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Sample records for bruxism temporomandibular disorders

  1. Management of temporomandibular disorder associated with bruxism

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    Bedi S

    2009-01-01

    Full Text Available Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or, less commonly in the daytime in 5-20% of adults and about 30% of 56 year old children. Although research on bruxism is extensive, its etiology remains debatable. There is some literature to suggest that bruxism is correlated with temporomandibular disorders (TMDs and malocclusion. The aim of this article is to present the course of this condition in a case of bruxism coupled with TMD with special emphasis on the importance of accurate diagnosis of maxillofacial pain. We also report an association between supernumerary teeth and TMDs that has not been reported earlier in the literature.

  2. Nasal obstruction may alleviate bruxism related temporomandibular joint disorders.

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    Bektas, Devrim; Cankaya, Mustafa; Livaoglu, Murat

    2011-02-01

    Temporomandibular disorder (TMD) is a collective term used to identify a group of musculoskeletal conditions of the temporomandibular region. Bruxism is a non-functional activity characterized by repeated tooth clenching or grinding in an unconscious manner. Over the time bruxism may lead to TMD by the uploading it causes. Nasal obstruction is a common complaint that necessitates mouth breathing when severe. The treatment of bruxism is frequently performed by oral appliances, which induce occlusal disengagement and relax jaw musculature and therefore reduce the force on the temporomandibular joint (TMJ). We believe that nasal obstruction may indirectly have a preemptive and therapeutic effect on sleep bruxism related TMD by causing mouth breathing.

  3. Methadone treatment, bruxism, and temporomandibular disorders among male prisoners.

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    Enguelberg-Gabbay, Judith V; Schapir, Lior; Israeli, Yair; Hermesh, Haggai; Weizman, Abraham; Winocur, Ephraim

    2016-06-01

    There is little information on bruxism related to illicit drug use. Prolonged drug use may damage the stomatognathic system via oral motor overactivity. The aim of the present study was to compare the rates of bruxism and temporomandibular disorders (TMDs) between prisoners with and without drug-use disorders, to evaluate the association between methadone treatment and bruxism and to assess the possible relationship between bruxism and pain. The sample included 152 male prisoners, 69 of whom were drug users maintained on methadone. All prisoners were examined by an experienced dentist and completed a questionnaire on their oral habits, with the aim of detecting signs or symptoms of TMD and/or bruxism. Additional data were collected from medical files. The prevalence of sleep bruxism and awake bruxism, but not of TMDs, was significantly higher among drug-user than non-drug user prisoners (52.2% vs. 34.9% for sleep bruxism, 59.7% vs. 30.1% for awake bruxism, and 46.3% vs. 25.6% for TMDs, respectively). Participants with awake bruxism were statistically more sensitive to muscle palpation compared with participants with sleep bruxism [rating scores (mean ± SD): 0.32 ± 0.21 vs. 0.19 ± 0.28, respectively]. An association was found between sleep bruxism and awake bruxism. It seems that there is a direct or an indirect association between methadone maintenance treatment and sleep bruxism or awake bruxism in male prisoners.

  4. Sleep bruxism and myofascial temporomandibular disorders

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    Raphael, Karen G.; Sirois, David A.; Janal, Malvin N.; Wigren, Pia E.; Dubrovsky, Boris; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2015-01-01

    Background Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients’ self-reports rather than on direct observation. Methods The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants. Results The results of independent sample t tests and χ2 analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent). Conclusions Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned. Clinical Implications Although other reasons to consider treating SB may exist, misplaced concern about SB’s sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment. PMID:23115152

  5. Occlusal Grinding Pattern during Sleep Bruxism and Temporomandibular Disorder

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    Yeni Wijaya

    2013-09-01

    Full Text Available Sleep Bruxism is a significant etiology of temporomandibular disorder (TMD and causes many dental or oral problems such as tooth wear or facet. There is no study analyzing the relationship between sleep bruxism and TMD. Objective: To investigate any relationship between occlusal grinding pattern during sleep bruxism and temporomandibular disorder. Methods: A cross-sectional study involving 30 sleep bruxism patients attended the Faculty Dentistry Universitas Indonesia Teaching Hospital (RSGMP FKG UI. Completion of 2 forms of ID-TMD index and questionnaire from American Academy of Sleep Medicine were done. BruxChecker was fabricated and used for two nights to record the occlusal grinding pattern. The occlusal grinding pattern was categorized into laterotrusive grinding (LG and mediotrusive side. Further divisons of LG were: incisor-canine (IC, incisor-caninepremolar (ICP and incisor-canine-premolar-molar (ICPM. Mediotrusive side was classified as mediotrusive contact (MC and mediotrusive grinding (MG. Results: It was found that occlusal grinding pattern in non-TMD subjects were IC+MC, in subjects with mild TMD were ICP+MG and in subjects with moderate TMD were ICP+MG and ICPM+MG. TMJ was more significantly affected by ICP and ICPM grinding pattern than that of IC. Conclusion: There was a significant relationship between occlusal grinding pattern during sleep bruxism and TMD.DOI: 10.14693/jdi.v20i2.149

  6. Association between painful temporomandibular disorders, sleep bruxism and tinnitus

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    Giovana Fernandes

    2014-01-01

    Full Text Available The present cross-sectional study was designed to investigate the association between sleep bruxism (SB, tinnitus and temporomandibular disorders (TMD. The sample consisted of 261 women (mean age of 37.0 years. The Research Diagnostic Criteria for Temporomandibular Disorders were used to classify TMD and self-reported tinnitus. SB was diagnosed by clinical criteria proposed by the American Academy of Sleep Medicine. The results showed an association between painful TMD and tinnitus (OR = 7.3; 95%CI = 3.50-15.39; p < 0.001. With regard to SB, the association was of lower magnitude (OR = 1.9; 95%CI = 1.16-3.26; p < 0.0163. When the sample was stratified by the presence of SB and painful TMD, only SB showed no association with tinnitus. The presence of painful TMD without SB was significantly associated with tinnitus (OR = 6.7; 95%CI = 2.64-17.22; p < 0.0001. The concomitant presence of painful TMD and SB was associated with a higher degree of tinnitus severity (OR = 7.0; 95%CI = 3.00-15.89; p < 0.0001. It may be concluded that there is an association between SB, painful TMD and self-reported tinnitus; however, no relationship of a causal nature could be established.

  7. Self-reported bruxism and temporomandibular disorders: findings from two specialised centres

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    Manfredini, D.; Winocur, E.; Guarda-Nardini, L.; Lobbezoo, F.

    2012-01-01

    The aims of this investigation were to report the frequency of temporomandibular disorders (TMD) diagnoses and the prevalence of self-reported awake and sleep bruxism as well as to describe the possible differences between findings of two specialised centres as a basis to suggest recommendations for

  8. Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008

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    Manfredini, D.; Lobbezoo, F.

    2010-01-01

    Objectives: The present paper aims to systematically review the literature on the temporomandibular disorders (TMD)-bruxism relationship published from 1998 to 2008. Study design: A systematic search in the National Library of Medicine's PubMed database was performed to identify all studies on human

  9. Bruxism, oral parafunctions, anamnestic and clinical findings of temporomandibular disorders in children.

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    Emodi-Perlman, A; Eli, I; Friedman-Rubin, P; Goldsmith, C; Reiter, S; Winocur, E

    2012-02-01

    The reported prevalence of temporomandibular disorders (TMD) present during childhood and adolescence ranges between 7% and 68%. The range of the reported prevalence of sleep bruxism in children is also wide. The purpose of the current study was threefold: (i) determine the prevalence of oral parafunctions, sleep bruxism and of anamnestic and clinical findings of TMD among Israeli children with primary or mixed dentition; (ii) to establish whether the parafunctional activities are associated with anamnestic and clinical findings of TMD in this population and (iii) to examine the possible impact of stressful life events on the prevalence of bruxism, oral parafunctions, and anamnestic and clinical findings of TMD in children. A total of 244 children (183 girls and 61 boys) aged 5-12 years were included in the study. Each participant underwent a full TMD examination. Parents, in collaboration with their children, completed a questionnaire on TMD symptoms, oral parafunctions and stressful life events in their children's life. Most participants (78·8%) reported at least one oral habit. Of these, only 'jaw play' was associated with TMD anamnestic and clinical findings. Stressful life events were associated only with the performance of multiple oral habits. These findings indicate that the performance of oral parafunctions is commonplace during childhood, with younger children exhibiting fewer oral parafunctions than adolescents. Stressful life events are related with an increase in the performance of multiple oral parafunctions in children but the later are not necessarily associated with anamnestic and clinical findings of TMD in the paediatric population.

  10. [Temporomandibular joint, occlusion and bruxism].

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    Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

    2016-09-01

    Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner.

  11. Validity of Self-reported Sleep Bruxism among Myofascial Temporomandibular Disorder Patients and Controls

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    Raphael, Karen G.; Janal, Malvin N.; Sirois, David A.; Dubrovsky, Boris; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2015-01-01

    Sleep bruxism (SB), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of orofacial problems, including temporomandibular disorders (TMD). Since laboratory polysomnographic (PSG) assessment is extremely expensive and time-consuming, most research testing this belief has relied on patient self-report of SB. The current case-control study examined the accuracy of those self-reports relative to laboratory-based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD (n=124) and a demographically matched control group without TMD (n=46). A clinical research coordinator administered a structured questionnaire to assess self-reported SB. Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB, or severe SB, using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self-report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self-reported SB failed to significantly predict presence or absence of either moderate or severe SB as assessed by PSG, for both cases and controls. These data show that self-report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB. Studies relying on self-report to assess SB must be viewed with extreme caution. PMID:26010126

  12. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

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    Stapelmann, Henrike; Türp, Jens C

    2008-01-01

    Background The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. Methods We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. Results Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavaklı 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. Conclusion Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be

  13. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

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    Türp Jens C

    2008-07-01

    Full Text Available Abstract Background The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs, tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. Methods We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007. The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. Results Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4 or with bruxism alone (Kavaklı 2006, Jadad score: 2; in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3, a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5 no difference was found. In one RCT (Shankland 2002, Jadad score: 1, patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. Conclusion Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a

  14. Relação entre bruxismo e o grau de sintomatologia de disfunção temporomandibular The relationship between the bruxism and the severity of symptoms in the temporomandibular disorder

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    Cíntia Corrêa Blini

    2010-06-01

    Full Text Available OBJETIVO: verificar a ocorrência de bruxismo em sujeitos adultos do sexo feminino com queixa de disfunção temporomandibular e sua relação com o grau de sintomatologia da disfunção. MÉTODOS: participaram deste estudo 28 mulheres na faixa etária de 19 a 56 anos, que apresentavam sintomas de disfunção temporomandibular e que não haviam realizado tratamento anterior. Todas responderam o questionário de Índice Anamnésico proposto por Fonseca et al (1994, o qual possibilita a classificação do grau de sintomatologia de disfunção temporomandibular e verificação da queixa do hábito parafuncional bruxismo; e realizaram uma avaliação odontológica, constituída de exame da musculatura mastigatória, por meio de palpação digital intra e extra-oral, inspeção das articulações temporomandibulares e exame dental. Os resultados foram analisados descritivamente e, para verificar a relação entre o grau de severidade da disfunção temporomandibular com a ocorrência de bruxismo, foram realizados o Teste de Independência do Qui-quadrado e o Teste Exato de Fisher, ambos ao nível de significância de 5%. RESULTADOS: verificou-se que o bruxismo esteve presente em 50% dos casos de disfunção temporomandibular. Não houve relação entre o bruxismo e o grau de sintomatologia de disfunção temporomandibular, estabelecido pelo Índice Anamnésico. CONCLUSÃO: os resultados deste estudo sugerem que sujeitos com sintomas de disfunção temporomandibular devem ser questionados e avaliados quanto à presença de bruxismo, independentemente do grau de sintomatologia da disfunção. Assim como deve ser realizado diagnóstico e tratamento do bruxismo em sujeitos assintomáticos de disfunção temporomandibular como forma de prevenir o desenvolvimento de lesões nas articulações temporomandibulares e demais estruturas do sistema estomatognático.PURPOSE: to check the occurrence of bruxism in female gender adult subject, with temporomandibular

  15. Maximal bite force in young adults with temporomandibular disorders and bruxism Força de mordida máxima em adultos jovens com disfunção temporomandibular e bruxismo

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    Raquel Aparecida Pizolato

    2007-09-01

    Full Text Available Parafunctional habits, such as bruxism, are contributory factors for temporomandibular disorders (TMD. The aim of this study was to evaluate the maximal bite force (MBF in the presence of TMD and bruxism (TMDB in young adults. Twelve women (mean age 21.5 years and 7 men (mean age 22.4 years, composed the TMDB group. Ten healthy women and 9 men (mean age 21.4 and 22.4 years, respectively formed the control group. TMD symptoms were evaluated by a structured questionnaire and clinical signs/symptoms were evaluated during clinical examination. A visual analogical scale (VAS was applied for stress assessment. MBF was measured with a gnatodynamometer. The subjects were asked to bite 2 times with maximal effort, during 5 seconds, with a rest interval of about one minute. The highest values were considered. The data were analyzed with Shapiro-Wilks W-test, descriptive statistics, paired or unpaired t tests or Mann-Whitney tests when indicated, and Fisher's exact test (p Hábitos parafuncionais, como o bruxismo, podem contribuir para a disfunção temporomandibular (DTM. O objetivo deste trabalho foi avaliar a força de mordida máxima (FMM na presença de DTM e bruxismo (DTMB em adultos jovens. Doze mulheres (idade média de 21,5 anos e sete homens (idade média 22,4 anos compuseram o grupo DTMB. O grupo controle foi formado por 10 mulheres e 9 homens saudáveis, com idades médias de 21,4 e 22,4 anos, respectivamente. Os sintomas de DTM foram avaliados com um questionário estruturado, e os sinais/sintomas clínicos foram avaliados no exame clínico. Para avaliar estresse, utilizou-se a escala analógica visual (VAS. A FMM foi mensurada com gnatodinamômetro, e o participante foi orientado a morder com o máximo esforço durante 5 segundos, duas vezes, com intervalo de aproximadamente 1 minuto, considerando-se os valores máximos. Os dados foram analisados pelo teste de Shapiro-Wilks, estatística descritiva, teste t pareado e independente, Mann

  16. Temporomandibular Disorders and Parafunctional Habits in Children and Adolescence: A Review

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    Seraj, B.; R Ahmadi; Mirkarimi, M.; S. Ghadimi; M. Beheshti

    2009-01-01

    The aim of this study is to review the existing literature about temporomandibular disorders(TMD) and parafunctional habits (bruxism) and their relationship in children and adolescents,which is still controversial. TMD is a collective term used to identify a group ofmusculoskeletal conditions of the temporomandibular region. Bruxism defined as the habitual nonfunctional forceful contact between occlusal tooth surfaces. Some studies have linked oral parafunctional habits to TMD, whereas others...

  17. BRUXISM, PERLUKAH DIRAWAT? (TINJAUAN PUSTAKA)

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    Laura Susanti Himawan

    2015-01-01

    Every dentist knows about bruxism. However, the etiology, the treatment, and the relationship between bruxism and temporomandibular disorders (TMD) are still unknown and controversional. Bruxism can happen to all ages, from children (15% of all children) to adults (96% of all adults), male and female. Given the data, what can a dentist do to help the patient with bruxism? The various clinical signs that can be found in these patients are excessive tooth wear, muscle and joint fatigue, headach...

  18. Temporomandibular disorders

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    List, Thomas; Jensen, Rigmor Højland

    2017-01-01

    , limitations in jaw movement, and noise from the TMJs during jaw movements. TMD affects up to 15% of adults and 7% of adolescents. Chronic pain is the overwhelming reason that patients with TMD seek treatment. TMD can associate with impaired general health, depression, and other psychological disabilities......, and may affect the quality of life of the patient. Assessment Evaluations indicate that the recently published Diagnostic Criteria for TMD (DC/TMD) are reliable and valid. These criteria cover the most common types of TMD, which include pain-related disorders (e.g., myalgia, headache attributable to TMD...

  19. Bruxism in Movement Disorders: A Comprehensive Review.

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    Ella, Bruno; Ghorayeb, Imad; Burbaud, Pierre; Guehl, Dominique

    2016-04-14

    Bruxism is an abnormal repetitive movement disorder characterized by jaw clenching and tooth gnashing or grinding. It is classified into two overlapping types: awake bruxism (AB) and sleep bruxism (SB). Theories on factors causing bruxism are a matter of controversy, but a line of evidence suggests that it may to some extent be linked to basal ganglia dysfunction although so far, this topic has received little attention. The purpose of this article was to review cases of bruxism reported in various movement disorders. The biomedical literature was searched for publications reporting the association of bruxism with various types of movement disorders. As a whole, very few series were found, and most papers corresponded to clinical reports. In Parkinsonian syndromes, AB was rarely reported, but seems to be exacerbated by medical treatment, whereas SB is mainly observed during non-REM sleep, as in restless leg syndrome. AB is occasionally reported in Huntington's disease, primary dystonia, and secondary dystonia; however, its highest incidence and severity is reported in syndromes combining stereotypies and cognitive impairment, such as Rett's syndrome (97%), Down syndrome (42%), and autistic spectrum disorders (32%). Taken as a whole, AB seems to be more frequent in hyperkinetic movement disorders, notably those with stereotypies, and is influenced by anxiety, suggesting an involvement of the limbic part of the basal ganglia in its pathophysiology.

  20. Computerized occlusal analysis in bruxism

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    Lazić Vojkan; Todorović Aleksandar; Živković Slavoljub; Martinović Željko

    2006-01-01

    Introduction. Sleep bruxism as nocturnal parafunction, also known as tooth grinding, is the most common parasomnia (sleep disorder). Most tooth grinding occurs during rapid eye movement - REM sleep. Sleep bruxism is an oral habit characterized by rhythmic activity of the masticatory muscles (m. masseter) that causes forced contact between dental surfaces during sleep. Sleep bruxism has been associated with craniomandibular disorders including temporomandibular joint discomfort, pulpalgia, pre...

  1. Etiology of temporomandibular disorder pain.

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    Oral, Koray; Bal Küçük, Burcu; Ebeoğlu, Buğçe; Dinçer, Sibel

    2009-07-01

    Pain in the masticatory muscles and temporomandibular joint is the main symptom of temporomandibular disorders. The etiology of temporomandibular disorder pain is multifactorial. Several studies have reported that there are predisposing, initiating and aggravating factors contributing to this disorder. Although factors such as trauma, occlusal discrepancies, stress, parafunctions, hypermobility, age, gender, and heredity have been implicated in the maintenance of temporomandibular disorder pain, there are still controversies regarding the actual etiology. This review will summarize the past and current concepts related to the etiology of arthrogenic- and myogenic-originated temporomandibular pain.

  2. Prevalence of signs and symptoms of temporomandibular disorders and their association with young university students

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    Renata Cunha Matheus Rodrigues Garcia

    2008-01-01

    Full Text Available Objective: To verify the prevalence of signs and symptoms of temporomandibular disorder and their association with joint noise, joint hypermobility, occlusal interference, orthodontic treatment and bruxism in a specific population composed of young university students. Methods: One hundred and seventeen (117 volunteers (mean age of 22 years were selected from the undergraduate course in Dentistry at the School of Dentistry of the “Centro Universitário Hermínio Ometto” (Araras, São Paulo, Brazil. The volunteers answered a questionnaire and were submitted to clinical and electrovibratography exams. Afterwards, the volunteers were classified as either having temporomandibular disorder or not, considering the presence of painful sensitivity in the temporomandibular joint and/or presence of joint noise. The prevalenceof the studied factors was calculated together with the association between each factor, and the presence of temporomandibular disorderwas analyzed by the Chi-square test. Results: The prevalence of temporomandibular disorder in the evaluated sample was 42.9% and significant association was found between temporomandibular disorder and joint noise (p<0.05; and between temporomandibular disorder and bruxism (p<0.05. Conclusion: The results suggest that patients with presence of precisely diagnosed bruxism and joint noise should be monitored with regard to the appearance of signs and symptoms of temporomandibular disorder.

  3. Temporomandibular joint disorders.

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    Buescher, Jennifer J

    2007-11-15

    Temporomandibular joint disorders are common in adults; as many as one third of adults report having one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint. Most symptoms improve without treatment, but various noninvasive therapies may reduce pain for patients who have not experienced relief from self-care therapies. Physical therapy modalities (e.g., iontophoresis, phonophoresis), psychological therapies (e.g., cognitive behavior therapy), relaxation techniques, and complementary therapies (e.g., acupuncture, hypnosis) are all used for the treatment of temporomandibular joint disorders; however, no therapies have been shown to be uniformly superior for the treatment of pain or oral dysfunction. Noninvasive therapies should be attempted before pursuing invasive, permanent, or semi-permanent treatments that have the potential to cause irreparable harm. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy.

  4. Features of temporomandibular disorders in fibromyalgia syndrome.

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    Pimentel, Marcele Jardim; Gui, Maisa Soares; Martins de Aquino, Luana Maria; Rizzatti-Barbosa, Célia Marisa

    2013-01-01

    This study aimed to investigate the prevalence of clinical features of temporomandibular disorders (TMD) in patients with fibromyalgia. The test group (FMG) consisted of 40 women with fibromyalgia (FM) compared to the control group of 40 healthy subjects using the research diagnostic criteria for temporomandibular disorders (RDC/TMD). The variables were compared using Fisher's exact test and a Mann-Whitney test. Facial pain was reported by 85% of the FM group, and 77.5% were diagnosed with myofascial TMD. Muscle pain during jaw movements, daytime bruxism/clenching, and limited mouth opening were significantly higher in the test group. There was no difference between groups in: (1) joint noises; (2) sleep bruxism/clenching; and (3) excursive or non-excursive movements. Classic signs of TMD, such as joint noise and self-reporting of clenching at night, are not associated with fibromyalgia syndrome as demonstrated in the current study. However, the self-reported daytime parafunctions, muscle pain in jaw movements, and limited mouth opening are features of the patients in the current study. This study revealed specific muscle involvement of TMD is also presence in FM.

  5. Temporomandibular Disorders and Parafunctional Habits in Children and Adolescence: A Review

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    B. Seraj

    2009-03-01

    Full Text Available The aim of this study is to review the existing literature about temporomandibular disorders(TMD and parafunctional habits (bruxism and their relationship in children and adolescents,which is still controversial. TMD is a collective term used to identify a group ofmusculoskeletal conditions of the temporomandibular region. Bruxism defined as the habitual nonfunctional forceful contact between occlusal tooth surfaces. Some studies have linked oral parafunctional habits to TMD, whereas others did not observe this relationship.The role of bruxism -as is currently described- can be considered a controversial and unresolved issue. Taking all evidence together, the authors suggest that there is not any clear relationship between bruxism and TMD.

  6. Etiology of temporomandibular disorders.

    Science.gov (United States)

    Greene, C S

    1995-12-01

    This article discusses the subject of causation (etiology) as it has been applied to the field of temporomandibular disorders (TMD). These disorders have been the focus of considerable disagreement about what constitutes proper diagnosis and treatment, and it is clear that the main basis for these controversies has been conflicting views about the etiology of the various disorders. Many earlier theories emphasized dental morphological factors of malocclusion, occlusal dysharmony, and bad mandibular alignment as being primarily responsible for the development of TMD symptoms. Certain versions of these dental/skeletal concepts have long been a part of the belief system of the orthodontic specialty, leading to some special orthodontic protocols for managing TM disorders. Today, it is generally agreed that the etiology of TM disorders includes a multifactorial combination of physical and psychosocial factors, with some of them being either poorly understood or difficult to assess. In most cases, there are no special occlusal or orthodontic factors to be considered, and therefore occlusion-changing procedures are not generally required for successful treatment. This means that contemporary orthodontists must face the same challenge as all their other dental colleagues: to learn about modern concepts of diagnosis and treatment for all types of orofacial pain patients, and then to use currently recommended protocols for pain management and musculoskeletal therapy for those patients who have temporomandibular disorders.

  7. Temporomandibular disorders and occlusion.

    Science.gov (United States)

    Badel, Tomislav; Marotti, Miljenko; Pavicin, Ivana Savić; Basić-Kes, Vanja

    2012-09-01

    Occlusion has an important place within the multifactorial concept of the temporomandibular disorder (TMD) etiopathogenesis as well as in every form of dental treatment. The modern concept of treatment of these disorders differentiates initial and definitive forms of treatment. The aim of this paper is to analyze recent viewpoints on the role of occlusion in the etiopathogenesis and treatment ofTMDs. Masticatory muscles and temporomandibular joints are directly connected with occlusal relations and TMDs are traditionally linked with occlusal disorders. The initial occlusal treatment can be applied to all TMD patients, regardless of their having intact teeth with respect to physiological occlusal relations and in patients in need of orthodontic or prosthodontic treatment or an oral surgical procedure. On managing TMD patients, there are doubts about the indications for definitive treatment and whether there has been a possibility of treating a painful TMD by reversible treatment modalities, that is, by initial treatment. Other types of orofacial pain such as trigeminal neuralgia can be comorbid with TMDs but also result in unnecessary procedures on the teeth and prosthodontic work if they are not recognized. Although dental profession mainly recognizes the importance of occlusal treatment of TMD problems, their relationship is controversial because it is not strictly demonstrated in numerous scientific studies. Occlusion is not the dominant cause of TMD problems.

  8. Bruxism and Current Treatment Approaches

    Directory of Open Access Journals (Sweden)

    Selin Eren

    2016-06-01

    Full Text Available Among the mastication system disorders bruxism is a parafunctional behavior that comes from psychophysiological origin. Epidemiologic studies have reported great variability of bruxism prevalence. The factors that could cause bruxism is highly controversial. There are different opinions on this issue. The etiologic factors of bruxism include stress, malnutrition, allergic and endocrinologic diseases, central nervous system disorders, genetic factors, medicines, malocclusion, and wrong dental treatment. The aim of treatment of bruxism is to prevent damage that may occur on teeth and in the temporomandibular joint and to eliminate pain. Dental treatment, physical therapy, pharmacological treatment and behavioral and cognitive therapy can be considered for this purpose of treatment. This review summarizes the etiologic factors, epidemiology, diagnosis, and current treatment approaches of patient with bruxism. [Archives Medical Review Journal 2016; 25(2.000: 241-258

  9. BRUXISM, PERLUKAH DIRAWAT? (TINJAUAN PUSTAKA

    Directory of Open Access Journals (Sweden)

    Laura Susanti Himawan

    2015-08-01

    Full Text Available Every dentist knows about bruxism. However, the etiology, the treatment, and the relationship between bruxism and temporomandibular disorders (TMD are still unknown and controversional. Bruxism can happen to all ages, from children (15% of all children to adults (96% of all adults, male and female. Given the data, what can a dentist do to help the patient with bruxism? The various clinical signs that can be found in these patients are excessive tooth wear, muscle and joint fatigue, headache, tooth sensitivity or mobility, fractures of teeth and restorations, as well as TMD symptoms. Currently no method can permanently eliminate bruxism, but there are several ways to help patients with symptoms caused by parafunctions. Two categories of bruxism are bruxism withous symptoms and bruxism with symptoms that lead to temporomandibular disorders. To make the patient aware of the destructive parafunctional activities, self-monitoring, biofeedback, medications, occlusal adjustment and fabricating a splint can reduce the unfavorable consequences of bruxism. Although they usually do not stop it. Periodical control is advisable.

  10. Clinical Aspects of Temporomandibular Disorders

    OpenAIRE

    2000-01-01

    Temporomandibular disorders are common problems in populations presenting signs and symptoms of muscle and joint pain on palpation, limitations in mandibular motion, joint sounds, pain and locking on mandibular function as well as dental, periodontal, occlusal and psychosocial variables. Problems that involve the temporomandibular joint and related structures include myofacial pain-dysfunction, various internal disarrangements of the joint space and degenerative joint diseases. T...

  11. Parafunctional habits are associated cumulatively to painful temporomandibular disorders in adolescents.

    Science.gov (United States)

    Fernandes, Giovana; Franco-Micheloni, Ana Lúcia; Siqueira, José Tadeu Tesseroli; Gonçalves, Daniela Aparecida Godói; Camparis, Cinara Maria

    2016-01-01

    This cross-sectional study was designed to evaluate the effect of sleep bruxism, awake bruxism and parafunctional habits, both separately and cumulatively, on the likelihood of adolescents to present painful TMD. The study was conducted on a sample of 1,094 adolescents (aged 12-14). The presence of painful TMD was assessed using the Research Diagnostic Criteria for Temporomandibular Disorders, Axis I. Data on sleep bruxism, awake bruxism and parafunctional habits (nail/pen/pencil/lip/cheek biting, resting one's head on one's hand, and gum chewing) were researched by self-report. After adjusting for potential demographic confounders using logistic regression, each of the predictor variables (sleep bruxism, awake bruxism and parafunctional habits) was significantly associated with painful TMD. In addition, the odds for painful TMD were higher in the concomitant presence of two (OR=4.6, [95%CI=2.06, 10.37]) or three predictor (OR=13.7, [95%CI=5.72, 32.96]) variables. These findings indicate that the presence of concomitant muscle activities during sleep and awake bruxism and parafunctional habits increases the likelihood almost linearly of adolescents to present painful TMD.

  12. Parafunctional habits are associated cumulatively to painful temporomandibular disorders in adolescents

    Directory of Open Access Journals (Sweden)

    Giovana FERNANDES

    2016-01-01

    Full Text Available Abstract This cross-sectional study was designed to evaluate the effect of sleep bruxism, awake bruxism and parafunctional habits, both separately and cumulatively, on the likelihood of adolescents to present painful TMD. The study was conducted on a sample of 1,094 adolescents (aged 12-14. The presence of painful TMD was assessed using the Research Diagnostic Criteria for Temporomandibular Disorders, Axis I. Data on sleep bruxism, awake bruxism and parafunctional habits (nail/pen/pencil/lip/cheek biting, resting one’s head on one’s hand, and gum chewing were researched by self-report. After adjusting for potential demographic confounders using logistic regression, each of the predictor variables (sleep bruxism, awake bruxism and parafunctional habits was significantly associated with painful TMD. In addition, the odds for painful TMD were higher in the concomitant presence of two (OR=4.6, [95%CI=2.06, 10.37] or three predictor (OR=13.7, [95%CI=5.72, 32.96] variables. These findings indicate that the presence of concomitant muscle activities during sleep and awake bruxism and parafunctional habits increases the likelihood almost linearly of adolescents to present painful TMD.

  13. Temporomandibular joint disorders in children.

    Science.gov (United States)

    Howard, James A

    2013-01-01

    A child's difficulty in verbalizing the precise location and nature of facial pain and jaw dysfunction often results in a nondefinitive history, increasing the importance of the dentist's awareness of the early signs and symptoms of temporomandibular joint disorders (TMD). A focused examination of the masticatory musculature, the temporomandibular joints, and associated capsular and ligamentous structures can reveal if a patient's symptoms are TMD in origin. An accurate differential diagnosis enables timely referral to appropriate health care providers and minimizes the use of diagnostic imaging.

  14. Oral habits of temporomandibular disorder patients with malocclusion.

    Science.gov (United States)

    Fujita, Yukie; Motegi, Etsuko; Nomura, Mayumi; Kawamura, Sakura; Yamaguchi, Daisuke; Yamaguchi, Hideharu

    2003-11-01

    The purpose of this study was to clarify the relationship between oral habits and symptoms of temporomandibular joint disorder in patients who had sought orthodontic treatment by analyzing their present and past history. The subjects were 57 female patients (average age: 23 years and 6 months old) who had visited the "Temporomandibular Disorder Section" in our orthodontic department. Their chief complaints were the symptom of TMJ and the abnormalities of occlusion such as maxillary protrusion, open bite, crowding, mandibular protrusion, cross bite, deep bite, edge-to-edge bite, and spacing. Their present conditions and past histories were examined and evaluated. The most typical primary symptom was joint sound (23 patients, 40.0%). The second was joint sound and pain (15 patients, 26.3%). Of the symptoms present at the time of examination, the most prevalent were joint sound and pain (20 patients, 35.1%). The 48 patients (82.8%) had significant oral habits. Unilateral chewing was seen in 35 patients (72.9%), bruxism in 27 (56.3%), abnormality of posture in 14 (29.2%), habitual crunching in 10 (20.8%) and resting the check on the hand in 4 (8.3%), respectively. When comparing the primary symptoms to those at the time of examination, the patients with unilateral chewing and bruxism tended to have more complicated symptoms. In conclusion, the TMD symptoms of the patients with notable oral habits did not change or become worse during a period of about 5 years.

  15. [Course of action in front of children or adolescent suffering from temporomandibular disorders].

    Science.gov (United States)

    Robin, Olivier

    2013-03-01

    Temporomandibular disorders are described in children from the age of 4. Their prevalence and severity increase strongly during the second decade, which corresponds to the period of orthodontic treatments. At this age the most common symptoms are joint clicking sounds (more than 70% of the cases), sometimes accompanied by episodes of intermittent locking. They would be favored by oral parafunctional activities (gum chewing, biting habits, bruxism...), ligamentous hyperlaxity and modification of the intra-articular space relations during growth. The questioning of the patient and his parents and clinical examination (muscular, articular and occlusal) are essential and very often sufficient for establishing the diagnosis. Even more than in the adult, the therapeutic attitude must rely on conservative and non-irreversible methods (explanations, suppression of the parafunctions, occlusal splints in the case of severe bruxism). These considerations are illustrated by the presentation of two representative clinical cases of temporomandibular disorders frequently encountered in children and adolescents.

  16. Facial pain and temporomandibular disorders

    OpenAIRE

    2002-01-01

    Abstract The study was undertaken to determine the prevalence of facial pain and the association of facial pain with temporomandibular disorders (TMD) as well as with other factors, in a geographically defined population-based sample consisting of subjects born in 1966 in northern Finland, and in a case-control study including subjects with facial pain and their healthy controls. In addition, the influence of conservative stomatognathic and necessary prosthetic treatme...

  17. Temporomandibular disorders after whiplash injury

    DEFF Research Database (Denmark)

    Kasch, Helge; Hjorth, Tine; Svensson, Peter

    2002-01-01

    patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Methods: Prospectively, 19 acute whiplash patients exposed......Aims: Whiplash injury to the neck, is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies however have examined TMD-related pain in acute whiplash...... diagnostic criteria. Participants underwent structured interviews, filled out the McGill Pain Questionnaire (MPQ), and bad their masticatory system examined by a trained dentist, blinded to their diagnosis. Pain detection threshold (PDT) to pressure stimuli, and maximal voluntary occlusal force (MVOF) were...

  18. Bruxism: A Literature Review

    Science.gov (United States)

    Reddy, S Varalakshmi; Kumar, M Praveen; Sravanthi, D; Mohsin, Abdul Habeeb Bin; Anuhya, V

    2014-01-01

    Parafunctional activities associated with the stomatognathic system include lip and cheek chewing, nail biting, and teeth clenching. Bruxism can be classified as awake or sleep bruxism. Patients with sleep bruxism are more likely to experience jaw pain and limitation of movement, than people who do not experience sleep bruxism. Faulty occlusion is one of the most common causes of bruxism that further leads to temporomandibular joint pain. Bruxism has been described in various ways by different authors. This article gives a review of the literature on bruxism since its first description. PMID:25628497

  19. Temporomandibular Disorders and Physical Therapy Approaches

    Directory of Open Access Journals (Sweden)

    ilke Coskun Benlidayi

    2015-12-01

    Full Text Available Temporomandibular disorders are comprised of clinical problems associated with masticatory muscles, temporomandibular joint and neighboring tissues. The frequency of temporomandibular disorders is high among premenopausal women. Patient education and behavioral therapy, occlusal splints, pharmacological agents, intra-articular and surgical approaches and physical therapy methods are used in the treatment of temporomandibular disorders. Physical therapy approaches include exercise (passive stretching, resistive and posture exercises, superficial heat and cold applications, transcutaneous electrical nerve stimulation, therapeutic ultrasound, trigger point injections, acupuncture and laser. In this article, temporomandibular disorders were reviewed and physical therapy methods used for treatment were discussed in detail. [Archives Medical Review Journal 2015; 24(4.000: 542-554

  20. Temporomandibular disorders and declarative memory.

    Science.gov (United States)

    Yang, Dongmei; Ye, Ling

    2011-05-01

    Temporomandibular disorder (TMD) is a somatic manifestation of stress. Previous researches suggested hypothalamic-pituitary-adrenal (HPA) axis hyperactivity in TMD, through which TMD patients exhibited abnormalities of the stress response hormone - causing additional cortisol release. Increased cortisol, the principal circulating glucocorticoid in humans, would impair memory retrieval of declarative material. This effect on memory retrieval may in particular be due to glucocorticoid receptors (GR) in the hippocampus. The hypothesis we proposed is that TMD might result in declarative memory impairment by increasing the cortisol.

  1. Temporomandibular Joint Disorders and Orofacial Pain.

    Science.gov (United States)

    Ahmad, Mansur; Schiffman, Eric L

    2016-01-01

    Temporomandibular disorders (TMD) affect 5% to 12% of the United States population. This article discusses common conditions related to temporomandibular joints, including disc displacements, inflammatory disturbances, loose joint bodies, traumatic disturbances, and developmental conditions. Also addressed are the appropriate imaging modalities and diagnostic criteria for TMD.

  2. Primary headaches interfere with the efficacy of temporomandibular disorders management

    Directory of Open Access Journals (Sweden)

    André Luís PORPORATTI

    2015-04-01

    Full Text Available OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache (PH on efficacy of a Temporomandibular Disorders (TMD conservative therapy and its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I Muscular TMD (n=64; II Muscular TMD+PH (n=48; III Muscular TMD+Articular TMD (n=173; IV Muscular TMD+Articular TMD+PH (n=115. All groups had undergone a TMD therapy for three months with a stabilization appliance and counseling for habits and behavioral changes, with no specific headache management. Current pain intensity and existence or not of self-reported bruxism were assessed. Repeated measures ANOVA and Chi-Square test followed by Odds were used for statistical analysis, with a significance level of 5%. RESULTS: results of this study showed that: (1 A conservative therapy with stabilization appliance and counseling for habits and behavioral changes was effective in the TMD pain relief; (2 Groups with an additional diagnosis of PH had worsened the pain improvement significantly; and (3 no association between the presence of self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD management.

  3. Oral parafunctions as temporomandibular disorder risk factors in children.

    Science.gov (United States)

    Widmalm, S E; Christiansen, R L; Gunn, S M

    1995-10-01

    Oral parafunctions are generally considered to be important factors in the etiology of temporomandibular disorders (TMDs) and many reports have been published about their prevalence in adults and schoolchildren. However, few have included significant numbers of children below the age of 7. The aim of this study was to examine the association between parafunctions and oral/facial TMD-related pain in preschool children. Bruxism, nail biting, and thumb sucking were found to be significantly associated with important oral/facial pain symptoms of clinical interest in the diagnoses of TMD indicating that those parafunctions are risk factors. The study included 525 4- to 6-year-old African-American and Caucasian children, mean age 5.1 +/- 0.65 (SD). An alpha level of 5% was chosen for comparison with a Pearson Chi-Square test. Bonferroni correction was made and a p-value of sucking was reported by 57% of the children, more often by Caucasian girls (69%) than by Caucasian boys (43%) (p habit. Forty-one percent had a history of nail biting. Bruxism was noted in 20% of the children, but occurred mostly in combination with other parafunctions and was seldom (in 3.4%) the only parafunction. Of the 10 pain variables, bruxism was significantly associated with eight, thumb sucking with three, and nail biting with two. Analysis with logistic regression confirmed the results. Association does not, however, tell if a parafunction is the cause or the consequence of pain, or if a third factor is causing both pain and increased prevalence of oral parafunctions. Further prospective longitudinal studies including higher age groups are needed to clarify those relations and to determine if there are long-term effects of childhood parafunctions.

  4. RADIOGRAPHIC EXAMINATION OF TEMPOROMANDIBULAR DISORDERS IN CHILDREN

    OpenAIRE

    Heru Suryonegoro

    2015-01-01

    The temporomandibular joint has a very important role in the stomatognathic system. Its main function is for the opening and closing movement, mastication, and speech. It is located anterior to the ear. The temporomandibular joint connects maxilla and mandible through the articular fossa, hence the slightest change that happens would cause serious matters such as pain, exiting, speech disorder, difficulty in opening and closing movement, headache, and even trismus. In a child or an adolescent...

  5. Gnathological splint therapy in temporomandibular joint disorder

    OpenAIRE

    Gnanashanmugham, K.; Saravanan, B.; Sukumar, M. R.; T Faisal Tajir

    2015-01-01

    Temporomandibular joint (TMJ) forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD) is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic...

  6. Modem view on etiology and treatment of temporomandibular disorder

    OpenAIRE

    K. Yu. Galebskaya

    2015-01-01

    The review is dedicated to the interrelationship between temporomandibular disorder and such factors as malocclusion, teeth alteration, dynamic occlusal factors, orthodontic treatment, position of heads of mandibular relative to glenoid fossa. Some aspects of temporomandibular disorder treatment are also discussed.

  7. Prevalence of signs and symptoms of temporomandibular disorders in children and adolescents with and without crossbites.

    Science.gov (United States)

    Tecco, Simona; Festa, Felice

    2010-01-01

    This study investigated the prevalence of signs and symptoms of temporomandibular disorders (TMD) in 1,134 orthodontically untreated children and adolescents (593 boys, 541 girls; age range 5 to 15 years) with and without crossbites. The sample with crossbites was further grouped according to the type (anterior, posterior, unilateral, or bilateral). The TMD symptoms bruxism (obvious active attrition/myalgia), joint sounds (clicking/crepitation), deviation during opening, reduced functional movements (maximum opening Temporomandibular Disorders) and compared among the various groups. Girls had a significantly higher prevalence of myopain than boys (x(2)=3.882, P<.05). Furthermore, individuals with posterior unilateral crossbites showed a significantly higher prevalence of TMD symptoms (x(2)=33.877, P<.001) and reduced functional movements (x2 = 10.800, P<.05) than any other group. In conclusion, sex and type of crossbite play a role in the prevalence of TMD signs and symptoms.

  8. RADIOGRAPHIC EXAMINATION OF TEMPOROMANDIBULAR DISORDERS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Heru Suryonegoro

    2015-06-01

    Full Text Available The temporomandibular joint has a very important role in the stomatognathic system. Its main function is for the opening and closing movement, mastication, and speech. It is located anterior to the ear. The temporomandibular joint connects maxilla and mandible through the articular fossa, hence the slightest change that happens would cause serious matters such as pain, exiting, speech disorder, difficulty in opening and closing movement, headache, and even trismus. In a child or an adolescent, the symptoms are often vague; everything is interpreted as “pain”. This is probably why temporomandibular disorder are often undetected by dentists. Therefore, patience and accuracy is needed to determine the actual disorder through means of clinical and radiographic examination. The radiographic examination suitable for child is the transcranial projection. This projection is believed to be more accurate amongst other projection for child patients.

  9. Temporomandibular dysfunction and headache disorder.

    Science.gov (United States)

    Speciali, José G; Dach, Fabíola

    2015-02-01

    It has been well established that primary headaches (especially migraine, chronic migraine, and tension-type headache) and temporomandibular dysfunction (TMD) are comorbid diseases, with the presence of one of them in a patient increasing the prevalence of the others. The relationship between the 2 diseases may involve the sharing of common physiopathological aspects. Studies about the treatment of this disease association have shown that a simultaneous therapeutic approach to the 2 diseases is more effective than the separate treatment of each. As a consequence, specialists in orofacial pain are now required to know the criteria for the diagnosis of headaches, and headache physicians are required to know the semiologic aspects of orofacial pain. Nevertheless, a headache may be attributed to TMD, instead be an association of 2 problems - TMD and primary headaches - in these cases a secondary headache, described in item 11.7 of the International Classification of Headache Disorders, is still a controversial topic. Attempts to determine the existence of this secondary headache with a specific or suggestive phenotype have been frustrated. The conclusion that can be reached based on the few studies published thus far is that this headache has a preferential unilateral or bilateral temporal location and migraine-like or tension-type headache-like clinical characteristics. In the present review, we will consider the main aspects of the TMD-headache relationship, that is, comorbidity of primary headaches and TMD and clinical aspects of the headaches attributed to TMD from the viewpoint of the International Headache Society and of a group of specialists in orofacial pain. This paper aims to explore our understanding of the association between TMD and headaches in general and migraine in particular.

  10. Is bruxism a disorder or a behaviour? Rethinking the international consensus on defining and grading of bruxism.

    Science.gov (United States)

    Raphael, K G; Santiago, V; Lobbezoo, F

    2016-10-01

    Inspired by the international consensus on defining and grading of bruxism (Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ et al. J Oral Rehabil. 2013;40:2), this commentary examines its contribution and underlying assumptions for defining sleep bruxism (SB). The consensus' parsimonious redefinition of bruxism as a behaviour is an advance, but we explore an implied question: might SB be more than behaviour? Behaviours do not inherently require clinical treatment, making the consensus-proposed 'diagnostic grading system' inappropriate. However, diagnostic grading might be useful, if SB were considered a disorder. Therefore, to fully appreciate the contribution of the consensus statement, we first consider standards and evidence for determining whether SB is a disorder characterised by harmful dysfunction or a risk factor increasing probability of a disorder. Second, the strengths and weaknesses of the consensus statement's proposed 'diagnostic grading system' are examined. The strongest evidence-to-date does not support SB as disorder as implied by 'diagnosis'. Behaviour alone is not diagnosed; disorders are. Considered even as a grading system of behaviour, the proposed system is weakened by poor sensitivity of self-report for direct polysomnographic (PSG)-classified SB and poor associations between clinical judgments of SB and portable PSG; reliance on dichotomised reports; and failure to consider SB behaviour on a continuum, measurable and definable through valid behavioural observation. To date, evidence for validity of self-report or clinician report in placing SB behaviour on a continuum is lacking, raising concerns about their potential utility in any bruxism behavioural grading system, and handicapping future study of whether SB may be a useful risk factor for, or itself a disorder requiring treatment.

  11. Development of temporomandibular disorder symptoms: a 3-year cohort study of university students.

    Science.gov (United States)

    Akhter, R; Morita, M; Esaki, M; Nakamura, K; Kanehira, T

    2011-06-01

    The aims of this study were to examine the incidence of temporomandibular disorders (TMDs) over a 3-year period and to evaluate the risk of self-reported TMDs among university students in Japan. The study population comprised 2374 university students examined at the start of their undergraduate course and 492 students re-examined after 3 years using questionnaires on symptoms of TMD and experiences of jaw injury, stress, orthodontic treatment and parafunctional habits. Cumulative incidence (%) and relative risks were calculated overall. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the degree of risks of these variables for symptoms of TMDs using logistic regression. Results of logistic regression analysis showed that male subjects with experience of jaw injury had a 3·54 (CI=1·45-8·68, Pstress and bruxism had 10·56 (CI=1·28-87·54, Pstress or bruxism. The results indicated that experiences of jaw injury, stress and bruxism were significantly associated with increased risks of development of TMJ disorders in a 3-year cohort.

  12. Epidemiology, diagnosis, and treatment of temporomandibular disorders.

    Science.gov (United States)

    Liu, Frederick; Steinkeler, Andrew

    2013-07-01

    Temporomandibular disorder (TMD) is a multifactorial disease process caused by muscle hyperfunction or parafunction, traumatic injuries, hormonal influences, and articular changes. Symptoms of TMD include decreased mandibular range of motion, muscle and joint pain, joint crepitus, and functional limitation or deviation of jaw opening. Only after failure of noninvasive options should more invasive and nonreversible treatments be initiated. Treatment can be divided into noninvasive, minimally invasive, and invasive options. Temporomandibular joint replacement is reserved for severely damaged joints with end-stage disease that has failed all other more conservative treatment modalities.

  13. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Susan Armijo-Olivo

    2012-09-01

    Full Text Available Objectives: The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods: A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance to determine cervical musculoskeletal impairments. Results: A strong relationship between neck disability and jaw disability was found (r = 0.82. Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD and healthy subjects. However, the difference was too small (3.3º to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07. However, clinically important effect sizes (0.42 - 0.82 were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions: Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders.

  14. Temporomandibular joint remodeling for the treatment of temporomandibular joint disorders: a clinical case study

    OpenAIRE

    Wurgaft, R; Wong, RWK

    2009-01-01

    Introduction: The author (R. Wurgaft) has tried a unique way of splint therapy in the treatment of temporomandibular disorder. An orthopedic splint that only contact in the posterior occlusion, actually only the most distal contacts, is designed to distalize the mandible, and in turn to produce tissue remodeling of the temporomandibular joint. With this technique, it is possible to treat temporomandibular disorders in both adults and children by producing tissue remodeling. Method: Two clinic...

  15. Oral Health, Temporomandibular Disorder, and Masticatory Performance in Patients with Charcot-Marie-Tooth Type 2

    Directory of Open Access Journals (Sweden)

    Rejane L. S. Rezende

    2013-01-01

    Full Text Available Background. The aim of this study was to evaluate the oral health status of temporomandibular disorders (TMD and bruxism, as well as to measure masticatory performance of subjects with Charcot-Marie-Tooth type 2 (CMT2. Methods and Results. The average number of decayed, missing, and filled teeth (DMFT for both groups, control (CG and CMT2, was considered low (CG = 2.46; CMT2 = 1.85, P=0.227. The OHIP-14 score was considered low (CG = 2.86, CMT2 = 5.83, P=0.899. The prevalence of self-reported TMD was 33.3% and 38.9% (P=0.718 in CG and CMT2 respectively and for self-reported bruxism was 4.8% (CG and 22.2% (CMT2, without significant difference between groups (P=0.162. The most common clinical sign of TMD was masseter (CG = 38.1%; CMT2 = 66.7% and temporalis (CG = 19.0%; GCMT2 = 33.3% muscle pain. The geometric mean diameter (GMD was not significantly different between groups (CG = 4369; CMT2 = 4627, P=0.157. Conclusion. We conclude that the CMT2 disease did not negatively have influence either on oral health status in the presence and severity of TMD and bruxism or on masticatory performance.

  16. Influence of Occlusal Interference on the Prevalence of Temporomandibular Disorders

    OpenAIRE

    Ćelić, R.; Pandurić, J.; Badel, T.; Kraljević, S.; Dulčić, N.

    2002-01-01

    The significance of occlusal interference in the etiology of temporomandibular disorders has been questioned in numerous recent articles. The aim of this study was to determine the prevalence of the clinical signs and symptoms of temporomandibular disorders in a young male nonpatient population and to investigate a possible association between the signs and symptoms of temporomandibular disorders and occlusal interference. A questionnaire including data from history and clinical functional ...

  17. Gnathological splint therapy in temporomandibular joint disorder

    Directory of Open Access Journals (Sweden)

    K Gnanashanmugham

    2015-01-01

    Full Text Available Temporomandibular joint (TMJ forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences. This article presents a case report of a patient with TMD caused by occlusal discrepancy

  18. Gnathological splint therapy in temporomandibular joint disorder

    Science.gov (United States)

    Gnanashanmugham, K.; Saravanan, B.; Sukumar, M. R.; Tajir, T. Faisal

    2015-01-01

    Temporomandibular joint (TMJ) forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD) is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences). This article presents a case report of a patient with TMD caused by occlusal discrepancy PMID:26015741

  19. Gnathological splint therapy in temporomandibular joint disorder.

    Science.gov (United States)

    Gnanashanmugham, K; Saravanan, B; Sukumar, M R; Tajir, T Faisal

    2015-04-01

    Temporomandibular joint (TMJ) forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD) is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences). This article presents a case report of a patient with TMD caused by occlusal discrepancy.

  20. Temporomandibular disorders: the habitual chewing side syndrome.

    Directory of Open Access Journals (Sweden)

    Urbano Santana-Mora

    Full Text Available BACKGROUND: Temporomandibular disorders are the most common cause of chronic orofacial pain, but, except where they occur subsequent to trauma, their cause remains unknown. This cross-sectional study assessed chewing function (habitual chewing side and the differences of the chewing side and condylar path and lateral anterior guidance angles in participants with chronic unilateral temporomandibular disorder. This is the preliminary report of a randomized trial that aimed to test the effect of a new occlusal adjustment therapy. METHODS: The masticatory function of 21 randomly selected completely dentate participants with chronic temporomandibular disorders (all but one with unilateral symptoms was assessed by observing them eat almonds, inspecting the lateral horizontal movement of the jaw, with kinesiography, and by means of interview. The condylar path in the sagittal plane and the lateral anterior guidance angles with respect to the Frankfort horizontal plane in the frontal plane were measured on both sides in each individual. RESULTS: Sixteen of 20 participants with unilateral symptoms chewed on the affected side; the concordance (Fisher's exact test, P = .003 and the concordance-symmetry level (Kappa coefficient κ = 0.689; 95% confidence interval [CI], 0.38 to 0.99; P = .002 were significant. The mean condylar path angle was steeper (53.47(10.88 degrees versus 46.16(7.25 degrees; P = .001, and the mean lateral anterior guidance angle was flatter (41.63(13.35 degrees versus 48.32(9.53 degrees P = .036 on the symptomatic side. DISCUSSION: The results of this study support the use of a new term based on etiology, "habitual chewing side syndrome", instead of the nonspecific symptom-based "temporomandibular joint disorders"; this denomination is characterized in adults by a steeper condylar path, flatter lateral anterior guidance, and habitual chewing on the symptomatic side.

  1. CRITICAL APPRAISAL. Sleep Bruxism and Sleep-Disordered Breathing.

    Science.gov (United States)

    Bender, Steven D

    2016-01-01

    Sleep bruxism (SB) is a repetitive jaw muscle activity with clenching or grinding of the teeth during sleep. SB is characterized by what is known as rhythmic masticatory muscle activity (RMMA). RMMA is the laboratory polysomnographic finding that differentiates SB from other oromandibular movements seen during sleep. Most often RMMA episodes are associated with sleep arousal. Some patients will report similar complaints related to both SB and sleep disordered breathing (SDB). There are some reports that would suggest that SB is a result of SDB. It has has been postulated that SB is a compensatory mechanism to re establish muscle tone of the upper airway. While these disorders do in fact often present concomitantly, the relationship between the two is yet to be fully elucidated. This Critical Appraisal reviews 3 recent publications with the intent to better define what relationships may exists between SDB and SB. While the current evidence appears to support the notion that these are often concomitant disorders, it also makes clear that evidence to support the hypothesis that SDB is causative for SB is currently lacking.

  2. Temporomandibular disorders and hormones in women.

    Science.gov (United States)

    Warren, M P; Fried, J L

    2001-01-01

    Temporomandibular disorders (TMD) are loosely defined as an assorted set of clinical conditions, characterized by pain and dysfunction of the masticatory system. Pain in the masticatory muscles, in the temporomandibular joint (TMJ), and in associated hard and soft tissues, limitation in jaw function, and sounds in the TMJ are common symptoms. That women make up the majority of patients treated for TMD is extensively hypothesized and documented in numerous epidemiological studies. Certain contradictory studies exist which propose that there are no statistically significant gender differences in the actual incidence of changes in joint morphology. Nonetheless, extensive literature suggests the disorder is 1.5-2 times more prevalent in women than in men, and that 80% of patients treated for TMD are women. The severity of symptoms is also related to the age of the patients. Pain onset tends to occur after puberty, and peaks in the reproductive years, with the highest prevalence occurring in women aged 20-40, and the lowest among children, adolescents, and the elderly. The gender and age distribution of TMD suggests a possible link between its pathogenesis and the female hormonal axis. In this review, we will use the hypothesis that the overwhelming majority of patients treated for temporomandibular disorders are women and use the available literature to examine the role of hormones in TMD.

  3. Bruxism and Current Treatment Approaches

    OpenAIRE

    Selin Eren; Humeyra Kocaelli Arikan; Cuneyt Tamam; Cetin Kasapoglu

    2016-01-01

    Among the mastication system disorders bruxism is a parafunctional behavior that comes from psychophysiological origin. Epidemiologic studies have reported great variability of bruxism prevalence. The factors that could cause bruxism is highly controversial. There are different opinions on this issue. The etiologic factors of bruxism include stress, malnutrition, allergic and endocrinologic diseases, central nervous system disorders, genetic factors, medicines, malocclusion, and wrong dental ...

  4. Morphological causes of temporomandibular joint disorder

    Energy Technology Data Exchange (ETDEWEB)

    Yotsui, Yoritaka [Osaka Dental Univ., Hirakata (Japan)

    1997-06-01

    I investigated the contribution of temporomandibular joint (TMJ) morphology to the development of temporomandibular joint disorder (TMD) in a retrospective study of the MR images of TMD patients and individuals free of clinical TMD symptoms. I examined retrospectively the axial MR images of 397 patients with clinical diagnosis of TMD, using 550 individuals without clinical symptoms as controls. The distance between the bilateral mandibular heads, and the horizontal angulation of the mandibular heads were measured for each subject. The average horizontal angulation of the mandibular heads in the TMD group was 20.1deg in males and 18.4deg in females, while the average in the controls was 18.2deg and 19.3deg, respectively. The average distance between the bilateral mandibular heads was 102.8 mm in males and 97.4 mm in females for the TMD group, compared with 106.6 mm and 101.8 mm for the controls, respectively. There was no statistical significance between the horizontal angulation and the distance between the bilateral heads at any age. However, there was a statistical difference of 100 mm in males and 95 mm in females for the distance between the bilateral heads of the TMD group and the controls. These results indicate that this factor may be useful in discriminating between normal individuals and those with TMD, and further suggest that a narrow distance between the bilateral heads rather than horizontal angulation may contribute to the etiology of temporomandibular joint disorder. (author)

  5. Diagnosis and treatment of temporomandibular disorders.

    Science.gov (United States)

    Gauer, Robert L; Semidey, Michael J

    2015-03-15

    Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, and surrounding musculature and osseous components. TMD affects up to 15% of adults, with a peak incidence at 20 to 40 years of age. TMD is classified as intra-articular or extra-articular. Common symptoms include jaw pain or dysfunction, earache, headache, and facial pain. The etiology of TMD is multifactorial and includes biologic, environmental, social, emotional, and cognitive triggers. Diagnosis is most often based on history and physical examination. Diagnostic imaging may be beneficial when malocclusion or intra-articular abnormalities are suspected. Most patients improve with a combination of noninvasive therapies, including patient education, self-care, cognitive behavior therapy, pharmacotherapy, physical therapy, and occlusal devices. Nonsteroidal anti-inflammatory drugs and muscle relaxants are recommended initially, and benzodiazepines or antidepressants may be added for chronic cases. Referral to an oral and maxillofacial surgeon is indicated for refractory cases.

  6. Factors involved in the etiology of temporomandibular disorders - a literature review

    Science.gov (United States)

    CHISNOIU, ANDREA MARIA; PICOS, ALINA MONICA; POPA, SEVER; CHISNOIU, PETRE DANIEL; LASCU, LIANA; PICOS, ANDREI; CHISNOIU, RADU

    2015-01-01

    Background and aim This review aims at presenting a current view on the most frequent factors involved in the mechanisms causing temporomandibular disorders (TMD). Method We conducted a critical review of the literature for the period January 2000 to December 2014 to identify factors related to TMD development and persistence. Results The etiology of TMD is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. Occlusal overloading and parafunctions (bruxism) are frequently involved as biomechanical factors; increased levels of estrogen hormones are considered biological factors affecting the temporo-mandibular-joint. Among bio-psychosocial factors, stress, anxiety or depression, were frequently encountered. Conclusions The etiopathogenesis of this condition is poorly understood, therefore TMDs are difficult to diagnose and manage. Early and correct identification of the possible etiologic factors will enable the appropriate treatment scheme application in order to reduce or eliminate TMDs debilitating signs and symptoms. PMID:26732121

  7. Myogenous temporomandibular disorders: diagnostic and management considerations.

    Science.gov (United States)

    Fricton, James

    2007-01-01

    Myogenous temporomandibular disorders (or masticatory myalgia) are characterized by pain and dysfunction that arise from pathologic and functional processes in the masticatory muscles. There are several distinct muscle disorder subtypes in the masticatory system, including myofascial pain, myositis, muscle spasm, and muscle contracture. The major characteristics of masticatory myalgia include pain, muscle tenderness, limited range of motion, and other symptoms (eg, fatigability, stiffness, subjective weakness). Comorbid conditions and complicating factors also are common and are discussed. Management follows with stretching, posture, and relaxation exercises, physical therapy, reduction of contributing factors, and as necessary, muscle injections.

  8. Diagnostic criteria for headache attributed to temporomandibular disorders

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas;

    2012-01-01

    We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD).......We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD)....

  9. Modem view on etiology and treatment of temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    K. Yu. Galebskaya

    2015-01-01

    Full Text Available The review is dedicated to the interrelationship between temporomandibular disorder and such factors as malocclusion, teeth alteration, dynamic occlusal factors, orthodontic treatment, position of heads of mandibular relative to glenoid fossa. Some aspects of temporomandibular disorder treatment are also discussed.

  10. Vertical Craniofacial Morphology and its Relation to Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Paula Furlan Bavia

    2016-06-01

    Full Text Available Objectives: This study investigated the association between craniofacial morphology and temporomandibular disorders in adults. The influence of different craniofacial morphologies on painful temporomandibular disorders was also evaluated. Material and Methods: A total of 200 subjects were selected, including 100 with temporomandibular disorders (TMD and 100 without TMD (control, diagnosed by research diagnostic criteria for temporomandibular disorders. All subjects were submitted to lateral cephalometric radiographs, and classified as brachyfacial, mesofacial, or dolichofacial by Ricketts’ analysis. Data were analysed by Tukey-Kramer and Chi-square tests. Results: No association between craniofacial morphology and TMD was found (P = 0.6622. However, brachyfacial morphology influences the presence of painful TMD (P = 0.0077. Conclusions: Craniofacial morphology is not related to temporomandibular disorders in general.

  11. Sleep bruxism: Current knowledge and contemporary management.

    Science.gov (United States)

    Yap, Adrian U; Chua, Ai Ping

    2016-01-01

    Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that "cures" or "stops" SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief.

  12. A Case of Bruxism-Induced Otalgia.

    Science.gov (United States)

    Kim, Se-Hyung

    2016-09-01

    Here, the author presents a case of bruxism-induced otalgia in a 29-year-old female patient. The pain was sharp and penetrating in character. It was usually worse in the morning and frequently radiated to the right temporal area. She had received unsuccessful medical treatments for migraine headache. The otoendoscopic examination revealed a normal tympanic membrane. A thorough inspection of her teeth revealed excessive wear on the incisal edges, and the cause of her otalgia was identified as bruxism-related temporomandibular joint disorder. After the use of an occlusal splint and repeated botulinum toxin injections in the masseter and anterior temporalis muscles, along with good sleep hygiene, she experienced significant relief of pain and symptoms. The author suggests that multidisciplinary cooperation between ENT clinicians and dentists is necessary for the quick and accurate diagnosis and treatment of bruxism and the consequential referred otalgia.

  13. Sleep bruxism: Current knowledge and contemporary management

    Directory of Open Access Journals (Sweden)

    Adrian U.J. Yap

    2016-01-01

    Full Text Available Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB. Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors and not peripherally (morphological factors. Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that “cures” or “stops” SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief.

  14. Sleep bruxism: Current knowledge and contemporary management

    Science.gov (United States)

    Yap, Adrian U.; Chua, Ai Ping

    2016-01-01

    Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that “cures” or “stops” SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief. PMID:27656052

  15. Orthodontics and temporomandibular disorders: a curriculum proposal for postgraduate programs.

    Science.gov (United States)

    Greene, Charles S; Stockstill, John; Rinchuse, Donald; Kandasamy, Sanjivan

    2012-07-01

    In a previous article, we reported the results of a survey of American and Canadian orthodontic postgraduate programs to determine how the topics of occlusion, temporomandibular joint, and temporomandibular disorders were currently being taught. Based on the finding of considerable diversity among those programs, we decided to write a curriculum proposal for temporomandibular disorders that would be compatible with and satisfy the current curriculum guidelines for postgraduate orthodontic programs. These guidelines arose from a combination of the requirements published by the American Dental Association's Commission on Dental Accreditation and the written guide (July 2010) of the American Board of Orthodontics for the its clinical examination. The proposed curriculum, based on the latest scientific evidence in the temporomandibular disorder field, gives program directors a template for covering these subjects thoroughly. At the same time, they can focus on related orthodontic issues, so that their future graduates will be prepared to deal with patients who either have or later develop temporomandibular disorder problems.

  16. Current Treatments of Bruxism

    OpenAIRE

    Guaita, Marc; Högl, Birgit

    2016-01-01

    Opinion statement Despite numerous case reports, the evidence for treatment of bruxism is still low. Different treatment modalities (behavioral techniques, intraoral devices, medications, and contingent electrical stimulation) have been applied. A clinical evaluation is needed to differentiate between awake bruxism and sleep bruxism and rule out any medical disorder or medication that could be behind its appearance (secondary bruxism). A polysomnography is required only in a few cases of slee...

  17. Imaging Approach to Temporomandibular Joint Disorders.

    Science.gov (United States)

    Morales, H; Cornelius, R

    2016-03-01

    Internal derangement is the most common temporomandibular joint disorder. Degenerative osteoarthritis and trauma are next in frequency. Less common pathology includes rheumatoid arthritis, synovial chondromatosis, calcium pyrophosphate dehydrate deposition disease, pigmented villonodular synovitis, tumors, infection, and osteonecrosis. We provide a systematic approach to facilitate interpretation based on major anatomic structures: disc-attachments, joint space, condyle, and lateral pterygoid muscle. Relevant graphic anatomy and state of the art imaging are discussed in correlation with current clinical and therapeutic highlights of pathologic entities affecting the joint.

  18. Speech evaluation in children with temporomandibular disorders

    OpenAIRE

    Raquel Aparecida Pizolato; Frederico Silva de Freitas Fernandes; Maria Beatriz Duarte Gavião

    2011-01-01

    OBJECTIVE: The aims of this study were to evaluate the influence of temporomandibular disorders (TMD) on speech in children, and to verify the influence of occlusal characteristics. MATERIAL AND METHODS: Speech and dental occlusal characteristics were assessed in 152 Brazilian children (78 boys and 74 girls), aged 8 to 12 (mean age 10.05 ± 1.39 years) with or without TMD signs and symptoms. The clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) (axis I) and...

  19. Computerized occlusal analysis in bruxism

    Directory of Open Access Journals (Sweden)

    Lazić Vojkan

    2006-01-01

    Full Text Available Introduction. Sleep bruxism as nocturnal parafunction, also known as tooth grinding, is the most common parasomnia (sleep disorder. Most tooth grinding occurs during rapid eye movement - REM sleep. Sleep bruxism is an oral habit characterized by rhythmic activity of the masticatory muscles (m. masseter that causes forced contact between dental surfaces during sleep. Sleep bruxism has been associated with craniomandibular disorders including temporomandibular joint discomfort, pulpalgia, premature loss of teeth due to excessive attrition and mobility, headache, muscle ache, sleep interruption of an individual and problems with removable and fixed denture. Basically, two groups of etiological factors can be distinguished, viz., peripheral (occlusal factors and central (pathophysiological and psychological factors. The role of occlusion (occlusal discrepancies as the causative factor is not enough mentioned in relation to bruxism. Objective. The main objective of this paper was to evaluate the connection between occlusal factors and nocturnal parafunctional activities (occlusal disharmonies and bruxism. Method. Two groups were formed- experimental of 15 persons with signs and symptoms of nocturnal parafunctional activity of mandible (mean age 26.6 years and control of 42 persons with no signs and symptoms of bruxism (mean age 26.3 yrs.. The computerized occlusal analyses were performed using the T-Scan II system (Tekscan, Boston, USA. 2D occlusograms were analyzed showing the occlusal force, the center of the occlusal force with the trajectory and the number of antagonistic tooth contacts. Results. Statistically significant difference of force distribution was found between the left and the right side of the arch (L%-R% (t=2.773; p<0.02 in the group with bruxism. The difference of the centre of occlusal force - COF trajectory between the experimental and control group was not significant, but the trajectory of COF was longer in the group of

  20. Temporomandibular disorders in the medical practice.

    Science.gov (United States)

    Okeson, J P; de Kanter, R J

    1996-10-01

    Patients suffering with various orofacial pain conditions are likely to seek advice and treatment from a family physician. Temporomandibular disorders (TMD) are common in the general population, and the clinician should be aware of the common associated signs and symptoms so that proper therapy can be provided. The family physician can often provide initial therapies that are effective in reducing TMD symptoms. In some instances, it is appropriate for the family physician to refer the patient to a dentist for a more comprehensive evaluation of the masticatory system. This article describes the common patient complaints associated with TM disorders. A few simple therapies are discussed along with suggestions regarding the appropriate time for referral to a dentist for a thorough dental evaluation.

  1. The role of orthodontics in temporomandibular disorders.

    Science.gov (United States)

    Michelotti, A; Iodice, G

    2010-05-01

    Temporomandibular Disorder (TMD) is the main cause of pain of non-dental origin in the oro-facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD-related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible association between malocclusion, orthodontic treatment and TMD.

  2. Clinical signs indicative of temporomandibular disorders in adults: time trends and associated factors.

    Science.gov (United States)

    Köhler, Alkisti Anastassaki; Hugoson, Anders; Magnusson, Tomas

    2013-01-01

    The study aimed to examine possible time trends in the prevalence of clinical signs indicative of temporomandibular disorder (TMD) in an adult population, to analyse possible associations between TMD signs and associated factors and to estimate the need for TMD treatment. Three independent, stratified and randomly selected samples of around 100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years participated in the Jönköping studies in 1983,1993 and 2003. The study material consisted of 1,693 subjects who, after answering a questionnaire and being interviewed about the presence of TMD symptoms, were clinically examined in terms of the presence of TMD signs according to the Clinical Dysfunction Index (Di) by Helkimo. Associations between clinical signs and the Di as dependent variables and each of the independent variables of age group, gender, reported bruxism, trauma, self-perceived healthiness and the year of investigation were analysed in binary logistic regression models. Estimates of the need for TMD treatment were based on the presence of a combination of severe symptoms and clinical signs. The prevalence of severely impaired jaw movement capacity, relating to horizontal movements, had increased in 2003. The prevalence of muscle pain and temporomandibular joint pain upon posterior palpation was found to vary statistically significantly between 1993 and 2003. Gender differences were noted in these changes overtime. Female gender, advancing age, awareness of bruxism, self-perceived health impairment and the wearing of complete dentures were associated with TMD signs and a higher degree of clinical dysfunction. The estimated need for TMD treatment increased from 5% in 1983 to 8% in 2003 and was higher in women than in men. In conclusion, the results indicate that the prevalence of some TMD signs and of estimated treatment need increased during the period 1983-2003.

  3. Personality traits and temporomandibular disorders in a group of children with bruxing behaviour.

    Science.gov (United States)

    Restrepo, C C; Vásquez, L M; Alvarez, M; Valencia, I

    2008-08-01

    The aim of the present study was to compare the personality pattern, the anxiety level and the temporomandibular disorders (TMD) between bruxist and non-bruxist children with mixed dentition. Fifty-two subjects, with a mean age of 9.45 years (range 8-11) were evaluated and classified as bruxist (n = 26), according to the American Academy of Sleep Medicine (AASM) and the presence of dental wear clinically visible, under the same conditions of artificial light and position. The control children (n = 26) did not present dental wear and did not accomplished all the AASM criteria. The personality pattern and the anxiety of the bruxist children were studied by means of the Children's Personality Questionnaire (CPQ) and the Conners' Parents Rating Scales (CPRS), respectively, and compared with the personality traits and the anxiety level of a non-bruxist population. The TMD were also evaluated using the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) criteria. The data were analysed with the student's t-test, Fisher's exact test and chi-squared tests. A multivariated analysis was performed using a logistic regression with the stepwise likelihood ratio method. Compared with the controls, the bruxist children had significantly higher tension personality and were more anxiety prone. The bruxist children presented more TMD-related signs and symptoms than children in the control group. A strong correlation was found among bruxism, TMD, the high anxiety level and the high tension personality trait.

  4. Assessment of the relationship between stress and temporomandibular joint disorder in female students before university entrance exam (Konkour exam

    Directory of Open Access Journals (Sweden)

    Ahmad Mottaghi

    2011-01-01

    Conclusion: The parallel increase of temporomandibular disorders and anxiety between the two stages can suggest a possible relationship between anxiety and temporomandibular disorders. Therefore, the effect of anxiety in triggering temporomandibular disorder symptoms is probable.

  5. Oral splint for temporomandibular joint disorders with revolutionary fluid system

    OpenAIRE

    2013-01-01

    Temporomandibular joint (TMJ) diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD)...

  6. Temporomandibular disorders and functional somatic syndromes: Deliberations for the dentist

    OpenAIRE

    Suma, S; B Veerendra Kumar

    2012-01-01

    Temporomandibular disorder (TMD) is an umbrella term for a collection of disorders affecting the temporomandibular joint (TMJ) and associated tissues. TMD is not a rare pathology for the dentist. The most common presenting symptom is pain, which causes the patient seek immediate treatment. Management is dictated by the cause. The most ′famed′ causes include trauma, inflammation, aging, parafunctional habits, infections, neoplasms, and stress; and these are always considered in the differentia...

  7. Effects of sleep bruxism on functional and occlusal parameters: a prospective controlled investigation

    Science.gov (United States)

    Alicia Ommerborn, Michelle; Giraki, Maria; Schneider, Christine; Michael Fuck, Lars; Handschel, Jörg; Franz, Matthias; Hans-Michael Raab, Wolfgang; Schäfer, Ralf

    2012-01-01

    This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm (s.d., 0.69 mm) in the sleep bruxism group and a mean slide of 0.4 mm (s.d., 0.57 mm) in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects (Mann–Whitney U-test; P=0.008). However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However, as the literature reveals a possible association between bruxism and certain subgroups of temporomandibular disorders, it appears advisable to incorporate the individual adaptive capacity of the stomatognathic system into future investigations. PMID:22935746

  8. Study of the relationship of psychosocial disorders to bruxism in adolescents

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    Katayoun E

    2008-12-01

    Full Text Available Background and Aim: Bruxism has been defined as a diurnal or nocturnal parafunctional habit. Etiology of bruxism has remained controversial and some investigators believe that psychological factors may play a major role in promoting and perpetuating this habit. The aim of this case-control study was to assess the existence of an association between bruxism and psychosocial disorders in adolescents., Participants were chosen among 114, 12-14 year old students (girls. They were divided into two groups, bruxers and nonbruxers, on the basis of both validated clinical criteria and interview with each patient. A few participants were excluded on the basis of presence of systemic disorders, TMJ disorders, other oral habits, primary teeth, defective restorations and premature contacts. Following matching of two groups in regard to parent′s age and education, mother′s marital status, child support status, mother′s employment status, and socio-economical status, 25 cases and 25 controls were enlisted. A self report validated questionnaire (YSR, 11-18 yr was then filled out by both groups for the evaluation of 12 psychosocial symptoms. Results: Remarkable differences in certain psychosocial aspects were found between the two groups. Prevalence of psychosocial disorders including Thought Disorders (P < 0.005, Conduct Disorders (P < 0.05, Antisocial Disorders (P < 0.06 as identified by YSR was significantly higher in bruxers. Significant differences between the two groups also emerged in total YSR scores (P < 0.005. The results of Odds Ratio revealed that a bruxer adolescent has 16 times greater probability for psychosocial disorders than a non-bruxer one. Fischer exact test and T-test were used and Odds Ratio and Confidence Interval was estimated. Conclusion: Support to the existence of an association between bruxism and psychosocial disorders has been provided.

  9. Differential diagnosis of temporomandibular disorders and other orofacial pain disorders.

    Science.gov (United States)

    Okeson, Jeffrey P; de Leeuw, Reny

    2011-01-01

    There are many types of pain conditions that are felt in the orofacial structures. Most of the conditions treated by the dentist are associated with the teeth, periodontal structures, and associated mucosal tissues. This article focuses on the differential diagnosis of other common pain conditions the dentist will likely face, such as temporomandibular disorders, neuropathic pain disorders, and common headaches; and the clinical presentation of each. Controlling or reducing pain can be accomplished by controlling perpetuating factors such as parafunctional habits and by some simple behavioral modifications. Finally, this article offers some simple treatment considerations.

  10. Masticatory function and temporomandibular disorders in patients with dentofacial deformities.

    Science.gov (United States)

    Abrahamsson, Cecilia

    2013-01-01

    About 30% of individuals in the Swedish population will at some stage during life have treatment with orthodontic appliances. In more severe cases, when orthodontic treatment is not considered sufficient enough to correct the malocclusion, the orthodontic treatment is combined with orthognathic surgery. For these cases, a satisfying jaw relation is achieved by surgically moving the maxilla and/or the mandible into a pre-planned position. Patients due to be treated with orthognathic surgery often suffer from an impaired masticatory function, symptoms from the masticatory muscles or temporomandibular joints (temporomandibular disorders), headaches as well as dissatisfaction with their facial aesthetics. Since orthognathic treatment is expensive, in many cases arduous to the patient and not without complications, it is important to assess the treatment outcome and if this is satisfying for the patients. Previous studies that have examined the outcome after orthognathic treatment have had diverging study designs and have come to different conclusions with regard to both temporomandibular disorders and masticatory function. The overall aim of this thesis was to assess and compare the frequencies of temporomandibular disorders and the masticatory function in patients with dentofacial deformities before and after orthognathic treatment. THE THESIS IS BASED ON THE FOLLOWING STUDIES: Paper I is a systematic literature review aiming to, in an evidence-based approach, answer the question whether orthognathic treatment affects the prevalence of signs and symptoms of temporomandibular disorders. The review encompasses the period from January 1966 to April 2006 and was further extended to May 2013 in the frame story of this thesis. CONCLUSIONS IN PAPER I AND THE COMPLEMENTARY SURVEY: There is insufficient scientific evidence for a decrease of sub diagnoses of temporomandibular disorders after orthognathic treatment. There is limited scientific evidence for a reduction of

  11. Current panorama of temporomandibular disorders' field in Brazil

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    Naila Aparecida de Godoi MACHADO

    2014-06-01

    Full Text Available In 2012, the recognition of the specialty of Temporomandibular Disorders and Orofacial Pain completed ten years. Given this scenario, it is extremely important to track the current situation of this field of knowledge in Brazil, specifically in the area of research and training. We hope to discuss the importance of the recognition of this specialty and the inclusion of these subjects in undergraduate programs in Dentistry. Objective: The objective of this study is to perform a bibliometric survey of researches regarding Temporomandibular Disorders and Orofacial Pain conducted in the country, determine the number of specialization courses in Orofacial Pain and the number of specialists in the field. Methods: The bibliometric survey was conducted based on the Dissertations Portal of Coordination for the Improvement of Higher education Personnel (CAPES and on PubMed. The panorama of the field of Orofacial Pain and Temporomandibular disorders in Brazil was determined by searching on the website of the Brazilian Council of Dentistry. Results: We found 731 theses and dissertations with Temporomandibular Disorders and Orofacial Pain as the main subjects; 81 accredited/recognized Courses on Orofacial Pain and Temporomandibular Dysfunction completed; 8 accredited/recognized Specialization Courses on Orofacial Pain and Temporomandibular Dysfunction still in progress, and 1,064 registered specialists in Orofacial Pain and Temporomandibular Dysfunction in the Brazilian Council of Dentistry. Search in the PUBMED database yielded 576 articles published with the participation of Brazilian researchers as first authors and/or co-authors in the period from 2000 to 2013. From this amount, only 5 were published in Portuguese, while all the others were published in english. We can also notice that the number of published articles increases over time. Conclusion: The number of researches related to temporomandibular disorders has increased over the last ten years, as

  12. Mouse genetic models for temporomandibular joint development and disorders.

    Science.gov (United States)

    Suzuki, A; Iwata, J

    2016-01-01

    The temporomandibular joint (TMJ) is a synovial joint essential for hinge and sliding movements of the mammalian jaw. Temporomandibular joint disorders (TMD) are dysregulations of the muscles or the TMJ in structure, function, and physiology, and result in pain, limited mandibular mobility, and TMJ noise and clicking. Although approximately 40-70% adults in the USA have at least one sign of TMD, the etiology of TMD remains largely unknown. Here, we highlight recent advances in our understanding of TMD in mouse models.

  13. Mouse genetic models for temporomandibular joint development and disorders

    OpenAIRE

    Suzuki, A.; Iwata, J.

    2015-01-01

    The temporomandibular joint (TMJ) is a synovial joint essential for hinge and sliding movements of the mammalian jaw. Temporomandibular joint disorders (TMD) are dysregulations of the muscles or the TMJ in structure, function, and physiology, and result in pain, limited mandibular mobility, and TMJ noise and clicking. Although approximately 40–70% adults in the USA have at least one sign of TMD, the etiology of TMD remains largely unknown. Here, we highlight recent advances in our understandi...

  14. Speech evaluation in children with temporomandibular disorders

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    Raquel Aparecida Pizolato

    2011-10-01

    Full Text Available OBJECTIVE: The aims of this study were to evaluate the influence of temporomandibular disorders (TMD on speech in children, and to verify the influence of occlusal characteristics. MATERIAL AND METHODS: Speech and dental occlusal characteristics were assessed in 152 Brazilian children (78 boys and 74 girls, aged 8 to 12 (mean age 10.05 ± 1.39 years with or without TMD signs and symptoms. The clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD (axis I and the symptoms were evaluated using a questionnaire. The following groups were formed: Group TMD (n=40, TMD signs and symptoms (Group S and S, n=68, TMD signs or symptoms (Group S or S, n=33, and without signs and symptoms (Group N, n=11. Articulatory speech disorders were diagnosed during spontaneous speech and repetition of the words using the "Phonological Assessment of Child Speech" for the Portuguese language. It was also applied a list of 40 phonological balanced words, read by the speech pathologist and repeated by the children. Data were analyzed by descriptive statistics, Fisher's exact or Chi-square tests (α=0.05. RESULTS: A slight prevalence of articulatory disturbances, such as substitutions, omissions and distortions of the sibilants /s/ and /z/, and no deviations in jaw lateral movements were observed. Reduction of vertical amplitude was found in 10 children, the prevalence being greater in TMD signs and symptoms children than in the normal children. The tongue protrusion in phonemes /t/, /d/, /n/, /l/ and frontal lips in phonemes /s/ and /z/ were the most prevalent visual alterations. There was a high percentage of dental occlusal alterations. CONCLUSIONS: There was no association between TMD and speech disorders. Occlusal alterations may be factors of influence, allowing distortions and frontal lisp in phonemes /s/ and /z/ and inadequate tongue position in phonemes /t/; /d/; /n/; /l/.

  15. Association between otalgia, tinnitus, vertigo and hypoacusia, with temporomandibular disorders

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    Francisco Guedes Pereira de Alencar Junior

    2009-01-01

    Full Text Available Because nonespecific symptoms and signs are associated with others well-established in the temporomandibular disorders, it is difficult for the clinician to decide what symptoms and signs should be considered during the diagnosis and the treatment plan. Therefore, the aim of this literature review was to evaluate the prevalence of aural symptoms (otalgias, tinnitus, dizziness and deafness in patients with orofacial pain. Although several hypotheses have been proposed to explain the association between aural symptoms and temporomandibular disorders, the results of the previous studies differed in magnitude. For this reason, it is difficult to establish the prevalence of these aural symptoms concomitantly with temporomandibular disorders. Moreover, such relationship does not necessarily imply a cause-effect relationship. Because of the diagnosis complexity, different treatments must be considered, so the nonespecific symptoms of temporomandibular disorders can be effectively controlled as well. It is crucial for the the clinician to be aware of the possible etiology of aural symptoms, so he should determine if such symptoms may be associated with temporomandibular disorders and thus include them in the treatment.

  16. Review: Psychological intervention in temporomandibular disorders.

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    Pamela Araneda

    2013-08-01

    Full Text Available Patients with temporomandibular disorders (TMD frecuently present psychological and psychiatric problems. These patients often show increased somatization, depression, anxiety, stress reaction and catastrophism, wich plays a role in the predisposition, initiation and perpetuation of TMD and treatment response. This review presents thaerapeutic options that compromise the psychological axis of patients with TMD, wich primarily seek to reduce the anxiety and the emotional stress present, modify different perceptions of pain and coping. There are different posibilities, within wich are: patient education, identifying situations that increase the tension to avoid them, teaching relaxation techniques such as biofeedback, hipnosis and yoga. As for psychological treatment, the most common for chronic orofacial pain is cognitive behavioral therapy (CBT. The appropriate and effective psychological intervention can reduce TMD pain, decreasing the probability that the symptoms become more complex. Within psychological treatment options for TMD, conservative standard treatment (education, self-instruction, avoidance of painful movements, soft diet, even the shortest, may be sufficient in the short term for most patients with TMD, especially in cases of acute conditions. The addition of CBT, by a specialist, gives coping skills that will add to the effectiveness, especially in chronic cases, obtaining better results in the long term.

  17. Pseudodynamic MR imaging of temporomandibular joint disorders

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    Nakasato, Tatsuhiko; Ehara, Shigeru (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1992-09-01

    Magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) has now been established as a procedure of choice in the evaluation of TMJ disorders. In this study, we evaluated the dynamics of TMJ motion on MR imaging, which resembles arthrography. Sixty-eight TMJs in 38 symptomatic patients and one healthy volunteer were examined using pseudodynamic images with gradient echo sequences using a 0.5 Tesla MR unit and 8 cm circular planar surface coil. For depiction of each compartment of the meniscus, the optimum sequence was 200/15/2 (TR/TE/excitations) with 50 deg or 60 deg flip angle in gradient refocused acquisition in steady-state (GRASS) sequences. Three contiguous slices on sagittal MR images were routinely obtained at 14-18 different phases of the opening cycle and displayed in closed-loop cine fashion. Internal derangement was observed in 57% of 68 joints. The most common type was anterior meniscal displacement without reduction. Sideway and rotational displacements, observed in 10% each, were noted on both sagittal multislice images and axial reference images. As a pseudodynamic MR technique, jaw movement specifically designed to check bite procedure to adjust splints is useful for detecting the exact time of meniscal redisplacement on the second click. After conservative therapy for arthrosis, pseudodynamic MR provided information on changes in the meniscus and condylar relationship. Pseudodynamic MR with multiple phases is suitable for evaluating subtle motion abnormality of the meniscus and for post-therapeutic monitoring. (author).

  18. Epidemiology and natural progression of articular temporomandibular disorders

    NARCIS (Netherlands)

    deBont, LGM; Dijkgraaf, LC; Stegenga, B

    1997-01-01

    The reported prevalence of temporomandibular disorders (TMDs) differs from study to study, probably because of methodologic errors and lack of standardized definitions of TMDs and their characteristics. Classification of TMDs should be in accordance with classification of synovial joint disorders as

  19. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

    NARCIS (Netherlands)

    Peck, C.C.; Goulet, J-P; Lobbezoo, F.; Schiffman, E.L.; Alstergren, P.; Anderson, G.C.; De Leeuw, R.; Jensen, R.; Michelotti, A.; Ohrbach, R.; Petersson, A.; List, T.

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for

  20. Risk Factors for Temporomandibular Disorders in Older Adults

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    Rogelio Cabo García

    2016-04-01

    Full Text Available There are various risk factors for temporomandibular disorders in older patients. Consequently, a detailed analysis of each case should be performed in order to assess the possible concomitance of some of them, giving greater importance to the potential etiologic factor and paying attention to the lasting and aggravating factors. This literature review aims to update the information on risk factors for temporomandibular disorders in older adults. A literature search was performed using specialized search engines and descriptors related to the topic. It was concluded that psychological factors favor the development of chronic orofacial pain in older patients and reduce their capacity to rehabilitate. Occlusion, as the cause of temporomandibular disorders, presents itself in different ways in each patient. It is convenient to consider occlusal conditions from the static and dynamic point of view, before discarding occlusion as a triggering factor.

  1. Perceived pain and temporomandibular disorders in neuromuscular diseases.

    Science.gov (United States)

    Fischer, Michael J; Riedlinger, Kathrin; Schoser, Benedikt; Bernateck, Michael

    2009-10-01

    Little is known about pain associated with temporomandibular disorders (TMD) in neuromuscular diseases. Inpatients (N = 134) with neuromuscular disorder diagnoses were given questionnaires to estimate pain localization and intensity. Research Diagnostic Criteria for Temporomandibular Disorders and the Temporomandibular Index (TMI) were utilized to assess TMD. Pain was reported by 116 patients (86%). Legs (52%) and arms (33%) were the most common locations for pain localization, but the highest Pearson correlations (TMI vs. perceived pain) appeared for pain located in the trunk and arms (0.861, P < 0.01). No correlation between TMI and diagnosis group existed except for "acquired myopathy" and "miscellaneous neuromuscular diseases." These results suggest that the degree of TMD does not correlate with pain according to disease, although common mechanisms might be responsible for pain development in specific body regions connected with TMD. Most important, higher levels of TMD are associated with higher levels of perceived pain.

  2. Global body posture evaluation in patients with temporomandibular joint disorder

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    Eliza Tiemi Saito

    2009-01-01

    Full Text Available AIM: To identify the relationship between anterior disc displacement and global posture (plantar arches, lower limbs, shoulder and pelvic girdle, vertebral spine, head and mandibles. Common signs and symptoms of anterior disc displacement were also identified. INTRODUCTION: Global posture deviations cause body adaptation and realignment, which may interfere with the organization and function of the temporomandibular joint. METHODS: Global posture evaluation was performed in a group of 10 female patients (20 to 30 years of age with temporomandibular joint disc displacement and in a control group of 16 healthy female volunteers matched for age, weight and height. Anterior disc displacement signs, symptoms and the presence of parafunctional habits were also identified through interview. RESULTS: Patients with disc displacement showed a higher incidence of pain in the temporomandibular joint area, but there were no differences in parafunctional habits between the groups. In the disc displacement group, postural deviations were found in the pelvis (posterior rotation, lumbar spine (hyperlordosis, thoracic spine (rectification, head (deviation to the right and mandibles (deviation to the left with open mouth. There were no differences in the longitudinal plantar arches between the groups. CONCLUSION: Our results suggest a close relationship between body posture and temporomandibular disorder, though it is not possible to determine whether postural deviations are the cause or the result of the disorder. Hence, postural evaluation could be an important component in the overall approach to providing accurate prevention and treatment in the management of patients with temporomandibular disorder.

  3. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescent girls.

    Science.gov (United States)

    Gavish, A; Halachmi, M; Winocur, E; Gazit, E

    2000-01-01

    A group of 248 randomly selected high school girls, aged 15-16 years, completed a questionnaire and were examined clinically with regard to various oral habits and signs and symptoms of temporomandibular disorders (TMD). Common habits reported in the literature, such as gum chewing, nail biting, biting foreign objects, clenching and bruxism, eating seeds and crushing ice, as well as two less reported habits, 'jaw play' and continuous arm leaning, were evaluated. The most outstanding finding was the high prevalence and intensity of gum chewing among our study group: 92% of the girls chewed daily and 48% chewed gum for more than 3 h a day (intensive gum chewing). Statistically significant associations were found between intensive gum chewing and muscle sensitivity (P<0.001) and joint noises (P<0. 05), and between crushing ice and muscle sensitivity to palpation (P<0.005). A positive association was found between 'jaw play' and joint disturbances: reported joint noises (P<0.01), catching of the joint (P<0.01) and joint tension (P<0.001). A positive association was also found between arm leaning and reported joint noises (P<0. 05), catching (P<0.05), and joint tension (P<0.005). There was no association between the presence of bruxism and muscle sensitivity to palpation or joint disturbances. The potential harmful effects of intensive gum chewing, 'jaw play', continuous arm leaning and ice crushing are presented in this study. In light of these findings, the professional community should address these habits with proper data gathering, examination and consultation.

  4. The Prevalence of Bruxism and Correlated Factors in Children Referred to Dental Schools of Tehran, Based on Parent's Report

    Science.gov (United States)

    Seraj, Bahman; Shahrabi, Mehdi; Ghadimi, Sara; Ahmadi, Rahil; Nikfarjam, Jaleh; Zayeri, Farid; Taghi, Fatemeh Pour; Zare, Hadi

    2010-01-01

    Objective Bruxism is defined as the habitual nonfunctional forceful contact between occlusal tooth surfaces. The aim of this study was to determine the prevalence of bruxism and correlated factors in children referred to dental schools of Tehran, based on Parent's report. Methods This cross-sectional descriptive study was conducted on 600 4-12 year-old children with a mean age of 7.4±2.4 years, who were referred to four dental schools in Tehran. After collecting information with questionnaire filled out by parents, χ2, Fisher Test, Mann-Whitney and t-Test were used to analyze the data. Findings The prevalence of bruxism was 26.2%. Bruxism begun in average at the age of 4.9±2 years. Also it occurred 2.6 times more in children who had a family history of bruxism (father-mother), compared to children who didn't have such a history. 87% of children with bruxism had a history of distressing events in their life, and 13% of children with bruxism did not report any history of distressing events in their life. In this study most common oral habit was nail biting. In study of parasomnias, drooling was the most, and snoring the least reported sleep disorder. Bruxism in children with drooling was twice more than in other children. The prevalence of bruxism in children with temporomandibular disorder was 63.6% and in children without TMD was 24.7%. Conclusion Based on Parent's report, 26.2% of children showed bruxism and there was a significant relation between bruxism and mother's job, family history, distressing event in life, parasomnias, especially drooling and sleep walking, TMD, hyperactivity, depression, acrophobia and lygophobia. PMID:23056700

  5. Diagnosis of temporomandibular joint disorders: indication of imaging exams

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    Luciano Ambrosio Ferreira

    Full Text Available ABSTRACT INTRODUCTION: Knowledge of the different imaging tests and their appropriate indications is crucial to establish the diagnosis of temporomandibular disorders, especially in patients with overlapping signs and symptoms. OBJECTIVE: To present and assess the main diagnostic imaging tests for temporomandibular disorders and rationally discuss their indication criteria, advantages, and disadvantages. METHODS: Literature review in the Web of Knowledge, PubMed and SciELO databases, as well as manual search for relevant publications in reference lists of the selected articles. RESULTS: Computed tomography and magnetic resonance imaging were considered the gold standard assessments for the temporomandibular joint to evaluate hard and soft tissues, respectively. Each diagnostic method exhibited distinct sensitivity and specificity for the different subtypes of joint dysfunction. CONCLUSION: Selecting an evaluation examination based on its accuracy, safety, and clinical relevance is a rational decision that can help lead to an accurate diagnosis and an optimum treatment plan.

  6. Evaluating the effect of the temporomandibular disorder treatment over tinnitus

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    Webster, Guilherme

    2011-07-01

    Full Text Available Introduction: The interaction between tinnitus and temporomandibular disorders is a very complex issue that has been long approached, because neither the etiologic factors nor the pathogenesis of such a two-way association has been clearly defined yet. Additionally, tinnitus is known to be more prevalent in temporomandibular dysfunction individuals in comparison with the general population, hence, suggesting the existence of this two-way association. Objective: Evaluate the effect of the temporomandibular disorder treatment when tinnitus is noticed. Methods: It is about a prospective cohort study, in which temporomandibular dysfunction (TMD individuals showing a tinnitus before and after the dental TMD treatment were studied. Patients' age, sex, and tinnitus features - place of symptom and time length were examined, and an audiometric evaluation was performed. Intensity of tinnitus was evaluated by a digital analogue scale before and after the TMD treatment. Results: We evaluated 15 TMD and tinnitus patients aged between 37.7±17.1, 86.7% of whom were female. In 60% of the cases, tinnitus was unilateral and the average time length was 24 months. In 5 (33.3% patients, a neurosensorial hearing loss was seen at audiometry. When comparing the visual analogue scale scores before and after the dental treatment, a significant decrease (p<0,001 in the intensity of tinnitus was evident. In 4 (26.6% patients, tinnitus disappeared. Conclusion: A significant decrease in the recognition of tinnitus by patients submitted to a temporomandibular dysfunction treatment was evident.

  7. Chewing over bruxism

    NARCIS (Netherlands)

    Lobbezoo, F.

    2014-01-01

    Bruxism has been studied increasingly over the past decades. Nevertheless, many aspects of this disorder are still unclear. In this article, a concise overview is provided on the current insights into sleep and awake bruxism, especially related to its definition, epidemiology, etiology, consequences

  8. [Temporomandibular joint disorders: Physiotherapy and postural approaches].

    Science.gov (United States)

    Breton-Torres, I; Trichot, S; Yachouh, J; Jammet, P

    2016-09-01

    Rehabilitation of temporomandibular joint dysfunctions has for a long time tried to treat symptoms: pain relief, joint kinetics restoration, disk re-capture by manual maneuvers. The authors present their own therapeutic approach, which is no longer limited to symptoms, but addresses the causes and identifies risk factors to prevent relapse.

  9. Nomenclature and classification of temporomandibular joint disorders

    NARCIS (Netherlands)

    Stegenga, B.

    2010-01-01

    P>Currently, there are basically two approaches to classification, one based on structural and one on positional changes occurring within the joint. Despite the increase in knowledge of pathologic changes occurring within the temporomandibular joint (TMJ), the disc still seems to be a central issue

  10. Predictors for the development of temporomandibular disorders in scuba divers

    NARCIS (Netherlands)

    Lobbezoo, F.; van Wijk, A.J.; Klinger, M.C.; Ruiz Vicente, E.; van Dijk, C.J.; Eijkman, M.A.J.

    2014-01-01

    The aim was to determine predictors for the development of complaints of temporomandibular disorders (TMD) in a large sample of Dutch scuba divers who were free of any TMD complaints before they started diving actively. Five-hundred and thirty-six scuba divers (mean ± SD age = 40·4 ± 11·9 years; 34·

  11. Diagnostic accuracy of temporomandibular disorder pain tests: a multicenter study

    NARCIS (Netherlands)

    Visscher, C.M.; Naeije, M.; de Laat, A.; Michelotti, A.; Nilner, M.; Craane, B.; Ekberg, E.; Farella, M.; Lobbezoo, F.

    2009-01-01

    AIMS: To estimate the diagnostic accuracy of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) clinical examination and of the dynamic/static tests for the recognition of TMD pain. Since the diagnosis of TMD pain is especially complicated in persistent orofacial pain patient

  12. Signs and symptoms of temporomandibular disorder (TMD) and craniofacial form

    NARCIS (Netherlands)

    Dibbets, JMH; vanderWeele, LT

    1996-01-01

    Signs and symptoms attributed to temporomandibular disorder (TMD) were registered in 170 persons at an average age of 12.5 years. One hundred and ten were reexamined at an average age of 26.4 years. Craniofacial form was defined on standardized lateral cephalograms, taken at the time points mentione

  13. Ethnic background as a factor in temporomandibular disorder complaints

    NARCIS (Netherlands)

    van der Meulen, M.J.; Lobbezoo, F.; Aartman, I.H.A.; Naeije, M.

    2009-01-01

    AIMS: To examine the associations between the ethnic backgrounds of temporomandibular disorder (TMD) patients in the Netherlands and the level of TMD pain complaints and psychological/behavioral factors and whether these associations are influenced by socioeconomic factors. METHODS: A sample of 504

  14. Temporomandibular disorders in females: acupuncture compared to occlusal splint

    OpenAIRE

    Rezende, Maria Cristina Rosifini Alves [UNESP; Sant´anna, Crischina Branco Marques [UNESP; Ávila de Aguiar, Sandra Maria Herondina Coelho [UNESP; Bertoz, André Pinhiero de Magalhães [UNESP; Hall, Kevin Bruce [UNESP; Dyonisio, Ana Luiza Di Bella; Lima, Jacquelyne do Valle; Costa, Leonardo Portilha Gomes da; Alves-Rezende, Luís Guilherme Rosifini

    2013-01-01

    To compare the effect of acupuncture and occlusal splint in the treatment of temporomandibular disorders (TMD) in female patients.Method: Forty-eight female patients (mean age of 39.3±6.8 years) with diagnosed pain in muscles or joint according to RDC/TMD criteria were attended at UNESP - Aracatuba Dental School. Including criteria were reported pain in the chewing muscles and/or in the temporomandibular joint measured by a visual analogue scale (range from 0 to 10) and a reported reduction o...

  15. The relationship of occlusal disharmonies and symptoms of temporomandibular disorders

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    Dodić Slobodan

    2006-01-01

    Full Text Available Introduction: The influence of occlusal condition on the onset of temporomandibular disorder (TMD has been strongly debated for many years and is still the source of controversy. Until 1980s, the occlusal factors such as the presence of uncured malocclusions, discrepancies between intercuspal position (ICP and retruded contact position (RCP greater than two millimeters, occlusal abnormality, particularly mediotrusion and retrusion, and loss of posterior teeth were considered the primary causes of TMD. Objective: The objective of our study was to find correlation of occlusion disharmonies (difference between ICP and RCP and present sings and symptoms of TMD. Method: The study involved 60 subjects between 18 and 26 years of age who were divided in two groups. The study group consisted of 30 subjects between 18 and 26 years of age with sings and symptoms of temporomandibular disorders (TMD. TMD was confirmed according to Helkimo index. An average value of Helkimo index in this group was 1. The control group included 30 subjects between 20 and 25 years of age without TMD sings and symptoms. An average value of Helkimo index in this group was 0. The function analysis of cinematic centers position in RCP and ICP was performed in each subject using the computer pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany. Results: The results of our study showed that the translation tracing of cinematic points from RCP to ICP was significantly different in TMD subjects and asymptomatic group (p>0.16. In addition, the study revealed that 53.4 % of subjects with sings and symptoms of temporomandibular disorders had marked translation in the lower temporomandibular joint (0.61-1.2 mm what directed to intracapsular disorders. Conclusion: The results of our study suggested significant difference of RCP and ICP between subjects with sings and symptoms of the temporomandibular disorders and subjects without sings and symptoms.

  16. [A particular temporomandibular disorder: the temporomandibular joint ankylosis. Basic and clinical concepts].

    Science.gov (United States)

    Bocquet, Emmanuelle; Mercier, Marie; Moreau, Alexis; Ferri, Joël; Danguy, Michel

    2014-12-01

    Ankylosis of the temporomandibular joint mostly affects children and young adults. Although it is rare, it is an extremely debilitating disease whose effects on growth, morphological development and personal development are significant. To manage this disorder, it is essential to be informed about the causes, about the anatomical shapes it presents and about its symptoms. This knowledge will also help us choose the most appropriate therapy, that may nevertheless result in failures and in relapses requiring prosthetic rehabilitation.

  17. Signs and symptoms of temporomandibular joint disorders in Caucasian children and adolescents.

    Science.gov (United States)

    Tecco, Simona; Crincoli, Vito; Di Bisceglie, Beatrice; Saccucci, Matteo; Macrĺ, Monica; Polimeni, Antonella; Festa, Felice

    2011-01-01

    This study investigated the prevalence of the signs and symptoms of temporomandibular disorders (TMD) in a population of children and adolescents. TMD signs and symptoms were recorded in 1134 subjects (593 males and 541 females; age range 5-15 years), divided into various groups according to the: (i) Angle dental class; (ii) presence and type of crossbite; (iii) gender; and (iv) age (ages 5-11 and 12-15 years). The percentages of signs and symptoms were compared using the chi2-test to determine the differences among the groups for the rates of TMD symptoms, bruxism, joint sounds, deviation during opening, reduced opening/lateral/protrusive movements, and myofascial pain. Subjects who were 12-15 years old showed a significantly higher prevalence of myofascial pain than those who were 5-11 years old (chi2 = 4.263; p < 0.05). Females showed a significantly higher prevalence of myofascial pain than males (chi2 = 3.882; p < 0.05). Subjects with posterior, unilateral crossbite showed a significantly higher prevalence of TMD symptoms (chi2 = 33.877; p < 0.001) and reduction of functional movements (chi2 = 10.800; p < 0.05) than those with no crossbite, or with anterior or posterior bilateral crossbite. TMD's signs and symptoms seem to be associated to some definite characteristics of the patient, such as female gender, young age, and presence of posterior unilateral crossbite.

  18. Psychological aspects of temporomandibular disorders – literature review

    Directory of Open Access Journals (Sweden)

    Berger Marcin

    2015-03-01

    Full Text Available Temporomandibular disorders (TMD constitute a group of clinical problems involving the masticatory muscles, the temporomandibular joint and associated structures. An etiological connection of TMD with psychological factors was proposed as early as the 1980’s. Indeed, the interdependence of psychological and health aspects in the patient’s treatment, place light upon the more important variables contributing to the various mental disorders that may accompany TMD. Current literature suggests a close relationship between TMD and selected psychological factors, such as personality traits, stress, depression, anxiety, and catastrophizing. Of note, anxiety-depressive disorders, somatisation and catastrophizing contribute to chronic TMD, mainly in the form of myofascial pain. Hence, knowledge of the influence of psychological factors affecting TMD, enables the identification of patients with an increased risk of chronic painful TMD.

  19. Psychoneuroimmunological disorders and temporomandibular joint pain: A review

    Directory of Open Access Journals (Sweden)

    Ranjani Shetty

    2014-01-01

    Full Text Available Psychoneuroimmunology characterizes a disease entity that combines psychological components, central nervous system regulation, and immunology, to explain the etiological complexity of a disease. Temporomandibular disorders (TMDs include a heterogeneous group of painful conditions that involve the temporomandibular joint (TMJ, muscles of mastication, and the adjacent anatomic structures. This review focuses on the psychoneuroimmunological diseases and disorders that mimic the symptoms of TMDs. The differentiation of these disorders is of great significance to the oral physician - differentiating and diagnosing the cause of TMJ pain and treating it effectively to benefit the patient.The literature for this review was taken from Medline/PubMed, other indexed journals, standard text books, and online material.

  20. Predictive value of combined clinically diagnosed bruxism and occlusal features for TMJ pain.

    Science.gov (United States)

    Manfredini, Daniele; Peretta, Redento; Guarda-Nardini, Luca; Ferronato, Giuseppe

    2010-04-01

    Several works showed a decreased role for occlusion in the etiology of temporomandibular disorders (TMD). Nonetheless, it may be hypothesized that occlusion acts as a modulator through which bruxism activities may cause damage to the stomatognathic structures. To test this hypothesis, a logistic regression model was created with the inclusion of clinically diagnosed bruxism and eight occlusal features as potential predictors for temporomandibular joint (TMJ) pain in a sample of 276 consecutive TMD patients. The final logit showed that the percentage of the total log likelihood for TMJ pain explained by the significant factors was small and amounted to 13.2%, with unacceptable levels of sensitivity (16.4%). The parameters overbite > or = 4 mm combined with clinically diagnosed bruxism [OR (odds ratio) 4.62], overjet > or = 5 mm (OR 2.83), and asymmetrical molar relationship combined with clinically diagnosed bruxism (OR 2.77) were those with the highest odds for disease, even though none of those values was significant with respect to confidence intervals. Thus, the hypothesis under evaluation has to be rejected. It is possible that future studies with a higher discriminatory power for the different bruxism activities might be indicated to get deeper into the analysis of the potential mechanisms through which occlusion may play a role, even if small, in the etiology of the different TMD.

  1. An evaluation on occlusal relation and malocclusion in the incidence of temporomandibular disorders among Mashhad adolescents

    OpenAIRE

    Madani AS.; Ajami B

    2004-01-01

    Statement of Problem: In recent years, the prevalence of temporomandibular disorders among children and adolescents has increased, however, no study on the correlation between occlusal relations and temporomandibular disorders, in Mashhad adolescents, has been conducted yet. Purpose: The aim of this study was to survey the relationship between occlusal indices and temporomandibular disorders (TMD) among Mashhad adolescents, with the age range of 11-14 years old. Methods and Material: In this ...

  2. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders.

    Science.gov (United States)

    Peck, C C; Goulet, J-P; Lobbezoo, F; Schiffman, E L; Alstergren, P; Anderson, G C; de Leeuw, R; Jensen, R; Michelotti, A; Ohrbach, R; Petersson, A; List, T

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria.

  3. Orofacial pain, jaw function, and temporomandibular disorders in adult women with a history of juvenile chronic arthritis or persistent juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Bakke, M.; Zak, M.; Jensen, B.L.;

    2001-01-01

    Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis......Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis...

  4. Signs and Symptoms of Temporomandibular Joint Disorders Related to the Degree of Mouth Opening and Hearing Loss

    Directory of Open Access Journals (Sweden)

    Kanavaros Panagiotis

    2011-05-01

    Full Text Available Abstract Background The temporomandibular joint is a unique bi-condylar joint involved in mastication and speech. Temporomandibular joint disorders (TMD have a range of symptoms, including aural symptoms, and are present in approximately 75% of normal populations. The present study examined the relationship between signs and symptoms of TMD and mouth opening, gender, joint and aural symptoms, and hearing loss. Methods The study involved 464 healthy Greek university students (156 men and 308 women with a mean age of 19.6 years. Age, gender and maximum mouth opening was recorded. Mouth opening was measured using Vernier calipers. An anamnestic questionnaire was used to stratify the subjects into four groups based on TMD severity. Aural symptoms and an audiogram were recorded for each subject too. Data were analyzed using multifactor ANOVA, chi-square, t-test, Mann-Whitney and Kruskal-Wallis tests. Results The overall incidence of TMD signs and symptoms was 73.3%. The incidence and severity was greater in females than males (p-value 0.0001 Conclusions TMD signs and symptoms were more common and severe in females than males. TMD severity is correlated with the degree of mouth opening and the number of aural symptoms. The absence or presence of mild TMD are associated with normal audiograms while moderate and severe TMD are related to hearing loss in median and low tones respectively. Bruxism, joint ankylosis, joint pain and ear itching were more common in TMD than non-TMD patients.

  5. Bite force and temporomandibular disorder in juvenile chronic arthritis.

    Science.gov (United States)

    Wenneberg, B; Kjellberg, H; Kiliaridis, S

    1995-08-01

    The aim of this study was to investigate the functional condition of the stomatognathic system in children suffering from juvenile chronic arthritis, with respect to bite force and temporomandibular disorder in relation to radiographic abnormalities of the mandibular condyle, occlusal factors and systemic disease parameters. Thirty-five children with juvenile chronic arthritis were compared to 89 healthy children with an Angle Class I occlusion and 62 children with an Angle Class II malocclusion. Subjective symptoms and clinical signs of temporomandibular disorder and radiographic mandibular condylar changes were more common in children with juvenile chronic arthritis than in the two comparison groups. Maximal molar and incisal bite forces and maximal molar bite force endurance times were also significantly reduced in children with juvenile chronic arthritis. It is concluded that the differences between the groups are caused mainly by the systemic inflammatory disease itself, but a functional influence of weakened masticatory muscles cannot be excluded.

  6. Oral splint for temporomandibular joint disorders with revolutionary fluid system

    Directory of Open Access Journals (Sweden)

    Rahul Srivastava

    2013-01-01

    Full Text Available Temporomandibular joint (TMJ diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD. The purpose of this article is to review the Aqualizer TM , an hydrostatic oral splint, as accurate, effective treatment and differential diagnostic tool in TMD that allow treating the patient′s pain quickly and accurately saving valuable treatment time. The review article has been prepared doing a literature review from the world-wide web and pubmed/medline.

  7. Oral splint for temporomandibular joint disorders with revolutionary fluid system.

    Science.gov (United States)

    Srivastava, Rahul; Jyoti, Bhuvan; Devi, Parvathi

    2013-05-01

    Temporomandibular joint (TMJ) diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD). The purpose of this article is to review the Aqualizer™, an hydrostatic oral splint, as accurate, effective treatment and differential diagnostic tool in TMD that allow treating the patient's pain quickly and accurately saving valuable treatment time. The review article has been prepared doing a literature review from the world-wide web and pubmed/medline.

  8. Statistical approaches to orofacial pain and temporomandibular disorders research

    CERN Document Server

    Manfredini, Daniele; Nardini, Luca Guarda; Carrozzo, Eleonora; Salmaso, Luigi

    2014-01-01

    This book covers the biostatistical methods utilized to interpret and analyze dental research in the areas of orofacial pain and temporomandibular disorders. It will guide practitioners in these fields who would like to interpret research findings or find examples on the design of clinical investigations. After an introduction dealing with the basic issues, the central sections of the textbook are dedicated to the different types of investigations in sight of specific goals researchers may have. The final section contains more elaborate statistical concepts for expert professionals. The field of orofacial pain and temporomandibular disorders is emerging as one of the most critical areas of clinical research in dentistry. Due to the complexity of clinical pictures, the multifactorial etiology, and the importance of psychosocial factors in all aspects of the TMD practice, clinicians often find it hard to appraise their modus operandi, and researchers must constantly increase their knowledge in epidemiology and ...

  9. [Can orthodontic treatment generate temporomandibular disorders and pain? A review].

    Science.gov (United States)

    Gebeile-Chauty, Sarah; Robin, Olivier; Messaoudi, Yassine; Aknin, Jean-Jacques

    2010-03-01

    While considered for years to play the primary role in the etiology of temporo-mandibular joint disturbances (TMD), occlusal discrepancies are now considered to be just one causative factor among many. Recent studies, literature reviews or meta-analyses, and longitudinal studies with follow-up of children treated for many years all conclude that there is no risk of orthodontic treatment giving rise to episodes of temporo-mandibular disorders. The signs of TMD appearing during the course of orthodontic treatment should be considered in the context of the epidemiology of the disorder, which is characterized by a strong increase in its occurrence during adolescence. In conclusion, it should be stated that if orthodontic treatment can no longer be considered as one of the etiopathogenic factors in the TMD complex, there are no scientific arguments to justify the converse, that there are indications for orthodontic treatment whose sole goal would be the treatment of TMD.

  10. 锥形束CT在夜磨牙患者颞下颌关节中的测量价值%Analysis of cone beam CT for the skeletal structure of temporomandibular joint in patients with sleep bruxism

    Institute of Scientific and Technical Information of China (English)

    李佳; 张娟; 李泽奎; 高平

    2016-01-01

    Objective To analyze the skeletal structure features of temporomandibular joint (TMJ) by using cone beam computed tomography (CBCT) in patients with sleep bruxism. Methods CBCT scanning was performed in the intercuspal position in 30 patients with sleep bruxism (sleep bruxism group) and 30 health adults (normal group). The reconstruction of TMJ images were analysed by Invivo5 software. Measurements of horizontal section include antero-posterior diameter, medial-lateral diameter and axial angel. Measurements of sagittal section include acetabulum depth, aricular eminence inclination, anterior space, superior space and posterior space. Measurements of coronal section include force angle. Results There were no significant differences in both sides of TMJ between sleep bruxism group and normal group(P>0.05). Compared with control group, there were significant differences in antero-posterior diameter, medial-lateral diameter, acetabulum depth, anterior space and force angle in sleep bruxism group (P0.05)。夜磨牙组与对照组在前后径、内外径、关节窝深度、前间隙和受力角之间差异有统计学意义(P<0.05)。与对照组比较,夜磨牙组髁状突的前后径、内外径减小,前间隙、关节窝深度、受力角增大,其余TMJ测量值无明显差异。结论夜磨牙患者双侧TMJ骨性结构基本对称;髁突在关节窝位置无明显改变,髁突前斜面吸收,髁突有变小的趋势。

  11. Relationship of Occlusal Schemes with the Occurrence of Temporomandibular Disorders

    OpenAIRE

    Dina H. Sugiaman; Laura S. Himawan; Sitti Fardaniah

    2013-01-01

    Masticatory system is a complex functional unit of the body responsible for mastication, speech, and deglutition process. Temporomandibular disorders (TMD) is used to describe all functional disturbances of the masticatory system. The etiology of TMD is multifactorial, such as occlusal disharmony and emotional stress. The relationship between occlusion and TMD has been highly debated in dentistry, one of the occlusal factors is the occlusal scheme. Occlusal schemes are defined as bilateral ca...

  12. Association between otalgia, tinnitus, vertigo and hypoacusia, with temporomandibular disorders

    OpenAIRE

    Francisco Guedes Pereira de Alencar Junior; Sabrina Pavan; Karin Hermana Neppelenbroek; Vanessa Migliorini Urban; Janaina Habib Jorge; Hércules Jorge Almilhati

    2009-01-01

    Because nonespecific symptoms and signs are associated with others well-established in the temporomandibular disorders, it is difficult for the clinician to decide what symptoms and signs should be considered during the diagnosis and the treatment plan. Therefore, the aim of this literature review was to evaluate the prevalence of aural symptoms (otalgias, tinnitus, dizziness and deafness) in patients with orofacial pain. Although several hypotheses have been proposed to explain the associati...

  13. Orthodontic Treatment, Genetic Factors and Risk of Temporomandibular Disorder

    OpenAIRE

    Slade, Gary D.; Diatchenko, Luda; Ohrbach, Richard; Maixner, William

    2008-01-01

    Traditionally, four groups of factors have been identified in the etiology of temporomandibular disorder (TMD): anatomical variation in the masticatory system; psychosocial characteristics; pain in other body regions; and demographics. Orthodontic treatment has been variously cited both as a protective and harmful factor in TMD etiology. Recently, a search has begun for a genetic influence on TMD etiology. Genetic markers can be of additional value in identifying gene-environment interactions...

  14. Why use oral splints for temporomandibular disorders (TMDs)?

    Science.gov (United States)

    Adibi, Shawn S; Ogbureke, Ezinne I; Minavi, Brian B; Ogbureke, Kalu U

    2014-06-01

    Several etiologic routes have either been determined or proposed for Temporomandibular Disorders (TMD). Notable among these are myofascial, disc displacement, and arthritides disorders. The absence of concrete and universally accepted evidence-based treatment approaches means that debates as to the precise etiology and treatment of TMDs continue while practitioners attempt to treat and improve the lives of patients who present with these debilitating disorders. The use of oral splints (OS) by clinicians with responsibility to manage TMDs is quite popular, even though its mechanism of action and efficacy remains unclear. This article reviews the rationale for the continued use of OS for the management of TMDs.

  15. Emotional and physiologic responses to laboratory challenges: patients with temporomandibular disorders versus matched control subjects.

    Science.gov (United States)

    Curran, S L; Carlson, C R; Okeson, J P

    1996-01-01

    This study explored psychologic and physiologic factors differentiating patients with temporomandibular disorders (n = 23) from sex-, age-, and weight-matched asymptomatic control subjects. Each subject completed several standard psychologic questionnaires and then underwent two laboratory stressors (mental arithmetic and pressure-pain stimulation). Results indicated that patients with temporomandibular disorders had greater resting respiration rates and reported greater anxiety, sadness, and guilt relative to control subjects. In response to the math stressor, patients with temporomandibular disorders reacted with greater anger than did control subjects. There were no differences between patients with temporomandibular disorders and control subjects on pain measures or any other measured variable for the pressure-pain stimulation trial. In addition, there were no differences in electromyography levels between patients with temporomandibular disorders and control subjects. The results are discussed in terms of their implications for the etiology and treatment of this common and debilitating set of disorders.

  16. Muscle disorders and dentition-related aspects in temporomandibular disorders: controversies in the most commonly used treatment modalities

    OpenAIRE

    2008-01-01

    This review explores the aetiology of temporomandibular disorders and discusses the controversies in variable treatment modalities. Pathologies of the temporomandibular joint (TMJ) and its' associated muscles of mastication are jointly termed temporomandibular disorders (TMDs). TMDs present with a variety of symptoms which include pain in the joint and its surrounding area, jaw clicking, limited jaw opening and headaches. It is mainly reported by middle aged females who tend to recognize the ...

  17. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    DEFF Research Database (Denmark)

    DeVocht, James W; Goertz, Christine M; Hondras, Maria;

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80 particip......BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD....

  18. [Diagnosis and treatment of temporo-mandibular disorders in orthodontics].

    Science.gov (United States)

    Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal

    2010-03-01

    Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy.

  19. The Diagnostic Value of Pressure Algometry for Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Włodzimierz Więckiewicz

    2015-01-01

    Full Text Available The aim of this study is to determine the diagnostic value of pressure algometry in temporomandibular disorders. Two hundred volunteers aged 19.3 to 27.8 (mean 21.50, SD 0.97 participated in this study. An analogue pressure algometer was used for the evaluation of muscle tenderness of the following masticatory muscles: superficial and deep parts of the masseter muscle; anterior and posterior parts of the temporal muscle; and the tissues adjacent to the lateral and dorsal part of the temporomandibular joint capsule. Each patient described the algometry result for the individual components of the masticatory motor system, by selecting each time the intensity of pain on a 100 mm Visual Analogue Scale (VAS ruler. The area under the receiver operating characteristic (ROC curve, indicating the discriminatory efficiency for asymptomatic subjects and patients with temporomandibular dysfunction according to the dysfunction Di index, was the largest for the mean pain value (AUC = 0.8572; SEM = 0.0531. The 7.4 VAS cut-off point marked 95.3% specificity for this variable in identifying healthy subjects and 58.4% sensitivity in identifying patients with symptoms of dysfunctions (accuracy 68.1%. Assuming comparable sensitivity (74.9% and specificity (74.2% for a diagnostic test, there was test accuracy of 74.5% at the 4.2 VAS cut-off point.

  20. Psycho-education programme for temporomandibular disorders: a pilot study

    Directory of Open Access Journals (Sweden)

    El Maaytah Mohammed

    2007-03-01

    Full Text Available Abstract Background Temporomandibular disorders (TMDs are by far the most predominant condition affecting the temporomandibular joint (TMJ, however many patients have mild self-limiting symptoms and should not be referred for specialist care. The aim of this pilot study was to develop a simple, cost-effective management programme for TMDs using CD-ROM. 41 patients (age 18–70 participated in this study, patients were divided into three groups: the 1st group were involved in an attention placebo CD-ROM (contain anatomical information about the temporomandibular system, the 2nd group received information on CD-ROM designed to increase their control and self efficacy, while the 3rd group received the same programme of the 2nd group added to it an introduction to self-relaxing techniques followed by audio tape of progressive muscle relaxation exercises. Each of the groups was asked to complete a number of questionnaires on the day of initial consultation and six weeks afterwards. Results The two experimental groups (2nd & 3rd were equally effective in reducing pain, disability and distress, and both were more effective than the attention placebo group (1st, however the experimental groups appeared to have improved at follow-up relative to the placebo-group in terms of disability, pain and depressed mood. Conclusion This pilot study demonstrates the feasibility and acceptability of the design. A full, randomized, controlled trial is required to confirm the efficacy of the interventions developed here.

  1. Role of temporomandibular disorders (TMD) in facial pain: occlusion, muscle and TMJ pain.

    Science.gov (United States)

    Rauhala, K; Oikarinen, K S; Raustia, A M

    1999-10-01

    Temporomandibular disorders (TMD) which comprise myogenic and arthralgic components have been reported to predispose subjects to headache and facial pain. The aim of this study was to evaluate the role of these components in patients with facial pain and to investigate the influence of treatment of TMD on pain of these patients. The subject group consisted of 25 patients suffering from facial pain. The clinical stomatognathic examination was performed before conservative treatment of TMD, and one-two weeks, three months and one year after treatment. The severity of TMD was assessed using the anamnestic (AI) and clinical dysfunction (DI) indices of Helkimo. The intensity of pain was evaluated on a numerical rating scale (NRS). According to clinical findings the patients were classified to following diagnostic subgroups: TMD myo (mainly myogenic), TMD arthro (mainly arthrogenous) and TMD comb (both myogenic and arthrogenous components involved). Fifteen patients were classified in the TMD myo group, nine in the TMD comb group and one in the TMD arthro group. The DI index decreased significantly one-two weeks after treatment and remained at this level at three month and one year follow-up examinations. At the first examination the TMD myo group had the highest level of NRS index, which decreased significantly during the time of follow-up, while no significant changes were found in other groups. Bruxism reported by the patient had a positive correlation with the amount of painful muscles on the right side at first examination. The results show that facial pain combined with TMD may be mostly of myogenic origin, and myogenic pain seems to have most favorable response to conservative treatment of TMD.

  2. Masticatory muscle sleep background electromyographic activity is elevated in myofascial temporomandibular disorder patients.

    Science.gov (United States)

    Raphael, K G; Janal, M N; Sirois, D A; Dubrovsky, B; Wigren, P E; Klausner, J J; Krieger, A C; Lavigne, G J

    2013-12-01

    Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P myofascial TMD (median = 3·31 μV and mean = 4·98 μV) than for control women (median = 2·83 μV and mean = 3·88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance.

  3. The relationship of bruxism with craniofacial pain and symptoms from the masticatory system in the adult population.

    Science.gov (United States)

    Ciancaglini, R; Gherlone, E F; Radaelli, G

    2001-09-01

    The association of bruxism with craniofacial pain and symptoms of dysfunction of the masticatory system was assessed in a sample of 483 adult subjects, aged 18-75 years and selected from the general population living in the municipality of Segrate, a metropolitan area in northern Italy. Subjects were interviewed by a questionnaire about oral conditions, occurrence of symptoms of masticatory disturbances, craniofacial and neck pain. The overall prevalence of bruxism was 31;4% (95% confidence interval (CI): 27;3-35;5%). At univariate analysis bruxism was significantly associated with craniofacial pain, difficulty in closing the mouth, difficulty in opening the mouth wide or in locking the mouth, temporomandibular joint sounds, pain on movement, a feeling of stiffness or fatigue of the jaws, and neck pain. After adjustment for reciprocal influences and confounding variables, logistic regression analysis disclosed a strong independent association of bruxism with difficulty in closing the mouth (adjusted odds ratio, (OR): 2;84, 95% CI: 1;68-4;48), and a weaker relationship with craniofacial pain (adjusted OR: 1;84, 95% CI: 1;16-2;93) and temporomandibular joint sounds (adjusted OR: 1;64, 95% CI: 1;00-2;69). The findings show that in the general adult population there is a complex connection among bruxism, craniofacial pain and symptoms of masticatory disturbances. Furthermore, they suggest that the most direct relationship of bruxism may be with difficulties in mouth movements, but also an independent association may exist with craniofacial pain and other symptoms of temporomandibular disorder.

  4. A clinical study of temporomandibular joint disorders by using arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hyun; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, (Korea, Republic of)

    1998-02-15

    The purpose of this study was to prove the relationship between arthrographic and clinical features in temporomandibular joint disorders. In order to carry out this study, ninety-eight arthrographic examinations of temporomandibular joints were performed in eighty-two patients who had the temporomandibular joint disorders. As the arthrographic examination, the cases were classified in three groups, disk displacement with reduction, disk displacement without reduction, within normal limit. After this, the cases were clinically examined, and the results were compared and analyzed in each other group. The obtained results were as follows: 1. As the classification by arthrographic examination, three groups (disc displacement with reduction, disc displacement without reduction, within normal limit) were 41%, 54%, 5% of total cases in this study, respectively. 2. The third decade (65%) was most frequent in this study. The average age of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 24, 28, 21, and disc displacement without reduction group was higher than any other group. 3. In the chief complaint, pain was the most frequent in all three groups. Joint sound was also frequent in disc displacement with reduction group, but in disc displacement without reduction group, limitation of mouth opening was more frequent. 4. Of the various pain, the movement pain was most frequent (61%) in this study. In joint sound, click (63%) was the most frequent in disc displacement with reduction group, but sound history (42%) and no sound (31%) were more frequent in disc displacement without reduction group. 5. The average maximum opening of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 44 mm, 32.9 mm, 44 mm, and disc displacement without reduction group was less than any other group. 6. The masticatory disturbance of each group (disc displacement with reduction, disc

  5. A new surgical classification for temporomandibular joint disorders.

    Science.gov (United States)

    Dimitroulis, G

    2013-02-01

    The role of temporomandibular joint (TMJ) surgery is ill-defined, so a universal classification is needed to collate the evidence required to justify the surgical interventions undertaken to treat TMJ disorders. The aim of this article is to introduce a new classification that divides TMJ disorders into 5 categories of escalating degrees of joint disease that can be applied to TMJ surgery. Using a category scale from 1 to 5, with category 1 being normal, and category 5 referring to catastrophic changes to the joint, the new classification will provide the basis for enhanced quantitative and descriptive data collection that can be used in the field of TMJ surgery research and clinical practice. It is hoped that this new classification will form the basis of what will eventually become the universal standard surgical classification of TMJ disorders that will be adopted by both researchers and clinicians so that ultimately, the role of TMJ surgery will be based on evidence rather than conjecture.

  6. Bruxismo Bruxism

    Directory of Open Access Journals (Sweden)

    RE Frugone Zambra

    2003-06-01

    Full Text Available El bruxismo es una actividad parafuncional que consiste en el apriete y rechinamiento dentario, es de etiología multifactorial y está asociado principalmente a stress y a alteraciones del sueño o parasomnias. De acuerdo a las características clínicas particulares, se presentan diferentes tipos de bruxismo asociándose principalmente con adultos y aunque se presenta escasamente en niños, se debe diferenciar del desgaste fisiológico en dicha población.Bruxism as a parafunctional activity consist in teeth clenching and grinding beyond the normal wear functions. It has multifactorial etiology, matched by stress, sleep disorders or parasomnia factors. There are several kinds of bruxism according to the clinical signs and symptomps and it has been associated mainly to adulthood. This parafunction is barely frequent in child and it has to be differentiated from the normal wear of the caduceus dentition present in a third of the infant population.

  7. Magnetic resonance imaging-based temporomandibular joint space evaluation in temporomandibular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2007-03-15

    Disc and condylar position were observed on MRIs of temporomandibular joint disorder patients and condylar position agreement between MRI and tranascranal radiography was evaluated. MRI and transcranial radiographs of both TM joints from 67 patients with temporomandibular disorder were used. On MRI, the position and shape of disc and condylar position as anterior, middle, posterior was evaluated at medial, center, and lateral views. On transcranial radiographs, condylar position was evaluated using the shortest distance from condyle to fossa in anterior, superior, and posterior directions. 1. On MRI, 96 joints (71.6%) of 134 had anterior disc dispalcement with reduction and 38 joints (28.4%) without reduction. 2. Fourteen (14.6%) of 96 reducible joints showed anterior condylar position. 19 (19.8%) showed central position, 63 joints (65.6%) showed posterior position. Two joints (5.3%) of 38 non-reducible joints showed anterior condylar position, while 9 (23.7%) showed central position, and 27 (71.1%)-posterior position. 3. In 85 joints (63.4%) of 134, the transcranial condylar position agreed with that of the central MRI view, 10 joints (7.5%) with that of medial, 16 joints (11.6%) with that of lateral, and 23 joints (17.2%) disagreed with that of MRI. On MRI, most of the reducible and non-reducible joints showed posterior condylar position. Transcranial radiographs taken with machine designed for TMJ had better agreement of condylar position with that of MRI. Extremely narrow joint spaces or very posterior condylar positions observed on transcranial radiographs had a little more than fifty percent agreement with those of MRIs.

  8. Can pterygoid plate asymmetry be linked to temporomandibular joint disorders ?

    Energy Technology Data Exchange (ETDEWEB)

    Guerrero, Maria Eugenia; Jacobs, Reinhilde [OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven (Belgium); Beltran, Jorge [Oral and Maxillofacial Radiology, Post-Graduate School, Universidad Privada Cayetano Heredia, Lima (Peru); Laat, Antoon [Stomatology and Maxillofacial Surgery, Dept. of Oral Health Sciences, KU Leuven, Leuven (Belgium)

    2015-06-15

    This study was performed to evaluate the relationship between pterygoid plate asymmetry and temporomandibular joint disorders. Cone-beam computed tomography (CBCT) images of 60 patients with temporomandibular disorders (TMD) involving pain were analyzed and compared with images of 60 age- and gender-matched controls. Three observers performed linear measurements of the lateral pterygoid plates. Statistically significant differences were found between measurements of the lateral pterygoid plates on the site that had pain and the contralateral site (p<0.05). The average length of the lateral pterygoid plates (LPPs) in patients with TMD was 17.01±3.64 mm on the right side and 16.21±3.51 mm on the left side, and in patients without TMD, it was 11.86±1.97 mm on the right side and 11.98±1.85 mm on the left side. Statistically significant differences in the LPP length, measured on CBCT, were found between patients with and without TMD (p<0.05). The inter-examiner reliability obtained in this study was very high for all the examiners (0.99, 95% confidence interval: 0.98-0.99). Within the limits of the present study, CBCT lateral pterygoid plate measurements at the side with TMD were found to be significantly different from those on the side without TMD. More research is needed to explore potential etiological correlations and implications for treatment.

  9. Sexual hormone serum levels and temporomandibular disorders. A preliminary study.

    Science.gov (United States)

    Landi, Nicola; Lombardi, Ilaria; Manfredini, Daniele; Casarosa, Elena; Biondi, Katya; Gabbanini, Massimo; Bosco, Mario

    2005-02-01

    The aim of the present study was to investigate the role of sexual hormones in a young adult population affected by articular forms of temporomandibular disorders (TMD), measuring 17beta-estradiol and progesterone serum levels. In the study, we included 40 patients (20 males and 20 females) with a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I group II diagnosis of disk displacement and/or group III diagnosis of arthralgia, osteoarthritis or osteoarhrosis, and 32 healthy controls. In female patients, blood samples were collected in follicular and luteal phases of the same menstrual cycle, while only one blood sample was drawn in male patients. Serum levels of estradiol and progesterone were determined using a radioimmunoassay and the comparison between the two groups was performed using a t test. Regarding estradiol, our results showed significantly higher serum levels in patients affected by TMD than in healthy controls, both in males (p hormones, these data suggest that high serum estrogen levels might be implicated in the physiopathology of TMD.

  10. Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients.

    Science.gov (United States)

    Hilgenberg, P B; Saldanha, A D D; Cunha, C O; Rubo, J H; Conti, P C R

    2012-04-01

    The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders (TMD) and otologic symptoms in patients with and without tinnitus. The influence of the level of depression was also addressed. The tinnitus group was comprised of 100 patients with tinnitus, and control group was comprised of 100 individuals without tinnitus. All subjects were evaluated using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) to determine the presence of TMD and depression level. Chi-square, Spearman Correlation and Mann-Whitney tests were used in statistical analysis, with a 5% significance level. TMD signs and symptoms were detected in 85% of patients with tinnitus and in 55% of controls (P≤0·001). The severity of pain and higher depression levels were positively associated with tinnitus (P≤0·001). It was concluded that tinnitus is associated with TMD and with otalgia, dizziness/vertigo, stuffy sensations, hypoacusis sensation and hyperacusis, as well as with higher depression levels.

  11. Temporomandibular disorders and functional somatic syndromes: Deliberations for the dentist

    Directory of Open Access Journals (Sweden)

    S Suma

    2012-01-01

    Full Text Available Temporomandibular disorder (TMD is an umbrella term for a collection of disorders affecting the temporomandibular joint (TMJ and associated tissues. TMD is not a rare pathology for the dentist. The most common presenting symptom is pain, which causes the patient seek immediate treatment. Management is dictated by the cause. The most ′famed′ causes include trauma, inflammation, aging, parafunctional habits, infections, neoplasms, and stress; and these are always considered in the differential diagnosis of TMJ pain. There are some less ′famed′ causes of TMD, which are characterized by increased pain sensitivity due to psychosocial factors; these include myofascial pain syndrome and functional somatic syndromes (FSS such as fibromyalgia and chronic fatigue syndrome. They present with chronic pain, fatigue, disability, and impairment in ability to perform daily activities. A non-systematic search in the English literature revealed numerous studies describing the occurrence of TMD in these conditions, along with few other oral manifestations. TMD has been even considered to be a part of the FSS by some. In these patients, TMD remains a recurring problem, and adequate management cannot be achieved by traditional treatment protocols. Awareness of these conditions, with correct diagnosis and modification of management protocols accordingly, may resolve this problem.

  12. Viola Playing May Be a Strong Aggravating Factor for Temporomandibular Disorder

    OpenAIRE

    Mahmut Alpayci

    2014-01-01

    Temporomandibular disorder (TMD) is the general term used to describe the symptoms originated from temporomandibular joint region. The most common symptom of the disorder is pain during mandibular movement. Etiology of TMD is multifactorial. Several factors such as trauma, occlusal discrepancies, stress, parafunctions, hypermobility, and heredity can make one more vulnerable to this disorder. It has been reported that viola playing might be a predisposing factor for TMD. In this article, we p...

  13. Are headache and temporomandibular disorders related? A blinded study

    DEFF Research Database (Denmark)

    Ballegaard, V.; Thede-Schmidt-Hansen, P.; Svensson, P.;

    2008-01-01

    To investigate overlaps between headache and temporomandibular disorders (TMD) in a clinical headache population and to describe the prevalence of TMD in headache patients, 99 patients referred to a specialized headache centre were diagnosed according to Research Diagnostic Criteria for TMD (RDC/TMD......) and classified in headache groups according to the International Classification of Headache Disorders, second edition for headache diagnoses in a blinded design. The prevalence of TMD in the headache population was 56.1%. Psychosocial dysfunction caused by TMD pain was observed in 40.4%. No significant...... differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence...

  14. Motion Artifact in the MR imaging of temporomandibular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Tamamura, Kiyoharu; Miyajima, Hisashi; Nihei, Yoshinobu; Nemoto, Ryuichi; Ohno, Tomoya [Ohu Univ., Koriyama, Fukushima (Japan). School of Dentistry

    1997-09-01

    Recently, magnetic resonance imaging (MRI) is indispensable for the diagnosis of temporomandibular disorders (TMD). Motion Artifacts of MRI occur more frequently than in other conventional methods, because it takes a long time to obtain the images. This paper reported on Motion Artifacts on MRI. MRI studies of 232 temporomandibular joints were performed in 116 patients with TMD by using a 0.5-T magnetic resonance (MR) scanner, with spin echo sequence: protondensity-weighted. And we took MRI slices at opening phase and closing phase. So 232 slices were gathered and we evaluated clinically the incidence of Motion Artifacts, that is to say, double and multiple images and other factors. The 103 slices in 56 patients showed Motion Artifacts. There is no significant difference between sexes. By age group, those in their teens were most frequent, followed by those in their fifties, forties, thirties and twenties. Also the same results were obtained for double image and multiple image. Incidence of Motion Artifact was most frequent at the opening phase. There is no significant difference between double and multiple image. (author)

  15. Temporomandibular disorders. Part 1: anatomy and examination/diagnosis.

    Science.gov (United States)

    Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

    2014-02-01

    Temporomandibular disorders (TMD) are a heterogeneous group of diagnoses affecting the temporomandibular joint (TMJ) and surrounding tissues. A variety of methods for evaluating and managing TMD have been proposed within the physical therapy profession but these sources are not peer-reviewed and lack updates from scientific literature. The dental profession has provided peer-reviewed sources that lack thoroughness with respect to the neuromusculoskeletal techniques utilized by physical therapists. The subsequent void creates the need for a thorough, research informed, and peer-reviewed source regarding TMD evaluation and management for physical therapists. This paper is the first part in a two-part series that seeks to fill the current void by providing a brief but comprehensive outline for clinicians seeking to provide services for patients with TMD. Part one focuses on anatomy and pathology, arthro- and osteokinematics, epidemiology, history taking, and physical examination as they relate to TMD. An appreciation of the anatomical and mechanical features associated with the TMJ can serve as a foundation for understanding a patient's clinical presentation. Performance of a thorough patient history and clinical examination can guide the clinician toward an improved diagnostic process.

  16. Therapeutic exercises for the control of temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Alberto da Rocha Moraes

    2013-10-01

    Full Text Available INTRODUCTION: Temporomandibular disorder (TMD is a multifactorial disease. For this reason, it is difficult to obtain an accurate and correct diagnosis. In this context, conservative treatments, including therapeutic exercises classified as stretching, relaxation, coordination, strengthening and endurance, are oftentimes prescribed. OBJECTIVE: Thus, the aim of the present article was to conduct a literature review concerning the types of exercises available and the efficacy for the treatment of muscular TMD. METHODS: The review included researches carried out between 2000 and 2010, indexed on Web of Science, PubMed, LILACS and BBO. Moreover, the following keywords were used: Exercise, physical therapy, facial pain, myofascial pain syndrome, and temporomandibular joint dysfunction syndrome. Studies that did not consider the subject "TMD and exercises", used post-surgery exercises and did not use validated criteria for the diagnosis of TMD (RDC/TMD were not included. RESULTS: The results comprised seven articles which proved therapeutic exercises to be effective for the treatment of muscular TMD. However, these studies are seen as limited, since therapeutic exercises were not applied alone, but in association with other conservative procedures. In addition, they present some drawbacks such as: Small samples, lack of control group and no detailed exercise description which should have included intensity, repetition, frequency and duration. CONCLUSION: Although therapeutic exercises are considered effective in the management of muscular TMD, the development of randomized clinical trials is necessary, since many existing studies are still based on the clinical experience of professionals.

  17. Posterior crossbite and temporomandibular disorders (TMDs): need for orthodontic treatment?

    Science.gov (United States)

    Thilander, Birgit; Bjerklin, Krister

    2012-12-01

    The aim of this work was to update the bibliography regarding the concept of 'temporomandibular disorder (TMD)' and 'posterior crossbite' and try to find out if there is any association between some special signs/symptoms of TMD and type of posterior crossbite. A literature search from 1970 to 2009, due to specified criterion, resulted in 14 publications that were found to be relevant for the present systematic review. An association between TMD and posterior crossbite (Yes-group) was reported as often as absence of such a relationship (No-group). The samples in the two groups showed similarities as well as differences with respect to number, gender, and age. Most articles reported only on 'presence' or 'absence' of crossbite and only few on type of crossbite opposite to a thorough account of clinical signs and symptoms of TMD. This review seems, however, to state that a functional posterior crossbite (mandibular guidance with midline deviation) is associated with headache, temporomandibular joint and muscular pain, and clicking. As evident from the discussion, such type needs orthodontic treatment to rehabilitate the asymmetric muscular activity between the crossbite and non-crossbite sides and the changed condyle/temporal relationship caused by mandibular deviation. Whether this treatment also will avoid future TMD problems can be answered only after clinical follow-up studies have been performed.

  18. Temporomandibular joint disorders' impact on pain, function, and disability.

    Science.gov (United States)

    Chantaracherd, P; John, M T; Hodges, J S; Schiffman, E L

    2015-03-01

    The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders ("TMJ intra-articular status"), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability ("TMD impact"). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject's most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], -0.04 to 0.13) for all TMD cases and 0.07 (95% CI, -0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored.

  19. Comparative evaluation of the efficacy of occlusal splints fabricated in centric relation or maximum intercuspation in temporomandibular disorders patients

    Directory of Open Access Journals (Sweden)

    Marcelo Matida Hamata

    2009-02-01

    Full Text Available Fabrication of occlusal splints in centric relation for temporomandibular disorders (TMD patients is arguable, since this position has been defined for asymptomatic stomatognathic system. Thus, maximum intercuspation might be employed in patients with occlusal stability, eliminating the need for interocclusal records. This study compared occlusal splints fabricated in centric relation and maximum intercuspation in muscle pain reduction of TMD patients. Twenty patients with TMD of myogenous origin and bruxism were divided into 2 groups treated with splints in maximum intercuspation (I or centric relation (II. Clinical, electrognathographic and electromyographic examinations were performed before and 3 months after therapy. Data were analyzed by the Student's t test. Differences at 5% level of probability were considered statistically significant. There was a remarkable reduction in pain symptomatology, without statistically significant differences (p>0.05 between the groups. There was mandibular repositioning during therapy, as demonstrated by the change in occlusal contacts on the splints. Electrognathographic examination demonstrated a significant increase in maximum left lateral movement for group I and right lateral movement for group II (p0.05 in the electromyographic activities at rest after utilization of both splints. In conclusion, both occlusal splints were effective for pain control and presented similar action. The results suggest that maximum intercuspation may be used for fabrication of occlusal splints in patients with occlusal stability without large discrepancies between centric relation and maximum intercuspation. Moreover, this technique is simpler and less expensive.

  20. Ocorrência de disfunção temporomandibular (DTM e sua relação com hábitos orais deletérios em crianças do município de Monte Negro - RO Occurrence of temporomandibular disorder (TMD and its relationship with harmful oral habits in children from Monte Negro - RO

    Directory of Open Access Journals (Sweden)

    Luciana Biral Mendes Merighi

    2007-12-01

    , pacifier, finger/thumb sucking and chewing (nail biting, biting objects, biting the oral or labial mucosa, bruxism and clenching was also found. RESULTS: among the 79 investigated children, 27 (34.18% showed symptoms of temporomandibular disorder, with highest periodicity of articular disorder (48.15%, n=13, followed by mixed (33.33%, n=9 and muscular disorder (18.52%, n=5. Harmful oral habits were found in 69.62% (n=55, mostly involving chewing habits (39.91%, n=26 followed by sucking (8.86%, n=7; some children showed both types of habits (27.85%, n=22. The results did not demonstrate any association among harmful oral habits and temporomandibular disorder according to the chi-square test, regardless of the type of habit (chewing or suction. CONCLUSION: one third of children evaluated (34% presented symptoms of temporomandibular disorder, without any association between temporomandibular disorder and the presence of harmful oral habits.

  1. Bruxism: Conceptual discussion and review

    Science.gov (United States)

    Murali, R. V.; Rangarajan, Priyadarshni; Mounissamy, Anjana

    2015-01-01

    Bruxism is commonly considered a detrimental motor activity, potentially causing overload of the stomatognathic structures. The etiology of bruxism is unclear, but the condition has been associated with stress, occlusal disorders, allergies and sleep positioning. Due to its nonspecific pathology, bruxism may be difficult to diagnose. Unfortunately, very little data exists on the subject of a cause-and-effect relationship of bruxism to the point that expert opinions and cautionary approaches are still considered the best available sources for suggesting good practice indicators. The present paper reviewed current concepts on bruxism, etiology, diagnosis and management, underlining its effects on dental structures in an attempt to provide clinically useful suggestions based on scientifically sound data. PMID:26015729

  2. Bruxism: Conceptual discussion and review

    Directory of Open Access Journals (Sweden)

    R V Murali

    2015-01-01

    Full Text Available Bruxism is commonly considered a detrimental motor activity, potentially causing overload of the stomatognathic structures. The etiology of bruxism is unclear, but the condition has been associated with stress, occlusal disorders, allergies and sleep positioning. Due to its nonspecific pathology, bruxism may be difficult to diagnose. Unfortunately, very little data exists on the subject of a cause-and-effect relationship of bruxism to the point that expert opinions and cautionary approaches are still considered the best available sources for suggesting good practice indicators. The present paper reviewed current concepts on bruxism, etiology, diagnosis and management, underlining its effects on dental structures in an attempt to provide clinically useful suggestions based on scientifically sound data.

  3. Prevalence of temporomandibular disorders in postmenopausal women and relationship with pain and HRT

    OpenAIRE

    Victor Ricardo Manuel Muñoz LORA; Giancarlo De la Torre CANALES; Leticia Machado GONÇALVES; MELOTO,Carolina Beraldo; BARBOSA,Celia Marisa Rizzatti

    2016-01-01

    Abstract The prevalence of temporomandibular disorders (TMD) is higher in females, reaching their high peak during reproductive years, probably because of the action of some female hormones, which alter pain threshold. This study aimed to investigate the prevalence of TMD in postmenopausal women and its relationship with pain and hormone replacement therapy (HRT). In total, 284 patients were evaluated and classified using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/T...

  4. Saliva cortisol levels and depression in individuals with temporomandibular disorder: preliminary study

    OpenAIRE

    Almeida,Claudyane de; Paludo,Alexsandro; Stechman-Neto,José; Amenábar, José Miguel

    2014-01-01

    BACKGROUND AND OBJECTIVES:Temporomandibular disorders are common in general population and their etiology is also linked to psychological factors. Cortisol is a hormone the secretion of which may be increased during emotional changes. This study aimed at evaluating the presence of depression and saliva cortisol levels in patients with temporomandibular disorders.METHODS:Participated in the research 48 students, being 36 females and 12 males, aged between 19 and 32 years. Participants were pre...

  5. Occlusion, prosthodontic treatment, and temporomandibular disorders: a review.

    Science.gov (United States)

    Hagag, G; Yoshida, K; Miura, H

    2000-03-01

    The purpose of this article is to review the literature on the relationship between occlusal discrepancies and temporomandibular disorders (TMD) and to summarize the guidelines of treating TMD by prosthetic rehabilitation. To date, the relationship between occlusal condition and TMD has not been confirmed, although there is a current trend toward making a weak correlation between occlusal interference and TMD. Furthermore, several types of occlusal discrepancies have been considered as variable features of the norm. But unstable occlusion in the intercuspal position may cause TMD. In cases of restored dentition, the problem is probably different and iatrogenic TMD are not rare. Namely, malformed occlusal surfaces, defects in anterior guidance, occlusal curvature, and vertical dimension may lead to some TMD trouble. According to these recent concepts the treatment modalities of TMD have been changed. Conservative treatments such as counseling, behavioral modification, physical therapy, pharmacotherapy, and interocclusal appliances should be the first choice, and treatments that lead to drastic changes of occlusion are not recommended.

  6. Is orthodontic treatment a risk factor for temporomandibular disorders?

    Directory of Open Access Journals (Sweden)

    Tomas Magnusson

    2012-04-01

    Full Text Available INTRODUCTION: The possibility that orthodontic treatment in childhood might be a risk factor for the development of temporomandibular disorders (TMD later in life has been an issue of great controversy in dental literature. OBJECTIVE: To determine a possible negative or positive correlation between orthodontic treatment and TMD by presenting the results and conclusions from a number of key-papers dealing with this subject. RESULTS AND CONCLUSION: According to current knowledge, there is no scientific evidence to support that orthodontic treatment is a risk factor for the development of TMD. On the other hand, there is some evidence to support that a proper orthodontic treatment performed in childhood might have a positive effect upon the functional status of the masticatory system later in life.

  7. Is the masticatory function changed in patients with temporomandibular disorder?

    Science.gov (United States)

    Rodrigues, Carolina Almeida; Melchior, Melissa de Oliveira; Magri, Laís Valencise; Mestriner, Wilson; Mazzetto, Marcelo Oliveira

    2015-01-01

    Patients with temporomandibular disorders (TMD) often complain and have limitation in masticatory function, which can be affected by a complex interaction of factors. The aim of this study was analyze the masticatory function in patients with TMD using surface electromyography (EMG) and masticatory efficiency (ME). Twenty-seven patients with TMD and 25 considered control (n), aged between 18 and 60 years, paired by age and gender, were evaluated according to RDC/TMD. In both groups were performed: EMG with chewing gum, clinical evaluation of habitual chewing with stuffed cookie (CE) (number of chewing strokes and time) and analysis of ME with fuchsin beads. Nonparametric statistical analyses were used (Mann-Whitney) for comparisons between groups, with 5% significance level. For all variables, the TMD group showed higher values than the control, with statistical significance for ME (pfunction.

  8. Estrogen-Induced Monocytic Response Correlates with Temporomandibular Disorder Pain.

    Science.gov (United States)

    Ribeiro-Dasilva, M C; Fillingim, R B; Wallet, S M

    2017-03-01

    Temporomandibular disorders (TMD) are a set of conditions characterized by pain and dysfunction in the temporomandibular joint and muscles of mastication. These pain conditions are associated with considerable morbidity, societal costs, and reduced quality of life. The prevalence varies between 4% and 10%, with females at higher risk, and a higher prevalence occurs during reproductive years. The increased prevalence of TMD in females and low prevalence in childhood reinforce that sex hormones, like estrogen, play an important, complex role in the pathophysiology of these disorders. The goal of this study was to determine whether women with TMD exhibit a monocytic hyperinflammatory response compared with control women, and to examine associations of monocytic inflammatory responses with clinical pain. Eighteen women, aged 18 to 35 y, were seen during their follicular menstrual phase. A blood sample was collected, a clinical questionnaire about pain history was administered, and a Research Diagnostic Criteria (RDC) exam was performed. Extracted monocytes were stimulated with the toll-like receptor (TLR)-4 ligand, lipopolysaccharide (LPS), in the presence and absence of estrogen, and the levels of IL6 expression evaluated. Women with TMD showed a systemic hyperinflammatory phenotype, manifested by an increased monocytic release of cytokines after an inflammatory insult, and this was further increased by estrogen. In addition, monocytes from participants who self-reported more pain on the VAS scale produced higher levels of IL6 compared with those from participants who self-reported lower pain sensitivity. These data suggest that an estrogen-induced hyperinflammatory phenotype in women with TMD may at least in part contribute to heightened clinical pain, perhaps via central sensitization.

  9. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors.

    Science.gov (United States)

    LeResche, L

    1997-01-01

    Epidemiology is the study of the distribution, determinants, and natural history of disease in populations. Epidemiology has several uses in addition to its traditional role of documenting the public health significance of a condition. Notably, epidemiologic methods and data can be used to identify and verify causes of disease. This article reviews the epidemiologic data on pain in the temporomandibular region, and on signs and symptoms associated with specific subtypes of temporomandibular disorders, with the aim of identifying possible etiologic factors for these conditions that deserve further study. Despite methodologic and population differences, several consistencies are apparent in the epidemiologic literature. Pain in the temporomandibular region appears to be relatively common, occurring in approximately 10% of the population over age 18; it is primarily a condition of young and middle-aged adults, rather than of children or the elderly, and is approximately twice as common in women as in men. This prevalence pattern suggests that etiologic investigations should be directed at biologic and psychosocial factors that are more common in women than in men, and diminish in older age groups. Most signs and symptoms associated with particular temporomandibular disorders (e.g., joint sounds, pain in the joint) also appear to be more prevalent in women than in men, although age patterns for these signs and symptoms are not as clear as for temporomandibular pain. The available data highlight the need for further research on etiologic factors associated with temporomandibular pain and with specific diagnostic subtypes of temporomandibular disorders.

  10. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

    Science.gov (United States)

    Conti, P C R; Costa, Y M; Gonçalves, D A; Svensson, P

    2016-09-01

    There are relevant clinical overlaps between some of the painful temporomandibular disorders (TMD) and headache conditions that may hamper the diagnostic process and treatment. A non-systematic search for studies on the relationship between TMD and headaches was carried out in the following databases: PubMed, Cochrane Library and Embase. Important pain mechanisms contributing to the close association and complex relationship between TMD and headache disorders are as follows: processes of peripheral and central sensitisation which take place in similar anatomical areas, the possible impairment of the descending modulatory pain pathways and the processes of referred pain. In addition, the clinical examination does not always provide distinguishing information to differentiate between headaches and TMD. So, considering the pathophysiology and the clinical presentation of some types of headache and myofascial TMD, such overlap can be considered not only a matter of comorbid relationship, but rather a question of disorders where the distinction lines are sometimes hard to identify. These concerns are certainly reflected in the current classification systems of both TMD and headache where the clinical consequences of diagnosis such as headache attributed to or associated with TMD are uncertain. There are several similarities in terms of therapeutic strategies used to manage myofascial TMD and headaches. Considering all these possible levels of interaction, we reinforce the recommendation for multidisciplinary approaches, by a team of oro-facial pain specialists and a neurologist (headache specialist), to attain the most precise differential diagnosis and initiate the best and most efficient treatment.

  11. Manual therapy of the mandibular accessory ligaments for the management of temporomandibular joint disorders.

    Science.gov (United States)

    Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico

    2011-02-01

    Temporomandibular joint disorders are characterized by chronic or acute musculoskeletal or myofascial pain with dysfunction of the masticatory system. Treatment modalities include occlusal splints, patient education, activity modification, muscle and joint exercises, myofascial therapy, acupuncture, and manipulative therapy. In the physiology of the temporomandibular joint, accessory ligaments limit the movement of the mandible. A thorough knowledge of the anatomy of accessory ligaments is necessary for good clinical management of temporomandibular joint disorders. Although general principles regarding the anatomy of the ligaments are relatively clear, very little substantiated information on the dimension, orientation, and function of the ligaments has been published, to the authors' knowledge. The authors review the literature concerning the accessory ligaments of the temporomandibular joint and describe treatment options, including manual techniques for mobilizing the accessory ligaments.

  12. Imaging bruxism.

    Science.gov (United States)

    Bonte, Frederick J; Harris, Thomas S

    2013-06-01

    A 62-year-old woman was referred for SPECT brain blood flow study with a diagnosis of possible dementia or depression. Findings within the brain were noncontributory, but extraneous structures with high blood flow were detected within the soft tissues of temporal regions and face. On questioning, the patient stated that she had sleep bruxism, with gnashing and grinding of her teeth. This did not occur during waking. Bruxisms and its consequences, with effects on the teeth and jaws, are a problem of importance to oral surgeons and dentists. There is considerable active research into methods of treatment of sleep bruxism.

  13. Epidemiological Analysis on 3614 Patients with Temporo-Mandibular Disorders (TMD Basic Statistical Aspects

    Directory of Open Access Journals (Sweden)

    Jurkemik J

    2015-12-01

    Full Text Available The aim of this work was to present data from a large sample of patients with Temporo-Mandibular Disorders (TMD in order to clarify some aspects of the development of pathological conditions that affect large parts of the population. In the past years there was a rapid growth of the incidence of the temporomandibular dissorders. The ethiopathogenesis is in most cases unclear. Based on the latest information supposed are the biopsychosocial factors.

  14. Temporomandibular Disorders (TMD) in Edentulous Patients: A Review and Proposed Classification (Dr. Bader’s Classification).

    OpenAIRE

    2015-01-01

    Temporomandibular disorders (TMD) are a collective term given to a number of clinical problems that involve the masticatory musculature, the temporomandibular joints and associated structures, or both. Although the aetiology of TMD has not been fully understood, in general it is considered to be multifactorial. The signs and symptoms of TMD which present in patients with natural teeth may also occur in edentulous patients. These symptoms may appear in various combinations and degrees. TMD has...

  15. Analgesia Evaluation of 2 NSAID Drugs as Adjuvant in Management of Chronic Temporomandibular Disorders

    OpenAIRE

    2015-01-01

    The aim of this triple-blind full-randomized clinical trial was to quantify analgesia in masticatory muscles and temporomandibular joints after occlusal splint therapy associated with the adjuvant administration of nonsteroidal anti-inflammatory drugs (NSAID) isolated or associated with other therapeutic agents. Pain relief was also recorded. Eighteen volunteers who had been suffering from chronic pain in masticatory muscles due to temporomandibular disorders were selected after anamnesis and...

  16. [Etiologic factors in temporomandibular joint disorders and pain].

    Science.gov (United States)

    De Laat, A

    1997-01-01

    Parallel to the construction of better classifications and the identification of subgroups of temporomandibular disorders, an important development has taken place in research concerning its etiology. The etiological factors implied in muscle problems refer to more generalised disorders as myofascial pain syndrome and fibromyalgia. The role of occlusal and articular factors has been brought down to realistic proportions, indicating a minor contribution. Similarly, doubt has arisen concerning the existence of a vicious cycle of pain/spasm/pain. With regard to internal derangements, emphasis has been put on the high prevalence in an otherwise normal population and the fluctuating character of the symptom. Also here, developments point towards constitutional and systemic factors, more than local influences. Trauma, however, seems to play an increasing role. The development of osteoarthrosis has been studied more in depth revealing local processes of inflammation, neurogenic inflammation and the existence of specific markers which might be important in the future. The relationship between disc derangement and the development of osteoarthrosis remains unclear.

  17. The Effect of Premolar Extraction on Temporomandibular Joint Disorders

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    L Eslamian

    2003-02-01

    Full Text Available According to researches, premolar extraction and anterior teeth retraction result in temporomandibular joint disorder due to posterior position of mandible. The aim of this study was to evaluate the effect of premolar extraction on TMJ disorder. In this interventiond study, 4 groups (10 patients for each group were treated.They were classified as 1- non extraction, 2- extraction of two upper first premolars, 3- extraction of four first premolars, 4- combined extraction groups. Helkimo scores were evaluated before treatment, after treatment, one and two years after treatment. The results were analyzed with ANOVA and paired t-test. At the end of the treatment and two years after treatment in comparison with before treatment, Helkimo score had Significant differentce in all groups (PO.001. In the second year after debanding in comparison with the first year after debanding, no significant differences were seen in each group. No significant difference was seen between the four groups in the final appraisal of TMD. It seems that extraction had no adverse effect on TMD.

  18. The Pursuit of Happiness, Stress and Temporomandibular Disorders

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    D. Marcus

    2013-11-01

    Full Text Available Mismanaging the pursuit of happiness causes negative psychological effects such as stress and disappointment. The resultant stress often manifests itself as psychological and physical health problems. We explore the problems of measuring happiness according to materialistic wealth and demonstrate that misinterpreting happiness can lead to a stress inducing pursuit. The happiness that human beings pursue is often material-based hedonism whereas eudaimonic happiness has been shown to be a by-product of the pursuit of meaningful activities. Pursuing a predefined happiness, the failure to achieve it and the resistance to it can create stress induced psychosomatic health problems; temporomandibular disorders (TMD are one such example. Masticatory myofascial pain syndrome is a form of TMD that has a strong association to psychological stress. In this paper the research on TMD associated facial pain across different socioeconomic status (SES groups is utilized to compare an objective, stress related physiological disorder with happiness data. We also discuss how the pressures of pursuing socially determined aesthetic happiness such as conforming to society’s expectations of smile and facial aesthetics can drive people to make surgical or orthodontic changes. This review proposes that pursuing happiness has the propensity to cause not only psychological stress but also negative behaviors. We aim to encourage further scientific research that will help to clarify this philosophical pursuit.

  19. Do women with migraine have higher prevalence of temporomandibular disorders?

    Directory of Open Access Journals (Sweden)

    Maria C Gonçalves

    Full Text Available OBJECTIVES: The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD, using the Research Diagnostic Criteria for TMD (RDC/TMD in women with episodic and chronic migraine (M and CM, as well as in asymptomatic women. METHOD: Sample consisted of 61 women, being 38 with M and 23 with CM, identified from a headache outpatient center; we also investigated 30 women without headaches for at least 3 months (women without headache group - WHG. Assessment of TMD was conducted by a physical therapist who was blind to the headache status. RESULTS: The prevalence of TMD, assessed through the RDC, was 33.3% in the WHG, 86.8% in the M group and 91.3% of the CM group. Differences were significant when comparing M and CM groups with WHG (p0.05 as well as higher risk for TMD [odds ratio (OR=3.15, 95% confidence interval (CI 1.73-5.71 and OR=3.97, 95%CI 1.76-8.94]. CONCLUSION: Women with migraine are more likely to have muscular and articular TMD, suggesting that both disorders might be clinically associated, which demonstrate the importance of physical therapy assessment in the multidisciplinary team.

  20. Agreement of the International Classification of Sleep Disorders Criteria with polysomnography for sleep bruxism diagnosis

    DEFF Research Database (Denmark)

    Stuginski-Barbosa, Juliana; Porporatti, André Luís; Costa, Yuri Martins

    2017-01-01

    STATEMENT OF PROBLEM: Validated questionnaires and guidelines for assessing sleep bruxism (SB) that can be administered by dentists in clinical practice are still lacking. PURPOSE: The purpose of this preliminary study was to compare the third edition of the International Classification of Sleep...

  1. Perceived orofacial pain and its associations with reported bruxism and insomnia symptoms in media personnel with or without irregular shift work.

    Science.gov (United States)

    Ahlberg, Kristiina; Ahlberg, Jari; Könönen, Mauno; Alakuijala, Anniina; Partinen, Markku; Savolainen, Aslak

    2005-08-01

    A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls in the same company with regular 8-hour daytime work. The aims were to investigate the prevalence and severity of perceived orofacial pain (Research Diagnostic Criteria for Temporomandibular Disorders Axis II) and to analyze whether current orofacial pain was associated with reported bruxism and insomnia symptoms (Diagnostic and Statistical Manual of Mental Disorders-IV and the International Classification of Sleep Disorders Revised). The response rate in the irregular shift-work group was 82.3% (56.6% men) and in the regular daytime-work group 34.3% (46.7% men). Current orofacial pain was found overall in 19.6%, of which 88.3% had experienced the pain over 6 months. All claimed that their pain fluctuated. No subjects with chronic orofacial pain reported disabling pain, and grades III and IV were not found. Insomnia symptoms and frequent bruxism were significantly more prevalent in chronic pain grade II than in lower grades. According to logistic regression, current orofacial pain was significantly positively associated with frequent bruxism (p orofacial pain and reported bruxism. The association held with both chronic orofacial pain intensity and current pain. Based on the multivariate analyses, it can be concluded that disrupted sleep and bruxism may be concomitantly involved in the development of orofacial pain.

  2. Association between temporomandibular disorders and abnormal head postures

    Directory of Open Access Journals (Sweden)

    Evandro Francisco FAULIN

    2015-01-01

    Full Text Available This study examines the possible correlation between the prevalence of temporomandibular disorders (TMD and different head postures in the frontal and sagittal planes using photographs of undergraduate students in the School of Dentistry at the Universidade de Brasília - UnB, Brazil. In this nonrandomized, cross-sectional study, the diagnoses of TMD were made with the Research Diagnostic Criteria (RDC/TMD axis I. The craniovertebral angle was used to evaluate forward head posture in the sagittal plane, and the interpupillary line was used to measure head tilt in the frontal plane. The measurements to evaluate head posture were made using the Software for the Assessment of Posture (SAPO. Students were divided into two study groups, based on the presence or absence of TMD. The study group comprised 46 students and the control group comprised 80 students. Data about head posture and TMD were analyzed with the Statistical Package for the Social Sciences, version 13. Most cases of TMD were classified as degenerative processes (group III, followed by disk displacement (group II and muscle disorders (group I. There was no sex predominance for the type of disorder. No association was found between prevalence rates for head postures in the frontal plane and the occurrence of TMD. The same result was found for the association of TMD diagnosis with craniovertebral angle among men and women, and the group that contained both men and women. Abnormal head postures were common among individuals both with and without TMD. No association was found between head posture evaluated in the frontal and sagittal planes and TMD diagnosis with the use of RDC/TMD.

  3. Anxiety and personality traits in patients with muscle related temporomandibular disorders.

    Science.gov (United States)

    Pallegama, R W; Ranasinghe, A W; Weerasinghe, V S; Sitheeque, M A M

    2005-10-01

    This study tested the hypothesis that muscle related temporomandibular disorder patients with cervical muscle pain exhibit greater degree of psychological distress compared with patients without cervical muscle pain and controls. Thirty-eight muscle related temporomandibular disorder patients including 10 patients with cervical muscle pain and 41 healthy individuals as controls participated in the study. State and trait anxiety levels were assessed with the Spielberger's state and trait anxiety inventory. Personality traits (extroversion, neuroticism, psychoticism and social desirability) were assessed using the Eysenck's personality questionnaire, and the pain intensities described over the muscles were recorded using a 100 mm visual analogue scale. The muscle related temporomandibular disorder patients, in general, exhibited significantly higher degrees of neuroticism and trait anxiety. The patients with cervical muscle pain demonstrated a significantly higher level of psychoticism compared with the patients without cervical muscle pain and the controls and a significantly higher state anxiety level than the controls. They also demonstrated higher pain intensities in masseter and temporalis muscles compared with patients without cervical muscle pain. It has been suggested that either subjects with psychological distress are prone to temporomandibular disorders, or psychological distress is a manifestation of existing chronic pain conditions. The present findings demand further investigations and broader approach in management, as muscle related temporomandibular disorder patients with cervical muscle pain were both physically and psychologically compromised to a greater degree compared with patients without cervical muscle pain.

  4. Viola Playing May Be a Strong Aggravating Factor for Temporomandibular Disorder

    Directory of Open Access Journals (Sweden)

    Mahmut Alpayci

    2014-12-01

    Full Text Available Temporomandibular disorder (TMD is the general term used to describe the symptoms originated from temporomandibular joint region. The most common symptom of the disorder is pain during mandibular movement. Etiology of TMD is multifactorial. Several factors such as trauma, occlusal discrepancies, stress, parafunctions, hypermobility, and heredity can make one more vulnerable to this disorder. It has been reported that viola playing might be a predisposing factor for TMD. In this article, we present a 24 year old male patient suffering from TMD symptoms exacerbated by viola playing and emphasize that viola playing may be a powerful aggravating factor for TMD.

  5. Impaired orofacial motor functions on chronic temporomandibular disorders.

    Science.gov (United States)

    Ferreira, Cláudia Lúcia Pimenta; Machado, Bárbara Cristina Zanandréa; Borges, Carina Giovana Pissinatti; Rodrigues Da Silva, Marco Antonio M; Sforza, Chiarella; De Felício, Cláudia Maria

    2014-08-01

    Because temporomandibular disorders (TMDs) rehabilitation continues to be a challenge, a more comprehensive picture of the orofacial functions in patients with chronic pain is required. This study assessed the orofacial functions, including surface electromyography (EMG) of dynamic rhythmic activities, in patients with moderate-severe signs and symptoms of chronic TMD. It was hypothesized that orofacial motor control differs between patients with moderate-severe chronic TMD and healthy subjects. Seventy-six subjects (46 with TMD and 30 control) answered questionnaires of severity of TMD and chewing difficulties. Orofacial functions and EMG during chewing were assessed. Standardized EMG indices were obtained by quantitative analysis of the differential EMG signals of the paired masseter and temporal muscles, and used to describe muscular action during chewing. TMD patients showed significant greater difficulty in chewing; worse orofacial scores; longer time for free mastication; a less accurate recruitment of the muscles on the working and balancing sides, reduced symmetrical mastication index (SMI) and increased standardized activity during EMG test than healthy subjects. SMI, TMD severity and orofacial myofunctional scores were correlated (Porofacial functions and increased activity of the muscles of balancing sides during unilateral chewing characterized the altered orofacial motor control in patients with moderate-severe chronic TMD. Implications for rehabilitation are discussed.

  6. Research Diagnostic criteria for Temporomandibular Disorders: current status & future relevance.

    Science.gov (United States)

    Dworkin, S F

    2010-10-01

    The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), published in 1992, was based on international expert recommendations and available empirical data. The major rationale was to offer a putative diagnostic and classification system whose reliability, validity and clinical usefulness for TMD diagnosis and classification could be scientifically evaluated and then revised using an evidence-based model for successive iterations. The present journal issue attests to the accomplishment of that major objective: the RDC/TMD has been translated into 18 languages and used very extensively in international research. One important component of that research has been to yield reliable and valid data resulting in an evidence-based revision of the RDC/TMD now available for continuing research and clinical application. The present article offers recommendations and speculations regarding how the RDC/TMD may continue to serve the function of guiding future research and, most importantly, serve as an evidence-based diagnostic and classification system to aid in the rational choice of clinical care for TMD sufferers around the world.

  7. An association between temporomandibular disorder and gum chewing.

    Science.gov (United States)

    Correia, Diana; Real Dias, Maria Carlos; Castanho Moacho, Antonio; Crispim, Pedro; Luis, Henrique; Oliveira, Miguel; Carames, Joao

    2014-01-01

    This single center, randomized, small study sought to investigate the prevalence and frequency of chewing gum consumption, and whether there is a relationship between these factors and the presence of symptoms associated with temporomandibular disorder (TMD). Subjects were divided into 7 groups based on their parafunctional oral habits. Of these, subjects who chewed gum were divided into 5 subgroups (A-E) based on their gum chewing habits. Group A chewed gum 3 hours at a time (n = 8); the frequency of gum chewing in Groups A-D was once a week. Group E subjects chewed gum 1-3 times/week for at least 1 hour each occurrence (n = 2). Sixty-three percent of the subjects in Group D reported TMD symptoms of arthralgia and myofascial pain. Thirty-three percent of the subjects in Group C showed symptoms of arthralgia. Eighty-three percent of the subjects in Group A and 27% in Group B reported myofascial pain. All subjects in Group E reported masseter hypertrophy. The remaining 2 groups were Group F, subjects that didn't chew gum but had other parafunctional oral habits (n = 2), and Group G, subjects who didn't have parafunctional oral habits (n = 12).

  8. Predictors for the development of temporomandibular disorders in scuba divers.

    Science.gov (United States)

    Lobbezoo, F; van Wijk, A J; Klingler, M C; Ruiz Vicente, E; van Dijk, C J; Eijkman, M A J

    2014-08-01

    The aim was to determine predictors for the development of complaints of temporomandibular disorders (TMD) in a large sample of Dutch scuba divers who were free of any TMD complaints before they started diving actively. Five-hundred and thirty-six scuba divers (mean ± SD age = 40.4 ± 11.9 years; 34.1% women) completed a specifically developed questionnaire, either online or on paper. Stepwise forward logistic regression analysis was performed to predict the presence of TMD pain, with several potential risk factors as predictors. Four hundred and eighty-five of the 536 respondents were free of any TMD pain before they started diving actively. In this sample, TMD pain was present in 214 persons (44.1%). Four predictors contributed significantly to the presence of TMD pain, viz., clenching (OR = 2.466), warm water (OR = 1.685), biting on the mouthpiece (OR = 1.598), and the quality rating of the mouthpiece (OR = 0.887, that is, a higher rating means a smaller odds of having TMD pain). TMD pain is a common complaint among scuba divers who were free of such complaints before they started diving actively. Clenching, biting on the mouthpiece, and a low rating of the mouthpiece are predictors for the presence of TMD pain in scuba divers, while diving in cold water serves as a protective factor for TMD pain.

  9. Orthodontics and temporomandibular disorder: a meta-analysis.

    Science.gov (United States)

    Kim, Myung-Rip; Graber, Thomas M; Viana, Marlos A

    2002-05-01

    As the importance of evidence-based health care has grown, meta-analysis has become more widely used in the medical and dental fields. In this meta-analysis, the relationship between traditional orthodontic treatment, including the specific type of appliance used and whether extractions were performed, and the prevalence of temporomandibular disorders (TMD) was investigated. After an exhaustive literature search of 960 articles, we found 31 that met the inclusion criteria (18 cross-sectional studies or surveys and 13 longitudinal studies). We divided and extracted data from the 31 articles according to study designs, symptoms, signs, or indexes. Due to severe heterogeneity, the results were summarized without further statistical analysis. The heterogeneous result might originate from lack of a universal diagnostic system and the variability of TMD. Because of heterogeneity, a definitive conclusion cannot be drawn. The data included in this comprehensive meta-analysis do not indicate that traditional orthodontic treatment increased the prevalence of TMD. It is apparent that a reliable and valid diagnostic classification system for TMD is needed for future research.

  10. Relationship of Occlusal Schemes with the Occurrence of Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Dina H. Sugiaman

    2013-07-01

    Full Text Available Masticatory system is a complex functional unit of the body responsible for mastication, speech, and deglutition process. Temporomandibular disorders (TMD is used to describe all functional disturbances of the masticatory system. The etiology of TMD is multifactorial, such as occlusal disharmony and emotional stress. The relationship between occlusion and TMD has been highly debated in dentistry, one of the occlusal factors is the occlusal scheme. Occlusal schemes are defined as bilateral canine guidance, unilateral canine guidance, group function and balanced occlusion. However, studies about the relationship of occlusal schemes and the occurrence of the TMD are still limited and remained controversial. Objective: To investigate the relationship of occlusal schemes witht he occurrence of TMD. Methods: A cross-sectional study was conducted at the Faculty of Dentistry, Uniiversitas Indonesia. A total of 127 students were included in this study. Subjects were examined based on Clinical Helkimo Index and divided into TMD and non-TMD groups. Subjects were categorized as non-TMD groups if the value of the clinical Helkimo index was 0 and as TMD group when the value ranged between 1-25. Results: Balanced occlusion schemes has a greater risk of TMD occurrence with odds ratio value 5.6 and 95% confidence interval 1.188 to 26.331 (p=0.021. Conclusion: Balanced occlusion has a significant relationship with the occurrence of TMD.

  11. Temporomandibular disorders and parafunctional oral habits: an anamnestic study

    Directory of Open Access Journals (Sweden)

    Melissa de Oliveira Melchior

    2012-04-01

    Full Text Available OBJECTIVE: To assess the frequency and severity of the signs and symptoms of temporomandibular disorders (TMD, the frequency of parafunctional oral habits and the correlation between the variables by means of the patients' perception regarding their problem. METHODS: One hundred patients diagnosed with TMD, through a clinical examination of their masticatory system, answered the questions of a previously published protocol concerning the signs and symptoms most frequently reported in the literature. RESULTS: According to the results from the non parametric statistical analysis, the frequency for the following signs and symptoms was significant: Fatigue and muscle pain, joint sounds, tinnitus, ear fullness, headache, chewing impairment and difficulty to yawn (p<0.01 and otalgia (p<0.05. As to the parafunctional oral habits, there was a significant presence of teeth clenching during the day and night (p<0.01 and teeth grinding at night (p<0.05. The variable correlation analysis showed that there was a positive correlation between symptom frequency and severity; age was correlated with the presence of otalgia, cervical pain and teeth sensitivity, besides being correlated with muscle and joint pain severity. Habit frequency was negatively correlated with age. TMD duration was also positively correlated with the symptoms of tinnitus, ear fullness, muscle and joint pain. CONCLUSION: The study results showed that the anamnestic assessment using ProDTMMulti can predict the severity of the TMD case.

  12. Radiological Evaluation of Temporomandibular Joint Disorders Followed by Clinical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won; You Dong Soo [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1989-11-15

    The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4 : 1. 2. The most common clinical findings was the pain on open mouth position (42.43%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. 7. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

  13. Orthodontic risk factors for temporomandibular disorders (TMD). I: Premolar extractions.

    Science.gov (United States)

    Kremenak, C R; Kinser, D D; Harman, H A; Menard, C C; Jakobsen, J R

    1992-01-01

    Concern about claims that premolar extractions may put patients at risk for temporomandibular disorders (TMD) led to this study. We report first findings from a longitudinal study of orthodontic patients begun in 1983. By using the methods of Helkimo, we collected TMD data before initiation of orthodontic treatment, between 0 and 12 months after debanding, and 12 to 24 months after debanding. Analyses related Helkimo scores with premolar extractions in 65 patients for whom orthodontic treatment had been completed. Twenty-six patients were treated without premolar extractions, 25 had four premolars extracted, and 14 had two upper premolars extracted. Tests for significance of differences between mean Helkimo scores were conducted for the nonextraction group compared with the extraction groups, and between pretreatment and posttreatment Helkimo scores for each group. Results included: (1) no significant intergroup differences between mean pretreatment or posttreatment scores, and (2) small but statistically significant (p less than 0.05) differences (in the direction of improvement) between mean pretreatment and posttreatment scores for both the nonextraction group and for the four premolar extraction group.

  14. Orthodontics as a risk factor for temporomandibular disorders (TMD). II.

    Science.gov (United States)

    Kremenak, C R; Kinser, D D; Melcher, T J; Wright, G R; Harrison, S D; Ziaja, R R; Harman, H A; Ordahl, J N; Demro, J G; Menard, C C

    1992-01-01

    Debate about orthodontic treatment as a risk factor for temporomandibular disorders (TMD) led to this study. This report, the second in a series, concerns findings from a longitudinal study in which 30 new orthodontic patients have been enrolled annually since 1983. The method of Helkimo was used to collect TMD data before initiation of orthodontic treatment, and at annual intervals after debanding. Treatment was by fixed edgewise appliances. Data from a pretreatment and at least one posttreatment Helkimo examination were available for 109 patients. Follow-up data were available for 92 patients in the first year after debanding, with the corresponding sample sizes declining to 56, 33, 19, 11, and 7 for the second through the sixth posttreatment years, respectively. Primary analyses involved comparison of mean scores from the Helkimo 25-point dysfunction index scale. There were no significant differences between mean pretreatment and posttreatment Helkimo scores for any of the various groupings except for small, clinically unimportant improvements seen in the 12 to 24 month subgroup of 55 patients and in the 48 to 60 month subgroup of 11 patients. With average follow-up time of about 2 years for the 109 patients, 90% had Helkimo scores that stayed the same or improved, and 10% had scores that increased or worsened from 2 to 5 Helkimo points. We conclude that the orthodontic treatment experienced by our sample was not an important etiologic factor for TMD.

  15. Occlusion, Orthodontic treatment, and temporomandibular disorders: a review.

    Science.gov (United States)

    McNamara, J A; Seligman, D A; Okeson, J P

    1995-01-01

    A review of the current literature regarding the interaction of morphologic and functional occlusal factors relative to TMD indicates that there is a relatively low association of occlusal factors in characterizing TMD. Skeletal anterior open bite, overjets greater than 6 to 7 mm, retruded cuspal position/intercuspal position slides greater than 4 mm, unilateral lingual crossbite, and five or more missing posterior teeth are the five occlusal features that have been associated with specific diagnostic groups of TMD conditions. The first three factors often are associated with TMJ arthropathies and may be the result of osseous or ligamentous changes within the temporomandibular articulation. With regard to the relationship of orthodontic treatment to TMD, the current literature indicates that orthodontic treatment performed during adolescence generally does not increase or decrease the odds of developing TMD later in life. There is no elevated risk of TMD associated with any particular type of orthodontic mechanics or with extraction protocols. Although a stable occlusion is a reasonable orthodontic treatment goal, not achieving a specific gnathologically ideal occlusion does not result in TMD signs and symptoms. Thus, according to the existing literature, the relationship of TMD to occlusion and orthodontic treatment is minor. Signs and symptoms of TMD occur in healthy individuals and increase with age, particularly during adolescence; thus, TM disorders that originate during various types of dental treatment may not be related to the treatment but may be a naturally occurring phenomenon.

  16. Analysis of sagittal condyl inclination in subjects with temporomandibular disorders

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    Dodić Slobodan

    2010-01-01

    Full Text Available Bacground/Aim. Disturbances of mandibular border movements is considered to be one of the major signs of temporomandibular disorders (TMD. The purpose of this study was to evaluate the possible association between disturbances of mandibular border movements and the presence of symptoms of TMD in the young. Methods. This study included two groups of volunteers between 18 and 26 years of age. The study group included 30 examineers with signs (symptoms of TMD, and the control group also included 30 persons without any signs (symptoms of TMD. The presence of TMD was confirmed according to the craniomandibular index (Helkimo. The functional analysis of mandibular movements was performed in each subject using the computer pantograph. Results. The results of this study did not confirm any significant differences between the values of the condylar variables/sagittal condylar inclination, length of the sagital condylar guidance, in the control and in the study group. Conclusion. The study did not confirm significant differences in the length and inclination of the protrusive condylar guidance, as well as in the values of the sagittal condylar inclination between the subjects with the signs and symptoms of TMD and the normal asymptomatic subjects.

  17. Botulinum toxin for treating muscular temporomandibular disorders: a systematic review

    Directory of Open Access Journals (Sweden)

    Eduardo Machado

    2012-12-01

    Full Text Available OBJECTIVE: This study, through a systematic literature review, aims to analyze the effectiveness of Botulinum Toxin as a treatment for masticatory myofascial pain and muscles temporomandibular disorders (TMD. METHODS: Survey in research bases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs and BBO, between the years of 1966 and April 2011, with focus in randomized or quasi-randomized controlled clinical trials, blind or double-blind. RESULTS: After applying the inclusion criteria, 4 articles comprised the final sample: 3 were double-blind randomized controlled clinical trials and 1 was single-blind randomized controlled clinical trial. CONCLUSIONS: According to the literature, there is lack of evidence about the real effectiveness of botulinum toxin in the treatment of masticatory myofascial pain and muscular TMD. Thus, further randomized controlled clinical trials, with representative samples and longer follow-up time, to assess the real effectiveness of the technique are needed.OBJETIVO: este trabalho, por meio de uma revisão sistemática da literatura, teve como objetivo analisar a efetividade da toxina botulínica como tratamento para dor miofascial mastigatória e disfunções temporomandibulares (DTM musculares. MÉTODOS: pesquisa nas bases de dados Medline, Cochrane, Embase, Pubmed, Lilacs e BBO, no período entre 1966 e abril de 2011, com enfoque em estudos clínicos controlados randomizados ou quase-randomizados, cegos ou duplo-cegos. RESULTADOS: após a aplicação dos critérios de inclusão, chegou-se a 4 artigos, sendo que 3 eram estudos clínicos controlados randomizados duplo-cego e 1 era estudo clínico controlado randomizado simples-cego. CONCLUSÕES: pela análise da literatura, verificou-se um número reduzido de evidências significativas sobre a real efetividade da toxina botulínica no tratamento da dor miofascial e de DTM musculares. Assim, são necessários novos estudos clínicos controlados randomizados, com amostras

  18. Sleep bruxism and anxiety level in children.

    Science.gov (United States)

    Oliveira, Marcelo Tomás de; Bittencourt, Sandra Teixeira; Marcon, Karina; Destro, Samia; Pereira, Jefferson Ricardo

    2015-01-01

    This study evaluated the association of level of anxiety in children with and without sleep bruxism (SB). The study was performed with 84 six- to eigth-years-old children, divided into two groups: with bruxism (BG) and without bruxism (CG). Following the criteria purposed by American Academy of Sleep Medicine (AASM) to determine SB, the presence of tooth wear has been verified through clinical examinations, and the parents have answered a questionnaire about their children's behavior and habits. Additionally, the State-Trait Anxiety Inventory for Children (STAIC) was applied to parents of the selected patients. Data analysis revealed a statistical significant difference between the groups (Student's t-test, p = 0.0136). Based on the results, anxiety assessment revealed that children with bruxism have reached higher levels in the STAIC scale than the non-bruxism group. Therefore, it indicates a direct relationship between the presence of anxiety disorder and the onset of bruxism in children.

  19. Association Between Self-Reported Bruxism and Malocclusion in University Students: A Cross-Sectional Study

    Science.gov (United States)

    Kataoka, Kota; Ekuni, Daisuke; Mizutani, Shinsuke; Tomofuji, Takaaki; Azuma, Tetsuji; Yamane, Mayu; Kawabata, Yuya; Iwasaki, Yoshiaki; Morita, Manabu

    2015-01-01

    Objectives Bruxism can result in temporomandibular disorders, oral pain, and tooth wear. However, it is unclear whether bruxism affects malocclusion. The aim of this study was to examine the association between self-reported bruxism and malocclusion in university students. Methods Students (n = 1503; 896 men and 607 women) aged 18 and 19 years were examined. Malocclusion was defined using a modified version of the Index of Orthodontic Treatment Need. The presence of buccal mucosa ridging, tooth wear, dental impression on the tongue, palatal/mandibular torus, and the number of teeth present were recorded, as well as body mass index (BMI). Additional information regarding gender, awareness of bruxism, orthodontic treatment, and oral habits was collected via questionnaire. Results The proportion of students with malocclusion was 32% (n = 481). The awareness of clenching in males with malocclusion was significantly higher than in those with normal occlusion (chi square test, P < 0.01). According to logistic regression analysis, the probability of malocclusion was significantly associated with awareness of clenching (odds ratio [OR] 2.19; 95% confidence interval [CI], 1.22–3.93) and underweight (BMI <18.5 kg/m2) (OR 1.89; 95% CI, 1.31–2.71) in males but not in females. In subgroup analyses, the probability of crowding was also significantly associated with awareness of clenching and underweight (P < 0.01) in males. Conclusions Awareness of clenching and underweight were related to malocclusion (crowding) in university male students. PMID:25865057

  20. A clinical study of temporomandibular disorder. The value of bone scintigraphy as an aid to diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Sugiura, Masashi [Nippon Dental Univ. (Japan). School of Dentistry at Niigata

    2000-07-01

    Temporomandibular disorder (TMD) is still not defined with respect to the point of an entity, terminological problems, and clinical classification and gradings. Moreover, diagnostic problems of internal deranegement and osteodeformity at the temporomandibular joint such as type IV and mechanism of bone remodeling at condylar head are also still not clear. In this investigation, we tried to classify the severity and progressive grading according to the symptoms and objective laboratory data taken from soft tissues such as muscles related to mastication, discs and ligaments, and hard tissues such as condylar head and temporal bone changes around the temporomandibular joint. Preliminary diagnostic clinical tool of the assessment of temporomandibular joint by maens of bone scintigraphy was attributed to the additional diagnostic procedure and research for the bone remodeling for the temporomandibular disorder because this can be defined between subjective and objective symptoms in this disorder. Bone scintigraphy will solve many problems concerning undefined degenerative bone changes in TMD, enable more accurate diagnosis, and the selection of treatment and prognosis in future investigation. Also, it is believed single photon emission computed tomography (SPECT) nuclear bone imaging is a highly accurate diagnostic method for craniomandibular disorders. (author)

  1. The Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD)

    NARCIS (Netherlands)

    Visscher, C.M.; Ohrbach, R.; van Wijk, A.J.; Wilkosz, M.; Naeije, M.

    2010-01-01

    For musculoskeletal disorders like low back pain and fibromyalgia, evidence is growing for fear of movement to play an important role in the development of chronic pain. In temporomandibular disorder (TMD) patients, however, this construct has not received any attention yet. Therefore, in this paper

  2. [Diagnosis and classification of headache and temporomandibular disorders, a new opportunity].

    Science.gov (United States)

    Koole, P; Koole, R

    2011-05-01

    Patients with orofacial pains are generally treated by physicians. A small number of patients are treated for pain in the temporomandibular joint, the masticatory and the neck muscles, by dentists and orofacial surgeons. Among half of the patients being treated in neurological headache clinics, the temporomandibular joint and the masticatory muscles are the source of the pain. In order to achieve better research and a classification, the International Headache Society, consisting largely of neurologists, developed a classification system. A comparable development occurred among oral health specialists. Employing these 2 methods with the same patients leads to different diagnoses and treatments. Both the International Classification of Headache Disorders II and the Research Diagnostic Criteria for Temporomandibular Disorders are being revised. This creates the opportunity to establish a single classification for these orofacial pains, preferably within the new International Classification of Headache Disorders.

  3. Personality traits, subjective health complaints, experimental pain sensitivity, and psychophysiological responding in female temporomandibular disorder (TMD) patients

    OpenAIRE

    Mohn, Hanne Christine

    2008-01-01

    Temporomandibular disorders (TMD) comprise a category of chronic complaints of pain and/or mobility dysfunction of the orofacial region. The main symptoms are pain from the temporomandibular joint and/or in the masticatory structures – sometimes radiating to the temples, head, and neck - clicking sounds from the temporomandibular joint, and restricted movement of the jaw. Psychological characteristics of TMD patients are mainly elevated levels of psychological distress, a relatively low corre...

  4. Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi arabian adolescents: a research report

    Directory of Open Access Journals (Sweden)

    Feteih Rabab M

    2006-08-01

    Full Text Available Abstract Background The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD and oral parafunction habits among Saudi adolescents in the permanent dentition stage. Methods A total of 385 (230 females and 155 males school children age 12–16, completed a questionnaire and were examined clinically. A stratified selection technique was used for schools allocation. Results The results showed that 21.3% of the subjects exhibited at least one sign of TMD and females were generally more affected than males. Joint sounds were the most prevalent sign (13.5% followed by restricted opening (4.7% and opening deviation (3.9%. The amplitude of mouth opening, overbite taken into consideration, was 46.5 mm and 50.2 mm in females and males respectively. TMJ pain and muscle tenderness were rare (0.5%. Reported symptoms were 33%, headache being the most frequent symptom 22%, followed by pain during chewing 14% and hearing TMJ noises 8.7%. Difficulty during jaw opening and jaw locking were rare. Lip/cheek biting was the most common parafunction habit (41% with females significantly more than males, followed by nail biting (29%. Bruxism and thumb sucking were only 7.4% and 7.8% respectively. Conclusion The prevalence of TMD signs were 21.3% with joint sounds being the most prevalent sign. While TMD symptoms were found to be 33% as, with headache being the most prevalent. Among the oral parafunctions, lip/cheek biting was the most prevalent 41% followed by nail biting 29%.

  5. Temporomandibular disorders in scuba divers-an increased risk during diving certification training.

    Science.gov (United States)

    Oztürk, Ozmen; Tek, Mustafa; Seven, Hüseyin

    2012-11-01

    The design of a diving regulator's mouthpiece increases the risk of a temporomandibular disorder (TMD) in scuba divers. The total weight of a diving regulator is reflected directly on the temporomandibular joint, causing articular and periarticular disorders. In the current study, the prevalence of TMD in scuba divers triggered during diving certification training is investigated. We also aimed to determine the factors that lead to TMD during diving training and clarify the observation that there is an increased incidence of TMD in inexperienced divers. The study was held between 2006 and 2011. Ninety-seven divers were referred with the complaint of pain around temporomandibular area. The divers were classified according to their diving experience. Symptoms and signs of TMD were graded. Fourteen divers were diagnosed with TMD. Temporomandibular disorder was seen more frequently in inexperienced divers than in experienced divers (P = 0.0434). The most prevalent symptom was an increased effort for mouthpiece gripping. Temporomandibular joint tenderness and trigger point activation were the mostly seen physical signs. Thirteen divers had an improvement with therapy. The increased effort for stabilizing the mouthpiece is a recognized factor in TMD development. Attention must be paid to an association of scuba diving with TMDs, especially in inexperienced divers having a scuba certification training.

  6. Temporomandibular disorders in relation to female reproductive hormones: a literature review.

    Science.gov (United States)

    Nekora-Azak, Aysen

    2004-05-01

    Temporomandibular disorders (TMD) are common pain conditions that have the highest prevalence among women of reproductive age. The pattern of onset after puberty and lowered prevalence rates in the postmenopausal years suggest that female reproductive hormones may play an etiologic role in temporomandibular disorders. The purpose of this article is to review the role of female reproductive hormones in TMD. English-language peer-reviewed articles between 1975 and 2002 were identified using Medline as well as a hand search and were reviewed.

  7. Familial aggregation of anxiety associated with bruxism

    Directory of Open Access Journals (Sweden)

    David Gorski

    2015-07-01

    Practical Implications: Anxiety disorders are highly related to suicidal behaviors, particularly in children and adolescents. Additionally, awaken bruxism can often serve as an indicator of anxiety or stress. By recognizing bruxism as a possible manifestation of psychological distress, the dental practitioner may be able to direct patients to life-saving services like psychologists and crisis hotlines when appropriate.

  8. Trauma in patients with temporomandibular disorders: frequency and treatment outcome.

    Science.gov (United States)

    De Boever, J A; Keersmaekers, K

    1996-02-01

    Controversy exists on the aetiological importance and the effect of jaw macrotrauma (fractures excluded) on the occurrence of temporomandibular joint disorders (TMD). The purpose of this study was to assess the incidence of jaw injury in TMD patients and to compare the severity of the symptoms, the clinical characteristics and the treatment outcome in TMD patients with or without a history of trauma to the head and neck region directly linked to the onset of symptoms. The study sample included 400 consecutive TMD clinical patients. In 24.5% of patients the onset of the pain and dysfunction could be linked directly to the trauma, mainly whiplash accidents. No significant differences could be found between the two groups in daily recurrent headache, dizziness, neck pain, joint crepitation and pain in the joints. Maximal mouth opening was less than 20 mm in 14.3% of patients with a history of trauma and in 4.1% of those without such a history. According to the Helkimo dysfunction index (DI), more trauma than non-trauma TMD patients belonged to the severe dysfunction groups (DI 4 and 5) at first examination. The outcome of a conservative treatment procedure (counselling, occlusal splint, physiotherapy, occasionally occlusal therapy and non-steroidal anti-inflammation drugs was not different between the two groups at the 1 year evaluation. The degree of maximal opening was similar: less than 20 mm in 3.7% and 2.2% in trauma and non-trauma patients respectively. Forty percent and 41% respectively were symptom free or had DI = 1. The results suggest that external trauma to the joint or to the jaw in general is an important initiating factor in the aetiology of TMD but also that the prognosis is favourable.

  9. Sleep bruxism - genetic factors and psychoactive substances : Studies in Finnish twins

    OpenAIRE

    Rintakoski, Katariina

    2014-01-01

    Background: Genetic and environmental factors have a varying influence on oral health-related problems. Although studies have been conducted, the contribution of genetic factors to sleep-related bruxism remains obscure. Bruxism causes several physical problems, including abnormal tooth wear, pain in the temporomandibular joint or jaw muscles, and headaches, as well as social problems. The detailed aetiology of bruxism is unknown. In addition to genetic factors, psychoactive substances are con...

  10. Effect of Mandibular Advancement Device Therapy on the Signs and Symptoms of Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Ritva Näpänkangas

    2012-12-01

    Full Text Available Objectives: Mandibular advancement device therapy is effectively used in the treatment of obstructive sleep apnea, but also several side effects in the masticatory system have been reported. The aim of this study was to evaluate the subjective symptoms and clinical signs of temporomandibular disorders connected to mandibular advancement device therapy. Material and Methods: The material consisted of 15 patients (9 men and 6 women, mean age 51.1 years, range 21 to 70 years diagnosed with obstructive sleep apnea (OSA. Subjective symptoms and clinical temporomandibular disorders (TMD signs were recorded at the beginning of the treatment (baseline and at 1-month, 3-month, 6-month and 24-month follow-ups. The degree of TMD was assessed using the anamnestic (Ai and the clinical dysfunction index (Di of Helkimo. For assessing the effect of TMD the patients were divided in discontinuing and continuing groups. Results: According to Ai and Di, the severity of TMD remained unchanged during the follow-up in most of the patients. Temporomandibular joint (TMJ crepitation was found more frequently in discontinuing patients at all follow-ups. The difference was statistically significant (P < 0.05 at the six-month follow-up. Masticatory muscle pain during palpation was a frequent clinical sign at the baseline and during the follow-up period but the difference between discontinuing and continuing patients was not significant. Conclusions: It seems that signs and symptoms of temporomandibular disorders do not necessarily increase during long-term mandibular advancement device therapy. However, it seems that patients with clinically assessed temporomandibular joint crepitation may discontinue their mandibular advancement device therapy due to temporomandibular disorders.

  11. MR of 2270 TMJs: prevalence of radiographic presence of otomastoiditis in temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Orhan, Kaan [Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ankara University, 06500 Besevler, Ankara (Turkey)]. E-mail: call53@yahoo.com; Nishiyama, Hideyoshi [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Tadashi, Sasaki [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Shumei, Murakami [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Furukawa, Souhei [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan)

    2005-07-01

    Objective: : The purpose of this study is to determine the prevalence of radiographic presence of otomastoiditis while examining temporomandibular joint (TMJ) disorders in magnetic resonance images (MRI) in a series of 2270 temporomandibular joint magnetic resonance images and to examine the relationship between otomastoiditis and TMJ disorders. Materials and methods: : 2270 temporomandibular joint magnetic resonance images and patients' data were retrospectively investigated. Magnetic resonance images were obtained from the patients who referred to Osaka University Dental Hospital Outpatient Clinic with TMJ complaints for the last four years (from January 1998 to January 2003). The patients, who were diagnosed as otomastoiditis based on their temporomandibular joint magnetic resonance images, were sent to Osaka University Hospital Department of Otolaryngology for a medical consultation in order to have their pathologies certified following their MR process. Age and sex were recorded for all patients and for otomastoiditis cases; location of the disease, symptoms of patients and TMJ findings were noted as well. Results: : Seven patients were diagnosed as acute otomastoiditis and one patient diagnosed as chronic active otitis media with cholesteatoma in the series of 2270 MR, which were representing a prevalence of 0.39%. Neurilemoma diagnosed in left mastoid process in one patient. The final diagnoses of all patients were made after medical consultation. Conclusion: : While examining temporomandibular joint magnetic resonance images; it is not only important to examine just the TMJ structures, but also to look at the nearby anatomical features to check evidence for inflammatory disease.

  12. Evaluation of occlusal factors in patients with temporomandibular joint disorder

    Directory of Open Access Journals (Sweden)

    Max Dória Costa

    2012-12-01

    Full Text Available OBJECTIVE: The aim of this study was to determine the prevalence and the relation between the main occlusal factors and the temporomandibular disorder (TMD. METHODS: We analyzed 100 patients (50 diagnosed with TMD and 50 asymptomatic volunteers, control group through a questionnaire that classified TMD as absent, mild, moderate and severe. Then, an evaluation was made of intraoral occlusal factors: Absence of posterior teeth, wear facets, overjet, overbite, open bite, posterior crossbite, sagittal relationship (Class I, II and III, centric relation discrepancy for maximum intercuspation, anterior guidance and balancing occlusal interference. The c² examined the association between TMD and considered occlusal variables. RESULTS: The prevalence of studied occlusal factors was higher in patients with moderate and severe TMD. Statistically significant results were found on: Absence of five or more posterior teeth, overbite and overjet greater than 5 mm, edge-to-edge bite, posterior crossbite, Class II and III, the absence of effective anterior guide and balancing side interferences. CONCLUSIONS: Indeed, it is concluded that there is a relationship between TMD and occlusal factors, however it can not be told to what extent these factors are predisposing, precipitating or perpetuating the disease. Therefore, despite its multifactorial etiology, one can not neglect the occlusal analysis of these patients.OBJETIVO: o presente estudo teve como objetivo verificar a prevalência e relação dos principais fatores oclusais com a disfunção temporomandibular. MÉTODOS: foram analisados 100 pacientes (50 com diagnóstico de DTM e 50 voluntários assintomáticos, grupo controle através de um questionário para classificação do grau de DTM, em ausente, leve, moderada e severa. Em seguida, foi realizada uma avaliação intrabucal dos fatores oclusais ausência de dentes posteriores, facetas de desgaste, overjet, overbite, mordida aberta anterior, mordida

  13. Prevalence of signs and symptoms of temporomandibular disorders in children in the State of Puebla, Mexico, evaluated with the research diagnostic criteria for temporomandibular disorders (RDC/TMD).

    Science.gov (United States)

    Moyaho-Bernal, Angeles; Lara-Muñoz, Ma Del Carmen; Espinosa-De Santillana, Irene; Etchegoyen, Graciela

    2010-01-01

    The aim of this work was to describe the prevalence of signs and symptoms of temporomandibular disorders (TMD) in children of the State of Puebla, Mexico. A descriptive observational study was performed. After calculating sample size, children who met the following selection criteria were included: registered at an official elementary school, either sex, ages between 8 and 12 years, who accept to participate in the study and whose parents have signed the informed consent forms. The Research Diagnostic Criteria for Temporomandibular Disorders were used by calibrated researchers (Kappa 90) under the same conditions. Descriptive statistics were applied by using SPSSv15 software. The study included 235 children, 129 (54.9%) female and 106 (45.1%) male, of average age 9.31 + 1.2 years. Prevalence of signs and symptoms was 33.2%, and predominately muscular (82%), 48.1% showed signs of muscular pain and 19.1% joint pain. 63.4% showed signs of alteration in the mouth opening pattern, 39.1% presented joint sounds on opening or closing the mouth and 20.4% on mandibular excursions. The high prevalence of signs and symptoms related to temporomandibular disorders, in particular in children with mixed dentition, shows the importance of TMD evaluation during this period, when morphological changes associated to growth and craniofacial development prevail.

  14. Case-Based Learning for Orofacial Pain and Temporomandibular Disorders.

    Science.gov (United States)

    Clark, Glenn T.; And Others

    1993-01-01

    The use of interactive computer-based simulation of cases of chronic orofacial pain and temporomandibular joint disfunction patients for clinical dental education is described. Its application as a voluntary study aid in a third-year dental course is evaluated for effectiveness and for time factors in case completion. (MSE)

  15. Time courses of myofascial temporomandibular disorder complaints during a 12-month follow-up period

    NARCIS (Netherlands)

    M.K.A. van Selms; F. Lobbezoo; M. Naeije

    2009-01-01

    AIMS: To investigate the time courses of myofascial temporomandibular disorder (TMD) pain and mandibular function impairment (MFI), and to identify predictive factors associated with these time courses. METHODS: During a 12-month period following conservative TMD treatment, the time courses of myofa

  16. The association between generalized joint hypermobility and temporomandibular joint disorders : A systematic review

    NARCIS (Netherlands)

    Dijkstra, PU; Kropmans, TJB; Stegenga, B

    2002-01-01

    To analyze conflicting evidence in the literature for the association between temporomandibular joint disorders (TMD) and generalized joint hypermobility (GJH), we performed a bibliographic search. The methodological quality of the 14 papers found was assessed according to 14 criteria. Papers were i

  17. Validity of the Research Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings.

    NARCIS (Netherlands)

    Steenks, M.H.; Wijer, A. de

    2009-01-01

    The lack of standardized diagnostic criteria for defining clinical subtypes of temporomandibular disorders (TMD) was the main motive to create the Research Diagnostic Criteria for TMD (RDC/TMD), which were provided to allow standardization and replication of research into the most common forms of mu

  18. Is there an association between temporomandibular disorders and playing a musical instrument? A review of literature

    NARCIS (Netherlands)

    Atallah, M.M.; Visscher, C.M.; van Selms, M.K.A.; Lobbezoo, F.

    2014-01-01

    Temporomandibular disorders (TMDs) have a multifactorial etiology. Among others, parafunctions and oral habits have been suggested as important initiating and perpetuating factors. Playing a musical instrument that loads the masticatory system, like wind instruments and the violin or viola, has been

  19. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings

    NARCIS (Netherlands)

    Manfredini, D.; Guarda-Nardini, L.; Winocur, E.; Piccotti, F.; Ahlberg, J.; Lobbezoo, F.

    2011-01-01

    Objectives. The aim of this study was to summarize and systematically review the literature on the prevalence of different research diagnostic criteria for temporomandibular disorders (RDC/TMD) version 1.0 axis I diagnoses in patient and in the general populations. Study design. For each of the rele

  20. COMPUTED-TOMOGRAPHY IN DIFFERENTIAL-DIAGNOSIS OF TEMPOROMANDIBULAR-JOINT DISORDERS

    NARCIS (Netherlands)

    DEBONT, LGM; VANDERKUIJL, B; STEGENGA, B; VENCKEN, LM; BOERING, G

    1993-01-01

    Computed tomography (CT) has great potential for imaging intra- and extracapsular hard-tissue abnormality of the temporomandibular joint (TMJ). CT is not the best method of imaging disk position and form. For differential diagnosis of TMJ disorders, CT is especially successful in bony lesions. The s

  1. Effect of hypnosis on oral function and psychological factors in temporomandibular disorders patients

    DEFF Research Database (Denmark)

    Abrahamsen, Randi; Zachariae, Robert; Svensson, Peter

    2009-01-01

    This study investigated the effect of hypnosis in patients with temporomandibular disorders (TMD) with focus on oral function and psychological outcomes. Forty women (mean age +/- s.d.: 38.6 +/- 10.8 years) suffering from TMD (mean duration 11.9 +/- 9.9 years) were randomized to four individual 1...... and anxiety (P

  2. Comorbid disorders and sociodemographic variables in temporomandibular pain in the general Dutch population

    NARCIS (Netherlands)

    Visscher, C.M.; Ligthart, L.; Schuller, A.A.; Lobbezoo, F.; de Jongh, A.; van Houtem, C.M.H.H.; Boomsma, D.I.

    2015-01-01

    Aims: (1) To determine the prevalence of temporomandibular disorder (TMD)-pain complaints in the general Dutch population; (2) to investigate its relationship with age, sex, educational attainment, and country of birth; (3) to determine its association with other pain complaints; and (4) to determin

  3. Comorbid Disorders and Sociodemographic Variables in Temporomandibular Pain in the General Dutch Population

    NARCIS (Netherlands)

    Visscher, Corine M.; Ligthart, Lannie; Schuller, Annemarie A.; Lobbezoo, Frank; de Jongh, Ad; van Houtem, Caroline M. H. H.; Boomsma, Dorret I.

    2015-01-01

    Aims: (1) To determine the prevalence of temporomandibular disorder (TMD) pain complaints in the general Dutch population; (2) to investigate its relationship with age, sex, educational attainment, and country of birth; (3) to determine its association with other pain complaints; and (4) to determin

  4. Evaluation of mandibular condylar bony changes in temporomandibular disorders using Polytome-U images

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    1998-08-15

    The author examined bone changes from 1274 polytomographic images of 182 temporomandibular joints which showed symptoms of temporomandibular disorder and the following results were obtained; 1. The number of temporomandibular joints which showed bone changes were 64 (35.2%) among 182 joints. 2. The age and sex distribution of 64 joints which had bone changes showed the prevalence of female (90.6%) and third decade (25.0%) followed by fourth (21.2%) and second decade (17.2%). 3. The 252 images which showed bone changes consisted of 56 images from lateral side (22.2%), 118 images from center (46.8%) and 78 images from medial side (30.9%). 4. The most frequently observed bone changes were flattening (22.7%) followed by sclerosis (19.3%) and cortical unsharpness (19.3%)

  5. Prevalence of different temporomandibular joint sounds, with emphasis on disc-displacement, in patients with temporomandibular disorders and controls.

    Science.gov (United States)

    Elfving, Lars; Helkimo, Martti; Magnusson, Tomas

    2002-01-01

    Temporomandibular joint (TMJ) sounds are very common among patients with temporomandibular disorders (TMD), but also in non-patient populations. A variety of different causes to TMJ-sounds have been suggested e.g. arthrotic changes in the TMJs, anatomical variations, muscular incoordination and disc displacement. In the present investigation, the prevalence and type of different joint sounds were registered in 125 consecutive patients with suspected TMD and in 125 matched controls. Some kind of joint sound was recorded in 56% of the TMD patients and in 36% of the controls. The awareness of joint sounds was higher among TMD patients as compared to controls (88% and 60% respectively). The most common sound recorded in both groups was reciprocal clickings indicative of a disc displacement, while not one single case fulfilling the criteria for clicking due to a muscular incoordination was found. In the TMD group women with disc displacement reported sleeping on the stomach significantly more often than women without disc displacement did. An increased general joint laxity was found in 39% of the TMD patients with disc displacement, while this was found in only 9% of the patients with disc displacement in the control group. To conclude, disc displacement is probably the most common cause to TMJ sounds, while the existence of TMJ sounds due to a muscular incoordination can be questioned. Furthermore, sleeping on the stomach might be associated with disc displacement, while general joint laxity is probably not a causative factor, but a seeking care factor in patients with disc displacement.

  6. An evaluation on occlusal relation and malocclusion in the incidence of temporomandibular disorders among Mashhad adolescents

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    Madani AS.

    2004-07-01

    Full Text Available Statement of Problem: In recent years, the prevalence of temporomandibular disorders among children and adolescents has increased, however, no study on the correlation between occlusal relations and temporomandibular disorders, in Mashhad adolescents, has been conducted yet. Purpose: The aim of this study was to survey the relationship between occlusal indices and temporomandibular disorders (TMD among Mashhad adolescents, with the age range of 11-14 years old. Methods and Material: In this descriptive cross-sectional study, 1066 students (533 males and 533 females, age ranging from 11-14 years old (12.620.96 years, from seven Mashhad educational regions, were selected. Temporomandibular joints were thoroughly examined for all subjects. All occlusal indices including dentition system, angles classification, types of malooclusion such as cross-bite, deep-bite as well as types of lateral occlusion, premature contacts in lateral and protrusive movements were investigated. Data were analyzed statistically using, Chi-Square and logestic regression tests. Results: The prevalence of TMD was 23.5%. There was no significant relation between TMD and type of dentition, angles classification and type of occlusion in lateral movements, however, statistically significant relation was found between TMD and deep over bite (P<0.05. Premature contacts in lateral movements at balancing side were proved to be significant etiologic factors of TMD (P=0.003. Conclusion: In the present study, premature contacts at balancing side and secondary deepbite malocclusion were considered to be the most important etiologic factors of TMD.

  7. The role of occlusion in temporomandibular disorders--a review of the literature.

    Science.gov (United States)

    Mackie, Andrew; Lyons, Karl

    2008-06-01

    According to the glossary of prosthodontic terms, temporomandibular disorders (TMD) are defined as: "Conditions producing abnormal, incomplete or impaired function of the temporomandibular joint(s)" or "a collection of symptoms related to the masticatory system, frequently observed in various combinations" (van Blarcom et al., 2005). Others have defined TMD as a collective term, embracing several clinical problems involving the muscles, temporomandibular joint (TMJ), or both (Okeson, 1996). TMDs form a cluster of related disorders with common symptoms which include localised pain, limited or asymmetric movement, and clicks or grating on opening. Unfortunately, there appears to be no consensus regarding the definition of a temporomandibular disorder within the literature (Mohlin and Thilander, 1984; Okeson, 2003a), and there is considerable variation among epidemiological studies. These studies report that between 5 and 50% of individuals experience TMD pain (Dworkin and Massoth, 1994), with females comprising 75% to 84% of those affected (Dworkin et al., 1990). This may be related to differences in pain measurement criteria or study design, and women tending to present for treatment more readily than men. The aim of this article is to review the history of how occlusion became associated with TMD, and the extent of that association in the contemporary scientific literature.

  8. Factors involved in the etiology of temporomandibular disorders - a literature review

    OpenAIRE

    CHISNOIU, ANDREA MARIA; PICOS, ALINA MONICA; POPA, SEVER; CHISNOIU, PETRE DANIEL; LASCU, LIANA; PICOS, ANDREI; CHISNOIU, RADU

    2015-01-01

    Background and aim This review aims at presenting a current view on the most frequent factors involved in the mechanisms causing temporomandibular disorders (TMD). Method We conducted a critical review of the literature for the period January 2000 to December 2014 to identify factors related to TMD development and persistence. Results The etiology of TMD is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. Occlusal overload...

  9. Management of Temporo-Mandibular Disorders in children and adolescents: A literature review

    OpenAIRE

    Rosales ME, Miguel; Garrocho DC, José; Ruiz MC, María; Márquez MC, Raúl; Pozos PhD, Amaury

    2016-01-01

    The purpose of this review is to provide the fundamental information for the early diagnosis of temporomandibular disorders (TMD) in children and adolescents, taking in account that the general trend among Dentists is to believe that these kind of disorders do not occur in the pediatric patient, or that they are present very rarely.  However, this is not true; therefore, it is mandatory that, during the comprehensive clinical exam of the pediatric patient, a meticulous evaluation of the devel...

  10. Reported concepts for the treatment modalities and pain management of temporomandibular disorders

    OpenAIRE

    2015-01-01

    Background Pain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management. Methods A survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ ...

  11. Trastornos temporomandibulares: Perfil clínico, comorbilidad, asociaciones etiológicas y orientaciones terapéuticas Temporomandibular disorders: clinical profile, comorbility, etiological associations and therapeutical guidelines

    Directory of Open Access Journals (Sweden)

    W. Meeder Bella

    2010-08-01

    Full Text Available Objetivo: El propósito de la presente investigación fue dilucidar factores etiológicos y determinar la comorbilidad en enfermos con trastornos temporomandibulares (TTM y dolor orofacial (DOF, con el objetivo de definir orientaciones terapéuticas. Materiales y métodos: Se realizó un estudio clínico-anamnésico entre abril de 2004 y abril de 2008, en pacientes que concurrieron en forma espontánea a la clínica universitaria de la especialidad. Resultados: Se examinaron 263 pacientes, de los cuales 80,22% fueron mujeres. El motivo de consulta más prevalente fue dolor cráneo-cérvicofacial (84%. El 49,43% de los pacientes no reconoció la causa de inicio del problema, siendo "estrés/depresión" (24,71% la más referida. Los TTM representaron una condición eminentemente crónica: el 34,55% de los pacientes relataron un tiempo de evolución entre 1-5 años, solo un 17,58% tuvo una evolución menor de 6 meses. La frecuencia relativa de diagnósticos, no excluyentes, fue: dolor muscular local, 81,37%; capsulitis/sinovitis, 74,52%; y desórdenes psicosociales, 61,98%. Se observó alta comorbilidad con cefaleas, 55,89%; alteraciones psicosociales, 52,47%; disturbios del sueño, 39,54%, y alteraciones cervicales, 28,9% Discusión: Las características sociodemográficas y clínicas de los pacientes evaluados, se corresponden con los reportes de la literatura actual. Se encontraron asociaciones significativas entre: bruxismo y dolor muscular local (p=0,014; bruxismo y capsulitis/sinovitis (p=0,025, y depresión severa/moderada con dolor muscular local (p=0,006. Se concluye que para el tratamiento de pacientes con TTM es necesaria la autorregulación física, el control de parafunciones y la colaboración interdisciplinaria.Purpose: The aim of this study was to elucidate the etiologic factors and assess comorbidity in patients with temporomandibular disorders (TMD and orofacial pain (OFP, to define therapeutic guidelines. Materials and methods: A

  12. Prevalence of neuropathic symptoms in patients referred for temporomandibular disorder in a Chilean hospital, 2014-2015.

    OpenAIRE

    Sebastian Miranda; Carol Gayoso; Patricio Ruiz; Diego Halabi

    2015-01-01

    Aim: To determine the prevalence of neuropathic symptoms in the orofacial region in patients referred for painful temporomandibular disorder at Hospital Base Valdivia in 2014 and 2015. Materials and method: An observational study was conducted on patients referred for painful temporomandibular disorder by general dentists working in primary dental health care at Hospital Base Valdivia, during October 2014 and March and April 2015. Patients were asked to complete the LANSS pain scale by...

  13. Freqüência de relatos de parafunções nos subgrupos diagnósticos de DTM de acordo com os critérios diagnósticos para pesquisa em disfunções temporomandibulares (RDC/TMD Frequency of relates of parafunctions in the diagnostic subgroups of TMD according to research diagnostic criteria for temporomandibular disorders (RDC/TMD

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    Raquel Stumpf Branco

    2008-04-01

    Diagnostic Criteria for Temporomandibular Disorders" (RDC/TMD. Parafunctional habits are those not related to the execution of normal functions of stomatognatic system. Bruxism is characterized by nocturnal involuntary parafunctional activity of masticatory muscles, while clenching is considered as a diurnal parafunction involving this musculature, although this may also occur at night. OBJECTIVE: the goal of the present study was to evaluate the frequency of relates of diurnal and/or nocturnal oral parafunctions in patients with TMD in different diagnostic subgroups of RDC/TMD. METHODOLOGY: it has been used data from 217 patients that seek for treatment at TMD and Orofacial Pain Clinic of Petropolis Medicine School, being evaluated through questionnaire and physical examination that compose RDC/TMD. RESULTS: from 182 TMD patients studied, 76.9% has related some kind of parafunction, that could be diurnal, nocturnal or both. Diurnal parafunction was the most frequent related among TMD subgroups, present in 64.8% of cases against 55.5% of cases with relates of bruxism. Relate of both parafunctions was verified in 43.4% of TMD patients. CONCLUSION: regarding each diagnostic subgroup, relates of diurnal and nocturnal parafunctions has been more frequent in patients of miofascial pain group.

  14. Early interception of skeletal-dental factors predisposing to temporomandibular disorders during child development.

    Science.gov (United States)

    Romagnoli, M; Landi, N; Manfredini, D; Gandini, P; Bosco, M

    2003-02-01

    Temporomandibular disorders (TMD) comprise a heterogoneous group of pathologies or dysfunctions of the temporomandibular joints and their related neuromuscular systems. The multifactoral etiology of these disorders raises serious diagnostic and therapeutic problems. A modern approach demands close collaboration between a number of specialists in order to create the best possible treatment plan. The progressive nature of certain forms of TMD, combined with the major advantages deriving from early treatment, encourage the dental surgeon to carry out early interception of all those dental and/or skeletal anomalies which may determine the dysharmonic function and development of the facial mass, even though such anomalies may not represent the sole causes of the various forms of TMD. The general practitioner, and to an even greater extent the pediatrician, may therefore play a role of primary importance as those medical influences capable of early detection of TMD risk situations.

  15. Pain detection by clinical questionnaire in patients referred for temporomandibular disorders in a Chilean hospital.

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    Tomás Maturana

    2015-10-01

    Full Text Available Aim: To determine pain frequency by means of a clinical screening questionnaire in patients with temporomandibular disorders (TMD referred to the general Hospital of Valdivia (HBV between September and December 2014. Material and method: A descriptive study, which included patients referred to the TMD Unit of the dental service at HBV between September and December 2014, was carried out. A clinical screening questionnaire was applied by an examiner in order to detect painful Temporomandibular Joint Disorders. The variables age, sex, wait time, and presence of related TMD pain were measured. Results: 101 patients were surveyed; 88.17% (84 patients were women. Average age was 33.5 (11-70 years; 66% of patients had mandibular pain or stiffness upon awakening; 80% informed pain related to painful TMD. Conclusion: Most surveyed patients were women. Pain was highly frequent in the surveyed population; its main location was in temporal areas.

  16. Fatores predisponentes de desordem temporomandibular em crianças com 6 a 11 anos de idade ao início do tratamento ortodôntico Factors predisposing 6 to 11-year old children in the first stage of orthodontic treatment to temporomandibular disorders

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    Patrícia Porto Loddi

    2010-06-01

    Full Text Available INTRODUÇÃO: atualmente, considera-se multifatorial a etiologia da desordem temporomandibular (DTM, na qual fatores psicológicos, parafunções orais, má oclusão morfológica e funcional constituem possíveis causas para o desenvolvimento dessa disfunção. OBJETIVO: avaliar as crianças que procuram por tratamento ortodôntico preventivo, visando compreender melhor suas queixas e avaliar a prevalência de sinais e sintomas de desordem temporomandibular. MÉTODOS: sessenta e cinco crianças, com idades variando entre 6 e 11 anos, foram avaliadas por dois examinadores. RESULTADOS: o bruxismo foi o sintoma que apresentou o maior índice de prevalência na amostra estudada e a deglutição atípica apresentou o maior índice dentre os fatores predisponentes. CONCLUSÃO: recomenda-se que a avaliação dos possíveis sinais e sintomas da DTM em crianças seja adotada como rotina durante o exame clínico inicial.INTRODUCTION: The etiology of temporomandibular disorders (TMD's is currently considered multifactorial, involving psychological factors, oral parafunctions, morphological and functional malocclusion. OBJECTIVES: In keeping with this reasoning, we evaluated children who seek preventive orthodontic treatment, to better understand their grievances and to assess the prevalence of TMD signs and symptoms in these patients. METHODS: Two examiners evaluated 65 children aged 6 to 11 years. RESULTS: In our sample, bruxism featured the highest prevalence rate, whereas atypical swallowing displayed the highest rate among predisposing factors. CONCLUSION: We therefore recommend that the evaluation of possible TMD signs and symptoms in children be adopted as routine in the initial clinical examination.

  17. Association and Correlation between Temporomandibular Disorders and Psychological Factors in a Group of Dental Undergraduate Students

    OpenAIRE

    Divya Sood; Arun V Subramaniam; Tulsi Subramaniam

    2014-01-01

    Aims/Objectives: To evaluate the prevalence and severity of temporomandibular disorders (TMD) and presence of psychological factors (i.e.,anxiety and depression levels) in dental undergraduate students. Second purpose was to assess the association and correlation between TMD degree and psychological factors viz. anxiety and depression. Materials and methods: The sample comprised of 400 Dental undergraduatestudents aged 18- 25 years, including both the genders. TMD degree was evaluated usi...

  18. The knowledge level of dental surgeons regarding the relationship between occlusal factors and Temporomandibular Disorders (TMD)

    OpenAIRE

    Jefferson Filippo Castro de ASSIS; SILVA,Pâmela Lopes Pedro da; LIMA,Jully Anne Soares de; FORTE,Franklin Delano Soares; Batista,André Ulisses Dantas

    2015-01-01

    AbstractIntroductionThe relationship between dental occlusion and temporomandibular disorders (TMD) remains a subject of disagreement. Many professionals erroneously base diagnosis and treatment strictly on the occlusal factor, despite the fact that current scientific evidence does not show such a relationship.ObjectiveTo evaluate the knowledge of dental surgeons (DSs) from João Pessoa (PB)-Brazil, regarding the relationship between occlusal factors and TMD.Materials and methodA sample of 100...

  19. Assessment of temporomandibular disorder and occlusion in treated class III malocclusion patients

    OpenAIRE

    Karyna Valle-Corotti; Arnaldo Pinzan; Caio Vinícius Martins do Valle; Ana Carla Raphaelli Nahás; Mauro Vinícius Corotti

    2007-01-01

    Objective: The aims of this study were to compare the prevalence of temporomandibular disorders (TMD) in individuals submitted to either orthodontic or ortho-surgical Class III malocclusion treatment and to assess the influence of occlusal aspects on TMD severity. Material and methods: The sample consisted of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery). The presence of signs and symptoms of TMD was evaluated...

  20. Temporomandibular disorders in patients with removable partial dentures: prevalence according to Kennedy classification

    OpenAIRE

    2013-01-01

    OBJECTIVE: The aim of this study was to determine the prevalence of temporomandibular disorders in patients with removable partial dentures according to Kennedy classification. METHOD: The population consisted of patients who required care at the State University of Ponta Grossa. The patients wore complete upper and lower removable partial dentures between 1 to 5 years. The patients were divided into five groups (n = 15): G1: wearer of complete maxillary denture opposed by a Class I (Kennedy)...

  1. Association of edentulousness and removable prosthesis rehabilitation with severity of signs and symptoms of temporomandibular disorders

    OpenAIRE

    2016-01-01

    Context: There are very few studies concerning the role of denture status in temporomandibular disorders (TMDs) and those show conflicting results. Aim: To evaluate the association of edentulousness and removable prosthesis rehabilitation with severity of TMD signs and symptoms. Settings and Design: Data were collected from 2000 subjects reporting for dental treatment, above 30 years of age. Subjects and Methods: The subjects were interviewed with a questionnaire and clinically exami...

  2. Cephalometric deviations present in children and adolescents with temporomandibular joint disorders

    OpenAIRE

    Leticia Vilaça Willeman Bastos; Ricardo de Souza Tesch; Odilon Victor Porto Denardin

    2012-01-01

    INTRODUCTION: Temporomandibular disorders (TMD) have proved to be a risk factor for developing hyperdivergent facial growth patterns. OBJECTIVE: The aims of this study were: (1) Assess differences between the cephalometric measurements in children with articular TMD and a control group, before and after mandibular growth peak according to cervical vertebral maturation; and (2) Identify a predictive model capable of differentiating patients with TMD and control group patients based on early ce...

  3. Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample

    OpenAIRE

    de-Pedro-Herráez, Miguel; Mesa-Jiménez, Juan; Fernández-de-las-Peñas, César; de-la-Hoz-Aizpurua, José-Luis

    2016-01-01

    Background Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. Objetives The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of sy...

  4. Temporomandibular disorders and oral habits in high-school adolescents: a public health issue?

    OpenAIRE

    OLIVEIRA,Carolline Bronzeado de; Lima,Jully Anne Soares de; SILVA,Pâmela Lopes Pedro da; Forte, Franklin Delano Soares [UNESP; Bonan,Paulo Rogério Ferreti; Batista, André Ulisses Dantas

    2016-01-01

    ABSTRACT Objective: Determine the prevalence of signs and symptoms of temporomandibular disorder (TMD) and its relationship with parafunctional habits in a sample of adolescents. Methods: The sample consisted of 129 high school students, between 16 and 19 years old in public schools. Data were collected through: a questionnaire about parafunctional habits and TMD symptoms, the Fonseca's index (DMF) and a summarized protocol of clinical evaluation of the TMD signals. These data were analyz...

  5. EXAMINATION OF TEMPOROMANDIBULAR DISORDERS IN THE ORTHODONTIC PATIENT: A CLINICAL GUIDE

    OpenAIRE

    Ana Claúdia de Castro Ferreira Conti; Paula Vanessa Pedron Oltramari; Ricardo de Lima Navarro; Márcio Rodrigues de Almeida

    2007-01-01

    The possible association between orthodontic treatment and temporomandibular disorders (TMD) is a topic of great interest in the current literature. The true role of orthodontic therapy on the etiology of TMD, however, is still uncertain. From the clinical prospective, a thorough examination of the stomatognathic system is always necessary in order to detect possible TMD signs and symptoms prior to the beginning of the orthodontic therapy. Caution should be exercised when planning, performing...

  6. Evolution of occlusion and temporomandibular disorder in orthodontics: Past, present, and future.

    Science.gov (United States)

    Okeson, Jeffrey P

    2015-05-01

    Occlusion has been an important consideration in orthodontics since the beginning of the discipline. Early emphasis was placed on the alignment of the teeth, the stability of the intercuspal position, and the esthetic value of proper tooth positioning. These factors remain important to orthodontists, but orthopedic principles associated with masticatory functions must also be considered. Orthopedic stability in the masticatory structures should be a routine treatment goal to help reduce risk factors associated with developing temporomandibular disorders.

  7. Signs and symptoms of temporomandibular disorders in adolescents Sinais e sintomas de disfunção temporomandibular em adolescentes

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    Leonardo Rigoldi Bonjardim

    2005-06-01

    Full Text Available The aim of this study was to verify the prevalence of signs and symptoms of temporomandibular disorders (TMD in adolescents and its relationship to gender. The sample comprised 217 subjects, aged 12 to 18. The subjective symptoms and clinical signs of TMD were evaluated, using, respectively, a self-report questionnaire and the Craniomandibular Index, which has 2 subscales; the Dysfunction Index and the Palpation Index. The results of muscle tenderness showed great variability (0.9-32.25%. In relation to the temporomandibular joint, tenderness of the superior, dorsal and lateral condyle regions occurred in 10.6%, 10.6% and 7.83%, respectively, of the sample. Joint sound during opening was present in 19.8% of the sample and during closing in 14.7%. The most prevalent symptoms were joint sounds (26.72% and headache (21.65%. There was no statistical difference between genders (p > 0.05, except for the tenderness of the lateral pterygoid muscles, which presented more prevalence in girls. In conclusion, clinical signs and symptoms of TMD can occur in adolescents; however, gender influence was not perceived.O objetivo deste estudo foi verificar a prevalência de sinais e sintomas de disfunção temporomandibular (DTM em adolescentes e sua relação com o gênero. A amostra foi constituída de 217 voluntários, com idade entre 12 e 18 anos. Os sintomas subjetivos e os sinais clínicos de DTM foram avaliados usando-se, respectivamente, um questionário e o "Craniomandibular Index", o qual possui 2 subescalas: "Dysfunction Index" e "Palpation Index". Os resultados para sensibilidade muscular mostraram grande variabilidade (0,9-32,25%. Com relação à articulação temporomandibular, a sensibilidade à palpação nas regiões superior, dorsal e lateral do côndilo ocorreu, respectivamente, em 10,6%, 10,6% e 7,83% da amostra. A prevalência do ruído articular no movimento de abertura foi de 19,8% e no fechamento, 14,7%. Os sintomas relatados mais

  8. Association between signs and symptoms of temporomandibular disorders and pregnancy (case control study).

    Science.gov (United States)

    Mayoral, Verónica A; Espinosa, Irene A; Montiel, Alvaro J

    2013-01-01

    Temporomandibular disorders (TMD) are a combination of multifactoral etiological muscular-skeletal symptoms. Prevalence is greater in women, where sexual hormones are important in pathogenesis, and its behavior at different stages of the reproductive life of women has never been fully documented. The general objective was to determine the association between signs and symptoms of temporomandibular disorders and pregnancy. A case-control study was conducted on 66 pregnant patients who met with a medical specialist and 66 non-pregnant women paired by age, who visited the General Regional Hospital 36 of Mexico's Social Security Institute (IMSS). These patients were examined for the Temporomandibular (TMD) research project to establish the prevalence of TMD in both groups. Descriptive variables were calculated through him SPSS 17 program and the association between groups with Xi Square and Ratio Possibilities (OR), The average age was 28.23 +/- 5.9 years in both groups, with median gestation 32.97 weeks. Most of the participants had a domestic partner. The prevalence of TDM in the non-pregnant group was 45.5% and only 15.2% in the pregnant group (chi2 = 14.34, p disorders.

  9. Painful temporomandibular disorders, self reported tinnitus, and depression are highly associated

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    Giovana Fernandes

    2013-12-01

    Full Text Available Objective The aim of this study was to investigate the association among painful temporomandibular disorders (TMD, self reported tinnitus, and levels of depression. Method The sample consisted of 224 individuals with ages ranges from 18 to 76 years. The Research Diagnostic Criteria for Temporomandibular Disorders Axis I were used to classify TMD and Axis II were used for self reported tinnitus, and to score the levels of depression. The odds ratio (OR with 95% confidence interval (CI was applied. Results The presence of painful TMD without tinnitus was significantly associated with moderate/severe levels of depression (OR=9.3, 95%; CI: 3.44-25.11. The concomitant presence of painful TMD and tinnitus self-report increased the magnitude of the association with moderate/severe levels of depression (OR=16.3, 95%; CI, 6.58-40.51. Conclusion Painful temporomandibular disorders, high levels of depression, and self reported tinnitus are deeply associated. However, this association does not imply a causal relationship.

  10. Etiological factors correlated with temporomandibular disorder in complete denture wearers: a comparative analysis

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    Ricardo Alexandre Zavanelli

    2009-01-01

    Full Text Available Objective: The aim of this study was to make a comparative evaluation of the prevalence of temporomandibular disorder in complete denturewearers, with regard to the etiological factors, such as gender, age, and complete dentures clinical conditions, according to the anamnestic(Ai and clinical (Di dysfunction index, developed by Helkimo.Methods: The randomized sample was composed of 90 institutionalized patients and bimaxillary complete denture wearers, with a mean ageof 67.2 years, who were included in this study. The collected data were tabulated and the Kruskal-Wallis and Chi-square statistical tests were applied, at the level of significance of 5% (p<0.05.Results: Statistically significant difference in the prevalence of temporomandibular disorder was observed with regard to the ages of the current complete dentures, free-way space, wear of the occlusal surfaces of the artificial teeth, and the conditions of retention and stability of the maxillary and mandibular complete dentures, according to both the indexes. Conclusion: The patients who wore complete dentures in adequate clinical conditions presented fewer signs and symptoms of temporomandibular disorder than the patients who wore complete dentures in poor clinical conditions.

  11. The Role of Transcutaneous Electrical Nerve Stimulation in the Management of Temporomandibular Joint Disorder.

    Science.gov (United States)

    Awan, Kamran Habib; Patil, Shankargouda

    2015-12-01

    Temporomandibular joint disorders (TMD) constitutes of a group of diseases that functionally affect the masticatory system, including the muscles of mastication and temporomandibular joint (TMJ). A number of etiologies with specific treatment have been identified, including the transcutaneous electrical nerve stimulation (TENS). The current paper presents a literature review on the use of TENS in the management of TMD patients. Temporomandibular joint disorder is very common disorder with approximately 75% of people showing some signs, while more than quarter (33%) having at least one symptom. An attempt to treat the pain should be made whenever possible. However, in cases with no defined etiology, starting with less intrusive and reversible techniques is prescribed. Transcutaneous electrical nerve stimulation is one such treatment modality, i.e. useful in the management of TMD. It comprises of controlled exposure of electrical current to the surface of skin, causing hyperactive muscles relaxation and decrease pain. Although the value of TENS to manage chronic pain in TMD patients is still controversial, its role in utilization for masticatory muscle pain is significant. However, an accurate diagnosis is essential to minimize its insufficient use. Well-controlled randomized trials are needed to determine the utilization of TENS in the management of TMD patients.

  12. Bruxismo Bruxism

    OpenAIRE

    RE Frugone Zambra; C. Rodríguez

    2003-01-01

    El bruxismo es una actividad parafuncional que consiste en el apriete y rechinamiento dentario, es de etiología multifactorial y está asociado principalmente a stress y a alteraciones del sueño o parasomnias. De acuerdo a las características clínicas particulares, se presentan diferentes tipos de bruxismo asociándose principalmente con adultos y aunque se presenta escasamente en niños, se debe diferenciar del desgaste fisiológico en dicha población.Bruxism as a parafunctional activity consist...

  13. Roentgencraniometric analysis of the angular craniofacial dimensions in subjects with temporomandibular disorders

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    Dodić Slobodan

    2007-01-01

    Full Text Available Introduction: Anomalies in growth and development of the craniofacial skeleton, particularly of vertical dysplasia, may be accompanied by distinct signs and symptoms of temporomandibular disorders. Vertical dysplasia followed by numerous occlusal disturbances alters muscular activity resulting in non-physiological strain on articular structures and their remodelling. Objective. The purpose of this study was to evaluate a possible assocciation between certain morphologic features of the craniofacial skeleton and the presence of signs and symptoms of temporomandibular disorders in young adults with preserved natural dentition. Method. The investigation was carried out on 30 lateral cephalometric radiographs made of 30 subjects with signs and symptoms of temporomandibular disorders. According to the values of the ANB angle (Steiner cephalometric analysis, all subjects were classified in the skeletal class 1.The control group consisted of 50 lateral cephalometric radiographs made of subjects with the skeletal class 1 without signs and symptoms of temporomandibular disorders. The roentgencraniometric analysis of lateral cephalometric radiographs included the evaluation of 20 angular dimensions. Results. The result of this study points at significant differences between the Bolton standards and the following angular dimensions in subjects with temoromandibular disorders:(S-Na-Pg, (B-Na-Pg, (Pns-Ans-(Go-Gn, Occl-i, (S-Na-i, (S-Na-(Go-Me, (Go-Me-i, SNB. The comparative analysis between the subjects of the experimental and the control group revealed significant differences in the values of the following angular dimensions: OccP-(Go-Po i (S-N-(Go-Me at the level of p<0.001. Conclusion. The values of the analyzed angular dimensions in both subjects of the experimental and the control group show significant differences when related to the same angular dimensions in the Bolton standards. This can be explained by specific morphologic features of the

  14. Evaluation of condylar positions in patients with temporomandibular disorders: A cone-beam computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Imanimoghaddam, Mahrokh; Mahdavi, Pirooze; Bagherpour, Ali; Darijani, Mansoreh; Ebrahimnejad, Hamed [Dept. of Oral and Maxillofacial Radiology, Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad (Iran, Islamic Republic of); Madani, Azam Sadat [Dept. of Oral and Maxillofacial Radiology, Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad (Iran, Islamic Republic of)

    2016-06-15

    This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.

  15. Application of Infrared Thermal Imaging in a Violinist with Temporomandibular Disorder.

    Science.gov (United States)

    Clemente, M; Coimbra, D; Silva, A; Aguiar Branco, C; Pinho, J C

    2015-12-01

    Temporomandibular disorders (TMD) consist of a group of pathologies that affect the masticatory muscles, temporomandibular joints (TMJ), and/or related structures. String instrumentalists, like many orchestra musicians, can spend hours with head postures that may influence the biomechanical behavior of the TMJ and the muscles of the craniocervicomandibular complex (CCMC). The adoption of abnormal postures acquired during performance by musicians can lead to muscular hyperactivity of the head and cervical muscles, with the possible appearance of TMD. Medical infrared thermography is a non-invasive procedure that can monitor the changes in the superficial tissue related to blood circulation and may serve as a complement to the clinical examination. The objective of this study was to use infrared thermography to evaluate, in one subject, the cutaneous thermal changes adjacent to the CCMC that occur before, during, and after playing a string instrument.

  16. Replacement of Missing Anterior Teeth in a Patient with Temporomandibular Disorder

    Directory of Open Access Journals (Sweden)

    Satheesh B. Haralur

    2014-01-01

    Full Text Available The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth.

  17. Recent Tissue Engineering Advances for the Treatment of Temporomandibular Joint Disorders.

    Science.gov (United States)

    Aryaei, Ashkan; Vapniarsky, Natalia; Hu, Jerry C; Athanasiou, Kyriacos A

    2016-12-01

    Temporomandibular disorders (TMDs) are among the most common maxillofacial complaints and a major cause of orofacial pain. Although current treatments provide short- and long-term relief, alternative tissue engineering solutions are in great demand. Particularly, the development of strategies, providing long-term resolution of TMD to help patients regain normal function, is a high priority. An absolute prerequisite of tissue engineering is to understand normal structure and function. The current knowledge of anatomical, mechanical, and biochemical characteristics of the temporomandibular joint (TMJ) and associated tissues will be discussed, followed by a brief description of current TMD treatments. The main focus is on recent tissue engineering developments for regenerating TMJ tissue components, with or without a scaffold. The expectation for effectively managing TMD is that tissue engineering will produce biomimetic TMJ tissues that recapitulate the normal structure and function of the TMJ.

  18. Bruxism (Teeth Grinding or Clenching) (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Bruxism (Teeth Grinding or Clenching) KidsHealth > For Parents > Bruxism ( ... called bruxism , which is common in kids. About Bruxism Bruxism is the medical term for the grinding ...

  19. Is the incidence of temporomandibular disorder increased in polycystic ovary syndrome?

    Science.gov (United States)

    Soydan, Sidika Sinem; Deniz, Kagan; Uckan, Sina; Unal, Aslı Dogruk; Tutuncu, Neslihan Bascıl

    2014-11-01

    The prevalence of temporomandibular disorders is higher among women than men (ratio 3:1 -9:1). Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in women, which is characterised by chronic low-grade inflammation and excess of androgenic hormones that lead to metabolic aberrations and ovarian dysfunction. Increased activities of various matrix metalloproteinases (particularly MMP-2 and 9) in the serum of these patients has been reported, and it has been hypothesised that high activities of MMP may contribute to loss of matrix and chronic inflammation of the fibrocartilage in temporomandibular disorders. Our aim was to evaluate the incidence of temopormandibular dysfunction in women with PCOS compared with an age-matched, disease-free, control group. We studied 50 patients with previously diagnosed PCOS and 50 volunteers who had normal menstrual cycles. We made a comprehensive clinical examination of the temporomandibular joint (TMJ) and muscles of mastication in both groups and recorded the Visual Analogue Scores (VAS) for pain. There were significant differences (ptemporomandibular disorders (n=43 (86%) in the PCOS group compared with n=12 24% in the control group), muscle tenderness(n=32 (64%) in the PCOS group compared with n=14 (28%) in the control group) and pain in the TMJ (mean (SD) VAS 2.9 (2.61) compared with 0.3 (1.56). We confirm the higher incidence and severity of disorders of the TMJ in patients with PCOS and suspect that chronic low-grade inflammation may play a part in the aetiology of the disease.

  20. Association between estrogen levels and temporomandibular disorders: a systematic literature review

    Science.gov (United States)

    Berger, Marcin; Szalewski, Leszek; Bakalczuk, Magdalena; Bakalczuk, Szymon; Szkutnik, Jacek

    2015-01-01

    Introduction To evaluate whether the hypothesis that estrogen levels are associated with temporomandibular disorders (TMD) in humans can be confirmed or contradicted by available literature. Material and methods A systematic review based on the content of PubMed, Scopus, and Cochrane Library databases was performed. Studies were identified using a combination of key words ‘temporomandibular disorder’ and ‘estrogen’. Nine studies were included into our review. Results The relationship between estrogen levels and TMD was found in seven out of nine reviewed papers. Results from two papers suggest that a high estrogen level is associated with an increased prevalence of TMD. Five additional papers found a relationship between a low estrogen level and an increase in TMD pain. In considering the value of evidence and inconsistencies of results in the reviewed publications, we state that there is weak evidence to support the hypothesis that estrogen levels are associated with TMD. Conclusions Results of reviewed studies were divergent and sometimes contradictory. One possible explanation is that estrogen influences TMD pain processing differently than temporomandibular joints (TMJ) structures, as shown in many animal studies. Estrogen may influence TMD pain processing differently than TMJ structures. We suggest consideration of the dual action of estrogen when planning future studies on its association with TMD. PMID:26848299

  1. Correlation between signs of temporomandibular (TMD) and cervical spine (CSD) disorders in asthmatic children.

    Science.gov (United States)

    Chaves, Thaís Cristina; Grossi, Débora Bevilaqua; de Oliveira, Anamaria Siriani; Bertolli, Fabiana; Holtz, Amanda; Costa, Dirceu

    2005-01-01

    Neck accessory respiratory muscles and mouth breathing suggest a direct relationship among asthma, Temporomandibular (TMD) and Cervical Spine (CSD) Disorders. This study was performed to evaluate and correlate TMD, CSD in asthmatic and non-asthmatic. Thirty asthmatic children (7.1 +/- 2.6 years old), 30 non-asthmatic predominantly mouth breathing children (Mouth Breathing Group - MBG) (8.80 +/- 1.61 years) and 30 non-asthmatic predominantly nasal breathing children (Nasal breathing Group - NBG) (9.00 +/- 1.64 years) participated in this study and they were submitted to clinical index to evaluate stomatognathic and cervical systems. Spearman correlation test and Chi-square were used. The level of significance was set at p temporomandibular joint (TMJ), TMJ sounds, pain during cervical extension and rotation, palpatory tenderness of sternocleidomastoids and paravertabrae muscles and a severe reduction in cervical range of motion were observed in AG. Both AG and MBG groups demonstrated palpatory tenderness of posterior TMJ, medial and lateral pterygoid, and trapezius muscles when compared to NBG. Results showed a positive correlation between the severity of TMD and CSD signs in asthmatic children (r = 0.48). No child was considered normal to CSD and cervical mobility. The possible shortening of neck accessory muscles of respiration and mouth breathing could explain the relationship observed between TMD, CSD signs in asthmatic children and emphasize the importance of the assessment of temporomandibular and cervical spine regions in asthmatic children.

  2. Temporomandibular joint development and functional disorders related to clinical otologic symptomatology.

    Science.gov (United States)

    Badel, Tomislav; Savić-Pavicin, Ivana; Zadravec, Dijana; Marotti, Miljenko; Krolo, Ivan; Grbesa, Durdica

    2011-03-01

    Temporomandibular disorders (TMDs) are a form of musculoskeletal pain of the temporomandibular joint (TMJ) and/or masticatory muscles of nonspecific etiology. In this study, the relationship between embryonic and anatomic-topographic similarities of the TMJ and the ear was analyzed, i.e. secondary otologic symptoms that can be closely connected to TMJ disorder. Nonspecific otologic symptoms are not primary diagnostic symptoms of TMD, but may cause diagnostic confusion due to patients' inability to correctly locate the origin of pain. The most common otologic symptoms that can be related to TMDs are otalgia, tinnitus and vertigo. Otorhinolaryngologists have to differentiate between primary otologic symptoms and those caused by TMJ disorders. In TMD diagnosis, manual techniques are used to determine the arthrogenic or myogenic form, whereas in the diagnosis of arthrogenic disorders magnetic resonance imaging is indicated as the highly specific imaging method ofjoint disk and osteoarthritic changes. Symptomatic treatments for TMD as well as the etiologic diagnosis of the pain require multidisciplinary cooperation between dentists and medical specialists.

  3. Evaluation of extraarticular consequences of Temporomandibular joint disorders

    Directory of Open Access Journals (Sweden)

    Sh. Jafari

    1994-07-01

    Full Text Available Temporo Mandibular Joint disorders are the most important ethiologic factor for chronic orofacial pain and have a relatively new place in scientific researches and clinical studies in dentistry. Since dentists can play an important role in diagnosis and treatment of these disorders, routine dental examination should include functional examination of osteomatognatic apparatus.

  4. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

    DEFF Research Database (Denmark)

    Peck, C C; Goulet, J-P; Lobbezoo, F

    2014-01-01

    criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included...

  5. A comparison of clinical symptoms and magnetic resonance images in temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yong Suk; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2003-06-15

    To determine the relationship between clinical symptoms and magnetic resonance (MR) images in patients presenting with temporomandibular joint (TMJ) disorders. This study was based on 172 joints in 86 patients presenting with TMJ disorders. Joint pain and sound during jaw opening and closing movements were recorded, and the possible relationship between disc positions and bony changes of the condylar head and the articular fossa in MR images in the oblique sagittal planes were examined. Data were analyzed by Chi-square test. There was no statistically significant relationship between clinical symptoms and MR images in the patients with TMJ disorders. In the patient with TMJ disorders, joint pain and sound could not be specific clinical symptoms that are related with MR image findings, and asymptomatic joint did not necessarily imply that the joints are normal according to MR image findings.

  6. Voz e disfunção temporomandibular em professores Voice and temporomandibular joint disorders in teachers

    Directory of Open Access Journals (Sweden)

    Ilza Maria Machado

    2009-12-01

    Full Text Available OBJETIVO: verificar a presença e possível correlação entre alteração vocal e DTM, em professores, a partir de dados de avaliação autorreferida, fonoaudiológica, otorrinolaringológica e odontológica. MÉTODOS: participaram deste estudo, 29 professores de uma escola de rede pública do ensino fundamental e médio do município de Sorocaba - SP. Os professores responderam questionário para levantamento de alteração vocal, e de disfunção temporomandibular (DTM. Foram realizadas quatro avaliações: perceptivo-auditiva; otorrinolaringológica; motricidade orofacial e odontológica. A menção a três ou mais sintomas no questionário determinou "presença" de queixa de voz e de DTM. As avaliações: perceptivo-auditiva e otorrinolaringológica concluíram a "ausência" e "presença" de alteração de voz e de laringe. Nas avaliações da motricidade orofacial e odontológica foi considerada DTM quando registrados três ou mais sinais e/ou sintomas, sendo indispensável à presença de dor. Na análise estatística dos dados, foram empregados: teste de Igualdade de Duas Proporções, teste exato de Fisher e de concordância Kappa. RESULTADOS: dentre os participantes, 82,8% fizeram autorreferência à alteração vocal e 62,1% de sintomas de DTM; 51,7% apresentaram alteração de voz na avaliação otorrinolaringológica e 65,5%, alteração de DTM na avaliação odontológica. Na comparação da avaliação de alteração de voz e DTM foi registrada correlação significante presente na avaliação perceptivo-auditiva da voz e de motricidade orofacial para DTM, e com tendência a significância na aplicação do questionário. CONCLUSÃO: os resultados apontam na direção de confirmar a presença de alteração de voz e DTM no grupo de professores pesquisado e correlação entre os mesmos.PURPOSE: to check the presence and possible correlation between vocal disorders and temporomandibular joint disorders (TMJD in teachers, from self

  7. Fluctuation of temporomandibular disorders in accordance with two classifications: the Helkimo dysfunction index and treatment need grouping.

    Science.gov (United States)

    Alanen, P; Kuttila, M; Le Bell, Y

    1997-01-01

    We studied the fluctuation of temporomandibular disorders, applying two classifications systems, in a 2-year follow-up study of 411 subjects. In general, the fluctuation was not large. There were no major differences between the two classifications. In our opinion, a decision to treat a patient on the basis of the treatment need grouping would not lead to overtreatment. The study design suffered from the fact that it is not possible to separate the fluctuation of the TMD itself and the fluctuation of its signs and symptoms from each other, owing to the descriptive nature of the diagnosis 'temporomandibular disorder'.

  8. Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner.

    NARCIS (Netherlands)

    Boever, JA De; Nilner, M.; Orthlieb, J.D.; Steenks, M.H.

    2008-01-01

    The Council of the European Academy of Craniomandibular Disorders charged the Educational Committee with the task of establishing Guidelines and Recommendations for the examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practi

  9. General health status and incidence of first-onset temporomandibular disorder: OPPERA prospective cohort study

    OpenAIRE

    Sanders, Anne E.; Slade, Gary D; Bair, Eric; Fillingim, Roger B; Knott, Charles; Dubner, Ronald; Greenspan, Joel D.; Maixner, William; Ohrbach, Richard

    2013-01-01

    Temporomandibular disorders (TMD) overlap with other health conditions but no study has examined which of these conditions increase the risk of developing first-onset TMD. The authors prospectively evaluated the relationship between health status at enrollment and subsequent incidence of TMD in 2,722 men and women. Participants aged 18–44 years had no history of TMD and were clinically free of TMD when enrolled in 2006–08 at four U.S. study sites in the OPPERA prospective cohort study. First-...

  10. Neuralgia associated with transcutaneous electrical nerve stimulation therapy in a patient initially diagnosed with temporomandibular disorder.

    Science.gov (United States)

    Omolehinwa, Temitope T; Musbah, Thamer; Desai, Bhavik; O'Malley, Bert W; Stoopler, Eric T

    2015-03-01

    Head and neck neoplasms may be difficult to detect because of wide-ranging symptoms and the presence of overlapping anatomic structures in the region. This case report describes a patient with chronic otalgia and temporomandibular disorder, who developed sudden-onset neuralgia while receiving transcutaneous electrical nerve stimulation (TENS) therapy. Further diagnostic evaluation revealed a skull base tumor consistent with adenoid cystic carcinoma. To our knowledge, this is the first report of TENS-associated neuralgia leading to a diagnosis of primary intracranial adenoid cystic carcinoma.

  11. Long-term results of treatment for temporomandibular disorders: an evaluation by patients.

    Science.gov (United States)

    Okeson, J P; Hayes, D K

    1986-04-01

    In this study, 110 patients with temporomandibular disorders who had been treated 2 to 81/2 years earlier were asked to evaluate the treatment they received. Of the patients, 85.5% reported that they were not experiencing pain or that they were experiencing much less pain; 79.1% reported that the treatment they had received had helped them completely or considerably. Analysis of the data did not disclose a subgroup or factor that could be correlated with the reduction of pain or the patient's perception of the success of treatment.

  12. [The role of occlusal disorders in development of temporomandibular joint dysfunction].

    Science.gov (United States)

    Arsenina, O I; Popova, A V; Gus, L A

    2014-01-01

    Currently Temporomandibular joint (TMJ) dysfunction is a very highly discussed topic by both researchers and clinicians. the incidence of the of TMJ is dysfunctions still not very well established because of heterogeneity of the diagnostic criteria used by different authors. This article is dedicated to the analysis of basic theories of the etiology of the aforementioned pathology, including overview of main pathophysiological mechanisms of the TMJ, dysfunctions occlusive disorders in particular. The main problem being analyzed is the use and efficacy of the electronic axiography in successful diagnostic and therapy of the TMJ dysfunction.

  13. Termo do 1º Consenso em Disfunção Temporomandibular e Dor Orofacial Statement of the 1st Consensus on Temporomandibular Disorders and Orofacial Pain

    Directory of Open Access Journals (Sweden)

    Simone Vieira Carrara

    2010-06-01

    Full Text Available O Termo do 1º Consenso em Disfunção Temporomandibular e Dor Orofacial* foi criado com o propósito de substituir divergências por evidência científica dentro dessa especialidade da Odontologia. O documento oferece informações claras e fundamentadas para orientar o cirurgião-dentista e demais profissionais de saúde sobre os cuidados demandados pelo paciente, tanto no processo de diagnóstico diferencial quanto na fase de aplicação das terapias de controle da dor e disfunção. O Termo foi aprovado no mês de janeiro de 2010 em reunião realizada durante o Congresso Internacional de Odontologia do Estado de São Paulo e converge o pensamento dos profissionais mais conceituados do Brasil na especialidade Disfunção Temporomandibular e Dor Orofacial.This Statement of the 1st Consensus on Temporomandibular Disorders and Orofacial Pain was created with the purpose of substituting controversies for scientific evidence within this specialty field of dentistry. The document provides clear and well-grounded guidance to dentists and other health professionals about the care required by patients both in the process of differential diagnosis and during the stage when they undergo treatment to control pain and dysfunction. The Statement was approved in January 2010 at a meeting held during the International Dental Congress of São Paulo and draws together the views of Brazil's most respected professionals in the specialty of Temporomandibular Disorders and Orofacial Pain.

  14. Prevalence of temporomandibular disorders in postmenopausal women and relationship with pain and HRT

    Directory of Open Access Journals (Sweden)

    Victor Ricardo Manuel Muñoz LORA

    Full Text Available Abstract The prevalence of temporomandibular disorders (TMD is higher in females, reaching their high peak during reproductive years, probably because of the action of some female hormones, which alter pain threshold. This study aimed to investigate the prevalence of TMD in postmenopausal women and its relationship with pain and hormone replacement therapy (HRT. In total, 284 patients were evaluated and classified using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD. Pain was measured using the Visual Analogue Scale (VAS, and patients were also asked about the use of HRT. All data was analyzed using analysis of variance (ANOVA and chi-square test. In total, 155 subjects did not have TMD and 129 had TMD; TMD group patients were classified according to RDC/TMD axis I classification as follows: muscle disorder group (1.6%, disk displacement group (72.87%, and arthralgia, osteoarthritis, and osteoarthrosis group (37.98%. Pain was registered in 35 patients who belonged to the TMD group, while 48 patients reported the use of HRT. There was a similar percentage of TMD and non TMD patients; moreover, the use of exogenous hormones was no associated with TMD, suggesting that there is no influence on the pain threshold.

  15. Prevalence of temporomandibular disorders in postmenopausal women and relationship with pain and HRT.

    Science.gov (United States)

    Lora, Victor Ricardo Manuel Muñoz; Canales, Giancarlo De la Torre; Gonçalves, Leticia Machado; Meloto, Carolina Beraldo; Barbosa, Celia Marisa Rizzatti

    2016-08-22

    The prevalence of temporomandibular disorders (TMD) is higher in females, reaching their high peak during reproductive years, probably because of the action of some female hormones, which alter pain threshold. This study aimed to investigate the prevalence of TMD in postmenopausal women and its relationship with pain and hormone replacement therapy (HRT). In total, 284 patients were evaluated and classified using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Pain was measured using the Visual Analogue Scale (VAS), and patients were also asked about the use of HRT. All data was analyzed using analysis of variance (ANOVA) and chi-square test. In total, 155 subjects did not have TMD and 129 had TMD; TMD group patients were classified according to RDC/TMD axis I classification as follows: muscle disorder group (1.6%), disk displacement group (72.87%), and arthralgia, osteoarthritis, and osteoarthrosis group (37.98%). Pain was registered in 35 patients who belonged to the TMD group, while 48 patients reported the use of HRT. There was a similar percentage of TMD and non TMD patients; moreover, the use of exogenous hormones was no associated with TMD, suggesting that there is no influence on the pain threshold.

  16. Electromyographic activity assessment of individuals with and without temporomandibular disorder symptoms

    Directory of Open Access Journals (Sweden)

    Juliana de Paiva Tosato

    2007-04-01

    Full Text Available INTRODUCTION: Temporomandibular disorders (TMD present several signs and symptoms that hinder their correct diagnosis, which is imperative on the elaboration of a treatment plan. Over the past years, several studies have been conducted to characterize and classify TMD to better understand these disorders. Therefore, the purpose of this study was to assess the electromyographic behavior of the masseter and temporal muscles in individuals with and without myogenic, arthrogenic and mixed TMD. METHOD: Forty volunteers of both genders responded to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD Questionnaire, were submitted to clinical exam and underwent bilateral electromyographic exam of the masseter and temporal muscles. RESULTS: No statistically significant difference (p>0.05 was observed during the assessment of isotonic contraction. Regarding isometric contraction, pairing between the mixed TMD group and the asymptomatic subjects did not present significant difference (p>0.05. Comparison between the myogenic and arthrogenic TMD groups and the asymptomatic group showed statistically significant difference (p<0.05. The findings of the present study demonstrated alteration on the muscle contraction pattern of TMD individuals compared to that of asymptomatic patients.

  17. Sleep bruxism and anxiety level in children

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    Marcelo Tomás de OLIVEIRA

    2015-01-01

    Full Text Available This study evaluated the association of level of anxiety in children with and without sleep bruxism (SB. The study was performed with 84 six- to eigth-years-old children, divided into two groups: with bruxism (BG and without bruxism (CG. Following the criteria purposed by American Academy of Sleep Medicine (AASM to determine SB, the presence of tooth wear has been verified through clinical examinations, and the parents have answered a questionnaire about their children’s behavior and habits. Additionally, the State-Trait Anxiety Inventory for Children (STAIC was applied to parents of the selected patients. Data analysis revealed a statistical significant difference between the groups (Student’s t-test, p= 0.0136. Based on the results, anxiety assessment revealed that children with bruxism have reached higher levels in the STAIC scale than the non-bruxism group. Therefore, it indicates a direct relationship between the presence of anxiety disorder and the onset of bruxism in children.

  18. To see bruxism: a functional MRI study

    Science.gov (United States)

    2015-01-01

    Objective: Since the pathophysiology of bruxism is not clearly understood, there exists no possible treatment. The aim of this study is to investigate the cerebral activation differences between healthy subjects and patients with bruxism on behalf of possible aetiological factors. Methods: 12 healthy subjects and 12 patients with bruxism, a total of 24 right-handed female subjects (aged 20–27 years) were examined using functional MRI during tooth-clenching and resting tasks. Imaging was performed with 3.0-T MRI scanner with a 32-channel head coil. Differences in regional brain activity between patients with bruxism and healthy subjects (control group) were observed with BrainVoyager QX 2.8 (Brain Innovation, Maastricht, Netherlands) statistical data analysis program. Activation maps were created using the general linear model: single study and multistudy multisubject for statistical group analysis. This protocol was approved by the ethics committee of medical faculty of Kirikkale University, Turkey (02/04), based on the guidelines set forth in the Declaration of Helsinki. Results: The group analysis revealed a statistically significant increase in blood oxygenation level-dependent signal of three clusters in the control group (p < 0.005), which may indicate brain regions related with somatognosis, repetitive passive motion, proprioception and tactile perception. These areas coincide with Brodmann areas 7, 31, 39 and 40. It is conceivable that there are differences between healthy subjects and patients with bruxism. Conclusions: Our findings indicate that there was a decrease of cortical activation pattern in patients with bruxism in clenching tasks. This indicates decreased blood flow and activation in regional neuronal activity. Bruxism, as an oral motor disorder concerns dentistry, neurology and psychiatry. These results might improve the understanding and physiological handling of sleep bruxism. PMID:25806864

  19. Relationship between temporomandibular disorders and orthodontic treatment: a literature review

    Directory of Open Access Journals (Sweden)

    Ronaldo Antônio Leite

    2013-02-01

    Full Text Available OBJECTIVE: The objective of this study was to review the most recent studies from the last 15 years, in search of clinical studies that report the relationship between TMD and orthodontic treatment and/or malocclusion. Our intention was to determine whether orthodontic treatment would increase the incidence of signs and symptoms of TMD, and whether orthodontic treatment would be recommended for treating or preventing signs and symptoms of TMD. METHODS: Literature reviews, editorials, letters to the editor, experimental studies in animals and short communications were excluded from this review. Were included only prospective, longitudinal, case-control or retrospective studies with a large sample and significant statistical analysis. Studies that dealt with craniofacial deformities and syndromes or orthognathic surgery treatment were also excluded, as well as those that reported only the association between malocclusion and TMD. RESULTS: There were 20 articles relating orthodontics to TMD according to the inclusion criteria. The studies that associated signs and symptoms of TMD to orthodontic treatment showed discrepant results. Some have found positive effects of orthodontic treatment on signs and symptoms of TMD, however, none showed a statistically significant difference. CONCLUSIONS: All studies cited in this literature review reported that orthodontic treatment did not provide risk to the development of signs and symptoms of TMD, regardless of the technique used for treatment, the extraction or non-extraction of premolars and the type of malocclusion previously presented by the patient. Some studies with long-term follow-up concluded that orthodontic treatment would not be preventive or a treatment option for TMD.OBJETIVO: revisar a literatura mais atual, dos últimos 15 anos, em busca de estudos clínicos que relatem a relação entre a disfunção temporomandibular (DTM e o tratamento ortodôntico e/ou a má oclusão. A intenção foi

  20. Logistic regression analysis of temporomandibular disorders in young people in Xinjiang%新疆大学生颞下颌关节紊乱病相关因素的Logistic回归分析

    Institute of Scientific and Technical Information of China (English)

    赵晓敏; 包旭英; 龚忠诚; 林兆全

    2015-01-01

    Objective To investigate the prevalence and of the temporomandibular disorders( TMD) in young people in Xinjiang and to identify its possible clinical risk factors . Methods A sample of 812 medical students was randomly selected from Xinjiang Medical University. The prevalence of TMD was analyzed by Helkimo index,and the possible risk factors associated with the disease were identi-fied by logistic regression analysis. Results The prevalence of TMD was 39. 50% in this population. Malocclusion,chewing-side pref-erence and bruxism were the main risk factors which increased the possible occurrence of TMD . Conclusions Malocclusion and occlu-sal stress fatigue were related to the formation of temporomandibular disorders.%目的:探讨新疆大学生颞下颌关节紊乱病患病率及其相关的发病因素。方法对新疆医科大学812名在读医学生使用Helkimo指数进行分析颞下颌关节紊乱病的患病情况调查。相关因素进行Logistic回归分析。结果颞下颌关节紊乱病的患病率占39.50%。咬合关系中前牙深覆牙合及反牙合,不良习惯中的偏侧咀嚼,夜磨牙为主要危险因素,增加TMD患病的风险。结论错牙合畸形与牙合应力疲劳与颞下颌关节紊乱病的发生有关。

  1. Evaluation of the applicability of temporomandibular opening index in Turkish children with and without signs and symptoms of temporomandibular joint disorders.

    Science.gov (United States)

    Sari, Saziye; Kucukesmen, Cigdem; Sonmez, Hayriye

    2008-07-01

    Limitation of mandibular movement is one of the cardinal signs of temporomandibular disorders. Temporomandibular Opening Index (TOI) is a new technique to determine the restricted mouth opening in temporomandibular joint dysfunction syndrome (TMD). The purpose of this study was to compare the TOI of Turkish children with and without TMD in primary, mixed, and permanent dentitions. In this study, a total of 270 children were evaluated. One hundred thirty-five (135) subjects had no signs or symptoms of TMD (Group 1), while the remaining 135 subjects did have signs and symptoms of TMD (Group 2). Forty-five (45) patients were selected for each dentition for two groups. "Maximum Voluntary Mouth Opening" (MVMO) values and TOI ranges were calculated. A Mann-Whitney U test and a Kruskal Wallis test were used to compare the data (p<0.05). TOI showed statistical differences between all dentitions with and without TMD (p<0.05). There were no significant differences between different dentitions or genders in Group 1 or Group 2 (p<0.05).

  2. Effectiveness of global postural reeducation in the treatment of temporomandibular disorder: case report.

    Science.gov (United States)

    Monteiro, Wagner; Francisco de Oliveira Dantas da Gama, Thomaz; dos Santos, Robiana Maria; Collange Grecco, Luanda André; Pasini Neto, Hugo; Oliveira, Claudia Santos

    2013-01-01

    The aim of the present study was to evaluate the effectiveness of global postural reeducation in the treatment of temporomandibular disorder through bilateral surface electromyographic (EMG) analysis of the masseter muscle in a 23-year-old volunteer. EMG values for the masseter were collected at rest (baseline) and during a maximal occlusion. There was a change in EMG activity both at rest and during maximal occlusion following the intervention, evidencing neuromuscular rebalancing between both sides after treatment as well as an increase in EMG activity during maximal occlusion, with direct improvement in the recruitment of motor units during contractile activity and a decrease in muscle tension between sides at rest. The improvement in postural patterns of the cervical spine provided an improvement in aspects of the EMG signal of the masseter muscle in this patient. However, a multidisciplinary study is needed in order to determine the effect of different forms of treatment on this condition and compare benefits between interventions. Therefore, this study can provide a direction regarding the application of this technique in patients with temporomandibular disorder.

  3. Estrogen replacement therapy among postmenopausal women and its effects on signs and symptoms of temporomandibular disorders.

    Science.gov (United States)

    Nekora-Azak, Aysen; Evlioglu, Gulumser; Ceyhan, Arzu; Keskin, Haluk; Berkman, Sinan; Issever, Halim

    2008-07-01

    The prevalence of temporomandibular disorders (TMD) is about two to five times higher in females than in males. Data for the higher prevalence of TMD in women and prevalence rates peak during the reproductive years and decrease after menopause. This indicated that female sex hormones may play a role in the etiology or maintenance of TMD. The aim of this study was to investigate the relationship between postmenopausal hormone use and TMD in Turkish postmenopausal women. One hundred-eighty (180), postmenopausal women, aged 42-72 years, were examined both clinically and by questionnaire with regard to the signs and symptoms of temporomandibular disorders, general health status and use of postmenopausal hormone replacement therapy in the preceding year. Ninety-one (91) postmenopausal women (50.6%) were on hormone replacement therapy (HRT). The remaining 89 (49.4%) postmenopausal women were not on hormone replacement therapy. There was no significant difference found in the signs and symptoms of TMD between postmenopausal women using hormone therapy and those not using postmenopausal hormones. There was no association between the use of postmenopausal hormones and the signs and symptoms of TMD in this study.

  4. Accuracy of the surface electromyography RMS processing for the diagnosis of myogenous temporomandibular disorder.

    Science.gov (United States)

    Berni, Kelly Cristina dos Santos; Dibai-Filho, Almir Vieira; Pires, Paulo Fernandes; Rodrigues-Bigaton, Delaine

    2015-08-01

    Due to the multifactor etiology of temporomandibular disorder (TMD), the precise diagnosis remains a matter of debate and validated diagnostic tools are needed. The aim was to determine the accuracy of surface electromyography (sEMG) activity, assessed in the amplitude domain by the root mean square (RMS), in the diagnosis of TMD. One hundred twenty-three volunteers were evaluated using the Research Diagnostic Criteria for Temporomandibular Disorders and distributed into two groups: women with myogenous TMD (n=80) and women without TMD (n=43). The volunteers were then submitted to sEMG evaluation of the anterior temporalis, masseter and suprahyoid muscles at rest and during maximum voluntary teeth clenching (MVC) on parafilm. The accuracy, sensitivity and specificity of the muscle activity were analyzed. Differences between groups were found in all muscles analyzed at rest as well as in the masseter and suprahyoid muscles during MVC on parafilm. Moderate accuracy (AUC: 0.74-0.84) of the RMS sEMG was found in all muscles regarding the diagnosis of TMD at rest and in the suprahyoid muscles during MVC on parafilm. Moreover, sensitivity ranging from 71.3% to 80% and specificity from 60.5% to 76.6%. In contrast, RMS sEMG did not exhibit acceptable degrees of accuracy in the other masticatory muscles during MVC on parafilm. It was concluded that the RMS sEMG is a complementary tool for clinical diagnosis of the myogenous TMD.

  5. Etiological factors associated with temporomandibular joint disorder - study on animal model.

    Science.gov (United States)

    Chisnoiu, Andrea Maria; Chisnoiu, Radu; Moldovan, Marioara; Lascu, Liana Maria; Picoş, Alina Monica

    2016-01-01

    The etiology of temporomandibular disorder (TMD) is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. The main objectives of our study were investigation and analysis of the degree of involvement for several presumptive etiological factors of TMD: biomechanical stress (BS), estrogen hormones (EH) and emotional stress (ES). Six groups (n=10) of mature female Wistar rats were included in the study. Single presumptive etiological factor was applied in three groups (BS, EH and ES groups) and also association of presumptive etiological factors were applied in two groups (BSEH and BSES groups). No etiological factor was applied for the control group. Animals were sacrificed after a 60 days period and histological analysis of the temporomandibular joint (TMJ) tissues was performed. The changes in the mandibular cartilage, articular disc, temporal bone and synovial tissue were observed under optical magnification and quantified. All samples developed changes in the thickness of the condylar cartilage comparing to control group. The reduction was highly statistical significant for the EH, ES and BSES groups (petiological factors in TMD.

  6. Association between headache and temporomandibular joint disorders in children and adolescents.

    Science.gov (United States)

    Branco, Luciana P; Santis, Tatiana O; Alfaya, Thays A; Godoy, Camila H L; Fragoso, Yara D; Bussadori, Sandra K

    2013-03-01

    The aim of the present study was to assess the relationship between temporomandibular joint disorder (TMJD) and headache in children and adolescents. A prospective cross-sectional cohort study was carried out involving 93 children and adolescents (6 to 14 years of age) at the outpatient service of a dental school. All participants underwent a clinical examination involving Axis 1 of the Research Diagnostic Criteria for Temporomandibular Disorders, along with a characterization of headache and an anthropometric evaluation. Statistical analysis involved the chi-squared test for quantitative variables and the Student's t-test, ANOVA and Tukey's test for quantitative data. An adjusted logistic regression model was used to determine significant associations among gender, age, TMJD and headache. Mild TMJD was identified in 35.8% of the sample and was not associated the presence of headache. Moderate TMJD was found in 25.8% of patients and severe TMJD was found in 11.8%; both forms of TMJD were associated with headache. A significant correlation was found between the intensity of TMJD and the risk of headache. The present findings demonstrate a positive correlation between TMJD and headache in children and adolescents, independently of gender and age.

  7. Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders.

    Science.gov (United States)

    Ucar, Mehmet; Sarp, Ümit; Koca, İrfan; Eroğlu, Selma; Yetisgin, Alparslan; Tutoglu, Ahmet; Boyacı, Ahmet

    2014-12-01

    [Purpose] This study compared the effectiveness of home exercise alone versus home exercise combined with ultrasound for patients with temporomandibular joint disorders. [Subjects and Methods] This study enrolled 23 female and 15 male patients who were divided randomly into two groups. The home exercise group performed a home exercise program consisting of an exercise program and patient education, and the home exercise combined with ultrasound group received ultrasound therapy in addition to the home exercise program. Pain intensity was evaluated using a visual analogue scale. Pain free maximum mouth opening was evaluated at baseline and 2 weeks after the treatment. [Results] There was no difference between the two groups in baseline values. After the treatment, the visual analogue scale decreased and pain free maximum mouth opening scores improved significantly in each group. Additionally, both values were higher in the home exercise combined with ultrasound group than in the home exercise group. [Conclusion] The combination of home exercise combined with ultrasound appears to be more effective at providing pain relief and increasing mouth opening than does home exercise alone for patients with temporomandibular joint disorders.

  8. Does altering the occlusal vertical dimension produce temporomandibular disorders? A literature review.

    Science.gov (United States)

    Moreno-Hay, I; Okeson, J P

    2015-11-01

    The purpose of this review was to present a comprehensive review of the scientific evidence available in the literature regarding the effect of altering the occlusal vertical dimens-ion (OVD) on producing temporomandibular disorders. The authors conducted a PubMed search with the following search terms 'temporoman-dibular disorders', 'occlusal vertical dimension', 'stomatognatic system', 'masticatory muscles' and 'skeletal muscle'. Bibliographies of all retrieved articles were consulted for additional publications. Hand-searched publications from 1938 were included. The literature review revealed a lack of well-designed studies. Traditional beliefs have been based on case reports and anecdotal opinions rather than on well-controlled clinical trials. The available evidence is weak and seems to indicate that the stomatognathic system has the ability to adapt rapidly to moderate changes in occlusal vertical dimension (OVD). Nevertheless, it should be taken into consideration that in some patients mild transient symptoms may occur, but they are most often self-limiting and without major consequence. In conclusion, there is no indication that permanent alteration in the OVD will produce long-lasting TMD symptoms. However, additional studies are needed.

  9. The effects of two methods of Class III malocclusion treatment on temporomandibular disorders.

    Science.gov (United States)

    Kurt, Hanefi; Alioğlu, Ceylan; Karayazgan, Banu; Tuncer, Necat; Kılıçoğlu, Hülya

    2011-12-01

    The aim of this research was to evaluate, within a controlled clinical study, the effects of a Delaire-type facemask or a modified Jasper Jumper (JJ) used in the treatment of children with Class III malocclusions due to maxillary retrognathia on temporomandibular disorders (TMDs). Forty-six patients with Class III malocclusions referred for orthodontic treatment were divided into two groups, a test and a control. The test group comprised 33 randomly chosen patients (15 females, 18 males) aged 8-11 years. The control group included 13 patients (eight females, five males) with similar features. TMD assessment was performed before and after treatment using a two-axis questionnaire, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs). Qualitative data were evaluated using chi-square and McNemar tests. No statistically significant differences related to the presence of TMD were observed pre- or post-treatment (P > 0.05). The most commonly encountered diagnosis was arthralgia in the JJ group both before and after treatment. Evaluation of joint and muscle regions showed decreased symptoms, apart from the diagnosed discomforts, in the JJ group (P < 0.05). Reduced symptoms were observed in the Delaire group; however, this reduction was not statistically significant. An increase, not considered to be statistically significant, was observed in the control group. The Delaire-type facemask and modified JJ used in the early phase of Class III malocclusion treatment did not result in TMD.

  10. Temporomandibular joint pain-dysfunction syndrome in patients from “Guillermo Tejas” polyclinic

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    Delarays Ossani Pérez Alfonso

    2015-09-01

    Full Text Available Background: when the physiological levels of the components of the temporomandibular joint are altered by any risk factor, there can appear functional and structural disorders with their corresponding clinical repercussions, which are part of the temporomandibular joint pain-dysfunction syndrome.Objective: to characterize clinically and epidemiologically those patients suffering from temporomandibular joint pain-dysfunction syndrome of “Guillermo Tejas” polyclinic in Las Tunas municipality, from November, 2012 to October, 2014.Methods: a descriptive study was carried out in patients from 12 to 20 years old who came to the dental clinic of the above mentioned polyclinic and time period. The universe consisted of 135 patients who entered the service and the sample was comprised 75 patients diagnosed with temporomandibular joint pain-dysfunction syndrome.Results: females were the most representative ones; regarding age, the groups of 18, 19 and 20 years old patients prevailed. The most frequent para-functional habits were unilateral mastication and bruxism. The prevailing associated factors were occlusal disharmonies. The joint noise and mandibular deviation were the most frequent symptoms and signs.Conclusions: it was possible to characterize clinically and epidemiologically those patients suffering from temporomandibular joint pain-dysfunction syndrome, more frequently found in those older than 18 years old.

  11. Disfunções temporomandibulares: sinais, sintomas e abordagem multidisciplinar Temporomandibular Disorders: signs, symptoms and multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Mariana Del Cistia Donnarumma

    2010-10-01

    Full Text Available OBJETIVO: verificar perfil, queixa e principais sinais e sintomas de uma amostra de pacientes com disfunção temporomandibular que estiveram ou estão em tratamento ortodôntico e observar a ocorrência de atendimentos multidisciplinares. MÉTODOS: foram coletados dados de 125 prontuários em uma clínica odontológica da cidade de Sorocaba e os itens analisados nos prontuários foram: sexo, idade, profissão, queixa, três principais sinais e sintomas dos pacientes e se houve encaminhamento para avaliação fonoaudiológica, fisioterápica e psicológica. RESULTADOS: predominância feminina, sendo 107 mulheres (85,6% e 18 homens (14,4%. Média de idade de 35 anos, sendo a menor idade 14 anos e a maior 74 anos. Relação da disfunção temporomandibular com as profissões: 43 (34,4% eram profissionais com vínculo empregatício. Queixa trazida pelo paciente: dor na região da articulação temporomandibular e masseter: 86 - (68,8%. Três principais sinais e sintomas observados na avaliação ortodôntica: dor na região da articulação temporomandibular e masseter: 98 - 78,4%; estalos unilaterais: 55 - 44% e travamento: 23 - 18,4%. Conduta de encaminhamentos: fonoaudiologia 59 (47,2%; fisioterapia 40 (32% e psicologia 53 (42,4%. CONCLUSÃO: na amostra pesquisada, a prevalência de casos de disfunção temporomandibular foi maior no sexo feminino, com queixa de dor. Os principais sinais e sintomas foram: dor, estalo unilateral e travamento e houve encaminhamento para atendimentos multidisciplinares nas áreas de Fonoaudiologia, Fisioterapia e Psicologia.PURPOSE: to check the main signs and symptoms of a sample of patients with temporomandibular dysfunction that were or are under orthodontic treatment and observe if there was a possible multidisciplinary treatment. METHODS: data from 125 medical records collected in a orthodontic clinic located in Sorocaba and the analyzed items were: gender, age, profession, complains, three main signs and

  12. Vestibular schwannoma (acoustic neuroma mimicking temporomandibular disorders: a case report Schwannoma vestibular (neurinoma do acústico imitando desordens temporomandibulares: um relato de caso

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    Maurício A. Bisi

    2006-12-01

    Full Text Available Approximately 6 to 16% of patients with trigeminal neuralgia symptoms present intracranial tumors, the most common being the vestibular schwannoma (acoustic neuroma. Some symptoms reported by patients include hearing loss, tinnitus, headaches, vertigo and trigeminal disturbances. An increased muscle response in the surrounding head and neck musculature may also be observed, which mimics signs and symptoms of temporomandibular disorders. In these cases, magnetic resonance imaging (MRI has proved to be a useful tool in tumor diagnosis. The differential diagnosis between myofascial and neuralgic pain is important, as both may present similar characteristics, while being of different origin, and demanding special treatment approaches. The purpose of this paper is to demonstrate the relationship among trigeminal neuralgia symptoms, intracranial tumors and temporomandibular dysfunction by presenting a clinical case.Aproximadamente 6 a 16% dos pacientes com sintomas de neuralgia trigeminal apresentam tumores intracranianos, sendo mais comum o schwannoma vestibular (neurinoma do acústico. Alguns sintomas relatados pelos pacientes são perda da audição, zumbido, dores de cabeça, vertigens e distúrbios trigeminais. Uma resposta muscular aumentada na musculatura associada da cabeça e do pescoço também pode ser observada, o que pode mimetizar sinais e sintomas de desordens temporomandibulares. Nestes casos é de grande valia o uso de imagem de ressonância magnética (IRM para detecção de tumores. É importante, também, a diferenciação de dores miofasciais e neurálgicas, pois ambas podem apresentar características semelhantes, mas com origens e tratamentos diferentes. O objetivo desse trabalho foi demonstrar através de relato de caso clínico a associação entre sintomas de neuralgia trigeminal, tumores intracranianos e disfunção temporomandibular.

  13. Value of cone-beam computed tomography in the process of diagnosis and management of disorders of the temporomandibular joint

    NARCIS (Netherlands)

    de Boer, E. W. J.; Dijkstra, P. U.; Stegenga, B.; de Bont, L. G. M.; Spijkervet, F. K. L.

    2014-01-01

    The objective of this study was to assess the value of cone-beam computed tomographic (CT) images in the primary diagnosis and management of 128 outpatients with disorders of the temporomandibular joint (TMJ). Before a diagnosis was made and treatment planned, the history was taken, physical examina

  14. Increased risk of tinnitus in patients with temporomandibular disorder: a retrospective population-based cohort study.

    Science.gov (United States)

    Lee, Chun-Feng; Lin, Ming-Chia; Lin, Hui-Tzu; Lin, Cheng-Li; Wang, Tang-Chuan; Kao, Chia-Hung

    2016-01-01

    This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus.

  15. Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample

    Science.gov (United States)

    Mesa-Jiménez, Juan; Fernández-de-las-Peñas, César; de-la-Hoz-Aizpurua, José-Luis

    2016-01-01

    Background Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. Objetives The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups. Material and Methods Restrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (average 39.96 years), diagnosed with MTMD (Masticatory Myofascial Pain), with a control group with the same number of individuals, gender and age range to evaluate if there is a significant statistical difference in the presence of medical comorbidities in this group of patients with MTMD and if they are in a higher risk of suffering different pathological conditions. Results It was found that the group affected by MTMD presented many more associated medical conditions than the control group: health changes during the last year, medical evaluations and treatments, presence of pain, sinus disease, tinnitus, headache, joint pain, ocular disorders, fatigue, dizziness, genitourinary disorders and xerostomia among others; and they were also in a higher risk to suffer other pathological entities as headaches and articular pain. Conclusions These results reinforce our hypothesis that MTMD belong to a group of medical conditions triggered by a loss of equilibrium of the individual’s Psycho-Neuro-Endocrine-Immune (PNEI) Axis that produces alterations in the response against external stimuli in some genetically predisposed individuals. It is, therefore, necessary to change the way of diagnosing and managing these individual’s medical conditions, being mandatory to look from a more

  16. Occlusal splint for sleep bruxism: an electromyographic associated to Helkimo Index evaluation.

    Science.gov (United States)

    Nascimento, Leonardo Lopes do; Amorim, César Ferreira; Giannasi, Lilian Chrystiane; Oliveira, Claudia Santos; Nacif, Sérgio Roberto; Silva, Alecsandro de Moura; Nascimento, Daniela Fernandes Figueira; Marchini, Leonardo; de Oliveira, Luis Vicente Franco

    2008-08-01

    This study aims to evaluate long-term effects of using an occlusal splint in patients with sleep bruxism (SB), using surface electromyography (EMG) of masseter and temporalis muscles, as well as the Helkimo Index. The subjects were 15 individuals aged from 19 to 29 years, bearers of SB, with presence of signs and symptoms of temporomandibular disorders (TMD), which never have used occlusal splints. The subjects answered the Helkimo's Index and underwent EMG before and after 60 days of occlusal splints use. There was no indication of a significant decrease in mean EMG levels over the therapy in the muscles. A significant decrease in TMD signs and symptoms were observed in SB patients after 60 days of occlusal splints therapy.

  17. Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review

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    Mila Leite de Moraes Maia

    2012-12-01

    Full Text Available Temporomandibular disorders (TMD are characterized by the presence of temporomandibular joint (TMJ and/or masticatory muscle pain and dysfunction. Low-level laser is presented as an adjuvant therapeutic modality for the treatment of TMD, especially when the presence of inflammatory pain is suspected. Objective: To systematically review studies that investigated the effect of low level laser therapy (LLLT on the pain levels in individuals with TMD. Material and Methods: The databases Scopus, embase, ebsco and PubMed were reviewed from January/2003 to October/2010 with the following keywords: laser therapy, low-level laser therapy, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, temporomandibular joint, temporomandibular, facial pain and arthralgia, with the inclusion criteria for intervention studies in humans. exclusion criteria adopted were intervention studies in animals, studies that were not written in english, Spanish or Portuguese, theses, monographs, and abstracts presented in scientific events. Results: After a careful review, 14 studies fit the criteria for inclusion, of which, 12 used a placebo group. As for the protocol for laser application, the energy density used ranged from 0.9 to 105 J/cm², while the power density ranged from 9.8 to 500 mW. The number of sessions varied from 1 to 20 and the frequency of applications ranged from daily for 10 days to 1 time per week for 4 weeks. A reduction in pain levels was reported in 13 studies, with 9 of these occurring only in the experimental group, and 4 studies reporting pain relief for both the experimental group and for the placebo. Conclusion: Most papers showed that LLLT seemed to be effective in reducing pain from TMD. However, the heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. Thus, it is necessary to conduct further research in order to obtain a consensus regarding the

  18. Somatosensory assessment and conditioned pain modulation in temporomandibular disorders pain patients.

    Science.gov (United States)

    Kothari, Simple Futarmal; Baad-Hansen, Lene; Oono, Yuka; Svensson, Peter

    2015-12-01

    The pathophysiology and underlying pain mechanisms of temporomandibular disorders (TMD) are poorly understood. The aims were to assess somatosensory function at the temporomandibular joints (TMJs) and to examine whether conditioned pain modulation (CPM) differs between TMD pain patients (n = 34) and healthy controls (n = 34). Quantitative sensory testing was used to assess the somatosensory function. Z-scores were calculated for patients based on reference data. Conditioned pain modulation was tested by comparing pressure pain thresholds (PPTs) before, during, and after the application of painful and nonpainful cold stimuli. Pressure pain thresholds were measured at the most painful TMJ and thenar muscle (control). Data were analyzed with analyses of variance. Most (85.3%) of the patients exhibited at least 1 or more somatosensory abnormalities at the most painful TMJ with somatosensory gain with regard to PPT and punctate mechanical pain stimuli, and somatosensory loss with regard to mechanical detection and vibration detection stimuli as the most frequent abnormalities. There was a significant CPM effect (increased PPT) at both test sites during painful cold application in healthy controls and patients (P painful cold application between groups (P = 0.227). In conclusion, somatosensory abnormalities were commonly detected in TMD pain patients and CPM effects were similar in TMD pain patients and healthy controls.

  19. Postural evaluation of patients with temporomandibular disorders under use of occlusal splints

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    Paulinne Junqueira Silva Andresen Strini

    2009-10-01

    Full Text Available OBJECTIVES: Alterations in the temporomandibular complex can reflect in adaptations of the individual's entire muscular system, intervening with the head position and scapular waist, developing postural alterations and modifying all corporal biomechanics. The aim of this study was to evaluate the head position (HP and head postural alterations before and after installation of occlusal splints. MATERIAL AND METHODS: Twenty patients with temporomandibular disorders (TMD underwent clinical and postural examination, before the installation of an occlusal splint, and after 1 week and 1 month of use. RESULTS: There were statistically differences for HP, between the initial values and after 1 week of use of the occlusal device (p= 0.048 and also between 1 week and 1 month of evaluation (p= 0.001. Decrease of the painful symptomatology and maintenance of the rectification were also observed. CONCLUSIONS: The individual's postural position can suffer biomechanical alterations due to stomatognathic alterations, causing clinically visible changes in dysfunctional individuals and affecting the performance of the involved structures.

  20. Occlusion and temporomandibular disorders: a malpractice case with medical legal considerations.

    Science.gov (United States)

    Bucci, M B; Aversa, M; Guarda-Nardini, L; Manfredini, D

    2011-01-01

    Occlusion and temporomandibular The issue of temporomandibular disorders (TMD) diagnosis and treatment has become a matter of increasing interest in the medical legal field in recent years. The old-fashioned theories based on the occlusal paradigm was proven to be erroneous, and clinicians who still provide irreversible treatments to TMD patients have to be conscious of the potential legal consequences of their behavior. The present paper described an illustrative case report of a patient to whom extensive and irreversible occlusal therapies were performed with the unique aim to provide relief from TMD symptoms. The treatment was unsuccessful and the dental practitioner was called into cause for a professional liability claim. The clinician was judged guilty of malpractice on the basis of the lack of scientific evidence of the irreversible occlusal approaches to TMD, which were erroneously used and did not give the patient any benefit, thus forcing him to a non necessary financial and biological cost. The failure to satisfy the contract with the patient, which is usually not covered by any insurance company, forced the practitioner to give the money back to the patient. The ethical and legal implications of such case were discussed, with particular focus on the concept that medical legal advices need to satisfy the highest standards of evidence and have to be strictly based on scientific knowledge.

  1. The difficult relationship between occlusal interferences and temporomandibular disorder - insights from animal and human experimental studies.

    Science.gov (United States)

    Xie, Q; Li, X; Xu, X

    2013-04-01

    The aetiology of temporomandibular disorder (TMD) is multifactorial, and numerous studies have addressed that occlusion may be of great importance. However, whether occlusion plays a crucial role in the pathogenesis of TMD remains controversial. Study designs utilising animal models have been used to study the effects of artificial occlusal alterations. Experimental traumatic occlusion affects blood flow in the temporomandibular joint and results in changes in the condylar cartilage, and artificial occlusal interference induces masticatory muscle nociceptive responses that are associated with peripheral sensitisation and lead to central sensitisation, which maintains masticatory muscle hyperalgesia. The possibility that occlusal interference results in TMD has been investigated in humans using a double-blind randomised design. Subjects without a history of TMD show fairly good adaptation to interferences. In contrast, subjects with a history of TMD develop a significant increase in clinical signs and self-report stronger symptoms (occlusal discomfort and chewing difficulties) in response to interferences. Meanwhile, psychological factors appear meaningful for symptomatic responses to artificial interferences in subjects with a history of TMD. Thus, individual differences in vulnerability to occlusal interferences do exist. Although there are advantages and disadvantages to using human and animal occlusal interference models, these approaches are indispensable for discovering the role of occlusion in TMD pathogenesis.

  2. The Relationship between Temporomandibular Disorders (TMDs and Overall Denture Conditions in Complete Denture Wearers

    Directory of Open Access Journals (Sweden)

    Fatemeh Rostamkhani

    2015-06-01

    Full Text Available Introduction: The aim of this study was to investigate whether there is any relationship between the condition of complete dentures and TMDs. Methods: The sample consisted of 61 consecutive patients (35 females and 26 males who were admitted to the Department of Prosthodontics of Mashhad Faculty of Dentistry for fabrication of new complete dentures.  The age range of the participants was between 32 and 80 years, with the mean age of 57.05±10.26 years. The patients were examined by two prosthodontists. Using a questionnaire, the first prosthodontist asked the patients about their habits and history of trauma to the temporomandibular joints (TMJs. She then examined the participants for signs and symptoms of temporomandibular disorders (TMDs.  The second prosthodontist examined each participant's existing denture and checked its fit, stability, retention, occlusion, and centric relation, and recorded how long it had been in service. The examination was double blind. The data were recorded in examination sheets. Results: The relationship between TMDs and denture fit, stability, retention, centric relation and occlusion was analyzed using Fisher’s Exact Test. No significant relationship was found between denture characteristics and TMDs in complete denture wearers (P-value>0.05. Conclusion: Complete denture characteristics did not play a role in the development of TMDs in edentulous patients.

  3. Long-term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder

    Science.gov (United States)

    Mitsui, Silvia Naomi; Yasue, Akihiro; Kuroda, Shingo; Tanaka, Eiji

    2016-01-01

    This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function. PMID:27556023

  4. Fixed orthodontic therapy in temporomandibular disorder (TMD) treatment: an alternative to intraoral splint.

    Science.gov (United States)

    Tecco, Simona; Teté, Stefano; Crincoli, Vito; Festa, Mario Armando; Festa, Felice

    2010-01-01

    This study evaluated the use of a fixed orthodontic appliance in treatment of temporomandibular disorder (TMD) compared to the use of an intra-oral splint. Fifty (50) adult patients, with confirmed anterior disk displacement with reduction in at least one temporomandibular joint (TMJ), were divided into three groups: 20 patients treated with AR splint (Group I); 20 patients treated with a fixed orthodontic appliance (Group II) and 10 patients who underwent no treatment (Control Group). Joint pain, joint noise, muscle pain, and subjective relief were evaluated monthly before the treatment began (T0) and for six months thereafter. Subjects in Group I and Group II displayed a significant decrease in joint pain (p orthodontic appliance seems to be as efficacious as the use of an AR maxillary splint in the treatment of joint pain and muscle pain, but not in the treatment of joint noise. These results are valid, at least for the short-term clinical results (first six months of treatment). Clinical implications for long-term use are not clarified by these results.

  5. Long-term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder.

    Science.gov (United States)

    Mitsui, Silvia Naomi; Yasue, Akihiro; Kuroda, Shingo; Tanaka, Eiji

    2016-01-01

    This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function.

  6. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies.

    Science.gov (United States)

    Murphy, Meghan K; MacBarb, Regina F; Wong, Mark E; Athanasiou, Kyriacos A

    2013-01-01

    Temporomandibular disorders (TMD) are a class of degenerative musculoskeletal conditions associated with morphologic and functional deformities that affect up to 25% of the population, but their etiology and progression are poorly understood and, as a result, treatment options are limited. In up to 70% of cases, TMD are accompanied by malpositioning of the temporomandibular joint (TMJ) disc, termed "internal derangement." Although the onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Because of the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient's disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches that can restore joint functionality while responding to changes in the joint have become a necessity. One such approach, tissue engineering, which may be capable of integration and adaptation in the TMJ, carries significant potential for the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. An analysis of native tissue characterization to assist clinicians in identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ is followed by a discussion of current trends in tissue engineering.

  7. A tomographic study of the condyle position in temporomandibular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sung Youn; Ryu, Young Kyu [Dept. of Oral Radiology, College of Dentistry, Yonsei University, Seoul (Korea, Republic of)

    1988-11-15

    The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05

  8. The use of low level laser therapy in the treatment of temporomandibular joint disorders. Review of the literature

    OpenAIRE

    Herranz Aparicio, Judit; Vázquez Delgado, Eduardo; Arnabat Domínguez, Josep; España Tost, Antonio Jesús; Gay Escoda, Cosme

    2013-01-01

    Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial. Objectives: Literature...

  9. Bruxism after brain injury: successful treatment with botulinum toxin-A.

    Science.gov (United States)

    Ivanhoe, C B; Lai, J M; Francisco, G E

    1997-11-01

    Bruxism, the rhythmic grinding of teeth--usually during sleep--is not an infrequent complication of traumatic brain injury. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown. Untreated, bruxism causes masseter hypertrophy, headache, temporomandibular joint destruction, and total dental wear. We report a case of complete resolution of postanoxic bruxism after treatment with botulinum toxin-A (BTX-A). The patient was a 28-year-old man with no history of bruxism who sustained an anoxic brain injury secondary to cardiac arrest of unknown etiology. On admission to our rehabilitation unit 2 months after the injury, the patient presented with severe bruxism and heavy dental wear. The patient was injected with a total of 200 units of BTX-A to each masseter and temporalis. There was total resolution of bruxism 2 days after injection, with no complications. On follow-up 3 months after injection, the patient remained free of bruxism. We propose that botulinum toxin be considered as a treatment for bruxism secondary to anoxic brain injury. Further studies regarding muscle selection and medication dosage are warranted to elucidate the toxin's efficacy in this condition.

  10. Association between temporomandibular disorders and pain in other regions of the body.

    Science.gov (United States)

    Bonato, L L; Quinelato, V; De Felipe Cordeiro, P C; De Sousa, E B; Tesch, R; Casado, P L

    2017-01-01

    The pain from temporomandibular disorder (TMD) is often associated with physical symptoms of other chronic pain disorders and comorbidities, such as generalised muscle and joint pain. However, this association is not widely studied. To evaluate the prevalence of comorbid pain in joints, specifically in the knees, hips, ankles, shoulders, wrists and elbows, in individuals with and without TMD. We evaluated 337 patients from a public hospital in the city of Rio de Janeiro, Brazil. The Research Diagnostic Criteria for TMD questionnaire were used for the diagnosis of TMD. To assess the presence of other joint pain, the patients were asked to answer questions considering: the presence of pain in the knee, hip, ankle, shoulder, wrist and elbow joints and time duration of pain. Individuals with TMD are 5·5 times more likely to present with other joint pain compared with those without the disorder. TMD muscle disorders were most associated with a higher number of pain at the other locations. There was a significant association between the presence of pain at the other locations, muscle (P other locations. Individuals with TMD showed a high prevalence of pain in other joints of the body when compared with individuals without the disorder, and knee pain was the most prevalent pain complaint.

  11. 咬合异常与颞下颌关节紊乱病相关性调查研究%The investigation of the association between occlusal interference and the temporomandibular joint disorders

    Institute of Scientific and Technical Information of China (English)

    侯文平; 龚忠诚; 迪丽努尔·阿吉; 李宇; 热比古丽·阿卜来提; 买买提吐逊·吐尔地

    2015-01-01

    Objective To survy the temporomandibular disorders(TMD)prevalence of Urumqi staffs and evaluate the association between bad habits,occlusal disorders with TMD. Methods To abstract 600 male from The Health Management Center of The First Afflicated Hospital of Xinjiang Medical University check their temporomandibular joint while granting questionnaires and count the situation of bruxism,unilateral chewing, clenching, teeth misssing and check their TMJ,occlusal and occlusal movement.The TMD patients with occlusal interference set as the experiment group,and the health people with occlusal interference as the control group. ResuIts The prevalence of TMD in The First Afflicated Hospital of Xinjiang Medical University of Health Management Center is high, 49.33%. lncluding 16 bruxism,29 unilateral chewing and 30 clenching;49 teeth missing,95 overbite and 153 occlusal interference.ln the control group,the bruxism 3,unilateral chewing 15,clenching 13,teeth missing 20,occlusal interference 35,overbite 29 and the health occlusion 225.The occlusal interference OR=8.3(χ2=113, 95% Cl:5.67,12.15,P<0.01). ConcIusion The prevalence of TMD in the first afflicated hospital of XinJiang Medical University of health management center is high, 49.3%. There is closely association between Occlusal interference and TMD.%目的:调查乌鲁木齐市就职人员颞下颌关节紊乱病患病情况,探讨其生活不良习惯、咬合异常与颞下颌关节紊乱病之间的相关性.方法:抽取新疆医科大学附属第一医院体检中心体检男性600人进行颞下颌关节情况检查,同时问卷调查,统计夜磨牙、偏侧咀嚼、紧咬牙情况,并检查记录缺失牙、静态咬合关系和动态咬合运动情况,将有咬合干扰的TMD阳性者设为病例组,阴性者设为对照组.结果:TMD体征阳性者295例,TMD阴性者305例,TMD患病率约49.33%.其中紧咬牙30例,夜磨牙16例,偏侧咀嚼者29例,牙齿缺失49例,深覆牙合95例,咬合干扰153例.阴

  12. Influence of the Splint Therapy on Muscle Function and on Mandibular Kinetics in the Treatment of a Patient with Malocclusion and Severe Temporomandibular Disorder

    OpenAIRE

    2002-01-01

    INTRODUCTION: Despite the most recent changes in the treatment of temporomandibular disorders, the relaxation splint is still the most employed therapeutic variety.Some authors, however, have doubts about its actions on neuromuscular function and suspect that its effectiveness is onlydue to psychological factors and placebo effect. AIM: In this study an attempt was made to study the neuromuscular response of the stomatognathic apparatus in a temporomandibular disorder patient during splint th...

  13. Warm Needling Combined with Iontophoresis of Chinese Medicine for Temporomandibular Joint Disorder

    Institute of Scientific and Technical Information of China (English)

    Liu Min-juan; Mu Jing-ping

    2014-01-01

    Objective: To observe the clinical efficacy of warm needling combined with iontophoresis of Chinese medicine for temporomandibular joint disorder (TMD). Methods: A total of 100 TMD cases were randomly allocated into a treatment group and a control group, 50 in each group. Cases in the treatment group were treated with warm needling combined with iontophoresis of Chinese medicine, whereas cases in the control group were treated with Western medication. The therapeutic efficacies in two groups were assessed after three courses of treatment. Results: The recovery rate and total effective rate were 54.0% and 98.0% respectively in the treatment group, versus 30.0% and 82.0% in the control group, showing significant differences (bothP Conclusion: Warm needling combined with iontophoresis of Chinese medicine is remarkably effective for TMD and deserves further clinical application.

  14. The coexistence of paroxysmal hemicrania and temporomandibular disorder: Importance of multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    André Luís Porporatti

    2014-01-01

    Full Text Available Paroxysmal hemicrania (PH is a trigeminal autonomic cephalalgia, a rare primary headache characterized by unilateral periorbital and/or temporal attacks of severe intensity and short duration. In this situation, the determination of a correct diagnosis is crucial for the establishment of a proper management strategy. In the case of head and facial pain, this step is usually a big challenge since many conditions share the same features, as some primary headaches and temporomandibular disorders (TMD. The relationship between PH and TMD has not been determined. This paper describes a case of a female patient diagnosed with TMD and presenting concomitant headache attacks fulfilling the International Headache Society′s criteria for PH. It is also emphasized the importance of dentist in this scenario, for many times responsible for the initial diagnosis of facial/head pain. Moreover, it is presented an integrated and simultaneously approach of both conditions, PH and TMD.

  15. Temporomandibular disorders and psychological status in adult patients with a deep bite

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Svensson, Peter

    2008-01-01

    Temporomandibular disorders (TMDs) and psychological status were examined in adult patients with a deep bite and compared with an adult age- and gender-matched control group with neutral occlusion. The deep bite group consisted of 20 females (mean age 30.3 years) and 10 males (mean age 33.1 years......). The control group comprised 20 females (mean age 29.4 years) and 10 males (mean age 34.2 years). TMD examination, according to the Research Diagnostic Criteria for TMD (RDC/TMD), cephalometric lateral radiographs, registration of occlusion, and bite force were performed. To test the mean differences between...... craniofacial morphology, bite force, the occurrence of RDC/TMD diagnostic groups, and headache between the two groups, unpaired t-test, Fisher's exact test, Mann-Whitney U test, and multiple logistic regression analyses were performed. Deep bite patients more frequently reported nocturnal and diurnal clenching...

  16. Segmental LeFort I osteotomy for treatment of a class III malocclusion with temporomandibular disorder

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    Marcos Janson

    2008-08-01

    Full Text Available This article reports the case of a 19-year-old young man with Class III malocclusion and posterior crossbite with concerns about temporomandibular disorder (TMD, esthetics and functional problems. Surgical-orthodontic treatment was carried out by decompensation of the mandibular incisors and segmentation of the maxilla in 4 pieces, which allowed expansion and advancement. Remission of the signs and symptoms occurred after surgical-orthodontic intervention. The maxillary dental arch presented normal transverse dimension. Satisfactory static and functional occlusion and esthetic results were achieved and remained stable. Three years after the surgical-orthodontic treatment, no TMD sign or symptom was observed and the occlusal results had not changed. When vertical or horizontal movements of the maxilla in the presence of moderate maxillary constriction are necessary, segmental LeFort I osteotomy can be an important part of treatment planning.

  17. Temporomandibular disorders, trismus and malignancy: development of a checklist to improve patient safety.

    Science.gov (United States)

    Beddis, H P; Davies, S J; Budenberg, A; Horner, K; Pemberton, M N

    2014-10-01

    Trismus is a restriction in the ability to open the mouth. Trismus can occur following trauma, surgery, radiation therapy, infection, inflammatory diseases, temporomandibular disorders (TMD) or less commonly as a result of malignancy. Following two cases of delayed diagnosis of carcinoma presenting with features of TMD to a specialist clinic, a checklist was developed for completion in cases of trismus, to alert the clinician to suspicious features suggesting a possible non-TMD cause. The use of this checklist, together with an increased awareness, has improved early recognition of atypical features in patients presenting with trismus and has contributed to the early diagnosis of a further case of malignancy presenting to this clinic. This article discusses the presentation of malignancy with trismus, the relevance of imaging in these cases, and the implementation of a checklist to reduce the risk of future misdiagnosis.

  18. Examination of temporomandibular disorders in the orthodontic patient: a clinical guide

    Directory of Open Access Journals (Sweden)

    Ana Claúdia de Castro Ferreira Conti

    2007-02-01

    Full Text Available The possible association between orthodontic treatment and temporomandibular disorders (TMD is a topic of great interest in the current literature. The true role of orthodontic therapy on the etiology of TMD, however, is still uncertain. From the clinical prospective, a thorough examination of the stomatognathic system is always necessary in order to detect possible TMD signs and symptoms prior to the beginning of the orthodontic therapy. Caution should be exercised when planning, performing and finalizing orthodontics, especially in patients who with history of signs and symptoms of TMD. The clinician must always eliminate patient's pain and dysfunction before initiating any type of orthodontic mechanics. Muscle incoordination, unstable disc-condyle relationship and bone alterations are usual TMD conditions that can interfere with the presenting occlusal relationship. This article reviews these aspects and presents a detailed clinical guide for the examination of the orthodontic patient, considering aspects related to facial pain and dysfunction.

  19. The study of temporomandibular disorders and orofacial pain from the perspective of the predoctoral dental curriculum.

    Science.gov (United States)

    Attanasio, Ron

    2002-01-01

    This paper addresses questions 2 to 6 posed in the charge to the conference to discuss the study of temporomandibular disorders (TMD) and orofacial pain from the perspective of the predoctoral dental curriculum. This paper lends itself to an additional query: how much diagnostic and therapeutic skill relative to TMD and orofacial pain should a new graduate possess and demonstrate to be deemed competent in accordance with the definition of competence of the American Dental Association's Commission on Dental Accreditation? Although much of the content of this and the accompanying articles from the conference pertain to the TMD and orofacial pain curricula of dental schools in North America, most of what is presented here is universal to the teaching of the subject matter; therefore, it could be applied to educational institutions in other parts of the world. Indeed, an international survey relative to the teaching of TMD and orofacial pain would be of interest and value to dental schools worldwide.

  20. Association of temporomandibular disorder symptoms with anxiety and depression in Portuguese college students.

    Science.gov (United States)

    Minghelli, Beatriz; Morgado, Marcos; Caro, Tatiana

    2014-06-01

    We investigated the prevalence of temporomandibular disorder (TMD) and its association with anxiety and depression among 1,493 Portuguese college students (age 17-69 years) at Piaget Institute. The assessment instruments were the Fonseca Anamnestic Questionnaire and the Hospital Anxiety and Depression Scale. TMD was present in 633 (42.4%) students, and anxiety or depression was present in 456 (30.5%) students. Regarding the association of TMD with anxiety and depression, 280 of the 633 students (61.4%) with TMD symptoms also had signs of anxiety or depression (P students without signs of anxiety or depression, students with such signs had an odds ratio of 3.1 (95% confidence interval: 2.42-3.84; P College students from various fields of study and regions of Portugal had a high prevalence of TMD, which was significantly associated with anxiety and depression.

  1. ID migraine questionnaire in temporomandibular disorders with craniofacial pain: a study by using a multidisciplinary approach.

    Science.gov (United States)

    Di Paolo, Carlo; Di Nunno, Anna; Vanacore, Nicola; Bruti, Gianluca

    2009-08-01

    To evaluate the prevalence of migraine and related disability and the role of ID migraine questionnaire as a screening tool in patients with temporomandibular disorders (TMDs) and craniofacial pain (CFP). TMDs patients with CFP underwent stomatognathic (RDC/TMD criteria) and neurological visits (IHS criteria, 2004). ID migraine questionnaire and MIgraine Disability Assessment Scale (MIDAS) were also administered. Out of 45 patients, 69% met diagnosis of migraine plus chronic tension-type headache (CTTH); 9% presented CTTH and 20% were migraineurs. Out of 39 migraineurs who completed MIDAS, 56% presented the highest disability grade. Out of 37 patients who completed ID migraine questionnaire, 32 resulted affected by probable migraine with a diagnostic sensibility and specificity of 94% and 100%, respectively. Our findings showed a clinical association between TMDs and migraine. We support a clinical role of ID migraine and MIDAS in TMDs patients with CFP and we underline the importance of a multidisciplinary evaluation in this group of migraineurs.

  2. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0...... shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS: Through a series of workshops...... of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. RESULTS: The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting...

  3. Accuracy study of the main screening tools for temporomandibular disorder in children and adolescents.

    Science.gov (United States)

    de Santis, Tatiana Oliveira; Motta, Lara Jansiski; Biasotto-Gonzalez, Daniela Aparecida; Mesquita-Ferrari, Raquel Agnelli; Fernandes, Kristianne Porta Santos; de Godoy, Camila Haddad Leal; Alfaya, Thays Almeida; Bussadori, Sandra Kalil

    2014-01-01

    The aims of the present study were to assess the degree of sensitivity and specificity of the screening questionnaire recommended by the American Academy of Orofacial Pain (AAOP) and the patient-history index proposed by Helkimo (modified by Fonseca) and correlate the findings with a clinical exam. All participants answered the questionnaires and were submitted to a clinical exam by a dentist who had undergone calibration training. Both the AAOP questionnaire and Helkimo index achieved low degrees of sensitivity for the detection of temporomandibular disorder (TMD), but exhibited a high degree of specificity. With regard to concordance, the AAOP questionnaire and Helkimo index both achieved low levels of agreement with the clinical exam. The different instruments available in the literature for the assessment of TMD and examined herein exhibit low sensitivity and high specificity when administered to children and adolescents stemming from difficulties in comprehension due to the age group studied and the language used in the self-explanatory questions.

  4. Cephalometric deviations present in children and adolescents with temporomandibular joint disorders

    Directory of Open Access Journals (Sweden)

    Leticia Vilaça Willeman Bastos

    2012-02-01

    Full Text Available INTRODUCTION: Temporomandibular disorders (TMD have proved to be a risk factor for developing hyperdivergent facial growth patterns. OBJECTIVE: The aims of this study were: (1 Assess differences between the cephalometric measurements in children with articular TMD and a control group, before and after mandibular growth peak according to cervical vertebral maturation; and (2 Identify a predictive model capable of differentiating patients with TMD and control group patients based on early cephalometric characteristics. METHOD: The study included children and adolescents with maximum age of 17 years, divided into experimental group (n=30 diagnosed with articular TMD-according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD for children and adolescents-subdivided according to growth stage, called pre-peak (n=17 and post-peak (n=13 and control group (n = 30, matched by gender, skeletal maturity stage of the cervical vertebrae and classification of malocclusion. Lateral cephalometric and craniofacial structures were traced and their relations divided into: Cranial base, maxilla, mandible, intermaxillary relations, vertical skeletal relations and dental relations. Differences between the means for each variable were evaluated by applying the statistical Student t test for independent samples. RESULTS: The means of the variables analyzed in the pre-peak showed no statistically significant differences. However, analysis of post-peak showed that the experimental group displayed decreased SNA and SNB and increased SN.Gn and 1.NB (p<0.05. CONCLUSION: It was possible to identify a predictive model able to differentiate patients with TMD and asymptomatic controls from early cephalometric characteristics.

  5. Is there an association between anxiety/depression and temporomandibular disorders in college students?

    Directory of Open Access Journals (Sweden)

    Leticia Bojikian CALIXTRE

    2014-01-01

    Full Text Available Objective: Considering the high incidence of Temporomandibular Disorders (TMD in the population aged 15-30 years and the fact that students are exposed to stressful psychosocial factors, the purposes of this study were: to verify clinical symptoms and jaw functionality in college students with TMD according to the anxiety/depression (A/D level and to evaluate the correlation between A/D and functionality, maximum mouth opening (MMO and pain and muscle activity. Material and Methods: Nineteen students with TMD diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders underwent two assessments during an academic semester. The evaluations were based on questionnaires (MFIQ - Mandibular Function Impairment Questionnaire; HADS - Hospital Anxiety and Depression Scale, clinical measurements (MMO without pain, MMO and assisted MMO; palpation of joint and masticatory muscles, and electromyography. The HADS scores obtained in the two assessments were used to classify all data as either "high" or "low" A/D. Data normality, differences and correlations were tested with the Shapiro-Wilk test, Student's t-test (or the Wilcoxon test, and Spearman test, respectively. The alpha level was set at 0.05. Results: None of the clinical variables were significantly different when comparing low and high A/D data. In low A/D there was a significant correlation between HADS score and: MFIQ (P=0.005, r=0.61, and MMO without pain (P=0.01, r=-0.55. Conclusions: Variation in A/D level did not change clinical symptoms or jaw functionality in college students with TMD. Apparently, there is a correlation between TMJ functionality and A/D level, which should be further investigated, taking into account the source of the TMD and including subjects with greater functional limitation.

  6. Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review.

    Science.gov (United States)

    Kellesarian, Sergio Varela; Al-Kheraif, Abdulaziz A; Vohra, Fahim; Ghanem, Alexis; Malmstrom, Hans; Romanos, Georgios E; Javed, Fawad

    2016-01-01

    The aim of this study was to review the cytokine profiles in the synovial fluid (SF) of patients with temporomandibular joint disorders (TMJD). Databases were searched from 1965 till September 2015 using different combinations of the following key words: "Temporomandibular joint"; "Cytokine"; "disorder"; and "synovial fluid" and "inflammation". Titles and abstracts of studies identified using the above-described protocol were screened and checked for agreement. Full-texts of articles judged by title and abstract to be relevant were read and independently evaluated. Hand-searching of the reference lists of potentially relevant original and review articles was also performed. The pattern of the present systematic review was customized to mainly summarize the relevant data. Fifteen studies were included. In 12 studies, cytokine profile of patients with TMJD was assessed using enzyme linked immunosorbent assay; and in 2 studies, histological analysis was performed to assess the cytokine profile of patients with TMJD. Patients with TMJD presented raised levels of interleukin (IL)-6 in 8 studies, IL-1beta (1β) in 5 studies and tumor necrosis factor-alpha (TNF-α) in 5 studies. Two studies showed no significant difference in TNF-α levels in patients with and without TMJD; and IL-1β levels were comparable in patients with and without TMJD in 2 studies. Raised levels of IL-6, TNF-α, IL-1β, IL-8, and IFN-γ in the SF have been associated with inflammation in patients with TMJD. Cytokines IL-10, osteoclastogenesis inhibitory factor/osteoprotegerin (OCIF/OPG), and VEGF found in the SF of TMJs could have an anti-inflammatory effect.

  7. Exercícios terapêuticos nas desordens temporomandibulares: uma revisão de literatura Therapeutic exercises in temporomandibular disorders: a literature review

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    Sâmia Amire Maluf

    2008-12-01

    Full Text Available A articulação temporomandibular faz parte do sistema estomatognático que, junto com os dentes, periodonto, coluna cervical, crânio e cintura escapular, é responsável pela mastigação, fonação, deglutição, respiração e expressão facial. Exercícios terapêuticos têm sido empregados na reabilitação e prevenção das disfunções temporomandibulares (DTM. Este estudo teve como objetivo revisar a literatura a respeito, verificando a eficácia dos exercícios terapêuticos nas DTM. Foram examinados periódicos do período entre 1991 e agosto de 2008, nas bases de dados Medline, Lilacs e Pubmed, utilizando as palavras-chave "desordem temporomandibular", "terapia por exercícios" e as correspondentes em inglês. Foram selecionados relatos de caso, artigos de revisão e ensaios clínicos com mais de 20 pacientes, num total de 53 artigos. A maioria relatou efeitos positivos na redução da dor, melhora da mobilidade e dos aspectos psicológicos, sugerindo que os exercícios podem contribuir no tratamento da DTM. Entretanto, o tipo, tempo de duração, número de repetições, freqüência e intensidade dos exercícios não está bem descrita. A falta de padronização das pesquisas, bem como da forma de avaliar, dificultam a comparação dos resultados. Mais estudos com métodos padronizados devem ser estimulados.The temporomandibular joint is part of the stomatognathic system, which comprises a complex set of orofacial structures, including teeth, cervical spine, cranium and shoulder. The system is responsible for masticatory, phonation, and deglutition functions, as well as for breathing and facial expression. Physical therapy exercises have been used for rehabilitation and prevention of temporomandibular disorders (TMD. The purpose of this study was to review studies on the subject and assess the effectiveness of physical therapy exercises for TMD. Case reports, review articles, and clinical trials with more than 20 patients

  8. Temporomandibular Dysfunction and Oral Parafunctions in Late Adolescence

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    Liset María Frías Figueredo

    2012-06-01

    Full Text Available Background: Temporomandibular dysfunction is a pathological entity related to functional problems that affect the temporomandibular joint and / or the masticatory muscles and associated structures. Its frequency tends to increase during puberty. Objective: To determine the frequency of temporomandibular dysfunction and its association with the presence of oral parafunctional in students from 16 to 18 years old. Methods: A descriptive study was conducted including 86 students from 16 to 18 years old who were studying at Robert Labrada Águila high school from September to November 2010. Helkimo index was applied in order to determine temporomandibular dysfunction frequency. Sociodemographic variables were also assessed and the presence of oral parafunctional habits as detected during physical examination. Results: 69.8% of respondents presented some level of temporomandibular dysfunction. Bruxism was the parafunction that mostly related to the initiation and development of temporomandibular dysfunction. Conclusions: There was a high frequency of temporomandibular dysfunction in this population.

  9. Application of physical therapy plus massage in the treatment of temporomandibular disorders%物理疗法配合按摩在颞下颌关节紊乱病中的应用

    Institute of Scientific and Technical Information of China (English)

    黄昊红; 徐文华; 李佐强; 韩永红

    2003-01-01

    BACKGROUND:Temporomandibular disorders ( TMD) included a group of clinical symptoms and disorder of masticate muscle group and temporomandibular joint,while its causes are not clear.TMD is characterized by pain around temporomandibular joi nt,sanp,and movement disorder in mandible,Currently,it is generally accepted that multiple factors resulted in TMD,including mental and psychological,muscular and tooth factors.Comprehensive treatment rather than single treatment is suggested for TMD.

  10. Temporomandibular Joint Assesment in Children with Cerebral Palsy

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    Özden Canbay

    2017-01-01

    Full Text Available Introduction: Aim of this study was to functionally evaluate temporomandibular joint (TMJ in children with Cerebral palsy (CP. Materials and Methods: After recording the individual’s demographic information, questions about TMJ stiffness, presence of saliva, nutrition, oral splint, pain, respiratory system, history of epilepsy, chewing problems and disease were asked to the individuals and/or parents. Mandibular mobility was evaluated with length measurement and neck muscle strength was evaluated with manual muscle test. Results: It was found that 15% individuals with CP who participated in the study, had jaw sensitivity, stiffness and locked up, 30% had headache, 25 % had bruxism, 15 %had nail biting and 25 % had otalgia. Swallowing problems were seen majorly in boys than girls (p<0.05. Conclusions: It was seen that children with CP have TMJ problems. Literature on this area is limited so it was thought that research is needed about prevention and treatment of TMJ disorders.

  11. Arthrocentesis and Temporomandibular Joint Disorders: Clinical and Radiological Results of a Prospective Study

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    Giacomo De Riu

    2013-01-01

    Full Text Available Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ disorders. Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO, joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT and magnetic resonance imaging (MRI at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpaired t-tests, and McNemar’s test was used to evaluate CBCT and MRI changes (. Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs. Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered with NCT01903512.

  12. The prevalence of clinical diagnostic groups in patients with temporomandibular disorders.

    Science.gov (United States)

    Machado, Luciana Pimenta e Silva; Nery, Cláudio de Góis; Leles, Cláudio Rodrigues; Nery, Marianita Batista de Macedo; Okeson, Jeffrey P

    2009-07-01

    The aim of this study was to observe the prevalence of diagnostic groups of temporomandibular disorders (TMD) in patients who were referred or sought treatment for TMD and/or orofacial pain in a private clinic. The clinical records of 357 patients were evaluated and selected based on inclusion/exclusion criteria; the mean age was 32 years. A clinical examination was performed and the diagnosis was based on the American Academy of Orofacial Pain criteria. Results showed that 86.8% of patients were women and 93.3% of the patients presented more than one diagnosis. The most frequent chief complaint (n = 216, chi2 = 30.68, p = 0.001) and total diagnosis realized (n = 748, chi2 = 14.14, p = 0.001) were muscle related. We concluded that women seek treatment for dysfunction/disorders of orofacial structures more than men do; patients seeking specialized treatment have more than one diagnosis and muscle dysfunction is more prevalent than intra-articular disorders.

  13. Generalized joint laxity and its relation with oral habits and temporomandibular disorders in adolescent girls.

    Science.gov (United States)

    Winocur, E; Gavish, A; Halachmi, M; Bloom, A; Gazit, E

    2000-07-01

    A group of 248 girls, aged 15-16 years, were randomly selected and examined both clinically and by questionnaire with regard to the signs and symptoms of temporomandibular disorders (TMD), generalized joint laxity (GJL), range of mandibular opening, temporomandibular joint (TMJ) hypermobility and presence of oral parafunctions. The prevalence of GJL was 43% and that of TMJ hypermobility (TMJH) was 27.3%. A significant, albeit weak, correlation was found between the two. In the presence of joint click, both active and passive opening were significantly larger. When either muscle or joint sensitivity to palpation was present, the difference between the active and passive range of mouth opening increased significantly. The presence of reported clicks was negatively associated with GJL. This association was not valid in the presence of parafunction. Some of the signs and symptoms of TMD affected the range of mouth opening. In the presence of joint clicks, the mean active and passive mandibular opening were significantly larger. In the presence of joint and muscle sensitivity to palpation, the difference between passive and active mouth opening was larger. This was possibly because of the effect of pain on the full active range of opening, which was invalid in the registration of the passive mandibular opening. GJL, when present, did not seem to jeopardize the health of the stomatognathic system as expressed in the signs and symptoms of TMD. There was a negative association between GJL and the presence of reported joint clicks and catch. When a parafunction was present in addition to GJL, this association was invalid but not reversed, as has been previously reported.

  14. Laser acupuncture therapy in patients with treatment-resistant temporomandibular disorders.

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    Wen-Long Hu

    Full Text Available To investigate the clinical effects of laser acupuncture therapy for temporomandibular disorders (TMD after ineffective previous treatments.A retrospective observational study was conducted in 29 treatment-resistant TMD patients (25 women, 4 men; age range, 17-67 years. Subjects were treated 3 times per week for 4 weeks with the Handylaser Trion (GaAlAs laser diode, 810 nm, 150 mW, pulsed waves, which delivered 0.375 J of energy (5 s to ST7, ST6, and LI4 and 3 J (40 s to each Ashi point, 7.5-26.25 J/cm2 in total. The visual analog scale (VAS and maximal mouth opening (MMO were evaluated before and after treatment.VAS analysis showed that the patients were free of pain at rest (endpoint after 5.90±6.08 sessions of laser acupuncture for acute TMD and after 16.21±17.98 sessions for chronic TMD. The VAS score on palpation of the temporomandibular joint reduced to 0.30±0.67 for patients with acute TMD (p = 0.005 and to 0.47±0.84 for those with chronic TMD (p<0.001. The MMO significantly increased in patients with acute TMD (7.80±5.43 mm, p = 0.008 and in patients with chronic TMD (15.58±7.87 mm, p<0.001.Our study shows that laser acupuncture therapy improves the symptoms of treatment-resistant TMD. Further studies with a more appropriate design, involving long-term follow-up examinations in a larger patient sample, are needed to evaluate its efficacy.

  15. Current status of temporomandibular joint disorders and the therapeutic system derived from a series of biomechanical, histological, and biochemical studies

    OpenAIRE

    Kazuo Tanne; Yuki Okamoto; Shao-Ching Su; Tomomi Mitsuyoshi; Yuki Asakawa-Tanne; Kotaro Tanimoto

    2015-01-01

    This article was designed to report the current status of temporomandibular joint disorders (TMDs) and the therapeutic system on the basis of a series of clinical, biomechanical, histological and biochemical studies in our research groups. In particular, we have focused on the association of degenerative changes of articular cartilage in the mandibular condyle and the resultant progressive condylar resorption with mechanical stimuli acting on the condyle during the stomatognathic function. In...

  16. Trigeminal Electrophysiology: a 2 × 2 matrix model for differential diagnosis between temporomandibular disorders and orofacial pain

    OpenAIRE

    Chessa Giacomo; Frisardi Gianni; Sau Gianfranco; Frisardi Flavio

    2010-01-01

    Background Pain due to temporomandibular disorders (TMDs) often has the same clinical symptoms and signs as other types of orofacial pain (OP). The possible presence of serious neurological and/or systemic organic pathologies makes differential diagnosis difficult, especially in early disease stages. In the present study, we performed a qualitative and quantitative electrophysiological evaluation of the neuromuscular responses of the trigeminal nervous system. Using the jaw jerk reflex (JJ...

  17. Analgesic efficacy of diazepam and placebo in patients with temporomandibular disorders: A double blind randomized clinical trial

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    G V Pramod

    2011-01-01

    Full Text Available Aim: The aim of the study was to evaluate and compare the analgesic efficacy of placebo and diazepam in patients with temporomandibular disorder. Materials and Methods: Thirty-five patients were recruited with a diagnosis of temporomandibular disorder based on standard clinical diagnostic criteria for temporomandibular disorder. The patients were put in to one of the two groups: placebo or diazepam at random. The average pain intensity was recorded with visual analog scale (VAS at pretreatment, at weekly interval till the completion of a three-week trial and at post-treatment visit on the eighth week from baseline. The secondary outcome measures were changes in masticatory muscle tenderness, viz. massater muscle, lateral pterygoid muscle, medial pterygoid muscle and temporalis muscle and changes in mouth opening. Statistical Analysis: Intra-group comparison for analgesic efficacy and mouth opening was carried out by Wilcoxon′s signed ranked test. Inter-group comparison for analgesic efficacy was also carried out using Mann-Whitney′s test. Results: A statistically significant (P<0.01 decrease in temporomandibular disorder pain in the placebo group (65% and statistically highly significant (P<0.001 decrease in the diazepam group (72% were observed on VAS after three weeks of treatment. The inter-group comparison demonstrated no statistically significant difference between the groups. Conclusion: This study suggests that the placebo can give near similar results as diazepam can. So the role of placebo should also be considered as one of the important management strategies. In the short term, reduction in the masticatory muscle tenderness and significant improvement in the mouth opening in both the groups were observed.

  18. Association between symptoms of temporomandibular disorders and gender, morphological occlusion, and psychological factors in a group of university students

    OpenAIRE

    Bonjardim Leonardo; Lopes-Filho Ricardo; Amado Guilherme; Albuquerque Ricardo; Goncalves Suzane

    2009-01-01

    Aim: The purpose of this study was to find out the prevalence of temporomandibular disorder (TMD) in a sample of university students and its relationship to gender, occlusion, and psychological factors. Materials and Methods: The sample comprised 196 subjects, aged 18-25 years. The TMD degree was evaluated using an anamnestic questionnaire. Morphologic occlusion was evaluated according to Angle classification (classes I, II, and III). The Hospital Anxiety and Depression Scale (HADS), a 14-...

  19. Temporomandibular Joint Disorders Among Patients Treated in the Department of Oral and Maxillofacial Surgery at Muhimbili National Hospital

    OpenAIRE

    2010-01-01

    Temporomandibular joint disorders (TMJD) are the most common debilitating conditions of the stomatognathic system. Although they exist in the community they are not mentioned in the literature as an endemic health problem. Their prevalence does not seem to be clear enough for the health system in Tanzania to give them priority as other health problems. Study setting: The study was done in the department of Oral and Maxillofacial Surgery at Muhimbili National Hospital (MNH). To determine the o...

  20. DENTAL WEAR CAUSED BY ASSOCIATION BETWEEN BRUXISM AND GASTROESOPHAGEAL REFLUX DISEASE: A REHABILITATION REPORT

    OpenAIRE

    Machado, Naila Aparecida de Godoi; Fonseca, Rodrigo Borges; BRANCO, Carolina Assaf; Barbosa, Gustavo Augusto Seabra; Fernandes, Alfredo Júlio; Soares, Carlos José

    2007-01-01

    Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related str...

  1. Frequency of Temporomandibular Disorders in Asymptomatic Removable Partial and Complete Denture Wearers

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    N. Dulčić

    2006-01-01

    Full Text Available A dogmatic view on occlusion as the main aetiological factor for temporomandibular disorder (TMD has been present in the literature for a long time, but a direct scientific correlation between occlusal disorders and TMD has never been proven. The purpose of this study was to determine the frequency of TMD signs and tissue-specific diagnoses in a population of 164 asymptomatic participants, 70 removable partial denture wearers and 94 complete denture wearers of an average age of 61.3 years, by means of clinical manual functional analysis. TMD was found in 42.1% of the participants. No statistically significant difference in the occurrence of TMD was found between removable partial and complete denture wearers and between genders (P > 0.05. The most frequent tissue-specific diagnoses were osteoarthrosis (11%, total anterior disc displacement (9.1% and partial anterolateral disc displacement (8.5%. The frequency of tissue-specific diagnoses was also not influenced by the type of prosthetic replacements.

  2. The role of intercuspal occlusal relationships in temporomandibular disorders: a review.

    Science.gov (United States)

    Seligman, D A; Pullinger, A G

    1991-01-01

    The purpose of this review is to highlight consensus in past research on the role of intercuspal occlusal factors in the pathophysiology of temporomandibular disorders. The occlusal intercuspal relationships considered are skeletal anterior open bite, overbite, overjet, symmetry of contacts in the retruded contact position (RCP), crossbite, and posterior occlusal support. Skeletal anterior open bite, reduced overbite, and increased overjet are associated with osteoarthritic TMJ patients, but lack specificity for defining patient populations per se. There is no evidence that overbite or overjet plays a role in the pathophysiology of nonarthritic disorders. A combination of unilateral RCP with an absence of a clinically apparent RCP-ICP (intercuspal position) slide may encourage TMJ disc displacement, but unilateral RCP per se was not associated with TMJ diagnoses. Crossbite does not seem to provoke TMJ symptoms or disease. Lost molar support may be associated with osteoarthrosis presence and severity, but studies have not yet been distinguished for age effects. Where appropriate, implications for clinical practice are drawn.

  3. Comparison of static MRI and pseudo-dynamic MRI in temporomandibular joint disorder patients

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    Lee, Jin Ho; Yun, Kyoung In [Eulji Univ. School of Medicine, Seoul (Korea, Republic of); Park, In Woo; Choi, Hang Moon; Park, Moon Soo [Kangnung National Univ. College of Dentistry, Kangnung (Korea, Republic of)

    2006-12-15

    The purpose of this study was to elevate comparison of static MRI and pseudo-dynamic (cine) MRI in temporomandibular joint (TMJ) disorder patients. In this investigation, 33 patients with TMJ disorders were examined using both conventional static MRI and pseudo-dynamic MRI. Multiple spoiled gradient recalled acquisition in the steady state (SPGR) images were obtained when mouth opened and closed. Proton density weighted images were obtained at the closed and open mouth position in static MRI. Two oral and maxillofacial radiologists evaluated location of the articular disk, movement of condyle and bony change respectively and the posterior boundary of articular disk was obtained. No statistically significant difference was found in the observation of articular disk position, mandibular condylar movement and posterior boundary of articular disk using static MRI and pseudo-dynamic MRI (P>0.05). Statistically significant difference was noted in bony changes of condyle using static MRI and pseudo-dynamic MRI (P<0.05). This study showed that pseudo-dynamic MRI didn't make a difference in diagnosing internal derangement of TMJ in comparison with static MRI. But it was considered as an additional method to be supplemented in observing bony change.

  4. Prevalence of temporomandibular disorder in children and adolescents from public schools in Southern Portugal

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    Beatriz Minghelli

    2014-01-01

    Full Text Available Background: The prevalence of temporomandibular disorder (TMD in children and adolescents is in the range of 6-68% and can be triggered or aggravated by emotional stress. Aim: The study was to investigate the prevalence of TMD in Portuguese children and adolescents and its association with emotional stress. Materials and Methods: The sample comprised 3,260 students aged 5-19 years. The questionnaire was used to assess the presence of TMD, and was applied in a single moment. Results: TMD was observed in 821 (25.2% students. The most common symptoms of TMD were: if considered tense or nervous (52%, have headaches (36.8%, and habit of clenching or grinding teeth (27.3%. The girls had a 1.36 higher probability of developing TMD than boys (95% CI: 1.14-1.63; p < 0.001; moreover, students from the older age group had a 2.31 higher probability of developing the disorder (95% CI: 1.85-2.89; p < 0.001. Students who considered themselves tense or nervous presented 8.74 higher probability (95% CI: 7.03-10.86; p < 0.001 of developing TMD. Conclusion: This study showed a high prevalence of TMD in children and adolescents in southern Portugal, and revealed a significant association between this dysfunction and the levels of emotional stress. Female students, older students, and those considered tense or nervous have a higher probability of developing TMD.

  5. Psychological factors and the incidence of temporomandibular disorders in early adolescence

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    Luciano José Pereira

    2009-06-01

    Full Text Available The purpose of the present study was to evaluate the relationship between psychological variables and the clinical diagnosis of temporomandbular disorders (TMD in 12-year-old adolescents. TMD pain was assessed by RDC/TMD examination (Research Diagnostic Criteria for Temporomandibular Disorders (Axis I and II. Five-hundred and fifty-eight subjects (330 girls and 228 boys were examined. Bivariate analyses were performed using the Chi-square test (χ2. The logistic regression models were adjusted estimating the Odds Ratios (OR, their 95% confidence intervals (CI, and significance levels. Only 2.19% of the boys and 8.18% of the girls presented one of the Axis I categories. All variables from axis II were related to TMD diagnosis (p < 0.001. Gender was significantly related to TMD diagnosis (p = 0.0028. The risk of TMD incidence for girls was 3.5 times higher than that for boys (Odds Ratio = 3.52, Confidence Interval 1.31-9.43. The individuals who presented the variable "characteristics of pain intensity" (CPI higher than 0 had 31 times more risk of TMD incidence (Odds Ratio = 31.361, Confidence interval 6.01-163.5. We concluded that psychological variables and female gender are important risk indicators related to TMD incidence, even in adolescents.

  6. Is there an association between temporomandibular disorders and playing a musical instrument? A review of literature.

    Science.gov (United States)

    Attallah, M M; Visscher, C M; van Selms, M K A; Lobbezoo, F

    2014-07-01

    Temporomandibular disorders (TMDs) have a multifactorial etiology. Among others, parafunctions and oral habits have been suggested as important initiating and perpetuating factors. Playing a musical instrument that loads the masticatory system, like wind instruments and the violin or viola, has been suggested to be part of this group of etiological factors. However, the evidence base for this suggestion is lacking. Therefore, the aim of this study was to review the literature on the possible association between playing a musical instrument and developing and/or having a TMD. A PubMed search, using the query ['Music'(Mesh) AND 'Craniomandibular Disorders'(Mesh)], yielded 19 articles, 14 of which were included in this review. Six of 14 papers had a case-control or pre-test-post-test design; the remaining eight papers were case reports of expert opinions. The former papers were analysed and tabulated according to the PICO (Patient/population-Intervention-Control/comparison-Outcome/results) system; the latter ones were only summarised and tabulated. All articles with a case-control or pre-test-post-test design suggested a possible association between TMD and playing a musical instrument, especially the violin and viola. However, no clear-cut conclusion could be drawn as to whether playing a musical instrument is directly associated with TMD, or only in combination with other factors. More and better research on this topic is needed, as to enable a better counselling and possibly even a better treatment of the suffering musician.

  7. Duloxetine-induced Sleep Bruxism in Fibromyalgia Successfully Treated With Amitriptyline

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    Şule Şahin Onat

    2015-10-01

    Full Text Available A 44-year-old woman, who was suffering from widespread musculoskeletal pain, fatigue, and sleep disorder, was diagnosed as fibromyalgia. There was no apparent organic disease. Duloxetine therapy was introduced with a dose of 60 mg/day at bedtime. A few days later her husband noted severe teeth clenching and associated loud grinding noises during sleep. Then, duloxetine dosage was reduced to 30 mg/day. The bruxism continued with this dosage, thus the therapy was discontinued. The bruxism resolved after cessation. Three weeks later, duloxetine therapy was restarted at the dosage of 60 mg/day. On the third day of the therapy, bruxism started again and amitriptyline therapy at the dosage of 10 mg/day was added to duloxetine therapy. The dosage of amitriptyline was incrementally adjusted to 25 mg/ day. On the fourth day of the combined therapy, bruxism symptoms improved. Two months later, the bruxism symptoms were resolved and the complaints for fibromyalgia were under control. Although bruxism has been reported due to venlafaxine use, there is only one duloxetine-induced bruxism case in the literature which was treated with buspirone. However, we report duloxetine-induced bruxism treated successfully with amitriptyline in a patient with fibromyalgia. Tricyclic antidepressants have a suppression effect on the REM phase of the sleep cycle; this may help to cease the bruxism symptoms appearing in that phase of the sleep cycle. This is the first reported case of fibromyalgia with duloxetine-induced sleep bruxism successfully treated with amitriptyline.

  8. Genetic polymorphisms in folate pathway enzymes, DRD4 and GSTM1 are related to temporomandibular disorder

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    Mayor-Olea Alvaro

    2011-05-01

    Full Text Available Abstract Background Temporomandibular disorder (TMD is a multifactorial syndrome related to a critical period of human life. TMD has been associated with psychological dysfunctions, oxidative state and sexual dimorphism with coincidental occurrence along the pubertal development. In this work we study the association between TMD and genetic polymorphisms of folate metabolism, neurotransmission, oxidative and hormonal metabolism. Folate metabolism, which depends on genes variations and diet, is directly involved in genetic and epigenetic variations that can influence the changes of last growing period of development in human and the appearance of the TMD. Methods A case-control study was designed to evaluate the impact of genetic polymorphisms above described on TMD. A total of 229 individuals (69% women were included at the study; 86 were patients with TMD and 143 were healthy control subjects. Subjects underwent to a clinical examination following the guidelines by the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD. Genotyping of 20 Single Nucleotide Polymorphisms (SNPs, divided in two groups, was performed by multiplex minisequencing preceded by multiplex PCR. Other seven genetic polymorphisms different from SNPs (deletions, insertions, tandem repeat, null genotype were achieved by a multiplex-PCR. A chi-square test was performed to determine the differences in genotype and allelic frequencies between TMD patients and healthy subjects. To estimate TMD risk, in those polymorphisms that shown significant differences, odds ratio (OR with a 95% of confidence interval were calculated. Results Six of the polymorphisms showed statistical associations with TMD. Four of them are related to enzymes of folates metabolism: Allele G of Serine Hydoxymethyltransferase 1 (SHMT1 rs1979277 (OR = 3.99; 95%CI 1.72, 9.25; p = 0.002, allele G of SHMT1 rs638416 (OR = 2.80; 95%CI 1.51, 5.21; p = 0.013, allele T of Methylentetrahydrofolate

  9. Polysomnographic Investigation of Sleep and Respiratory Parameters in Women with Temporomandibular Pain Disorders

    Science.gov (United States)

    Dubrovsky, Boris; Raphael, Karen G.; Lavigne, Gilles J.; Janal, Malvin N.; Sirois, David A.; Wigren, Pia E.; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.

    2014-01-01

    Study Objectives: Temporomandibular pain disorders (TMD) and myofascial pain were linked to increased prevalence of insomnia and obstructive sleep apnea (OSA) on clinical grounds. However, the literature lacks an accurate polysomnographic (PSG) characterization of sleep abnormalities associated with TMD, given that prior studies included small or uncontrolled samples of TMD patients. The present investigation aims to objectively evaluate measures of sleep and respiratory disturbance in a large representative sample of TMD cases in comparison with matched controls. Methods: Sleep, respiration, and limb movements were measured using a 2-night attended PSG protocol in 170 women—124 TMD cases with myofascial pain and 46 demographically matched controls. The second night data were compared between the groups using ANCOVAs. In TMD cases, the relationship between pain ratings and sleep parameters was analyzed using multiple regressions. Results: In comparison to healthy controls, TMD cased evidenced a significant increase in stage N1 sleep (12.2% ± 7.6% vs. 9.2% ± 5.0%, p = 0.03), which was only mild relative to normative values. TMD cases also demonstrated mild but significant elevations in arousals associated with all types of respiratory events (6.0/h ± 6.1 vs. 3.5/h ± 3.3 p = 0.02) and in respiratory effort related arousals (RERAs, 4.3/h ± 4.3 vs. 2.6/h ± 2.7, p = 0.02). Myofascial pain predicted a lower sleep efficiency (p = 0.01), more frequent awakenings (p = 0.04), and higher RERA index (p = 0.04) among TMD cases. Conclusions: Myofascial pain in TMD is associated with mild elevation in sleep fragmentation and increased frequency of RERA events. Further research is required to evaluate the clinical significance of these findings. Citation: Dubrovsky B; Raphael KG; Lavigne GJ; Janal MN; Sirois DA; Wigren PE; Nemelivsky LV; Klausner JJ; Krieger AC. Polysomnographic investigation of sleep and respiratory parameters in women with temporomandibular pain

  10. Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder

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    Castelo Paula M

    2011-05-01

    Full Text Available Abstract Background Oral health-related quality of life (OHRQoL in children and adolescents with signs and symptoms of temporomandibular disorder (TMD has not yet been measured. This study aimed to evaluate the validity and reliability of OHRQoL measure for use in children and preadolescents with signs and symptoms of TMD. Methods Five hundred and forty-seven students aged 8-14 years were recruited from public schools in Piracicaba, Brazil. Self-perceptions of QoL were measured using the Brazilian Portuguese versions of Child Perceptions Questionnaires (CPQ8-10 (n = 247 and CPQ11-14 (n = 300. A single examiner, trained and calibrated for diagnosis according to the Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD, examined the participants. A self-report questionnaire assessed subjective symptoms of TMD. Intraexaminer reliability was assessed for the RDC/TMD clinical examinations using Cohen's Kappa (κ and intraclass correlation coefficient (ICC. Criterion validity was calculated using the Spearman's correlation, construct validity using the Spearman's correlation and the Mann-Whitney test, and the magnitude of the difference between groups using effect size (ES. Reliability was determined using Cronbach's alpha, alpha if the item was deleted and corrected item-total correlation. Results Intraexaminer reliability values ranged from regular (κ = 0.30 to excellent (κ = 0.96 for the categorical variables and from moderate (ICC = 0.49 to substantial (ICC = 0.74 for the continuous variables. Criterion validity was supported by significant associations between both CPQ scores and pain-related questions for the TMD groups. Mean CPQ8-10 scores were slightly higher for TMD children than control children (ES = 0.43. Preadolescents with TMD had moderately higher scores than the control ones (ES = 0.62; p 8-10 and 0.94 for CPQ11-14. For the overall CPQ8-10 and CPQ11-14 scales, the corrected item-total correlation coefficients ranged from 0

  11. Stakeholder engagement analysis - a bioethics dilemma in patient-targeted intervention: patients with temporomandibular joint disorders.

    Science.gov (United States)

    Barkhordarian, Andre; Demerjian, Gary; Jan, Allison; Sama, Nateli; Nguyen, Mia; Du, Angela; Chiappelli, Francesco

    2015-01-20

    Modern health care in the field of Medicine, Dentistry and Nursing is grounded in fundamental philosophy and epistemology of translational science. Recently in the U.S major national initiatives have been implemented in the hope of closing the gaps that sometimes exist between the two fundamental components of translational science, the translational research and translational effectiveness. Subsequent to these initiatives, many improvements have been made; however, important bioethical issues and limitations do still exist that need to be addressed. One such issue is the stakeholder engagement and its assessment and validation. Federal, state and local organizations such as PCORI and AHRQ concur that the key to a better understanding of the relationship between translational research and translational effectiveness is the assessment of the extent to which stakeholders are actively engaged in the translational process of healthcare. The stakeholder engagement analysis identifies who the stakeholders are, maps their contribution and involvement, evaluates their priorities and opinions, and accesses their current knowledge base. This analysis however requires conceptualization and validation from the bioethics standpoint. Here, we examine the bioethical dilemma of stakeholder engagement analysis in the context of the person-environment fit (PE-fit) theoretical model. This model is an approach to quantifying stakeholder engagement analysis for the design of patient-targeted interventions. In our previous studies of Alzheimer patients, we have developed, validated and used a simple instrument based on the PE-fit model that can be adapted and utilized in a much less studied pathology as a clinical model that has a wide range of symptoms and manifestations, the temporomandibular joint disorders (TMD). The temporomandibular joint (TMJ) is the jaw joint endowed with sensory and motor innervations that project from within the central nervous system and its dysfunction can

  12. The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

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    Vasconcelos Belmiro CE

    2008-09-01

    Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

  13. Clinical Utility of bone Scan in the Diagnosis of Temporomandibular disorders

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    Kim, In Joo; Kang, Yang Ho; Son, Seok Man; Lee, Kyoung Seog; Lee, Jae Bok; Kim, Yong Ki; Seo, Bong Jik; Park, June Sang; Park, June Sang; Ko, Myung Yun [Pusan National University College of Medicine, Pusan (Korea, Republic of); Son, Seong Pyo [Saint Benedict Hospital, Pusan (Korea, Republic of)

    1995-09-15

    Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement (I3 unilaterally affected, 8 bilaterally affected), 26 patients with TMJ arthritis (23 unilateral, 3 bilateral), and 39 volunteers with no signs, symptoms, or history of TMJ disease TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in {sup 99m}Tc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were 1.67 +-0.606 in TMJs affected with arthritis, 1.350+-0.351 in TMJs affected with disc displacement, and 1.084+-0.172 in TMJs of controls Significant differences were demonstrated among them(p<001). Difference of both TMJ SUR was highest in patients with unilateral TMJ arthritis(0.608+-0.533, p<001), and there is no significant difference between that of controls and that of unilateral TMJ disc displacement patients(0.062+-0.063 vs 0.122+-0.100). TMJ SUR of joint with bone change on X-ray finding was not significantly different from that of joint with normal X-ray finding. Those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). The proportions of patients with increased TMJ SUR and difference of both TMJ SUR(>mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan may help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

  14. Evaluation of oro-facial function in young subjects with temporomandibular disorders.

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    Kobayashi, F Y; Gavião, M B D; Montes, A B M; Marquezin, M C S; Castelo, P M

    2014-07-01

    The aim of this study was to evaluate bite force (BF) and oro-facial functions at different dentition phases (initial-mixed, intermediate-mixed, final-mixed and permanent dentition) in children and adolescents diagnosed with temporomandibular disorders (TMDs). The sample was selected from four public schools in Piracicaba, São Paulo, Brazil. Of the 289 participants recruited, aged 8-14 years old, 46 were placed into the TMD group. TMD was diagnosed using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (2011). Oro-facial functions were evaluated using the Nordic Orofacial Test-Screening (NOT-S), which involves both an interview and a clinical examination. BF was measured using a digital gnathodynamometer. Age and body mass index (BMI) were also considered. The data were analysed by the following tests: Kolmogorov-Smirnov test, Student's t-test, Spearman and Pearson coefficients, Qui-square test, Fisher's exact or binomial test, as indicated. Moreover, univariate and multivariable logistic regression were applied. For the TMD group, scores associated with NOT-S interview and NOT-S total were higher than for the control group (P = 0.033 and P = 0.0062, respectively). No differences in BF between genders or groups (P > 0.05) were detected. Variables included in the multivariate logistic regression were BMI and NOT-S total. Based on this analysis, NOT-S total was associated with TMDs. Reported sensory function was the specific domain within NOT-S interview that established the significant difference between the groups (P = 0.021). The TMD group also had a greater number of alterations in the face-at-rest domain of the NOT-S exam (P = 0.007). Concluding, it did not detect an association between TMDs and either dentition phase or BF. Instead, BF correlated with age and BMI. Oro-facial dysfunction was associated with TMD in the studied sample, but this association may be bidirectional, requiring further researches.

  15. Prevalence of temporomandibular disorders in Uigur and Han young people in Xinjiang Medical University%新疆医科大学维汉青年颞下颌关节紊乱病的流行病学调查

    Institute of Scientific and Technical Information of China (English)

    赵晓敏; 尼娜; 米丛波; 林兆全; 戈军; 龚忠诚

    2009-01-01

    目的:探讨颞下颌关节紊乱病(TMD)在新疆医科大学维汉青年人中的患病情况.方法:对新疆医科大学812名在读维汉医学生(年龄17~28岁)进行了TMD患病状况及咬合情况调查.按照Helkimo指数进行分析,包括既往功能紊乱指数和临床检查功能紊乱指数.采用SPSS13.0软件包对数据进行X2检验.结果:无既往功能紊乱者(Ai0)占73.40%,既往功能紊乱者(Ai Ⅰ+Ⅱ)占26.60%,无临床检查功能紊乱者(DiO)占60.50%,临床检查功能紊乱者(DiⅠ~Ⅲ)占39.50%.结论:TMD的患病率为39.50%,男女患病率无显著差异,异常组发病率显著高于正常组,TMD的发生与夜磨牙、偏侧咀嚼有关.%PURPOSE: To investigate the prevalence and distribution of temporomandibular disorders (TMD) and the related factors to TMD in Uigur and Han young people (17-28 years) from Xinjiang Medical University. METHODS: A sample of 812 persons was randomly selected from Xinjiang Medical University. Subjective disorders were assessed using questionnaire, and objective symptoms were determined by clinical examination. The Anamnestic and Clinical Dysfunction Indices (Ai and Di) according to Helkimo were employed. SPSS13.0 software package was used for data analysis. RESULTS: The percentage distribution of the sample was as follows :AiO=73.40 %, Ai Ⅰ+ Ⅱ = 26.60%, Dio=60.50%, Di Ⅰ- Ⅲ = 39.50 %. CONCLUSIONS: The prevalence of temporomandibular joint disorders was 39.50%. In anamnestic symptoms and clinical symptoms, there was no significant different between the males and females. ③The incidence of TMD in malocclusion group was higher than that in group without malocclusion. TMD is associated with some factors as bruxism, lateral biting.

  16. Bruxism: Is There an Indication for Muscle-Stretching Exercises?

    Science.gov (United States)

    Gouw, Simone; de Wijer, Anton; Creugers, Nico Hj; Kalaykova, Stanimira I

    Bruxism is a common phenomenon involving repetitive activation of the masticatory muscles. Muscle-stretching exercises are a recommended part of several international guidelines for musculoskeletal disorders and may be effective in management of the jaw muscle activity that gives rise to bruxism. However, most studies of muscle-stretching exercises have mainly focused on their influence on performance (eg, range of motion, coordination, and muscle strength) of the limb or trunk muscles of healthy individuals or individuals with sports-related injuries. Very few have investigated stretching of the human masticatory muscles and none muscle-stretching exercises in the management of (sleep) bruxism. This article reviews the literature on muscle-stretching exercises and their potential role in the management of sleep bruxism or its consequences in the musculoskeletal system.

  17. Bruxism Associated with Anoxic Encephalopathy: Successful Treatment with Baclofen

    Science.gov (United States)

    Janati, A. Bruce; ALGhasab, Naif Saad; ALGhassab, Fahad Saad

    2013-01-01

    Introduction. Bruxism is a movement disorder characterized by grinding and clenching of the teeth. Etiology of bruxism can be divided into three groups: psychosocial factors, peripheral factors, and pathophysiological factors. Methods. The clinical investigation was conducted at King Khaled Hospital in Hail, Saudi Arabia, in 2012. Results. A 16-year-old Saudi female was brought to the hospital in a comatose state and with generalized convulsive seizures secondary to acute anoxic encephalopathy. In the third week of hospitalization, while still in a state of akinetic mutism, she developed incessant bruxism which responded favorably to a GABA receptor agonist (baclofen). Conclusion. Our data support the hypothesis that bruxism emanates from imbalance or dysregulation of the neurotransmitter system. Larger scale studies will be needed to confirm this hypothesis. PMID:24455317

  18. Bruxism Associated with Anoxic Encephalopathy: Successful Treatment with Baclofen

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    A. Bruce Janati

    2013-01-01

    Full Text Available Introduction. Bruxism is a movement disorder characterized by grinding and clenching of the teeth. Etiology of bruxism can be divided into three groups: psychosocial factors, peripheral factors, and pathophysiological factors. Methods. The clinical investigation was conducted at King Khaled Hospital in Hail, Saudi Arabia, in 2012. Results. A 16-year-old Saudi female was brought to the hospital in a comatose state and with generalized convulsive seizures secondary to acute anoxic encephalopathy. In the third week of hospitalization, while still in a state of akinetic mutism, she developed incessant bruxism which responded favorably to a GABA receptor agonist (baclofen. Conclusion. Our data support the hypothesis that bruxism emanates from imbalance or dysregulation of the neurotransmitter system. Larger scale studies will be needed to confirm this hypothesis.

  19. Prevalence of temporomandibular dysfunction in children and adolescents

    OpenAIRE

    Marina Fernandes de Sena; Késsia Suênia F. de Mesquita; Santos,Fernanda Regina R.; Silva, Francisco Wanderley G. P.; Kranya Victoria D. Serrano

    2013-01-01

    OBJECTIVE: To review the prevalence of temporomandibular disorders (TMD) in children and adolescents, verifying the methodological variations. DATA SOURCES: Research conducted in Medline, PubMed, Lilacs and BBO databases, including manuscripts (except reviews and case reports) published from 1990 to 2012. The descriptors were "temporomandibular joint syndrome", "temporomandibular joint dysfunction syndrome", "temporomandibular joint disorders", "prevalence studies", and "cross-sectional ...

  20. The utility and validity of current diagnostic procedures for defining temporomandibular disorder patients.

    Science.gov (United States)

    Clark, G T; Delcanho, R E; Goulet, J P

    1993-08-01

    This paper describes the evolution of different concepts of classifying and defining Temporomandibular Disorders (TMD) for both clinical and research settings. The literature is reviewed with respect to the utility and validity of the different questionnaire and examination procedures that have been used to assess TMD patients. The presented view is that many of these procedures have not been validated, that there is a lack of standardization in the use of the procedures themselves, and that an ideal method of classifying this broad group of patients into better-defined subgroups has not yet been developed. More standardized and better-defined research by trained and calibrated researchers is needed worldwide to elucidate these subgroups so that a better and widely agreed upon research classification system can be developed for widespread use. It also seems clear that as research requirements for defining TMD patient subgroups become more stringent over time, it may not be practical for the clinician to implement them on a day-to-day basis in his or her practice. As such, a practical utilitarian definition of the common subtype of TMD patients is also needed which parallels any research grouping, so that data from research are valuable and generalizable to the practicing clinician.

  1. Psychosocial and Somatosensory Factors in Women with Chronic Migraine and Painful Temporomandibular Disorders

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    Alfonso Gil-Martínez

    2016-01-01

    Full Text Available Introduction. Psychosocial and somatosensory factors are involved in the pathophysiology of chronic migraine (CM and chronic temporomandibular disorders (TMD. Objective. To compare and assess the relationship between pain catastrophizing and kinesiophobia in patients with CM or chronic TMD. Method. Cross-sectional study of 20 women with CM, 19 with chronic TMD, and 20 healthy volunteers. Pain catastrophizing and kinesiophobia were assessed. The level of education, pain intensity, and magnitude of temporal summation of stimuli in the masseter (STM and tibialis (STT muscles were also evaluated. Results. There were significant differences between the CM and chronic TMD groups, compared with the group of asymptomatic subjects, for all variables (p<.05 except kinesiophobia when comparing patients with CM and healthy women. Moderate correlations between kinesiophobia and catastrophizing (r=0.46; p<.01 were obtained, and the strongest association was between kinesiophobia and magnification (r=0.52; p<.01. The strongest associations among physical variables were found between the STM on both sides (r=0.93; p<.01 and between the left and right STT (r=0.76; p<.01. Conclusion. No differences were observed in pain catastrophizing and kinesiophobia between women with CM and with chronic TMD. Women with CM or chronic TMD showed higher levels of pain catastrophizing than asymptomatic subjects.

  2. Are temporomandibular disorders associated with habitual sleeping body posture or nasal septal deviation?

    Science.gov (United States)

    Yalçınkaya, Esin; Cingi, Cemal; Bayar Muluk, Nuray; Ulusoy, Seçkin; Hanci, Deniz

    2016-01-01

    Numerous factors can be considered for the etiology of temporomandibular disorders (TMD). The aim of the present study was to investigate whether the presence of both nasal septal deviation (NSD) and habitual prone sleeping posture (HPSP) predisposes TMD. We evaluated 200 subjects in 4 groups. Group I (NSD-, HPSP-/control group), Group II (NSD+, HPSP-), Group III (NSD-, HPSP+), Group IV (NSD+, HPSP+). All patients were examined according to the research diagnostic criteria to determine the presence of TMD. Group IV had the highest value for TMD incidence (44 %). Thus, we found that the presence of both NSD and HPSP parameters increased TMD incidence in Group IV compared to the control group (p = 0.000). Additionally, Group IV showed significantly higher values than Group II (p = 0.012) and Group III (p = 0.039). For Group III (NSD-, HPSP+), TMD was determined higher compared to the control group (p = 0.009). A statistically higher value of presence of TMD was determined in Group II (NSD+, HPSP-) than control group (p = 0.029). The incidence of TMD was significantly higher in women than men (p = 0.020). We concluded that one having an unilateral obstructive nasal septal deviation in addition to a habit of sleeping in prone position must be alert for potential TMD.

  3. Analysis of the postural stability in individuals with or without signs and symptoms of temporomandibular disorder

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    Lilian Gerdi Kittel Ries

    2008-12-01

    Full Text Available The objective of this study was to evaluate the stability and the distribution of weight of individuals with TMD (Temporomandibular Disorder when placed in an orthostatic position. Forty female volunteers, participating in this study, were distributed into a control and a TMD group. Clinical examinations of the craniomandibular system and of the neck were performed. Postural stability was evaluated using a stabilographic platform. Through this system, the sway index (SI, the maximum medial-lateral distance (MMLD, the maximum anterior-posterior distance (MAPD and the medial-lateral symmetry (MLS could be determined. Tests were performed in the mandibular rest position and during isometric and isotonic contraction. The variables were analyzed through repeated measures ANOVA. The level of significance was p < 0.05. The results of this study indicate that individuals with TMD present more pain in the cervical region (p < 0.05. The group with TMD showed a significant reduction in SI (p < 0.05, MMLD (p < 0.05 and MLS (p < 0.01. Individuals with TMD presented greater postural asymmetry, and cervical pain demonstrated a potential link with an increase in postural stability.

  4. Effect of parafunctional clenching on temporomandibular disorder pain and proprioceptive awareness.

    Science.gov (United States)

    Glaros, A G; Forbes, M; Shanker, J; Glass, E G

    2000-07-01

    This study tested the hypothesis that parafunctional clenching increases pain, can lead to a diagnosis of temporomandibular disorder (TMD) pain, and can produce reductions in proprioceptive awareness. Twenty individuals participated in EMG biofeedback training sessions on the left and right temporalis and masseter muscles. No subjects had TMD prior to training. Subjects were randomly assigned to either a Decrease group, who were instructed to maintain EMG activity below 2 microV during training, or an increase group, who were instructed to maintain EMG activity above 10 microV. To test the impact of parafunctional clenching on proprioceptive awareness, all subjects were instructed to barely touch their teeth together while EMG activity was recorded pre- and post-training. Three subjects assigned to the Increase group and no subjects assigned to the Decrease group were diagnosed with TMD pain following training. Self-reported pain post-training was significantly higher for the Increase group. Parafunctional clenching did not affect performance in the proprioceptive test.

  5. Chronicity factors of temporomandibular disorders: a critical review of the literature

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    Maísa Soares GUI

    2015-01-01

    Full Text Available Facial pain often persists long after any identifiable organic pathology has healed. Moreover, in a subgroup of patients with temporomandibular disorder (TMD, no treatment is effective. Knowledge of factors associated with persistent pain in TMD could help identify personalized treatment approaches. Therefore, we conducted a critical review of the literature for the period from January 2000 to December 2013 to identify factors related to TMD development and persistence. The literature findings showed that chronic TMD is marked by psychological distress (somatization and depression, affective distress, fear of pain, fear of movement, and catastrophizing and characteristics of pain amplification (hyperalgesia and allodynia. Furthermore, these factors seem to interact in TMD development. In addition, our review demonstrates that upregulation of the serotonergic pathway, sleep problems, and gene polymorphisms influence the chronicity of TMD. We conclude that psychological distress and pain amplification contribute to chronic TMD development, and that interactions among these factors complicate pain management. These findings emphasize the importance of multidisciplinary assistance in TMD treatment.

  6. Assessment of temporomandibular disorder and occlusion in treated class III malocclusion patients

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    Karyna Valle-Corotti

    2007-04-01

    Full Text Available OBJECTIVE: The aims of this study were to compare the prevalence of temporomandibular disorders (TMD in individuals submitted to either orthodontic or ortho-surgical Class III malocclusion treatment and to assess the influence of occlusal aspects on TMD severity. MATERIAL AND METHODS: The sample consisted of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery. The presence of signs and symptoms of TMD was evaluated by an anamnestic questionnaire and a clinical examination, including TMJ and muscle palpation, active mandibular range of motion, joint noises and occlusal examination. RESULTS: Based on the anamnestic questionnaire, 48% had no TMD, 42% had mild TMD and 10% had moderate TMD. The presence and severity of TMD did not show any relationship with the type of orthodontic treatment (p>0.05. The chi-square test showed a positive association (p<0.05 between TMD and non-working side occlusal interferences. CONCLUSION: Based on the methodology used and the results obtained, it may be concluded that Class III orthodontic treatment was not associated with the presence of TMD signs and symptoms and the non-working side contacts can be occlusal factors of risk. There was no significant difference in TMD prevalence between the studied groups (orthodontically treated patients and patients treated with orthodontics followed by orthognathic surgery.

  7. Orthodontics as a therapeutic option for temporomandibular disorders: a systematic review

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    Eduardo Machado

    2012-06-01

    Full Text Available OBJECTIVE: Orthodontics as an option for treatment and prevention of Temporomandibular Disorders (TMD is a topic that has generated discussion over time. While an occlusion current defends Orthodontics as an alternative to treatment, another current defends more conservative and reversible treatments. The objective of this study, through a systematic literature review, was to analyze the relationship between Orthodontics and TMD, checking the effects of orthodontic therapy in treatment and prevention of TMD. METHODS: Survey in research bases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs and BBO, between the years of 1966 and May 2009, with focus in randomized clinical trials, non-randomized prospective longitudinal studies, systematic reviews and meta-analysis was performed. RESULTS: After application of the inclusion criteria 11 articles were selected, 9 which were non-randomized prospective longitudinal studies, 1 randomized clinical trial and 1 systematic review. CONCLUSIONS: According to the literature, there is a lack of specific studies that evaluated Orthodontics as an option for treatment and prevention of TMD. Thus the data conclude that there is no significant scientific evidences that orthodontic treatment treats or prevents TMD.

  8. Temporomandibular disorders and orthodontic treatment need in orthodontically untreated children and adolescents.

    Science.gov (United States)

    Špalj, Stjepan; Šlaj, Martina; Athanasiou, Athanasios E; Žak, Irena; Šimunović, Martina; Šlaj, Mladen

    2015-03-01

    The aim of this study was to explore the association between signs and symptoms of temporomandibular disorders (TMD) and orthodontic treatment need in orthodontically untreated children and adolescents. One thousand five hundred and ninety-seven subjects aged 11-19 years, without previous orthodontic history, from sixteen randomly selected public schools in Zagreb, Croatia, were examined. Malocclusion characteristics were assessed by using the criteria proposed by Bjork et al., the Dental Aesthetic Index, and the Aesthetic Component of Index of Orthodontic Treatment Need. Data on TMD signs/symptoms and parafunctional behaviour were obtained by means of questionnaire and clinical examination, respectively. Multiple logistic regression models were used for analysis. Twenty-two percent of children and young adolescents had one or more signs of TMD, ranging from 17% in age of 11 years up to 24% in age of 19. There was poor correlation between presence of TMD and orthodontic treatment need. Multiple logistic regression models showed that Class III, crowding and spacing were related to mandibular deflection on opening. Ectopic eruption was related to TMJ clicking, and severely tipped teeth with reduced mouth opening. Headaches presented a positive relationship with reverse overjet and severe rotations, and tooth wear with crowding, spacing and lateral openbite. Age, female gender and parafunctional habits were related to several TMD signs. Although logistic regression models were statistically significant (p TMD signs/symptoms. TMD signs and symptoms seemed to be poorly related to malocclusions or treatment needs.

  9. Histamine and substance P in synovial fluid of patients with temporomandibular disorders.

    Science.gov (United States)

    Li, W; Long, X; Jiang, S; Li, Y; Fang, W

    2015-05-01

    Although psychosocial factors and malocclusion are regarded as potential causes of temporomandibular disorders (TMD), the underlying pathogenesis is poorly understood. Recent studies suggest that substance P (SP), which has been associated with both psychosocial factors and malocclusion, and histamine, whose release can be induced by SP, may be implicated in the pathogenetic process. This study was designed to measure the concentration of histamine and SP in synovial fluid (SF) of both 38 patients with TMD and 11 healthy controls, and analyse the correlation between histamine and SP. Patients with TMD were divided into three subgroups: displaced disc with reduction (DDR), displaced disc without reduction (DDNR) and osteoarthritis (OA), with 10, 13, 15 subjects in every subgroup, respectively. After collecting SF samples, histamine and SP levels were measured by enzyme-linked immunosorbent assay analysis (ELISA) and calibrated by bicinchoninic acid (BCA)-quantified protein level in the samples. The results suggest that OA group presented a significantly higher level of both histamine and SP than DDNR, DDR and healthy control groups. Histamine or SP in DDR and DDNR groups tend to be higher than control group, but no significance was found. Painful TMJs show higher histamine and SP than painless TMJs. Correlation analysis reveals a significant correlation between histamine and SP concentrations. Collectively, this study showed the changes of histamine and SP in the SF from different stages of TMD and found a significant correlation between the two substances, suggesting their potential implication in the pathogenesis of TMD.

  10. Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

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    Castro Lopes, Sergio Lucio Pereira [Dept. of Diagnosis and Surgery, Sao Jose dos Campos Dental School, Sao Paulo (Brazil); Ferreira Costa, Andre Luiz [Dept. of Pediatric Dentistry and Orthodontics, University of Sao Paulo, Sao Paulo (Brazil); Oliveira Gamba, Thiago; Flores, Isadora Luana [Dept. of ral Diagnosis, School of Dentistry, Sao Paulo (Brazil); Cruz, Adriana Dibo [Dept. of Specific Formation, Area of Radiology, Nova Friburgo Dental School, Fluminense Federal University, Rio de Janeiro (Brazil); Min, Li Li [Laboratory of Neuroimaging, Dept. of Neurology, Faculty of Medical Sciences, Sao Paulo (Brazil)

    2015-03-15

    Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

  11. Animal models of temporomandibular joint disorders: implications for tissue engineering approaches.

    Science.gov (United States)

    Almarza, Alejandro J; Hagandora, Catherine K; Henderson, Sarah E

    2011-10-01

    Animal models for temporomandibular joint disorder (TMD) or degradation are necessary for assessing the value of current and future tissue engineering therapies. After reviewing the literature, it is quite apparent that most TMD animal studies can be categorized into chemical approaches or surgical/mechanical approaches. Overall, it was found that the top five cited manuscripts for all chemical models were cited by almost 40% more manuscripts than the top five manuscripts for surgical/mechanical models. It is clear that the chemical approaches have focused on the inflammatory aspect of TMDs and its relationship to pain. However, chemical irritants must be tested in larger animal models, and the effect of short-term inflammation on the mechanical properties of the fibrocartilage must be examined. Nevertheless, therapeutic approaches aimed at reducing or controlling inflammation could use the established chemical methods. Surgical/mechanical methods can be used as negative controls for first generation TMJ tissue engineering approaches when the therapy is applied immediately after injury. Next generation tissue engineering approaches will require testing on tissues degenerated for a few months after the surgical/mechanical methods, with enhanced functional assessment techniques.

  12. Dual joint space arthrography in temporomandibular joint disorders: Comparison with single inferior joint space arthrography

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    Choi, Hyung Sik; Chang, Duk Soo; Lee, Kyung Soo; Kim, Woo Sun; Sung, Jung Ho; Jun, Young Hwan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1989-02-15

    The temporomandibular joint(TMJ) is really a complex of two synovial space separated by fibrocartilaginous disc. Single inferior joint space arthrography is commonly performed for evaluation of TMJ disorders, which is known to be superior in demonstrating joint dynamics. But it reveals only the inferior surface of the disc. Therefore, dual space arthrography is superior to demonstrate the soft tissue anatomic feature of the joint such as disc position and shape. Authors performed 83 TMJ arthrograms in TMJ problems. Initially, the inferior joint space was done and then the superior space was sequentially contrasted. The follow results were noted: 1. In all cases, dual space arthrography revealed accurate disc shape and positions. 2. Concordant findings between the two techniques: 68 cases (82%). Discordance between the two techniques: 15 cases (18%) 3. Possible causes of discordance between inferior and dual space arthrography. a) Normal varians of anterior recess: 3 cases b) Posterior disc displacement: 4 cases c) Influence of the patient's head position change :4 cases d) False perforation: 2 cases e) Reduction change: 2 cases 4. In 5 cases with anterior displacement, dual space arthrography gave additional findings such as adhesion within the superior space, which could not be evaluated by single inferior space.

  13. Diagnostic MR imagings of temporomandibular joint disorders by 1. 5 tesla superconducting magnet

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    Murakami, Ken-ichiro; Tsuda, Yoshitugu; Moriya, Hiroyuki; Segami, Natsuki; Konishi, Junji; Iizuka, Tadahiko (Kyoto Univ. (Japan). Faculty of Medicine)

    1991-01-01

    For diagnostic imaging of temporomandibular joint (TMJ) disorders, 1.5 tesla superconducting magnet system was applied in 65 patients with 75 joints. MR imaging was performed with GE-Signa 1.5 tesla MR imaging system with the body coil used as the transmitter and 3 inch surface coil as the receiver. For detecting T{sub 1} weighted images, the following parameters were used; TR: 1000, TE: 25, Excitation: 1. Data matrix: 256 x 128, FOV: 8 cm, Slice thickness: 3 mm. For taking T{sub 2} weighted images, TR: 2200, TE:80 was used. For anatomical interpretation of TMJ, 3-mm thick images with a 1-mm interspace sagittal multiplane with TR: 1000/TE: 25 sequence was useful, and additional coronal images were beneficial for examining condylar morphology as well as mediolateral disk position. T{sub 2} weighted imaging obtained the joint effusion suspected of intra-articular inflammation. These findings suggest that MR imaging is useful in the detection and evaluation of TMJ patho-morphology. (author).

  14. Association between Ear Fullness, Earache, and Temporomandibular Joint Disorders in the Elderly.

    Science.gov (United States)

    Macedo, Julya; Doi, Marcelo; Oltramari-Navarro, Paula Vanessa; Gorres, Vanessa; Mendes, Marina Stephany; Silva, Izabele Machado; Navarro, Ricardo; Marchiori, Luciana Lozza

    2014-10-01

    Introduction An earache (otalgia or ear pain) is pain in one or both ears that may last a short or long time. Earache is prevalent in the population with temporomandibular joint disorders (TMJDs), but there is a dearth of epidemiologic studies regarding the association between TMJD and ear pain and ear fullness in older people. Objective To assess the presence of earache and ear fullness in elderly patients with TMJD. Methods A cross-sectional study was conducted in independently living, elderly individuals. TMJD was assessed by dental evaluation and earache was verified by medical history. Statistical analysis was performed using the chi-square test and relative risk. Results Of the 197 subjects evaluated in this part of the study, 22 had earache, and 35 was verified by ear fullness. Of the 22 subjects with earache, none had conductive or mixed hearing loss in the ears tested. There was a significant association (p = 0.036) between the TMJD and earache (odds ratio = 2.3), but there was no significant association between the TMJD and ear fullness. Conclusion These results highlight the importance of identifying risk factors for earache that can be modified through specific interventions, which is essential in the prevention of future episodes, as well as managing the process of treatment of elderly patients in general.

  15. Cytopathologic diagnosis on joint lavage fluid for patients with temporomandibular joint disorders.

    Science.gov (United States)

    Mikami, Toshinari; Kumagai, Akiko; Aomura, Tomoyuki; Javed, Fawad; Sugiyama, Yoshiki; Mizuki, Harumi; Takeda, Yasunori

    2014-01-01

    Temporomandibular joint (TMJ) disorders (TMD) are usually diagnosed based on the patient's clinical findings and the results of image investigations; however, understanding of the inflammatory process in TMJ is difficult. In addition, many of the TMJ disease types share common principal symptoms. Therefore, TMJ diseases in the early stage can be misdiagnosed with TMD. It is hypothesized that cytopathologic examination of the joint lavage fluids is useful in interpreting the TMD-associated inflammatory process from a cellular aspect. The aim of this study was to assess the TMJ lavage fluid cytopathologically in TMD patients. Thirty-nine patients, clinically diagnosed as TMD, were included in the present study. Clinical symptoms of the patients were recorded. Forty-four samples of TMJ lavage fluid were collected and paraffin-embedded cell sections were made by cell block tissue array method. Cytologic conditions in upper articular cavity of TMJ were cytopathologically diagnosed and were compared with the clinical symptoms of each patient. Cell components were detected in 22 of the 44 analyzed joint lavage fluids. There was a correlation between cytopathologic findings and clinical symptoms. Variety of cytopathology and inflammatory conditions in patients with similar clinical symptoms were also found. The results suggested that cytopathologic examination of the joint lavage fluids from TMD patients is helpful for gaining an understanding of the inner local conditions of TMJ at the cellular level.

  16. Botulinum toxin therapy for temporomandibular joint disorders: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Chen, Y-W; Chiu, Y-W; Chen, C-Y; Chuang, S-K

    2015-08-01

    The objective of this study was to undertake a systematic review to assess the efficacy of botulinum toxin therapy (BTX) for temporomandibular joint disorders (TMDs). A comprehensive search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was conducted to locate all relevant articles published from inception to October 2014. Eligible studies were selected based on inclusion criteria and included English language, peer-reviewed publications of randomized controlled trials comparing BTX versus any alternative intervention or placebo. Quality assessment and data extraction were done according to the Cochrane risk of bias tool and recommendations. The entire systematic search and selection process was done independently by two reviewers. Five relevant study trials were identified, involving 117 participants. Two trials revealed a significant between-group difference in myofascial pain reduction, another trial that compared BTX with fascial manipulation showed equal efficacy of pain relief on TMDs, while the remaining two trials showed no significant difference between the BTX and placebo groups. Because of considerable variations in study methods and evaluation of results, a meta-analysis could not be performed. Based on this review, no consensus could be reached on the therapeutic benefits of BTX on TMDs. A more rigorous design of trials should be carried out in future studies.

  17. Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index

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    Juliana Alvares Duarte Bonini Campos

    2014-01-01

    Full Text Available The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF, used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP. The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA using Chi-Square Over Degrees of Freedom (χ2/df, Comparative Fit Index (CFI, Tucker-Lewis Index (TLI, and Root Mean Square Error of Approximation (RMSEA as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE and the composite reliability (CR. Internal consistency was assessed by Cronbach's alpha coefficient (α.The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (χ2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058. The convergent validity (AVE = 0.513, CR = 0.878 and internal consistency (α = 0.745 were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women.

  18. Psychosocial and Somatosensory Factors in Women with Chronic Migraine and Painful Temporomandibular Disorders

    Science.gov (United States)

    Grande-Alonso, Mónica; La Touche, Roy; Lara-Lara, Manuel; Fernández-Carnero, Josué

    2016-01-01

    Introduction. Psychosocial and somatosensory factors are involved in the pathophysiology of chronic migraine (CM) and chronic temporomandibular disorders (TMD). Objective. To compare and assess the relationship between pain catastrophizing and kinesiophobia in patients with CM or chronic TMD. Method. Cross-sectional study of 20 women with CM, 19 with chronic TMD, and 20 healthy volunteers. Pain catastrophizing and kinesiophobia were assessed. The level of education, pain intensity, and magnitude of temporal summation of stimuli in the masseter (STM) and tibialis (STT) muscles were also evaluated. Results. There were significant differences between the CM and chronic TMD groups, compared with the group of asymptomatic subjects, for all variables (p < .05) except kinesiophobia when comparing patients with CM and healthy women. Moderate correlations between kinesiophobia and catastrophizing (r = 0.46; p < .01) were obtained, and the strongest association was between kinesiophobia and magnification (r = 0.52; p < .01). The strongest associations among physical variables were found between the STM on both sides (r = 0.93; p < .01) and between the left and right STT (r = 0.76; p < .01). Conclusion. No differences were observed in pain catastrophizing and kinesiophobia between women with CM and with chronic TMD. Women with CM or chronic TMD showed higher levels of pain catastrophizing than asymptomatic subjects. PMID:27818609

  19. Craniofacial Morphology Affects Bite Force in Patients with Painful Temporomandibular Disorders.

    Science.gov (United States)

    Bavia, Paula Furlan; Vilanova, Larissa Soares Reis; Garcia, Renata Cunha Matheus Rodrigues

    2016-01-01

    Craniofacial morphology affects masticatory performance in healthy dentate subjects, but little is known about its effects in patients with painful temporomandibular disorders (TMDs). Forty-eight female patients (mean age of 28±5.8 years) with painful TMDs underwent lateral cephalometric radiography. Using Ricketts' cephalometric analysis and the Vert method, subjects were assigned to three groups according to their craniofacial morphology: brachyfacial (n=22), mesofacial (n=13), and dolichofacial (n=13). Research diagnostic criteria for TMD were used to confirm the TMD diagnosis for each patient. Pain intensity was reported by each patient based on a visual analog scale (VAS). Maximum bite force (MBF) was measured with pressure sensors placed on the first molar site. Masticatory performance (MP) was assessed by chewing a silicone-based artificial material and determining the resulting particle size by the sieve method. Chewing ability (CA) was evaluated for seven food types and analyzed by a VAS questionnaire. Data were analyzed by one-way ANOVA followed by a Tukey-Kramer test (pcraniofacial morphology affects the MBF without impairing MP or CA in patients with painful TMDs.

  20. Psychological and sleep quality differences between chronic daily headache and temporomandibular disorders patients.

    Science.gov (United States)

    Vazquez-Delgado, E; Schmidt, J E; Carlson, C R; DeLeeuw, R; Okeson, J P

    2004-06-01

    The aim of this study was to investigate whether chronic daily headache (CDH) and temporomandibular disorders (TMD) patients present with different psychological and sleep quality characteristics. Sixty-seven patients diagnosed with CDH, according to classification criteria from Silberstein et al., were matched by age and sex with 67 patients who had a primary diagnosis of myofascial pain (MP) and 67 patients with a primary diagnosis of TMJ intracapsular pain (IC) according to the Research Diagnostic Criteria for TMD. The CDH group was comprised of three mutually exclusive diagnostic groups: chronic migraine (n = 35); chronic tension-type headache (n = 26); 'other CDH' (n = 6). All patients completed a battery of psychological and sleep quality questionnaires. All CDH subgroups showed similar psychological and sleep quality profiles. Pain intensity and duration were controlled in the multivariate analyses (Mancova) by treating them as covariates. The CDH and MP groups revealed higher levels of psychological distress than the IC group on most psychological domains. The MP group also revealed numerically higher levels of psychological distress in most psychological domains than the CDH group, although these differences were generally not significant. We did not find significant differences between the three groups on post traumatic stress symptoms either. Sleep quality was significantly worse in the MP group than in the CDH and IC groups. These results are discussed in the context of multimodal patient evaluation and treatments that are often necessary for successful clinical management.

  1. Prevalência de alteração morfológica do processo estilóide em pacientes com desordem temporomandibular Prevalence of morphological alterations of the styloid process in patients with temporomandibular joint disorder

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    Simone Maria Ragone Guimarães

    2006-12-01

    Full Text Available OBJETIVO: Avaliar, radiograficamente, a prevalência de alterações morfológicas do processo estilóide em pacientes com desordens temporomandibulares. MATERIAIS E MÉTODOS: Foram analisadas 1.500 radiografias panorâmicas da articulação temporomandibular de pacientes de ambos os sexos e sem limitação de idade, que foram atendidos pelo Serviço de Desordem Temporomandibular da Faculdade de Odontologia da Universidade Federal de Juiz de Fora, MG, no período de 1997 a 2003. RESULTADOS: Oitenta e três (5,53% dos pacientes da amostra apresentaram pelo menos um dos lados da articulação com alteração morfológica do processo estilóide, sendo 74 do sexo feminino e 9 do sexo masculino, concentrados na faixa dos 41 a 50 anos de idade (32,5%. Com relação ao tipo morfológico do processo estilóide, verificaram-se 113 alongados, 21 pseudo-articulados e 19 segmentados. Constatou-se, também, que as alterações morfológicas do processo estilóide desenvolvem-se de forma simétrica. CONCLUSÃO: Em pacientes com desordem temporomandibular as alterações do processo estilóide ocorrem de forma diferenciada e de maneira simétrica em cada paciente, independentemente do sexo e da idade.OBJECTIVE: To assess radiographically the prevalence of morphological alterations of the styloid process in patients with temporomandibular joint disorders. MATERIALS AND METHODS: We have analyzed 1,500 panoramic x-ray films of temporomandibular joint from both male and female patients with no age limit, who were attended in the Service of Temporomandibular Joint Disorder of Faculty of Odontology at Universidade Federal de Juiz de Fora, MG, Brazil, in the period between 1997 and 2003. RESULTS: Eighty-three (5.53% of the analyzed patients (74 female and 9 male, predominantly in the age range between 41 and 50 years (32.5%, presented with, at least, one of the joint sides with morphological alteration of the styloid process. As far as the type of styloid process in

  2. Treatment of chronic pain associated with nocturnal bruxism with botulinum toxin. A prospective and randomized clinical study

    Science.gov (United States)

    Al-Wayli, Hessa

    2017-01-01

    Background To evaluate the role of botulinum toxin type A (BTX-A) in the treatment of pain associated with nocturnal bruxism. Material and Methods Fifty subjects reporting nocturnal bruxism were recruited for a randomized clinical trial. Twenty five bruxers were injected with botulinum toxin in both masseters, and twenty five were treated with traditional methods of treating bruxism. Patients were evaluated at 3rd week, 2nd and 6th month and one year after injection and then used to calculate bruxism events. Bruxism symptoms were investigated using questionnaires. Results Mean pain score due to Bruxism events in the masseter muscle decreased significantly in the botulinum toxin injection group A (P =0.000, highly significant). However, in the conventional treatment group, mean pain score does not show improvement with time (p>0.05). Conclusions Our results suggest that botulinum toxin injection reduced the mean pain score and number of bruxism events, most likely by decreasing the muscle activity of masseter rather than affecting the central nervous system. Key words:Temporomandibular pain, nocturnal bruxism, botulinum toxin.

  3. Evaluation of meniscus displacement of the temporomandibular joint by MR imaging. Correlation with clinical symptoms of TMJ disorders

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    Toyoda, Nagataka; Asada, Koichi; Naohara, Hiroaki; Jibiki, Masato; Ishibashi, Katsunori; Kobayashi, Kaoru [Tsurumi Univ., Yokohama (Japan). School of Dental Medicine

    1996-04-01

    MR imaging is useful in the diagnosis of bilateral internal derangement of the temporomandibular joint. This study was performed to investigate the correlation between clinical symptoms and displacement of the bilateral articular disk in patients with temporomandibular joint disorders (TMJD). A series of 170 patients who had signs and symptoms of TMJDs (TMJ pain, TMJ sound, trismus) were examined bilaterally by MR imaging. One hundred twenty-six patients had only unilateral symptoms, but 55 (44%) of them showed bilateral disk displacement. Among 93 patients with unilateral TMJ pain, 89% showed disk displacement (22 TMJs with reduction, 61 TMJs without reduction) on the symptomatic side, and 44% showed disk displacement on the asymptomatic side. Among 53 patients with unilateral TMJ sound, 96% showed disk displacement (28 TMJs with reduction, 23 TMJs without reduction) on the symptomatic side, and 53% showed disk displacement on the asymptomatic side. In patients with severe trismus (interincisal opening distance <39 mm), unilateral or bilateral disk displacement without reduction was frequently found. The results indicate that examinations by MR imaging are important for the diagnosis of internal derangement of the temporomandibular joint. (author).

  4. Results of the dental treatment in children with bruxism

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    Kirenia Pieri Silva

    2015-02-01

    Full Text Available Background: bruxism is a habit associated to stress and to occlusal disturbances which can be solved applying an odontological treatment. Objective: to evaluate the effectiveness of the odotological treatment in students from 5 to 11 years with bruxism. Methods: a study of cuasiexperimental intervention design of type before and after in all the children with bruxim (52, with ages of 5 to 11 elderly years, belonging to Health Area II. Cienfuegos. An oral exam to each child was made; parents and teachers were interviewed as well. Studied variables were: Age, sex, the bruxism's grade of affectation, psychological diagnosis and symptoms and the bruxism's signs. The results present itself in draw of numbers and percentages. Results: the bigger affectation predominated in the female sex from 6 to 11 elderly years and the psychological diagnosis of severe disorders. When examining the signs and symptoms of bruxism before the intervention, the more frequent were the dental squeaking and the dental squeezing. After applying the treatment, more than the half of the children improved his symptomatology in relation to the initial status, and an improvement of over the 70 % in the event of the muscular pain was achieved. Conclusion: the effectiveness of the dental treatment in the improvement of the signs and symptoms of the bruxism was demonstrated.

  5. Magnetic resonance evidence of joint effusion in patients with temporomandibular joint disorders

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    Ko, Jee Young; Kim, Kee Deog; Park, Chang Seo [Yonsei Univ. College of Dentistry, Seoul (Korea, Republic of)

    2001-06-15

    The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1% in early state and 23.1% in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4%) (p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1%) (p<0.001). MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

  6. Targeting temporomandibular disorder pain treatment to hormonal fluctuations: a randomized clinical trial.

    Science.gov (United States)

    Turner, Judith A; Mancl, Lloyd; Huggins, Kimberly Hanson; Sherman, Jeffrey J; Lentz, Gretchen; LeResche, Linda

    2011-09-01

    Mounting evidence supports the importance of hormonal fluctuations in temporomandibular disorder (TMD) pain among women. Stabilizing influential hormones or having a plan and skills for coping with hormonally related increases in TMD pain, therefore, may be beneficial for women with TMD pain. This randomized clinical trial evaluated the short- and long-term efficacy of 3 interventions for women with TMD pain: (1) dental hygienist-delivered pain self-management training (SMT; n=59); (2) the same dental hygienist-delivered pain self-management training, but with a focus on menstrual cycle-related changes in pain and other symptoms (targeted SMT, or TSMT; n=55); and (3) continuous oral contraceptive therapy (6-month trial) aimed at stabilizing hormones believed to be influential in TMD pain (COCT; n=57). Study participants completed outcome (pain, activity interference, depression) and process (pain beliefs, catastrophizing, coping effectiveness) measures before randomization, and 6 and 12months later. Intent-to-treat analyses supported the benefits of the SMT and TSMT interventions relative to COCT. Targeting the self-management treatment to menstrual cycle-related symptoms did not increase the treatment's efficacy. The benefits of the self-management interventions relative to COCT for pain and activity interference were statistically significant at 12 months, but not at 6 months, whereas the benefits for the process measures generally were apparent at both time points. COCT was associated with multiple adverse events (none serious). The study provides further support for long-term benefits of a safe, low-intensity (2 in-person sessions and 6 brief telephone contacts), dental hygienist-delivered self-management treatment for TMD pain.

  7. Body posture changes in women with migraine with or without temporomandibular disorders

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    Mariana C. Ferreira

    2014-03-01

    Full Text Available Background: Migraine and temporomandibular disorders (TMDs are reported to be associated. However, there are no reports on the association among migraines, TMDs and changes in body posture. Objectives : To assess changes in body posture in women suffering migraines with or without TMD compared with a control group. Method: Sixty-six women with a mean age of 18 to 45 years participated in this study. The groups were composed of 22 volunteers with migraine and TMD (MTMD, 22 volunteers with migraines without TMD (MG and 22 women in the control group (CG. Static posture was assessed by photogrammetry, and 19 angles were measured. Results: Postural asymmetry was observed in the face for 4 angles measured on the frontal plane in the MG group and for 4 angles of the trunk in the MG and MTMD groups with respect to CG. However, for comparisons between MTMD and CG, clinical relevance was identified for two angles of the sagittal plane (Cervical and Lumbar Lordosis, Effect Size - ES - moderate: 0.53 and 0.60. For comparisons between the MG and CG, the clinical relevance/potential was verified for three angles with moderate ES (ES>0.42. The clinical relevance when comparing MTMD and CG was identified for four angles of facial symmetry head inclination (ES>0.54 and for two angles between MG and CG (ES>0.48. Conclusion : The results demonstrated the presence of postural changes compared with a control group in women with migraines with or without TMD, and there were similar clinically relevant postural changes among the patients with migraines with and without TMD.

  8. Dysregulation of the autonomous nervous system in patients with temporomandibular disorder: a pupillometric study.

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    Annalisa Monaco

    Full Text Available The role of the autonomic nervous system (ANS was recently investigated in Temporomandibular disorders (TMD. Several authors argue that in subjects with TMD there is a dysregulation of ANS. Recent literature support that Pupillometry is a simple non-invasive tool to study ANS. The aim of this study was to investigate the relationship between TMD and ANS activity using pupillometry recording in Infrared light at rest Mandible Position (RP; Infrared light at Forced Habitual Occlusion (FHO; Yellow-green light at RP; Yellow-green light at FHO. Forty female subjects were enrolled: 20 case patients showed TMD based on the Research Diagnostic Criteria for TMD, and 20 control patients, aged matched, had no signs or symptoms of TMD. Statistical analysis was performed on average pupil size. Ratio between pupil size in FHO and RP (FHO/RP ratio and yellow-green and infrared (light/darkness ratio lighting were carried out. Within group differences of pupil size and of "ratio" were analyzed using a paired t test, while differences of pupil size between groups were tested using an unpaired t test. Statistical comparisons between groups showed no significant differences of absolute values of pupil dimension in RP and FHO, both in yellow-green and in infrared lighting. In addition, there were no significant differences within groups comparing RP and FHO in yellow-green light. In within group comparison of pupil size, differences between RP and FHO were significant in infrared conditions. Control subjects increased, whereas TMD patients decreased pupil size at FHO in infrared lightening. FHO/RP ratio in darkness and light/darkness ratio in RP were significantly different between groups. Taken together, these data suggest that TMD subjects have an impairment of the sympathetic-adrenergic component of the ANS to be activated under stress. The present study provides preliminary pupillometric data confirming that adrenergic function is dysregulated in patients with

  9. Orientation of craniofacial planes and temporomandibular disorder in young adults with normal occlusion.

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    Ciancaglini, R; Colombo-Bolla, G; Gherlone, E F; Radaelli, G

    2003-09-01

    The aim of this study was to investigate the relationship between orientation of craniofacial planes relative to the true horizontal and temporomandibular disorder (TMD), in normal occlusion. Fourteen university dental students, with full natural dentition and bilateral Angle Class I occlusion, who exhibited signs and symptoms of TMD, were compared with 14 age- and sex-matched healthy controls. Frontal and lateral photographs were taken in natural head position with the subject standing up, clenching a Fox plane and having a facial arch positioned. Photographs were examined by a standardized image analysis. Inter-pupillary axis, Frankfurt, occlusal and Camper planes were evaluated. In frontal view, the Frankfurt plane was right rotated relative to the true horizontal both in TMD subjects (P TMD subjects (mean difference between groups, 1.1 degrees, 95% confidence interval, 95% CI, 0.2-2.0 degrees ). No significant deviation from the horizontal or difference between groups was observed for the interpupillary axis and occlusal plane. In lateral view, the Frankfurt plane was upward-orientated relative to the true horizontal in TMD group (mean angular deviation 2.8 degrees, 95% CI, 1.0-4.6 degrees ). The occlusal and Camper planes were downward-orientated in both groups (P occlusal plane tended to be smaller in TMD subjects (mean difference between groups, -3.8 degrees, 95% CI, -7.6-0.1 degrees ). Angles between any craniofacial planes did not significantly differ between groups. The findings show that in young adults with normal occlusion, a weak association exists between the orientation of craniofacial planes in natural head position and signs and symptoms of TMD. Furthermore, they suggest that, within this population, TMD might be mainly associated with head posture rather than with craniofacial morphology.

  10. Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

    Science.gov (United States)

    Lopes, Sérgio Lúcio Pereira de Castro; Costa, André Luiz Ferreira; Gamba, Thiago de Oliveira; Cruz, Adriana Dibo; Min, Li Li

    2015-01-01

    Purpose Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Materials and Methods Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Results Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. Conclusion In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable. PMID:25793177

  11. Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults

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    Akhter Rahena

    2013-02-01

    Full Text Available Abstract Background To investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD symptoms in a young adult population in Japan. Methods A personal interview survey was conducted on first-year university students (n = 1,930 regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender. Results Among the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n = 319, pain in the TMJ only (Group II, n = 21, difficulty in mouth opening only (Group III, n = 18, clicking and pain (Group IV, n = 29, clicking and difficulty in mouth opening (Group V, n = 48, difficulty in mouth opening and pain (Group VI, n = 11, and combination of three symptoms (Group VII, n = 97. The control group (n = 1,387 were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV and tinnitus (OR = 12.1 and 13.2, respectively. TMD symptoms (Group I, II and III were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only. Conclusions TMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache.

  12. The teaching of temporomandibular disorders and orofacial pain at undergraduate level in Brazilian dental schools

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    Wagner SIMM

    2013-12-01

    Full Text Available Objectives: Evaluate the way the topics for the study of pain mechanisms in general, and Orofacial Pain (OFP and temporomandibular disorders (TMDs more specifically, are addressed in undergraduate courses curricula, and also to verify the existence of specialist OFP/TMD teachers in Brazilian dental schools. Methods: Between July 2010 and January 2011, course Coordinators/Directors of all dental schools duly registered at the Ministry of Education were invited to answer a questionnaire on topics related to OFP/TMD teaching in their institutions. Results: Fifty-three dental schools representatives answered the questionnaire. The study of pain mechanisms was found to cover an average of less than 10% of the courses' total time. Pharmacology, Endodontics and Physiology were identified as the departments usually responsible for addressing pain mechanisms in dental courses. Psychosocial aspects were found to occupy a very small proportion in the syllabi, while most of the content referred to biological or somatic aspects. OFP/TMD is addressed by a specific department in only 28.4% of the participating dental schools, while in most cases (46.3%, OFP/TMD is under the responsibility of the Prosthodontics department. Only 38.5% of respondents indicated that they had a specialist OFP/TMD teacher in their Schools. Conclusion: Among the Brazilian dental schools participating in the study, the teaching of OFP/TMD was found to be insufficient, segmented or with an extremely restricted focus. This initial assessment indicates that Curricular Guidelines for the study of OFP/TMD at undergraduate dental schools should be developed and implemented to facilitate their appropriate inclusion into the curricula and in specific pedagogical projects.

  13. Impact of tobacco use on the symptoms of painful temporomandibular joint disorders.

    Science.gov (United States)

    Weingarten, Toby N; Iverson, Barton C; Shi, Yu; Schroeder, Darrell R; Warner, David O; Reid, Kevin I

    2009-12-15

    This study examines the relationship between the severity of painful temporomandibular joint disorders (TMD) symptoms and current tobacco use in patients evaluated at a specialized orofacial pain clinic. Medical records, including responses to the Chronic Pain Grading Scale (CPGS), from 606 consecutive patients evaluated at the Mayo Clinic orofacial pain clinic with TMD by RDC-TMD criteria were retrospectively reviewed. Univariate analyses were performed comparing tobacco users and non-users. Analysis of covariance and multiple logistic regression models were used to adjust for demographic variables. A p value

  14. The knowledge level of dental surgeons regarding the relationship between occlusal factors and Temporomandibular Disorders (TMD

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    Jefferson Filippo Castro de ASSIS

    Full Text Available AbstractIntroductionThe relationship between dental occlusion and temporomandibular disorders (TMD remains a subject of disagreement. Many professionals erroneously base diagnosis and treatment strictly on the occlusal factor, despite the fact that current scientific evidence does not show such a relationship.ObjectiveTo evaluate the knowledge of dental surgeons (DSs from João Pessoa (PB-Brazil, regarding the relationship between occlusal factors and TMD.Materials and methodA sample of 100 DSs who do not have expertise in TMD and orofacial pain (CG Group and seven DSs with this specialty (EG Group completed a questionnaire that addresses issues concerning knowledge of TMD and its relationship with occlusal factors. The questionnaire also contained information used to characterize the sample, such as age, gender, and length of experience. The current literature's degree of consensus was established as the "gold standard" response for each statement and was compared with the responses of the specialists and non-specialists. Data were tabulated using the SPSS software package and analyzed descriptively (by percentage and statistically using the chi-square and Fisher's exact tests (p < 0.05.ResultA wide divergence could be observed between the knowledge of DSs who do not specialize in TMD and orofacial pain and that of professionals who do.ConclusionThere was low agreement between specialists and non-specialists. The relationship between dental occlusion and TMD remains unclear for the vast majority of participating professionals, which may prove to be reflected in diagnostic behaviors and inappropriate occlusal treatment for the management of TMD.

  15. Temporomandibular joint disorder complaints in tinnitus: further hints for a putative tinnitus subtype.

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    Veronika Vielsmeier

    Full Text Available OBJECTIVE: Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ disorder complaints and compared the two groups with respect to etiologic factors. METHODS: 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. RESULTS: Tinnitus patients with TMJ complaints (22% of the whole group were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt, onset related events (whiplash etc., character (pulsatile or not, hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.. CONCLUSION: Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical

  16. Somatosensory profiles in subgroups of patients with myogenic temporomandibular disorders and Fibromyalgia Syndrome.

    Science.gov (United States)

    Pfau, Doreen B; Rolke, Roman; Nickel, Ralf; Treede, Rolf-Detlef; Daublaender, Monika

    2009-12-15

    Some patients with myofascial pain from temporomandibular disorders (TMD) report pain in extra-trigeminal body regions. Our aim was to distinguish TMD as regional musculoskeletal pain syndrome (n=23) from a widespread pain syndrome (FMS; n=18) based on patients' tender point scores, pain drawings and quantitative sensory testing (QST) profiles. Referenced to 18 age- and gender-matched healthy subjects significant group differences for cold, pressure and pinprick pain thresholds, suprathreshold pinprick sensitivity and mechanical detection thresholds were found. Pain sensitivity in TMD patients ranged between those of FMS patients and healthy controls. The group of TMD patients was inhomogeneous with respect to their tender point count with an insensitive group (n=12) resembling healthy controls and a sensitive TMD group (n=9) resembling FMS patients. Nevertheless sensitive TMD patients did not fulfil diagnostic criteria for FMS in regard to widespread pain as shown by their pain drawings. TMD subgroups did not differ with respect to psychological parameters. The sensitive subgroup was more sensitive compared to healthy controls and to insensitive TMD patients in regard to their QST profile over all test areas as well as to their tenderness over orofacial muscles and trigeminal foramina. However, sensitive TMD patients had a short pain duration arguing against a transition from TMD to FMS over time. Data rather suggest an overlap in pathophysiology with FMS, e.g. a disturbance of central pain processing, in this subgroup of TMD patients. Those patients could be identified on the basis of their tender point count as an easy practicable screening tool.

  17. Evaluation of occlusal splint therapy and relaxation procedures in patients with temporomandibular disorders.

    Science.gov (United States)

    Okeson, J P; Moody, P M; Kemper, J T; Haley, J V

    1983-09-01

    Twenty-four patients were selected to participate in this study. Twelve patients were randomly selected to receive occlusal splint therapy and the other 12 to receive a simplified relaxation therapy technique. Observable pain scores, maximum comfortable interincisal distance, and maximum interincisal distances were recorded for each group before and after treatment. The occlusal splint group showed a significant decrease in total mean observable pain scores (decrease score of 10.5, t = 3.124; P less than 0.1). The relaxation group showed no significant decrease in total mean observable pain scores (decrease score of 1.8, t = 0.888; P = ns). The occlusal splint group showed a significant increase in the mean maximum comfortable opening (an increase of 12.4 mm, t = 5.085; P less than .01). The relaxation group showed no significant increase in the mean maximum comfortable opening (an increase of 2.3 mm, t = 0.734; P = ns). The occlusal splint group showed a significant increase in the mean maximum opening (an increase of 6.0 mm, t = 2.471; P less than .05). The relaxation group showed no increase in the mean maximum opening (decrease of 0.7 mm, t = 0.343; P = ns). This study suggests that occlusal splint therapy is a more effective treatment for the pain, tenderness, and limited mandibular opening associated with temporomandibular disorders than relaxation therapy. In this study, the relaxation technique used had no significant effect on the patients' pain, tenderness, or limited opening.

  18. Prevalence of temporomandibular disorders among junior high school students who play wind instruments

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    Eriko Yasuda

    2015-10-01

    Full Text Available Objectives: This study investigated whether playing wind instruments has adverse effects on musculoskeletal functions among junior high school students who play in music clubs. Material and Methods: The study included 210 junior high school students (35 boys, 175 girls belonging to 1 of 4 different school clubs that practiced playing wind instruments more than 6 days/week. The mean age of the participants was 14 years. The study was performed using a questionnaire survey and an electromyographic examination of jaw and cervical muscle activities during playing wind instruments. Results: The prevalence of temporomandibular disorders (TMD among the children playing woodwind (WW or brass wind (BW instruments was higher than in those playing non-wind (NW instruments. Long duration of playing WW with a reed mouthpiece or BW with a small mouthpiece was suggested to affect the incidence of TMD, which was more marked in girls than in boys, irrespective of height or weight. Muscle activity in the masseter muscle during playing an instrument was significantly higher in the BW with a small mouthpiece group than in the NW group (p < 0.05. In cervical muscles, muscle activity of both the sternocleidomastoid and trapezius muscles was higher during playing BW than in the case of other instruments, and activity in the sternocleidomastoid muscle was significantly higher in the BW with a small mouthpiece group than in the case of other instrument groups (p < 0.05. Conclusions: Playing wind instruments may have adverse effects on musculoskeletal functions among junior high school students playing in music clubs as compared with playing NW instruments. The prevalence of TMD among the students playing wind instruments was higher than in those playing other instruments. Long duration of playing those instruments affects musculoskeletal function, and this effect is more marked in girls than in boys, irrespective of height or weight.

  19. Association and Correlation between Temporomandibular Disorders and Psychological Factors in a Group of Dental Undergraduate Students

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    Divya Sood

    2014-12-01

    Full Text Available Aims/Objectives: To evaluate the prevalence and severity of temporomandibular disorders (TMD and presence of psychological factors (i.e.,anxiety and depression levels in dental undergraduate students. Second purpose was to assess the association and correlation between TMD degree and psychological factors viz. anxiety and depression. Materials and methods: The sample comprised of 400 Dental undergraduatestudents aged 18- 25 years, including both the genders. TMD degree was evaluated using an anamnestic questionnaire (modified version of Helkimo’s anamnestic index. Morphologic occlusion was evaluated according to Angle classification. The Hospital Anxiety and Depression Scale (HADS was used to assess of levels of anxiety (HADSa and depression (HADSd in the dental undergraduate students. Results: Onbasisof the TMD anamnestic index, 74% of students were TMD free. 24.5% of subjects presented with mild degree of TMD and only 1.5% of subjects presented with moderate degree of TMD. According to the results obtained from HADSa, 35.3% of subjects presented with mild anxiety level, 13.8% with moderate anxiety level, and only 1.3% with severe anxiety level. According to the results obtained from HADSd, 10.3% of subjects presented with mild depression level and only 2.3% with moderate depression level. A definite association between TMD degree and Anxiety level (HADSa was found. A definite association between TMD degree and Depression level (HADSd was found. Therewas significant association between TMD degree and occlusion. Conclusions: On the basis of anamnestic index, this study revealed a 26% TMD prevalence in the dental undergraduate students included in the study; majority of cases being of mild degree. Both anxiety and depression were found to be associated with TMD degree/severity. Both anxiety and depression are weakly correlated with TMD in the present study.

  20. Association Between Magnetic Resonance Imaging, Temporo-Mandibular Joint Scanographic Findings and Clinical Manifestations of Joint Pain and Sounds in Temporo-Mandibular Disorders

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    D. Goodarzi Pour

    2010-12-01

    Full Text Available Background/Objective: Exploring the association between magnetic resonance imaging (MRI,"ntemporomandibular joint (TMJ scanography and clinical manifestations of joint pain and sounds"nin patients with temporomandibular (TM disorder."nPatients and Methods: This study included 62 TM joints with internal derangement. Sagittal"nscanography and MRI of these TMJs were obtained and reported blindly by the consensus of two"nradiologists."nResults: No significant association was observed between clinical and scanographic findings with"nMRI. The abnormal range of motion had significant relationship with pain (P=0.017 and sound"n(P=0.046. There was a strong association between sound and condylar flattening (P=0.007."nConclusion: It was demonstrated that joint pain and sounds were predictors of the abnormal"nrange of motion in TMJ scanography. Sound could be heard more often in patients with condylar"nflattening, and TMJ scanographic findings as well as joint pain and sounds had limited value in the"ndiagnosis of disk position or effusion.

  1. 颞下颌关节紊乱指数临床应用评价%Study on the use of temporomandibular joint dysfunction index in temporomandibular disorders

    Institute of Scientific and Technical Information of China (English)

    傅开元; 马绪臣; 张震康; 田岳红; 周彦恒; 赵燕平

    2002-01-01

    目的探讨如何采用客观定量的方法评价颞下颌关节功能障碍程度和颞下颌关节紊乱病(temporomandibular disorders,TMD)的治疗效果.方法分别采用Fricton颞下颌关节紊乱指数和Helkimo临床检查功能障碍指数,定量计算每例患者(共60例)的颞下颌关节紊乱指数,评价不同检查者获得的各项指数的一致性,并应用Fricton颞下颌关节紊乱指数定量评价TMD急性不可复性盘前移位的临床治疗效果. 结果①不同检查者获得的各项Fricton紊乱指数值相近;②Fricton紊乱指数可明确反映TMD急性不可复性盘前移位治疗后临床功能的改善.结论评价TMD功能障碍程度或评价TMD治疗效果宜避免使用非客观的、描述性的报告,Fricton紊乱指数是一方便且有效的客观定量指标.

  2. Influence of estrogen 'alfa' receptor genetic polymorphism in women with signal and symptoms of temporomandibular disorders

    OpenAIRE

    Margarete Cristiane Ribeiro

    2005-01-01

    Resumo: Desordem Temporomandibular (DTM) é um termo utilizado para determinar as condições de patologias clínicas que envolvem os músculos mastigatórios e articulações temporomandibulares (ATM). Ocorre freqüentemente entre as mulheres em idade fértil, aumentando a prevalência após a puberdade e diminuindo na pós-menopausa, o que sugere uma correlação com os hormônios reprodutivos, principalmente o estrógeno. O objetivo deste trabalho foi correlacionar a freqüência de dois polimorfismos do gen...

  3. Reliability of a questionnaire for diagnosing the severity of temporomandibular disorder

    OpenAIRE

    2009-01-01

    CONTEXTUALIZAÇÃO: Disfunção temporomandibular (DTM) é um termo coletivo que engloba vários problemas clínicos envolvendo a musculatura da mastigação, as articulações temporomandibulares (ATM) e suas estruturas associadas, com alta prevalência nas populações. OBJETIVOS: Sabendo-se que estudos brasileiros vêm utilizando o instrumento proposto por Da Fonseca et al. (1994) para diagnóstico da severidade desta disfunção, realizou-se este estudo com o objetivo de verificar e estimar a consistência ...

  4. Prevalence of temporomandibular disorders and its association with parafunctional habits among senior-secondary school children of Lucknow, India

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    Kriti Agarwal

    2016-01-01

    Full Text Available Introduction: Temporomandibular disorders (TMD are defined as heterogeneous group of psychological disorders, commonly characterized by orofacial pain, chewing dysfunction, or both. Aim: To determine the prevalence of TMD and to describe the association between parafunctional habits and signs and symptoms of TMD among 15–17-year-old school children in Lucknow. Materials and Methods: This study followed a cross-sectional design, with a sample of 407 school children aged 15–17-year-old. A single, trained, calibrated investigator interviewed the participants according to Fonseca's Anamnestic Questionnaire-1994, which provided information on the prevalence of TMD, followed by the clinical examination of temporomandibular joint (TMJ according to WHO (1997. Chi-square test and Univariate and Multivariate Logistic Regression analysis were used. Results: The prevalence of TMD was (22.4%. There was no statistically significant association was found between age, (P = 0.81 gender (P = 0.09 and TMD. Nail-biting (88.3% was the most common habit, followed by clenching/grinding (68.4% and mouth breathing (53.4%. However, habits and TMJ symptoms were found statistically significant P < 0.01 or P < 0.001 associated to TMD. Further, adjusted (age and gender logistic regression analysis revealed that digit-sucking, mouth breathing, nail biting, and clenching has made a significant contribution to prediction (P < 0.001. Conclusion: The habits especially digit-sucking, mouth breathing, nail biting, and clenching had statistically significantly associated with TMD.

  5. Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD): The Polish version of a dual-axis system for the diagnosis of TMD.* RDC/TMD form

    NARCIS (Netherlands)

    Osiewicz, M.A.; Lobbezoo, F.; Loster, B.W.; Wilkosz, M.; Naeije, M.; Ohrbach, R.

    2013-01-01

    Aim of the study. To describe steps taken to conduct a formal forward translation/back-translation from English to Polish, and to establish the cultural equivalence of the Polish version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). This will be preceded by a brief h

  6. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group

    NARCIS (Netherlands)

    Schiffman, E.; Ohrbach, R.; Truelove, E.; Look, J.; Anderson, G.; Goulet, J.P.; List, T.; Svensson, P.; Gonzalez, Y.; Lobbezoo, F.; Michelotti, A.; Brooks, S.L.; Ceusters, W.; Drangsholt, M.; Ettlin, D.; Gaul, C.; Goldberg, L.J.; Haythornthwaite, J.A.; Hollender, L.; Jensen, R.; John, M.T.; De Laat, A.; de Leeuw, R.; Maixner, W.; van der Meulen, M.; Murray, G.M.; Nixdorf, D.R.; Palla, S.; Petersson, A.; Pionchon, P.; Smith, B.; Visscher, C.M.; Zakrzewska, J.; Dworkin, S.F.

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.

  7. Prevalence of the different Axis I clinical subtypes in a sample of patients with orofacial pain and temporomandibular disorders in the Andalusian Healthcare Service

    Science.gov (United States)

    Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velázquez, Lourdes; Rodríguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael

    2016-01-01

    Background The main objective of this paper is to analyze the prevalence of each of the different clinical subtypes of temporomandibular disorders (TMD) in a sample of patients with this pathology. In addition, a second objective was to analyze their distribution according to gender. Material and Methods To this end, the results of 1603 patients who went to the Unit of Temporomandibular Disorders in the Córdoba Healthcare District because they suffered from this pathology were analyzed. In order to diagnose them, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were applied, analyzing the different Axis I subtypes (myopathy, discopathy and arthropathy) and obtaining the combined Axis I for each patient and the relation of all these variables according to gender. The null-hypothesis test confirmed the lack of connection between the gender variable and the different subtypes in the clinical analysis, and between the former and the combined Axis I of the RDC/TMD. Results The prevalence was high for the muscle disorders subtype in general, showing an 88.7% prevalence, while the presence of discopathies or arthropathies was much lower. Among discopathies, the most frequent ones were disc displacements with reduction, with 39.7% and 42.8% for the left and right temporomandibular joints (TMJ), respectively, while the prevalence of arthropathies was 26.3% for the right TMJ and 32.9% for the left TMJ. The bivariate analysis on the connection with gender reveals a p≥ 0.05 value for the muscle and arthralgia subtypes. Conclusions The patients seen at the TMD Unit where mostly middle-aged women whose main clinical axis subtype was the muscle disorder subtype. For their part, both discopathies and arthropathies, although present, are much less prevalent. Key words:RDCTMD, axis I, orofacial pain, temporomandibular disorders, gender. PMID:26615508

  8. Taking the Bite out of Bruxism (For Kids)

    Science.gov (United States)

    ... the Operating Room? Taking the Bite Out of Bruxism KidsHealth > For Kids > Taking the Bite Out of ... have bruxism (say: BRUK-siz-um). What Is Bruxism? Bruxism is the term for grinding or clenching ...

  9. Mobilization with movement, thoracic spine manipulation, and dry needling for the management of temporomandibular disorder: a prospective case series.

    Science.gov (United States)

    González-Iglesias, Javier; Cleland, Joshua A; Neto, Francisco; Hall, Toby; Fernández-de-las-Peñas, César

    2013-11-01

    The purpose of this case series was to describe the outcomes of patients with temporomandibular disorder (TMD) treated with mobilization with movement (MWM) directed at the temporomandibular joint (TMJ) and the cervical spine, thoracic manipulation, and trigger point (TrP) dry needling. Fifteen patients with TMD completed the Steigerwald/Maher TMD disability questionnaire, the Visual Analog Scale (VAS), and maximal mouth opening (MMO) at baseline. The VAS and MMO were also collected at 15 days posttreatment and at a 2-month follow-up, and the Steigerwald/Maher TMD disability questionnaire was completed at the 2-month follow-up. Repeated measure ANOVAs were used to determine the effects of the intervention on each outcome. Within-group effect sizes were calculated in order to assess clinical effectiveness. Fifteen patients participated in this case series. The ANOVA revealed significant decreases (all, p  physical therapy management strategy between baseline and final visit with a mean of 11.4 (95% CI, 6.9, 15.9) and 10.2 (95% CI, 5.2, 15.2) between baseline and the 2-month follow-up. Within-group effect sizes were large (d  >  1.0) for all outcomes at both follow-up periods. Patients with TMD treated with a multimodal treatment exhibited significant and clinical improvements in pain intensity, disability, and MMO.

  10. Validation of the clinical diagnostic criteria for temporomandibular disorders for the diagnostic subgroup of degenerative joint disease.

    Science.gov (United States)

    Brandlmaier, I; Grüner, S; Rudisch, A; Bertram, S; Emshoff, R

    2003-04-01

    Research is needed to assess the validity of the Clinical Diagnostic Criteria for Temporomandibular Disorders (CDC/TMD). The purpose of this study was to test the reliability of the clinical diagnosis of temporomandibular joint (TMJ) degenerative joint disease (DJD) as compared with the magnetic resonance imaging (MRI) 'gold standard'. The TMJ DJD group comprised 48 joints in 24 consecutive patients who were assigned a clinical bilateral diagnosis of TMJ DJD. The TMJ non-DJD group consisted of 82 joints in 41 consecutive patients without a TMJ-related diagnosis of TMD. Bilateral sagittal and coronal MR images were obtained subsequently to establish the corresponding diagnosis of degenerative joint changes. An MRI diagnosis of osteoarthrosis (OA) was defined by the presence of flattening, subchondral sclerosis, surface irregularities, and erosion of the condyle or presence of condylar deformities associated with flattening, subchondral sclerosis, surface irregularities, erosion and osteophyte. For the CDC/TMD interpretations, the positive predictive of DJD for OA was 67%, and for the presence of degenerative joint changes 88%. The overall diagnostic agreement for DJD was 44.6% with a corresponding K-value of 0.01. Most of the disagreement was due to false-negative interpretations of asymptomatic joints. The results suggest CDC/TMD to be predictive for degenerative joint changes but insufficient for determination of OA. Patients assigned a clinical TMJ-related diagnosis of DJD may need to be supplemented by evidence from MRI to determine the presence or absence of OA.

  11. Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review

    Directory of Open Access Journals (Sweden)

    Eduardo Machado

    2013-10-01

    Full Text Available INTRODUCTION: In some cases, conservative treatment of internal derangements of the Temporomandibular Joint (TMJ is considered little responsive. Thus, it is necessary to accomplish treatments that aim at reducing pain and improve patients' functions who present arthrogenic temporomandibular disorders. OBJECTIVE: This study, by means of a systematic review of the literature, aimed to analyze the effectiveness of intra-articular injections with corticosteroids and sodium hyaluronate for treating internal derangements of the TMJ. METHODS: Carry out a research in the following databases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs, and BBO, considering publications issued between 1966 and October of 2010, focusing on randomized or quasi-randomized controlled clinical trials, single or double-blind. RESULTS: After applying the inclusion criteria we collected 9 articles, 7 of which were randomized controlled double-blind clinical trials and 2 randomized controlled single-blind clinical trials. CONCLUSION: After analyzing the literature, it was found that intra-articular injection with corticosteroids and sodium hyaluronate seems to be an effective method for treating internal derangements of the TMJ. However, further randomized controlled clinical trials, with representative samples and longer follow-up time must be carried out in order to assess the real effectiveness of this technique.

  12. Correlation between malocclusion, vertical dimension of occlusion and temporomandibular disorders in children and adolescents.

    OpenAIRE

    Marangoni,Analúcia Ferreira

    2010-01-01

    A presença de maloclusões associada à alteração da dimensão vertical de oclusão pode ser um fator predisponente à instalação de disfunções temporomandibulares. Em vista disso, o objetivo deste estudo foi verificar se existe correlação entre tipos de maloclusão, alteração de Dimensão Vertical de Oclusão e Disfunção Temporomandibular em seus diferentes graus de severidade em crianças e adolescentes de 7 a 12 anos, de ambos os gêneros. Foram avaliados 105 indivíduos do Instituto Rogacionista em...

  13. TMJ evaluation with multiplanar reconstruction in patients with and without headache associated to temporomandibular disorder

    OpenAIRE

    2008-01-01

    Resumo: O presente trabalho teve como objetivo verificar o uso da reconstrução em três dimensões da articulação temporomandibular (ATM) em imagens geradas por ressonância magnética (RM) em indivíduos com desordem temporomandibular (DTM) e cefaléia e DTM sem cefaléia. Para tal, um grupo de 42 pacientes com DTM e desarranjo interno (DI) unilateral e um grupo controle (sem DTM e DI) de 18 indivíduos foram selecionados. O grupo de 42 indivíduos citado foi dividido em presença de cefaléia e ausênc...

  14. Craniocervical posture analysis in patients with temporomandibular disorder Análise da postura cranio-cervical em pacientes com disfunção temporomandibular

    Directory of Open Access Journals (Sweden)

    DH Iunes

    2009-02-01

    Full Text Available OBJECTIVE: To compare head positioning and cervical spine alignment between individuals with and without temporomandibular disorders (TMDs, by means of positional evaluation using photographs, radiographs and visual observation, and to investigate whether the type of TMD influences head posture and cervical spine positioning. METHODS: Ninety randomly chosen women were diagnosed using the research diagnostic criteria for TMDs (RDC/TMD by a trained examiner and were divided into three groups: Group 1, with a diagnosis of myofascial dysfunction (group I of RDC axis I; Group 2, with mixed TMD (groups I, II and III of RDC axis I; and Control, without TMD. Following this, the participants were photographed in frontal and lateral views by a single examiner. To produce these photos, the following anatomical points were marked out on the skin: occipital protuberance, C4, C7, acromioclavicular joint and sternoclavicular joint. From these points, different angles were analyzed by means of the ALCimagem-2000 application. These same photos were then evaluated qualitatively (visual evaluation. Next, lateral teleradiography and radiography of the cervical spine was requested. The examiner was blind when analyzing the images. To compare the results, the chi-squared test and analysis of variance were used, with significance levels of 5%. RESULTS: Regardless of the method used, the results revealed that head and cervical spine posture did not differ between the groups with and without TMD, independent of the diagnostic group. CONCLUSION: The posture of individuals with myogenic or arthrogenous TMD does not differ from the posture of individuals without TMD. The presence of TMD does not influence the head and cervical spine posture.OBJETIVO: Comparar o posicionamento da cabeça e o alinhamento da coluna cervical em indivíduos com e sem DTM, por meio da avaliação postural por fotografias, radiografias e por observação visual e verificar se o tipo de DTM

  15. Rehabilitación dental y trastornos temporomandibulares en adolescentes de Puebla, México / Dental rehabilitations and temporomandibular disorders in adolescents of Puebla, Mexico

    Directory of Open Access Journals (Sweden)

    Gabriel Muñoz Q

    2014-05-01

    Full Text Available Objetivo: determinar el factor de riesgo para desarrollar trastornos temporomandibulares (ttm en adolescentes sometidos a rehabilitación dental. Métodos: cohorte realizada en 153 adolescentes, (52,9% mujeres y 47% hombres libres de ttm. Para diagnosticar los ttm se utilizaron los Criterios Diagnósticos para la Investigación de los ttm (cdi/ttm, para determinar caries se aplicó el índice cpod. Se formaron dos grupos, el grupo expuesto a rehabilitación dental (74, y el grupo no expuesto (79. Se realizaron seguimientos a las dos semanas, tres y seis meses de la rehabilitación dental. Se utilizó estadística descriptiva y se calculó el riesgo relativo con intervalos de confianza al 95%. Para el grupo de los expuestos, se incluyeron adolescentes libres de ttm en los que fue necesario realizar tratamiento de rehabilitación dental en órganos posteriores con caries en esmalte y dentina en fosas y fisuras. Para el grupo no expuesto, se incluyeron adolescentes pareados por edad y sexo con los expuestos, libres de ttm sin necesidades de rehabilitación dental. Resultados: la incidencia de ttm a los quince días de los expuestos (18,9% fue superior en contraste con los no expuestos (5,0%. El riesgo relativo de desarrollar ttm en los adolescentes rehabilitados con resina a las dos semanas posteriores a la rehabilitación fue de 2.412 (I.C. 95% 1.001-5,81 veces más que en aquellos que no fueron sometidos a la rehabilitación. Conclusión: la rehabilitación dental es un factor de riesgo mínimo para desarrollar ttm a corto plazo (15 días de realizado el procedimiento, dicho padecimiento inducido por la rehabilitación dental es agudo y auto limitante Objective: determine the risk factor involved with developing temporomandibular disorders (tmd in adolescents undergoing dental rehabilitation. Methodology: cohort study carried out on 153 tmd-free adolescents (52.9% women and 47% women. In order to diagnose tmds the Diagnostic Criteria for Research

  16. Sinais e sintomas da disfunção temporomandibular nas diferentes regiões brasileiras Signs and symptoms of temporomandibular disorders across Brazilian regions

    Directory of Open Access Journals (Sweden)

    Anamaria Siriani de Oliveira

    2008-12-01

    Full Text Available O objetivo deste estudo foi avaliar a prevalência da severidade de sinais e sintomas de disfunção temporomandibular (DTM em não-pacientes nas diferentes regiões do país. Questionários foram aplicados a 2.396 universitários, dos quais 73,7% mulheres (21±5 anos e 26,3% homens (22±4 anos. Determinado o nível de severidade dos sinais e sintomas da DTM, os dados foram tratados estatisticamente, com nível de significância de 5%. Maior prevalência de sinais e sintomas de DTM foi constatada para o sexo feminino (73,03%. Na região Centro-Oeste não foi observada diferença significante entre estudantes com sinais e sintomas de DTM moderada e severa; mas aí há mais probabilidade de encontrar universitários com sinais e sintomas severos do que nas demais regiões. A região Sul apresentou maior porcentagem de estudantes com sinais e sintomas, porém com menor severidade que nas demais regiões. No Nordeste e no Sul, é mais provável encontrar universitários sem sinais e sintomas que universitárias. Pode-se concluir que a porcentagem de universitários não-pacientes portadores de algum nível de severidade de sinais e sintomas da DTM foi maior que a de não-portadores, em todas as regiões. Diferentes regiões apresentam diferentes probabilidades de se encontrarem universitários com algum sinal ou sintoma de DTM.The aim of this study was to assess prevalence of temporomandibular disorders (TMD signs and symptoms in non-patients from different Brazilian geographic areas. Questionnaires were applied to 2,396 college students, of which 73.7% were women (aged 21±5 and 26.3% men (aged 22±4. Once severity levels were classified, data were statistically treated, and significance level set at 5%. Greater percentage of TMD signs and symptoms was found in women (73.03% than among men. No significant differences between percentages of students with moderate and severe signs and symptoms were found in Central-West region - where chances of

  17. Change in the number of occlusal contacts following splint therapy in patients with a temporomandibular disorder (TMD).

    Science.gov (United States)

    Al-Ani, Ziad; Davies, Stephen; Sloan, Philip; Gray, Robin

    2008-09-01

    The mean number of occlusal contacts before and after occlusal appliance therapy were compared in three temporomandibular disorder groups and one control group. Only patients with a successful treatment outcome were considered in the statistical analysis. Statistically significant changes were seen in the disc displacement with reduction group, which was managed with anterior repositioning splint: the mean number of contacts increased 3 months after weaning off the splint. If the disc is out of position then the number of occlusal contacts appears to be reduced. It would therefore appear to be sound advice not to make permanent and irreversible adjustment to the occlusion in the presence of disc displacement as when the disc is repositioned occlusal contacts will change.

  18. Clinical, magnetic-resonance imaging and surgical findings in patients with temporomandibular joint disorders - a survey of 47 patients

    Energy Technology Data Exchange (ETDEWEB)

    Raustia, A.M. (Dept. of Prosthodontics and Stomatognathic Physiology, Inst. of Dentistry, Oulu Univ., Aapistie (Finland)); Pyhtinen, J. (Dept. of Diagnostic Radiology, University Central Hospital, Oulu (Finland)); Pernu, H. (Dept. of Oral and Maxillofacial Surgery, Inst. of Dentistry, Oulu Univ. (Finland))

    1994-05-01

    The purpose of this study was to evaluate and correlate the clinical, magnetic-resonance imaging (MRI), and surgical findings in 47 patients with temporomandibular joint (TMJ) disorders. 51 TMJs (24 right, 27 left) were operated on, because 4 patients underwent treatment of both TMJs. The best correlation between MRI and surgical findings was noted in connection with position of the disk. This was surgically confirmed altogether in 88% of cases (45/51). The clinical diagnosis was confirmed by surgical findings in 75% of cases of anterior dislocation of the disk with reduction and 89% of cases of anterior dislocation of the disk without reduction. Bone changes noted by MRI were confirmed by surgery in 71% of cases. MRI was excellent especially relating to disk position and changes in disk morphology. The results show also that there are findings using MRI, e.g. of joint effusion, which cannot be confirmed during surgery. (orig.)

  19. Evaluation of the effect of two different occlusal splints on maximum occlusal force in patients with sleep bruxism: a pilot study

    Science.gov (United States)

    Dogan, Arife; Bek, Bulent

    2014-01-01

    PURPOSE The occlusal splint has been used for many years as an effective treatment of sleep bruxism. Several methods have been used to evaluate efficiency of the occlusal splints. However, the effect of the occlusal splints on occlusal force has not been clarified sufficiently. The purpose of this study was to evaluate the effect of occlusal splints on maximum occlusal force in patients with sleep bruxism and compare two type of splints that are Bruxogard-soft splint and canine protected hard stabilization splint. MATERIALS AND METHODS Twelve students with sleep bruxism were participated in the present study. All participants used two different occlusal splints during sleep for 6 weeks. Maximum occlusal force was measured with two miniature strain-gage transducers before, 3 and 6 weeks after insertion of occlusal splints. Clinical examination of temporomandibular disorders was performed for all individuals according to the Craniomandibular Index (CMI) before and 6 weeks after the insertion of splints. The changes in mean occlusal force before, 3 and 6 weeks after insertion of both splints were analysed with paired sample t-test. The Wilcoxon test was used for the comparison of the CMI values before and 6 weeks after the insertion of splints. RESULTS Participants using stabilization splints showed no statistically significant changes in occlusal force before, 3, and 6 weeks after insertion of splint (P>.05) and participants using Bruxogard-soft splint had statistically significant decreased occlusal force 6 weeks after insertion of splint (P<.05). There was statistically significant improvement in the CMI value of the participants in both of the splint groups (P<.05). CONCLUSION Participants who used Bruxogard-soft splint showed decreases in occlusal force 6 weeks after insertion of splint. The use of both splints led to a significant reduction in the clinical symptoms. PMID:24843394

  20. Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders

    Science.gov (United States)

    Wu, Jun-Yi; Zhang, Chao; Xu, Yang-Peng; Yu, Ya-Yu; Peng, Le; Leng, Wei-Dong; Niu, Yu-Ming; Deng, Mo-Hong

    2017-01-01

    Abstract Purpose: The purpose of this study was to evaluate conventional acupuncture therapy in the management of clinical outcomes for temporomandibular disorders (TMD) in adults. Methods: The electronic databases PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Clinical Trails.gov were searched for reports published until March 31, 2016. Results: Nine eligible studies from 8 publications involving 231 patients were included in the meta-analysis. A comparison of the main outcome of visual analog scale (VAS) values of pain between the acupuncture group and control group showed a significant decrease (MD = −0.98, 95% CI [−1.62, −0.34], I2=54%, P = 0.003) in the VAS following acupuncture treatment. However, subgroup analysis according to the type of sham control group indicated that there were significant differences in the results when sham acupuncture was used as the control group (MD = −1.54, 95% CI [−2.63, −0.45], I2=58%, P = 0.006) as well as when sham laser treatment was used as the control group (MD = −1.29, 95% CI [−2.32, −0.27], I2 = 0%, P = 0.01). However, there was no significant difference when the splint treatment group was used as the control group (MD = −0.09, 95% CI [−0.69, 0.50], I2 = 0%, P = 0.76). Subgroup analyses of VAS for pain by the classification of diseases indicated that the myogenous TMD subgroup demonstrated a significant difference (MD = −1.49, 95% CI [−2.45, −0.53], I2 = 47%, P = 0.002), and TMD showed no statistically significant difference (MD = −0.42, 95% CI [−1.14, 0.30], I2 = 46%, P = 0.25). Subgroup analysis according to whether the subgroup penetrated the skin showed that nonpenetrating sham acupuncture as the control group showed a significant difference (MD = −1.56, 95% CI [−2.70, −0.41], I2 = 58%, P = 0.008) compared with the conventional acupuncture as the treatment modality, while penetrating sham acupuncture as the control group showed no

  1. 弹性树脂制作牙合垫治疗颞下颌关节紊乱综合征临床观察%Management of disorder of temporomandibular joint syndrome using elastic resin occlusal pad: a clinical observation

    Institute of Scientific and Technical Information of China (English)

    张云; 郭传波; 朱起

    2001-01-01

    Objective To investigate the possibility of occlusal pad in treating disorder of temporomandibular joint syndrome.Methods We treated 25 patients with disorder of temporomandibular joint syndrome using occlusal pad made of elastic resin,and evaluated the effects.Results Total effective rate was 96% .Clicking and pain dissappeared in all patients.Conclusion Occlusal pad made of elastic resin could be used for treating disorder of temporomandibular joint syndrome in clinic.

  2. Effect of hypnotic pain modulation on brain activity in patients with temporomandibular disorder pain

    DEFF Research Database (Denmark)

    Abrahamsen, Randi; Dietz, Martin; Lodahl, Sanne

    2010-01-01

    Hypnosis modulates pain perception but the associated brain mechanisms in chronic pain conditions are poorly understood. Brain activity evoked by painful repetitive pin-prick stimulation of the left mental nerve region was investigated with use of fMRI in 19 patients with painful temporomandibular...... hyperalgesia. Direct contrasts between control and hypnotic hypoalgesia conditions demonstrated significant decreases in right posterior insula and BA21, as well as left BA40 during hypoalgesia. These findings are the first to describe hypnotic modulation of brain activity associated with nociceptive...

  3. Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs)

    OpenAIRE

    2015-01-01

    Aim: To compare between soft and hard occlusal splint therapy for the management of myofacial pain dysfunction (MPD) or internal derangement (ID) of the temporomandibular joint (TMJ) with reciprocal clicking. Patients and methods: This study included 50 patients (age range: 24–47 years) who had been diagnosed with MPD or ID of the TMJ in the form of reciprocal clicking. Patients were divided into two groups. They were treated for 4 months with either a vacuum-formed soft occlusal splint co...

  4. First diagnosis of rheumatoid arthritis in a patient with temporomandibular disorder: a case report.

    Science.gov (United States)

    Malliari, Maria; Bakopoulou, Athina; Koidis, Petros

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic disease of unknown etiology, characterized by synovitis of the diarthroidal joints, gradual bone erosion, and cartilage destruction. Temporomandibular joint (TMJ) arthritis is frequent in patients with RA, but it is seldom the first joint to be affected. This report presents a case of a female patient with undiagnosed RA who first presented with signs and symptoms of the disease in the TMJs. It highlights the importance of professional awareness and provides a roadmap for clinical and radiologic examination followed by biochemical and genetic monitoring for early diagnosis of RA.

  5. Aural signs and symptoms of patients with temporomandibular joint disorders treated with flat occlusal splints

    OpenAIRE

    2011-01-01

    Resumo: Este estudo avaliou a evolução clínica dos sinais e sintomas otológicos relatados por 25 voluntários, com predominância para o gênero feminino, pertencentes ao banco de pacientes do serviço de otorrinolaringologia do ambulatório "Araújo Lima", da Universidade Federal do Amazonas, com idade média de 46,7 anos, portadores de disfunção temporomandibular (DTM), tratados com aparelhos oclusais lisos e planos. Transtornos otorrinolaringológicos agudos ou crônicos de origem médica foram fato...

  6. The role of the lateral pterygoid muscle in the temporomandibular joint disorders

    Directory of Open Access Journals (Sweden)

    Maria ANTONOPOULOU

    2013-12-01

    Full Text Available Being the only muscle directrly related to the temporomandibular joint (TMJ, the lateral pterygoid muscle (LPM has been the subject of many studies seeking to understand the problems of this joint. Many anatomical studies have been carried out on cadavers, in order to specifically examine the attachment of the LPM to the TMJ. These studies have led to different results and conclusions. Aim: The present study aims to provide a review of the recent literature and draw conclusions on the impact that the anatomical position of the LPM attachment can have on TMJ dysfunction.

  7. PATHOLOGY OF TEMPOROMANDIBULAR-JOINT INTERNAL DERANGEMENT AND OSTEOARTHROSIS

    NARCIS (Netherlands)

    DEBONT, LGM; STEGENGA, B

    1993-01-01

    Temporomandibular joint (TMJ) osteoarthrosis and disk displacement seem to be strongly related, but they may also represent mutually independent temporomandibular disorders. This paper presents relevant aspects of normal physiology and degeneration of synovial joints, aspects of normal temporomandib

  8. Three-dimensional finite element analysis of cartilaginous tissues in human temporomandibular joint during prolonged clenching

    NARCIS (Netherlands)

    Mori, H.; Horiuchi, S.; Nishimura, S.; Nikawa, H.; Murayama, T.; Ueda, K.; Ogawa, D.; Kuroda, S.; Naito, H.; Tanaka, M.; Koolstra, J.H.; Tanaka, E.

    2010-01-01

    Objective: Bruxism, the parafunctional habit of nocturnal grinding of the teeth and clenching, is associated with the onset of joint degeneration. Especially prolonged clenching is suggested to cause functional overloading in the temporomandibular joint (TMJ). In this study, the distributions of str

  9. Electric toothbrush application is a reliable and valid test for differentiating temporomandibular disorders pain patients from controls

    Directory of Open Access Journals (Sweden)

    Schiffman Eric L

    2009-07-01

    Full Text Available Abstract Background Current methods for identifying patients with pain hypersensitivity are sufficiently complex to limit their widespread application in clinical settings. We assessed the reliability and validity of a simple multi-modal vibrotactile stimulus, applied using an electric toothbrush, to evaluate its potential as a screening tool for central sensitization. Methods Fourteen female temporomandibular disorders (TMD subjects with myofascial pain (RDC/TMD Ia or Ib and arthralgia (RDC/TMD IIIa were compared to 13 pain-free controls of matched age and gender. Vibrotactile stimulus was performed with an electric toothbrush, applied with 1 pound pressure for 30 seconds in four locations: over the lateral pole of the temporomandibular joint, masseter, temporalis, and mid-ventral surface of forearm. Pain intensity (0–10 was recorded following the stimulus at 0, 15, 30, and 60 seconds. Test-retest reliability was assessed with measurements from 8 participants, taken 2–12 hours apart. Case versus control differentiation involved comparison of area under the curve (AUC. A receiver operating characteristic (ROC curve was used to determine cutoff AUC scores for maximum sensitivity and specificity for this multi-modal vibrotactile stimulus. Results Test-retest reliability resulted in an ICC of 0.87 for all 4 pooled sites. ROC-determined AUC cutoff scores resulted in a sensitivity of 57% and specificity of 92% for all 4 pooled sites. Conclusion The electric toothbrush stimulus had excellent test-retest reliability. Validity of the scores was demonstrated with modest sensitivity and good specificity for differentiating TMD pain patients from controls, which are acceptable properties for a screening test.

  10. 颞下颌关节紊乱病患者口腔不良习惯与髁突骨质改变相关性的影像学研究%Relationship between oral habits and temporomandibular joint radiographic findings showed by cone beam computed tomography in temporomandibular disorder patients

    Institute of Scientific and Technical Information of China (English)

    张伟华; 余丽霞; 王晓冬; 李晓箐

    2012-01-01

    Objective The purpose of this retrospective study was to investigate the relationship between oral habits and temporomandibular joint (TMJ) bony change of temporomandibular disorder (TMD) patients. Methods One hundred and six TMD patients diagnosed according to Research Diagnostic Criteria (RDC/TMD) were selected. All the patients had undergone cone beam computed tomography (CBCT) imaging of TMJ, and their oral habits had been investigated. The associations between oral habits and TMJ radiographic findings were analysed. Results Among 106 patients, the incidence of bruxism, clenching, chewing on one side and being fond of hard food were high. Preferring to hard food increased the risk of ill -defined cortical bone change. Hobby of hard food increased the risk of bony changes in the anterolateral and posterolateral part of the condyle, as well as in the articular tubercle. Chewing on one side could increase the risk of bony changes in the anteromedial aspect of articular fossa. Conclusion Oral habits of TMD patients were associated with type and position TMJ bony change.%目的 研究颞下颌关节病患者口腔不良习惯与颞下颌关节髁突骨质改变之间的关系.方法 选取诊断为颞下颌关节紊乱病的患者106例,问卷调查患者的口腔不良习惯,并行双侧颞下颌关节锥形束CT成像,分析患者口腔不良习惯与颞下颌关节髁突骨质影像学改变的相关性.结果 106例患者中,口腔不良习惯以偏侧咀嚼、紧咬牙、夜磨牙和喜食硬物较常见.经统计学分析,喜食硬物是出现髁突骨皮质模糊消失型改变的危险因素(P =0.019,OR=2.570).喜食硬物是髁突前外侧(P =0.025,OR =2.298)、髁突后外侧(P =0.023,OR =2.692)及关节结节(P=0.020,OR =3.067)易出现骨质改变的危险因素.偏侧咀嚼习惯则是关节窝前内侧(P=0.013,OR =0.311)易出现骨质改变的危险因素.结论 口腔的不良习惯与颞下颌关节骨质改变的类型及部位有一定相关性.

  11. Analgesic effect of cathodal transcranial current stimulation over right dorsolateral prefrontal cortex in subjects with muscular temporomandibular disorders: study protocol for a randomized controlled trial

    OpenAIRE

    Brandão Filho, Rivail Almeida; Baptista, Abrahão Fontes; Brandão, Renata de Assis Fonseca Santos; Meneses, Francisco Monteiro; Okeson, Jeffrey; de Sena, Eduardo Pondé

    2015-01-01

    Background Temporomandibular disorders are a group of orofacial pain conditions that are commonly identified in the general population. Like many other chronic pain conditions, they can be associated with anxiety/depression, which can be related to changes in the activity of the dorsolateral prefrontal cortex. Some studies have demonstrated clinical improvement in subjects with chronic pain who are given therapeutic neuromodulation. Transcranial direct current stimulation is a noninvasive bra...

  12. Bruxism defined and graded: an international consensus

    NARCIS (Netherlands)

    Lobbezoo, F.; Ahlberg, J.; Glaros, A.G.; Kato, T.; Koyano, K.; Lavigne, G.J.; de Leeuw, R.; Manfredini, D.; Svensson, P.; Winocur, E.

    2013-01-01

    To date, there is no consensus about the definition and diagnostic grading of bruxism. A written consensus discussion was held among an international group of bruxism experts as to formulate a definition of bruxism and to suggest a grading system for its operationalisation. The expert group defined

  13. PENGARUH BRUXISM TERHADAP PERUBAHAN MORFOLOGI GIGI PERMANEN

    OpenAIRE

    TAMRIL, RUDIN

    2014-01-01

    2014 Bruxism merupakan kebiasaan buruk menggerindingkan atau clenching gigi geligi pada saat tidur dalam keadaan sadar maupun tidak sadar dan terjadi pada hampir semua manusia diseluruh dunia, mulai dari anak-anak hingga dewasa. bruxism sangat erat kaitannya dengan perubahan morfologi gigi karena berhubungan dengan pengikisan permukaan gigi terutama pada bagian oklusal. Tujuan dari penelitaian ini adalah untuk mengetahui pengaruh bruxism terhada...

  14. Progress of the Relationship between Bruxism and Temporomandibular Disorders%磨牙症与颞下颌关节紊乱病关系的研究

    Institute of Scientific and Technical Information of China (English)

    李雪铃; 林雪峰

    2007-01-01

    磨牙症和颞下颌关节紊乱病都是口腔临床上的常见病,均病因不明,诊治困难.多年来学者们试图研究两者的内在联系和机制,但至今观点仍不统一.本文就磨牙症与颞下颌关节紊乱病的关系以及磨牙症引起颞下颌关节紊乱病的可能机制的研究进展作一综述.

  15. Correlação entre os achados clínicos e imaginológicos nas disfunções temporomandibulares Correlation between clinical and imaging findings in patients with temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Fábio Augusto Cozzolino

    2008-02-01

    Full Text Available OBJETIVO: Verificar a relação entre sinais e sintomas observados no exame clínico de pacientes com diagnóstico de disfunção temporomandibular, conforme os resultados fornecidos pelo exame de ressonância magnética. MATERIAIS E MÉTODOS: Trinta pacientes que apresentavam sinais e sintomas de disfunção temporomandibular foram submetidos a exame clínico e de ressonância magnética. Cada exame de ressonância magnética de articulação temporomandibular foi interpretado, independentemente, por dois radiologistas experientes. Os exames de ressonância magnética foram realizados com 12 cortes de 3 mm de espessura, em orientação coronal (T1 em posição de boca fechada, cortes sagitais em posição de boca aberta e fechada (T1 e T2 e em abertura e fechamento progressivos, com intervalo de 5 mm, para reproduzir toda a extensão do movimento mandibular. A significância estatística entre a análise clínica dos pacientes com disfunção temporomandibular e os resultados obtidos no exame de ressonância magnética foi avaliada pelo teste kappa. RESULTADOS: Obteve-se, na análise interobservadores de imagens, concordância bruta do lado esquerdo e direito, respectivamente, de 56,7% (kappa = 0,1 e 56,7 (kappa = 0. CONCLUSÃO: Não foi encontrada correlação entre o diagnóstico clínico da luxação discal e imagens de ressonância magnética.OBJECTIVE: To correlate the signals and symptoms observed on clinical examination of patients with temporomandibular disorder with the results demonstrated by magnetic resonance imaging. MATERIALS AND METHODS: Thirty patients presenting with signs and symptoms of temporomandibular disorders underwent clinical evaluation and subsequent magnetic resonance imaging. The magnetic resonance imaging studies were independently evaluated by two experienced radiologists. Magnetic resonance imaging studies consisted of 12 images in coronal, T1-weighted sequences with 3 mm-thick slices with the mouth closed

  16. Temporomandibular Joint Dysfunction: A Dental Overview

    OpenAIRE

    Hillier, Clyde D.

    1985-01-01

    Temporomandibular joint dysfunction is common and often acutely painful. Because of the large and diverse symptom complex created by this disorder, patients frequently first seek relief from their physician rather than their dentist. In this article temporomandibular joint (TMJ) dysfunction is defined and the presenting signs and symptoms are discussed. Their etiology is described in relation to the anatomy of the temporomandibular joint. Examination techniques can help in the differential di...

  17. Rehabilitación dental y trastornos temporomandibulares en adolescentes de Puebla, México / Dental rehabilitations and temporomandibular disorders in adolescents of Puebla, Mexico

    OpenAIRE

    Gabriel Muñoz Q; Luis G. Vázquez De Lara C; Irene A. Espinosa; Martha A. Delgado M

    2014-01-01

    Objetivo: determinar el factor de riesgo para desarrollar trastornos temporomandibulares (ttm) en adolescentes sometidos a rehabilitación dental. Métodos: cohorte realizada en 153 adolescentes, (52,9% mujeres y 47% hombres) libres de ttm. Para diagnosticar los ttm se utilizaron los Criterios Diagnósticos para la Investigación de los ttm (cdi/ttm), para determinar caries se aplicó el índice cpod. Se formaron dos grupos, el grupo expuesto a rehabilitación dental (74)...

  18. 高职大学生夜磨牙症患病情况的调查分析%Sleep Bruxism in the Vocational and Technical College Students

    Institute of Scientific and Technical Information of China (English)

    何伟

    2014-01-01

    目的:了解高职大学生夜磨牙症的发生情况及相关影响因素。方法:随机抽取2562名高职大学生进行问卷调查和口腔检查,采用 Excel 表格和 SPSS 13.0软件进行数据处理。结果:高职大学生夜磨牙症发病率为10.34%,其中男生9.72%,女生为10.93%,女生略高于男生,性别差异无统计学意义(P>0.05);口腔损害状况以颞下颌关节紊乱和牙齿磨损多见;影响因素以精神紧张因素多见。结论:高职大学生夜磨牙症发病率较高,学校应加强口腔健康宣传教育,减少夜磨牙症的发病率。%Objective: To investigate the etiology and related factors of sleep bruxism in the vocational college students. Methods: 2 562 randomly selected college students were conducted with a questionnaire survey and oral examination. Office Excelland SPSS 13 software were used for data processing. Results: Average sleep bruxism incidence rate was 10.34%,of which 9.72%were in male students,and 10.93%were in female students. The difference was not significant(P>0.05). Temporomandibular joint disorders and tooth wear and tear were more common during oral examination among the bruxism students. Mental stress was the main influence factor. Conclusion: Vocational college students have high incidence of sleep bruxism,schools should pay more attention on the spiritual education and counseling psychology to the pupils.

  19. Diagnóstico por la imagen de los trastornos de la articulación craneomandibular Imaging diagnosis of temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    J López López

    2005-04-01

    Full Text Available El diagnóstico de las alteraciones que afectan a la articulación craneomandibular (ACM debe basarse en la información obtenida a través de la anamnesis médica, de la exploración física y de los factores psiocoemocionales presentes en el paciente. También es importante constatar los síntomas dolorosos y disfuncionales presentes, así como los problemas auditivos, del habla y de la deglución entre otros que le puedan aquejar. La valoración integral del complejo articular debe incluir los tejidos orofaciales, la función muscular y neurológica, el estudio de la oclusión y de los movimientos mandibulares y la identificación de los posibles hábitos parafuncionales. Si bien todo lo anterior es imprescindible en muchas ocasiones debemos apoyarnos en las diferentes técnicas de diagnóstico por la imagen para poder etiquetar el cuadro clínico que aqueja al paciente. En el presenta trabajo revisamos y actulizamos los conceptos referentes al diagnóstico por la imagen de los trastornos que afectan a esta articulación.Clinical history, exploration and anamnesis about depressive -anxious symptoms are the basis of diagnosis of temporomandibular disorders. It’s also very important to know about pain, loss of function of temporomandibular joint, swallowing and talking. We should consider temporomandibular joint as a syndrome and is necessary to include an exploration of orofacial tissues, muscles, nerves and parafunctions. After the anamnesis and exploration, it’s necessary to perform some test, mainly based in imaging techniques, in order to reach a correct diagnosis. In this paper we review the importance of imaging in the diagnosis of temporomandibular disorders.

  20. Facial pain evaluation and electromyography activity of masticatory muscles in fibromyalgia and sleep disorders patients with diagnosis of temporomandibular disorder

    OpenAIRE

    Maísa Soares Gui

    2011-01-01

    Resumo: A prevalência e a coexistência das Disfunções Temporomandibulares (DTM) na Síndrome Fibromiálgica (SFM) têm sido frequentemente estudadas na literatura, no entanto os estudos que correlacionem as duas condições de dor crônica e a eletromiografia são escassos. Além disso, os distúrbios do sono representam um fator perpetuador da dor na SFM. Desse modo realizou-se uma revisão bibliográfica buscando conhecer a relação entre os distúrbios do sono e os sintomas da fibromialgia e sua import...

  1. Condylar bony changes in patients with temporomandibular disorders: a CBCT study

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of)

    2012-09-15

    Diagnosis of osteoarthritis most commonly depends on clinical and radiographic findings. The present study attempted to observe the bony changes in temporomandibular joint (TMJ) patients from all age groups. The first-visit clinical records and cone beam computed tomography (CBCT) data of 440 TMJs from 220 consecutive TMJ patients were reviewed retrospectively. The most frequent condylar bony change observed was sclerosis (133 joints, 30.2%) followed by surface erosion (129 joints, 29.3%), flattening of the articular surface (112 joints, 25.5%), and deviation in form (58 joints, 13.2%), which included 33 TMJs in a cane-shape, 16 with a lateral or medial pole depression, 6 with posterior condylar surface flattening, and 3 with a bifid-shaped condyle. Fifty-three joints (12.0%) showed hypoplastic condyles but only 1 joint showed hyperplasia. Osteophyte was found in 35 joints (8.0%) and subcortical cyst in 24 joints (5.5%), 5 of which had surface erosion as well. One hundred nineteen joints (27.0%) had only one kind of condylar bony change, 66 joints (15.0%) had two, 52 joints (11.8%) had three, 12 joints (5.0%) had four, and 6 joints (1.4%) had five kinds of condylar bony changes at the same time. Eighty-five (65.9%) of 129 joints with surface erosion had pain recorded at the chief complaint. With more widespread use of CBCT, more specific or detailed guidelines for osteoarthritis are needed.

  2. Dental occlusion, body posture and temporomandibular disorders: where we are now and where we are heading for.

    Science.gov (United States)

    Manfredini, D; Castroflorio, T; Perinetti, G; Guarda-Nardini, L

    2012-06-01

    The aim of this investigation was to perform a review of the literature dealing with the issue of relationships between dental occlusion, body posture and temporomandibular disorders (TMD). A search of the available literature was performed to determine what the current evidence is regarding: (i) The physiology of the dental occlusion-body posture relationship, (ii) The relationship of these two topics with TMD and (iii) The validity of the available clinical and instrumental devices (surface electromyography, kinesiography and postural platforms) to measure the dental occlusion-body posture-TMD relationship. The available posturographic techniques and devices have not consistently found any association between body posture and dental occlusion. This outcome is most likely due to the many compensation mechanisms occurring within the neuromuscular system regulating body balance. Furthermore, the literature shows that TMD are not often related to specific occlusal conditions, and they also do not have any detectable relationships with head and body posture. The use of clinical and instrumental approaches for assessing body posture is not supported by the wide majority of the literature, mainly because of wide variations in the measurable variables of posture. In conclusion, there is no evidence for the existence of a predictable relationship between occlusal and postural features, and it is clear that the presence of TMD pain is not related with the existence of measurable occluso-postural abnormalities. Therefore, the use instruments and techniques aiming to measure purported occlusal, electromyographic, kinesiographic or posturographic abnormalities cannot be justified in the evidence-based TMD practice.

  3. Assessment of type of bite and vertical dimension of occlusion in children and adolescents with temporomandibular disorder.

    Science.gov (United States)

    Marangoni, Analúcia Ferreira; de Godoy, Camila Haddad Leal; Biasotto-Gonzalez, Daniela Aparecida; Alfaya, Thays Almeida; Fernandes, Kristianne Porta Santos; Mesquita-Ferrari, Raquel Agnelli; Bussadori, Sandra Kalil

    2014-07-01

    The aim of the present study was determine the type of bite and abnormalities in the vertical dimension of occlusion (VDO) among children and adolescents with temporomandibular disorder (TMD). The Helkimo index was employed for the diagnostic investigation of TMD. A clinical examination was performed for the determination of occlusion. The VDO was measured using a digital caliper. Fisher's exact text was used to determine associations between type of bite, gender and TMD. The Student's t-test was used to compare age and VDO by gender. The significance level was set to 5% or corresponding p-value. Children and adolescents with anterior open bite were 1.2-fold more likely to develop TMD in comparison to those without any type of malocclusion. The same was found for those with posterior crossbite and mixed malocclusion. A statistically significant association was found between the VDO and age in both genders. TMD affected 68.85% of the sample. No correlation was found between malocclusion, VDO and TMD in the sample. The present findings suggest that individuals with malocclusion are more prone to TMD. Therefore, it is important to evaluate all variables capable of influencing the harmony of the stomatognathic system for an effective diagnosis of TMD and malocclusion.

  4. Clinical signs and symptoms of tinnitus in temporomandibular joint disorders: A pilot study comparing patients and non-patients

    Directory of Open Access Journals (Sweden)

    Amisha Kanji

    2013-12-01

    Full Text Available Background: Tinnitus is one of the otologic symptoms commonly reported to be associated with temporomandibular disorder (TMD, and questions regarding its nature and cause continue to plague the clinical and research community.Objectives: The current pilot study aimed to investigate the clinical signs and symptoms of presenting tinnitus in a group of individuals with TMD (group A, and compare them with a group with tinnitus but without TMD (group B. Twenty participants were included in the study, 10 from each group.Methods: All participants underwent basic audiological as well as ear, nose and throat (ENT evaluations to establish group A and group B. For tinnitus assessment, all participants completed a tinnitus survey questionnaire, and their tinnitus was evaluated using tinnitus matching procedures.Results: Findings revealed clinically relevant differences in attributes of tinnitus in patients with and without TMD. Most of the participants in group A matched their tinnitus to a 6 000 Hz tone or noise, at lower intensity levels than participants in group B, although these results were not statistically significant. Participants in group A associated their tinnitus with a single sound whereas some participants in group B associated it with more than one sound. More participants in group B reported the duration of their tinnitus as constant.Conclusions: Tinnitus may occur in patients with TMD, and be of high frequency. This highlights the importance of thorough assessment for patients with tinnitus as this might have implications for diagnosis and management.

  5. Tactile stimulation as a complementary treatment of temporomandibular disorders in patients with fibromyalgia syndrome. A pilot study.

    Science.gov (United States)

    Adiels, Anne-Marie; Helkimo, Martti; Magnusson, Tomas

    2005-01-01

    Pain of long duration is a common suffering in modern man. One such pain condition is fibromyalgia syndrome (FMS). Opinions about what treatment regimen that are to be used in these patients are diverging, and many of the treatments suggested are not, or only poorly, scientifically investigated. The aim of this pilot investigation was to evaluate if FMS patients with signs and symptoms of temporomandibular disorders (TMDs) refractory to conservative TMD treatment would respond positively to tactile stimulation in respect of local and/or general symptoms. Ten female patients fulfilling the inclusion criteria received such treatment once a week during a 10-week period. At the end of treatment, a positive effect on both clinical signs and subjective symptoms of TMD, as well as on general body pain, was registered. Eight out of 10 patients also perceived an improved quality of their sleep. At follow-ups after 3 and 6 months some relapse of both signs and symptoms could be seen, but there was still an improvement compared to the initial degree of local and general complaints. At the 6-months follow-up, half of the patients also reported a lasting improvement of their sleep quality. One hypothetical explanation to the positive treatment effect experienced by the tactile stimulation might be the resulting improvement of the patients' quality of sleep leading to increased serotonin levels. The results of the present pilot study are so encouraging that they warrant an extended, controlled study.

  6. Are occlusal characteristics, headache, parafunctional habits and clicking sounds associated with the signs and symptoms of temporomandibular disorder in adolescents?

    Science.gov (United States)

    Lauriti, Leandro; Motta, Lara Jansiski; Silva, Paula Fernanda da Costa; Leal de Godoy, Camila Haddad; Alfaya, Thays Almeida; Fernandes, Kristianne Porta Santos; Mesquita-Ferrari, Raquel Agnelli; Bussadori, Sandra Kalil

    2013-10-01

    [Purpose] To assess the association between the oclusal characteristics, headache, parafunctional habits and clicking sounds and signs/symptoms of TMD in adolescents. [Subjects] Adolescents between 14 and 18 years of age. [Methods] The participants were evaluated using the Helkimo Index and a clinical examination to track clicking sounds, parafunctional habits and other signs/symptoms of temporomandibular disorder (TMD). Subjects were classified according to the presence or absence of headache, type of occlusion, facial pattern and type of bite. In statistical analyse we used the chi-square test and Fisher's exact test, with a level of significance of 5%. [Results] The sample was made up of 81 adolescents with a mean age of 15.64 years; 51.9% were male. The prevalence of signals/symptoms of TMD was 74.1%, predominantly affecting females. Signals/symptoms of TMD were significantly associated with clicking sounds, headache and nail biting. No associations were found between signals/symptoms of TMD and angle classification, type of bite and facial pattern. [Conclusion] Headache is one of the most closely associated symptoms of TMD. Clicking sounds were found in the majority of cases. Therefore, the sum of two or more factors may be necessary for the onset and perpetuation of TMD.

  7. Association between symptoms of temporomandibular disorders and gender, morphological occlusion, and psychological factors in a group of university students

    Directory of Open Access Journals (Sweden)

    Bonjardim Leonardo

    2009-01-01

    Full Text Available Aim: The purpose of this study was to find out the prevalence of temporomandibular disorder (TMD in a sample of university students and its relationship to gender, occlusion, and psychological factors. Materials and Methods: The sample comprised 196 subjects, aged 18-25 years. The TMD degree was evaluated using an anamnestic questionnaire. Morphologic occlusion was evaluated according to Angle classification (classes I, II, and III. The Hospital Anxiety and Depression Scale (HADS, a 14-item self-administered rating scale developed specifically to identify anxiety and depression in nonpsychiatric medical outpatients, was used to assess the levels of anxiety (HADSa and depression (HADSd. Statistical Analysis: The incidence of TMD level, malocclusion, anxiety, and depression in both genders was calculated as percentages. Association between TMD degree and occlusion, HADSa, and HADSd was tested using the Chi-square test. Results: According to our results, 50% of the subjects had TMD, but it was of moderate or severe degree in only 9.18% of them. No statistically significant association could be found between TMD and gender or occlusion. TMD was found to have statistically significant association with HADSa but not with HADSd. Conclusion : A high prevalence of TMD was found in this student population; however, most of the cases could be classified as mild. Of the variables studied, only HADSa had a statistically significant association with TMD.

  8. Análise da sintomatologia em pacientes com disfunções intra-articulares da articulação temporomandibular Analysis of symptomatology in patients with intra-articular disorders of the temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Sílvio Henrique de Paula DONEGÁ

    1997-01-01

    Full Text Available Foi realizado estudo analisando a sintomatologia em pacientes com disfunções intra-articulares da articulação temporomandibular. A queixa mais citada foi de dor na região pré-auricular (40,7%. Sintomatologia dolorosa articular (63,2% e ruídos articulares (83,3% foram os achados mais comuns ao exame clínico. Os ruídos articulares mais freqüentes foram os estalos (66,6%. Dor muscular ocorreu, em especial, nos músculos pterigóideo medial e lateral e na inserção do temporal. Houve decréscimo na amplitude para a protrusão dentre os movimentos mandibulares máximosThe study analyzed the symptomatology in patients with intra-articular disorders of the temporomandibular joint. The most frequent complaint was pain in the preauricular region (40.7%. Articular pain (63.2% and articular sounds (83.3% were the most common findings during clinical examination. Muscular pain occurred particularly in the medial and lateral pterygoid muscles and at the insertion of the temporalis muscle. The most frequent articular sound was clicking (66.6%. There was a decrease in extent of protrusion among the mandibular border positions.

  9. Assessment of temporomandibular joint disease.

    Science.gov (United States)

    Kostrzewa-Janicka, J; Mierzwinska-Nastalska, E; Jurkowski, P; Okonski, P; Nedzi-Gora, M

    2013-01-01

    The diagnosis of temporomandibular joint (TMJ) disorders consists of clinical (Reaserch Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD) and additional (computer tomography, CT or magnetic resonance imaging, and MRI) examinations. Due to the growing knowledge of pathologic changes within the TMJ, the researches become more aware of the difficulty in detection the early symptoms of disorders using conventional examination. Therefore, it is now expected that the collected samples of synovial fluid, serum, or urine samples could enable easier identification of inflammatory process course, and degenerative cartilage changes state.

  10. 弱激光治疗颞下颌关节紊乱病疼痛的研究进展%The research progress of low level laser therapy for temporomandibular disorders pain

    Institute of Scientific and Technical Information of China (English)

    徐高丽; 谷志远; 柳毅

    2015-01-01

    疼痛是颞下颌关节紊乱病患者最常见的临床表现之一,也是大多数人治疗颞下颌关节紊乱病的原因。弱激光在牙科领域的应用越来越广泛,且在颞下颌关节紊乱病治疗中的应用也越来越多,用来抗炎和缓解疼痛。本文对弱激光疗法在治疗颞下颌关节紊乱病疼痛机理方面进行概述。了解弱激光疗法的机制对弱激光治疗颞下颌关节紊乱病具有重要意义。%Pain is a symptom of temporomandibular disorders. It is also the reason for most people to treat temporomandibular disor-ders. Low-level laser is more and more widely applied in the field of dentistry,and is often used in the clinical treatment of temporoman-dibular joint pain for anti-inflammation and pain relief. In this paper,the mechanisms of the low-level laser therapy in treatment of tem-poromandibular disorders pain are summarized. Understanding its mechanism is of great significance for the clinical application of low-level laser in treating temporomandibular disorders.

  11. Alexithymic and somatisation scores in patients with temporomandibular pain disorder correlate with deficits in facial emotion recognition.

    Science.gov (United States)

    Haas, J; Eichhammer, P; Traue, H C; Hoffmann, H; Behr, M; Crönlein, T; Pieh, C; Busch, V

    2013-02-01

    Current studies suggest dysfunctional emotional processing as a key factor in the aetiology of temporomandibular disorder (TMD). Investigating facial emotion recognition (FER) may offer an elegant and reliable way to study emotional processing in patients with TMD. Twenty patients with TMD and the same number of age-, sex- and education-matched controls were measured with the Facially Expressed Emotion Labelling (FEEL) test, the 26-item Toronto Alexithymia Scale (TAS-26), the Screening for Somatoform Symptoms (SOMS-2a), the German Pain Questionnaire and the 21-item Hamilton Depression Rating Scale (HAMD). The patients had significantly lower Total FEEL Scores (P = 0·021) as compared to the controls, indicating a lower accuracy of FER. Furthermore, we were able to demonstrate significant group differences with respect to the following issues: patients were more alexithymic (P = 0·006), stated more somatoform symptoms (P < 0·004) and had higher depressive scores in the HAMD (P < 0·003). The factors alexithymia and somatisation could explain 31% (adjusted 27%) of the variance of the FEEL Scores in the sample. The estimation of the standardised regression coefficients suggests an equivalent influence of TAS-26 and SOMS-2a on the FEEL Scores, whereas 'group' (patients versus healthy controls) and depressive symptoms did not contribute significantly to the model. Our findings highlight FER deficits in patients with TMD, which are partially explained by concomitant alexithymia and somatisation. As suggested previously, impaired FER in patients with TMD may further point to probable aetiological proximities between TMD and somatoform disorders.

  12. Value of cone-beam computed tomography in the process of diagnosis and management of disorders of the temporomandibular joint.

    Science.gov (United States)

    de Boer, E W J; Dijkstra, P U; Stegenga, B; de Bont, L G M; Spijkervet, F K L

    2014-03-01

    The objective of this study was to assess the value of cone-beam computed tomographic (CT) images in the primary diagnosis and management of 128 outpatients with disorders of the temporomandibular joint (TMJ). Before a diagnosis was made and treatment planned, the history was taken, physical examination made, and the orthopantomogram studied. After assessment of the cone-beam CT, the oral and maxillofacial surgeon (specialist or resident) was allowed to revise the provisional primary diagnosis and management. The degree of certainty was rated by the clinician before and after the cone-beam CT had been assessed. The primary diagnosis was changed in 32 patients (25%), additional diagnostic procedures were changed in 57 (45%), and the treatment was changed in 15 (12%) (in 4 the treatment was changed to a (minimally) invasive procedure). A total of 74 patients (58%) had their diagnosis and management changed after the cone-beam CT had been assessed. Changes in diagnosis and management were clinically relevant in 9/32 and 9/61 patients, respectively. The clinician's certainty about the primary diagnosis increased after the cone-beam CT had been assessed in 57 patients. Logistic regression analysis showed that the odds in favour of changes in primary diagnosis and management increased when limited mandibular function was a primary symptom, the patient was taking medication for pain, and the articular eminence could not be assessed on OPT. Assessment of cone-beam CT led to changes in primary diagnosis and management in more than half the patients with disorders of the TMJ.

  13. Self-Reported bruxism and associated factors in Israeli adolescents.

    Science.gov (United States)

    Emodi Perlman, A; Lobbezoo, F; Zar, A; Friedman Rubin, P; van Selms, M K A; Winocur, E

    2016-06-01

    Little is known about the epidemiological characteristics of sleep and awake bruxism (SB and AB) in adolescents. The aims of the study were: to assess the prevalence rates of self-reported SB and AB in Israeli adolescents; to determine the associations between SB/AB and several demographical, exogenous and psychosocial factors in Israeli adolescents; and to investigate the possible concordance between SB and AB. The study made use of a questionnaire. The study population included 1000 students from different high schools in the centre of Israel. Prevalence of self-reported SB and AB in the Israeli adolescents studied was 9·2% and 19·2%, respectively. No gender difference was found regarding the prevalence of SB and AB. Multiple variable regression analysis revealed that the following predicting variables were related to SB: temporomandibular joint sounds (P = 0·002) and feeling stressed (P = 0·001). The following predicting variables were related to AB: age (P = 0·018), temporomandibular joint sounds (P = 0·002), oro-facial pain (P = 0·006), and feeling stressed (P = 0·002) or sad (P = 0·006). A significant association was found between SB and AB; that is, an individual reporting SB had a higher probability of reporting AB compared with an individual who did not report SB (odds ratio = 5·099). Chewing gum was the most common parafunction reported by adolescents. The results of this study demonstrate that self-reports of AB and SB are common in the Israeli adolescents population studied and are not related to gender. The significant correlation found between SB and AB may be a confounding bias that affects proper diagnosis of bruxism through self-reported questionnaires only.

  14. Relationships between craniofacial pain and bruxism.

    Science.gov (United States)

    Svensson, P; Jadidi, F; Arima, T; Baad-Hansen, L; Sessle, B J

    2008-07-01

    A still commonly held view in the literature and clinical practice is that bruxism causes pain because of overloading of the musculoskeletal tissue and craniofacial pain, on the other hand, triggers more bruxism. Furthermore, it is often believed that there is a dose-response gradient so that more bruxism (intensity, duration) leads to more overloading and pain. Provided the existence of efficient techniques to treat bruxism, it would be straightforward in such a simple system to target bruxism as the cause of pain and hence treat the pain. Of course, human biological systems are much more complex and therefore, it is no surprise that the relationship between bruxism and pain is far from being simple or even linear. Indeed, there are unexpected relationships, which complicate the establishment of adequate explanatory models. Part of the reason is the complexity of the bruxism in itself, which presents significant challenges related to operationalized criteria and diagnostic tools and underlying pathophysiology issues, which have been dealt with in other reviews in this issue. However, another important reason is the multifaceted nature of craniofacial pain. This review will address our current understanding of classification issues, epidemiology and neurobiological mechanisms of craniofacial pain. Experimental models of bruxism may help to further the understanding of the relationship between craniofacial pain and bruxism in addition to insights from intervention studies. The review will enable clinicians to understand the reasons why simple cause-effect relationships between bruxism and craniofacial pain are inadequate and the current implications for management of craniofacial pain.

  15. Self-assessment of pain and discomfort in patients with temporomandibular disorders: a comparison of five different scales with respect to their precision and sensitivity as well as their capacity to register memory of pain and discomfort.

    Science.gov (United States)

    Magnusson, T; List, T; Helkimo, M

    1995-08-01

    Five different scales of self-assessment of pain were tested in patients with temporomandibular disorders. The precision and sensitivity and the capacity to register memory of pain and discomfort were compared for each of the five scales. The behaviour rating scale was found to be superior to the other four scales in respect of precision and sensitivity to pain and discomfort and when recording the memory of these two variables. This scale was also considered by the patients to be the most relevant and the simplest to understand. From these results, the behaviour rating scale can be recommended when measuring pain and discomfort in patients with temporomandibular disorders.

  16. Trigeminal Electrophysiology: a 2 × 2 matrix model for differential diagnosis between temporomandibular disorders and orofacial pain

    Directory of Open Access Journals (Sweden)

    Chessa Giacomo

    2010-07-01

    Full Text Available Abstract Background Pain due to temporomandibular disorders (TMDs often has the same clinical symptoms and signs as other types of orofacial pain (OP. The possible presence of serious neurological and/or systemic organic pathologies makes differential diagnosis difficult, especially in early disease stages. In the present study, we performed a qualitative and quantitative electrophysiological evaluation of the neuromuscular responses of the trigeminal nervous system. Using the jaw jerk reflex (JJ and the motor evoked potentials of the trigeminal roots (bR-MEPs tests, we investigated the functional and organic responses of healthy subjects (control group and patients with TMD symptoms (TMD group. Method Thirty-three patients with temporomandibular disorder (TMD symptoms and 36 control subjects underwent two electromyographic (EMG tests: the jaw jerk reflex test and the motor evoked potentials of the trigeminal roots test using bilateral electrical transcranial stimulation. The mean, standard deviation, median, minimum, and maximum values were computed for the EMG absolute values. The ratio between the EMG values obtained on each side was always computed with the reference side as the numerator. For the TMD group, this side was identified as the painful side (pain side, while for the control group this was taken as the non-preferred masticatory side (non-preferred side. The 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles were also calculated. Results Analysis of the ratios (expressed as percentages between the values obtained on both sides revealed a high degree of symmetry in the bR-MEPs % in the control (0.93 ± 0.12% and TMD (0.91 ± 0.22% groups. This symmetry indicated organic integrity of the trigeminal root motor fibers and correct electrode arrangement. A degree of asymmetry of the jaw jerk's amplitude between sides (ipJJ%, when the mandible was kept in the intercuspal position, was found in the TMD group (0.24% ± 0.14% with a

  17. Gender Difference in Associations between Chronic Temporomandibular Disorders and General Quality of Life in Koreans: A Cross-Sectional Study.

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    Tae-Yoon Kim

    Full Text Available Chronic temporomandibular disorder (TMD is known to have strong correlations with psychological factors and to display gender disparity. However, while chronic TMD is known to affect quality of life, large-scale studies investigating the influence on quality of life by gender are scarce.This cross-sectional study assessed the data of 17,198 participants aged ≥19 years who completed chronic TMD and EuroQol-5 Dimension sections in the 4th Korean National Health and Nutrition Examination Survey (2007-2009. We adjusted for covariates (health behavior, sociodemographic factors in regression analysis for complex sampling design to calculate regression coefficients and 95% CIs for gender difference in the association between chronic TMD and quality of life. We also evaluated which covariates of somatic health, mental health, health behavior, and sociodemographic factors weakened the relationship between TMD and EQ-5D.Prevalence of chronic TMD was 1.6% (men 1.3%, women 1.8%, and chronic TMD persisted to negatively impact quality of life even after adjusting for confounding variables. Low sociodemographic factors and health behavior had a negative effect on quality of life. Somatic health and mental health were most affected by chronic TMD. As for quality of life, women were affected to a greater extent than men by TMD. Women were more affected by osteoarthritis and general mental health (stress, depressive symptoms, and thoughts of suicide, and men by employment.These results imply that chronic diseases and psychological factors are important in chronic TMD, and that there may be physiological and pathological gender differences in TMD.

  18. Association of malocclusion and functional occlusion with temporomandibular disorders (TMD) in adults: a systematic review of population-based studies.

    Science.gov (United States)

    Gesch, Dietmar; Bernhardt, Olaf; Kirbschus, Antje

    2004-03-01

    The aim of this systematic review of population-based studies was to establish whether or not associations exist between different types of malocclusions, as well as factors of functional occlusion (eg, occlusal interferences, nonworking-side occlusal contacts) and temporomandibular disorders (TMD) in adults 20 years or older. Defined criteria were employed in the search of MEDLINE and EMBASE databases, as well as in a manual search. Finally, using inclusion criteria (eg, random sampling from residents' registration office files or census lists, adequate response rates), out of 22 preselected studies, four relevant population-based studies on this subject were found. Eighteen studies were excluded because of insufficient description of material and methods (eg, lack or unclear description of sample method, randomization, age distribution), mixed under- and over-20-year-old study population, or different outcome of interest (eg, tooth loss, dentures). The methodologic quality of the selected studies was established with a quality assessment list. The average total methodologic score achieved was 43 out of a possible 100 points. Few associations were reported between malocclusion and parameters of functional occlusion and clinical as well as subjective TMD, and these associations were not uniform. No particular morphologic or functional occlusal factor became apparent. Additionally, the occlusal factors found were partly protective for TMD, ie, subjects with these occlusal parameters showed fewer signs and symptoms of TMD (angle Class II malocclusion, deep bite, anterior crossbite). A positive relationship was only described in two cases-between the number of rotated lateral teeth and subjective symptoms of dysfunction, and between excessive abrasions and clinical dysfunction. In neither case, however, was the strength of the correlation given. In summary, few associations were established between malocclusion or functional occlusion and signs and symptoms of TMD. In

  19. Associations among temporomandibular disorders, chronic neck pain and neck pain disability in computer office workers: a pilot study.

    Science.gov (United States)

    Bragatto, M M; Bevilaqua-Grossi, D; Regalo, S C H; Sousa, J D; Chaves, T C

    2016-05-01

    Neck pain is the most common musculoskeletal complaint among computer office workers. There are several reports about the coexistence of neck pain and temporomandibular disorders (TMD). However, there are no studies investigating this association in the context of work involving computers. The purpose of this study was to verify the association between TMD and neck pain in computer office workers. Fifty-two female computer workers who were divided into two groups: (i) those with self-reported chronic neck pain and disability (WNP) (n = 26) and (ii) those without self-reported neck pain (WONP) (n = 26), and a control group (CG) consisting of 26 women who did not work with computers participated in this study. Clinical assessments were performed to establish a diagnosis of TMD, and craniocervical mechanical pain was assessed using manual palpation and pressure pain threshold (PPT). The results of this study showed that the WNP group had a higher percentage of participants with TMD than the WONP group (42·30% vs. 23·07%, χ(2) = 5·70, P = 0·02). PPTs in all cervical sites were significantly lower in the groups WNP and WONP compared to the CG. Regression analysis revealed TMD, neck pain and work-related factors to be good predictors of disability (R(2) = 0·93, P neck disability in computer workers is explained by the association among neck pain, TMD and unfavourable workplace conditions. Consequently, this study attempted to emphasise the importance of considering work activity for minimising neck pain-related disability.

  20. Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

    Science.gov (United States)

    2010-01-01

    Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs). However, a recent report described a discrepancy between the habitual occlusal position (HOP) and the bite plate-induced occlusal position (BPOP) and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP) as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI) and the Helkimo Clinical Dysfunction Index (CDI) before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p 0.1). Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted. PMID:20346167

  1. Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

    Directory of Open Access Journals (Sweden)

    Chiwata Ichiro

    2010-03-01

    Full Text Available Abstract Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs. However, a recent report described a discrepancy between the habitual occlusal position (HOP and the bite plate-induced occlusal position (BPOP and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI and the Helkimo Clinical Dysfunction Index (CDI before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p 0.1. Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted.

  2. Ortodontia como fator de risco para disfunções temporomandibulares: uma revisão sistemática Orthodontics as risk factor for temporomandibular disorders: a systematic review

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    Eduardo Machado

    2010-12-01

    Full Text Available INTRODUÇÃO: nos últimos anos, a inter-relação entre a Ortodontia e as disfunções temporomandibulares (DTMs tem despertado interesse crescente na classe odontológica, sendo tema de discussões e controvérsias. Em um passado recente, a oclusão era considerada como principal fator etiológico das DTMs, sendo o tratamento ortodôntico uma medida terapêutica primária para um restabelecimento fisiológico do sistema estomatognático. Assim, passou-se a investigar o papel da Ortodontia na prevenção, desencadeamento e tratamento das DTMs. Com a realização de estudos científicos com metodologias mais rigorosas e precisas, a relação entre o tratamento ortodôntico e as DTMs pôde ser avaliada e questionada dentro de um contexto baseado em evidências científicas. OBJETIVO: o presente trabalho, através de uma revisão sistemática de literatura, teve como objetivo analisar a inter-relação entre a Ortodontia e as DTMs, verificando se o tratamento ortodôntico é fator contribuinte para o desenvolvimento de DTM. MÉTODOS: foi realizado um levantamento em bases de pesquisa (Medline, Cochrane, Embase, Pubmed, Lilacs e BBO entre os anos de 1966 e 2009, com enfoque em estudos clínicos randomizados, estudos longitudinais prospectivos não randomizados, revisões sistemáticas e meta-análises. RESULTADOS: após a aplicação dos critérios de inclusão, chegou-se a 18 artigos, sendo que 12 eram estudos longitudinais prospectivos não randomizados, 4 revisões sistemáticas, 1 estudo clínico randomizado e uma meta-análise, os quais avaliaram a relação entre tratamento ortodôntico e DTM. CONCLUSÕES: pela análise da literatura, conclui-se que o tratamento ortodôntico não pode ser considerado fator contribuinte para o desenvolvimento de disfunções temporomandibulares.INTRODUCTION: The interrelationship between Orthodontics and temporomandibular disorders (TMD has attracted an increasing interest in Dentistry in the last years

  3. Hiperplasia coronoidea bilateral: Una rara patología causante de disfunción temporomandibular Bilateral coronoid hyperplasia: An uncommon pathology cause of temporomandibular disorders

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    A. Eguia del Valle

    2011-10-01

    Full Text Available La hiperplasia coronoidea es una condición patológica muy poco frecuente, caracterizada por un crecimiento exagerado de la apófisis coronoides mandibular unilateral o bilateral. Desde la primera descripción realizada por Langenbeck a mediados del siglo XIX han aparecido descritos ocasionalmente en la literatura nuevos casos de esta rara alteración. Aunque en ocasiones es asintomática, su principal manifestación clínica es la restricción de la movilidad mandibular, principalmente en los movimientos de apertura y protrusión. Dicha limitación se debe a la impactación de la apófisis coronoides con el hueso cigomático. En este trabajo se presenta el caso clínico de un varón de 30 años de edad sin antecedentes médicos de interés que acude a consulta por un cuadro de limitación de apertura progresiva y dolor en la región temporomandibular. Tras la exploración, el empleo de técnicas radiológicas convencionales y especiales permitieron confirmar el diagnóstico de hiperplasia coronoidea bilateral. Así mismo, en este trabajo se recogen los principales aspectos clinicopatológicos y diagnósticos de esta alteración. Se realiza un repaso de los aspectos más importantes en el diagnóstico diferencial de los procesos que cursan con limitación de la apertura bucal. Dentro de este diagnóstico diferencial, y a pesar de su baja prevalencia, debe incluirse esta patología.Coronoid hyperplasia is an uncommon pathology characterized by an excessive uni or bilateral growth of the mandibular coronoid process. Since the first description by Langenbeck in the middle of the XIX century, many cases have been reported in the literature. In some cases patients are asymptomatic. Nevertheless, in most of them a limitation in the mouth movements can be observed, especially during the opening and protrusion movements. This limitation is caused by the impact of the coronoid process with the zigomatic bone. In this paper we present the case of a 30

  4. Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder Avaliação radiográfica da coluna cervical de indivíduos com distúrbios internos da articulação temporomandibular

    OpenAIRE

    2004-01-01

    Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were...

  5. Confiabilidade de um formulário para diagnóstico da severidade da disfunção temporomandibular Reliability of a questionnaire for diagnosing the severity of temporomandibular disorder

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    JADB Campos

    2009-02-01

    Full Text Available CONTEXTUALIZAÇÃO: Disfunção temporomandibular (DTM é um termo coletivo que engloba vários problemas clínicos envolvendo a musculatura da mastigação, as articulações temporomandibulares (ATM e suas estruturas associadas, com alta prevalência nas populações. OBJETIVOS: Sabendo-se que estudos brasileiros vêm utilizando o instrumento proposto por Da Fonseca et al. (1994 para diagnóstico da severidade desta disfunção, realizou-se este estudo com o objetivo de verificar e estimar a consistência interna e a reprodutibilidade do mesmo. MÉTODOS: O delineamento amostral adotado foi o probabilístico, e participaram 1230 indivíduos moradores da cidade de Ribeirão Preto (SP, maiores de 18 anos de idade. As entrevistas foram realizadas por um único entrevistador por meio de ligações telefônicas. Para estudo da consistência interna, calculou-se o Coeficiente de Kuder-Richardson (kr-20 e para estimar a reprodutibilidade, utilizou-se a estatística Kappa (κ. RESULTADOS: A consistência interna do formulário foi de 0,5594, apontando para uma validação abaixo do desejado. Observou-se maior contribuição das questões 1, 2, 3, 6 e 7 para o coeficiente kr-20 total e maior consistência do instrumento quando composto apenas pelas mesmas (0,7044. Observou-se reprodutibilidade "Boa" e "Ótima" para as questões. CONCLUSÕES: Frente ao exposto, sugere-se que o formulário proposto por Da Fonseca et al. (1994 seja adaptado, ficando composto apenas pelas questões 1, 2, 3, 6 e 7 da versão inicial, colaborando, assim, para aumento da confiabilidade do instrumento. Deve-se ressaltar ainda a necessidade da realização de estudos de validade para assegurar adequadas características psicométricas à nova versão do instrumento.BACKGROUND: Temporomandibular disorder (TMD is a collective term that encompasses many clinical problems involving the masticatory muscles, temporomandibular joints (TMJ and associated structures and it has high

  6. Does playing a musical instrument impose a risk for temporomandibular disorders? A review of literature: Stellt das Spielen eines Instruments ein Risiko für kraniomandibuläre Dysfunktionen dar? Eine Übersichtsarbeit

    NARCIS (Netherlands)

    M.K.A. van Selms; M.M. Attallah; C.M. Visscher; J. Ahlberg; F. Lobbezoo

    2015-01-01

    Playing a musical instrument that loads the masticatory system, such as the violin or oboe, has been suggested to be part of the group of etiological factors for temporomandibular disorders (TMDs). In 2014, a review of literature was published that explicitly focused on the possible association betw

  7. Temporomandibular disorders due to improper surgical treatment of mandibular fracture: clinical report.

    Science.gov (United States)

    Mortellaro, Carmen; Rimondini, Lia; Farronato, Giampietro; Garagiola, Umberto; Varcellino, Vittorio; Berrone, Mattia

    2006-03-01

    A case of mandibular fracture surgically consolidated in a wrong position resulting in craniomandibular disorders is reported. The inadequate surgical alignment of the healed bony segments caused a malocclusion. This changed the original neuromuscular system such that compensatory mechanisms began to change the whole balance of the organism. The patient presented a mandibular crossbite, an asymmetry of the face, and extensive alteration of muscular, articular, and postural function. The bony malunion and malocclusion were treated using an interdisciplinary surgical-orthodontic treatment for correcting functional disorders and aesthetic deformity. Electromyography and computerized mandibular scanning were used to evaluate improvement of the muscular activity, during rest and function, and of the mandibular kinesiology. Timing of surgical treatment and adequate fixation and immobilization of fracture segments are very important to avoid complications such as infection, delayed union, nonunion, malunion, skeletal discrepancies, nerve injury, and (rarely) ankylosis. The surgical approach should be based on the general criteria of traumatologic therapy, restoring the original bone shape and the right occlusal relations as soon as possible.

  8. Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects

    Science.gov (United States)

    Kuzmanovic Pficer, Jovana; Dodic, Slobodan; Lazic, Vojkan; Trajkovic, Goran

    2017-01-01

    Background Psychological discomfort, physical disability and functional limitations of the orofacial system have a major impact on everyday life of patients with temporomandibular disorders (TMDs). In this study we sought to determine short and long term effects of stabilization splint (SS) in treatment of TMDs, and to identify factors influencing its efficacy. Methods MEDLINE, Web of Science and EMBASE were searched for randomized controlled trials (RCTs) comparing SS to: non-occluding splint, occlusal oral appliances, physiotherapy, behavioral therapy, counseling and no treatment. Random effects method was used to summarize outcomes. The effect estimates were expressed as odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval. Subgroup analyses were carried out according to the use of Research Diagnostic Criteria (RDC/TMD) and TMDs origin. Strength of evidence was assessed by GRADE. Meta-regression was applied. Results Thirty three eligible RCTs were included in meta-analysis. In short term, SS presented positive overall effect on pain reduction (OR 2.08; p = 0.01) and pain intensity (SMD -0.33; p = 0.02). Subgroup analyses confirmed SS effect in studies used RDC/TMD and revealed its effect in patients with TMDs of muscular origin. Important decrease of muscle tenderness (OR 1.97; p = 0.03) and improvement of mouth opening (SMD -0.30; p = 0.04) were found. SS in comparison to oral appliances showed no difference (OR 0.74; p = 0.24). Meta-regression identified continuous use of SS during the day as a factor influencing efficacy (p = 0.01). Long term results showed no difference in observed outcomes between groups. Low quality of evidence was found for primary outcomes. Conclusion SS presented short term benefit for patients with TMDs. In long term follow up, the effect is equalized with other therapeutic modalities. Further studies based on appropriate use of standardized criteria for patient recruitment and outcomes under assessment

  9. Laser Therapy and Occlusal Stabilization Splint for Temporomandibular Disorders in Patients With Fibromyalgia Syndrome: A Randomized, Clinical Trial.

    Science.gov (United States)

    Molina-Torres, Guadalupe; Rodríguez-Archilla, Alberto; Matarán-Peñarrocha, Guillermo; Albornoz-Cabello, Manuel; Aguilar-Ferrándiz, María Encarnación; Castro-Sánchez, Adelaida María

    2016-09-01

    Context • Patients with fibromyalgia syndrome (FMS) report frequent and severe symptoms from temporomandibular disorders (TMDs). The appropriate treatment of TMDs remains controversial. No studies have occurred on the efficacy of therapy with a laser or an occlusal stabilization splint in the treatment of TMDs in patients with FMS. Objective • The study intended to investigate the therapeutic effects of laser therapy and of an occlusal stabilization splint for reducing pain and dysfunction and improving the quality of sleep in patients with TMDs and FMS. Design • The research team designed a single-blinded, randomized clinical trial. Setting • The study took place in the research laboratory at the University of Granada (Granada, Spain). Participants • Participants were 58 women and men who had been diagnosed with FMS and TMDs and who were referred from the clinical setting. Intervention • Participants were randomly assigned to the occlusal-splint or the laser group. The laser group received a treatment protocol in which laser therapy was applied to the participant's tender points, and the occlusal-splint group underwent a treatment protocol in which an occlusal stabilization splint was used. Both groups underwent treatment for 12 wk. Outcomes Measures • Pain intensity, widespread pain, quality of sleep, severity of symptoms, active and passive mouth opening, and joint sounds were assessed in both groups at baseline and after the last intervention. The measurements used were (1) a visual analogue scale (VAS), (2) the Widespread Pain Index (WPI), (3) the Symptom Severity Scale (SSS), (4) the Patient's Global Impression of Change (PGIC), (5) the Pittsburgh Quality of Sleep Questionnaire Index (PSQI), (6) an assessment of the number of tender points, (7) a measurement of the active mouth opening, (8) a measurement of the vertical overlap of the incisors, and (9) the measurement of joint sounds during mouth opening and closing. Results • The group X time

  10. Implant rehabilitation in bruxism patient

    Science.gov (United States)

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas

    2014-01-01

    A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported. PMID:24907215

  11. Principles for the management of bruxism

    NARCIS (Netherlands)

    Lobbezoo, F.; van der Zaag, J.; van Selms, M.K.A.; Hamburger, H.L.; Naeije, M.

    2008-01-01

    The management of bruxism has been the subject of a large number of studies. A PubMed search, using relevant MeSH terms, yielded a total of 177 papers that were published over the past 40 years. Of these papers, 135 were used for the present review. Apparently, research into bruxism management is se

  12. Are bruxism and the bite causally related?

    NARCIS (Netherlands)

    Lobbezoo, F.; Ahlberg, J.; Manfredini, D.; Winocur, E.

    2012-01-01

    In the dental profession, the belief that bruxism and dental (mal-)occlusion (‘the bite’) are causally related is widespread. The aim of this review was to critically assess the available literature on this topic. A PubMed search of the English-language literature, using the query ‘Bruxism [Majr] AN

  13. Bruxism and associated factors among Dutch adolescents

    NARCIS (Netherlands)

    M.K.A. van Selms; C.M. Visscher; M. Naeije; F. Lobbezoo

    2013-01-01

    Objectives To assess the prevalence rates of self-reported sleep bruxism and awake bruxism and their associations with several demographical, exogenous, and psychosocial factors among Dutch adolescents. Methods In a cross-sectional questionnaire survey, 4285 questionnaires were completed, with an ab

  14. Implant rehabilitation in bruxism patient

    OpenAIRE

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline [UNESP; da Silva, Emily Vivianne Freitas

    2014-01-01

    A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocol...

  15. 成人正畸治疗与颞下颌关节紊乱病的MRI研究%Correlations between temporomandibular disorder and orthodontic treatment in adult patients

    Institute of Scientific and Technical Information of China (English)

    蹇敦翃; 王汝玲; 郭海鹰; 王立振

    2012-01-01

    Objective To investigate the correlations between temporomandibular disorder(TMD)and orthodontic treatment in adult patients.Methods Sixty adult orthodontic patients,aged from 20 to 29 years old,were divided into two groups according to Helkimo index.Group Ai =0 included 44 patients.Group Ai =Ⅰ included 16 patients.Before and after orthodontic treatment,temporomandibular joint disc positions were measured in MRI images.According to Helkimo index,the function of temporomandibular joint (TMJ) was evaluated.Results The incidence of TMD in Group Ai =Ⅰ (8/16) was much higher than in Group Ai =0 (9/44) (P < 0.05).The anterior displacements of the temporomandibular joint disc were found.After orthodontic treatment,anterior space area of TMJ was increased and posterior space area was reduced(P > 0.05).Conclusions Orthodontic treatment couldn't cause TMD,but it might induce and aggravate the symptoms of TMJ.%目的 探讨成人正畸治疗与颞下颌关节紊乱病(temporomandibular disorder TMD)的关系,为预防和治疗TMD提供参考.方法 选择60例20 ~ 29岁成年正畸患者,用Helkimo指数将患者分为TMJ无症状组(44例)、TMJ有症状组(16例),分别于治疗前(t1)、治疗中(t2)、治疗后(t3),用MRI检查TMJ关节盘的位置,并用电子测量尺测量TMJ前、后间隙,观察颞下颌关节在治疗前后的变化情况与TMD间的关系.结果 治疗中TMJ无症状组、TMJ有症状组分别有8、9例患者发生TMD,两组TMD发生比例差异有统计学意义(P<0.05);治疗前后两组均发现关节盘移位;两组治疗前后TMJ各间隙线距发生改变,但两组差异无统计学意义(P>0.05).结论 成人正畸治疗不会导致TMD,但治疗过程中可诱发TMD症状,并有出现TMD重度症状的风险.在成人正畸治疗前对TMJ进行评估有重要意义.

  16. Prevalence study of signs and symptoms of temporomandibular disorder in Brazilian college students Prevalência de sinais e sintomas de disfunção temporomandibular em universitários brasileiros

    Directory of Open Access Journals (Sweden)

    Anamaria Siriani de Oliveira

    2006-03-01

    Full Text Available The aim of this study was to evaluate the prevalence and severity of temporomandibular disorders (TMD in Brazilian college students. A questionnaire was administered to 2,396 students. Seventy-three percent of women (mean age 21.94 ± 5 years and 27% of men (mean age 22.41 ± 4.8 years answered the questionnaire. The anamnestic index was used to classify the volunteers according to TMD severity degree. The results showed a higher percentage of men without TMD (43.74% (p 0.05. The results indicated TMD prevalence in Brazilian college students similar to that presented in other studies found in the literature reviewed. Longitudinal studies are recommended to follow the prevalence and health care needs in this population.O objetivo deste estudo foi avaliar a prevalência e a severidade da disfunção temporomandibular (DTM em universitários brasileiros. Participaram do estudo 2.396 estudantes. Responderam ao questionário 73% de mulheres (21,94 ± 5 anos e 27% de homens (22,41 ± 4,8 anos. O índice anamnésico foi utilizado para classificar os voluntários por nível de severidade da DTM. Os resultados mostraram uma maior porcentagem de homens sem DTM (43,74% (p < 0,05 teste Qui-quadrado. As mulheres mostraram algum nível de severidade (73,03% com maior freqüência que os homens (56,26%. Não foram evidenciadas diferenças de freqüência entre os sexos classificados com DTM de mesma severidade. Os resultados indicam que a prevalência de DTM em universitários brasileiros é semelhante à de outros trabalhos presentes na literatura. Estudos longitudinais são necessários para acompanhar a prevalência e a necessidade de tratamento nessa população.

  17. Tomographic evaluation of TMJ in adolescents with temporomandibular disorders Avaliação tomográfica da ATM em adolescentes com disfunção temporomandibular

    Directory of Open Access Journals (Sweden)

    Luciano José Pereira

    2004-09-01

    Full Text Available This study evaluated the TMJ images of normal subjects and of those who presented TMD (temporomandibular disorders using linear tomography at rest position. Craniomandibular Index (CMI and a questionnaire on subjective symptoms were used to assess 217 subjects aged 12 to 18 years. Those with the highest and the lowest scores were divided into Control (n = 20 and TMD groups (n = 20, respectively. Corrected tomography was used to measure the narrowest anterior, superior and posterior joint spaces, to determine the condyle position in all 40 subjects. The distance means did not correlate with CMI scores (p > 0.05. The number of posteriorly positioned condyles was significantly higher in TMD patients (p = 0.05, especially in females. It was concluded that condyle position in linear tomography at rest position cannot yield TMD diagnosis.O objetivo deste estudo foi avaliar imagens da ATM de indivíduos portadores e não portadores de distúrbios temporomandibulares (DTM, através da tomografia linear corrigida na posição de repouso. Foram avaliados 217 adolescentes com idade entre 12 e 18 anos através do Índice Craniomandibular (CMI e de questionário de sintomas subjetivos. Foram selecionados 40 indivíduos com escores extremos, 20 sem DTM e 20 com DTM, para a formação dos grupos controle e DTM, respectivamente. Os espaços articulares anterior, superior e posterior foram mensurados pela tomografia corrigida, tendo como referência a região de menor comprimento subjetivo, determinando a posição condilar. As médias das distâncias não se correlacionaram com os escores do CMI (p > 0,05. O número de côndilos posteriorizados foi significativamente maior nos pacientes com DTM (p = 0,05, principalmente no sexo feminino. Concluímos que a posição condilar na posição de repouso não pode predizer diagnóstico de DTM.

  18. Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol

    Science.gov (United States)

    2014-01-01

    Background Bruxism is a disorder of jaw-muscle activity characterised by repetitive clenching or grinding of the teeth which results in discomfort and damage to dentition. The two clinical manifestations of the condition (sleep and awake bruxism) are thought to have unrelated aetiologies but are palliated using similar techniques. The lack of a definitive treatment has prompted renewed interest in biofeedback, a behaviour change method that uses electronic detection to provide a stimulus whenever bruxism occurs. This systematic review aims to provide a comprehensive overview of the state of research into biofeedback for bruxism; to assess the efficacy and acceptability of biofeedback therapy in management of awake bruxism and, separately, sleep bruxism in adults; and to compare findings between the two variants. Methods A systematic review of published literature examining biofeedback as an intervention directed at controlling primary bruxism in adults. We will search electronic databases and the grey literature using a predefined search strategy to identify randomised and non-randomised studies, technical reports and patents. Searches will not be restricted by language or date and will be expanded through contact with authors and experts, and by following up reference lists and citations. Two authors, working independently, will conduct screening of search results, study selection, data extraction and quality assessment and a third will resolve any disagreements. The primary outcomes of acceptability and effectiveness will be assessed using only randomised studies, segregated by bruxism subtype. A meta-analysis of these data will be conducted only if pre-defined conditions for quality and heterogeneity are met, otherwise the data will be summarized in narrative form. Data from non-randomised studies will be used to augment a narrative synthesis of the state of technical developments and any safety-related issues. PROSPERO registration number: CRD42013006880

  19. Evaluation of the signs and symptoms of temporomandibular disorders in children with headaches Avaliação dos sinais e sintomas de disfunções temporomandibulares em crianças com cefaléias

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    Fernanda Mara de Paiva Bertoli

    2007-06-01

    Full Text Available PURPOSE: The purpose of this study was to evaluate the presence of signs and symptoms of temporomandibular disorders (TMD in children with headaches in a neuropediatric ambulatory. METHOD: Fifty patients between 4 and 18 years of age were examined: 31 had headaches (24 migraine, 4 tension type and 3 unspecific headache and 19 formed the control group. The data collection was comprised of a structured questionnaire answered by the children's parents, and a subjective evaluation about the children’s emotional state. A specific questionnaire for TMD was applied, followed by a clinical dental examination of the children. As signs of TMD, mouth opening limitation, mandibular trajectory deviation in opening mouth, and joint noise were considered. As symptoms, pain on palpation of masseter and temporal muscles and on the poromandibular joint. RESULTS: A significant increase in signs and symptoms of TMD was found in patients with headaches when compared to the control group. There was also a significant difference in signs and symptoms of TMD according to age (increased with age and emotional state (tense> calm. CONCLUSION: There is a higher frequency of TMD in pediatric patients with headaches; thus, it is important to look for TMD signs and symptoms in this population.OBJETIVO: Avaliar a presença de sinais e sintomas de disfunção temporomandibular (DTM em crianças com cefaléias em um ambulatório de neuropediatria. MÉTODO: Foram examinados 50 pacientes com idade entre 4 e 18 anos, 31 com cefaléias (24 com enxaqueca, 4 com cefaléia tensional e 3 com cefaléia inespecífica e 19 do grupo controle. Os dados compreenderam um questionário estruturado respondido pelos pais e uma avaliação subjetiva sobre o estado emocional das crianças. Foi aplicado um questionário específico para DTM e realizado um exame clínico dental. Foram considerados como sinais de DTM: limitação da abertura bucal, desvio da trajetória ao abrir a boca e ru

  20. Effect of trazodone on sleep bruxism in children and adolescents 6-18 years of age, a pilot study

    Directory of Open Access Journals (Sweden)

    Fereshteh Shakibaei

    2008-02-01

    Full Text Available

    • BACKGROUND: Sleep bruxism is a common sleep disorder with unclear etiology and no definitive treatment. Recent
    • suggested medications are not often practically used due to their numerous limitations. Based on the fact that sleep bruxism occurs most often in the second stage of non-REM sleep, this study aimed to assess the effect of trazodone on sleep bruxism.
    • METHODS: This pilot study was conducted as a before-after design on 28 children and adolescents with 6-18 years of age suffering from sleep bruxism referring by children and adolescents mental health clinic, children dental specialists and pediatricians. The treatment started with 0.5mg/kg/day. In non-responders, it was weekly added by 0.5 mg/kg/day (with optimum of 2 mg/kg/day. Frequency of bruxism and related morning face/jaw pain were assessed daily from two weeks before (baseline to four weeks after starting the intervention by the parents/roommate.
    • RESULTS: Findings showed a significant reduction in the frequency of both bruxism and related morning pain from baseline to the 2nd and the 4th weeks of the intervention (P<0.001. Minor side effects such as drowsiness, nausea and dry mouth were seen among approximately one-third of the patients. These side effects were self-limited and tolerable.
    • CONCLUSIONS: Trazodone could be effective in reducing the frequency of sleep bruxism and its related morning face/jaw pain. Well-designed placebo-controlled trials are needed to confirm the results.
    • KEY WORDS: Sleep bruxism, trazodone, teeth clenching, teeth grinding.

  1. Current status of temporomandibular joint disorders and the therapeutic system derived from a series of biomechanical, histological, and biochemical studies

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    Kazuo Tanne

    2015-01-01

    Full Text Available This article was designed to report the current status of temporomandibular joint disorders (TMDs and the therapeutic system on the basis of a series of clinical, biomechanical, histological and biochemical studies in our research groups. In particular, we have focused on the association of degenerative changes of articular cartilage in the mandibular condyle and the resultant progressive condylar resorption with mechanical stimuli acting on the condyle during the stomatognathic function. In a clinical aspect, the nature and prevalence of TMDs, association of malocclusion with TMDs, association of condylar position with TMDs, association of craniofacial morphology with TMDs, and influences of TMDs, TMJ-osteoarthritis (TMJ-OA in particular, were examined. In a biomechanical aspect, the nature of stress distribution in the TMJ from maximum clenching was analyzed with finite element method. In addition, the pattern of stress distribution was examined in association with varying vertical discrepancies of the craniofacial skeleton and friction between the articular disk and condyle. The results demonstrated an induction of large compressive stresses in the anterior and lateral areas on the condyle by the maximum clenching and the subsequent prominent increases in the same areas of the mandibular condyle as the vertical skeletal discrepancy became more prominent. Increase of friction at the articular surface was also indicated as a cause of larger stresses and the relevant disk displacement, which further induced an increase in stresses in the tissues posterior to the disks, indicating an important role of TMJ disks as a stress absorber. In a histological or biological aspect, increase in TMJ loading simulated by vertical skeletal discrepancy, which has already been revealed by the preceding finite element analysis or represented by excessive mouth opening, produced a decrease in the thickness of cartilage layers, an increase in the numbers of

  2. 三种物理因子治疗颞下颌关节紊乱的疗效观察%Three Kinds of Physical Factors in the Treatment of Temporomandibular Disorders Curative Effect Observation/

    Institute of Scientific and Technical Information of China (English)

    王学智

    2013-01-01

      目的:对比观察三种物理因子在治疗颞下颌关节紊乱方面的疗效.方法:对246例颞下颌关节紊乱患者随机分组,分别给予超声波治疗、短波治疗、电磁治疗,并将三组分别对照观察,分析三种物理因子在治疗颞下颌关节紊乱方面的痊愈显效率.结果:超声波治疗组治疗颞下颌关节紊乱的痊愈显效率明显高于电磁治疗组及短波治疗组,经统计学处理差异有统计学意义(P<0.01).结论:超声波治疗颞下颌关节紊乱的痊愈显效率明显高于电磁治疗组及短波治疗组,为颞下颌关节紊乱的物理治疗提供优选物理因子的依据.%Objective:To compare the three kinds of physical factors in the treatment of temporomandibular disorders in terms of efficacy. Methods:246 cases of patients with temporomandibular disorders randomized,respectively,ultrasonic treatment,HF treatment,electromagnetic therapy,and the three groups were observed,analyzed three kinds of physical factors in the treatment of temporomandibular joint disorder recovery rate. Results:Ultrasonic of therapy in temporomandibular joint disorders recovered significantly higher efficiency of electromagnetic therapy group and short wave therapy group,Differences were statistically significant (P<0.01).Conclusion:Ultrasonic treatment of temporomandibular joint disorder cure significant efficiency was significantly higher than that of electromagnetic therapy group and short wave therapy group for temporomandibular disorders,physical therapy provides a preferred basis physical factor.

  3. Medical image of the week: sleep bruxism

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    Bartell J

    2015-03-01

    Full Text Available No abstract available. Article truncated at 150 words. A 42 year-old man with a past medical history of insomnia, post-traumatic stress disorder, depression and both migraine and tension headaches was referred for an overnight sleep study. He had presented to the sleep clinic with symptoms of obstructive sleep apnea. Medications included sumatriptan, amitryptiline, sertraline, and trazodone. His sleep study showed: sleep efficiency of 58.2%, apnea-hypopnea index of 33 events per hour, and arousal index of 14.5/hr. Periodic limb movement index was 29.2/hr. The time spent in the sleep stages included N1 (3.6%, N2 (72.5%, N3 (12.9%, and REM (10.9%. Figure 1 is representative of the several brief waveforms seen on his EEG and chin EMG. Sleep bruxism (SB is a type of sleep-related movement disorder that is characterized by involuntary masticatory muscle contraction resulting in grinding and clenching of the teeth and typically associated with arousals from sleep (1,2. The American academy of sleep medicine (AASM criteria for ...

  4. Electromyography evaluation of the trapezius, sternocleidomastoid and suprahyoid muscles in edentulous patients with temporomandibular disordes submitted to occlusal aplliance therapy

    OpenAIRE

    2011-01-01

    Resumo: O objetivo deste trabalho foi avaliar a atividade eletromiográfica dos músculos supra-hioideos, esternocleidomastoideo e trapézio em 15 voluntários desdentados totais, com dimensão vertical de oclusão (DVO) baixa, portadores de disfunção temporomandibular (DTM) e tratados com aparelhos oclusais planos. Foram submetidos ao exame clinico, de acordo com o protocolo clínico do CETASE (Centro de Estudos e Tratamento das Alterações Funcionais do Sistema Estomatognático) da FOP - Unicamp, e ...

  5. Sleep bruxism: challenges and restorative solutions

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    Mengatto CM

    2016-04-01

    Full Text Available Cristiane Machado Mengatto, Fábio Herrmann Coelho-de-Souza, Oswaldo Baptista de Souza Junior Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS, Porto Alegre, Brazil Abstract: Bruxism is a parafunctional activity related to clenching or grinding the teeth and tooth wear can be a consequence of sleep bruxism (SB. Management of severe tooth wear due to SB is a challenging situation because of the common reduced amount of remaining dental structure and loss of vertical dimension of occlusion. Rationale for the planning of oral rehabilitation of patients with SB presenting severe tooth wear should rely on evidence-based approaches; however, few studies have discussed properties of dental materials for SB rehabilitation and how to cosmetically manage severe tooth wear. This review aimed to provide an overview into bruxism cosmetic rehabilitation and how this can be implemented with good outcomes for the patient. Keywords: sleep bruxism, restoration, rehabilitation, prosthodontics, dentistry

  6. Prevalência de portadores de DTM em pacientes avaliados no setor de otorrinolaringologia Prevalence of patients harboring temporomandibular disorders in an otorhinolaryngology departament

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    Alexandra Magalhães Silveira

    2007-08-01

    Full Text Available A interação entre disfunção temporomandibular e otalgia é, mesmo nos dias atuais, motivo para especulações e hipóteses. Vários pesquisadores sugerem causas, conseqüências e supostos tratamentos. OBJETIVO: Verificar a prevalência de pacientes portadores de DTM em um serviço de otorrinolaringologia. TIPO DE ESTUDO: Este é um estudo epidemiológico do tipo descritivo com amostra transversal. MATERIAL E MÉTODO: Foram avaliados 221 pacientes do Serviço de Otorrinolaringologia do Hospital da Cidade, em Passo Fundo, Rio Grande do Sul, durante um período de dois meses. Para captação e interpretação dos dados, bem como verificação da disfunção temporomandibular, foi utilizado um questionário auto-aplicado previamente validado. RESULTADO: Após coleta e interpretação dos dados de 221 pacientes, os resultados obtidos foram: 48 pacientes (21.72% considerados como necessitando de tratamento para DTM (índice de DTM moderada e severa, dos quais 35 pertenciam ao gênero feminino (72.9% e 13 ao masculino (21.1%. Apenas 15 indivíduos do total (7.24% estavam totalmente livres de sintomas de DTM. Quanto aos demais, apresentaram: dor de cabeça (33,5%, dor no pescoço e ombro (28,5%, dor na região do ouvido (29% e ruídos articulares (25%. CONCLUSÃO: A prevalência de DTM foi de 21.72% sendo significantemente maior no gênero feminino (p: 0.0001; e as prevalências, em relação aos índices, foram: DTM ausente 37.56%; DTM leve 40.72%; DTM moderada 19%, e DTM severa 2.72%.The interaction between Temporomandibular disorders (TMD and otalgia is, even nowadays, a reason for speculation and hypotheses raising. Several researchers suggest causes, consequences and alleged treatments. STUDY DESIGN: This is an epidemiological, sectional cohort study of prevalence. AIM: The study demonstrates the prevalence of patients harboring TMDs in an otorhinolaryngology department. MATERIAL AND METHODOS: During a two-month period, 221 patients from the

  7. Investigation of the relationship between psychosocial stress and temporomandibular disorder in adults by measuring salivary cortisol concentration: A case-control study

    Science.gov (United States)

    Salameh, Ebtisam; Alshaarani, Fandi; Hamed, Hussein Abou; Nassar, Jihad Abou

    2015-01-01

    Background/Purpose of the Study: Psychological factors, particularly psychosocial stress, have been implicated as risk indicators for temporomandibular disorder (TMD). The aim of this study was to assess any differences in salivary cortisol concentration, scores of perceived stress scale (PSS), and scores of depression and distress between TMD patients and matched controls. Materials and Methods: This case-control study comprised two groups; the patient group consisted of 60 patients attending the Department of Fixed Prosthodontics at the Faculty of Dentistry who met the inclusion criteria (42 females and 18 males aged 19–44), whereas the control group was selected to match the patient group in number, age and sex. Two questionnaires were used for stress assessment: The PSS 10 and the psychosocial measure of Research Diagnostic Criteria (RDC) for TMD axis II. Salivary cortisol levels were measured by a competitive immunoenzymatic colorimetric method. Data were analyzed using SPSS 17. Descriptive statistics, one-way ANOVA test, and independent t-test were used. Results: This study showed statistically significant differences between the patient group and the control group at the three measures of psychosocial stress (P < 0.05). Increased occurrence of this disorder in women has been observed. Conclusion: Psychosocial stress plays an important role in the etiopathogenesis of TMD. Women are at increased risk of TMD when compared to men. Sub-types TMD patients approximately have the same level of stress. Muscle disorders were the most common. PMID:26929502

  8. Prevalence of signs and symptoms of temporomandibular disorders in urban and rural children of northern hilly state, Himachal Pradesh, India: A cross sectional survey

    Directory of Open Access Journals (Sweden)

    Deepak Chauhan

    2013-01-01

    Full Text Available Background: Temporomandibular disorders (TMDs have been recognized as a common orofacial painful condition. Many epidemiological studies of TMDs in children and adolescents have been performed. However, the results of such studies have varied, and a comprehensive view of the prevalence and severity of symptoms and signs is difficult to obtain. Objectives: To determine the prevalence of signs and symptoms of TMDs among school children of Himachal Pradesh and to establish a baseline for comparison with future studies. Study Design: Cross sectional. Materials and Methods: A sample of 1188 school children in the age group of 9 and 12 years (males n = 650 and females n = 538, from randomly selected schools of rural and urban areas of Himachal Pradesh were included as study subjects. The survey was done according to the WHO Oral Health Assessment Form (modified. Results: The results of TMDs, i.e., clicking, tenderness and reduced jaw mobility showed that overall prevalence was 2.5% and the rest 96.5% were not suffering from these disorders. In 9 years age group, the prevalence was 1.6% whereas it was more than double, 3.5% in 12 years age group. Signs and symptoms of TMDs were determined to assess their oral health status. Statistical Analysis: SPSS version 15. Conclusion: This study contrasts with what is found in the other societies regarding the high prevalence of TMDs disorders.

  9. Perceived stress and bruxism in university students

    OpenAIRE

    Cavallo, Pierpaolo; Carpinelli, Luna; Savarese, Giulia

    2016-01-01

    Background Many studies have shown the correlation between bruxism and stress that affects the quality of life of university students. The present study highlights this correlation—for the first time—in a group of university students in Italy. Methods We have investigated the prevalence of awake and asleep bruxism and its correlation with perceived stress in a group of 278 Italian undergraduate students (117 M). A self report questionnaire was constructed using a socio-demographic test, the P...

  10. Signs of temporomandibular disorders in girls receiving orthodontic treatment. A prospective and longitudinal comparison with untreated Class II malocclusions and normal occlusion subjects.

    Science.gov (United States)

    Henrikson, T; Nilner, M; Kurol, J

    2000-06-01

    The aim of this investigation was to prospectively and longitudinally study signs of temporomandibular disorders (TMD) and occlusal changes in girls with Class II malocclusion receiving orthodontic treatment and to compare them with subjects with untreated Class II malocclusions and with normal occlusion subjects. Three groups of age-matched adolescent girls were examined for clinical signs of TMD and re-examined 2 years later. Sixty-five Class II subjects received orthodontic fixed straight-wire appliance treatment (Orthodontic group), 58 subjects were orthodontically untreated (Class II group), and 60 subjects had a normal occlusion (Normal group). In the Orthodontic group, the prevalence of muscular signs of TMD was significantly less common post-treatment. The Class II and the Normal groups showed minor changes during the 2-year period. Temporomandibular joint clicking increased in all three groups over the 2 years, but was less common in the Normal group. The Normal group also had a lower overall prevalence of signs of TMD than the Orthodontic and the Class II groups at both registrations. Functional occlusal interferences decreased in the Orthodontic group, but remained the same in the other groups over the 2 years. In conclusion, orthodontic treatment did not increase the risk for or worsen pretreatment signs of TMD. On the contrary, subjects with Class II malocclusions and signs of TMD of muscular origin seemed to benefit functionally from orthodontic treatment in a 2-year perspective. The Normal group had a lower prevalence of signs of TMD than the Orthodontic and the untreated Class II groups.

  11. Association of malocclusion and functional occlusion with signs of temporomandibular disorders in adults: results of the population-based study of health in Pomerania.

    Science.gov (United States)

    Gesch, Dietmar; Bernhardt, Olaf; Kocher, Thomas; John, Ulrich; Hensel, Elke; Alte, Dietrich

    2004-08-01

    The objective of this study was to determine whether associations exist between occlusal factors and signs of temporomandibular disorders (TMD) in adults using the population-based Study of Health in Pomerania (SHIP), Germany. A representative sample of 4310 men and women aged 20 to 81 years (response 68.8%) was investigated for TMD signs, malocclusions, functional occlusion factors, and sociodemographic parameters. Multiple logistic regression analysis, adjusted for sex, age, and socioeconomic status, was used. The results were compared with other population-based studies identified by a systematic review. Few malocclusions and no factors of functional occlusion except socioeconomic parameters were associated with TMD signs, and these associations were mostly weak. Only bilateral open bite up to three mm appeared to be clinically relevant and was associated with TMD signs (odds ratio [OR] = 4.0). This malocclusion, however, was of rare occurrence, with a prevalence of 0.3% (n = 9), and this finding was not confirmed by other representative studies. Occlusal factors examined in this study explained only a small part of the differences between normal subjects and those with TMD signs. This and other population-based studies indicate that malocclusions and factors of functional occlusion surveyed should be seen as merely cofactors in the sense of one piece of the mosaic in the multifactorial problem of temporomandibular dysfunction. Single occlusal factors that showed significant effects throughout several studies could not be detected. In view of the large number of occlusal variables already investigated, other variables including nonocclusal ones probably also play a role and should be looked at more intensely.

  12. Spee曲线与颞下颌关节紊乱病的相关性%Research progress of the relationship between curve of Spee and temporomandibular disorders

    Institute of Scientific and Technical Information of China (English)

    毓天昊; 张宁; 王佟辉; 战德松; 钟丽芳

    2013-01-01

    牙合因素在颞下颌关节紊乱病(temporomandibular disorders,TMD)的病因和病理中占有重要地位。Spee曲线是评价牙合这一生物力学三维结构中垂直向位置关系的关键指标,该曲线与TMD相关性的研究与分析一直是口腔医学中常做常新的课题。本文从Spee曲线的基本功能、形态特点以及各类影响因素等方面,对该曲线与TMD的相关性研究现状进行综述,并提出相关展望。%Occlusal factors occupy an important position in etiology and pathology of temporomandibular disorders (TMD). Because curve of Spee(COS)is an important morphological characteristic to describe occlusion,and a key in-dex to evaluate vertical position of three-dimensional structure of biomechanical properties of occlusion ,the research and analysis of relativity between COS and TMD have always been an advanced topic of stomatology. This article intro-dues the analysis of the relativity between COS and TMD from basic function,morphological characteristics and various influence factors of COS,and it also summarizes the existing problems of research mode and gives direction for further research.

  13. Morphological and positional assessments of TMJ components and lateral pterygoid muscle in relation to symptoms and occlusion of patients with temporomandibular disorders.

    Science.gov (United States)

    Liu, Z J; Yamagata, K; Kuroe, K; Suenaga, S; Noikura, T; Ito, G

    2000-10-01

    Disc displacement is accepted as one of major findings in temporomandibular disorders (TMD). However, the associations of disc positions with morphological and positional changes of temporomandibular joint (TMJ) components and lateral pterygoid (LP), TMD clinical symptoms, and occlusion have rarely been discussed quantitatively. In this study, the morphological and positional changes of TMJ components and LP were assessed by means of magnetic resonance imaging (MRI) and tomography of the TMJ in 41 TMD and nine control (CN) subjects. Disc positions in TMD subjects were divided into normal position (NP) and anterior displacement with and without reduction (ADR+ and ADR-, respectively). From MRI scans and tomograms, the morphological and positional changes of TMJ components and LP were measured and compared among CN, NP, ADR+ and ADR- groups. Correlations between these measurements and the scored clinical symptoms and occlusal factors were analysed in TMD subjects. The results indicated that: (1) TMJ osseous structures and LP showed no significant difference among CN and the three TMD groups, except for a posterior seat of condyle and shorter/steeper condylar movement during jaw opening; (2) disc length and inclination were significantly shorter and steeper, respectively, in ADR+ and ADR-; (3) disc positions were not specified by clinical symptoms and occlusal factors, except for the dominant TMJ sounds in ADR+; (4) an uncoordinated movement of the condyle/disc complex was found in ADR+ and/or ADR-; (5) TMJ osseous structures and the disc were weakly associated with clinical symptoms and occlusal factors. However, the LP showed negative associations with palpable pain for both the TMJ and jaw muscles and the static occlusal factors. These findings suggest that TMJ internal derangements are more related to the positional changes or spatial relationships of TMJ components but less to the individual morphologies of TMJ osseous structures, disc and LP, as well as specific

  14. Spontaneous neural activity alterations in temporomandibular disorders: a cross-sectional and longitudinal resting-state functional magnetic resonance imaging study.

    Science.gov (United States)

    He, S-S; Li, F; Song, F; Wu, S; Chen, J-Y; He, N; Zou, S-J; Huang, X-Q; Lui, S; Gong, Q-Y; Chen, S

    2014-10-10

    The involvement of the central nervous system in the pathophysiology of temporomandibular disorders (TMD) has been noticed. TMD patients have been shown dysfunction of motor performance and reduced cognitive ability in neuropsychological tests. The aim of this study is to explore the spontaneous neural activity in TMD patients with centric relation (CR)-maximum intercuspation (MI) discrepancy before and after stabilization splint treatment. Twenty-three patients and twenty controls underwent clinical evaluations, including CR-MI discrepancy, Helkimo indices and chronic pain, and resting state functional magnetic resonance imaging scans at baseline. Eleven patients repeated the evaluations and scanning after the initial wearing (T1) and 3months of wearing (T2) of the stabilization splint. The fractional amplitude of low-frequency fluctuation (fALFF) was calculated to compare the neural functions. At baseline, the patients showed decreased fALFF in the left precentral gyrus, supplementary motor area, middle frontal gyrus and right orbitofrontal cortex compared with the controls (P<0.05, AlphaSim corrected). Negative correlations were found between the fALFF in the left precentral gyrus and vertical CR-MI discrepancy of bilateral temporomandibular joints of patients (P<0.05, two-tailed). At T2, the symptoms and signs of the patients were improved, and a stable condylar position on the CR was recovered, with increased fALFF in the left precentral gyrus and left posterior insula compared with pretreatment. The fALFF decrease in the patients before treatment was no longer evident at T2 compared with the controls. The results suggested that TMD patients with CR-MI discrepancy showed significantly decreased brain activity in their frontal cortexes. The stabilization splint elicited functional recovery in these cortical areas. These findings provided insight into the cortical neuroplastic processes underlying TMD with CR-MI discrepancy and the therapeutic mechanisms of

  15. Temporomandibular joint osteochondromatosis: an unusual cause of preauricular swelling.

    LENUS (Irish Health Repository)

    Phelan, Eimear

    2012-02-01

    We report an unusual and rare cause of preauricular swelling and review the most recent literature concerning synovial osteochondromatosis of the temporomandibular joint. We report the clinical and radiologic findings of a case of synovial osteochondromatosis of the temporomandibular joint that presented as preauricular swelling in a female patient. This disease typically affects large joints; fewer than 100 cases reported in the literature affect the temporomandibular joint. This case illustrates that disorders of the temporomandibular joint should also be included in the differential diagnosis of patients who present with a preauricular mass.

  16. Sleep Bruxism in Respiratory Medicine Practice.

    Science.gov (United States)

    Mayer, Pierre; Heinzer, Raphael; Lavigne, Gilles

    2016-01-01

    Sleep bruxism (SB) consists of involuntary episodic and repetitive jaw muscle activity characterized by occasional tooth grinding or jaw clenching during sleep. Prevalence decreases from 20% to 14% in childhood to 8% to 3% in adulthood. Although the causes and mechanisms of idiopathic primary SB are unknown, putative candidates include psychologic risk factors (eg, anxiety, stress due to life events, hypervigilance) and sleep physiologic reactivity (eg, sleep arousals with autonomic activity, breathing events). Although certain neurotransmitters (serotonin, dopamine, noradrenalin, histamine) have been proposed to play an indirect role in SB, their exact contribution to rhythmic masticatory muscle activity (RMMA) (the electromyography marker of SB) genesis remains undetermined. No specific gene is associated with SB; familial environmental influence plays a significant role. To date, no single explanation can account for the SB mechanism. Secondary SB with sleep comorbidities that should be clinically assessed are insomnia, periodic limb movements during sleep, sleep-disordered breathing (eg, apnea-hypopnea), gastroesophageal reflux disease, and neurologic disorders (eg, sleep epilepsy, rapid eye movement behavior disorder). SB is currently quantified by scoring RMMA recordings in parallel with brain, respiratory, and heart activity recordings in a sleep laboratory or home setting. RMMA confirmation with audio-video recordings is recommended for better diagnostic accuracy in the presence of neurologic conditions. Management strategies (diagnostic tests, treatment) should be tailored to the patient's phenotype and comorbidities. In the presence of sleep-disordered breathing, a mandibular advancement appliance or CPAP treatment is preferred over single occlusal splint therapy on the upper jaw.

  17. Association between bruxism, alcohol and tobaco use among brazilian students

    OpenAIRE

    Alves-Rezende, Maria Cristina Rosefini [UNESP; Bertoz, André Pinheiro de Magalhães [UNESP; Dekon, Stefan Fiúza de Carvalho [UNESP; Alves-Rezende, Luis Guilherme Rosefini; Alves-Rezende, Ana Laura Rosefini; Montanher, Ingrid Silva; Cunha-Correia, Adriana Sales [UNESP; Aguiar,Sandra Maria Herondina Coelho Ávila de

    2011-01-01

    The etiology of bruxism is not well defined. Different factors affecting the central nervous system are considered as risk factors for bruxism. Dental students are not immune to the bruxism, alcohol consumption and tobacco use, despite their training, knowledge of its effects and social responsibility. The purpose of this study was to evaluate the association between bruxism, alcohol consumption and tobacco use among Brazilian dental students. Participants were chosen among 180, 17-29 year-ol...

  18. Acupuntura como recurso terapêutico na dor e na gravidade da desordem temporomandibular Acupuncture as therapeutic resource in the pain and in the severity of the temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    Graciele da Silva Borin

    2011-09-01

    Full Text Available Este estudo avaliou o efeito da acupuntura no nível de dor e gravidade da Desordem Temporomandibular (DTM. Participaram dele 40 mulheres entre 20 e 40 anos com DTM diagnosticada pelo Research Diagnostic Criteria (RDC/TMD. A dor foi avaliada pela escala visual analógica e a gravidade da desordem pelos Índices de Disfunção Craniomandibular e de Fonseca. As 20 primeiras participantes foram submetidas a acupuntura duas vezes na semana por cinco semanas ininterruptas e, após o período, foram reavaliadas. Os dados destas participantes constituíram os resultados para o grupo acupuntura. As demais voluntárias receberam o tratamento após o primeiro grupo e seus dados, coletados no início e após cinco semanas sem tratamento, foram utilizados para controle. Na análise estatística foram levados em conta os testes de Wilcoxon para o nível de dor e Índice Craniomandibular e Teste t de Student para o Índice de Fonseca, com nível de significância de 5%. Houve redução significante no nível de dor (p=0,000 e na gravidade da DTM pelos Índices Craniomandibular (p=0,004 e de Fonseca (p=0,000 após o tratamento. O grupo controle não apresentou melhora. A efetividade da acupuntura foi demonstrada pela melhora no nível da dor e na gravidade da DTM.This study assessed the effect of acupuncture on the pain level and severity of the temporomandibular disorder (TMD. Forty women with TMD diagnosed by Research Diagnostic Criteria, from 20 and 40 years old, took part in the study. Pain was assessed by visual analogue scale and severity by the Craniomandibular Dysfunction and Fonseca Indexes. The first 20 volunteers were undergone to acupuncture twice a week for five weeks without interruption, and after they were reassessed. The results of these participants constituted acupuncture group. The other volunteers received the treatment after the first group and their data, collected in the beginning and after five weeks without treatment, were utilized as

  19. Avaliação clínica e da qualidade de vida de indivíduos com disfunção temporomandibular Clinical and quality-of-life assessment among women with temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    BGD Moreno

    2009-06-01

    Full Text Available OBJETIVOS: Este estudo teve como objetivo avaliar sintomas de dor, apertamento dos dentes, qualidade do sono e sensibilidade dolorosa nos principais músculos mastigatórios e estabilizadores cervicais e qualidade de vida de mulheres com Disfunção Temporomandibular (DTM. MÉTODOS: Foram avaliadas 45 mulheres, divididas