraint stress could induce anxiety-like behavior, overactivity of the masseter muscle, and significant activation of locus coeruleus neurons in mice. Furthermore, inhibition of noradrenergic neuron activity within the locus coeruleus could alleviate stress-induced anxiety behavior and masseter muscle overactivity. Activation of noradrenergic neurons in locus coeruleus induced by stress may be one of the central regulatory mechanisms for stress-induced anxiety-like behaviors and overactivity of masseter muscles.

The association between genetic factors and temporomandibular disorders: A systematic literature review

ObjectiveThis study aimed to investigate the correlation between genetic factors and the occurrence and progression of temporomandibular disorders (TMDs) using a comprehensive review and meta-analysis. DesignA comprehensive search was conducted using the ScienceDirect, PubMed, Cochrane Library, Dimensions, and Emerald databases. A reviewer selected the study using modified PICO criteria, considering human subjects with TMDs, comparing different genetic factors among TMD and non-TMD patients, and reporting TMD signs and symptoms as outcomes. The methodological standards of the eligible papers were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Non-randomized Experimental Investigations. Information was collected methodically and examined. ResultsThe electronic database search yielded 851 articles, 19 of which were included in this study. The data analysis showed a significant influence of genetic factors, such as polymorphisms and gene differences, on the development of TMD signs and symptoms, such as myofascial pain, chronic pain, and disc displacement. In addition, gene polymorphism significantly influenced TMD development, with an odds ratio of 2.46 (1.93–3.14) and p of 0.00001. ConclusionsGenetic factors significantly influenced TMD signs and symptoms, and genetic polymorphisms significantly influenced TMD onset and progression. Further research should be conducted in diverse settings with larger sample sizes to verify and validate these findings.

Can temporomandibular disorder symptoms and headaches be prevented in 13- to 15-year-old girls by information provided in a school setting?

Temporomandibular disorders (TMD) may develop, especially among girls, during the adolescence period. The aim of this study was to study if information and advice in a school setting could prevent development of TMD symptoms and headaches during the early teenage period. Thirteen-year-old girls, at 19 upper elementary schools were invited to participate in a study with structured information about the jaw system, TMD symptoms and risk factors, as well as advice how to manage risk factor and TMD. Six hundred and fifty-one girls enrolled, of which 507 girls were followed for 2-2.5 years. Half received information on three occasions (cases), and the other half served as controls. Included in the analysis of incidence of TMD symptoms were those without frequently occurring TMD symptoms (not including headaches) at baseline (n = 396) and included in the analysis of incidence of headaches were those without frequent headaches at baseline (n = 297). The 2-year incidence of TMD symptoms was significantly lower in the information cohort (19%) compared to the controls (28%) (p = .03). The 2-year incidence of headaches was lower among those who were allocated to information (30%) compared to controls (40%), but the difference was not statistically significant (p = .099). Cases who had headaches at baseline reported a significantly lower prevalence at follow-up compared to controls (p = .03). Standardized information in school settings can prevent development of TMD symptoms and headaches among young girls.

Three-Dimensional Changes of Condylar Position After Bimaxillary Surgery to Correct Skeletal III Malocclusion: Cone Beam Computed Tomography Voxel-Based Superimposition Analysis

BackgroundThe stability of the condylar position within the first three months after orthognathic surgery in patients with skeletal Class III malocclusion is crucial for subsequent orthodontic treatment. PurposeThe purpose was to compare condylar positional changes three months after bimaxillary surgery to correct skeletal Class III deformities, utilizing the conventional two-dimensional (2D) combined with the cone beam computed tomography (CBCT) voxel-based superimposition analysis. Study design, setting, sampleThis retrospective cohort study included skeletal Class III patients undergoing bimaxillary orthognathic surgery at Khon Kaen University, Thailand in 2020. Exclusion criteria were patients with temporomandibular disorder (TMD) symptoms, facial asymmetry prior to the surgery, or surgical complications. Exposure variableThe exposure variable was the timing, both preoperatively and 3 months postoperatively. This 3-month postoperative time point was chosen because complete healing of the bimaxillary surgery is expected by then, without any potential influence of condylar changes resulting from subsequent orthodontic treatment. Main outcome variablesThe outcome variable is condylar position measurement, joint space (mm) and axial condylar angle (degrees). CovariatesDemographics (age, sex), and surgical details (direction and amount of movement) were collected as covariates. AnalysesStatistical analysis of condylar positional changes and correlations was performed using paired t-test and linear correlation (P-value < 0.05), respectively. ResultsThe sample included 11 subjects (22 condyles), with a mean age of 24±5.24 years. Both 2D measurements and voxel-based 3D superimposition showed significant changes in condylar position three months after bimaxillary surgery: inferior (0.45±0.26 mm, P < 0.001), posterior (0.46±0.39 mm, P = 0.003), lateral (0.38±0.42 mm, P = 0.01) displacement, and inward rotation (5.21±2.54°, P < 0.001). No significant correlation was found between jaw movement distance and condylar changes. Conclusions and relevanceTo our knowledge, this is the first study to report measures of condylar changes at 3 months, when complete healing of the osteotomies would be expected, using Le Fort I osteotomy for maxillary advancement combined with bilateral sagittal split ramus osteotomy (BSSRO) for mandibular setback. These changes are small in magnitude and may be of little relevance to patient care.

High prevalence of orofacial pain in juvenile fibromyalgia as detected by a novel tool specifically devised for children and adolescents.

To examine the prevalence of temporomandibular disorders (TMD) in patients with juvenile fibromyalgia syndrome (JFS) and identify TMD characteristics specifically associated to JFS. Signs and symptoms of TMD were assessed using a novel clinical tool specifically devised for children that consists of: 1. a self-report multiple-choice questionnaire; 2. a protocol for the clinical examination of the orofacial region. Multivariate logistic regression model was used to identify TMD features associated with JFS. Thirty JFS patients (median age 15.5 years) and 45 healthy controls (median age 15.0 years) were included in this cross-sectional study. Orofacial pain was reported by 26 of 30 JFS patients (86.7%) and by 3 of 45 controls (6.7%; p<0.001). Pain on TMJ palpation was present in 18 of 30 JFS patients (60%) and in 5 of 45 controls (11.1%; p<0.001). Median values of maximum spontaneous mouth opening, voluntary active opening and assisted passive opening were significantly higher in JFS patients than in controls. On multiple regression analysis spontaneous orofacial pain (OR: 21.0; p=0.005), diffuse tenderness on palpation of the masticatory muscles (OR: 14.9; p=0.026) and TMJ hypermobility (OR 1.42; p=0.008) were independently associated with JFS. The high prevalence of TMD in JFS highlights the need for a broader interdisciplinary evaluation of JFS patients. TMJ hypermobility, in addition to orofacial and masticatory muscle pain, is an important clue for the diagnosis of TMD in adolescents with JFS. Elucidating the link between these disorders will advance individualised management and improve treatment efficacy.