TMJ Pain Dysfunction Syndrome Research Articles

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.

Occlusive therapy in the complex treatment of TMJ pain dysfunction syndrome in patients with dental abnormalities and deformities

<h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Повышение эффективности лечения болевой дисфункции височно-нижнечелюстного сустава (ВНЧС) у пациентов, имеющих аномалии и деформации зубных рядов. <h3>МАТЕРИАЛ И МЕТОДЫ</h3> Простое проспективное рандомизированное исследование в параллельных группах. Были обследованы 64 пациента в возрасте от 25 до 48 лет, обратившиеся за ортодонтической помощью по поводу аномалий и деформаций зубных рядов, осложненных болевой дисфункцией ВНЧС. Пациентам первой группы (32 человека) в план комплексного лечения патологии была включена миорелаксационная терапия съемным ортодонтическим аппаратом (сплинт). Во вторую группу (32 человека) были включены пациенты, отказавшиеся от проведения сплинт-терапии. Проведена оценка болевых ощущений пациентов в области ВНЧС через один, два и три месяца после начала ортодонтического лечения. <h3>РЕЗУЛЬТАТЫ</h3> Оценка динамики болевых ощущений через месяц после начала ортодонтического лечения показала уменьшение болевых ощущений у 23 (72%) пациентов и полное их исчезновение у 9 (28%) пациентов первой группы. Во второй группе данный показатель составил 16 (50%) случаев и 5 (16%) случаев соответственно. Аналогичное исследование, проведенное через три месяца после начала ортодонтического лечения, показало отсутствие болей у 30 (94%) пациентов первой группы. Среди пациентов второй группы боли различной степени выраженности сохранились у 9 (28%) пациентов. <h3>ЗАКЛЮЧЕНИЕ</h3> Окклюзионная терапия, направленная на снижение мышечного тонуса жевательной мускулатуры, является эффективным методом лечения пациентов с аномалиями и деформациями зубных рядов, осложненными болевой дисфункцией ВНЧС.

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.

MATHEMATICAL MODELING IN PREDICTION OF TMJ PAIN DYSFUNCTION SYNDROME

The study presents technology of the development of formalized forecasting model of the risk group for temporomandibular pain dysfunction syndrome on the basis of a systemic analysis of multivariate rapid screening questionnaire for prevalence rate of etiological and amnesic predisposing factors and manifestations of TMJ pain dysfunction syndrome. Formalized model allows us to identify an individual consulting and diagnostic itinerary of the subject, to diagnose the cause of abnormalities in the biomechanical system, to conduct timely correction, and to start the treatment. Aim - development of affordable formal risk prediction method for predicting the development of TMJ pain dysfunction syndrome. Materials and methods. The subjects of the study were 94 respondents, 34 men and 60 women aged from 18 to 57 years, chosen by accidental sampling. The following methods were used: sociological (rapid screening questionnaire), systemic multivariate analysis, regression analysis, mathematical modeling. The study was conducted with consistent integration of rapid screening questionnaire data of clinically healthy research subjects and those with signs of TMJ dysfunction, who did not complain and did not seek dental advice concerning the changes in the TMJ. Integration was carried out by multivariate systemic analysis of personal data and the assessment of changes in the dentition of all the subjects of the sampling. The two components were taken into account in the survey system corresponding to the two data blocks: "causes" and "effects". Information from the subjects of study was obtained by the principle of dichotomous presentation, during which the test subjects noticed the presence or absence of a specific sign (symptom) in the dentition. Results. Boundary values of the integral system status indicator (min Xbi = 0,04 + 0,01, max 0,11 + 0,04) were calculated, whereby the test subject can be attributed to the risk group for the causes and predisposing factors or the first manifestation of symptoms of TMJ pain dysfunction syndrome. Conclusion. The subjects of the research with the values of the integral index falling within the confidence interval boundary values of the modified system (from Xbi = 0,04 ± 0,01 to Xbi = 0,11 ± 0,04) require determination of an individual trajectory of system correction.

EMG pattern of masticatory muscles in altered dentition - Part I

The aim of this study is to reveal how any alteration in occlusion results in functional disturbances in masticatory muscles, which may in turn develop TMJ pain dysfunction syndrome in the long ran.<br>Electromyography (EMG) of masseter and temporalis muscles (if ten adult individuals with normal occlusion and either 36 or 46 carious, was recorded in rest position and during chewing activity of mandible. After cavity preparation, inlay with high point (or occlusal interference) was fabricated, which seas fitted in the tooth and EMG recordings were repeated. Again the same recordings were done after stablishing the occlusal equilibrium.<br>Atypical pattern of muscle activity was observed only in presence of occlusal interference and obolished after removal of the same. This activity resembled the spasm in skeletal muscle. Spasm in masticatory muscles may initiate the symptoms of TMJ pain dysfunction syndrome.

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome. Can occlusal analysis be used to predict success of splint therapy?'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome. Can occlusal analysis be used to predict success of splint therapy?'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome. Can occlusal analysis be used to predict success of splint therapy?'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome. Can occlusal analysis be used to predict success of splint therapy?'

A comparison of two splints in the treatment of TMJ pain dysfunction syndrome. Can occlusal analysis be used to predict success of splint therapy?

Controversy surrounds the diagnosis and treatment of TMJ pain dysfunction syndrome (TMJPDS). This is also reflected in the widely divergent recommendations in splint design. A study was undertaken to examine the comparative success rates of treatment by two occlusal splints with apparently diametrically opposed modes of action and to determine whether there were any factors which could be utilised to predict the success of splint therapy. Sixty-eight TMJPDS patients were randomly distributed into one of two comparable groups and were treated solely with an occlusal splint for night time wear. One group was treated with a stabilisation splint (SS) and the other with a localised occlusal interference splint (LOIS). The success rate at review with the SS was 67.6% and with the LOIS was 80.9%. This difference was not statistically significant. Pretreatment occlusal analysis demonstrated three indicators of successful splint therapy which appeared to be independent of design. These were the absence of centric relation occlusion, the existence of non-working side interferences and an absence of ideal anterior guidance.

Role of psychologic and social variables in TMJ pain dysfunction syndrome (PDS) symptoms.

The aim of this study was to measure the relative importance of a number of psychologic and social variables in explaining the severity of symptoms of functional disturbances of the stomatognathic system. 261 non-care seeking patients with respect to pain and dysfunction of the stomatognathic system were examined. The total sample consisted of two subgroups: Group 1 (n = 130) with a complete natural dentition and Group 2 (n = 131) wearing complete maxillary and mandibular dentures. Symptoms of functional disturbances of the stomatognathic system were assessed using two questionnaires. One was derived from the Anamnestic Dysfunction Index and the other was an extended questionnaire which included accessory symptoms frequently mentioned in the literature. The patients also completed the Hopkins Symptom Checklist, the Dutch Personality Inventory, and a Dutch form of the Minnesota Multiphasic Personality Inventory. In both patient subgroups symptoms of functional disturbances of the stomatognathic system were significantly correlated with patient's sex and a complex of highly intercorrelated psychologic variables: psychoneurotic- and somatic symptoms, neuroticism, negativism, and somatization.

Relative importance of psychologic and social variables in TMJ pain dysfunction syndrome (PDS) signs.

The aim of this study was to measure the relative importance of a number of psychologic and social variables in explaining the severity of signs of functional disturbances of the stomatognathic system. A group of 261 non care seeking patients with respect to pain and dysfunction of the stomatognathic system were examined. The total sample consisted of two subgroups: Group one (n = 130) with a complete natural dentition and Group two (n = 131) wearing complete maxillary and mandibular dentures. Signs of functional disturbances of the stomatognathic system were assessed using the Clinical Dysfunction Index and a Palpation Test. The patients also completed the Hopkins Symptoms Checklist, the Dutch Personality Inventory and a Dutch form of the Minnesota Multiphasic Personality Inventory. Patient education, age and sex were also registered. In both patient subgroups signs of functional disturbances of the stomatognathic system were significantly correlated with patient's sex and a complex of highly intercorrelated psychologic variables: psychoneurotic and somatic symptoms, neuroticism and somatization.

Relations between TMJ pain dysfunction syndrome (PDS) and some psychologic and biographic variables.

A total of 211 persons with a complete natural dentition were examined for signs and symptoms of the TMJ pain dysfunction syndrome. They also answered the questions of the Dutch version of the Hopkins Symptoms Check List (HSCL). Schooling, age and sex were also registered. Signs and symptoms of the TMJ pain dysfunction syndrome proved to be highly correlated to the psychologic and somatic scales of the HSCL with one exception: maximal mouth opening. The total palpation score proved to be a reliable, sensitive, easy and fast predictor for the severity of the TMJ pain dysfunction syndrome.

Maxillary sinusitis as a differential diagnosis in temporomandibular joint pain-dysfunction syndrome

Maxillary sinusitis may be diagnosed incorrectly as TMJ pain-dysfunction syndrome because of a similarity of signs and symptoms. Both conditions can manifest with headache, facial pain radiating to the ear and the maxillary teeth, preauricular pain, and pain in the buccal vestibule posterior and superior to the maxillary tuberosity. It can be concluded that (1) more consideration should be given to sinus disturbances as a differential diagnosis in TMJ pain-dysfunction syndrome, (2) it may be preferable to refer some patients with TMJ pain to a medical center where specialists in dentistry, otolaryngology, neurology, rheumatology, and psychiatry can evaluate the patient, and (3) TMJ pain-dysfunction syndrome should be evaluated and treated by a dentist experienced in management of this disorder.

Herpes Simplex Virus and Acute Temporomandibular Joint Pain-Dysfunction Syndrome

Although the TMJ or myofascial pain-dysfunction syndrome is probably not brought about by any single etiologic agent, the findings discussed here offer strong evidence that the primary disease is a form of cranial polyneuritis similar in onset, duration, and natural course to acute facial paralysis. These findings of sensory neuritis with secondary neuromuscular dysfunction leave no question unanswered, whereas the classic concept that has evolved through the years into the pain-dysfunction syndrome cannot adequately explain the myriad of signs and symptoms found in this condition. By removing the psychophysiologic (functional) label and recognizing the organic nature of this self-limiting disease, we should now be able to consolidate the many different modes of therapy that are effective in treating patients with the acute TMJ pain-dysfunction syndrome.

The importance of radiography in the diagnosis of TMJ dysfunctions: A comparative evaluation of transcranial radiographs and serial tomography

Eight men and 22 women with TMJ pain-dysfunction syndrome were selected. After clinical examination, TR and serial tomography were performed in 5 to 7 different planes. In 27 patients, TR showed a condylar displacement. This was confirmed by serial tomography, which also showed that the apparent position may vary from the medial to the lateral aspects due to rotation in some patients. Changes in shape were a common feature and did not necessarily occur in the same manner on each side or in the different sections of the same condyle. In these patients, the TR shape was generally more similar to that of the middle and lateral tomographic planes. The relationship between remodeling pattern and condylar position was confirmed. Degenerative lesions were present in some patients but could only be clearly detected by serial tomography. This study confirms the important role of the TMJ in dysfunctions and the validity of radiography in diagnosis.

Condylar remodeling after occlusal therapy

Seven men and 15 women with TMJ pain dysfunction syndrome were selected. After clinical examination, polytomography of the TMJ was performed in centric occlusion in different planes. Open-mouth projections were also made in three patients, frontal tomography in one patient, and transcranial radiographs in 16 patients. Occlusal analysis was performed on the articulator. Twenty patients showed various patterns of condylar displacement with flattening of the anterior, superior, or posterior condylar walls in 11 patients, including three with arthritic lesions. Therapy included occlusal splints (21 patients), selective grinding (seven patients), prosthodontic rehabilitation (10 patients), and orthodontic treatment (two patients). After therapy, tomographic examination was repeated at intervals of 9 to 44 months. A distinct reshaping of the condyle was seen in seven patients. The new shape tended to be rounded. The three patients with degenerative changes before treatment showed regression of the lesions. No change was seen in condyles which were rounded before therapy.

Relationship between the temporomandibular joint and pantographic tracings of mandibular movements

Lateral polytomography of the TMJ and pantographic tracings of mandibular movement were performed in 30 patients with TMJ pain-dysfunction syndrome. The condyles were classified as rounded or flattened. The articular eminences were classified as convex or flattened. Two types of immediate side shift, progressive side shift and vertical protrusive tracing, were observed. Type A was curved, Type B was straight. A significant relationship was found between the shape of the TMJ and the tracing pattern. Type A immediate side shift (when present), progressive side shift, and vertical protrusive tracings were more typical of patients with rounded condyles and convex articular eminences. Type B was typical of patients with flattened condyles and, to a lesser extent, flattened articular eminences. Superior displacement of the rotating condyle was found only in patients with flattened condyles.