Temporomandibular Disorders Research Articles

Understanding Occlusion and Temporomandibular Joint Function Using Deep Learning and Predictive Modeling.

Advancements in artificial intelligence (AI)-driven predictive modeling in dentistry are outpacing the clinical translation of research findings. Predictive modeling uses statistical methods to anticipate norms related to TMJ dynamics, complementing imaging modalities like cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). Deep learning, a subset of AI, helps quantify and analyze complex hierarchical relationships in occlusion and TMJ function. This narrative review explores the application of predictive modeling and deep learning to identify clinical trends and associations related to occlusion and TMJ function. Debates persist regarding best practices for managing occlusal factors in temporomandibular joint (TMJ) function analysis while interpreting and quantifying findings related to the TMJ and occlusion and mitigating biases remain challenging. Data generated from noninvasive chairside tools such as jaw trackers, video tracking, and 3D scanners with virtual articulators offer unique insights by predicting variations in dynamic jaw movement, TMJ, and occlusion. The predictions help us understand the highly individualized norms surrounding TMJ function that are often required to address temporomandibular disorders (TMDs) in general practice. Normal TMJ function, occlusion, and the appropriate management of TMDs are complex and continue to attract ongoing debate. This review examines how predictive modeling and artificial intelligence aid in understanding occlusion and TMJ function and provides insights into complex dental conditions such as TMDs that may improve diagnosis and treatment outcomes with noninvasive techniques.

MiR-374 family is a key regulator of chronic primary pain onset.

Chronic primary pain conditions (CPPCs) are linked to catecholamine activation of peripheral adrenergic receptors. Yet, catecholamine-dependent epigenetic mechanisms, such as microRNA (miRNA) regulation of mRNA transcripts, remain largely unknown. We sought to identify RNA species correlated with case status in 3 pain cohorts, to validate RNAs found to be dysregulated in a mouse model of CPPC onset, and to directly test the role of adrenergic receptors in miRNA regulation. Furthermore, we tested antinociceptive effects of miR-374 overexpression. We used RNA-seq and quantitative reverse transcription polymerase chain reaction to measure RNA expression in 3 pain cohorts. Next, we validated identified RNAs with quantitative reverse transcription polymerase chain reaction in a mouse model of CPPC onset, measuring expression in plasma, peripheral (adipose, muscle, dorsal root ganglia [DRG]), and central (spinal cord) tissues. Then, we stimulated adrenergic receptors in primary adipocyte and DRG cultures to directly test regulation of microRNAs by adrenergic signaling. Furthermore, we used in vitro calcium imaging to measure the antinociceptive effects of miR-374 overexpression. We found that one miRNA family, miR-374, was downregulated in the plasma of individuals with temporomandibular disorder, fibromyalgia syndrome, or widespread pain following a motor vehicle collision. miR-374 was also downregulated in plasma, white adipose tissue, and spinal cord from mice with multisite mechanical sensitivity. miR-374 downregulation in plasma and spinal cord was female specific. Norepinephrine stimulation of primary adipocytes, but not DRG, led to decreased miR-374 expression. Furthermore, we identified tissue-specific and sex-specific changes in the expression of predicted miR-374 mRNA targets, including known (HIF1A, NUMB, TGFBR2) and new (ATXN7, CRK-II) pain targets. Finally, we demonstrated that miR-374 overexpression in DRG neurons reduced capsaicin-induced nociceptor activity. Downregulation of miR-374 occurs between adrenergic receptor activation and mechanical hypersensitivity, and its adipocyte source implicates adipose signaling in nociception. Further study of miR-374 may inform therapeutic strategies for the millions worldwide who experience CPPCs.

Sleep and circadian rhythm disturbances as risk and progression factors for multiple chronic overlapping pain conditions: a protocol for a longitudinal study.

Chronic overlapping pain conditions (COPCs), such as chronic low back pain (cLBP) and fibromyalgia, frequently cooccur and incur substantial healthcare costs. However, to date, much focus has been placed on individual anatomically based chronic pain conditions, whereas little is known about the mechanisms underlying progression to multiple (more than 1) COPCs. This study aims to address the gap by investigating the role of common and modifiable risk factors, specifically sleep and circadian rhythm disturbances, in the development of multiple COPCs. The study will enroll 300 participants with cLBP, including 200 with cLBP only and 100 with cLBP plus other COPCs (ie, fibromyalgia, temporomandibular disorders, irritable bowel syndrome, and chronic headaches) and follow them up for 12 months. Sleep and circadian rhythms will be assessed using wireless sleep electroencephalography, 24-hour evaluation of the rhythm of urinary 6-sulfatoxymelatonin, actigraphy, and sleep diaries. Pain amplification using quantitative sensory testing, psychological distress using validated self-report measures, and the number of pain sites using a pain body map will also be assessed. This research aims to (1) comprehensively characterize sleep/circadian disturbances in individuals with single and multiple COPCs using multimodal in-home assessments; (2) examine the associations between sleep/circadian disturbances, changes in pain amplification, and psychological distress; and (3) investigate the relationship among these factors and the progression in the number of pain sites, a proxy for multiple COPCs. The findings will provide insights into the mechanisms leading to multiple COPCs, potentially informing treatment and prevention strategies for these complex conditions.

Temporomandibular Disorders in Children and Adolescents

Temporomandibular disorder (TMD) is characterized by pain, dysfunction, and distress in the masticatory muscles and/or temporomandibular joints and associated structures. Despite its high prevalence in children and adolescents, exceeding 20%, TMD has not been extensively studied. Therefore, this review aimed to establish an overview of TMD in children and adolescents and describe its diagnosis and treatment. TMD more predominantly occurs in girls and has multifactorial etiologies, with several risk factors interacting differently at the individual level. TMD is associated with poor oral health-related quality of life and abnormal facial growth. The Diagnostic Criteria for TMD (DC/TMD) assessment protocol is used to diagnose TMD in young patients, and TMD can be effectively managed with conservative therapies such as patient education, home care, physical therapy, occlusal appliance therapy, and pharmacotherapy. During routine dental checkups, pediatric dentists can identify TMD in children and adolescents to reduce the occurrence of complications due to its chronic progression.

Recovery of hearing loss in atypical Meniere’s disease after treatment with orofacial and neck massage: A case report

BACKGROUND A 48-year-old female presented with sudden-onset right-sided aural fullness, low-frequency hearing loss, and tinnitus. Medical history included right-sided temporomandibular joint disorder (TMJD) with crepitation, and retro-orbital headaches. The patient was diagnosed with atypical Meniere’s disease (MD) and received intratympanic steroids, prednisone, betahistine, and began a low-sodium diet; however, the patient’s symptoms worsened. CASE SUMMARY The patient sought physical therapy for TMJD; testing revealed reduced motion and dysfunction with vertical opening, lateral excursion of the mandible to the right, and tenderness to palpation. Treatment included soft tissue mobilization of right facial structures and temporal fossa, intraoral massage of the right pterygoid musculature, and massage of right neck structures. After 4 weeks, the patient noticed subjective improvement in hearing and decreased headaches. After 11 weeks, an audiogram showed that the hearing loss had recovered. The patient has continued the daily at-home intraoral/neck massage therapy and maintained normal hearing over 4 years to date. The temporal relationship between physical therapy and recovery of hearing loss suggests muscular or inflammatory etiology as at least partially causative of this patient’s symptoms. The mechanism of healing may have been due to decreased inflammation, improved blood flow, restored function of cranial nerves, or some combination of these and other unknown factors. CONCLUSION This report suggests that orofacial physical and massage therapy may be an effective treatment for the cochlear symptoms associated with MD.

Temporomandibular Disorders and the Singing Voice: A Summary of the Research

ABSTRACT Temporomandibular Disorders are a prevalent group of disorders affecting the temporomandibular joints and surrounding structures. The purpose of this article is to summarize and integrate medical research regarding TMDs with research regarding the singing voice. Its intent is to provide practical information for voice teachers or other professionals who may work with singers experiencing a TMD. This article will draw from medical and voice-related literature, with the author summarizing the relationship between the TMJ function and the speaking and singing voice. Since TMDs are shown to be prevalent within the singer population, associations between TMDs and the voice will also be discussed, as well as the impact that the experience of TMDs may have on the singer. While research does not support the claim that singing causes TMDs, certain predisposing and precipitating factors in its development and progression exist commonly within the singer population. The article will conclude with a discussion of limitations within the literature and suggestions for future research.

Immediate Effects of the Mandibular Muscle Energy Technique in Adults with Chronic Temporomandibular Disorder

Background/Objectives: Temporomandibular disorders affect the muscles used for chewing, the temporomandibular joint, and other related tissues, resulting in pain, limited mobility, and dysfunction of the masticatory muscles. Physical therapy plays a critical role in treatment. Manual therapy can trigger neurophysiological mechanisms that contribute to pain relief and a reduction in muscle activation. Evaluations of different manual therapy techniques are needed on this topic. The main objective of this study was to evaluate the effects of a specific manual therapy technique (the mandibular muscle energy technique) in adults with temporomandibular disorders. Methods: A randomized, parallel clinical trial was conducted, and 31 participants were recruited into an experimental group and 30 were recruited into a control group in order to analyze its effects on outcomes such as pain, pain threshold to pressure, mandibular mobility, and kinesiophobia. Pre- and post-intervention assessments were performed, followed by statistical analyses to verify the intra- and intergroup changes. Results: The results showed that the mandibular muscle energy technique produced positive effects with significant differences in the intra- and intergroup comparisons for pain threshold to pressure, mandibular mobility, and kinesiophobia, demonstrating its efficacy and safety as a treatment option for adults with temporomandibular disorders, with proven effects in the short term. Conclusions: The effects obtained and the absence of side effects showed that this technique can be integrated into multimodal treatment along with other types of interventions in patients with temporomandibular disorders.

Efficacy of combination treatment in a patient with temporomandibular joint dysfunction

Background: Muscle and joint dysfunction is a common complication, particularly in females over 40 years. It is strongly associated with age-related hormonal changes in the bones, as well as concomitant dentoalveolar deformities and tooth loss. Case description: The efficacy of combination treatment of dentoalveolar abnormalities and deformities complicated by temporomandibular joint (TMJ) dysfunction was demonstrated. The efficacy of combination treatment in patients with missing teeth, as well as dentoalveolar abnormalities and deformities complicated by TMJ dysfunction, was confirmed. To ensure a representative before-and-after comparison, the restoration of masticatory efficiency following orthodontic and orthopedic rehabilitation was assessed. A physical examination in patient M. revealed hypertonia of masticatory muscles, restricted mouth opening, jaw shifting to the left, partially absent dentition in distal sections, and prosthetic restoration failure. On MRI, there were signs of deforming arthrosis of both TMJs. The following observation methods were used to assess the efficacy of rehabilitation: questioning to identify symptoms of TMJ pain; follow-up examination for joint clicking when opening the mouth; palpation of the external pterygoid muscle, masticatory muscle, and internal pterygoid muscle; X-ray examination (TMJ CT and MRI) following treatment; masticatory efficiency assessment using a masticatory performance test (according to Trezubov) before and after treatment. Diagnostic testing following combination orthodontic and orthopedic treatment revealed that the patient’s left TMJ no longer felt heavy, and she could open her mouth easily; moreover, jaw shifting resolved, and masticatory muscle rigidity decreased. Conclusion: This clinical case demonstrates why orthopedic surgeons and orthodontists must collaborate in the diagnosis and treatment of TMJ dysfunction. The authors present a well-established approach to the treatment of patients with TMJ dysfunction that has been used successfully in clinical practice for several years.

Clinical Features of Temporomandibular Disorders: Validity and Reliability of the Fonseca Anamnestic Index in Persian

Background: Temporomandibular Disorders (TMDs) are a group of disorders associated with masticatory dysfunction. TMDs are usually diagnosed late which leads to complicated treatments. Early diagnosis and treatment of TMDs are essential. Methods: A valid and reliable version of Fonseca’s Anamnestic Index (FAI) was prepared in Persian from the English version. It was used to assess TMD in 350 patients. Clinical signs of TMD were also recorded based on examination. Results: FAI scores showed 161(46%) people had TMD. There was no significant difference between occlusion classes in terms of the frequency of TMD. There was no significant difference between the mean maximum mouth opening and severity of TMD. Conclusion: In this study the validity and reliability of the FAI in Persian language, as a simple tool for TMD screening in health centers, was confirmed. Based on results, there is a relationship between clinical findings and the severity of TMD by using FAI and it can be used for screening TMD patients.

Jaw exercise in head and neck cancer patients for prevention of temporomandibular disorders: a randomized controlled trial.

To prospectively evaluate the effect of a preventive jaw-training intervention program on the development of temporomandibular disorders (TMD) in patients treated for head and neck cancer (HNC). We randomized 58 consecutive patients with squamous cell carcinoma in the head and neck area into two groups before initiation of a curatively intended oncologic treatment: training with a jaw mobilizer once a day or a control group without active exercise. A comprehensive examination according to diagnostic criteria for temporomandibular disorders (DC/TMD) was conducted at baseline (before oncologic treatment) 6 and 12months after completed radiation therapy (RT). The patients recorded training frequency in a diary. There were significant differences in the changes of maximal incisal opening (MIO) between the intervention and control groups at 6 and 12months compared to baseline (p = 0.010 and p = 0.012, respectively) with more deterioration in the control group. The control group had a higher prevalence of TMD diagnosis at the 6-month follow-up (p = 0.010) and a close to significant level at the 12-month follow-up (p = 0.055). This unique study, which evaluates the effect of a preventive jaw-training program for prevention of TMD in patients with HNC undergoing high dose RT, found that the preventive jaw-training program could prevent the deterioration of MIO and development of TMD. This preventive exercise program could prevent the deterioration in MIO and the development of TMD in HNC patients, leading to less pain and better jaw function.

Long-Term Stability in Temporomandibular Joint Replacement: A Review of Related Variables.

Background: The temporomandibular joint (TMJ) is a key component of the stomatognathic system, playing a major role in maintaining mandibular stability and function. Temporomandibular disorders (TMDs) are a prevalent disease in the world, with surgical treatment being reserved for complex cases or end-stage TMJ disease. A narrative review was conducted to describe the quantitative and qualitative factors that affect TMJ prosthesis stability. Methods: Studies with a sample size equal to or greater than 10 subjects who underwent surgical procedures for joint replacement using stock or customized ATM prostheses were included. This narrative review examined some variables that may influence in terms of the longevity of the TMJ prosthesis, highlighting issues to be considered in future research. Results: The current development of TMJ prostheses is benefiting from technological advances, offering a suitable adaptation to the patient's anatomy and superior results in functionality and patient satisfaction. However, the biomechanical complexity of the TMJ shows unique challenges compared to other joints in the body, where anatomical, biomechanical, and functional requirements are high. The stability of the TMJ prosthesis is affected by multiple variables, including the selection of biocompatible materials that resist corrosion and wear, the design of the prosthesis, the diagnosis and indication for its use, and the surgeon's experience. The success of TMJ replacement can be measured by improving the patient's quality of life, reducing pain, restoring mandibular functionality, and recovering suitable facial morphology for the patient's conditions. Conclusion: There is a need for training of maxillofacial surgeons in TMJ surgery and replacement, as well as a greater focus on the research and development of systems to simplify surgical design and procedures and to optimize the results of TMJ replacement.

Evaluating Surgical Approaches for Hemimandibular Hyperplasia Associated with Osteochondroma: A Systematic Literature Review.

Background/Objectives: Hemimandibular hyperplasia (HH) associated with osteochondroma presents complex challenges in maxillofacial surgery, including facial asymmetry, occlusal instability, and temporomandibular joint (TMJ) dysfunction. Surgical interventions vary widely in approach and outcomes, underscoring the need for a systematic evaluation of effectiveness. This systematic review assesses the effectiveness of surgical approaches for managing HH associated with osteochondroma, focusing on techniques including condylectomy, orthognathic surgery, distraction osteogenesis, total joint replacement (TJR), and genioplasty. Methods: Following PRISMA 2020 guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science for studies published from 2000 to 2023. Eligibility criteria were based on the PICO framework, with primary outcomes evaluated for facial symmetry, occlusal correction, mandibular function, and recurrence rates. The Cochrane Risk of Bias Tool assessed study quality, while the GRADE framework evaluated the certainty of evidence. This review was not registered due to exclusion criteria for certain dental topics in PROSPERO. Results: Of 145 studies identified, 18 met inclusion criteria, totaling 214 patients. High and low condylectomy both effectively corrected asymmetry, with high condylectomy reducing recurrence risk but often requiring reconstruction. Orthognathic surgery, combined with condylectomy, significantly enhanced facial symmetry and occlusal function. Distraction osteogenesis proved valuable for mandibular lengthening in cases of severe deformities, while TJR offered definitive solutions for extensive joint involvement. Genioplasty corrected chin asymmetry, contributing to improved facial balance. Limitations included small sample sizes and variable follow-up durations. Conclusions: Surgical approaches tailored to individual patient needs show effectiveness in treating HH associated with osteochondroma, achieving functional and esthetic outcomes. Future studies should prioritize larger cohorts and standardized follow-up protocols to better assess long-term efficacy. Advances in 3D surgical planning and individualized treatment strategies show promise for optimized patient-specific care.

Investigating the Relationship Between Orthodontic Treatment and Temporomandibular Joint Disorders in Adolescents

ABSTRACT Background: Orthodontic treatment is widely utilized to correct malocclusions and improve dental aesthetics in adolescents. However, its potential association with the development of temporomandibular joint disorders (TMDs) remains controversial. Materials and Methods: A prospective cohort study was conducted involving 200 adolescents aged 12–18 years undergoing orthodontic treatment. Participants were divided into two groups: those receiving fixed appliances (n = 150) and those undergoing aligner therapy (n = 50). The presence and severity of TMDs were assessed using the Research Diagnostic Criteria for Temporomandibular Disorders at baseline, 6 months, and 12 months post-treatment initiation. Data were analyzed using the Chi-square tests and multivariate logistic regression to identify potential risk factors. Results: At baseline, 10% of the total cohort exhibited mild TMD symptoms. After 12 months, 25% of the fixed appliance group showed an increase in TMD symptoms, compared to 15% in the aligner group. The logistic regression analysis revealed a significant association between the duration of treatment with fixed appliances and the development of TMDs (OR = 2.5; 95% CI: 1.2–5.1; P = 0.02). However, no significant correlation was found between aligner therapy and TMD incidence (OR = 1.1; 95% CI: 0.5–2.3; P = 0.67). Conclusion: The findings suggest that prolonged orthodontic treatment with fixed appliances may increase the risk of developing TMDs in adolescents, whereas aligner therapy appears to have a minimal impact on TMJ function.

Enhancing Temporomandibular Disorders Education for Initial Care Clinicians Through Interprofessional Education.

Temporomandibular disorders (TMDs) are common musculoskeletal pain conditions that can significantly impact daily activities such as eating, talking, breathing, intimacy, and expressing emotion. TMDs are often complex and multifactorial, and many patients experience overlapping pain conditions, sleep difficulties, and mental health challenges. The National Academies of Sciences, Engineering and Medicine (NASEM) has called for improved TMD education and training for health professionals, as current training opportunities are limited. To prepare health professionals to care for patients who have a TMD, we designed a 5-hour, interactive, module-based curriculum aligned with the 2020 NASEM recommendations. The four-part module set addresses TMD physiology and pathophysiology, assessment, diagnosis, and management. Instructional methods are founded on the Cognitive Theory of Multimedia Learning and include engaging videos, clinical evaluation and education tools, and interactive digital simulation scenarios. Thirty learners from diverse health professional backgrounds (medicine, dentistry, physician assistant, nursing, physical therapy) participated. Multiple-choice question assessments and pre/post retrospective survey scores demonstrated enhanced knowledge (M = 2.9 vs. M = 4.2, p < .001) and perceived competence (M = 1.9 vs. M = 3.4, p < .001), respectively. Encouragingly, all participants indicated applicability to their clinical practice. Our modules offer educators and clinicians a valuable resource to improve TMD knowledge and facilitate best practices. Supplementary resources included in the curriculum are conducive to clinical implementation, fostering improved clinician assessment and patient education.

The effectiveness of physical therapy for temporomandibular disorder: A systematic review

Background Temporomandibular disorders (TMD) are diseases of the stomatognathic system characterized by various signs and symptoms. TMD treatment must be multidisciplinary because its causes are multifactorial. Noninvasive conservative treatment strategies should be carried out before considering invasive treatment options that may lead to irreparable damage. Physical therapy is an effective noninvasive therapy for managing the signs and symptoms of TMD. To date, the most effective therapeutic approach for managing TMD pain remains controversial. Therefore, this study aimed to evaluate the most effective physical therapy for pain management, symptom control, and quality of life improvement in patients with TMD. Methods Data search was performed using the PubMed, SCOPUS, and Web of Sciences databases. The results are reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews. Interventions based on physical therapy, including physical exercise, manual therapy, myofacial muscle manipulation, and postural therapy, with pain relief, increased mouth opening, or improved quality of life as primary outcomes, were examined. Results Twenty eligible articles were analyzed. Most interventions demonstrated statistically significant improvements as measured by the study outcomes. Conclusions Most types of physical therapy demonstrated positive effects on patients with TMD. Furthermore, physical therapy for both cervical and regional TMJ manipulation can be an alternative long-term treatment for TMD.

Analysis of Temporomandibular Disorders, Bruxism and Well-Being in Patients With Fibromyalgia Syndrome: A Case-Control Study.

To analyse temporomandibular disorders (TMD), bruxism and well-being in patients with fibromyalgia and compare these outcomes with a control group. Diagnostic criteria for the assessment of TMD, bruxism and well-being were used in a clinic context including patients with fibromyalgia (n = 71) and a control group of healthy subjects (n = 151). Participants completed an online questionnaire measuring temporomandibular pain, headache attributed to TMD, jaw locking, joint sounds, headache to bruxism, potential sleep bruxism, potential awake bruxism, jaw functional limitation scale 8 (JFLS-8), generalised anxiety disorder scale 7, oral health impact profile scale 14, World Health Organization well-being index (WHO-5) and Pittsburgh sleep quality index (PSQI). TMD and bruxism were significantly associated with the type of population (χ2 = 8.77-57.62; p < 0.05; ES = 0.20-0.51). Fibromyalgia patients showed higher prevalence (% values) than control group in temporomandibular pain, headache attributed to TMD, jaw locking, headache attributed to potential bruxism, sleep bruxism and awake bruxism. However, there was a greater prevalence of joint sounds in the control group compared to the fibromyalgia group. Also, fibromyalgia patients scored significantly higher (p < 0.001) on JFLS-8, GAD-7, OHIP-14 and PSQI with a large effect size (ES = 0.51-0.73), while WHO-5 scores were significantly lower (ES = 0.58). Patients with fibromyalgia had greater prevalence than the control group in TMJ pain, headache attributed to TMD, jaw locking, headache attributed to bruxism, sleep bruxism and awake bruxism. Another main finding was that patients with fibromyalgia had greater jaw functional limitation, generalised anxiety and impact of oral health on an individual's life. In addition, fibromyalgia patients showed lower sleep quality and well-being index.

Integrative Korean Medicine Treatment for Temporomandibular Disorder and Facial Paresthesia after Tumor Removal Surgery: A Case Report (Case Report Guidelines-Compliant)

Integrative Korean Medicine Treatment for Temporomandibular Disorder and Facial Paresthesia after Tumor Removal Surgery: A Case Report (Case Report Guidelines-Compliant)

Oral Health Complications of SCUBA Diving

OBJECTIVE This review aims to assess the specific oral health complications associated with SCUBA diving, including barodontalgia, barosinusitis, and temporomandibular joint (TMJ) disorders, and to examine the dental implications of hyperbaric oxygen therapy (HBOT) used in decompression sickness treatment. Additionally, this review identifies gaps in the literature and suggests areas for further research to improve dental care guidelines for divers. MATERIALS AND METHODS A systematic literature search was conducted using PubMed and Scopus databases from 2004 to 2024, focusing on terms such as "barodontalgia," "dental barotrauma," and "diving dentistry." From 77 initial articles, 25 studies were selected based on relevance to pressure-induced oral complications, diving-related barotrauma, and dental management for SCUBA divers. RESULTS The review identifies barodontalgia as a prevalent issue, commonly triggered by untreated caries or defective restorations, with symptoms intensified by pressure changes. TMJ disorders, linked to prolonged clenching on diving mouthpieces, and sinus-related barotrauma also emerged as significant concerns. Preventive measures, including regular dental checkups, use of resin-based cements, and customized mouthpieces, are recommended to reduce risks. Furthermore, the review highlights a need for larger, controlled studies across diverse diver populations to validate current recommendations and develop accessible guidelines, especially for recreational divers who may lack access to specialized dental care.

Effect of yoga-based exercise program in female patients with myofacial pain of temporomandibular disorders.

The study was conducted to investigate the effect of Yoga-based exercise program on pain, range of motion (ROM), quality of sleep, depression and quality of life in female patients with myofacial pain of temporomandibular disorders (TMD). 39 Female patients with myofacial pain of TMD were included in the study. Yoga based exercise program was performed to the first group and second group was control group. Visual Analog Scale (VAS), Neck Pain and Disability Scale (NPDS), neck and jaw ROM, Pittsburg Sleep Quality Index (PUQI), Beck Depression Inventory (BDI) and Short Form 36 (SF36) were evaluated. Evaluations were repeated before treatment and 6 weeks later. From the measurements, a decrease in Temporomandibular Joint (TMJ) (p = 0.005) and neck pain (p = 0.031) was found to be significant in favor of Yoga Group. It was also observed that the increase in ROM in the neck right lateral flexion (p = 0.001) in favor of Yoga Group. The sleep quality did not change. In yoga group, a decrease in depression level (p = 0,023) and increase Quality of life in parameters of physical function (p = 0.023), vital capacity (p = 0.026), emotional health (p = 0.002), mental health (p = 0.080) were found as significant, statistically. It was concluded that yoga-based exercise program can be used as an alternative program in patients with myofacial pain of TMD. Further study on myofascial pain of TMD is recommended. Yoga-based exercise program can be used in patients with myofascial pain due to TMD.

A CBCT study of changes in temporomandibular joint morphology with immediate implant placement and immediate loaded full-arch fixed dental prostheses

BackgroundDental implants are becoming a popular treatment of choice. Immediate implant placement with immediate loaded full-arch fixed dental prostheses (IPILFFDP) presents an attractive solution for edentulous and partially edentulous patients because of its high success rate, reduction in overall treatment time, and improved esthetics. However, whether it can minimize the risk of temporomandibular disorder (TMD) has not been previously studied.ObjectiveTo quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT).MethodsTwelve participants without TMJ symptoms undergoing IPILFFDP were included in the study. Preoperative and 1-year postoperative assessment of CBCT scans were performed on 18 items related to TMJ and vertical dimensions. Mimics software was used for data analysis. T-test, Pearson, and Spearman correlation analyses were performed.ResultsThere were no significant differences in bilateral joints between pre and post IPILFFDP. Compared with pre-treatment CBCT, post-treatment CBCT showed a significant increase in posterior joint space. There was an approximately 2 mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space.ConclusionsFor patients without TMJ-related signs and symptoms, the IPILFFDP could keep the neuromuscular memory of patient’s facial muscles and occlusion, and use adapted centric posture as a guide, which led to more precise restoration of the original jaw position and may shed light in future related clinical studies.