Symptoms 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).

STATISTICAL ANALYSIS OF THE PREVALENCE OF INTERNAL TEMPOROMANDIBULAR JOINT DISORDERS IN FEMALE PATIENTS BASED ON C. H. WILKES CLASSIFICATION

Introduction. Severity levels of temporomandibular joint dysfunction can be assessed by certain parameters based on images obtained using magnetic resonance imaging. In order to assess the condition of the joint and choose the optimal treatment plan depending on the detected changes on the magnetic resonance imaging images, the most common classification according to C. H. Wilkes was chosen. This study aimed to assess the severity of temporomandibular joint dysfunction symptoms in women of child-bearing and post-menopausal age according to the C. H. Wilkes classification. Participants and methods. 63 patients were selected: reproductive period n=45 and post-menopausal n=17. Magnetic resonance imaging is described in detail and the diagnosis according to the C. H. Wilkes classification is made. Statistical analysis was carried out by calculating the χ2 test in order to analyze the independence between categorical variables; Kendall's correlation coefficient was applied to assess the correlation between age and disease stages. Results. Diseases of the temporomandibular joint are more common among women of child-bearing age compared to women of postmenopausal age. This may be related to hormonal changes characteristic of the reproductive period: in the group of child-bearing age, there is a greater variety of stages of the disease, while in the group of post-menopausal age, stage IV prevails. This may indicate the influence of age factors on TMJ development. The relationship between age and diseases of the temporomandibular joint has a statistically significant correlation. The results of the χ2 test show a statistically significant relationship between age and TMJ disease stages. In addition, Kendall's correlation coefficient confirms the presence of a moderate degree of relationship between age and stages of the disease. Conclusion. The results of the analysis of the distribution of temporomandibular joint disease stages between age groups can serve as important data for optimizing clinical practice, improving treatment outcomes, and increasing patients' quality of life. For example, our study indicates that stage Ⅱ according to the classification of C. H. Wilkes is more common in women of reproductive age, and stage Ⅳ is more common in women of postmenopausal age. Clinicians should take this dada into account when developing individual treatment plans.

Prevalence of temporomandibular joint dysfunction among the indigenous population of India

PurposePrimary dental care facilities and awareness about temporomandibular disorders are lacking among the indigenous population of Kerala. The aim of the study was to determine the prevalence of temporomandibular joint dysfunction (TMD) disorders among the indigenous populations of Kerala. MethodologyThis cross-sectional study included adults aged 18 years and above, visiting primary health care centre in the tribal hamlet in the town of Kalpetta, Wayanad District, Kerala, India, for reasons other than dental. Axis I and II of Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to screen for TMD. A local language validated screening questionnaire was used. The clinical examination was carried out as per the DC/TMD by a calibrated examiner. The data was processed using SPSS and the frequencies and proportions for signs and symptoms of TMD were estimated. ResultsAmong 198 adults screened, 23 (11.6 %) had TMD. Among these 60 % of the adults were aged 31–65 years and predominantly females (86.9 %). 39 % of these patients were dentulous. All affected adults experienced TMD related pain for more than 3 months with 90 % of them experiencing moderate-to-severe pain. Myofascial pain was the most prevalent type. Other findings included moderate anxiety levels in 34.8 % and abnormal oral behaviour and high physical symptoms in 40 % TMD patients. ConclusionTMD disorders were prevalent among the indigenous population and remained undiagnosed. The study highlights the need for screening and the availability of basic dental care for the indigenous populations.

The Influence of Occlusal Adjustment on Long-term Post-treatment Stability of Orthodontic Treatment

Objective: This study aimed to compare the long-term occlusal stability in patients treated orthodontically with and without occlusal adjustment. Material and Methods: This observational study followed the STROBE guidelines. The sample comprised 77 patients with class I malocclusion treated without dental extractions and without signs and symptoms of temporomandibular joint dysfunction (TMD), divided into two groups. Group 1 with occlusal adjustment comprised 37 patients, 16 males and 21 females, with mean initial, final, and post-retention ages of 18.33 (s.d.=3.96), 20.99 (s.d.=3.33), and 25.79 years (s.d.=3.34), respectively. The treatment time was 2.66 years (s.d.=1.57), and the time of post-retention evaluation was 4.80 years (s.d.=1.10). Group 2, without occlusal adjustment involved 40 patients, 21 males and 19 females, with mean initial, final, and post-retention ages of 18.07 (s.d.=3.03), 20.75 (s.d.=3.54), and 25.89 (s.d.=3.73) years, respectively. The treatment time was 2.68 years (s.d.=1.09) and the time of post-retention evaluation was 5.14 years (s.d.=1.36). The PAR and Little irregularity indices were measured in the initial, final, and post-retention dental casts. Intergroup comparison was performed using the independent t-test. Results: There was no statistically significant difference observed in the intergroup comparison of the PAR and Little irregularity indexes in all phases and periods evaluated. Conclusion: There was no significant difference found in the long-term post-treatment crowding and occlusal relapse between class I patients treated with orthodontic non-extraction with and without occlusal adjustment. The occlusal adjustment did not influence the alignment and occlusal post-retention stability.

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

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

Prevalence of Temporomandibular disorders 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.

MANAGING TEMPOROMANDIBULAR JOINT DISORDERS: TREATMENT STAGES AND ESSENTIAL ASPECTS

Introduction. Meniscus displacement in the temporomandibular joint (TMJ) is known to provoke the development of TMJ dysfunction, thereby impairing the quality of life. Managing TMJ disorders is divided into three stages, the first of which is intermediate in determining the prognosis and further tactics. The aim of the study is to evaluate the effectiveness of occlusal splint systems and to assess the different stages of TMJ dysfunction management. Materials and methods. The study included 54 patients. Based on the findings of magnetic resonance imaging, patients were divided into two groups: group I included patients with dysfunctional changes in the TMJ (n=38), group II involved patients with dysfunctional changes in the joints and concomitant osteoarthritic changes (n=16).&#x0D; Results and discussion. The first stage of treatment was carried out using a Michigan occlusal splint. During this time, the myotatic reflex was restructured and clinical symptoms of the TMJ disorder disappeared. The treatment outcomes were as follows: the subjects of the 1st group reported about health improvement in a month since the treatment started, 20 individuals out of 38 patients had no symptoms of TMJ dysfunction. The treatment course of these patients was completed. The other 18 patients were referred for the orthodontic treatment. After the end of the splint treatment, no longer than in 2 weeks, the patients of the II group reported bout the recurrence of some symptoms that indicated a relapse of the disease; therefore, patients were recommended to continue the treatment. In the second stage of the treatment, we used occlusal plates on the lower unprepared teeth. At the third stage of treatment, radical prosthetics was carried out, which includes temporary fixation of polymethyl methacrylate prototypes on specially prepared teeth, and then the final fixation of permanent structures in the new medical condition of the lower jaw.&#x0D; Conclusion. Bite-sized intraoral guards that allow mesialisation of the lower jaw and increase the height of the bite, in particular, the Michigan occlusal splint have been found as effective appliances. Patients who had only dysfunctional TMJ changes (group I) over the course of treatment need only restructuring of the myotonic reflex, rather than those who suffer from osteoarthritic changes (group II), and therefore should undergo radical orthopaedic treatment.

Relationship assessment between mood disorders, headaches, and temporomandibular disorders in healthcare workers post-COVID-19 pandemic

Objectives: To evaluate the relationship between depression, anxiety, and stress levels, headaches, and symptoms of temporomandibular joint disorders in healthcare professionals in a post-pandemic setting. Methods: A cross-sectional study conducted through an online questionnaire was distributed among healthcare professionals in Mainland Portugal. The sample’s characterization was undertaken according to sociodemographic parameters. The following assessment instruments were used: 21-item Depression, Anxiety, and Stress Scale (DASS-21) for emotional parameters, namely depression, anxiety, and stress; International Classification of Headache Disorders (ICHD-3) for headache disorders; Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for temporomandibular joint dysfunction symptoms. Inferential analysis was performed using phi, Cramer’s V, and gamma tests. Results: The sample comprised 118 individuals (93.2% female, 6.8% male). Results showed a prevalence of 38.1% for depression, 51.7% for anxiety, and 39.8% for stress. Regarding headaches, a prevalence of 62.7% was reported. Symptoms of temporomandibular disorders had a prevalence of 50%. Significant differences were found between headache and stress (p=0.034), headache and temporomandibular joint disorders symptoms (p=0.002), and symptoms of temporomandibular disorders and depression (p=0.009), anxiety (p=0.003), and stress levels (p=0.014). Conclusions: There seems to be a positive correlation between headaches and stress levels, between temporomandibular disorders symptoms and all psychosocial parameters, and between temporomandibular disorder symptoms and headaches. Data suggests that these symptoms worsened after the pandemic.

Role of Dynamic 3 Tesla MRI in the Evaluation of Temporomandibular Joint Dysfunction.

The internal derangement of the temporomandibular joint (TMJ) is the most common type of dysfunction. Internal derangement can be divided into anterior and posterior disc displacement. Anterior disc displacement is the most common type, which is further classified into anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR). Temporomandibular joint dysfunction (TMD) symptoms are pain, reduced mouth opening, and joint sound. The main aim of this study was to correlate the clinical findings and magnetic resonance imaging (MRI) diagnosis of TMD in symptomatic and asymptomatic TMJs. This prospective observational study was conducted in a tertiary care hospital on a 3T Philips Achieva MRI machine with 16-array channel coils after obtaining approval from the institutional ethical committee. A total of 60 TMJs of 30 patients were included in the study. After the clinical examination of each patient, an MRI of both right and left TMJs was done. In patients with unilateral TMD, the asymptomatic side was used as the asymptomatic joint, and the affected side as the symptomatic joint. Asymptomatic patients without any symptoms of TMD were used as controls for bilateral TMD cases. MRI with high-resolution specific serial sections was obtained in both open- and closed-mouth positions. A p-value of <0.05 was considered a statistically significant agreement between clinical and MRI diagnoses of internal derangement. Out of a total of 30 clinically asymptomatic TMJs, only 23 were normal on MRI. On MRI, 26 TMJs showed ADDWRand 11 showed ADDWoR. The most common shape of the disc was biconcave and the displacement was anterior in symptomatic joints. The most common type of articular eminence shape was sigmoid in ADDWR and flattened in ADDWoR. Agreement between clinical and MRI diagnosis in this study was 87.5% (p < 0.001). The study concluded substantial agreement between clinical and MRI diagnosis of TMJ internal dysfunction and suggests that the diagnosis of the internal dysfunction can be made clinically but the exact position, shape, and type of disc displacement can be assessed precisely with the help of MRI.

To Assess the Effect of Trauma on the Temporomandibular Joint in Postoperative Cases of Zygomaticomaxillary Complex Fractures.

The study aims to assess the incidence and features of temporomandibular joint(TMJ) dysfunction in post-surgical treatment of unilateral zygomaticomaxillary complex(ZMC) fractures.The objectives are:To assess severity of TMJ dysfunction in postoperative cases of ZMC fractures.To create awareness of the same among clinicians. Patients presenting with zygomaticomaxillary complex fractures were evaluated prospectively. Evaluation of TMJ dysfunction was done by different parameters via questionnaire, clinical and radiographic examination preoperatively and a follow-up period of 1week, 3months and 6months. The parameters were, clicking of joint, pain on opening /closing, pain on biting, deviation of mandible, pain in the preauricular region, ringing sound and mouth opening. Statistical analysis was done by the Friedman test and Post Hoc analysis. On presentation, 69.1% patients diagnosed with ZMC fractures presented with symptoms related to TMJ dysfunction. Post-surgery 1week majority findings persisted, with 21 patients complained of pain on opening or closing and 2 patients with a persistent opening click. These symptoms, however, decreased over the 3month and 6month follow up period. 5 patients presented with decreased mouth opening which was attributed to lack of adequate physiotherapy. Patients presented with mild symptoms of TMJ dysfunction until 6months post-surgery, however these symptoms weren't significant as the pain score assessed was found to decrease in the following post-operative periods. And the symptoms present were'nt exclusive to conclude a TMJ dysfunction. Early treatment and a close follow up are key to prevent progression of symptoms.

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.&#x0D; 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.&#x0D; 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.&#x0D; 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.&#x0D; 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.

State of the temporomandibular joint of professional flute players according to clinical examination and vibrography

BACKGROUND: When playing the flute, flautists take an asymmetrical posture, involve their masseter muscles extraordinarily, and experience stress. All these factors can affect the temporomandibular joint.&#x0D; AIM: To identify pathognomonic signs of temporomandibular dysfunction in professional musicians playing the flute by analyzing clinical examination data in combination with joint vibration.&#x0D; MATERIAL AND METHODS: Thirty professional flautists and 30 asymptomatic control subjects were examined. A standard clinical examination, a questionnaire survey based on the OHIP-14 questionnaire with additional questions, and a simple Hamburg test were conducted. We also conducted joint vibration analysis in both flautists and control subjects using the BioJVA device from the BioPAK complex (BioResearch, USA).&#x0D; RESULTS: The survey showed that flautists experience clicks and pain in the temporomandibular joint and pain in the muscles of the head and neck significantly more often than the control group. According to the results of the Hamburg test, symptoms of temporomandibular joint dysfunction were detected much more often among the musicians than among the control subjects. These were clicks in the joint and pain during palpation of the masticatory and temporal muscles. Joint vibration analysis showed that the total integral in flautists tracks exceeded 20 PaHz, which was three times more often than that in the control group and indicates a pathology in the temporomandibular joint.&#x0D; CONCLUSIONS: Clinical examination and joint vibration analysis revealed that the symptoms of temporomandibular dysfunction are more common in flute players than in the control participants; however, no pathognomonic signs of dysfunction were found.

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.

Електроміографічне обгрунтування доцільності застосування міорелаксуючих шин технології EXOCAD при лікуванні дисфункції скронево-нижньощелепних суглобів

The purpose of the study was to study and comparatively analyze the nature and degree of changes in electromyographic activity of the main and auxiliary chewing muscles in patients with temporomandibular joint dysfunction before and after the use of treatment with myorelaxant splints. Materials and methods. Five-year study on the basis of Stomatological Medical Center of Bogomolets National Medical University of patients with temporomandibular joint dysfunction (274 people) was conduscted. The general analysis provided 1024 detailed electromyograms before, after and at the stages of treatment of patients with temporomandibular joint dysfunction. Results and discussion. The results and conclusions of the analysis of the effectiveness of the treatment with the use of myorelaxant splints in the treatment of temporomandibular joint dysfunction indicate an increase in the quality of treatment of this pathology in patients and a reduction in the period of achievement of the result. The results obtained after 12 months indicate that the effectiveness of treatment of patients of control group I (with the lowest intensity of symptoms of temporomandibular joint dysfunction) reached 89.1±1.3%; control group II – up to 78.3±1.3%; control group III – 77.3±1.3%. In general, a study of the state of temporomandibular joint, complex clinical and paraclinic diagnosis, modern orthopedic treatment and prevention of musculoskeletal dysfunction of the temporomandibular joints were carried out. Based on the obtained data, the effectiveness of this algorithm of complex diagnosis, treatment and prevention of musculoskeletal dysfunction of temporomandibular joint was developed, clinically implemented and evaluated. Also, the data obtained as a result of the study by the authors were the basis for finding and correcting new methods and algorithms for diagnosing and treating pathology. The original author's concept of the pathogenesis of muscular-articular dysfunction of temporomandibular joint, used in the study and scientifically substantiated by the authors, united all existing theories of the development of this disease. The multifactorial analysis revealed an increase (p &lt;0.001) of the risk of not achieving the effect of treatment by reducing pain syndrome with an increase in scores on the Bayers scale before treatment, odds ratio = 1.6 (95% of BI 1.4–1.9) for each point of growth score (when standardizing on three other risk factors). An increase (p=0.002) of the risk of not achieving the effect of treatment by reducing pain syndrome with an increase in the asymmetry of the indicator J_MM_A_max, Index Bayers (visual analogue scale) = 1.08 (95% BI 1.03–1.12) for each point exceeding the value of the indicator for the left half above the right (when standardizing on three other risk factors). Also, an increase (p= 0.049) of the risk of not achieving the effect of treatment for a decrease in pain syndrome with an increase in the asymmetry of the J_MM_A_mean indicator, odds ratio = 1.28 (95% of BI 1.00–1.65) for each point exceeding the value of the indicator for the left side above the right side (when standardizing on three other risk factors) was found. Conclusion. Such a thorough approach to the implemented model of diagnosis and treatment of patients with temporomandibular joint dysfunction and a synchronized complex of studies and treatment of this pathology, developed in accordance with it, provided an opportunity to assess qualitative and quantitative changes in the link of the chewing apparatus and the central link of the corresponding functional biosystem that ensure the formation and implementation of the main functions of the temporomandibular joint

Correlation of arthroscopic findings with clinical–radiological signs and symptoms of temporomandibular joint dysfunction: retrospective study of 829 joints

Temporomandibular joint (TMJ) arthroscopic findings are difficult to predict based on clinical criteria. Few studies have attempted to correlate signs, symptoms, and characteristics of patients with the final arthroscopic findings. The aim of this study was to assess the correlation between clinical–radiological signs and symptoms and arthroscopic findings in patients with TMJ dysfunction undergoing arthroscopy. A retrospective study was performed involving 487 patients (829 joints) with TMJ dysfunction who underwent TMJ arthroscopy between 2000 and 2019. The clinical–radiological variables recorded were pain, maximum mouth opening, joint noises, Wilkes classification, and disc displacement. The arthroscopic findings evaluated were synovitis, chondromalacia, adhesions, disc perforation, disc displacement, and roofing. Pain symptoms were significantly associated with the intensity of synovitis (P = 0.005) and disc displacement evaluated arthroscopically (P < 0.001). A statistically significant relationship was observed between Wilkes stage and the level of synovitis (P < 0.001) and chondromalacia (P < 0.001). Mouth opening was negatively correlated with adhesions (P < 0.001). Based on this study, pain symptomatology was associated with the intensity of synovitis and disc displacement evaluated arthroscopically, the Wilkes stage was a good predictor of the severity of synovitis and chondromalacia, and mouth opening was negatively correlated with adhesions.

Multiple-echo recombined gradient echo MR imaging of the temporomandibular joint.

The purpose of this study was to compare images generated by a multiple-echo recombined gradient echo (MERGE) with the proton density-weighted fast spin-echo (PD-weighted FSE) sequence, T1-weighted fast spin-echo sequence (T1-weighted FSE), and T2-weighted fast spin-echo sequence (T2-weighted FSE) for the diagnostic imaging of the temporomandibular joint (TMJ). Twenty-three patients with signs and symptoms of TMJ dysfunction were enrolled in this study. The four imaging modalities were used to examine the TMJ. Three images (lateral, middle, and medial parts of the condylar head) were reviewed by two radiologists, who rated the visibility of the disk and cortex of the condylar head. For the medial part of the TMJ, in cases with a normally positioned disk, the results of the MERGE and PD-weighted FSE techniques were significantly better than those of the T1-weighted FSE and T2-weighted FSE. For visibility of the cortex in the normally positioned disk, MERGE was significantly better than PD-weighted FSE [P < 0.0125 (0.05/4)] at the middle and medial parts of the TMJ. MERGE was also significantly better than T1-weighted FSE [P < 0.0125 (0.05/4)] and T2-weighted FSE [P < 0.0125 (0.05/4)]. MERGE is better for visualizing the condylar only at the middle and the medial aspects of the TMJ in a normally positioned disk.

A Research Protocol on Effectiveness of Sub Occipital Myofacial Release on Functional Disability in Temporomandibular Dysfunction with Neck Pain: A Randomized Control Trial

Background: Temporomandibular joint dysfunction is one of commonest joint that gets affected in females, studies shows that the altered posture of cervical spine lead to mandibular retrusion and hence in long term leads to Temporomandibular dysfunction, the tightness of sub-occipital muscle leads to pulling of the ligaments around the joint in course causing retrusion or malocclusion. The common symptoms of temporomandibular joint dysfunction includes clicking, reduced mouth opening, headache. Alteration in the function of TMJ leads to poor quality of life of the individual as this joint is involved in basic activities like talking, eating, laughing and kissing. The sub-occipital muscles are the group of muscle extending from spinous process of C2 vertebrae to inferior nuchal line of occipital bone. Tightness of this muscle lead to extension of upper cervical spine and flexion of lower cervical spine. The common causes of temporomandibular dysfunction includes injury to jaw, overuse, inflammatory condition like arthritis and bruxism. Our aim is to find out the efficacy of sub-occipital Myofacial Release versus conventional physiotherapy on functional disability of TMJ. The clinical trial registry-India (CTRI) registration number for this trial is CTRI/2021/05/033493.&#x0D; Methodology: In this study the total of 60 patients with mild to moderate Temporomandibular dysfunction with neck pain were divided into two group one group received MFR and other group received stretching exercises followed by conventional physiotherapy. The treatment was given for two week 5 session in each week. The assessment was done at day one of treatment and the end of first week and at the end of second week.&#x0D; Discussion: This study was done to find out the effectiveness of suboccipital Myofacial release and stretching exercises in mild to moderate Temporomandibular joint dysfunction with neck pain.&#x0D; Conclusion: Conclusion of the study can be made based on the effect of both technique on functional disability in patient with mild to moderate TMD and opt for more specific treatment for rehabilitation of patient with TMD.

Condylar erosion is predictive of painful closed lock of the temporomandibular joint: a magnetic resonance imaging study

BackgroundTo assess whether magnetic resonance imaging (MRI) findings of condylar erosion (CE) are predictive of a specific clinical diagnosis of painful closed lock of the temporomandibular joint (TMJ), and to determine the strength of association between CE and types of internal derangement (ID).MethodsBased upon sample size estimation, this retrospective paired-design study involved 62 patients, aged between 18 and 67 years. Inclusion criteria were the presence of a unilateral clinical diagnosis of arthralgia coexisting with disk displacement without reduction (‘AR and DDwoR/wLO’), assigned according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I, and the absence of signs and symptoms of TMJ pain and dysfunction on the contralateral TMJ side. Bilateral sagittal and coronal MR images were obtained to establish the prevalence of CE and TMJ ID types of disk displacement with (DDR) and without reduction (DDNR). Logistic regression analysis was used to compute odds ratios for CE and ID types. Confounding variables adjusted for were age, sex, time since pain onset, pain intensity, and type of ID.ResultsIn the regression analysis, the MRI items of DDR (p = 0.533) and DDNR (p = 0.204) dropped out as nonsignificant in the diagnostic clinical ‘AR and DDwoR/wLO’ group. Significant increases in the risk of ‘AR and DDwoR’ occurred with CE (3.1:1 odds ratio; p = 0.026). The presence of CE was significantly related to DDNR (adjusted OR = 43.9; p < 0.001).ConclusionsThe data suggest CE as a dominant factor in the definition of painful closed lock of the TMJ, support the view that joint locking needs to be considered as a frequent symptom of osteoarthritis, and emphasize a strong association between the MRI items of CE and DDNR.

Is the Temporomandibular Joints' Reciprocal Clicking Related to the Morphology and Position of the Mandible, as Well as to the Sagittal Position of Lower Incisors?-A Case-Control Study.

The number of patients diagnosed with temporomandibular joint (TMJ) internal derangements, who are seeking orthodontic treatment, is increasing. The aim of the study was to assess the relationship between the presence of TMJ reciprocal clicking and the morphology and position of the mandible, and position of lower incisors, examined on the lateral cephalograms. Fifty patients diagnosed with reciprocal clicking in at least one of the TMJs and 55 patients with no symptoms of TMJ dysfunction were included in the study. Cephalometric analysis was used for the assessment of: skeletal class, sagittal and vertical position of the mandible, angle of the mandible, inclination of the mandibular ramus and the mandibular corpus, as well as for the assessment of the position of the mandibular incisors. The statistical significance level was set at p = 0.05. There were no statistically significant differences between the examined groups regarding the sagittal and vertical position of the mandible, as well as regarding the sagittal position of the mandibular incisors. Presence of TMJ reciprocal clicking is not associated with the position and the morphology of the mandible, as well as with the sagittal position of the mandibular incisors. Patients with early stages of TMJ internal derangements do not present any significant changes in Cephalometrics. Patients diagnosed with TMJ internal derangements before orthodontic treatment require an interdisciplinary approach to the treatment, including physiotherapy.

Балалар үйінде тәрбиеленуші балалар мен жасөспірімдердің шықшыт буыны дисфункциясы симптомдарының кездесу жиілігі

Diseases of the temporomandibular joint (TMJ) occur in 20-76% of the population, of which up to 70-89% are functional joint disorders. In children and adolescents, TMJ dysfunction occurs in 14-20%. Among the variety of pathogenetic factors in the development of this pathology, the most important are: stress, psychological disorders, imbalance in the tone of the masticatory muscles, occlusive disharmony. Purpose of the study. To study the prevalence of symptoms of TMJ dysfunction, including prenosological, in children and adolescents living in orphanages. Material and research methods. The frequency of occurrence of symptoms of functional disorders of the TMJ, including prenosological, was studied in 331 children and adolescents living in orphanages. The comparison group consisted of 218 students of secondary school No. 30 in the city of Almaty. Results and discussion. These symptoms were found in 32.62% of children and adolescents living in orphanages in the city of Almaty, and in 35.32% of practically healthy individuals, and their frequency increased with age. More common in girls. In different combinations there were revealed the dislocation of the middle inter-incisive line, pain on palpation of the masseter muscles, joint noise, malopening mouth. Dentofacial anomalies were more often observed in children and adolescents with certain symptoms of functional disorders of the temporomandibular joint. Keywords: temporomandibular joint malfunction, children and adolescents living in orphanages.