Temporomandibular Joint Pain Dysfunction Syndrome Research Articles

ORTHODONTIC PATHOLOGY IN THE SYNDROME OF PAIN DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT IN CHILDREN AND ADOLESCENTS

The number of patients with temporomandibular joint pain dysfunction syndrome (TMJ) is increasing every year, and the number of children and adolescents is also growing. One of the causes of the disease is considered to be dental pathology, in particular dental anomalies.
 A survey of 622 students of gymnasiums and lyceums was carried out, which were divided into 2 age groups according to the main periods of the formation of the dental system and the scheme of age periodization of human ontogenesis.
 An increase in the prevalence of TMJ SBD in adolescence was found (weak reliable relationship, r=0.10, p0.05).
 In two age groups, correlation analysis revealed a weak reliable relationship between HR and TMJ SBD (r=0,21 in children and r=0,16 in adolescents) (p0,01); as well as a weak significant association of distal bite (r=0,13, p0.01), and excessively deep vertical bite with TMJ SBD (r=0,15, p0,01) in adolescence.
 Key words: syndrome of pain dysfunction of the temporomandibular joint, dentomandibular anomalies, cervical vertebral dystrophy syndrome

Treatment approach to patients with distal malocclusion complicated by temporomandibular joint pain-dysfunction syndrome

Research is effective sequencing of measures for orthodontic treatment active period and unfavorable course of retention period predictors in patients with distal malocclusion, complicated by temporomandibular joint pain-dysfunction syndrome. The retrospective study consists of 102 case reports of patients from 18 to 37 (average age is 26.75±3.25 years) with distal malocclusion (Angle Class II division 2 subdivision) associated with temporomandibular joint pain-dysfunction syndrome. Cases of successful treatment were 30.4% (n=31), semi-successful - 42.2% (n=43), semi-unsuccessful - 18.6% (n=19), unsuccessful - 8.8% (n=9). ANOVA analysis of orthodontic treatment stages reveals main risk factors for pain syndrome recurrence in retention period. The ineffective morphofunctional compensation and unsuccessful orthodontic treatment predictors are: incomplete pain syndrome elimination, persistent masticatory muscles dysfunction, distal malocclusion recurrence, condylar process distal position recurrence, deep overbite, upper incisors retroinclination for more than 15°, single posterior tooth interference. Thus, pain syndrome recurrence prevention in retention orthodontic treatment period includes pain and masticatory muscles dysfunction elimination in pre-treatment period, physiological dental occlusion and condylar process central position in active period.

Роль функциональной терапии при болевой дисфункции височно-нижнечелюстного сустава: патофизиологические и клинические аспекты

Nowadays, each second patient seeking dental care suffers from some pathology of the temporomandibular joint. Most often patients are diagnosed with temporomandibular joint pain dysfunction syndrome, which is poorly treatable and often relapses. Objective: to evaluate changes in the clinical course of TMJ pain dysfunction syndrome when using myogymnastics in the complex rehabilitation of patients suffering from this pathology. Materials and methods. We performed dynamic observation of 62 young patients who suffered from painful dysfunction of the temporomandibular joint, revealed during the preparation of patients for dental prosthetics. Group 1 included 31 people who were treated with the conventional complex treatment to relieve painful dysfunction. Group 2 included 31 people, for the treatment of which the same standard complex of therapeutic and prophylactic measures with the additional application of masticatory muscles myogymnastics was applied. To objectivize the efficiency of using myogymnastics we used the method of severity degree evaluation as well as semi-quantitative method of efficiency evaluation of the treatment of the pathology in question. Results. It was found out that application of masticatory muscles myogymnastics in the complex treatment of painful dysfunction of the temporomandibular joint allows increasing the efficiency of dental rehabilitation of such patients by 6,9% and decreasing the number of patients with recurrence of the disease by 16,1% in the period up to 2 years. Conclusion. As a pathogenetic functional method of treatment of painful temporomandibular joint dysfunction, application of masticatory muscle myogymnastics to patients allowed to develop mutually consistent reflexes of the masticatory muscles, causing movements of the mouth opening (lowering the lower jaw) without its deviation and advancement. It is advisable to include the technique of masticatory muscle myogymnastics for painful TMJ dysfunction in the clinical guidelines.

Differential diagnosis of Costen's syndrome and cerebellopontine angle tumours

Relevance. Our study aimed to determine the main differential diagnosis criteria for temporomandibular joint (TMJ) pain dysfunction syndrome (temporomandibular disorders, Costen's syndrome) and cerebellopontine angle tumours.Materials and methods. We examined 22 people (19 women and three men), aged 21 to 74 years (mean age 37.2 ± 5.1 years), who presented to the prosthodontic clinic with facial pain.Results. The study proposed the following differential diagnostic criteria for TMJ pain dysfunction syndrome and brain tumors: different nature of pain, unilateral ear noise; distal displacement of the mandibular head diagnosed by cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), as well as articular disc displacement (detected by MRI) in temporomandibular disorders. Unilateral facial burning pain indicated meningioma of the cerebellopontine angle, which head MRI confirmed.Conclusion. The proposed table for evaluating clinical and paraclinical study methods for patients with facial pain helps to differentiate the cause of pain properly and proceed with the optimal treatment method.

Clinical assessment of the effectiveness of botulinum toxin A in the treatment of temporomandibular joint pain dysfunction syndrome

Assessment of the effectiveness of botulinum toxin A in the treatment of temporomandibular joint pain dysfunction syndrome. In accordance with the diagnostic and treatment guidelines for TMJPDS, 20 patients with TMJPDS with pronounced pain on palpation of the chewing muscles, discoordination of the chewing muscles according to the EMG, and degenerative changes in the temporomandibular joint according to the MRI were examined. The patients had no contraindications to the use of botulinum toxin. Exclusion criteria: 1) age under 21 years, 2) somatic pathology, 3) refusal of the steps of the proposed diagnostic and treatment algorithm. Methods used: clinical, psychometric (visual analogue scale (VAS) - for pain assessment), X-ray, electromyographic and statistical methods. An objective reduction in the tone of the chewing muscles was observed after treatment In both groups. However, 30 days after the injection of BtA the IMPACT indicator in the first group was reduced by 403.5 µV or more (38.5%, p<0.05), while in the second group it decreased by 201.5 µV or more (25%, p<0.05). A correlation was identified between the VAS index (mean 7 points, severe pain level) and IMPACT (p<0.05). The onset of a significant pain reduction was observed one week after BtA injection, the most pronounced effect was achieved after 2 weeks and lasted for about 3 months. The use of BtA as part of the temporomandibular joint pain dysfunction syndrome treatment algorithm contributes to the creation of a «therapeutic window» for comprehensive rehabilitation of patients in this group. It increases the efficacy of the conducted treatment and contributes to a significant prolongation of the TMJPDS remission.

Possibilities and organizational problems of diagnostics and treatment of patients with the syndrome of temporomandibular joint pain dysfunction

The relevance of research in the field of organization and provision of medical care to patients with the temporomandibular joint pain dysfunction syndrome (TMJ PDS) is determined by the prevalence of this disease not only among the pathologies of the maxillofacial region, but also among the pathologies of other organs and systems in general. Patients with the pathology of this joint are treated by doctors of various specialties. Therefore, there is often inconsistency not only in diagnostic algorithms, comprehensive examination and organization of medical care, but also in the terminological aspects of the TMJ PDS. The purpose of this review is to systematize the existing methods of diagnostics and treatment of TMJ PDS and to formulate possible options of osteopathic correction inclusion in the complex treatment of patients with this pathology. The review of literature sources on the problem of diagnosis and organization of treatment of TMJ PDS and masticatory muscle dysfunctions showed, on the one hand, a scientifically grounded spectrum of diagnostic and therapeutic capabilities of modern medicine, a trend in the development of highly informative digital technologies for diagnostic purposes, the development of various diagnostic and treatment protocols, a desire for an integrated approach involving specialists of different profiles. On the other hand, there is disunity between doctors of different specialties and the absence of a single algorithm for the diagnosis and treatment of TMJ PDS. Due to the variety of etiopathogenetic mechanisms of this disease development, further in-depth study of this issue is promising.

Biochemical Parameters of Temporemandibular Joint Pain Dysfunction Syndrome

The complex approach to the treatment of patients with rheumatic diseases (RD) has been elaborated at the department. Considering the above, this paper focuses on studying the biochemical parameters of blood serum characterizing the body's response to pain and stress. This is achieved by examining the content of histamine and hormones (adrenaline, cortisol, TSH, total alkaline phosphatase) (Total ALP) in patients with pain dysfunction syndrome of the TMJ, taking into account changes in the blood biochemical composition (K, Na, Ca, Mg, Cl, protein, glucose, Vitamin D, and adenosine triphosphate acid). Objective: To evaluate the efficiency of Biochemical Parameters of Temporemandibular Joint Pain Dysfunction Syndrome. Patients and Methods: The study of biochemical parameters of blood serum was held in patients with temporomandibular joint pain dysfunction syndrome. Biochemical studies were conducted in 61 patients with TMJ pain dysfunction syndrome at the age of 20 to 40 years (1st, main group) and in 10 healthy people of similar age who do not show any complaints characteristics of the studied pathology (2nd, control). Results and Discussion: There is a significant increase in the level of sodium and total protein, which has not been statistically confirmed. For vitamin D (total 40.98IU/ml) and alkaline phosphatase activity, there was a significant decrease in vitamin D in temporom and ibular disorder patients when compared to the controls (P=0.001). Also, there was a significant negative correlation between serum vitamin D activity with total alkaline phosphatase activity in temporomandibular disorder patients (P=0.001). In addition, there was a significant increase in serum total alkaline phosphatase as bone marker in temporomandibular disorder patients which provides a more reliable and complete profile of inflammatory contributors to temporomandibular disorder. A tendency to decreasing in the content of calcium, total protein, and glucose in the blood serum were found. Thus, this indicates the activation of stress systems and the enhancement of protein catabolism. A significant increase in the content of ATP, histamine, adrenaline, and cortisol confirms the important role of psycho-emotional disorders in the pathogenesis of temporomandibular joint pain dysfunction syndrome.

Myofascial pain syndrome in the dysfunction of the temporomandibular joint

Selection of the clinical characteristics of pain syndrome in the orofacial region in temporomandibular joint pain dysfunction syndrome (TMJ PDS). One hundred and two patients with TMJ PDS were examined using the Verbal Descriptive Pain Rating Scale of the orofacial area. The Clinical Index of TMJ dysfunction (CID) by Helkimo M. was used for objectification of the level of musculo-tonic disorders in the area of the chewing muscles. The psychopathological status of patients with TMJ PDS was assessed with HRDS and SCL-90-R. A significant proportion of patients with TMJ PDS, in addition to algic symptoms, have hypertonus of the facial muscles, the nature and severity of which require not only a special diagnostic assessment, but also follow-up treatment. The analysis of data allowed us to identify three clinical groups of patients: with isolated (muscular-tonic), neurological symptoms; with mixed (combination of muscular-tonic and somatoform manifestations) neurological and psychopathological symptoms and with somatoform symptoms. Patients with TMJ PDS are clinically heterogeneous and require clinical differentiation, distinguishing the common group of patients with muscular dysfunction accompanied by pain and emotional response to it (anxiety and minor depressive symptoms) and the group of patients with a somatoform disorder (and manifestations as general anxiety).

The Relationship of Tempromandibular joint disorders with Bony Exostosis in the Oral Cavity

The temporomandibular joint (TMJ) may be affected by inflammatory, traumatic, infectious, congenital, and developmental, as seen in other joints. However, the most common affliction of the TMJ and masticatory apparatus is a group of functional disorders with associated pain that occurs predominantly in women and was previously known as the TMJ pain dysfunction syndrome. Since 1978, there have been substantial changes in the study of etiologic factors, pathophysiology, diagnosis, and management of what are now called temporomandibular disorders (TMD).(1)The general perception that all symptoms in the head, face, and jaw region without an identifiable cause constitute a "TMJ" problem is clearly unfounded.Although some oral lesions, such as torus palatinus and torus mandibularis are normal variants, but require prompt diagnosis and sometime treatment to reduce the potential for serious complication and enhance prosthodontic treatment. The purpose of this study is to inspect the relation of TMJ dysfunction syndrome to the presence of oral exostosis, and find the prevalence of torus palatinus (TP) and torus mandibularis (TM)The sample consisted of 932 teachers, 301 males and 631 females were examined for the presence of TMD, TP and / or TM. Analysis was carried out according to age, gender, TMJ dysfunction and the presence of TP and TM.Results indicated that 123(16.1%) had at least one symptoms of TMD, where as 49 (5.3%) had TP; and 67 (7.2) had TM. The male: female prevalence ratios of TP and TM were 1: 3.42 and 1: 1.81 respectively. The results revealed that significant relationship between TMD and tori, and increase in percentage of mandibular tori with the presence of TMJ dysfunctional syndrome more than maxillary tori were found.TP and TM were more frequent in females and there is significant relation between the TP and TM with presence of TMJ dysfunction syndrome ( P&lt; 0.05 ) especially TM , the presence of TM might be useful to look for sign of dysfunction.

PHYSIOTHERAPY IN THE COMPLEX TREATMENT OF THE TEMPOROMANDIBULAR JOINT PAIN DYSFUNCTION SYNDROME IN PERSONS PROFESSIONALLY ENGAGED IN VOCAL

Application in complex treatment of the temporomandibular joint pain dysfunction syndrome in vocalists infrared irradiation and ultrasonic treatment eliminates the pain and increased tone of the masticatory muscles in a short time, which increases the amplitude of movements of the mandible and the functional capabilities of the temporomandibular joint with increased professional workload. The proposed course of physiotherapy procedures allows for successful rehabilitation in a complex of therapeutic measures and to improve the effectiveness of treatment of the temporomandibular joint pain dysfunction syndrome, which is especially important for the quality of life of people involved in the vocals.

Common functional pain syndromes

### Key points When a patient presents with pain of no obvious organic origin, they are often labelled as having ‘functional’ pain. The exact diagnosis is derived from the organ system displaying the predominant symptoms e.g. musculoskeletal pain in fibromyalgia (FM) or visceral pain in irritable bowel syndrome (IBS). The worldwide prevalence of all functional pain syndromes (FPS) is 15–20%. World Health Organization (WHO) surveys reveal that ∼10% of primary care patients develop a chronic pain condition within 12 months of initial registration. Of these, at least 50% continue to have symptoms beyond 1 yr. FPS cause enormous economic burden on society with concurrent ramifications for the individual's family in particular and society in general. FM alone has been estimated to cost around £4000 per patient per year. There has been a paradigm shift in the understanding of FPS. The old model of multiple discrete chronic pain conditions is being replaced by a more overarching, although no less complex, state of central sensitivity syndrome (CSS). Evidence is being accrued that FPS represent the phenotypic output of a complex interplay between genetic susceptibility, gene–environment interactions, and environmental triggers. Four common FPS will be reviewed in this article: FM, IBS, temporomandibular dysfunction (TMD), and chronic cardiac chest pain (CCCP). The pathophysiology and management of each will be examined and the case presented for a shared underlying mechanism called CSS. Once this new mechanism is adopted more widely, it will allow for future novel management options to be …

Patient with chronic orofacial pain in a private dental office: Diagnostic dilemmas

Patients with chronic orofacial pain (COP), which means pain lasting almost always more than six months and serving no obvious purpose, very often present a quite diagnostic dilemmas. In some instances, this may especially create problem in a private dental office as various variants and manifestations of COP should be treated differently. COP may have several clinical manifestations; however, it is usually classified in three basic categories: (1) neural pain, caused by functional or structural irregularities within neural components; (2) somatic pain, caused by disturbances within the muscular/skeletal system; and (3) atypical pain, mainly caused by emotional stress and consequent changes of psychological response. Diagnosis and treatment of any kind of COP should be undertaken only after thorough and meticulous diagnostic procedures, preferably done multidisciplinary in institutions particularly orientated to the treatment of COP syndromes. Choice of treatment method should be directed to control the basic cause of chronic pain, which is ascertained by detailed clinical assessment, and fully adjusted to the particular needs of each patient. That is why the treatment of most frequent chronic orofacial syndromes - paroxysmal trigeminal neuralgia, temporomandibular joint pain dysfunction syndrome, and atypical pains - after diagnosis of chronic pain made in a private dental office, should be often, and preferably, done in institutions particularly orientated to the treatment of COP syndromes.

Indicators of the functional state of the autonomic nervous system in different age group patients with temporomandibular joint pain dysfunction syndrome

Aim. To study the functional state of the autonomic nervous system and of the adaptative capabilities of the organism in patients of different age groups with temporomandibular joint pain dysfunction syndrome. Methods. The study included 234 patients with temporomandibular joint pain dysfunction syndrome (22 men and 212 women) aged 12 to 35 years, without anomalies of the dentition, who were divided into three age groups. Three control groups consisted of 30 healthy subjects (3 men and 27 women, 10 men in each age group) with intact dentition, and orthognathic bite. A clinical dental examination, and a multi-dimensional verbal-color pain test were conducted. In order to assess the functional status of the autonomic nervous system and the adaptive capacity of the organism used were the schemes of examination for detecting signs of autonomic disorders, a physicians questionnaire «Study Design for detecting signs of autonomic disorders», an autonomic test - «Questionnaire for detecting signs of autonomic changes for the patient» and a questionnaire, adapted for children and adolescents, cardiointervalography. Results. In all 234 patients with temporomandibular joint pain dysfunction syndrome revealed were the signs of autonomic dysfunction, possessing vagotonic features in 93.9% of the cases. An unbalanced condition of the autonomic nervous system in association with the temporomandibular joint pain dysfunction syndrome was registered significantly (p 0.05) more frequently in patients of the mature age group. According to cardiointervalography, in the patients revealed was a primarily vagotonic or hypersympaticotinic type of response, a significant predominance (p 0.05) of the functional stress adaptation mechanisms, mismatch of the processes that control heart rhythm until the breakdown of the adaptation mechanism. Conclusion. The revealed instability of the autonomic regulation and the features of autonomic responses in patients of different age groups with the temporomandibular joint pain dysfunction syndrome are necessary to consider when developing and selecting methods of pathogenetic therapy.

The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome.

Objectives: The goal of the present study was to evaluate the results of applying acupuncture or occlusal decompression splints in the treatment of patients diagnosed with the temporomandibular joint pain-dysfunction syndrome. Design of the study: We conducted a randomized clinical trial including 20 patients to whom the mentioned treatments were applied. Results were evaluated through an analogue pain scale, measurements of mouth opening and jaw lateral deviation in millimetres, and assessment of sensitivity to pressure on different points: preauricular, masseter muscle, temporal muscle and trapezius. Parameters were evaluated before and 30 days after the treatment. For standardized pressure, we used a pressure algometer. Results: Patients treated with decompression splints showed reductions in subjective pain and pain upon pressure on temporal, masseter and trapezius muscles, as well as increased mouth opening after the treatment. Patients treated with acupuncture showed pain reduction in the short term and improvements in all of the evaluated para-meters (stronger pressure was required to produce pain; mouth opening was improved). Conclusion: Acupuncture was an effective complement and/or an acceptable alternative to decompression splints in the treatment of myofascial pain and temporomandibular joint pain-dysfunction syndrome. Key words:Temporomandibular joint, temporomandibular dysfunction, acupuncture, decompression splint, arthralgia, myofascial pain, joint palpation.

Differentiating Clinical Groups Using the Serial Color-Word Test (S–Cwt)

The present study attempted to differentiate 11 diagnostic groups by means of the Serial Color-Word Test (S-CWT), using multivariate discriminant analysis. Two alternative scoring systems of the S-CWT were outlined. Asample of 514 individuals who had clinical diagnoses of various types and 397 controls who had no diagnostic findings comprised the sample. The first discriminant analysis failed to differentiate the groups adequately. The groups were consequently reduced to four (schizophrenia, bipolar disorders, temporo-mandibular joint pain dysfunction syndrome, and eating disturbances), which gave better reclassification findings for a clinical application of the test. This classification gave over 55% correct assignments. The final four groups had a statistically significant discrimination on the test, which remained stable also in a bootstrap procedure. Implications for treatment indications and outcomes as well as strategies for further studies using the S-CWT are discussed.

Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids

To screen patients with oligoarticular and polyarticular forms of Juvenile Idiopathic Arthritis (JIA) to determine (i) the severity of their class II skeletal pattern; (ii) temporomandibular joint signs and symptoms and (iii) use of systemic corticosteroids. Cross-sectional screening. Sixty-eight children with JIA aged between 9 and 16 years old who were screened at four regional treatment centres in the UK. Patients were screened clinically and radiographically for the presence of class II skeletal pattern and temporomandibular (TMJ) pain dysfunction syndrome. In addition, the JIA sub-type and history of disease activity and medication were recorded. Class II skeletal pattern, TMJ signs and symptoms, use of systemic corticosteroids. The mean ANB values were 4.2 degrees (SD = 2.9 degrees) in the oligoarticular group and 5.1 degrees (SD = 3.8 degrees) in the polyarticular group. Just under one-third of children had a moderate or severe class II skeletal pattern and a further quarter of children had a mild class II skeletal pattern. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low (<20%), except for crepitus and click which affected between 24 and 40% of JIA children. Radiographically, 57% of oligoarticular and 77% of polyarticular cases exhibited condylar erosion. Use of systemic corticosteroids varied between centres, but overall, was prescribed more in polyarticular cases (P = 0.001). Just under one-third of oligoarticular and polyarticular JIA patients exhibited a moderate or severe class II skeletal pattern. It is, therefore, likely that any future clinical trial to investigate the effect of functional appliance treatment in JIA patients, will need multicentre co-operation to fulfil potential sample size requirements. Clinical signs and symptoms of temporomandibular joint pain dysfunction syndrome were low except for crepitus and click. However, radiographic evidence of condylar erosion was high particularly in the polyarticular group. Use of systemic corticosteroids was prescribed more in polyarticular cases and this is likely to reflect the severity of the disease.

Personality and Psychopathology in Patients with Temporomandibular Joint Pain-Dysfunction Syndrome

Objective: Our aim was to deepen the understanding of the psychosomatic aspects of temporomandibular joint (TMJ) pain dysfunction syndrome. Patients affected by this syndrome were compared with both healthy subjects and psychiatric patients, using both self-report and physician-scored psychological measures. Methods: Three sex- and age-matched groups were recruited: a TMJ group (n = 32), a healthy group (n = 22) and a psychiatric group (n = 22). The psychiatric group consisted of outpatients diagnosed as having a DSM-IV anxiety or depressive disorder of mild to moderate severity. Psychometric assessment included the Minnesota Multiphasic Personality Inventory (MMPI) and the Hamilton Anxiety Rating Scale (HARS). Results: Psychiatric patients scored higher than both the comparison groups on all but one of the MMPI scales; the majority of the differences were significant or approached significance. TMJ patients scored higher than healthy controls on the Hs (hypochondriasis; p ≤ 0.01), Hy (hysteria; p ≤ 0.01) and D (depression; p ≤ 0.05) scales. Psychiatric patients scored higher than TMJ patients on the HARS psychic anxiety subscale (p ≤ 0.05), while TMJ patients scored higher than psychiatric patients on the somatic anxiety subscale (p ≤ 0.05). Conclusions: Certain personality characteristics were associated with TMJ dysfunction. However, further longitudinal studies should be performed to properly assess causal relationships. Despite signs of neuroticism, anxiety and depression, patients with TMJ dysfunction differed from anxious and depressed patients. While the latter displayed a higher level of psychopathology, each group was characterised by a distinct pattern of anxiety symptoms. In addition, a substantial proportion of TMJ patients had little awareness of their inner states and emotions.

Factors associated with anxiety and depression in facial arthromyalgia

Facial arthromyalgia (temporomandibular joint pain dysfunction syndrome, TMD) is a chronic pain condition of unknown origin. This paper examines the extent to which the condition is associated with symptoms of anxiety and depression. It also identifies factors which may be predictive of raised levels of these two moods and of the presence of clinical anxiety and clinical depression. Self-report measures of pain beliefs, coping strategies, pain intensity, disability and mood were administered to a sample of 80 facial arthromyalgia patients of differing chronicity. The results showed anxious mood to be associated with several factors including beliefs that pain is itself worsened by negative mood, passive coping in terms of catastrophising about pain, and speech problems. Depressed mood was associated with catastrophising and disability in the form of disturbance in taste and digestion. These factors may be considered as potential targets for therapy, rather than the orthodox objective of pain relief.

Personality Disorders and Regulative Styles of Patients with Temporo-Mandibular Joint Pain Dysfunction Syndrome

A sample of 42 women patients with Temporo-mandibular Joint Pain Dysfunction Syndrome was given the Millon Clinical Multiaxial Inventory-II and the Serial Color-Word Test. Compared with sex- and age-matched nonclinical controls, temporo-mandibular patients had significantly (1) higher scores on the Obsessive-Compulsive scale, (2) lower scores of ITa (a pattern concerned with initial times of response), and (3) higher scores of R (linear increase in reading times during the trials). The latter intergroup difference concerned mainly the first subtest, i.e., temporo-mandibular patients were characterized by higher scores of R from the very beginning of the process of adaptation.

Physiotherapy in the treatment of temporomandibular joint disorders: a comparative study of four treatment methods

Temporomandibular joint pain dysfunction syndrome (TMJPDS) comprises of a constellation of signs and symptoms including joint tenderness and pain on function, restricted jaw movement, clicking, jaw locking and tenderness in the muscles of mastication. Headache may also be a feature. Physiotherapy is commonly employed in the treatment of this condition but there is little published material reporting the relative efficacy of the different types of treatment currently available. Further, no attempt seems to have been made to compare the costs of physiotherapy with other forms of treatment of this disorder such as occlusal splint therapy. This paper reports a comparative evaluation of four different physiotherapy treatments and placebo in the management of TMJPDS and comments on their cost benefit aspects compared with that of splint therapy. The four methods of physiotherapy tested were short-wave diathermy, megapulse, ultrasound and soft laser. There was no statistically significant difference in success rate between any of the four tested (range 70.4-77.7%) although each individually was significantly better than placebo treatment. The time of improvement appeared to vary between the four methods.