Temporomandibular Disorders Research Articles

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.

Dental 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. To quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT). Twelve 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. There 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 2mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space. For 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.

Effectiveness of modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy

To investigate the effectiveness of modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy for temporomandibular joint anterior disc displacement (ADD). A clinical data of 30 patients (45 sides) with temporomandibular joint ADD, who met selective criteria and were admitted between September 2022 and February 2024, was retrospectively analyzed. Among them, 15 patients (23 sides) were treated with temporomandibular joint disc reduction and suture via small incision (open operation group), and 15 patients (22 sides) with modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy (arthroscopy group). There was no significant difference in gender, age, disease duration, affected side, Wilkes-Bronstein stage, preoperative visual analogue scale (VAS) score, maximal interincisal opening (MIO), and temporomandibular joint dysfunction index (DI), craniomandibular index (CMI), palpation index (PI), and other baseline data between groups ( P>0.05). VAS score, MIO, and temporomandibular joint function indicators (PI, DI, CMI) of patients were recorded at 3 months after operation, and the difference (change value) of the above indicators between pre- and post-operation was calculated. At 1 week after operation, MRI was performed to evaluate the reduction of the articular disc compared to the preoperative image. The results were classified as excellent, good, and poor, with excellent and good being considered effective reduction. The condition of condyle process repair was observed by cone beam CT (CBCT) at 3 months after operation. All incisions healed by first intention in the two groups. All patients were followed up 3-18 months (mean, 8.2 months). Facial nerve injury occurred in 3 cases in the open operation group and 1 case in the arthroscopy group, all of which returned to normal after physiotherapy and drug treatment. At 3 months after operation, MIO and VAS scores of both groups significantly improved when compared with those before operation ( P<0.05), and temporomandibular joint function indicators (PI, DI, CMI) significantly decreased ( P<0.05). The change values of MIO and temporomandibular joint function indicators in arthroscopy group were significantly higher than those in open operation group ( P<0.05). There was no significant difference in the change value of VAS score between groups ( P>0.05). There was no recurrence during follow-up. Postoperative MRI review showed that the effective reduction rate of joint disc was 95.65% (22/23) in the open operation group and 95.45% (21/22) in the arthroscopy group, with no significant difference between groups ( P>0.05). Postoperative CBCT found that early and timely effective reduction of joint disc was conducive to condyle process repair and reconstruction. Modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy has a clear effect in the treatment of ADD, with less trauma, fewer postoperative complications, and good early effectiveness.

Gender variability in palpation performance for temporomandibular disorders with three different methods: An experimental study.

Gender differences in pain reporting and prevalence have been demonstrated. As gender of examiner also affects reporting of pain on palpation, the aim of this study was to evaluate the effects of examiner gender on palpation performance using three different palpation methods. Examiners of both genders were instructed on the correct technique for each palpation method by either a female or male instructor. The target was to achieve a pressure of 100kPa, corresponding tothe 1kg of force for muscle palpation described in the diagnostic criteria for temporomandibular disorders (DC/TMD). All examiners performed traditional palpation with the index finger, palpation with a palpometer, and a novel bimanual palpation with visual feedback, in a randomized order. The examiner's gender, and its interaction with the gender of the instructor did not significantly affect magnitude, accuracy, or precision of the pressure applied. The method of palpation was the only factor that significantly impacted all metrics. The palpometer achieved the lowest palpation magnitude (mean pressure applied=113.7kPa, 95% CI: 109.8-117.6), the highest accuracy (absolute difference=15.7kPa, 95% CI: 12.3-19.1), and the highest precision (mean coefficient of variation=6.8, 95% CI: 6.0-7.6), followed by bimanual palpation and traditional palpation. The results suggest that gender differences in pain reporting in patients are not likely to be a result of the technical aspects associated with the gender of the examiner. Instead, these differences may be attributed to other factors, such as sociocultural influences.

Physiological response to pain in patients with temporomandibular joint disorders during physiotherapy.

Pain assessment in patients with temporomandibular joint (TMJ) disorders during physiotherapy is a challenging yet desired task. Our study addresses two issues. First, we compare the pain perception in patients with TMJ disorders and a control group. The hand dynamometer is verified as an alternate pain self-report device in the second stage. For the dynamometer validation, we employed a cuff-pressure test to induce pain of various intensities. In the second stage, physiological signals (electrodermal activity and blood volume pulse) have been acquired during the physiotherapy in a control group and patients suffering from TMJ disorder. The linear mixed-effects modeling is carried out to find differences in pain and no pain states, considering subjects' health condition. The main result of the present pilot study is that physiological reactions to painful physiotherapy do not differ between patients with chronic pain and the control group. This finding concludes that studies on TMJ disorder procedures may also be performed on healthy subjects.

FISIOTERAPIA NO ZUMBIDO SOMATOSENSSORIAL: REVISÃO SISTEMÁTICA

Somatosensory tinnitus is a type of tinnitus that can be influenced by musculoskeletal and somatic factors, such as cervical or temporomandibular disorders. Physiotherapy has emerged as a noninvasive treatment option with the aim of addressing these musculoskeletal abnormalities to reduce tinnitus intensity and improve patients' quality of life. This review aims to evaluate the effectiveness of physiotherapeutic approaches in the management of somatosensory tinnitus, exploring different treatment modalities and the results obtained in clinical studies. The article was analyzed through clinical trials and observational studies were conducted, focusing on the impact of physiotherapy on somatosensory tinnitus, using outcome measures such as the Visual Analog Scale (VAS) for tinnitus intensity and the Tinnitus Handicap Inventory (THI) for quality of life. Most studies reported significant improvements in tinnitus severity and functional well-being of patients after physiotherapy interventions. Techniques such as manual therapy and myofascial release have been particularly effective in reducing symptoms in patients with cervical or temporomandibular disorders. However, a major limitation identified was the lack of standardized treatment protocols, which makes it difficult to generalize the results. Physiotherapy appears to be a promising therapeutic option for somatosensory tinnitus, particularly for patients with associated cervical and temporomandibular disorders. Future research should aim to standardize treatment protocols and include larger randomized controlled trials to further validate these findings and establish evidence-based clinical guidelines.

A clinical case of treatment of temporomandibular joints disease caused by occlusive disorders

A method of treatment,described in this clinicalcase, isaimedateliminatingdisorders of occlusalrelationships of the dentition, (PatentNo.2797641dated06/07/2023) contributing to the normalization of TMJ functioning. At the first stage of treatment, a repositioning occlusal splint was used, applied to all teeth of the lower jaw, which was being corrected for six months. This stage was considered completed on the basis of the following criteria: absence of the patient`s complaints and smooth movements of the mandible without deviations and clicks on objective examination, as well as formation of symmetrical graphs of the TMJ condyles movement on axiographic examination, an optimal location of the TMJ condyles on sagittal projections of MSCT and positive changes in the bioelectric activity of the masticatory muscles, towards higher and more symmetrical values on both sides. Further treatment was carried out by an orthodontist with a non-removable technique,using a brace system. Wearing of the occlusal splint continued until the braces system was put on the teeth of the lowerjaw. It was then replaced by composite liningsin the projection of the firstmolars of the upperjaw. Dynamicmonitoring of thepatientforhalf ayearafter the end of the treatment indicated remission of TMJ disease. Normalization of occlusal relationships of dentitions in intact dentitions and small defects through splint therapy followed by the use of a brace systemis a minimally invasive andeffectivemethod of treatment TMJ diseases.

The Association Between Temporomandibular-Related Quality of Life and Oral Behaviours: A Cross-Sectional Study in Patients With Temporomandibular Disorders.

Oral behaviours (OB) are some oral overuse behaviours which could be observed in patients with temporomandibular disorders (TMD). This study aims to investigate the association between TMD-related quality of life and OB to enhance understanding of these behaviours. A total of 319 participants diagnosed with TMD were included in this research. According to the diagnostic criteria for TMD, patients were divided into three subgroups: pain-related TMD (PT, n = 71), intra-articular TMD (IT, n = 91) and combined TMD (CT, n = 157). Participants completed the oral behaviour checklist (OBC), the oral health impact profile for TMD (OHIP-TMD), the generalised anxiety disorder 7-item (GAD-7) and the patient health questionnaire 9-item (PHQ-9), and demographic characteristics were collected from medical records. TMD patients with high OBC scores (25-84 points) had higher scores in six of the seven OHIP-TMD domains (all p < 0.05). Logistic regression analysis indicated that OHIP-TMD scores (OR = 1.03), younger age (OR = 0.95), education (OR = 2.80-3.10), and PHQ-9 scores (OR = 1.14) were significantly positively correlated with OBC scores (p < 0.05). After adjusting for confounding factors, the psychological discomfort (OR = 1.09) and psychological disability (OR = 1.10) domains of the OHIP-TMD were identified as independent factors associated with higher OBC scores. Patients with more frequent OB exhibited a lower quality of life across nearly all OHIP-TMD domains. Higher OHIP-TMD scores and specific psychological domains were independently associated with a higher frequency of OB. The causal relationship between quality of life and OB in TMD patients requires further investigation.

Characteristics of Temporomandibular Joint Osteoarthritis Patients With Condylar Erosion: A Retrospective Cross-Sectional Study.

Condylar erosion (CE) may indicate an active progressive stage of temporomandibular joint osteoarthritis (TMJOA), but no studies have analysed the characteristics of this population. This cross-sectional study analysed the characteristics of TMJOA patients with CE. A total of 267 patients were included. The severity of CE of all joints was evaluated using cone beam computed tomography (CBCT) and scored using a four-point rating scale (0-III). Patients were categorised into mild (grade I), moderate (grade II) and severe (grade III) groups. Demographic and clinical characteristics were summarised and stratified by age and erosion severity. Univariate and multivariate logistic regression analyses were performed based on the assignment of the variables. The proportion of patients under 30 years old is much higher than other age groups. Compared to adults (≥ 20 years old), a higher proportion of adolescent patients (10-19 years old) choose orthodontics department for their first consultation (p < 0.01). And adolescent patients have a higher proportion of temporomandibular joint (TMJ) noise (p < 0.05) and a lower proportion of arthralgia (p < 0.001). Significant differences exist in CE severity between adolescents and adults (p < 0.001). The severe group had the youngest patients (p < 0.05) and the highest proportion of mandibular deviation and abnormal postural habits. Patients under 30 years of age constitute a significant proportion of TMJOA cases with CE. Compared to adults, adolescent patients have more severe CE and less arthralgia. Due to obvious dental and maxillofacial deformities and milder TMJ symptoms, adolescent patients may not be aware that they have TMJ disease, potentially leading to delayed treatment.

The Effect of a Single Temporomandibular Joint Soft Tissue Therapy on Cervical Spine Mobility, Temporomandibular Joint Mobility, Foot Load Distribution, and Body Balance in Women with Myofascial Pain in the Temporomandibular Joint Area—A Randomized Controlled Trial

In contemporary times, a significant portion of the population experiences symptoms of temporomandibular joint (TMJ) dysfunction. The objective of this study was to evaluate the effects of a single-session TMJ soft tissue therapy on the TMJ and cervical spine mobility as well as on body balance and the foot load distribution. This study was a parallel-group, randomized, controlled trial with a 1:1 allocation ratio. Fifty women aged 20–30 years diagnosed with myofascial pain in the TMJ area were included in the study and divided into two groups. The experimental group received TMJ soft tissue therapy. The following research tools were used: a Hogetex electronic caliper, a CROM Deluxe, and a FreeMed Base pedobarographic platform. In the experimental group, an increase in mobility within all assessed jaw and cervical spine movements was observed. This change was statistically significant (p &lt; 0.05) for lateral movement to the left, abduction, and protrusion of the jaw (an increase of 10.32%, 7.07%, and 20.92%, respectively) and for extension, lateral bending to the right and left, and rotation to the right and left, of the cervical spine (an increase of 7.05%, 7.89%, 10.44%, 4.65%, and 6.55%, respectively). In the control group, no significant differences were observed. No significant changes were observed in the load distribution and body balance assessment. A single session of TMJ soft tissue therapy increases jaw and cervical spine mobility but does not impact body balance or foot load distribution in static conditions in women diagnosed with myofascial pain in the TMJ area.

DIAGNOSTIC APPROACHES TO PAINFUL TEMPOROMANDIBULAR JOINT DYSFUNCTION: A LITERATURE REVIEW

Introduction. The temporomandibular joint (TMJ) is an anatomically and biomechanically complex structure, essential for critical functions such as chewing, breathing, verbal and non-verbal communication, and facial expressions. The term “temporomandibular joint disorders” encompasses a range of conditions characterized by pain with diverse, often polymorphic, manifestations. Purpose of this study is to analyze the trends and directions in publications on the diagnosis of painful temporomandibular joint disorders from 2017 to 2024 (up to March 31, 2024) across international and Ukrainian scientific resources. Materials and methods. We used the bibliosemantic method, the methods of the system approach and content analysis. We searched for scientific publications for the period from 2017 to 2024 as of 03/31/2024 in Google Academy and Medline (accessed via PubMed) using the following words and their combinations: “dysfunctional temporomandibular joint conditions” and “temporomandibular joint dysfunction”, “temporomandibular dysfunction and condylare position”, “temporomandibular dysfunction and classification”. Inclusion criteria were as follows: a) studies aimed at evaluating the anatomy of the temporomandibular joint; b) studies conducted with cone beam computed tomography images; c) research on humans; d) data of persons aged 18 to 60 years. Exclusion criteria were as follows: a) clinical cases; b) discussions; c) research with the participation of children and adolescents (under the age of 18). Results. For the period 2017-2024 (as of 31.03.2024), the main research topics on the painful form of temporomandibular joint dysfunction are the following: the prevalence of temporomandibular joint disorders (11 publications), the influence factors of the dysfunction development of the temporomandibular joint (42 publications), the improvement of existing and the search for new diagnostic criteria (17 publications); the anatomical and the morphological features of the temporomandibular join as the development predictors for the temporomandibular joint dysfunction (20 publications); search for new models for predicting the course and effectiveness of treatment for temporomandibular join dysfunction (4 publications). Conclusion. Researchers have primarily focused on examining factors influencing the clinical progression of temporomandibular joint dysfunction, accounting for 44.7% of all publications. Studies on anatomical and morphological features as predictors of temporomandibular joint dysfunction, along with new predictive models, remain contentious and highlight the need for further investigation.

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

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

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

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

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

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

STABILOMETRY AS A METHOD FOR DIAGNOSIS AND TRAINING OF THE HUMAN POSTURAL BALANCE

Introduction. Posture is intrinsically linked to balance and the maintenance of an upright body position. Achieving stable posture and upright movement relies on the body’s complex neuromuscular regulation system. In clinical practice, stabilometry is employed to assess balance function and postural control. This study aims to synthesize data on the effectiveness of stabilometry as a diagnostic tool for evaluating postural balance and as a training method to enhance it. Materials and Methods. An analysis of 45 sources from databases including Academia.edu, PubMed, ResearchGate, and Google Scholar over the past decade was conducted using Keywords: posture, stabilometry, and postural balance. Results. Stabilometry is a contemporary technique for tracking the projection of the body’s center of mass on the support plane, as well as its fluctuations while standing or performing diagnostic tests and medical procedures. This review examines the application of stabilometry both for diagnosing balance and as a supplementary training method to improve postural balance in athletes and individuals with musculoskeletal disorders. Stabilometry results have highlighted correlations between stomatognathic system dysfunctions and musculoskeletal issues and demonstrated the positive impact of occlusal adjustments on body balance. As such, stabilometry can serve as an effective diagnostic tool for assessing posture in a dental clinic, useful for both diagnostic assessments and evaluating preventive or treatment outcomes. Conclusions. Training that combines myogymnastic exercises with stabilometric platform exercises significantly improved balance and functional efficiency in patients, as shown through stabilometric analysis. A key area of ongoing research is the interplay between posture and other bodily systems, particularly the stomatognathic system, which may be pivotal in treating temporomandibular joint dysfunction.

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

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

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

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

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

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

Unilateral molar Incisor hypomineralization influences the chewing side? an observational study in children.

The aim of this observational study was to compare the chewing patterns of children with unilateral Molar Incisor Hypomineralization (MIH) to those of children without MIH and to assess how the MIH severity influences the risk of chewing deviation. The hypothesis was that children with unilateral MIH would prefer to chew on the side opposite the defect. A total of 121 children were included in this investigation and evaluated for their preferred chewing side (PCS). This study population comprised 45 children with unilateral mild MIH (G1), 42 with unilateral severe MIH (G2), and 34 children in the control group (CG) who had no MIH but presented with unilateral chewing complaints. The PCS pattern differed among the groups, with 31% of the children with MIH and 55.9% of the CG showing bilateral chewing. The chewing deviation prevalence was 24% in the CG and 52% in G2 (χ2 test; p = 0.03). Binomial logistic regression analysis revealed that both severities of MIH influenced the likelihood of chewing deviation (χ2 = 7.33, p = 0.026). Children with unilateral severe MIH were 3.57 times more likely to exhibit chewing deviation than were those without MIH. The null hypothesis was rejected, indicating that unilateral MIH affects children's masticatory patterns, increasing the risk of chewing deviation. Unilateral chewing may be associated with various health issues, such as temporomandibular disorders (TMDs), decreased hearing, and vision problems. Unilateral MIH is a potential risk factor for unilateral chewing.

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

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