Temporomandibular Disorders Research Articles

HE ROLE OF PHYSICAL THERAPY IN MANAGING SYMPTOMS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION SECONDARY TO OSTEOARTHRITIS

The purpose of the study is to evaluate the effectiveness of the physical therapy in managing symptoms of temporomandibular joint dysfunction in patients with osteoarthritis. Materials and methods. 48 people with diagnosis of osteoarthritis of the temporomandibular joints were examined. In Group 1 (23 participants), correction involved wearing customized relieving splints. In addition to splint therapy, Group 2 received a course of physical therapy, which included therapeutic exercises targeting the masticatory muscles, facial muscles, tongue, and anterior neck muscles, as well as a course of transcutaneous electrical nerve stimulation (TENS) using the unipolar method on the masticatory and temporal muscles. The correction period for both groups was 1 month. Outcomes were evaluated using the Hamburg Test, the Helkimo Index, and the Jaw Functional Limitation Scale. Results. After the application of relaxing splints and the implementation of the physical therapy program, the total score of the "Hamburg test" decreased by 39.6% in group 1, and by 59.4% in group 2 (p<0.05). The positive dynamics of the Helkimo index was 34.5% in group 1, 48.6% in group 2 (р<0.05), passing within the parameters of moderate temporomandibular joint dysfunction. When re-evaluating the functional state of the temporomandibular region according to the Jaw Functional Limitation Scale, the improvement of chewing in group 1 was 28.8%, in group 2 – 62.3%, the mobility of the lower jaw was 21.9% and 44.3%, respectively, verbal and emotional communication – 26% and 41.7%, the total score – by 26.2% and 49.6%. The developed program of physical therapy against the background of wearing individual relief splints demonstrated a statistically significantly better effect (p<0.05) on all the studied indicators of the functioning of the orofacial zone compared to the initial data and the results of the group that corrected the dysfunction of the temporomandibular joint with talc splints. Conclusion. Use the means of physical therapy can be recommended to increase the effectiveness of dental orthopedic correction in patients with osteoarthritis of the temporomandibular joint.

Radiation dose assessment during dental cone beam computed tomography procedures in Sri Lanka towards establishing a dose reference level

Abstract This study assesses radiation doses in cone beam computed tomography (CBCT) procedures in Sri Lanka, with the goal of establishing initial diagnostic reference levels (DRLs). Data from 1162 retrospective scans across four institutions were analyzed, and the medians of the pooled dose distribution for seven clinical indication categories were presented as the DRL values. The proposed DRLs based on clinical indications are 1013 mGy·cm2 for pathological conditions including cysts, tumors, and lesions, 1307 mGy·cm2 for implant planning, 1266 mGy·cm2 for presurgery assessment, and 1585 mGy·cm2 for evaluation of sinus and nasal pathology, temporomandibular disorder, and facial trauma. Considerable variability in doses across facilities was observed, driven by differences in equipment and imaging practices. Therefore, this study recommends adopting suggested DRL values as benchmarks, standardizing protocols to reduce dose variability, and implementing a national framework for regular updates of DRL values.

COMPARISON OF THE EFFICACY OF ARTHROCENTESIS WITH AND WITHOUT CONCENTRATED GROWTH FACTOR INJECTIONS IN REDUCING CLINICAL SYMPTOMS IN PATIENTS WITH TEMPOROMANDIBULAR JOINT OSTEOARTHRITIS

There is a significant prevalence of temporomandibular joint (TMJ) disorders, estimated at 34% according to various sources. Given that this condition often leads to a reduced quality of life and disability, there is a pressing need to develop and implement effective treatment methods. Arthrocentesis, along with the injection of pharmacological agents—particularly platelet-rich plasma—into the joint cavity, is a recognized treatment for TMJ osteoarthritis. Recently, a third generation of platelet concentrates has been developed, which is an evolutionary advancement of the platelet-rich plasma technique. This study involved 60 patients, equally divided into control and experimental groups. The control group was treated with arthrocentesis for TMJ osteoarthritis, while the experimental group received arthrocentesis combined with intra-articular injections of concentrated growth factor. The effectiveness of the treatments was evaluated using the visual analogue scale (VAS) for pain and measuring maximum mouth opening. The study results showed a 74.22% reduction in VAS scores in the control group and a 79.87% reduction in the experimental group (p < 0.001). Maximum mouth opening increased by 17.84% in the control group and by 20.53% in the experimental group (p < 0.001). Both treatment methods demonstrated significant clinical efficacy (p < 0.001). In our opinion, the use of arthrocentesis with concentrated growth factor injections for the treatment of TMJ osteoarthritis is clinically justified and more effective than arthrocentesis alone.

The association between temporomandibular disorders signs and symptoms, bruxism, and health variables: A cross‐sectional study

ABSTRACT Objective The study aimed to determine the associations between several important and potentially modifiable health variables and TMD signs and symptoms. Methods A total of 209 adult dental patients from two clinics completed surveys on demographics, self-reported awake and sleep bruxism, TMD signs and symptoms, stress, depression, chronic pain, and sleep quality. Correlations and regression analyses were used to identify associations between these health variables and TMD symptoms. Results Awake bruxism was significantly associated with chronic pain intensity, jaw pain, clenching pain, and headaches. Stress and depression correlated with chronic pain intensity and clenching pain. No correlation was found between BMI and TMD symptoms. In multivariate analysis, both awake and sleep bruxism were associated with TMD symptoms, while sleep quality was related to pain on chewing and depression was associated with chronic pain intensity. Conclusions Identifying these associations can guide clinicians in assessing, educating and managing TMD-related issues by addressing bruxism, sleep quality, and depressive symptoms.

Does salivary cortisol serve as a potential biomarker for temporomandibular disorders in adults?

BackgroundThe etiology of temporomandibular disorders (TMD) is multifactorial, involving a complex interplay of psychological and physiological factors. While salivary biomarkers, particularly cortisol, play an important role in TMD pathophysiology, evidence in the literature is still scarce and inconsistent. Hence, this study aims to evaluate the applicability of salivary cortisol as a potential biomarker for TMD in adults.MethodsThe Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were used to accurately diagnose TMD patients. The study included adults, both male and female, aged 18–40 in the TMD group (n = 66) and non TMD participants (n = 66) matched for age and gender. Salivary samples were collected from participants at two time points: early and late morning. Cortisol levels in the samples were quantified using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using a one-way ANOVA to evaluate the correlations between cortisol levels and the study variables. Tukey’s post-hoc tests were applied to adjust for multiple comparisons.ResultsSalivary cortisol levels were significantly higher in the TMD group than in the corresponding controls (p = 0.034). In the TMD group, the mean cortisol levels early in the morning were 29.95 ± 75.05 (0-398.64), while the late morning levels were recorded as 4.87 ± 3.96 (0-17.13). In the control group, the mean cortisol levels early in the morning were 10.98 ± 16.83 (2.16–92.90), and late morning mean cortisol levels were 6.15 ± 6.13 (0-20.42). This indicates that the early morning levels of cortisol are higher in TMD patients (p = 0.046). In the subgroup analysis of the TMD, the mean salivary cortisol levels recorded were highest at 82.49 ± 124.34 (8.32-398.64) in patients having disc displacement without reduction with limited mouth opening. Furthermore, the mean salivary cortisol levels in the early morning were statistically higher (84.83 ± 132.80) in males compared to females (9.36 ± 9.01) (p = 0.008) with TMD.ConclusionThe result of this study suggests that salivary cortisol could be a potential biomarker for a specific TMD subtype (disc displacement without reduction with limited mouth opening). However, further studies are needed to better understand the role of cortisol biomarker in the underlying pathogenesis of TMD.

Assessing the causal role of the structural connectome in temporomandibular disorders: A Mendelian randomization study

ABSTRACT Objective We examined the relationships between the structural connectome and temporomandibular disorders (TMDs). Methods Bidirectional Mendelian randomization analyses were conducted using Genome-wide association studies data on the structural connectome and TMDs. Results Positive associations with TMD risk were found for white matter structural connectivity from the left hemisphere limbic network to putamen, left hemisphere salience_ventral attention network to caudate, right hemisphere visual network to thalamus, and right hemisphere salience_ventral attention network to right hemisphere control network, while negative associations were observed for connectivity from the left hemisphere control and somatomotor networks to pallidum, left hemisphere somatomotor network to right hemisphere dorsal attention network, and right hemisphere somatomotor network to hippocampus (p< 0.05). In TMD patients, connectivity from the Left-hemisphere visual network to putamen was reduced, whereas connectivity from the Left-hemisphere limbic network to left-hemisphere control network was increased (p< 0.05). Conclusion Our findings provide insights into the TMD pathogenesis.

Relationships between personality factors and DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders

This cross-sectional analytical study aimed to assess the relationship between personality factors and the DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders (TMD). 120 participants (60 females and 60 males) who were diagnosed with pain related TMD according to the Axis I DC/TMD protocol were recruited. The participants were requested to complete four tests including the NEO Five Factor Inventory (NEO-FFI) to assess personality factors and three Axis II DC/TMD tools; the Graded Chronic Pain Scale (GCPS) Version 2.0 to assess TMD pain intensity and pain-related disability, Patient Health Questionnaire-4 (PHQ-4) to assess psychological distress due to TMD pain, and Generalized Anxiety Disorder-7 (GAD-7) to assess patients’ stress reactivity. Results showed that 49.2% of the participants experienced high intensity of characteristic pain, 14.2% reported pain related disability more than 30 days (grade 3 disability days) and had disability scores of 70 or above (grade 3 disability scores), 16.7% demonstrated severe distress, and 18.3% reported severe anxiety due to TMD pain. Females scored higher on all these variables than males (P < .05). Multiple regression analyses indicated that higher extraversion scores, higher agreeableness scores and being a female were associated with higher intensity of characteristic pain (p < .05). Also, higher neuroticism and agreeableness scores were associated with more disability days (p < .05). In addition, higher agreeableness scores were associated with higher disability scores and disability point values (p < .05). Furthermore, lower neuroticism scores and being a female were associated with higher PHQ total scores, while being a female and having a lower level of education were associated with higher GAD total scores (p < .05). In conclusion, personality profiles and gender significantly impact the DC/TMD Axis II scores of psychosocial impairment among patients with pain related TMD.

Determining the articulatory parameters in the "Avantis 3D" software, taking into account the position of the individual hinge axis.

In modern dentistry, the tactics of treating patients with occlusion and TMJ pathology are based on complex diagnostics. The key factor for the planned treatment of a patient depends on the accuracy of recording the individual parameters of the movement of the lower jaw. One of the methods for diagnosing the work of the temporomandibular joint and obtaining individual parameters for setting up the articulator is axiography (condylography). With the introduction of digital technologies into the practice of a dentist, such as CBCT, intraoral scanning, and the necessary software for creating 3D projects, the well-known method of registering protrusion and laterotrusion for setting the angles of the sagittal articular path and the angles of the Bennett joint angles in the articulator, based on the Christensen phenomenon, has found a new application. The creation of a virtual twin of the patient, the determination of his individual articulatory parameters greatly simplifies the procedure and reduces the time of diagnosis for the subsequent full rehabilitation of a patient with TMJ dysfunction.

Predicting temporomandibular disorders in adults using interpretable machine learning methods: a model development and validation study

IntroductionTemporomandibular disorders (TMD) have a high prevalence and complex etiology. The purpose of this study was to apply a machine learning (ML) approach to identify risk factors for the occurrence of TMD in adults and to develop and validate an interpretable predictive model for the risk of TMD in adults.MethodsA total of 949 adults who underwent oral examinations were enrolled in our study. 5 different ML algorithms were used for model development and comparison, and feature selection was performed by feature importance ranking and feature decreasing methods. Several evaluation indexes, including the area under the receiver-operating-characteristic curve (AUC), were used to compare the predictive performance. The precision-recall curve (PR), calibration curve, and decision curve analysis (DCA) further assessed the accuracy and clinical utility of the model.ResultsThe performance of the random forest (RF) model was the best among the 5 ML models. An interpretable RF model was developed with 7 features (gender, malocclusion, unilateral chewing, chewing hard substances, grinding teeth, clenching teeth, and anxiety). The AUCs of the final model on the training set, internal validation set, and external test set were 0.892, 0.854, and 0.857, respectively. Calibration and DCA curves showed high accuracy and clinical applicability of the model.DiscussionAn efficient and interpretable TMD risk prediction model for adults was successfully developed using the ML method. The model not only has good predictive performance, but also enhances the clinical application value of the model through the SHAP method. This model can provide clinicians with a practical and efficient TMD risk assessment tool that can help them better predict and assess TMD risk in adults, supporting more efficient disease management and targeted medical interventions.

Intra-Articular Physiological Saline in Temporomandibular Disorders May Be a Treatment, Not a Placebo: A Hypothesis, Systematic Review, and Meta-Analysis

Background: Intra-articular injections reduce pain in patients with temporomandibular joint (TMJ) disorders who are unresponsive to conservative treatment. Hyaluronic acid, blood products, and medications provide rapid relief when administered this way, although their mechanisms of action remain unclear. In control groups, which are intended to be untreated, 0.9% NaCl is typically delivered. The hypothesis that “normal saline injections in TMJ cavities produce a therapeutic effect” is proposed, with an exploration of its potential verification, alongside a systematic review and meta-analysis of studies on intra-TMJ 0.9% NaCl. Methods: Randomized controlled trials (RCTs) on patients with TMJ internal derangement, arthritis, or degeneration were selected under PRISMA 2020 and assessed with RoB2. Results: Seven RCTs with 359 patients were included. Weekly follow-ups revealed a decrease in articular pain by 23.72% (SE: 0.84%; 95% CI: 24.38–21.06%; p &lt; 0.01), and monthly follow-ups indicated a decrease of 34.01% (SE: 1.09%; 95% CI: 36.16–31.86%; p &lt; 0.01) compared to the baseline values. These findings were grounded in low-risk-of-bias evidence on 267 patients in five RCTs and 222 patients in four RCTs, respectively. Conclusions: The hypothesis warrants further testing to determine whether, in addition to the known biological activity of typical injectables, the mechanical action also contributes to pain relief.

A laser therapy e a manual therapy as treatment for temporomandibular temporomandibular disorders: a literature review

A laser therapy e a manual therapy as treatment for temporomandibular temporomandibular disorders: a literature review

Optimizing the treatment of patients with intrinsic temporomandibular joint disorders

Temporomandibular joint (TMJ) dysfunctions are conditions in which there is a disruption in the anatomical and functional relationship between the various structures of the joint, including the articular disc, intra-articular ligaments, mandibular head and capsule. These disorders have a negative impact on the patient’s quality of life, resulting in limitations in masticatory function and articulation. The multifactorial nature of this pathology emphasizes the need for an individualized and comprehensive approach to the treatment of each patient. In most cases, treatment includes both surgical and orthopedic methods. Currently, combined treatment approaches aimed at synergistic effects are being actively developed to maximize therapeutic Results.The purpose of this study. To evaluate the efficacy of the combination of treatment with a repositioning mouthguard and the use of the hydraulic articular disk repositioning method in patients with internal TMJ disorders combined with dental row end defects.Materials and methods. The study included 6 patients with TMJ dysfunction and end defects of the dentition. The study was conducted between September 2023 and May 2024. As part of the study, each patient underwent cone beam computed tomography (CBCT) to evaluate the bony structures of the TMJ and ultrasound (US) to evaluate the soft tissue structures of this joint.Results. The CBCT data showed that the mean posterior temporomandibular joint displacement before treatment was 1.67, while this value increased to 3.02 after treatment. The US results showed a significant decrease in the mean value of mandibular head displacement after treatment ranging from 0.21 to 0.03, indicating a positive effect of treatment. In addition, there was a decrease in the difference in the size of the anterior and posterior parts of the articular disc, confirming the elimination of its displacement.Conclusion. The treatment combination of using a repositioning mouth guard with the hydraulic repositioning method brought about a synergistic effect on the restoration of TMJ function.

Association between temporomandibular joint dysfunction signs and symptoms, mental health indices, and MRI diagnoses: should we scan patients?

Temporomandibular joint dysfunction (TMD) is a common condition; yet multifactorial in nature. Our understanding of the interplay between clinical symptoms in relation to Magnetic resonance imaging (MRI) findings and quality of life is limited. Our primary objective was to identify features of TMD contributing to anxiety and depression. Our secondary objective was to determine whether clinical symptoms, baseline characteristics, and mental health outcomes are associated with underlying disease severity, as determined by MRI. A retrospective analysis of 202 TMD patients was performed. Mental health outcomes were quantified using the IMPARTS psychometric questionnaire (Visual Analog Score, VAS; Generalised Anxiety Disorder Assessment, GAD7;, Patient Health Questionnaire, PHQ-9), and patients were categorised based on temporomandibular joint pathology severity (normal, anterior disc displacement with reduction, anterior disc displacement without reduction and severe degeneration). On multivariable analyses, both higher anxiety (p<0.001) and depression (p<0.001) scores on IMPARTS assessment were associated with worst perceived pain (on VAS). Unilateral joint involvement (OR2.48[95%CI 1.20;5.46],p=0.018), locking (OR4.28[95%CI 1.63;13.63],p=0.006) , and clicking (OR2.14[95%CI1.05;4.60],p=0.006) were significantly associated with increased odds of an abnormal TMJ on MRI, whereas higher anxiety scores (OR0.93[95%CI 0.88;0.99],p=0.006) and male gender (OR0.35[95%CI 0.15;0.79],p=0.012) were significantly predictive of a normal joint morphology on MRI. Our findings support a complex interplay between patient symptomology, mental health outcomes and objective radiologically-defined joint pathology in the TMD patient population.

Manual Therapy Techniques Versus Occlusal Splint Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis

Background: Manual therapy (MT) and occlusal splint therapy (OST) are the most conservative therapies applied on patients with temporomandibular disorders (TMDs). The aim was to compare the efficacy of MT vs. OST in improving pain, maximal mouth opening (MMO), disability, and health related-quality of life (hr-QoL) in these patients. Methods: According to PRISMA guidelines, a meta-analysis (CRD42022343915) was conducted including randomized controlled trials comparing the effectiveness of MT vs. OST in TMD patients, after searching in PubMed, PEDro, SCOPUS, and WOS up to March 2024. Methodological quality and risk of bias were assessed using the PEDro Scale. Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) were the pooled effect measures calculated. Results: Nine studies, providing data from 426 patients, were included. Meta-analyses revealed that MT is more effective than OST in reducing disability (SMD = −0.81; 95% CI −1.1 to −0.54) and increasing MMO (SMD = 0.52; 95% CI 0.27 to 0.76) without differences for improving pain intensity and hr-QoL. Subgroup analyses revealed the major efficacy of OST in reducing pain in myogenic patients (SMD = 0.65; 95% CI 0.02 to 1.28). Conclusions: With caution, due to the low number of studies included, MT may be more effective than OST for improving disability and MMO in patients with TMDs.

Enhancing the Rigor of Mendelian Randomization: Methodological Insights from the Study on Obstructive Sleep Apnea and Temporomandibular Disorders [Letter]

Enhancing the Rigor of Mendelian Randomization: Methodological Insights from the Study on Obstructive Sleep Apnea and Temporomandibular Disorders [Letter]

Diagnostic significance of the method of computerized joint vibration analysis in studying the functional state of temporomandibular joints

polyetiology, progressive course and high frequency of relapses is one of the urgent problems of modern dentistry. Different conceptual approaches to the analysis of etiological and pathogenetic aspects of the development of dysfunctional TMJ disorders predetermine the increased interest in the search for highly informative diagnostic methods, especially at the stage of preclinical manifestations.Goal. Evaluation of possibilities of computerized joint vibration analysis method in diagnostics of TMJ functional state.Materials and methods. The study involved 42 people of both sexes with physiologic types of bite, preserved tooth rows, no signs of functional disorders in TMJ and masticatory muscles. The patients underwent clinical dental examination, «Hamburg test», selective grinding of teeth, and measurement of mouth opening amplitude. Joint vibration analysis was performed on the hardware-software complex «BioPAK» with registration of TMJ noise oscillations according to the following indices: «Total Integral», «High Integral», «Low Integral», «Ratio». A flow chart (Ishigaki S. et al., 1993) was used to interpret the numerical values. The functional state of TMJ was de-termined according to the flowchart using numerical parameters in accordance with the classification of TMJ disorders (Wilkes С.Н., 1989).Results. In patients with physiologic occlusion, according to joint vibration analysis, Me «Total Integral» of the right TMJ was 11.7 PaHz, left TMJ – 12.6 PaHz, [Q-25; Q-75] – [9.3; 15.1] PaHz and [10.5; 18.3] PaHz respectively, Me «High Integral» of the right TMJ – 1.3 PaHz, left TMJ – 1.4 PaHz, [Q-25; Q-75] – [1.0; 1.8] PaHz and [1.2; 2.1] PaHz respectively, with no statistically significant (p≤0.05) differences in the studied parameters between the right and left TMJ.Conclusions. The diagnosis of «structurally intact» TMJ, corresponding to stage I of the American classification of TMJ disorders (Wilkes S.N., 1989) in people with physiologic types of bite, is confirmed by the numerical values [Q-25; Q-75] of «Total Integral», «High Integral» (block diagram of S. Ishigaki et al., 1993), the degree of maximum mouth opening [43; 50] mm in the absence of pronounced signs of facial asymmetry.

EARLY DETECTION OF DISEASES OF THE TEMPOROMANDIBULAR JOINT IN PATIENTS UNDERGOING DENTAL TREATMENT

The problem of early diagnosis of temporomandibular joint dysfunction remains important in dentistry today. The prevalence rate of diseases of the temporomandibular joint ranges from 35% to 83% according to various researchers.

Structural MRI findings in the brain related to pain distribution in chronic overlapping pain conditions: An explorative case-control study in females with fibromyalgia, temporomandibular disorder-related chronic pain and pain-free controls.

Few neuroimaging studies have investigated structural brain differences associated with variations in pain distribution. To explore structural differences of the brain in fibromyalgia (FM), temporomandibular disorder pain (TMD) and healthy pain-free controls (CON) using structural and diffusion MRI. A case-control exploratory study with three study groups with different pain distribution were recruited: FM (n = 16; mean age [standard deviation]: 44 [14] years), TMD (n = 17, 39 [14] years) and CON (n = 10, 37 [14] years). Participants were recruited at the University Dental Clinic in Malmö, Sweden. T1-weighted and diffusion MRIs were acquired, clinical and psychosocial measures were obtained. Main outcome measures were subcortical volume, cortical thickness, white matter microstructure and whole brain grey matter intensity. Patients with FM had smaller volume in the right thalamus than patients with TMD (p = .020) and CON (p = .030). The right thalamus volume was negatively correlated to pain intensity (r = -0.37, p = .022) and pain-related disability (r = -0.45, p = .004). The FM group had lower cortical thickness in the right anterior prefrontal cortex than CON (p = .005). Cortical thickness in this area was negatively correlated to pain intensity (r [37] = - 0.48, p = .002). This study suggests that thalamus grey matter alterations are associated with FM and TMD, and that anterior prefrontal cortex grey matter alterations are associated with FM but not TMD. Studies on chronic overlapping pain conditions are needed in relation to possible nociplastic pain mechanisms in the brain and central nervous system.

Cross Cultural Validation of Oral Health Index Profile for Temporomandibular Disorders in Spanish Speaking Population.

Structured patient-centred assessment is critical for improving care. OHIP-TMDs are a validated English-language outcome measure for temporomandibular disorders (TMD) which evaluates the biopsychosocial impact of TMD. Due to language and cultural changes, the original instrument's phrasing of its items may change when translated to Spanish. This study cross-culturally adapted and validated OHIP-TMDs for Spanish-speaking individuals with TMD. OHIP-TMDs was forward-backward translated into Spanish (OHIP-TMDs-Sp) and cross-culturally adapted to a Hispanic population with TMD (Diagnostic Criteria for TMD n = 154) according to international norms. All patients completed the OHIP-TMDs-Sp, the Graded Chronic Pain Scale (GCPS), and Jaw Functional Limitation Scale (JFLS-20). A subsample (n = 30) recompleted the OHIP-TMDs-Sp after a 3-week washout to measure test-retest reliability using an intra-class correlation coefficient (ICC 2.1). OHIP-TMDs-Sp, JFLS-20, and GCPS were analysed for convergent validity and internal consistency. The sample with articular and muscular TMD diagnoses was 85.7% female with a mean age of 29.5. (SD 9.01). OHIP-TMDs-Sp had high internal reliability (Cronbach's Alpha = 0.95) and good test-retest reliability (ICC = 0.82; 95% CI = 0.57-0.93). In terms of convergent validity, the OHIP-TMDs-Sp demonstrated moderate to large positive correlations with the total JLFS-20 score (ρ = 0.72; p < 0.01), Mastication (ρ = 0.68; p < 0.01), Communication (ρ = 0.68; p < 0.001), as well to GCPS disability score (ρ = 0.59; p < 0.01), and characteristic pain intensity (ρ = 0.69; p < 0.01). The total score of OHIP-TMDs-Sp is reliable for assessing quality-of-life in Spanish-speaking TMD patients.

Effectiveness of mobilization on cranio– –mandibular index in temporomandibular joint dysfunction among collegiates

Background: Temporomandibular disorder (TMD), according to the American Academy of Orofacial Pain (AAOP), is a collection of painful and/or dysfunctional diseases affecting the masticatory muscles, temporomandibular joints (TMJs), and associated tissues. This can be treated effectively by the manual mobilization. Objective: To find out the effectiveness of mobilization on craniomandibular index in Temporomandibular Joint Dysfunction among college students. Methods: It is a quasi-experimental pre and post type study performed among 40 college students, both boys and girls, with Temporomandibular Joint Dysfunction, selected through convenient sampling of the age group 18–25 years, with a Craniomandibular index score of more than 0.50. The selected group is treated with a 4 week mobilization to see the effectiveness of the treatment. Outcome measure: Cranio Mandibular Index which encloses of the mandibular movement, range of motion, joint palpation ,muscle palpation, TMJ noise. Results: The results show that there was a significant improvement in the mean values of the craniomandibular index score after mobilization, with a mean difference of 0.32 ± 0.05. Conclusion: The study concluded that mobilization is an effective treatment approach for temporomandibular joint dysfunction among college students.