Temporomandibular Disorders Research Articles

Assessing the credibility of AI-based Monitoring on Temporomandibular Disorders

Assessing the credibility of AI-based Monitoring on Temporomandibular Disorders

Elucidation of neuronal activity in mouse models of temporomandibular joint injury and inflammation by in vivo GCaMP Ca2+ imaging of intact trigeminal ganglion neurons.

Patients with temporomandibular disorders (TMDs) typically experience facial pain and discomfort or tenderness in the temporomandibular joint (TMJ), causing disability in daily life. Unfortunately, existing treatments for TMD are not always effective, creating a need for more advanced, mechanism-based therapies. In this study, we used in vivo GCaMP3 Ca2+ imaging of intact trigeminal ganglia (TG) to characterize functional activity of the TG neurons in vivo, specifically in mouse models of TMJ injury and inflammation. This system allows us to observe neuronal activity in intact anatomical, physiological, and clinical conditions and to assess neuronal function and response to various stimuli. We observed a significant increase in spontaneously and transiently activated neurons responding to mechanical, thermal, and chemical stimuli in the TG of mice with TMJ injection of complete Freund adjuvant or with forced mouth opening (FMO). An inhibitor of the calcitonin gene-related peptide receptor significantly attenuated FMO-induced facial hypersensitivity. In addition, we confirmed the attenuating effect of calcitonin gene-related peptide antagonist on FMO-induced sensitization by in vivo GCaMP3 Ca2+ imaging of intact TG. Our results contribute to unraveling the role and activity of TG neurons in the TMJ pain, bringing us closer to understanding the pathophysiological processes underlying TMJ pain after TMJ injury. Our study also illustrates the utility of in vivo GCaMP3 Ca2+ imaging of intact TG for studies aimed at developing more targeted and effective treatments for TMJ pain.

Evaluation of the single and combined therapeutic effects of individually manufactured earplug therapy in patients with myogenous temporomandibular disorders: A randomized controlled clinical trial

ObjectiveTo evaluate the effect of individually manufactured earplug therapy on pain intensity (PI), symptom severity (SS), and maximum mouth opening (MMO), in patients with myogenous temporomandibular disorders (TMD).MethodsOne-hundred-twenty patients were randomly allocated to six groups: Groups EP (earplug), OS (occlusal splint), EX (exercise), EPO (earplug with occlusal splint), EPE (earplug with exercise), and C (control). Outcomes were PI (assessed with a visual analog scale (VAS)), SS (assessed with the modified Symptom Severity Index Questionnaire (mSSI)), and MMO (evaluated with a digital caliper). Measurements were performed at T0 (before the therapy), T1 (1-month follow-up), and T2 (3-month follow-up). Data were analyzed using one-way analysis of variance (ANOVA), Tukey’s HSD, and chi-square tests (alpha = 0.05).ResultsAt T1 and T2, the greatest VAS and mSSI reduction was detected for the groups EPE (VAS = 5.3 ± 1.05, 3.3 ± 0.7; mSSI = 38.2 ± 2.27, 43.6 ± 3.94) and EPO (VAS = 5.2 ± 0.91, 3.2 ± 0.78; mSSI = 36.3 ± 3.97, 42.2 ± 3.19), respectively (p < 0.05). At T1, occlusal splint groups (groups OS (34.8 ± 2.97 mm) and EPO (33.8 ± 3.49 mm)) gave the highest MMO values, while T2 values did not constitute a significant difference with T1 (p > 0.05).ConclusionsThe short-term use of combined earplug therapy resulted in a decrease in both PI and SS. Improvement in MMO in participants using occlusal splints was observed in the 1st month and was maintained through the 3rd month.Clinical RelevanceEarplug therapy can be applied as a complementary therapy to occlusal splint and exercise treatments to decrease PI and SS in patients with myogenous TMD. To achieve functional recovery such as MMO, its combined use with splints should be taken into consideration by clinicians.

Piezoelectric-induced mechanoluminescence in centrosymmetric Lu3Al5O12: Properties of self-recoverable and tunable near-infrared luminescence

Mechanoluminescence (ML) materials with long-wavelength emission bands are essential for future in vivo bioimaging, non-destructive testing. However, most of the near-infrared (NIR) ML materials require pre-irradiation, which may limit their further applications. Generally, piezoelectric-induced ML materials were considered to be related to the piezoelectric effect from non-centrosymmetric structure. Innovatively in this work, a novel piezoelectric-induced near-infrared ML material Lu3Al5O12:Cr3+ with centrosymmetric structure is obtained. In Lu3Al5O12:Cr3+, piezoelectric effect is generated from the distortion of the centrosymmetric structure of the host due to the uneven electron distribution of Cr3+. Here, highly tunable ML FWHM from 7 nm to 118 nm is realized by introducing different content Ga3+ ions to Lu3Al5O12:Cr3+. The ML film fabricated by composite polydimethylsiloxane and Lu3Al2Ga3O12:Cr3+ can penetrate 20 mm pork tissue, which suggests the potential applications of the NIR ML material in the field of optical imaging of stress distribution in organisms. The discovery of distorted crystal structure to induce piezoelectric effect provides a new thinking for exploring ML in centrosymmetric materials. In addition, LuAl5-xGaxO:Cr3+ phosphors have broad prospects in self-powered sensing, temporomandibular disorders diagnosis, information security, and biomedical fields.

Prevalence and Severity of Temporomandibular Disorders in A Group of Iranian Musicians

ObjectiveAllegedly playing a musical instrument is a contributing factor to developing TMD signs and symptoms, but the literature is incoherent. The main aim of this study was to evaluate the prevalence of TMD among amateur musicians for the first time in the Iranian population. MethodsThis is a descriptive questionnaire-based cross-sectional study that includes 140 amateur musicians (35 international wind instrumentalists, 35 traditional wind instrumentalists, 35 international string instrumentalists, and 35 traditional string instrumentalists). Forty-eight violinists were studied separately from other study groups. The Fonseca questionnaire was used to evaluate TMD in this sample. A P-value of 0.05 was considered significant. ResultsThe Prevalence of the study sample was 72.8%. The prevalence of TMD and the mean severity score among musicians of international wind instruments, traditional wind instruments, international string instruments, and traditional string instruments were 77.1%, 67.6%, 82.8%, and 62.8%, and 30.00 ± 15.52, 32.42 ± 14.92, 30.71 ± 18.75, and 28.57 ± 19.87, respectively. The study groups did not show any significant differences regarding the TMD severity score. The prevalence of TMD was higher among women (P = 0.000017) and wind instrumentalists (P = 0.009). The prevalence of TMD and the mean severity score among violinists were 62.85% and 26.85 ± 20.68, respectively. ConclusionsRegardless of class or category, the prevalence of TMD is high among musicians compared to the available statistics reported previously on the Iranian population in the literature. Moreover, TMD prevalence is higher among wind instrumentalists than string instrumentalists.

Clinical decision of centric relation.

Centric relation (CR) was used in the complete dentures for edentulous jaws firstly. Then, CR was gradually applied in the clinical diagnosis and treatment of dentate jaws. Regarding the application of CR in dentate jaws, there are many doubts about its rationality. For instance, should CR be the core of diagnosis and treatment of temporomandibular disorders? Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction? Should CR serve as the target jaw position in orthodontic treatment? Meanwhile, varieties of CR clinical applications are objective. According to the existing evidence, this paper summarizes the applicable conditions of several main clinical situations with little controversy. We preliminarily put forward the decision tree for the clinical application of CR, which can be used as a reference in clinical practice.

The Relation between Psychological Stress and Temporomandibular Joint Disorder: A Rapid Review and Meta-Analysis

Introduction: Stress is one of the problems that often occur in human life that is inevitable. Stress can contribute 50-70% to the onset of most diseases. Psychosomatic and/or psychosocial stress have been associated with pain, including temporomandibular joint disorder. TMD's are not solely related to psychological stress. So there is a need to study the impact of direct stress on temporomandibular joint. Aims: This study aims to analyze the relationship between temporomandibular joint disorders and psychological stress. Methods: The research procedure was carried out using the rapid review method by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. Article searches were conducted using keywords in two databases, PubMed, and Scopus. The results of the quantitative analysis will be visualized in table and forest plots. Results: 11 articles were included in this review after screening process. The quantitative analysis showed a positive and significant relationship between distress (OR 1.21 [95% CI: 1.11, 1.32], p &lt; 0.00001), depression (OR 1.35 [95% CI: 1.09, 1.67], p &lt; 0.00001), and anxiety (OR 1.47 [1.09, 1.99], p &lt; 0.00001) towards temporomandibular joint disorder. Conclusion: This review shows a significant relationship between temporomandibular joint disorders and psychological stress that can be seen from various dimensions such as distress (OR 1.21 [95% CI: 1.11, 1.32], p &lt; 0.00001), depression(OR 1.35 [95% CI: 1.09, 1.67], p &lt; 0.00001), and anxiety (OR 1.47 [1.09, 1.99], p &lt; 0.00001). Keywords: TMD, stress, depression, anxiety, rapid review, meta-analysis This is an Open Access article that uses a funding model which does not charge readers or their institutions

Effects of Temporomandibular Disorders on the Oral Hygiene Status and Oral Health-Related Quality of Life of Young Adults

Objective: This study aimed to provide basic data to develop effective measures to improve the oral hygiene and oral health-related quality of life of individuals by preventing temporomandibular disorders. Methods: Data were collected from 148 young adults who visited the Department of Dental Hygiene of K University in Region D for practical training. The collected data were subjected to independent sample t-test and Pearson’s correlation coefficient and logistic regression analyses. Results: Incidence of temporomandibular disorders and oral hygiene status were significantly negatively correlated with oral health-related quality of life, whereas that of temporomandibular disorders was significantly positively correlated with the oral hygiene status. Additionally, incidence of temporomandibular disorders was 3.821 times higher in the poor oral hygiene group than in the good oral hygiene group and 0.845 times lower in the good oral health-related quality of life group than in the poor oral healthrelated quality of life group. The explanatory power of these factors was 53.9%. Conclusions: These results suggest the importance of the prevention, early detection, and treatment of temporomandibular disorders to ensure good oral hygiene status and oral health-related quality of life of young adults. Furthermore, there is need for effective oral health education measures, including oral health projects for young adults, to prevent and treat temporomandibular joint disorders.

Prevalence of Painful Temporomandibular Disorder Symptoms Among Professional and Student Musicians: An Online Survey.

Within the fields of medicine and music, increasing attention is given to evidence indicating music performance being an occupational risk factor for temporo-mandibular disorders (TMD). Assessment of self-reported painful TMD symptoms among student and professional musicians. Using Survey Monkey software, the German version of the 'TMD-Pain-Screener' was distributed electronically to professional and student musicians in Europe. Supplementary questions addressed age, gender, daily playtime, instrument type and type of professional practice. Results are presented as median [interquartile range]. The TMD-pain-screener was completed by 492 participants. Among them, 96 (19.5%) reported painful TMD (Pain_pos) and 396 did not experience pain (80.5%, Pain_neg). Pain_pos participants were significantly younger (Pain_pos: 34 years [26; 46], Pain_neg: 44 years [30; 56], p = 0.0003), had less work experience (Pain_pos: 15.5 years [6; 25], Pain_neg: 20 years [10; 32], p = 0.009), had fewer performances/year (Pain_pos: 20/year [10; 45], Pain_neg: 30/year [12; 53.5], p = 0.03) and were predominantly female (OR = 3.22 [1.87, 5.74], p < 0.0001). Comparisons among music performance types revealed no statistical significance in the overall test (p = 0.13), although 'keyboard' (OR = 2.99 [0.58, 30.12]), 'upper string' (OR = 2.31 [0.43, 23.63]) and 'singer' (OR = 2.14 [0.44, 20.75]) stood out compared to the reference group 'lower string' (OR 1.00). Organ players formed the largest group and showed a comparatively low prevalence of Pain_pos (16%), compared to other keyboard instruments (Pain_pos 30.2%). Prevalence of TMD pain was highest among young inexperienced female musicians. Playing keyboard instruments (other than organ) or upper strings instruments were frequently associated with painful TMD screening. An improved understanding of causes, implementation of preventive measures, professional guidance and a biopsychosocial health care perspective may decrease this occupational risk while maintaining the health benefits of music.

Occlusal therapy in patients with temporomandibular joint dysfunction and occlusal and articulatory disorders

the article presents a statistical analysis of the assessment of the impact of various factors that led to occlusal and articulatory disorders and functional disorders of the masticatory apparatus on the choice of occlusal constructions therapy for the treatment of temporomandibular joint dysfunction. For conducting the research, a clinical and laboratory examination was carried out and orthopedic treatment of 150 patients with various occlusal options violations Variants of occlusion therapy are described and given characteristic.

Neurological Interplay between Tinnitus and Temporomandibular Disorders: A Narrative Review of Mechanisms, Diagnosis and Treatment Strategies

Neurological Interplay between Tinnitus and Temporomandibular Disorders: A Narrative Review of Mechanisms, Diagnosis and Treatment Strategies

The crucial role of NR2A mediating the activation of satellite glial cells in the trigeminal ganglion contributes to orofacial inflammatory pain during TMJ inflammation

Temporomandibular joint inflammatory diseases are a significant subtype of temporomandibular disorders (TMD) characterized by inflammatory pain in the orofacial area. The N-methyl-D-aspartate receptor (NMDAR), specifically the NR2A subtype, was crucial in neuropathic pain. However, the exact role of NR2A in inflammatory pain in the TMJ and the molecular and cellular mechanisms mediating peripheral sensitization in the trigeminal ganglion (TG) remain unclear. This study utilized male and female mice to induce the TMJOA model by injecting Complete Freund's adjuvant (CFA) into the TMJ and achieve conditional knockout (CKO) of NR2A in the TG using Cre/Loxp technology. The Von-Frey filament test results showed that CFA-induced orofacial pain with reduced mechanical withdrawal threshold (MWT), which was not developed in NR2A CKO mice. Additionally, the up-regulation of interleukin (IL)-1β, IL-6, and nerve growth factor (NGF) in the TG induced by CFA did not occur by NR2A deficiency. In vitro, NMDA activated satellite glial cells (SGCs) with high expression of glial fibrillary acidic protein (GFAP), and both NMDA and LPS led to increased IL-1β, IL-6, and NGF in SGCs. NR2A deficiency reduced these stimulating effects of NMDA and LPS. The regulation of IL-1β involved the p38, Protein Kinase A (PKA), and Protein Kinase C (PKC) pathways, while IL-6 signaling relied on PKA and PKC pathways. NGF regulation was primarily through the p38 pathway. This study highlighted NR2A's crucial role in the TG peripheral sensitization during TMJ inflammation by mediating ILs and NGF, suggesting potential targets for orofacial inflammatory pain management.

Exploring the Complex Relationship Between Primary Headache Types and Bruxism: Patterns, Mechanisms, and Implications

Objective: The present study aims to explore the relationship between primary headache types and bruxism and determine how these two conditions may affect each other. Material and Methods: A total of 97 cases who applied to the Neurology Polyclinic of our hospital during 01.07.2023-01.08.2023 were included in the study. A comprehensive questionnaire was applied to the participants. The diagnosis of headache was established based on the International Classification of Headache Disorders criteria; the American Academy of Sleep Medicine criteria were used for the diagnosis of sleep bruxism and the Research Diagnostic Criteria for Temporomandibular Disorders were employed for the diagnosis of awake bruxism. Results: Nineteen (19.6%) of the participants were male and 78 (80.4%) were female. Tension-type headache (TTH) was reported by 22 participants (22.7%), 30 participants had migraine-type headache (30.9%), and 45 participants (46.4%) comprised the healthy control group. Sleep bruxism was observed in 29 patients (29.9%), while 11 patients (11.3%) were diagnosed with awake bruxism. Higher rates of sleep bruxism and awake bruxism were seen in patients in the TTH group compared to those in the migraine group and the healthy control group (p

Considerations in the Diagnosis and Management of Temporomandibular Disorders in Older Adults: A Narrative Review

Considerations in the Diagnosis and Management of Temporomandibular Disorders in Older Adults: A Narrative Review

Differences in Symptoms According to the Concordance Value Between Self-Reported Pain Sites and Standardized Palpation Pain Sites in Temporomandibular Disorder Patients: Pilot Study

Differences in Symptoms According to the Concordance Value Between Self-Reported Pain Sites and Standardized Palpation Pain Sites in Temporomandibular Disorder Patients: Pilot Study

Current thinking in the management of temporomandibular disorders in children: A narrative review

The aim of this narrative review is to discuss current opinions on paediatric temporomandibular disorders (TMDs) due to their increasing incidence in routine secondary care maxillofacial clinics. A MEDLINE and EMBASE search was performed of the literature published in the past three years concerning paediatric TMD. Of 261 papers identified, 89 were selected for relevance, of which 52 full texts were eligible and 41 included. The narrative of this paper follows three domains: myogenous and arthogenous pain, juvenile idiopathic arthritis (JIA), and reconstruction. The principles of treating mild TMD in children are similar to those in adults, with even more emphasis on the management of psychosocial issues and self-care. The use of medication, however, needs to be more cautious. Symptomatic disc displacement should be treated to reduce inflammation, so early arthrocentesis or arthroscopy is relevant. Controversy exists on disc repositioning to reduce or even reverse condylar degeneration in the growing condyle. If undertaken it should ideally be performed arthroscopically by surgeons with significant experience. Arthritic disease is usually associated with JIA so a multidisciplinary approach is the focus of treatment. The role of arthroscopy in the management of symptoms is increasing but it does not prevent disease progression. Surgical correction may be required for secondary deformity. Reconstruction remains a challenge with no ideal autogenous method. Alloplastic joints are gaining popularity, but the long-term outcomes are unknown. Surgery can be undertaken with minimal morbidity, and the use of joint replacements, even as space maintainers, may therefore be more beneficial than repeated failed autogenous treatments.

Causal relationships between immunophenotypes, plasma metabolites, and temporomandibular disorders based on Mendelian randomization

While numerous studies have underscored the implication of immune cells and metabolites in temporomandibular disorders (TMD), conclusive evidence for causality remains elusive. Consequently, our aim is to explore the causal connections between immunophenotypes and plasma metabolites in relation to TMD employing a bidirectional Mendelian randomization (MR) approach. Summary statistics data on 731 immunophenotypes (n = 3757) and 1091 plasma metabolites (n = 8299) were obtained from comprehensive genome-wide association studies (GWAS), while TMD data (5668 cases and 205,355 controls) were acquired from the FinnGen Consortium. Bidirectional MR analyses and a two-step MR approach assessed causal relationships and potential intermediaries. Various corrections and sensitivity analyses were utilized to assess the robustness of the findings. Two immunophenotypes and seven metabolites were significantly associated with TMD risk. Specifically, Alpha-hydroxyisovalerate mediated the link between CD33 on CD33dim HLA DR + CD11b + and TMD (β = 0.034, P = 5.95 × 10–5), while CD8 on NKT cells mediated the causal relationship between 5-acetylamino-6-formylamino-3-methyluracil levels and TMD (β = 0.069, P = 5.11 × 10–5). Our findings revealed the causal relationships between immunophenotypes and plasma metabolites on TMD from a genetic perspective, potentially aiding in TMD prevention.

Examination of Joint Effusion Magnetic Resonance Imaging of Patients with Temporomandibular Disorders with Disc Displacement.

In this study, we investigated joint effusion in patients with temporomandibular disorders (TMDs) with disc displacement. The magnetic resonance (MR) images of 97 temporomandibular joints (TMJs) were evaluated, and the appearance of joint effusion was investigated. Myofascial pain and TMJ pain were considered in addition to the duration from manifestation. Disc displacement with and without reduction, as well as the region and the area of joint effusion, were investigated using the MR images. Fisher's test was used for the analyses. Joint effusion was recognized in 70 TMJs, including 55 in the superior articular cavity, 1 in the inferior articular cavity, and 14 in both the superior and inferior articular cavities. The appearance of joint effusion did not differ with the existence of myofascial pain or TMJ pain. The region of joint effusion did not differ between disc displacement with and without reduction. A larger area of joint effusion was recognized in disc displacement without reduction (p < 0.05). The results showed that the amount of synovial fluid in the joint effusion did not change with the existence of myofascial pain or TMJ pain. Joint effusion commonly appeared in disc displacement without reduction.

Single- versus multi-visit approach for fragment reattachment in complicated crown-root fractures: a cohort study

BackgroundComplicated crown-root fractures are a type of tooth fracture that involves the enamel, dentin, and cementum and accompanied by pulp exposure. The treatment of a complicated crown-root fracture is always challenging due to the difficulties in achieving a hermetic seal and a stable restoration with a fracture level close to the crestale bone level. This study aimed to evaluate and compare the efficacy of single-visit and multi-visit approaches for fragment reattachment in complicated crown-root fractures of anterior teeth.MethodsTwo cohort consist of 10 adolescent patients in each group at both genders, who suffered from permanent anterior tooth complicated crown-root fracture were included. Fragment reattachment with root canal treatment was performed with either single or multiple-visit approach. Single visit fragment attachement combined with root cannel therapy was conducted in single-visit approach group immediately after injury. Fragment attachment, root cananel therapy and post resoration were performed during three times ‘ clinical visit in multi-visit approach group.ResultsAll the patients in both groups achieved satisfactory aesthetic results one year after fragment reattachment. Patients who underwent a multi-visit approach had a significantly shorter operative duration, less intra-operative pain and fatigue, slightly better periodontal health at an early stage, and a decreased incidence of temporomandibular joint disorders compared to those who underwent a single-visit approach. However, multiple visits approach may increase the risk of fragment detachment postoperatively.ConclusionFragment reattachment a reliable but temporary technique for adolescent patients who have suffered from complicated crown-root fractures. Multi-visit approach showed similar effecacy to single-visit approach but with slightly less complications. The choose of these two merhos should depend on the specific patient situation and patient compliance.Trial registrationThis prospective cohort study was retrospectively registered in Chinese Clinical Trial Registry (ChiCTR2300076811) on 19/10/2023.

Pediatric Dentists' Practice Patterns in the Screening, Diagnosis, and Management of Temporomandibular Disorders.

Pain associated with temporomandibular disorders (TMDs) is the main non-odontogenic cause of orofacial pain among youth. Pediatric dentists are often the first healthcare practitioners to perform a comprehensive oral examination in children, which should include evaluation of the temporomandibular joint, masticatory muscles, and surrounding structures for signs and/or symptoms of TMD. This study assessed pediatric dentists' practice patterns in the screening, diagnosis, and management of TMD. A 19-item online survey was used to assess pediatric dentists' clinical practice patterns and perceived knowledge and comfort levels in the screening, diagnosis, and management of TMD. The survey was distributed in July 2024, with a one-month window open for the study. Confidence levels and perceived knowledge were compared according to years from graduation and frequency of TMD screening assessment with ANOVA or independent t-test, as appropriate. Open-ended items were analyzed thematically. A total of 206 pediatric dentists and pediatric dentistry residents participated in this study. A share of 72.8% of respondents reported that up to 25% of their patients per week present with signs and symptoms of TMD. About one-fifth of pediatric dental providers never complete a screening history for TMD (22.1%) or a clinical assessment of TMD-related structures (21.6%). There was overall low self-perceived knowledge and confidence among pediatric dentists regarding the diagnosis, screening, and management of TMD in children and adolescents, regardless of the number of years from graduation. Respondents who reported seeing up to 50% of TMD patients reported significantly more knowledge and confidence in diagnosing pediatric TMD than those who encountered fewer TMD patients. An overwhelming majority (81.6%) indicated a need for continuing education courses and training focused on the management of TMD in pediatric patients. Providers reported low confidence and self-perceived knowledge about TMD in pediatric populations, a high rate of referral of patients with TMD, and a particular interest for professional development opportunities focused on management of TMD.