Signs Of Temporomandibular Disorders Research Articles

Bruxism, Lifestyle, Anxiety, and Sleep Impairment in Dental Students

AbstractThe aim of this study was to verify the correlation of self-reported sleep and awake bruxism with demographic characteristics, oral behaviors, anxiety, temporomandibular disorder (TMD) signs and symptoms, sleep quality, and orthodontic treatment history in dental students. A total of 104 students of Dentistry located in Paraná (South Brazilian State) answered the following self-administered questionnaires: Oral Behavior Checklist, State Anxiety Inventory, TMD signs and symptoms questionnaire, and the Pittsburgh Sleep Quality Index. Associations between possible awake bruxism (AB) and sleep bruxism (SB) with sleep quality, anxiety, and TMD were analyzed by Poisson Regression with robust variance. The significance level adopted was 5%. The frequency of AB and SB was 76% and 55.8%, respectively. A statistically higher frequency of AB was observed in students who had the following conditions: use of psychotropic medication, physical activity practitioners, moderate or high level of anxiety, more oral behaviors, sleep disorders, and sleep bruxism. Sleep bruxism was diagnosed more frequently in students who presented moderate or high levels of anxiety, oral behaviors, and sleep disorders. The frequency of TMD reported was higher in students with SB, as well as in those with AB. In conclusion, lifestyle, moderate and high anxiety levels, and sleep disorders are associated with a higher prevalence of AB and SB. Furthermore, AB and SB are associated with a higher frequency of TMD reporting.

Is painful temporomandibular disorder a real headache for many patients?

Temporomandibular disorders (TMDs) and primary headaches are common pain conditions and often co-exist. TMD classification includes the term ‘headache secondary to TMD' but this term does not acknowledge the likelihood that primary headache pathophysiology underpins headache causing painful TMD signs and symptoms in many patients. The two disorders have a complex link and we do not fully understand their interrelationship. However, growing evidence shows a significant association between the two disorders. This article reviews the possible connection between temporomandibular disorders and primary headaches, specifically migraine, both anatomically and pathogenetically.

Temporomandibular joint disorders and associated factors in a Turkish pediatric population.

To explore the presence and severity of temporomandibular disorders (TMD) signs and symptoms in a Turkish pediatric population, as well as their relationship to parafunctional behaviors, bruxism, malocclusion, anxiety, and sociodemographic traits. A cross-sectional study was conducted with patients between the ages of 5-15. Demographic variables, TMD signs and symptoms, parafunctional habits, bruxism, and malocclusion were evaluated by clinical examination. Fonseca Anamnestic Index (FAI) was used to determine the presence and severity of TMD. State-Trait Anxiety Scale for Children (STAI-C) was used to evaluate the anxiety. Student t, Mann-Whitney U, chi-square tests, and logistic regression were used for statistical analysis. One hundred sixty-two participants (85 girls, 77 boys) with a mean age of 10.03 ± 1.88 years were included. The frequency of the participants who reported signs/symptoms of TMD was 19.7% according to FAI scores. Logistic regression analysis with the associated factors showed a significant relationship between the presence of the signs/symptoms of TMD and parafunctional habits (OR 4.24, 95% CI 1.64-10.93), and the presence of signs/symptoms of anxiety (OR 1.09, 95% CI 1.02-1.16). Children and adolescents who exhibit parafunctional behaviors and anxiety had a higher likelihood of having TMD signs/symptoms of varying degrees of severity.

Treatment outcome and long-term stability of orthognathic surgery for facial asymmetry: A systematic review and meta-analysis.

: This systematic review aimed to provide a comparative analysis of the treatment outcomes, including hard and soft tissues, postoperative stability, temporomandibular disorders (TMD), and quality of life (QoL), in patients with facial asymmetry who underwent orthognathic surgery. : The primary objective was to address the question, "How do different factors related to surgery affect the outcomes and stability of orthognathic surgery in the correction of facial asymmetry?" A meta-analysis was conducted on the outcome parameters, such as skeletal, dental, and soft tissue symmetry, TMD, QoL, and relapse, using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Subgroup analyses were conducted considering surgery-related factors such as surgical techniques (one-jaw vs. two-jaw), use of the surgery-first approach, utilization of computer simulation, and analytical methods employed to evaluate asymmetry (2D vs. 3D). : Forty-nine articles met the inclusion criteria. The meta-analysis demonstrated a significant improvement in the symmetry of hard and soft tissues. The subgroup analysis indicated that the treatment outcomes showed significant improvement, regardless of the factors related to surgery. Changes in TMD signs and symptoms varied according to the surgical technique used. Quality of life improved in the facial, oral, and social domains. Skeletal relapse was observed during the follow-up. : Our findings support the positive outcomes of orthognathic surgery in the treatment of facial asymmetry in terms of skeletal and soft tissue improvements, stability, relief of TMD symptoms, and enhancement of QoL. However, most of the included studies showed a low certainty of evidence and high heterogeneity.

Clinical Study to Evaluate the Prevalence of TMD Before and After Delivery of Complete Denture

Temporomandibular disorder (TMD) is a broad term that encompasses number of clinical problems including the temporomandibular joints, the masticatory musculature and related structures, or both. The etiology of TMD is ambiguous since the signs and symptoms which exist in patients with natural teeth may also being observed in edentulous patients. Thus, TMD is a multifactorial problem with varying symptoms combinations and rates. Relationship between removable complete dentures and tempromandibular joint disorder in different gender and age groups. A total of 30 patients (15 female and 15 male) who submitted to Prosthodontics Department, College of Dentistry, Al-Mustansiriyah University to make a new complete denture. The age of participants ranges from (40-80) years with the mean age (65.9) years. Two clinical examiners conducted the patient’s examination; the first examiner takes on a questionnaire to identify the TMD symptoms signs and. Clinical examination of the patients was assessed through part I, II of research diagnostic criteria pre and post one and two months of applying the prosthesis. The clinical evaluation of prosthesis done by the second clinical examiner related to (retention, stability, fitness, occlusion and centric relation) was evaluated twice at predetermined intervals of 1 and 2 months after construction and delivery of denture. Evaluation performed by using Dawson's bimanual technique and recorded within clinical case sheet for complete denture records. The present study shows that the highest frequency of TMD obtained in age group of 70-80 years old followed by age group of 60-69 years old at all intervals, internal derangement (ID frequency) significantly higher in females than male patients (p=0.02). There is significant statistical difference regarding the Myofacial pain dysfunction (MPD) frequency according to the time of using the dentures, those patients with Diabetes Mellitus (DM) formed the highest percentage (39.1%) of those whom presented with MPD followed by those with Hypertension (HT) (32%) and those with history of HT and DM represent (17.4%) only The results also illustrated that prosthesis properties (retention, stability, fitness, occlusion and centric relation) show significant relation with TMDs improvement post one and two months. Most patients with complete denture perceived improvement in the sign and symptoms of TMDs.

Objectively measured adherence may affect side effects of mandibular advancement therapy in subjects with obstructive sleep apnea.

The purpose of this study was to determine if objectively measured adherence to oral appliance (OA) treatment may affect dental changes and temporomandibular disorders (TMD) in patients with obstructive sleep apnea (OSA). The original study group consisted of adults with OSA who were referred for OA therapy. Eight indicators of subjective side effects of using OA (temporomandibular joint (TMJ) and muscle pain, pain in teeth, jaw stiffness in the morning, clicking, dry mouth, hypersalivation, gingival irritation) were evaluated by a questionnaire. Three occlusal indicators (overjet, overbite, molar occlusion) and clinical TMD signs (TMJ pain, muscle pain, clicking, jaw deviation on opening) were evaluated at baseline and at the 3-, 6-, and 12-month follow-up. In addition, objective adherence monitoring for OA was registered. Statistical analyses included the chi-square test, Fisher's exact test, paired sample t-test, and linear regression analyses. A total of 58 adults with OSA were referred for OA therapy. Mean (SD) age was 50.7 (11.7) and mean apnea-hypopnea index (AHI) was 19.5 (10.0). At 1-year follow-up, the study group consisted of 28 men and 12 women.Overjet but not overbite reduced significantly after 1-year OA therapy. The average nightly wear of OA was related to overjet and overbite reduction, and to TMD signs. Hypersalivation, dry mouth, and tooth discomfort were the most common subjective side effects of OA therapy. There was a time-dependent relationship with the nightly wear of OA and reduction in overjet and overbite, and clinical TMD signs. With 60% of mandibular advancement, dental changes and TM-disorders were considered mild/minor in the1-year study period.

Frequency and Severity of Temporomandibular Disorders Among Weightlifters at Fitness Centers in a Subset Population of Saudi Arabia: A Cross-Sectional Observational Study.

Background Teeth clenching in weightlifters is a common finding that may result in temporomandibular disorders (TMDs). This study aimed to evaluate the severity and frequency of TMDs among weightlifters at fitness centers in Saudi Arabia. Methods A cross-sectional study was designed to collect data from weightlifters at fitness centers. A non-probability convenient sampling technique was applied using a valid and reliable Fonseca's questionnaire on a Google Sheet (Google, Mountain View, CA) to collect participant data. The survey was conducted from November 2022 to April 2023. Epi Info software (CDC,Atlanta, Georgia) was used to calculate the sample size, and a minimum sample of 278 was required. The data underwent analysis using SPSS version 20 (IBM Corp., Armonk, NY). Results Data analyzed from 375 participants revealed that 192 (51.2%) had mild signs of TMD, whereas 128 (34.13%) of the respondents had no symptoms of TMD. A significant difference was observed among female participants in all the temporomandibular joint severity categories. A statistically significant difference was observed between both genders concerning frequent headaches, earache, and nervousness. Conclusion The prevalence of TMD is high worldwide. Unsupervised athletic activity may result in the occurrence of TMD. Fonseca's questionnaire findings reveal a mild prevalence of TMD in weightlifters.

Practitioner/Practice- and Patient-Based Factors Contributing to Dental Practitioner Treatment Recommendations for Patients with Pain-Related TMDs: Findings from the National Dental PBRN.

To document National Dental Practice-Based Research Network (PBRN) practitioner treatment recommendations for patients with painful temporomandibular disorders (TMDs) and to identify practitioner/practice- and patient-related factors contributing to treatment recommendations made at the initial clinical visit. This prospective single-sample cohort study formed groups based on treatment recommendations made by 185 dental practitioners who treated 1,901 patients with painful TMDs. At the baseline visit, which this article describes, practitioners provided patients with their diagnoses and a treatment plan and then completed a comprehensive questionnaire. Self-care, an intraoral appliance, medication, and practitioner-recommended jaw exercises were the most frequently recommended treatments. Practitioners recommended multiple treatments to most patients. TMD signs, symptoms, and diagnoses were primary considerations in treatment planning, but the practitioner's expectations for improvement were only significant for intraoral appliances and self-care. Female practitioners and those with expertise in TMDs more frequently recommended patient-directed and multidisciplinary treatments compared to their counterparts. Practitioners used a wide range of treatments for patients with few consistent patterns. The propensity to use TMD signs, symptoms, and diagnoses when making treatment recommendations suggests a tendency to conceptualize patients using the biomedical model. Infrequent referral to nondental providers suggests a lack of availability of these providers, a misunderstanding of the complexity of TMDs, and/or discomfort with assessment of psychosocial factors. Implications include the need for comprehensive training in the assessment and management of TMD patients during dental school and participation in TMD continuing education courses following evidence-based guidelines.

Implant-supported crowns on maxillary laterals and canines—a long-term follow-up of aesthetics and function

ObjectivesTo assess the long-term aesthetic and functional aspects of implant-supported crowns in lateral (ISC-L) and canine positions (ISC-C).Materials and methodsThirty-two patients (14 males, 18 females, mean age: 23.1, SD:2.0) with an ISC-L or ISC-C participated in this prospective cohort study at baseline (T0) and in the long-term follow-up (T1, mean years: 11.1, SD: 1.0). Twenty-four patients (11 males, 13 females) participated in T1. Patient-reported outcomes (PROM) were rated using surveys with questions related to aesthetics and function. The colour of the implant crown and the buccal gingiva, the appearance of the papilla, periodontal health and temporomandibular disorder (TMD) outcomes were assessed in a clinical examination. The Mann-Whitney, Chi-square and Signed Rank tests were performed.ResultsPatients with an ISC-L and ISC-C were equally satisfied with the crown shape and colour at T0 and T1. No differences in TMD outcomes were reported by the patients and no clinical signs of TMD were observed. At T1, ISC-C had more bleeding on probing and a three mm greater pocket depth than ISC-L (p = 0.03, p = 0.01, respectively). At T0, operators graded the crown colour of ISC-L as being too dark (35%) and ISC-C as being too light (40%). At T1, no difference was seen between the two groups regarding crown colour, gingiva colour and the papilla (p = 0.2749, p = 0.2099, p = 0.8053, respectively).ConclusionsThe PROM and clinical examination show that ISC-L and ISC-C are equivalent with regard to aesthetics and function in the long term.Clinical relevanceAlthough ISC-L and ISC-C are aesthetically and functionally comparable in the long term, ISC-Cs are more likely to impact periodontal health.

Temporomandibular Disorders and Serological Tests in Patients with Rheumatoid Arthritis

Background: Rheumatoid Arthritis (RA) is a systemic and chronic autoimmune disease with inflammation at the synovial joints. The purposes of this study were to evaluate the correlation between serological variables and temporomandibular disorders (TMDs) in patients diagnosed with RA, evaluated through diagnostic criteria for temporomandibular disorders (DC/TMD), and to check the influence of comorbidities on the different TMD signs and symptoms, or any serological variables. Methods: This observational cohort research study included seventeen patients affected by RA. The comorbidities and some variables from the initial serological analyses were collected from the clinical rheumatological charts. Then, the presence of any of the following TMD signs/symptoms, temporal myalgia, temporomandibular joint arthralgia, click or crepitus, was evaluated through the symptom questionnaire of the DC/TMD during clinical evaluation following the DC/TMD examination form. Results: Rheumatoid factor (RF), anticitrullinated protein antibodies (ACPA), and anti-nuclear antibody (ANA) positivity were present in 82.4%, 52.9%, and 41.2% of patients, respectively. Indicators of tissue inflammation were evaluated with median values of 21 mm/h for erythrocyte sedimentation rate (ESR) and 0.50 mg/dL for C-reactive protein (CRP). The RA patients presented comorbidities such as hypertension in 70.6% and diabetes in 23.5%. Negative ACPA had a significant association with myalgia (p = 0.03), and positive ANA was significantly associated with crepitus (p = 0.05). Conclusion: ANA and ACPA evaluation can be considered predictive serological tests associated with specific TMDs. Conversely, no influence of any comorbidities was found between different TMD signs and symptoms, or any serological variables.

Associations of inflammatory polyarthritis with clinical and radiological findings of temporomandibular disorders

Objective To evaluate the association of different forms of inflammatory polyarthritis with clinical signs of temporomandibular disorders (TMD) and radiological findings in temporomandibular joint (TMJ), based on a nationwide health survey in Finland. The aim was also to assess the presence of clinical and radiological TMD findings in subjects with increased risk for developing rheumatoid arthritis (RA). Material and methods A nationally representative sample included 6331 Finnish adults who participated in the Health 2000 Survey (BRIF8901). Subjects were examined for signs of TMD, findings in panoramic radiograph of TMJ, musculoskeletal health and serology (rheumatoid factor, RF, and anti-cyclic citrullinated peptide, aCCP). Results Sixty-four percent of seronegative RA and 60% of seropositive RA subjects had at least one sign of TMD. While adjusting for confounding factors (gender, age, dentures and smoking history), RA was significantly associated with crepitation and abnormal radiological findings in TMJ. Seronegative RA was also associated with restricted mouth opening. Systemic autoimmunity associated with RA (“at risk of RA”) was not associated with clinical or radiological TMD findings. Conclusions Clinical and radiological findings of TMD are more prevalent among subjects with inflammatory polyarthritis than among the population in general in the Finnish adult population.

Parapharyngeal space carcinoma disguised as temporomandibular joint disorder: A clinical report

Parapharyngeal space neoplasms tend to have a considerable volume by the time of diagnosis because of their deep location in the neck and may have a relatively long progression before becoming symptomatic. Common presenting signs and symptoms of parapharyngeal space neoplasms include swelling in the neck, intraoral mass, dysphagia, dysphonia, heaviness in the ear, otalgia, and rarely, trismus. Some of these signs and symptoms could be mistaken for signs of temporomandibular disorder (TMD). This clinical report presents the incidental discovery of parapharyngeal space carcinoma initially presenting as TMD. A thorough clinical examination of the temporomandibular joints, supported by their magnetic resonance imaging, led to early detection of the neoplasm, thereby improving the patient's post-treatment survival probability.

The Effect of Photobiomodulation on Temporomandibular Pain and Functions in Patients With Temporomandibular Disorders: An Updated Systematic Review of the Current Randomized Controlled Trials.

Introduction: Temporomandibular disorders (TMDs) are the most prevalent non-dental origin orofacial pain conditions affecting the temporomandibular joints (TMJs) and/or orofacial muscles. Photobiomodulation therapy (PBMT) is a conservative way to improve function and reduce symptoms in TMD patients. This systematic review was conducted to update evidence about the effects of PBMT on pain intensity, TMJ movements, electromyography (EMG) activity, pressure pain threshold (PPT), and TMJ sound in patients with TMDs. Methods: A systematic literature search was conducted in Web of Science, PubMed/Medline, and Scopus databases using appropriate keywords and specific strategies from January 2000 to September 2022. Data extraction was done based on the inclusion/exclusion criteria. Results: A total of 40 studies were included. All included studies except one provided information on pain intensity; 27 studies showed a reduction in pain intensity in PBMT groups compared to control groups. Seven out of 15 studies, which reported maximum mouth opening (MMO), showed a greater MMO in PBMT groups than in placebo groups. In addition, the figures for passive maximum mouth opening (PMMO) and active maximum mouth opening (AMMO) in all the studies reporting PMMO and AMMO were higher in PBMT groups. In eight out of ten studies, lateral movement (LM) was greater in PBMT groups. Moreover, in three studies out of four, protrusive movement (PM) was reported to be greater in the PBMT group. Four out of nine studies showed a greater PPT in the PBMT group. Reduced TMJ sounds in the PBMT group were reported in two out of five studies. In addition, in most studies, no difference in EMG activity was detected between the two groups. Conclusion: This updated systematic review showed the promising effects of PBMT on the alleviation of pain and improvement in MMO. Using the infrared diode laser with a wavelength ranging between 780-980 nm, an energy density of<100 J/ cm2, and an output power of≤500 mW for at least six sessions of treatment seems to be a promising option for treating mentioned TMDs signs and symptoms based on the previously reported findings.

The relation of temporomandibular disorders with oral health-related quality of life in the Northern Finland Birth Cohort 1966

ABSTRACT Objective This study aimed to evaluate the association between temporomandibular disorders (TMD) and oral health-related quality of life (OHRQoL) in an adult population. Methods The data included 1,768 adults 46 years of age in the Northern Finland Birth Cohort 1966 (NFBC1966) study. The symptoms, signs and diagnoses of TMD were assessed using a modified protocol of the Diagnostic Criteria for TMD (DC/TMD) and validated questionnaires. OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Associations of TMD and OHRQoL were evaluated with χ2 -test and Fisher’s exact test. Results In females, pain-related TMD signs and diagnoses associated significantly with prevalence of OHIP total and all dimensions, whereas in joint-related TMD, psychological dimensions showed the strongest association. Males with pain- or joint-related TMD, the most impaired dimension was physical pain. Conclusion Pain-related TMD seems to associate more strongly with lower OHRQoL than joint-related TMD especially in females.

Effectiveness of Physical Therapy Interventions for Temporomandibular Disorders Associated with Tinnitus: A Systematic Review.

Temporomandibular disorders (TMDs) refers to different clinical conditions affecting the temporomandibular joints, masticatory muscles, and adjacent structures. Although TMDs signs and symptoms (e.g., pain and limited mouth opening) are common, otological symptoms, such as tinnitus, might also be present. This study aims to summarize the evidence of the effectiveness of physical therapy interventions in individuals with TMDs associated with tinnitus. Randomized controlled trials investigating the effectiveness of physical therapy in individuals of both genders aged 18 or older with TMDs associated with tinnitus were included. The electronic search was performed in the following databases: MEDLINE, EMBASE, CINAHL, PEDro and CENTRAL. A total of four studies were included. All studies showed that physical therapy reduced the intensity of tinnitus, and two trials showed a decrease in the pain intensity caused by TMDs, an increase in the pressure pain thresholds in the masticatory muscles and an improvement of mandibular function. Two studies presented a low risk of bias. Despite a low certainty of the evidence, this review showed that physical therapy reduces the intensity or severity of tinnitus associated with TMDs. Results may support future research on the topic and evidence-based practice by recommending the best physical therapy approach for patients, clinicians, researchers, and health system managers.

Post-traumatic stress, prevalence of temporomandibular disorders in war veterans: Systematic review with meta-analysis.

The physical and psychological effects of war are not always easy to detect, but they can be far-reaching and long-lasting. One of the physical effects that may result from war stress is temporomandibular disorder (TMD). To evaluate the prevalence of TMD sign and symptoms among war veterans diagnosed with PTSD. We systematically searched in Web of Science, PubMed and Lilacs for articles published from the inception until 30 December 2022. All documents were assessed for eligibility based on the following Population, Exposure, Comparator and Outcomes (PECO) model: (P) Participants consisted of human subjects. (E) The Exposure consisted of exposition to war. (C) The Comparison was between war veterans (subjects exposed to war) and subjects not exposed to war. (O) The Outcome consisted of presence of temporomandibular disorders sign or symptoms (we considered pain to muscle palpation in war veterans). Forty studies were identified at the end of the research. We chose only four study to draw up the present systematic study. The included subjects were 596. Among them, 274 were exposed to war, whereas the remaining 322 were not exposed to war stress. Among those exposed to war, 154 presented sign/symptoms of TMD (56.2%) whereas only 65 of those not exposed to war (20.18%). The overall effect revealed that subjects exposed to war and diagnosed with PTSD had a higher prevalence of TMD signs (pain at muscle palpation) than controls (RR 2.21; 95% CI: 1.13-4.34), showing an association PTSD war-related and TMD. War can cause lasting physical and psychological damage that can lead to chronic diseases. Our results clearly demonstrated that war exposure, directly or indirectly, increases the risk of developing TMJ dysfunction and TMD sign/symptoms.

Protective masks during the SARS-CoV-2 pandemic: Any relationship with temporomandibular disorders and orofacial pain?

Wearing protective face masks has been one of the indispensable measures to prevent droplets and aerosol particles transmission during the SARS-CoV-2 pandemic. This observational cross-sectional survey investigated the different types and modalities of protective mask wearing and the possible association with referred signs of temporomandibular disorders and orofacial pain by respondents. An online-questionnaire was developed, calibrated and administered anonymously to subjects with an age of ≥ 18 years. It consisted of different sections: demographics, type and wearing modalities of the protective masks, pain in the preauricular area, noise at the temporomandibular joints and headache. Statistical analysis was performed using statistical software STATA v16. The questionnaire received 665 replies mainly from participants aged 18-30 years (315 males, 350 females). The healthcare professionals were 37% of participants, 21.2% of them were dentists. The Filtering Facepiece 2 or 3 (FFP2/FFP3) mask was used by 334 subjects (50.3%), and 578 (87%) wore the mask with two elastics behind the ears. Pain while wearing the mask was referred by 400 participants, and 36.8% of them referred pain with a consecutive use of more than 4 hours (p = 0.042). 92.2% of participants did not report any TMJ noise. Headache associated with the FFP2/FFP3 was referred by 57.7% of subjects (p = 0.033). This survey highlighted the increased referred the presence of discomfort in the preauricular area and headache possibly associated with a prolonged use of protective face masks for more than 4 hours during the SARS-CoV-2 pandemic.

Temporomandibular joint involvement in psoriatic arthritis: a prospective clinical and ultrasonographic study.

To evaluate the prevalence of temporomandibular disorders (TMD) in a monocentric cohort of patients affected by psoriatic arthritis (PsA), and to investigate the accuracy of temporomandibular joint (TMJ) ultrasound (US) compared with clinical evaluation and clinimetric composite index in assessing TMJ involvement. We conducted a prospective cohort study of patients diagnosed with PsA who underwent at least one TMJ US examination and maxillofacial surgeon's evaluation between 2018 and 2021. The rheumatology physician's interpretation of each TMJ US exam (presence/absence of TMD) was compared with psoriatic arthritis disease activity indexes and maxillofacial surgeon's clinical judgement (presence/absence of TMD signs and/or symptoms). 142 psoriatic arthritis patients were included. 111 patients were totally asymptomatic for TMD, but 58.5% of them already showed TMJ US changes; moreover, 103 patients passed the maxillofacial surgeon's examination in the absence of any relevant findings but again, of these, 55.3% already presented US signs of TMD. Univariate analysis of subgroups with and without TMJ synovitis and with and without active power Doppler signal showed a significant prevalence of peripheral enthesitic involvement in patients affected by TMD (95.7% vs. 4.3%, p=0.001; and 72.2% vs. 27.3%, p=0.007, respectively). Multivariate regression analysis confirmed the results (p=0.01 and p=0.013, respectively). Peripheral enthesitic involvement may represent a potential risk factor for the development of TMJ synovitis in PsA patients. Since TMD often develops asymptomatically, TMJ US may detect early signs of TMD, ensuring precocious and adequate management.

The difference in signs of temporomandibular joint disorders between Airforce Pilot Corps, Paskhas Corps, and Supporting Corps in Indonesian Airforce

Objective: This study aims to analyze the difference in signs of TMJ disorders in Indonesian Air Force soldiers.&#x0D; Material and Methods: This was a cross sectional study. The research subjects were 39 Indonesian Air Force soldiers who were underwent periodic health check up at Lakespra Dr. Saryanto Jakarta who had met the inclusion and exclusion criteria.. The data obtained were tested with one way Anova, Kruskal Wallis and Mann Whitney test by SPSS.&#x0D; Results: The three groups had signs of TMJ disorders in different proportions. The Paskhas Corps had the highest percentage of abnormalities in the examination of muscle palpation, TMJ palpation, and TMJ auscultation of 23%, 23%, and 53.85%, respectively. Meanwhile, the Airforce Pilot had the most abnormalities in mandibular movement, about 92%. The results of statistical tests showed that there were significant differences in the TMJ auscultation examination in the three groups, but not on other examinations.&#x0D; Conclusion: Exercises and heavy physical loads in the Paskhas Corps can affect the masticatory muscles and cause microtrauma in the TMJ resulting in the occurrence of TMJ symptoms is higher.

AN INNOVATIVE DEVICE FOR TMJ VIBRATION ANALYSIS

Temporomandibular joint (TMJ) sounds are an important sign of temporomandibular disorder. Vibrations of different frequencies have been linked to certain types of disorders of the TMJ. Commercially available instrumentsemployed to record the vibrations of the TMJ are expensive and impractical to purchase in a clinical setup or for educational purposes. This article describes the development of a novel, innovative and inexpensive device using a pair of accelerometers, microphones and smartphones along with a developed software for the purpose of recording and analysing the recorded data from the TMJ.