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Sample records for temporomandibular disorders pain

  1. Painful Temporomandibular Disorder

    Science.gov (United States)

    Slade, G.D.; Ohrbach, R.; Greenspan, J.D.; Fillingim, R.B.; Bair, E.; Sanders, A.E.; Dubner, R.; Diatchenko, L.; Meloto, C.B.; Smith, S.; Maixner, W.

    2016-01-01

    In 2006, the OPPERA project (Orofacial Pain: Prospective Evaluation and Risk Assessment) set out to identify risk factors for development of painful temporomandibular disorder (TMD). A decade later, this review summarizes its key findings. At 4 US study sites, OPPERA recruited and examined 3,258 community-based TMD-free adults assessing genetic and phenotypic measures of biological, psychosocial, clinical, and health status characteristics. During follow-up, 4% of participants per annum developed clinically verified TMD, although that was a “symptom iceberg” when compared with the 19% annual rate of facial pain symptoms. The most influential predictors of clinical TMD were simple checklists of comorbid health conditions and nonpainful orofacial symptoms. Self-reports of jaw parafunction were markedly stronger predictors than corresponding examiner assessments. The strongest psychosocial predictor was frequency of somatic symptoms, although not somatic reactivity. Pressure pain thresholds measured at cranial sites only weakly predicted incident TMD yet were strongly associated with chronic TMD, cross-sectionally, in OPPERA’s separate case-control study. The puzzle was resolved in OPPERA’s nested case-control study where repeated measures of pressure pain thresholds revealed fluctuation that coincided with TMD’s onset, persistence, and recovery but did not predict its incidence. The nested case-control study likewise furnished novel evidence that deteriorating sleep quality predicted TMD incidence. Three hundred genes were investigated, implicating 6 single-nucleotide polymorphisms (SNPs) as risk factors for chronic TMD, while another 6 SNPs were associated with intermediate phenotypes for TMD. One study identified a serotonergic pathway in which multiple SNPs influenced risk of chronic TMD. Two other studies investigating gene-environment interactions found that effects of stress on pain were modified by variation in the gene encoding catechol O

  2. Psychosocial Profiles of Temporomandibular Disorder Pain Patients

    DEFF Research Database (Denmark)

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

    2017-01-01

    AIMS: To propose a visual method to screen and assess psychosocial functioning in temporomandibular disorder (TMD) pain patients in comparison with age- and gender-matched healthy controls by forming individual profiles and to evaluate the association between psychosocial profiles and quantitative...... scores were analyzed with t tests. T scores of psychosocial parameters and z scores of QST parameters were correlated using Spearman's correlation (ρ). RESULTS: Most (96.6%) TMD pain patients exhibited one or more parameters indicative of psychosocial distress, with psychological disability scores being...

  3. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Pain Part 6: Temporomandibular Disorders.

    Science.gov (United States)

    Yule, Pamela L; Durham, Justin; Wassell, Robert W

    2016-01-01

    TMDs are a complex collection of conditions which can have a significant impact on an individual's quality of life. The aetiology, diagnosis and management of TMDs will be described in this article with the hope of increasing a general dental practitioner's knowledge of these problems, thus helping them to institute simple, initial, conservative therapies for such patients. Diagnosis of TMDs can be simplified by following recent published clinical diagnostic criteria such as those outlined in this article. CPD/CLINICAL RELEVANCE: Pain and functional disturbances related to TMDs are common and require simple and pragmatic interventions for most patients. After providing a diagnosis, reassure patients that they do not have a sinister disease, and explain that the condition is usually self-limiting.

  5. Hormonal fluctuations intensify temporomandibular disorder pain without impairing masticatory function.

    Science.gov (United States)

    Vilanova, Larissa Soares; Gonçalves, Thais Marques; Meirelles, Lis; Garcia, Renata Cunha

    2015-01-01

    The influence of hormonal fluctuations on pain and mastication was evaluated in patients with painful temporomandibular disorder (TMD) symptoms. Fifty women were assigned to menstrual cycle and oral contraceptive groups (n = 25). Their TMD was diagnosed by Research Diagnostic Criteria for Temporomandibular Disorders. Pain levels, maximum oclusal force (MOF), and masticatory performance (MP) were measured in all menstrual cycle phases. A lower pain level was observed in the ovulatory phase when compared to menstrual and luteal phases (P = .02). No differences were found regarding MOF (P = .20) or MP (P = .94). Hormonal fluctuations intensify pain in women with symptomatic TMD without impairing mastication.

  6. 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

  7. Factors associated with temporomandibular disorders pain in adolescents

    NARCIS (Netherlands)

    Fernandes, G.; van Selms, M.K.A.; Gonçalves, D.A.G.; Lobbezoo, F.; Camparis, C.M.

    2015-01-01

    To gain a better understanding of temporomandibular disorders (TMD) pain in adolescents, it is important to study the factors associated with its presence. Therefore, the aim of this study was to investigate potential predictors for TMD pain in adolescents, thereby including a diversity of factors

  8. Pain Mechanisms and Centralized Pain in Temporomandibular Disorders

    Science.gov (United States)

    Harper, D.E.; Schrepf, A.; Clauw, D.J.

    2016-01-01

    Until recently, most clinicians and scientists believed that the experience of pain is perceptually proportional to the amount of incoming peripheral nociceptive drive due to injury or inflammation in the area perceived to be painful. However, many cases of chronic pain have defied this logic, leaving clinicians perplexed as to how patients are experiencing pain with no obvious signs of injury in the periphery. Conversely, there are patients who have a peripheral injury and/or inflammation but little or no pain. What makes some individuals experience intense pain with minimal peripheral nociceptive stimulation and others experience minimal pain with serious injury? It is increasingly well accepted in the scientific community that pain can be generated and maintained or, through other mechanisms, suppressed by changes in the central nervous system, creating a complete mismatch between peripheral nociceptive drive and perceived pain. In fact, there is no known chronic pain condition where the observed extent of peripheral damage reproducibly engenders the same level of pain across individuals. Temporomandibular disorders (TMDs) are no exception. This review focuses on the idea that TMD patients range on a continuum—from those whose pain is generated peripherally to those whose pain is centralized (i.e., generated, exacerbated, and/or maintained by central nervous system mechanisms). This article uses other centralized chronic pain conditions as a guide, and it suggests that the mechanistic variability in TMD pain etiology has prevented us from adequately treating many individuals who are diagnosed with the condition. As the field moves forward, it will be imperative to understand each person’s pain from its own mechanistic standpoint, which will enable clinicians to deliver personalized medicine to TMD patients and eventually provide relief in even the most recalcitrant cases. PMID:27422858

  9. Fibromyalgia syndrome and temporomandibular disorders with muscular pain. A review.

    Science.gov (United States)

    Moreno-Fernández, Ana Maria; Jiménez-Castellanos, Emilio; Iglesias-Linares, Alejandro; Bueso-Madrid, Débora; Fernández-Rodríguez, Ana; de Miguel, Manuel

    2017-03-01

    Temporomandibular disorders (TMD) refer to a group of clinical picture affecting the masticatory muscles and temporomandibular joint that are characterized by muscular or joint pain, dysfunction (limited or altered functions) and joint noises, as well as other associated symptoms, such as tension headaches, otalgia, dizziness, tinnitus, and others. Fibromyalgia (FM) is a syndrome of unknown etiology involving generalized chronic pain accompanied, in a high percentage of cases, by other symptoms such as asthenia, anxiety, depression, sleep disturbances, and other less frequent symptoms, such as temporomandibular disorders (TMD). Data were compiled by two experienced examiners following a specific form. An electronic search was carried out in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, and SCOPUS electronic databases (up to April 2016, unrestricted by date or language). Comparative clinical studies with patients with both clinical pictures involving the study of pathogenic processes. Fibromyalgia and temporomandibular disorders with muscle pain both have profiles that affect the muscular system and therefore share many epidemiological, clinical, and physiopathological symptoms. Because of this, we are led to think that there is, if not a common etiology, at least a common pathogenesis. This article revises the physiopathological processes of both clinical pictures in an attempt to determine their similarities and likenesses. This would undoubtedly help in providing a better therapeutic approach.

  10. Temporomandibular disorders in fibromyalgia patients: are there different pain onset?

    Science.gov (United States)

    Fujarra, Fábio J C; Kaziyama, Helena Hideko Seguchi; Siqueira, Silvia Regina D T de; Yeng, Lin Tchia; Camparis, Cinara M; Teixeira, Manoel Jacobsen; Siqueira, José Tadeu Tesseroli de

    2016-03-01

    To identify temporomandibular disorders (TMD) symptoms in two groups of fibromyalgia patients according to the temporal relation between the onset of facial pain (FP) and generalized body pain (GBP). CROSS-SECTIONAL STUDY DESIGN: Fifty-three consecutive women with fibromyalgia and FP were stratified according to the onset of orofacial pain: Group-A (mean age 47.30 ± 14.20 years old), onset of FP preceded GBP; Group-B (mean age 51.33 ± 11.03 years old), the FP started concomitant or after GBP. Research Diagnostic Criteria for Temporomandibular Disorders and the Visual Analogue Scale. Myofascial pain with mouth opening limitation (p = 0.038); right disc displacement with reduction (p = 0.012) and jaw stiffness (p = 0.004) were predominant in Group A. Myofascial pain without mouth opening limitation (p = 0.038) and numbness/burning were more common in Group B. All patients had temporomandibular joint symptoms, mainly muscle disorders. The prevalence of myofascial pain with limited mouth opening and right TMJ disc displacement with reduction were higher in Group A.

  11. Temporomandibular disorders

    DEFF Research Database (Denmark)

    List, Thomas; Jensen, Rigmor Højland

    2017-01-01

    Background Temporomandibular disorders (TMD) is an umbrella term for pain and dysfunction involving the masticatory muscles and the temporomandibular joints (TMJs). TMD is the most common orofacial pain condition. Its prominent features include regional pain in the face and preauricular area......, 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 arthralgia) as well as disorders associated with the TMJ (primarily disc displacements and degenerative disease). As peripheral mechanisms most likely play a role in the onset of TMD, a detailed muscle examination is recommended. The persistence of pain involves more central factors, such as sensitization...

  12. 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.

  13. 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 ...

  14. Temporomandibular disorders, head and orofacial pain: cervical spine considerations.

    Science.gov (United States)

    Kraus, Steve

    2007-01-01

    Head and orofacial pain originates from dental, neurologic, musculoskeletal, otolaryngologic, vascular, metaplastic, or infectious disease. It is treated by many health care practitioners, such as dentists, oral surgeons, and physicians. The article focuses on the nonpathologic involvement of the musculoskeletal system as a source of head and orofacial pain. The areas of the musculoskeletal system that are reviewed include the temporomandibular joint and muscles of mastication--collectively referred to as temporomandibular disorders (TMDs) and cervical spine disorders. The first part of the article highlights the role of physical therapy in the treatment of TMDs. The second part discusses cervical spine considerations in the management of TMDs and head and orofacial symptoms. It concludes with and overview of the evaluation and treatment of the cervical spine.

  15. Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement.

    Science.gov (United States)

    Gil-Martínez, Alfonso; Grande-Alonso, Mónica; López-de-Uralde-Villanueva, Ibai; López-López, Almudena; Fernández-Carnero, Josué; La Touche, Roy

    2016-12-01

    The objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD). A cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11). A total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p pain and disability (p pain and disability for the MP group (β = 0.62; p pain group, neck disability (β = 0.40; p pain and disability. Mixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.

  16. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Orofacial pain and temporomandibular disorders: the impact on oral health and quality of life

    Directory of Open Access Journals (Sweden)

    Paulo César Rodrigues Conti

    2012-01-01

    Full Text Available Many conditions may cause painful symptoms in orofacial structures. Among the chronic conditions that affect this area, temporomandibular disorders are the most common. Temporomandibular Disorder is a collective term that includes a number of clinical complaints involving the masticatory muscles, the Temporomandibular Joint and associated structures. In some cases, these complaints can be associated with depression, catastrophizing behavior and impact on quality of life. The present study aims to explain the relationship between Temporomandibular Disorders and pain chronification and their relation to a variety of psychosocial and behavioral comorbid conditions. The mechanisms of pain conduction and suggestions for management are also addressed.

  19. Orofacial pain and temporomandibular disorders: the impact on oral health and quality of life.

    Science.gov (United States)

    Conti, Paulo César Rodrigues; Pinto-Fiamengui, Lívia Maria Sales; Cunha, Carolina Ortigosa; Conti, Ana Cláudia de Castro Ferreira

    2012-01-01

    Many conditions may cause painful symptoms in orofacial structures. Among the chronic conditions that affect this area, temporomandibular disorders are the most common. Temporomandibular Disorder is a collective term that includes a number of clinical complaints involving the masticatory muscles, the Temporomandibular Joint and associated structures. In some cases, these complaints can be associated with depression, catastrophizing behavior and impact on quality of life. The present study aims to explain the relationship between Temporomandibular Disorders and pain chronification and their relation to a variety of psychosocial and behavioral comorbid conditions. The mechanisms of pain conduction and suggestions for management are also addressed.

  20. Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

    OpenAIRE

    Park, Ha-Na; Kim, Kyoung-A; Koh, Kwang-Joon

    2014-01-01

    Purpose This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. Materials and Methods The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on m...

  1. 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. © International & American Associations for Dental Research.

  2. Self-care behaviors associated with myofascial temporomandibular disorder pain.

    Science.gov (United States)

    Riley, Joseph L; Myers, Cynthia D; Currie, Thomas P; Mayoral, Oliver; Harris, Rochelle G; Fisher, Jocelyn A; Gremillion, Henry A; Robinson, Michael E

    2007-01-01

    To document the frequency of self-care in a clinical sample of patients with myofascial temporomandibular disorder (TMD) pain; report the perceived relief and control of pain for each of the self-care behaviors; and to test for associations between the frequency and efficacy of each self-care behavior and pain, depression and sleep quality, as assessed during a clinical visit, and to determine whether the frequency was associated with changes in pain intensity, depression, and sleep quality 30 days later. The sample consisted of 99 female and 27 male myofascial TMD pain patients who were participants in a multidisciplinary facial pain evaluation program. The subjects participated in a structured interview during a clinical visit and a follow-up telephone interview 30 days later. The interviews included questions about self-care, including resting, relaxation techniques, massage, hot and/or cold packs, home remedies, stretching or exercise, herbal remedies, and the use of vitamins or nutritional supplements for pain. The passive self-care behaviors, such as resting when experiencing pain (66%) and relaxation techniques (62%), were the most commonly used. Patients reported that hot or cold packs (5.3, 0-to-10 scale) and massage (4.7) provided the greatest relief from pain, whereas resting (4.9), relaxation (4.8), and massage (4.8) resulted in the greatest ability to control pain. The most striking finding was that initial levels of pain or change in pain were not consistently associated with self-care use; however, psychosocial outcomes of depression and sleep quality were associated with self-care frequency and reported efficacy and improved in relation to patient-reported self-care frequency. Since people with chronic myofascial TMD pain engage in a range of pain self-care strategies, clinicians need to discuss self-care with patients regularly.

  3. Association of Temporomandibular Joint Pain According to Magnetic Resonance Imaging Findings in Temporomandibular Disorder Patients.

    Science.gov (United States)

    Takahara, Namiaki; Nakagawa, Satoshi; Sumikura, Kanako; Kabasawa, Yuji; Sakamoto, Ichiro; Harada, Hiroyuki

    2017-09-01

    This study investigated the associations between magnetic resonance imaging (MRI) findings and pain in the temporomandibular joint (TMJ). The study included 646 TMJs of 323 consecutive patients with temporomandibular disorders; of these, 222 (34.4%) had TMJ pain whereas 424 (65.6%) had no TMJ pain. MRIs were used to evaluate disc position, osteoarthritis, joint fluid, and bone marrow edema. Internal derangement was classified as normal, anterior disc displacement with reduction, and anterior disc displacement without reduction (ADDWOR); condylar morphology was classified as normal, moderate bony change, and severe bony change. The odds ratio (OR) for each MRI variable for nonpainful versus painful TMJs was computed using logistic regression analysis. Compared with joints with normal disc position, the OR of those with ADDWOR was 2.74 (P pain. Similarly, compared with joints with normal condylar morphology, the OR of those with severe bony change was 4.62 (P = .02) for TMJ pain. In addition, the risk of TMJ pain increased by 2.37 in joints with joint fluid (P joints with bone marrow edema (P = .006). The risk of TMJ pain increased significantly with ADDWOR in combination with severe bony change, joint fluid, and bone marrow edema. These results suggest an association between TMJ pain and ADDWOR, severe bony change, joint fluid, and bone marrow edema. Thus, combining various MRI variables may improve the diagnostic accuracy of TMJ pain. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Temporomandibular disorder pain after whiplash trauma: a systematic review.

    Science.gov (United States)

    Häggman-Henrikson, Birgitta; List, Thomas; Westergren, Hans T; Axelsson, Susanna H

    2013-01-01

    To assess, by systematic review of the literature, (1) the prevalence and incidence of temporomandibular disorder (TMD) pain after whiplash trauma, and (2) whether treatment modalities commonly used for TMD are equally effective in patients with solely TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. A systematic literature search of the PubMed, Cochrane Library, and Bandolier databases was conducted from January 1966 through October 2012. The systematic search identified 125 articles. After an initial screening of abstracts, 45 articles were reviewed in full text. Two investigators evaluated the methodological quality of each identified study. Eight studies on prevalence/incidence of TMD pain in WAD and four studies on interventions in TMD pain and WAD met the inclusion criteria. The reported median prevalence of TMD pain after whiplash trauma was 23% (range 2.4% to 52%) and the incidence ranged from 4% to 34%. For healthy controls, the reported median prevalence was 3% (range 2.5% to 8%) and the incidence ranged from 4.7% to 7%. For patients with a combination of TMD pain and WAD, treatment modalities conventionally used for TMD, such as jaw exercises and occlusal splints, had less of an effect (median improvement rate of 48%, range 13% to 68%) compared to TMD patients without a whiplash injury (75%, range 51% to 91%). There is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. The poorer treatment outcome suggests that TMD pain after whiplash trauma has a different pathophysiology compared to TMD pain localized to the facial region.

  5. Factors associated with temporomandibular disorders pain in adolescents.

    Science.gov (United States)

    Fernandes, G; van Selms, M K A; Gonçalves, D A G; Lobbezoo, F; Camparis, C M

    2015-02-01

    To gain a better understanding of temporomandibular disorders (TMD) pain in adolescents, it is important to study the factors associated with its presence. Therefore, the aim of this study was to investigate potential predictors for TMD pain in adolescents, thereby including a diversity of factors from the biopsychosocial model to determine the strongest predictors. The sample of this cross-sectional study consisted of 1094 adolescents. The presence of TMD pain was assessed using the RDC/TMD, Axis I. Apart from demographical characteristics, the roles of parafunctional habits, psychosocial aspects, menarche and other bodily pain complaints were evaluated. Single and multiple logistic regression models were used to identify associations between the predictor variables and TMD pain. Painful TMD had a prevalence of 25·5%. Logistic regression analyses showed that TMD pain was associated with sleep bruxism (OR = 1·8 95% CI = 1·34-2·34), awake bruxism (OR = 2·1 95% CI = 1·56-2·83), other parafunctional habits (OR = 2·2 95% CI = 1·17-4·08) and bodily pain complaints (OR = 5·0 95% CI = 3·48-7·28). Parafunctional habits and other bodily pain complaints may play an important role in the presence of TMD pain in adolescents. Of course, it remains unclear whether the observed associations between the investigated factors and the adolescent's TMD pain have a true causal linkage. © 2014 John Wiley & Sons Ltd.

  6. Temporomandibular disorders and painful comorbidities: clinical association and underlying mechanisms.

    Science.gov (United States)

    Costa, Yuri Martins; Conti, Paulo César Rodrigues; de Faria, Flavio Augusto Cardoso; Bonjardim, Leonardo Rigoldi

    2017-03-01

    The association between temporomandibular disorders (TMDs) and headaches, cervical spine dysfunction, and fibromyalgia is not artefactual. The aim of this review is to describe the comorbid relationship between TMD and these three major painful conditions and to discuss the clinical implications and the underlying pain mechanisms involved in these relationships. Common neuronal pathways and central sensitization processes are acknowledged as the main factors for the association between TMD and primary headaches, although the establishment of cause-effect mechanisms requires further clarification and characterization. The biomechanical aspects are not the main factors involved in the comorbid relationship between TMD and cervical spine dysfunction, which can be better explained by the neuronal convergence of the trigeminal and cervical spine sensory pathways as well as by central sensitization processes. The association between TMD and fibromyalgia also has supporting evidence in the literature, and the proposed main mechanism underlying this relationship is the impairment of the descending pain inhibitory system. In this particular scenario, a cause-effect relationship is more likely to occur in one direction, that is, fibromyalgia as a risk factor for TMD. Therefore, clinical awareness of the association between TMD and painful comorbidities and the support of multidisciplinary approaches are required to recognize these related conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Influence of tinnitus on pain severity and quality of life in patients with temporomandibular disorders

    National Research Council Canada - National Science Library

    Calderon, Patrícia dos Santos; Hilgenberg, Priscila Brenner; Rossetti, Leylha Maria Nunes; Laurenti, João Vítor El Hetti; Conti, Paulo César Rodrigues

    2012-01-01

    The aim of this cross-sectional study was to evaluate the relationship among pain intensity and duration, presence of tinnitus and quality of life in patients with chronic temporomandibular disorders (TMD...

  8. Somatosensory abnormalities in Chinese patients with painful temporomandibular disorders.

    Science.gov (United States)

    Yang, Guangju; Baad-Hansen, Lene; Wang, Kelun; Fu, Kaiyuan; Xie, Qiu-Fei; Svensson, Peter

    2016-01-01

    The somatosensory phenotype of Chinese temporomandibular disorders (TMD) patients is not sufficiently studied with the use of contemporary techniques and guidelines. A standardized quantitative sensory testing (QST) battery consisting of 13 parameters with a stringent statistical protocol developed by the German Research Network on Neuropathic Pain was performed over the most painful and corresponding contralateral sites as well as the right hand of 40 Chinese patients with TMD and pain classified according to the Diagnostic Criteria for TMD (DC/TMD). The same QST protocol was performed bilaterally over the infraorbital, mental, and hand regions of 70 age- and gender-stratified healthy Chinese controls. Z-scores and loss/gain scores were computed for each TMD patient. For patients, 82.5 % had somatosensory abnormalities in the painful facial region, while 60.0 % had abnormalities confined to the right hand. The most frequent abnormalities were somatosensory gain to pinprick (35.0 %) and pressure (35.0 %) stimuli, somatosensory loss to pinprick (25.0 %), cold (22.5 %), and heat (15.0 %) nociceptive stimuli. The most frequent loss/gain score was L0G2 (no somatosensory loss combined with a gain of mechanical somatosensory function) for both the facial (40.0 %) and hand (27.5 %) regions. Involving side-to-side differences in the evaluation increased the diagnostic sensitivity by 2.5-25.0 % across different parameters. Somatosensory abnormalities were commonly detected in Chinese TMD pain patients both within and outside the primary painful region, strongly indicating disturbances in the central processing of somatosensory stimuli. The individual variations in somatosensory abnormalities indicate a possible need for development of individualized TMD pain management.

  9. 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.

  10. 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)

  11. 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

  12. 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

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

    OpenAIRE

    Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

    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 ...

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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...

  16. Temporomandibular disorders in patients with craniocervical dystonia

    Directory of Open Access Journals (Sweden)

    André L. Costa

    2011-12-01

    Full Text Available Temporomandibular disorders are a set of musculoskeletal dysfunctions within the masticatory system, with multiple etiologies. OBJECTIVE: Since craniocervical dystonia can involve the same neuromuscular structure as the temporomandibular joint, we sought to assess the correlation between temporomandibular disorders and craniocervical dystonia. METHOD: We applied the Research Diagnostic Criteria for Temporomandibular Disorders to 42 patients with craniocervical dystonia, in order to identify orofacial pain and temporomandibular characteristics on the day of botulinum toxin injection. RESULTS: Twenty-two patients (52.3% reported temporomandibular joint pain; 24 (57.1%, joint sounds; 20 (47.6%, masticatory muscle pain; and 21 (50%, diminished jaw mobility. The patients with oromandibular dystonia presented temporomandibular disorders more frequently than did patients with other types of craniocervical dystonia (p<0.001. CONCLUSION: Temporomandibular disorders occur frequently in patients with oromandibular dystonia. Further studies should address the proper treatment of temporomandibular disorders associated with dystonia.

  17. Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints.

    Science.gov (United States)

    Visscher, Corine M; Lobbezoo, Frank; Naeije, Machiel

    2004-01-01

    To determine the construct validity of algometry and to compare it with that of palpation, and to compare tenderness of masticatory muscle sites and the temporomandibular joint (TMJ) on palpation and on algometry. Two hundred fifty subjects, 148 with temporomandibular disorder (TMD) pain complaints, underwent a standardized blinded physical examination that included pain-intensity measures on palpation and pressure pain threshold measures on algometry of masseter muscle sites, temporalis muscle sites, and the TMJ. Logistic regression analysis indicated that the recognition of TMD pain complaints based on pressure algometry was comparable to that of palpation (R2 = 0.22 and R2 = 0.21, respectively). The masseter muscles were most tender to palpation and algometry, followed by the TMJs and the temporalis muscles. Construct validity of algometry in the recognition of TMD pain complaints is comparable to that of palpation, and differences in tenderness on palpation and on algometry are found between masticatory muscle sites and the TMJ.

  18. Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients.

    Science.gov (United States)

    Park, Ha-Na; Kim, Kyoung-A; Koh, Kwang-Joon

    2014-12-01

    This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the χ(2) test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (ppalpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

  19. 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 joint disorders (P = pain at the 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. © 2016 John Wiley & Sons Ltd.

  20. Health-related quality of life in child patients with temporomandibular disorder pain.

    Science.gov (United States)

    Jedel, Elizabeth; Carlsson, Jane; Stener-Victorin, Elisabet

    2007-07-01

    Temporomandibular disorders (TMDs) occurs frequently in children and measuring health-related quality of life (HRQL) can complement efficacy measures, offering a complete picture of the impact of disease and treatment on overall well-being. To compare HRQL, pain threshold (PT) and range of motion (ROM) in child patients with temporomandibular disorder (TMD) pain and an age and gender matched control group. The study design was a controlled cross-sectional study. Forty-two children participated in the study. Twenty-one child patients referred to a dental pediatric clinic for specialist treatment because of TMD pain and an age and gender matched control group completed the Child health questionnaire-child form 87 (CHQ-CF87). PT was measured with Pain matcher and ROM in terms of maximum unassisted mandibular opening was measured with a ruler. The child patients with pain more than once a week had a pain duration ranging from 3 months to almost 6 years. The median for pain intensity measured with visual analogue scale (VAS) was 47 ranging from 5 to 80 and the median for behavioral rating scale (BRS) was 3 ranging from 1 to 4. Child patients with TMD pain more than once a week reported significantly lower scores in CHQ-CF87 when compared with a control group. The results for PT and ROM were non-significant. CHQ-CF87 could be used for measuring health and to evaluate the efficacy of treatment in child patients with TMD pain.

  1. Clinical Aspects of Temporomandibular Disorders

    OpenAIRE

    ÖZDEN, Asiye Nehir

    2014-01-01

    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...

  2. Pain-Related Temporomandibular Disorder - Current Perspectives and Evidence-Based Management.

    Science.gov (United States)

    Ghurye, Supriya; McMillan, Roddy

    2015-01-01

    Pain-related temporomandibular disorder (TMD) is one of the top three most common chronic pain conditions, along with headaches and back pain. TMD has complex pathophysiology and significant associations with a variety of other chronic pain conditions, eg fibromyalgia, irritable bowel syndrome and migraine. Chronic TMD is associated with a negative impact upon quality of life and high levels of healthcare utility. It is important that clinicians are able to diagnose TMD correctly, provide appropriate management in keeping with current evidence-based practice, and identify when to refer patients to specialist care. The presence of risk factors, eg anxiety, depression, pain-related disability and chronic pain conditions elsewhere in the body, may help to identify which TMD patients require referral for multidisciplinary management. TMD should be managed using a holistic approach, incorporating patient education and encouragement towards self-management. TMD care pathways should consider using the three'pillars'of pain management: physical therapies, pharmacotherapy and clinical psychology.

  3. Different association between specific manifestations of bruxism and temporomandibular disorder pain.

    Science.gov (United States)

    Berger, Marcin; Szalewski, Leszek; Szkutnik, Jacek; Ginszt, Michał; Ginszt, Apolinary

    A growing body of evidence suggests that bruxism exists in two separate manifestations. However, little is known about the association between specific manifestations of bruxism and temporomandibular disorder (TMD) pain. The aim of our study was to analyze the association between TMD pain and specific diagnoses of bruxism (sleep, awake, and mixed diagnosis of sleep and awake bruxism). 508 adult patients (296 women and 212 men), aged between 18 and 64 years (mean age 34±12 years), attending to a clinic for general dental treatment. Patients were asked to fill an anonymous questionnaire, consisting of three questions, verifying the presence of TMD pain and two forms of bruxism. All questions were based on the Polish version of the Research Diagnostic Criteria for Temporomandibular Disorders patient history questionnaire. Cross tabulation was done, and χ 2 was used as a test of significance to find the association between the variables. Awake bruxism was associated with TMD pain only in men (χ 2 =7.746, pbruxism was associated with TMD pain in both women (χ 2 =10.486, pbruxism and TMD pain. Gender-related differences in the presence of all bruxism diagnoses were also statistically insignificant. Interaction between sleep and awake bruxism may increase the risk for TMD pain. We suggest considering concomitance as a confounder, when studying sleep or awake bruxism. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  4. Relationship between anxiety and chronic orofacial pain of temporomandibular disorder in a group of university students.

    Science.gov (United States)

    Monteiro, Douglas Roberto; Zuim, Paulo Renato Junqueira; Pesqueira, Aldiéris Alves; Ribeiro, Paula do Prado; Garcia, Alício Rosalino

    2011-07-01

    This study evaluated the relationship between anxiety levels and severity degrees of chronic orofacial pain of temporomandibular disorder in brazilian university students. 150 volunteers (117 men and 33 women), with age ranging from 17 to 30 years, were subjects to this study. Spielberger's trait-state anxiety inventory was used to evaluate trait and state anxiety of the students, while examination for chronic orofacial pain was performed in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Association between anxiety levels and severity degrees of chronic orofacial pain was tested using the Chi-square test. The significance level was set at porofacial pain was classified as degree 1 in 85.7% (n=42) and as degree 2 in 14.3% (n=7) of them. Based on the results of the Spielberger's trait-state anxiety inventory, the majority of the students had moderate anxiety (48.6% and 48.1%, respectively). The correlation between trait-anxiety levels and chronic orofacial pain degrees was significant and positive (porofacial pain degrees (p>.05). It was concluded that chronic orofacial pain of TMD could be present in university students and anxiety may be related. Copyright © 2010 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  5. Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ha Na; Kim, Kyoung A; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju (Korea, Republic of)

    2014-12-15

    This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the chi2 test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (p<0.05). However, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

  6. Association of clinical findings of temporomandibular disorders (TMD) with self-reported musculoskeletal pains.

    Science.gov (United States)

    Sipilä, Kirsi; Suominen, Anna Liisa; Alanen, Pentti; Heliövaara, Markku; Tiittanen, Pekka; Könönen, Mauno

    2011-11-01

    Temporomandibular disorders (TMD) can be related to self-reported musculoskeletal pains. The aim of the study was to investigate the association of clinical findings of TMD with self-reported pain in other parts of the body, and to discriminate pain clusters according to definite profiles of pain conditions including TMD among subjects in general population. A nationally representative Health 2000 Survey was carried out in 2000-2001 in Finland. The data were obtained from 6227 subjects aged ⩾30years. Information about pain in different parts of the body was collected from a questionnaire. The associations between clinically assessed TMD findings and pain in other areas were analyzed using chi-square test and logistic regression analyses. Latent class analysis (LCA) was used to form natural clusters, i.e., groups in which the individuals had similar profiles of pain conditions. Masticatory muscle pain on palpation associated with back, neck and shoulder pain and pain in joints. Temporomandibular joint (TMJ) pain on palpation associated with back, neck, shoulder and other joint pain. These associations did not change essentially after adjustment for confounders. After clustering of the study population with the LCA, 5.8% of the study population showed a multiple pain condition linked with TMD findings. Female gender, intermediate/poor self-reported health and presence of a longstanding illness increased the probability to belong to this cluster. TMD findings associate with pain in several locations. Female gender and presence of impaired health were particularly related to occurrence of multiple pain conditions. Copyright © 2011 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  7. Palpation and pressure pain threshold: reliability and validity in patients with temporomandibular disorders.

    Science.gov (United States)

    Gomes, Marden B; Guimarães, Josemar P; Guimarães, Franceane C; Neves, Ana Cristina C

    2008-07-01

    This study assessed the interexaminer reliability and validity of palpation (PA) and pressure pain threshold (PPT) of the temporomandibular joint (TMJ) and the masseter and temporalis muscles in patients with temporomandibular disorders (TMD) and asymptomatic controls. Eighty (80) subjects were distributed into two groups: Group 1 consisted of 40 TMD patients with muscular and joint pain selected by RDC/TMD Axis I; and Group 2 (control) with 40 asymptomatic individuals. Training and calibration of examiners was undertaken prior to testing. Mean reliability values were 0.64 and 0.78 (PPT), and 0.59 and 0.75 (PA), for patients and controls, respectively. Results showed statistically significant differences (p<0.001), for PA and PPT among TMD patients compared with the control. The results also showed acceptable specificity values (above 0.90), although sensitivity had low values. The tests had low diagnostic validity to discriminate between patients and controls, with low positive predictive values (PPV).

  8. Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

    Science.gov (United States)

    Park, Ha-Na; Kim, Kyoung-A

    2014-01-01

    Purpose This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. Materials and Methods The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the χ2 test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Results Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (ppain, pain on palpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Conclusion Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain. PMID:25473637

  9. 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.

  10. Orofacial pain induced by Eagle syndrome in an elderly patient with temporomandibular disorders - a case report.

    Science.gov (United States)

    Costantinides, Fulvia; Vidoni, Gabriele; Tonni, Ingrid; Bazzocchi, Gabriele; Bodin, Christiane; Di Lenarda, Roberto

    2016-09-01

    Eagle syndrome (ES) is a rare disorder that can be responsible for orofacial pain. To describe the treatment of an elderly patient affected by ES and temporomandibular disorders (TMD). A patient complained of constant pain of the right temporomandibular joint (TMJ) and of the sensation of having a foreign body in the throat. Based on the patient's medical history and symptoms, a TMJs internal derangement and concomitant ES were suspected. A magnetic resonance and a computerised tomography confirmed the clinical diagnosis. A conservative treatment was initially performed to re-establish a functional occlusion. The rehabilitative treatment alleviated the pain almost totally. A slight residual uncomfortable sensation of the presence of a foreign body in the throat persisted after the oral rehabilitation but without any influence on the quality of life. In elderly patients complaining a chronic orofacial pain, the possibility of a concomitant TMD and ES has to be considered to correctly identify the source of pain. A conservative approach to identify weather TMD is the main source of pain is preferable, avoiding unnecessary invasive treatments. © 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  11. The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Shigeaki Suenaga

    2016-11-01

    Full Text Available The causes of pain symptoms in the temporomandibular joint (TMJ and masticatory muscle (MM regions may not be determined by clinical examination alone. In this review, we document that pain symptoms of the TMJ and MM regions in patients with temporomandibular disorders (TMDs are associated with computed tomography and magnetic resonance (MR findings of internal derangement, joint effusion, osteoarthritis, and bone marrow edema. However, it is emphasized that these imaging findings must not be regarded as the unique and dominant factors in defining TMJ pain. High signal intensity and prominent enhancement of the posterior disk attachment on fat saturation T2-weighted imaging and dynamic MR imaging with contrast material are closely correlated with the severity of TMJ pain. Magnetic transfer contrast, MR spectroscopy, diffusion tensor imaging, and ultrasonography findings have helped identify intramuscular edema and contracture as one of the causes of MM pain and fatigue. Recently, changes in brain as detected by functional MR neuroimaging have been associated with changes in the TMJ and MM regions. The thalamus, the primary somatosensory cortex, the insula, and the anterior and mid-cinglate cortices are most frequently associated with TMD pain.

  12. Psychosocial Profiles of Temporomandibular Disorder Pain Patients: Proposal of a New Approach to Present Complex Data.

    Science.gov (United States)

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

    2017-01-01

    To propose a visual method to screen and assess psychosocial functioning in temporomandibular disorder (TMD) pain patients in comparison with age- and gender-matched healthy controls by forming individual profiles and to evaluate the association between psychosocial profiles and quantitative sensory testing (QST) findings of TMD pain patients. TMD patients (n = 58) and control participants (n = 41) completed a set of questionnaires profiling their psychosocial function, and QST was performed at the temporomandibular joint (TMJ) on both sides of the face in all participants. Psychosocial parameters from the Research Diagnostic Criteria for TMD (RDC/TMD), Oral Health Impact Profile (OHIP), and Pain Catastrophizing Scale (PCS) instruments were transformed into T scores, and QST parameters were transformed into z scores based on reference data. Group differences for psychosocial T scores were analyzed with t tests. T scores of psychosocial parameters and z scores of QST parameters were correlated using Spearman's correlation (ρ). Most (96.6%) TMD pain patients exhibited one or more parameters indicative of psychosocial distress, with psychological disability scores being the scores most frequently encountered outside the reference 95% confidence intervals (CI). TMD patients were psychosocially more distressed with regard to all psychosocial parameters compared with controls (P psychosocial profiles created an easy overview of psychosocial function in TMD pain patients. Increased sensitivity to tactile stimuli was associated with higher sleep dysfunction T scores.

  13. 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 kinesiophobia when comparing patients with CM and healthy women. Moderate correlations between kinesiophobia and catastrophizing (r = 0.46; p kinesiophobia and magnification (r = 0.52; p 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

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

    Science.gov (United States)

    Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

    2015-01-01

    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. 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 rheumatoid disorders and TMJ surgery. Original articles and review papers which presented the clinical relevance and practical validity regarding the possibility of application in TMD management have been included. Authors have excluded articles without outstanding practical aspect and evidence-based background. A first selection was carried out by reviewing titles and abstracts of all articles found according to the criteria. After that the full texts of potentially suitable articles were assessed. In line with these criteria, among 11467 results the writers have included 66 papers. The most commonly reported conservative treatments are massage therapy and individually fabricated occlusal splints. In addition to massage, other popular methods include manual therapy and taping, warming/cooling of aching joints, and light and laser therapy. Drugs are also commonly used. In the most severe cases of the temporomandibular joint degeneration, surgical restoration of the joint is sometimes applied. The authors concluded that conservative treatment including counselling, exercises, occlusal splint therapy, massage, manual therapy and others should be considered as a first choice therapy for TMD pain because of their low risk of side effects. In the case of severe acute pain or chronic pain resulting from serious disorders, inflammation and/or degeneration pharmacotherapy, minimally invasive and invasive procedures should be considered.

  15. Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders.

    Science.gov (United States)

    Blanco Aguilera, A; Gonzalez Lopez, L; Blanco Aguilera, E; De la Hoz Aizpurua, J L; Rodriguez Torronteras, A; Segura Saint-Gerons, R; Blanco Hungría, A

    2014-08-01

    The aim of this study was to evaluate the association between self-reported sleep bruxism and the age, gender, clinical subtypes of temporomandibular disorders (TMD), pain intensity and grade of chronic pain in patients previously diagnosed with TMD. Thousand two-hundred and twenty patients of the Andalusian Health Service were examined using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire. The inclusion and exclusion criteria were those included in the RDC/TMD criteria. The bruxism diagnosis was drawn from the question, 'Have you been told, or do you notice that you grind your teeth or clench your jaw while sleeping at night?' in the anamnestic portion of the questionnaire. A bivariate analysis was conducted, comparing the presence of perceived parafunctional activity with age (over age 60 and under age 60), gender, different subtypes of TMD, pain intensity, grade of chronic pain and presence of self-perceived locked joints. The overall prevalence of self-reported sleep bruxism (SB) was 54.51%. A statistically significant association was found between the presence of SB and patients under age 60, women, greater pain intensity, greater pain interference with activities of daily living, and the axis-I groups affected by both muscular and articular pathology. There is a statistically significant association between self-reported sleep bruxism and women under age 60 who have painful symptoms of TMD. There is also a positive association between this parafunctional habit and the presence of chronic pain. However, more studies that cover larger samples and differentiate between sleep bruxism and awake bruxism are needed. © 2014 John Wiley & Sons Ltd.

  16. Evaluation of microcurrent electrical nerve stimulation (MENS) effectiveness on muscle pain in temporomandibular disorders patients.

    Science.gov (United States)

    Zuim, Paulo Renato Junqueira; Garcia, Alicio Rosalino; Turcio, Karina Helga Leal; Hamata, Marcelo Matida

    2006-01-01

    The effect of Microcurrent Electrical Nerve Stimulation (MENS) was evaluated and compared with occlusal splint therapy in temporomandibular disorders (TMD) patients with muscle pain. Twenty TMD patients were divided into four groups. One received occlusal splint therapy and MENS (I); other received splints and placebo MENS (II); the third, only MENS (III) and the last group, placebo MENS (IV). Sensitivity derived from muscle palpation was evaluated using a visual analogue scale. Results were submitted to analysis of variance (p<0.05). There was reduction of pain level in all groups: group I (occlusal splint and MENS) had a 47.7% reduction rate; group II (occlusal splint and placebo MENS), 66.7%; group III (MENS), 49.7% and group IV (placebo MENS), 16.5%. In spite of that, there was no statistical difference (analysis of variance / p<0.05) between MENS and occlusal splint therapy regarding muscle pain reduction in TMD patients after four weeks.

  17. Is myofascial pain in temporomandibular disorder patients a manifestation of delayed-onset muscle soreness?

    Science.gov (United States)

    Koutris, Michail; Lobbezoo, Frank; Sümer, Nevruz Ceren; Atiş, Elif Sibel; Türker, Kemal S; Naeije, Machiel

    2013-08-01

    In a study to the possible role of overuse of the jaw muscles in the pathogenesis of jaw muscle pain, we used a protocol involving concentric and eccentric muscle contractions to provoke a state of delayed-onset muscle soreness (DOMS) in the jaw muscles of healthy individuals. We tested whether the accompanying signs and symptoms would yield the temporary diagnosis of myofascial pain according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD) in these individuals. Forty persons (mean age±SD=27.7±7.5 y) performed six, 5-minute bouts of eccentric and concentric jaw muscle contractions. Before and immediately after the exercise, and 24 hours, 48 hours, and 1 week later, self-reported muscle fatigue and pain, pain-free maximum mouth opening, pressure-pain thresholds, and the number of painful jaw muscle palpation sites were recorded. Significant signs and symptoms of DOMS in the jaw muscles were found, which all had resolved after 1 week. In 31 (77.5%) of the participants, these signs and symptoms also gave rise to a temporary diagnosis of myofascial pain according to the RDC/TMD. The results of this study demonstrate that an experimental protocol involving concentric and eccentric muscle contractions can provoke DOMS in the jaw muscles and the temporary diagnosis of myofascial pain according to the RDC/TMD. The results observed strengthen the supposition that the myofascial pain in TMD patients may be a manifestation of DOMS in the jaw muscles.

  18. Infield masticatory muscle activity in subjects with pain-related temporomandibular disorders diagnoses.

    Science.gov (United States)

    Khawaja, S N; McCall, W; Dunford, R; Nickel, J C; Iwasaki, L R; Crow, H C; Gonzalez, Y

    2015-04-01

    Pain-related temporomandibular disorders (TMDs) are the most prevalent conditions among TMDs. There is contrasting evidence available for association of pain-related TMD and masticatory muscle activity (MMA). The present investigation assesses the associations between MMA levels of masseter and temporalis muscles during awake and sleep among pain-related TMD diagnostic groups. The department of Oral Diagnostic Sciences, University at Buffalo. Twenty females and six males participated in this study. Using the diagnostic criteria for temporomandibular disorders (DC-TMDs), participants were diagnostically categorized. Subjects used a custom monitoring system, which recorded infield muscle activities. A factorial model tested for association between independent variable (muscle, time period, MMA level, and diagnostic group) effects and the logarithm of MMA. Greenhouse-Geisser test was used to determine any statistically significant associations (p≤0.003). No statistically significant association was found between four-way, three-way, and two-way analyses. However, among the main effects, range of magnitudes was the only variable to be statistically significant. Although the data suggest a trend of increased masseter MMA in the pain-related TMD diagnoses group both during awake and sleep time periods, such observation is not maintained for the temporalis muscle. In addition, temporalis MMA was found to be higher in the pain-related TMD diagnoses group only at extreme activity levels (<25 and ≥80% ranges). This data support the association between masticatory muscle hyperactivity and painful TMD conditions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Identifying potential predictors of pain–related disability in Turkish patients with chronic temporomandibular disorder pain

    Science.gov (United States)

    2013-01-01

    Background The aims of this study were to examine whether patients’ psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6 months in duration. Methods The Research Diagnostic Criteria of TMD (RDC/TMD) data for Axis I and II were obtained for 104 consecutive patients seeking treatment. Data were analyzed using descriptive statistics, t-test, Mann–Whitney U-test, chi-square test, One-way ANOVA, Kruskal-Wallis test, and binary multiple logistic regression tests. Patients were classified into two groups according to Graded Chronic Pain Scale scores: Grade III and IV were scored for patients with high levels of pain-related disability, whereas Grade I and II were scored for patients with low disability. Results Muscle and joint pain were found in 64.9% and 31.8% of the patients, respectively, and 27.3% of the patients suffered from both muscle and joint pain. Psychosocial disability was found in 26% of patients. There were no statistically significant differences among the diagnostic subgroups with regards to the demographic, behavioral, psychological, and psychosocial characteristics. Patients with high levels of pain-related disability had significantly higher depression, somatization, pain intensity and jaw disability scores than those with low levels of pain-related disability. Patients with high levels of pain-related disability were more likely to have higher pain intensity, to report higher somatization symptoms and functional impairment, and were less likely to have joint pain than those with low levels of pain related disability. Conclusion In conclusion, the Turkish version RDC/TMD, based on a dual axis system, may be used to screen chronic TMD patients at high-risk for pain-related disability who need comprehensive care treatment program. PMID:23565825

  20. Impact of temporomandibular disorder pain in adolescents: differences by age and gender.

    Science.gov (United States)

    Nilsson, Ing-Marie; Drangsholt, Mark; List, Thomas

    2009-01-01

    To evaluate the impact of temporomandibular disorder (TMD) pain by age and gender in adolescents, with assessments of this impact specifically on school absence, medication consumption, perceived need for treatment, jaw function limitation, depressive symptoms scores and somatic complaints, and graded chronic pain scale. In a population-based sample, a mailed questionnaire was sent to 350 patients with self-reported TMD pain (group 1) and 350 healthy age- and sex-matched individuals (group 2) aged 12 to 19 years 2 to 4 weeks after their annual dental examination. The groups were divided into younger (age 12 to 15) and older (age 16 to 19) groups. Descriptive statistics and 95% confidence intervals were used, and chi-square and t-tests were calculated for analyzing group differences. Odds ratios were estimated using logistic regression. As expected, groups 1 and 2 differed significantly in most variables related to psychosocial and behavioral factors. For adolescents reporting TMD pain once a week or more, no gender or age differences in pain intensity were seen. Jaw function limitation, depressive symptoms scores, somatic complaints, graded chronic pain, and perceived need for TMD treatment were all significantly higher in girls than in boys. Older girls reported higher analgesic consumption and school absences than older boys. Girls reporting TMD pain had significantly greater impact on behavioral and psychosocial factors than boys. Almost one third of older girls, compared to one out of 10 older boys, reported school absences and analgesic consumption because of their TMD pain.

  1. Alterations in Masticatory Muscle Activation in People with Persistent Neck Pain Despite the Absence of Orofacial Pain or Temporomandibular Disorders.

    Science.gov (United States)

    Testa, Marco; Geri, Tommaso; Gizzi, Leonardo; Petzke, Frank; Falla, Deborah

    2015-01-01

    To assess whether patients with persistent neck pain display evidence of altered masticatory muscle behavior during a jaw-clenching task, despite the absence of orofacial pain or temporomandibular disorders. Ten subjects with persistent, nonspecific neck pain and 10 age- and sex-matched healthy controls participated. Maximal voluntary contractions (MVCs) of unilateral jaw clenching followed by 5-second submaximal contractions at 10%, 30%, 50%, and 70% MVC were recorded by two flexible force transducers positioned between the first molar teeth. Task performance was quantified by mean distance and offset error from the reference target force as error indices, and standard deviation of force was used as an index of force steadiness. Electromyographic (EMG) activity was recorded bilaterally from the masseter muscle with 13 X 5 grids of electrodes and from the anterior temporalis with bipolar electrodes. Normalized EMG root mean square (RMS) was computed for each location of the grid to form a map of the EMG amplitude distribution, and the average normalized RMS was determined for the bipolar acquisition. Between-group differences were analyzed with the Kruskal Wallis analysis of variance. Task performance was similar in patients and controls. However, patients displayed greater masseter EMG activity bilaterally at higher force levels (Ppain despite the absence of orofacial pain or temporomandibular disorders.

  2. Influence of craniomandibular and cervical pain on the activity of masticatory muscles in individuals with Temporomandibular Disorder

    OpenAIRE

    Ries,Lilian Gerdi Kittel; Graciosa,Maylli Daiani; Medeiros,Daiane Lazzeri de; Pacheco, Sheila Cristina da Silva; Fassicolo,Carlos Eduardo; Graefling,Bárbara Camila Flissak; Degan, Viviane Veroni

    2014-01-01

    Purpose:This study aimed to establish the prevalence of pain in the craniomandibular and cervical spine region in individuals with Temporomandibular Disorders (TMD) and to analyze the effects of these disorders on the bilateral activation of anterior temporalis (AT) and masseter (MA) muscles during the masticatory cycle.Methods:The participants were 55 female volunteers aged 18–30 years. The presence of TMD and craniomandibular and cervical spine pain was evaluated by applying the Resea...

  3. The impact of orofacial pain on the quality of life of patients with temporomandibular disorder.

    Science.gov (United States)

    Barros, Vinícius de Magalhães; Seraidarian, Paulo Isaias; Côrtes, Maria Ilma de Souza; de Paula, Lylian Vieira

    2009-01-01

    To evaluate the relationships between gender, diagnosis, and severity of temporomandibular disorders (TMD) with self-reports of the impact of TMD on the quality of life. Eighty-three individuals seeking TMD treatment at the Dental School of Pontifical Catholic University Minas from May to August 2005 were evaluated by a single examiner who was trained and calibrated for diagnosis according to criteria of Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). The severity of TMD was established by the Temporomandibular Index and the impact on quality of life by the Oral Health Impact Profile (OHIP 14). Complete data were available for 78 of the 83 initial patients and evaluated by the Mann-Whitney test and Spearman correlation analysis. Except for one patient, all individuals showed some impact related to physical pain. Of the seven aspects evaluated on the OHIP 14, women presented a greater impact than men only for functional limitations (Mann-Whitney, P disorders (group I) or osteoarthritis (group III) reported a greater impact than those without (P quality of life and severity of TMD (P quality of life of individuals with TMD, without group difference between genders. The presence of muscular disorders (group I) and osteoarthritis (group III) was related to greater impact on quality of life, which was not observed for diagnoses of disc displacement (group II). A correlation between severity of TMD and impact on quality of life was clearly observed.

  4. Achieved Competencies and Satisfaction in Temporomandibular Disorders and Orofacial Pain Education.

    Science.gov (United States)

    Nordin, Sara; Dawson, Andreas; Ekberg, Ewa Carin

    2016-01-01

    To assess dental students' achieved competencies and perceived satisfaction with their temporomandibular disorders (TMD) and orofacial pain education and to compare these with the results of their final examination in TMD and orofacial pain. Dental students from two consecutive classes (2011/2012 and 2012/2013) at the Department of Orofacial Pain and Jaw Function at the dental school in Malmö, Sweden completed two self-evaluations, one at the beginning of semester seven and one at the end of semester eight. The questionnaire that they were given concerned achieved competencies and satisfaction with education in TMD and orofacial pain. Items focused on anatomy, physiology, and clinical training. Students estimated their competence and satisfaction on a numeric rating scale and described their idea of treating TMD and orofacial pain patients on a verbal rating scale. Outcome variables were tested with paired samples t test for differences over time and independent samples t test for between-class comparisons; both were adjusted for multiple testing with Bonferroni correction. Significant improvement in all items was observed for achieved competencies and satisfaction in both classes between semester seven and semester eight (P .05). This study has shown that expansion in undergraduate TMD and orofacial pain education at the dental school in Malmö has allowed all students to develop the same level of competence, independent of prior experience. The study also pointed out that continuous evaluation and enhancement of TMD and orofacial pain education in undergraduate dental education is beneficial.

  5. Genetic Polymorphisms of Catechol-O-Methyltransferase: Association with Temporomandibular Disorders and Postoperative Pain.

    Science.gov (United States)

    Mladenovic, Irena; Supic, Gordana; Kozomara, Ruzica; Dodic, Slobodan; Ivkovic, Nedeljka; Milicevic, Bojana; Simic, Ivana; Magic, Zvonko

    2016-01-01

    To evaluate the association between catechol-O-methyltransferase (COMT) gene polymorphisms and temporomandibular disorders (TMD), TMD pain, psychosocial impairment related to TMD, and postoperative pain. A total of 90 patients with a diagnosis of painful TMD and 92 matched controls were investigated for the presence of TMD, TMD pain, and psychosocial variables by the Research Diagnostic Criteria for TMD. In a prospective cohort study of 40 subjects who underwent extraction of at least one fully impacted mandibular third molar, subjects had 6 months post-surgery follow-up of postoperative pain. DNA extracted from peripheral blood was genotyped for three COMT polymorphisms (rs4680, rs6269, and rs165774) by real-time TaqMan method. The association between COMT polymorphisms and clinical variables was determined by calculating odds ratios (OR) and their 95% confidence intervals (CI). Homozygous AA genotype and heterozygous variant A allele carriers (genotype AG/AA) for rs165774 polymorphism were associated with increased risk of TMD compared to wild type (wt) GG genotype (OR = 9.448, P = .006; OR = 2.088, P = .017, respectively). In addition, AA genotype was associated with increased risk of arthralgia (OR = 4.448, P = .011), myofascial pain (OR = 3.543, P = .035), and chronic TMD pain (OR = 6.173, P = .006), compared to wt genotype. AA genotype for rs6269 polymorphism was related to less postoperative chronic TMD pain (P = .025) and lower postoperative acute pain at the extraction site (P = .030). No associations with depression and somatization were observed. AA genotype of rs165774 could be a significant risk factor for the development of TMD and TMD pain, while AA genotype of rs6269 presents less postoperative chronic TMD pain and acute pain at a dental extraction site.

  6. Pharmacotherapeutic agents used in temporomandibular disorders.

    Science.gov (United States)

    Bal Kucuk, B; Tolunay Kaya, S; Karagoz Motro, P; Oral, K

    2014-11-01

    Depending on the source and character, pharmacotherapy is one of the most commonly used methods to treat temporomandibular disorders in addition to the use of appliances, physiotherapy, behavioral therapy, and surgical interventions. To decide on the appropriate treatment approach for the treatment of temporomandibular disorders, pharmacotherapeutics should be understood in great detail. As for other pain treatments, pharmacotherapy can be used as a monotherapy or combined with other treatment options in temporomandibular disorders. The aim of the present review is to overview the primary analgesics and myorelaxants used in temporomandibular disorders. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Influence of tinnitus on pain severity and quality of life in patients with temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Patrícia dos Santos Calderon

    2012-04-01

    Full Text Available OBJECTIVE:The aim of this cross-sectional study was to evaluate the relationship among pain intensity and duration, presence of tinnitus and quality of life in patients with chronic temporomandibular disorders (TMD. MATERIAL AND METHODS: Fifty-nine female patients presenting with chronic TMD were selected from those seeking for treatment at the Bauru School of Dentistry Orofacial Pain Center. Patients were submitted to the Research Diagnostic Criteria anamnesis and physical examination. Visual analog scale was used to evaluate the pain intensity while pain duration was assessed by interview. Oral Health Impact Profile inventory modified for patients with orofacial pain was used to evaluate the patients' quality of life. The presence of tinnitus was assessed by self report. The patients were divided into: with or without self report of tinnitus. The data were analyzed statistically using the Student's t-test and Pearson's Chi-square test, with a level of significance of 5%. RESULTS: The mean age for the sample was 35.25 years, without statistically significant difference between groups. Thirty-two patients (54.24% reported the presence of tinnitus. The mean pain intensity by visual analog scale was 77.10 and 73.74 for the groups with and without tinnitus, respectively. The mean pain duration was 76.12 months and 65.11 months for the groups with and without tinnitus, respectively. The mean OHIP score was 11.72 and 11.74 for the groups with and without tinnitus, respectively. There was no statistically significant difference between groups for pain intensity, pain duration and OHIP scoreS (p>0.05. CONCLUSION: Chronic TMD pain seems to play a more significant role in patient 's quality of life than the presence of tinnitus.

  8. Influence of tinnitus on pain severity and quality of life in patients with temporomandibular disorders.

    Science.gov (United States)

    Calderon, Patrícia dos Santos; Hilgenberg, Priscila Brenner; Rossetti, Leylha Maria Nunes; Laurenti, João Vítor El Hetti; Conti, Paulo César Rodrigues

    2012-01-01

    The aim of this cross-sectional study was to evaluate the relationship among pain intensity and duration, presence of tinnitus and quality of life in patients with chronic temporomandibular disorders (TMD). Fifty-nine female patients presenting with chronic TMD were selected from those seeking for treatment at the Bauru School of Dentistry Orofacial Pain Center. Patients were submitted to the Research Diagnostic Criteria anamnesis and physical examination. Visual analog scale was used to evaluate the pain intensity while pain duration was assessed by interview. Oral Health Impact Profile inventory modified for patients with orofacial pain was used to evaluate the patients' quality of life. The presence of tinnitus was assessed by self report. The patients were divided into: with or without self report of tinnitus. The data were analyzed statistically using the Student's t-test and Pearson's Chi-square test, with a level of significance of 5%. The mean age for the sample was 35.25 years, without statistically significant difference between groups. Thirty-two patients (54.24%) reported the presence of tinnitus. The mean pain intensity by visual analog scale was 77.10 and 73.74 for the groups with and without tinnitus, respectively. The mean pain duration was 76.12 months and 65.11 months for the groups with and without tinnitus, respectively. The mean OHIP score was 11.72 and 11.74 for the groups with and without tinnitus, respectively. There was no statistically significant difference between groups for pain intensity, pain duration and OHIP scoreS (p>0.05). Chronic TMD pain seems to play a more significant role in patient 's quality of life than the presence of tinnitus.

  9. Influence of orthodontic treatment on temporomandibular disorders. A systematic review.

    Science.gov (United States)

    Fernández-González, Felipe J; Cañigral, Aránzazu; López-Caballo, José L; Brizuela, Aritza; Moreno-Hay, Isabel; Del Río-Highsmith, Jaime; Vega, José A

    2015-04-01

    The aim of this literature systematic review was to evaluate the possible association between malocclusions, orthodontic treatment and development of temporomandibular disorders. A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords "orthodontics and temporomandibular disorders", "orthodontics and facial pain" and "malocclusion and temporomandibular disorders". Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords "orthodontics and temporomandibular disorders", "orthodontics and facial pain" and "malocclusion and temporomandibular disorders". Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. The search strategy resulted in 61 articles. After selection according to the inclusion/exclusion criteria 9 articles qualified for the final analysis. The articles which linked orthodontics and development of temporomandibular disorders showed very discrepant results. Some indicated that orthodontic treatment could improve signs and symptoms of temporomandibular disorders, but none of them obtained statistically significant differences. According to the authors examined, there is no evidence for a cause-effect relationship between orthodontic treatment and temporomandibular disorders, or that such treatment might improve or prevent them. More longitudinal studies are needed to verify any possible interrelationship. Key words:Malocclusion and temporomandibular disorders, orthodontics and facial pain, orthodontics and temporomandibular disorders, temporomandibular disorders, temporomandibular dysfunction.

  10. Masticatory muscle and temporomandibular joint pain in Croatian war veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Uhac, Ivone; Tariba, Petra; Kovac, Zoran; Simonić-Kocijan, Suncana; Lajnert, Vlatka; Mesić, Vesna Fugosić; Kuis, Davor; Braut, Vedrana

    2011-12-01

    The aim of this study was to investigate the prevalence and intensity of masticatory muscle and temporomandibular joint (TMJ) pain in Croatian war veterans with posttraumatic stress disorder (PTSD). The examined group consisted of 100 Croatian war veterans, in whom PTSD had previously been diagnosed. Patients were compared with 92 subjects who had not taken part in the war and in whom PTSD was excluded by psychiatric examination. The clinical examination consisted of palpation of the masticatory muscles, the prominent neck musculature, and TMJ. The examination technique used and the definition of items were previously tested for reliability and validity. 93% of the subjects with PTSD had masticatory muscle tenderness compared to 45.65% of the subjects in the control group (chi2 = 51.46, p TMJ tenderness compared to 3.26% of subjects in the control group (chi2 = 66.23, p TMJ in both groups was the left posterior capsule; in the PTSD group 38% and in subjects in the control group 2.17% of cases. The most painful location was the left posterior capsule in 28% of subjects with PTSD, while not one subject in the control group reported severe painful sensitivity. The very high frequency and intensity of pain in subjects with PTSD confirms the effect of stress on muscle and joint sensitivity, i.e. perception of pain.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. The Temporomandibular Joint Pain Dysfunction Syndrome

    OpenAIRE

    Speck, John E.

    1988-01-01

    When a patient complains of headache, neckache, or earache and these are associated with noisy temporomandibular joint function, restricted opening or increased pain when chewing, a temporomandibular joint or masticatory muscle disorder should be considered in the differential diagnosis, because signs and symptoms of these disorders are common in all age groups. This article indicates the more common etiological contributions, that is, microtrauma, repeated microtrauma, muscle hyperactivity, ...

  14. Examining the Sensitivity and Specificity of 2 Screening Instruments: Odontogenic or Temporomandibular Disorder Pain?

    Science.gov (United States)

    Fonseca Alonso, Barbara; Nixdorf, Donald R; Shueb, Sarah S; John, Mike T; Law, Alan S; Durham, Justin

    2017-01-01

    Two groups of patients with orofacial pains that are clinically important to distinguish from each other are patients with odontogenic pain and temporomandibular disorder (TMD) pain. The aim of this study was to determine the sensitivity and specificity of 2 screening instruments in distinguishing between patients with these types of pain. A convenience sample of patients seeking care at an endodontic clinic and an orofacial pain clinic were recruited. The 14-item dental pain questionnaire (DePaQ) was used to screen for odontogenic pain and the 6-item TMD screener was used to screen for TMD pain. Sensitivity and specificity calculations with 95% confidence intervals (CIs) were performed for both instruments, and thresholds/acceptability/performance was assessed using published guidelines. Thirty-four patients with odontogenic pain and 37 patients with TMD pain were included in this study. The sensitivity of the DePaQ was 0.85 (95% CI, 0.69-0.95), and specificity was 0.11 (95% CI, 0.03-0.25). The sensitivity of the TMD screener was 0.92 (95% CI, 0.78-0.98), and specificity was 0.59 (95% CI, 0.41-0.75). The point estimates, a single value used to estimate the population parameter, for both the DePaQ and TMD screener were "acceptable" in identifying patients who had the pain condition in question (ie, sensitivity), whereas the point estimate for appropriately identifying patients who did not have the pain condition when they did not have it (ie, specificity) was "nonacceptable" for both. The DePaQ and the TMD screener lack diagnostic accuracy for differentiating TMD from odontogenic tooth pain without adjunctive (clinical) investigation(s) or examination. However, the TMD screener has high sensitivity for identifying true positives (ie, TMD pain) and would therefore be useful as a screening instrument when one can definitively exclude odontogenic etiology for pain on clinical and radiographic grounds, for instance in endodontic practices. In this study, the negative

  15. Stress-related adaptive versus maladaptive coping and temporomandibular disorder pain.

    Science.gov (United States)

    Reissmann, Daniel R; John, Mike T; Schierz, Oliver; Seedorf, Hartwig; Doering, Stephan

    2012-01-01

    To test whether patients with temporomandibular disorder (TMD) pain differ from subjects from the general population with regard to their stress-related coping styles. Consecutive adult TMD patients (n = 70) and adult subjects of a regional general population sample (n = 868), examined according to the German version of the Research Diagnostic Criteria for TMD (RDC/TMD), were included in this study. The inclusion criterion for TMD patients was at least one pain-related diagnosis according to the RDC/ TMD, while general-population subjects were excluded if they had any pain-related TMD diagnosis. Coping styles were assessed using a common and well-accepted German 114-item stress-coping questionnaire ("Stressverarbeitungsfragebogen" SVF 114). The coping style-TMD pain relationship was investigated using logistic regression analyses adjusted for possible confounders (age, sex, level of education), as well as the influence of psychosocial measures (RDC/TMD Axis II). Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Study participants who used fewer adaptive coping styles (OR = 0.47, CI: 0.26-0.83) and more maladaptive coping styles (OR = 1.55, CI: 1.05-2.29) were at greater risk for TMD pain. After adjustment for sociodemographic confounders, the coping style-TMD pain relationship changed only slightly in magnitude. In an analysis adjusted for sociodemographic confounders and psychosocial RDC/TMD Axis II measures, adaptive coping styles were even more profoundly related to TMD pain (OR: 0.27, 95 CI: 0.09-0.83), but maladaptive coping styles were less related to TMD pain (OR: 1.17, 95% CI: 0.51-2.72). Differences in the applied stress-related coping styles of TMD patients and subjects without TMD may have implications for clinical decision making and choosing among treatment alternatives.

  16. Prevalence of Painful Temporomandibular Disorders and Correlation to Lifestyle Factors among Adolescents in Norway

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    Vegard Østensjø

    2017-01-01

    Full Text Available Aim. To estimate the prevalence of painful temporomandibular disorders (TMD-P among adolescents and to investigate correlations with health, environment, and lifestyle factors. Methods. For this cross-sectional case-control study, 562 patients were consecutively recruited at their yearly revision control from four dental clinics in Rogaland County, Norway. Patients completed a questionnaire on general health, socioeconomics, demographics, and lifestyle factors. Responses to two screening questions identified patients with TMD-P, who then underwent clinical examination to verify the TMD diagnosis. Pain intensity was assessed on a visual analogue scale. Patients without TMD-P constituted the control group and were not clinically examined. Results. 7% experienced TMD-P. The female-to-male ratio is 3:1; median age is 17 years. Patients at urban clinics had higher prevalence compared with those at rural clinics. TMD-P patients had headache and severe menstrual pain compared to controls. They were more likely to live with divorced/single parents and less likely to have regular physical activity. Myalgia was present in 21 patients with TMD-P, arthralgia in nine, and myalgia and arthralgia in nine. Females had higher pain intensity than males. Conclusions. A low prevalence of TMD-P was shown but was comparable to other studies. Sex, health, lifestyle, and environment factors were associated with TMD-P.

  17. Clinical view of the temporomandibular joint disorder.

    Science.gov (United States)

    Badel, Tomislav; Ćimić, Samir; Munitić, Mirna; Zadravec, Dijana; Kes, Vanja Bašić; Šimunković, Sonja Kraljević

    2014-12-01

    Temporomandibular pain has a musculoskeletal origin because it occurs as a consequence of masticatory muscle function disorder and temporomandibular joint disorder. Most common diagnoses of disorders are disc displacement and osteoarthritis, but their comorbidity can also occur. Pain is the most common symptom, where chronic temporomandibular pain may con- tribute to the occurrence of psychological disorders in the patient population. Splint is the most widespread dental method of treatment but other, noninvasive methods of musculoskeletal pain treatment are also recommended. Electronic axiography is used for visualization of mandibular movements, in particular pathologic sounds in the joints. Mental health, although not so obvious in dental practice, can influence the need of a multidisciplinary approach to the patient with disorder of the temporomandibular joint.

  18. Goldenhar Syndrome and Pain-Related Temporomandibular Disorders. A Case Report.

    Science.gov (United States)

    Khawaja, Shehryar Nasir; Crow, Heidi; Gonzalez, Yoly

    2016-04-01

    Goldenhar syndrome (GS) is a development syndrome, characterized by incomplete development of the craniofacial region. The involvement is mainly unilateral; it varies from being mild to severe; and it can range from malocclusion and facial asymmetry to a more complex phenotype with complete absence of the mandibular ramus and temporomandibular joint. However, orthopedic symptoms of orofacial pain and dysfunction have not generally been considered as part of the symptom complex in GS cases. The case presented here is of a 15-year-old Caucasian patient, who was referred for evaluation because of bilateral pain in the masticatory muscles and temporomandibular joints.

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

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    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.

  20. The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders.

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    Pergamalian, Anna; Rudy, Thomas E; Zaki, Hussein S; Greco, Carol M

    2003-08-01

    It is unclear whether patients with temporomandibular disorders (TMD) who report high levels of bruxism have more severe signs and symptoms of TMD and more advanced tooth wear than patients with TMD who report lower levels of bruxism. The purpose of this study was to determine whether there was a significant association between tooth wear, the parafunctional oral habit of bruxism, temporomandibular joint (TMJ) pain, and muscle pain severity in a TMD population. A total of 84 subjects previously diagnosed with TMD, according to the Research Diagnostic Criteria for TMD (RDC/TMD) and who met 10 specific inclusion/exclusion criteria underwent a thorough multiaxial examination and classification recommended by the National Institute of Dental and Craniofacial Research (NIDCR). Measurement of tooth wear facets by use of a 4-point scale were graded in 10 zones on mandibular casts. One calibrated examiner performed all scoring. Bruxism was assessed in a standardized pretreatment questionnaire and in the dental history and interview (RDC/TMD) to indicate how frequently (0 = never to 3 = very often) subjects performed a list of oral habits, which included bruxism. The Kappa reliability coefficient (range from: -1.0 to 1.0) was used to correct for chance agreement, and was computed for each of the 10 study sites designated for rating. Subjects were also compared for muscle and joint pain. Muscle pain was a summed measure derived from the dental examination findings (range 0 to 20), calculated from the presence or absence of pain induced by palpation of 20 predetermined muscle sites. Similarly, joint pain was a summed measure of the presence or absence of pain in the TMJs induced by palpation of the joints on the outer surface and in the external auditory canal in 5 different positions of the mandible. A Pearson product-moment correlation was used to compute the summed severity of tooth wear and the subjects' age. Analysis of covariance was used to determine whether the number

  1. Association of temporomandibular disorder pain with awake and sleep bruxism in adults.

    Science.gov (United States)

    Sierwald, Ira; John, Mike T; Schierz, Oliver; Hirsch, Christian; Sagheri, Darius; Jost-Brinkmann, Paul-Georg; Reissmann, Daniel R

    2015-07-01

    Parafunctional habits such as clenching or grinding (bruxism) during daytime and at night are considered to have a great impact on the etiopathogenesis of temporomandibular disorders (TMD). However, the size of the effect and how daytime activities interact with nocturnal activities is not yet clear. The aim of this study was to assess the association of TMD pain with both awake and sleep bruxism in adults. In this case-control study, data of a consecutive sample of 733 TMD patients (cases; mean age ± SD: 41.4 ± 16.3 years; 82% women) with at least one pain-related TMD diagnosis according to the German version of the Research Diagnostic Criteria for TMD (RDC/TMD) and of a community-based probability sample of 890 subjects (controls; mean age ± SD: 40.4 ± 11.8 years; 57% female) without TMD were evaluated. Clenching or grinding while awake and/or asleep was assessed with self-reports. Association of TMD pain with awake and sleep bruxism was analyzed using multiple logistic regression analyses and controlled for potential confounders. Odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated. While 11.2% of the controls reported clenching or grinding while awake, this proportion was significantly higher in TMD patients (33.9%; p bruxism (OR 1.8; CI 1.4-2.4). However, risk for TMD pain substantially increased in cases of simultaneous presence of awake and sleep bruxism (OR 7.7; CI 5.4-11.1). When occurring separately, awake and sleep bruxism are significant risk factors for TMD pain. In case of simultaneous presence, the risk for TMD pain is even higher.

  2. 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 < 0·001). These results highlighted the importance of considering the work conditions of patients with TMD, as 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. © 2016 John Wiley & Sons Ltd.

  3. Prosthodontic Management of Temporomandibular Disorders

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    Kaur, Harsimran; Datta, Kusum

    2012-01-01

    Temporomandibular disorders (TMD) are examined from a biopsychosocial or illness perspective. It is considered that TMD share features with many common chronic pain conditions. Functional disturbances of the masticatory system can be as complicated as the system itself. Although numerous treatments have been advocated, the complex nature of TMD requires a multidisciplinary team. Effective treatment selection begins with a thorough understanding of the disorder & its etiology. However, the mul...

  4. Effects of high-frequency bio-oxidative ozone therapy in temporomandibular disorder-related pain.

    Science.gov (United States)

    Doğan, Mansur; Ozdemir Doğan, Derya; Düger, Cevdet; Ozdemir Kol, Iclal; Akpınar, Aysun; Mutaf, Burcu; Akar, Türker

    2014-01-01

    It was the aim of this study to compare the efficacy of ozone therapy and drug treatment in patients with painful temporomandibular joint (TMJ) disorder (TMD). A total of 63 patients with TMD were enrolled; 33 were treated with bio-oxidative therapy and 30 with a ketoprofen tablet thiocolchicoside capsule 2 × 1 for 7 days. Maximum voluntary interincisal mouth opening (MMO) was measured in millimeters using a scale and recorded during the pre- and posttreatment periods. The patients evaluated their subjective pain using a visual analogue scale (VAS). Data were analyzed using the Mann-Whitney U test, the Kolmogorov-Smirnov test, and the independent t test. The mean MMO of the group that received ozone therapy during the pretreatment period was 46.51 ± 8.2 mm, and it immediately increased to 48.78 ± 7.5 mm after 1 week of ozone therapy, which was statistically significant (p = 0.04). For those who received medication, the mean MMO during the pretreatment period was 46.30 mm, and at the end of 1 week it was 46.9 mm. In the ozone group, 29% of patients showed a gradual decrease in their VAS pain scores compared to pretreatment values (6.3 ± 2.1 to 3.0 ± 2.2). In the medication group, 24% of patients showed a significant decrease in VAS pain scores during the follow-up period (6.9 ± 1.4 to 5.0 ± 1.5). This study showed that bio-oxidative therapy was a more effective treatment than medication therapy for relieving TMJ pain. © 2014 S. Karger AG, Basel.

  5. Comparison Between Chronic Migraine and Temporomandibular Disorders in Pain-Related Disability and Fear-Avoidance Behaviors.

    Science.gov (United States)

    Gil-Martínez, Alfonso; Navarro-Fernández, Gonzalo; Mangas-Guijarro, María Ángeles; Lara-Lara, Manuel; López-López, Almudena; Fernández-Carnero, Josué; La Touche, Roy

    2017-11-01

    To compare patients with chronic migraine (CM) and chronic temporomandibular disorders (TMD) on disability, pain, and fear avoidance factors and to associate these variables within groups. Descriptive, cross-sectional study. A neurology department and a temporomandibular disorders consult in a tertiary care center. A total of 50 patients with CM and 51 patients with chronic TMD, classified by international criteria classifications. The variables evaluated included pain intensity (visual analog scale [VAS]), neck disability (NDI), craniofacial pain and disability (CF-PDI), headache impact (HIT-6), pain catastrophizing (PCS), and kinesiophobia (TSK-11). Statistically significant differences were found between the CM group and the chronic TMD group in CF-PDI (P  0.05). For the chronic TMD group, the combination of NDI and TSK-11 was a significant covariate model of CF-PDI (adjusted R2 = 0.34). In the CM group, the regression model showed that NDI was a significant predictive factor for HIT-6 (adjusted R2 = 0.19). Differences between the CM group and the chronic TMD group were found in craniofacial pain and disability, pain catastrophizing, and headache impact, but they were similar for pain intensity, neck disability, and kinesiophobia. Neck disability and kinesiophobia were covariates of craniofacial pain and disability (34% of variance) for chronic TMD. In the CM group, neck disability was a predictive factor for headache impact (19.3% of variance).

  6. Correlation between skin surface temperature over masticatory muscles and pain intensity in women with myogenous temporomandibular disorder.

    Science.gov (United States)

    Dibai-Filho, Almir Vieira; Costa, Ana Cláudia de Souza; Packer, Amanda Carine; Rodrigues-Bigaton, Delaine

    2013-01-01

    Pain is a common clinical manifestation in individuals with temporomandibular disorder (TMD). The literature report changes in microcirculation in this condition. The aim of the present study was to correlate skin surface temperature at the central point of the masticatory muscles with pain intensity in women with myogenous TMD. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the visual analogue scale (VAS) were used to divide 40 female university students into four groups: control group (n=10), mild pain group (n=10), moderate pain group (n=10) and severe pain group (n=10). Infrared thermography was used to assess the masticatory muscles. No significant correlations were found between pain intensity and skin surface temperature over the left masseter (p=0.368), right masseter (p=0.618), left anterior temporalis (p=0.293) and right anterior temporalis (p=0.922) muscles. No correlations were found between pain intensity and asymmetry of the masseter (p=0.375) and anterior temporalis (p=0.090) muscles. Moreover, no significant difference in skin surface temperature (p> 0.05) was found among the different groups. Pain intensity in women with myogenous TMD was not associated with skin surface temperature at the central point of the masseter and anterior temporalis muscles.

  7. The teaching of temporomandibular disorders and orofacial pain at undergraduate level in Brazilian dental schools

    Directory of Open Access Journals (Sweden)

    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.

  8. Identification of clusters of individuals relevant to temporomandibular disorders and other chronic pain conditions: the OPPERA study

    Science.gov (United States)

    Bair, Eric; Gaynor, Sheila; Slade, Gary D.; Ohrbach, Richard; Fillingim, Roger B.; Greenspan, Joel D.; Dubner, Ronald; Smith, Shad B.; Diatchenko, Luda; Maixner, William

    2016-01-01

    The classification of most chronic pain disorders gives emphasis to anatomical location of the pain to distinguish one disorder from the other (eg, back pain vs temporomandibular disorder [TMD]) or to define subtypes (eg, TMD myalgia vs arthralgia). However, anatomical criteria overlook etiology, potentially hampering treatment decisions. This study identified clusters of individuals using a comprehensive array of biopsychosocial measures. Data were collected from a case–control study of 1031 chronic TMD cases and 3247 TMD-free controls. Three subgroups were identified using supervised cluster analysis (referred to as the adaptive, pain-sensitive, and global symptoms clusters). Compared with the adaptive cluster, participants in the pain-sensitive cluster showed heightened sensitivity to experimental pain, and participants in the global symptoms cluster showed both greater pain sensitivity and greater psychological distress. Cluster membership was strongly associated with chronic TMD: 91.5% of TMD cases belonged to the pain-sensitive and global symptoms clusters, whereas 41.2% of controls belonged to the adaptive cluster. Temporomandibular disorder cases in the pain-sensitive and global symptoms clusters also showed greater pain intensity, jaw functional limitation, and more comorbid pain conditions. Similar results were obtained when the same methodology was applied to a smaller case–control study consisting of 199 chronic TMD cases and 201 TMD-free controls. During a median 3-year follow-up period of TMD-free individuals, participants in the global symptoms cluster had greater risk of developing first-onset TMD (hazard ratio = 2.8) compared with participants in the other 2 clusters. Cross-cohort predictive modeling was used to demonstrate the reliability of the clusters. PMID:26928952

  9. Oro-facial pain and temporomandibular disorders classification systems: A critical appraisal and future directions.

    Science.gov (United States)

    Klasser, G D; Manfredini, D; Goulet, J-P; De Laat, A

    2017-12-02

    It is a difficult undertaking to design a classification system for any disease entity, let alone for oro-facial pain (OFP) and more specifically for temporomandibular disorders (TMD). A further complication of this task is that both physical and psychosocial variables must be included. To augment this process, a two-step systematic review, adhering to PRISMA guidelines, of the classification systems published during the last 20 years for OFP and TMD was performed. The first search step identified 190 potential citations which ultimately resulted in only 17 articles being included for in-depth analysis and review. The second step resulted in only 5 articles being selected for inclusion in this review. Five additional articles and four classification guidelines/criteria were also included due to expansion of the search criteria. Thus, in total, 14 documents comprising articles and guidelines/criteria (8 proposals of classification systems for OFP; 6 for TMD) were selected for inclusion in the systematic review. For each, a discussion as to their advantages, strengths and limitations was provided. Suggestions regarding the future direction for improving the classification process with the use of ontological principles rather than taxonomy are discussed. Furthermore, the potential for expanding the scope of axes included in existing classification systems, to include genetic, epigenetic and neurobiological variables, is explored. It is therefore recommended that future classification system proposals be based on combined approaches aiming to provide archetypal treatment-oriented classifications. © 2017 John Wiley & Sons Ltd.

  10. Comparative effectiveness of traditional Chinese medicine and psychosocial care in the treatment of temporomandibular disorders-associated chronic facial pain.

    Science.gov (United States)

    Ritenbaugh, Cheryl; Hammerschlag, Richard; Dworkin, Samuel F; Aickin, Mikel G; Mist, Scott D; Elder, Charles R; Harris, Richard E

    2012-11-01

    This dual-site study sought to identify the appropriate role for traditional Chinese medicine (TCM; acupuncture and herbs) in conjunction with a validated psychosocial self-care (SC) intervention for treating chronic temporomandibular disorders (TMD)-associated pain. Participants with Research Diagnostic Criteria for Temporomandibular Disorders-confirmed TMD (n = 168) entered a stepped-care protocol that began with a basic TMD class. At weeks 2 and 10, patients receiving SC whose worst facial pain was above predetermined levels were reallocated by minimization to SC or TCM with experienced practitioners. Characteristic facial pain (CFP: mean of worst pain, average pain when having pain, and current pain; each visual analog scale [VAS] 0-10) was the primary outcome. Social activity interference (VAS 0-10) was a secondary outcome. Patients were monitored for safety. TCM provided significantly greater short-term (8-week) relief than SC (CFP reduction difference, -.60 [standard deviation of the estimate .26], P = .020) and greater reduction in interference with social activities (-.81 [standard deviation of the estimate .33], P = .016). In 2 of 5 treatment trajectory groups, more than two thirds of participants demonstrated clinically meaningful responses (≥30% improvement) in pain interference over 16 weeks. This study provides evidence that TMD patients referred for TCM in a community-based model will receive safe treatment that is likely to provide some short-term pain relief and improved quality of life. Similar designs may also apply to evaluations of other kinds of chronic pain. (ClinicalTrials.gov number NCT00856167). This short-term comparative effectiveness study of chronic facial pain suggests that TCM is safe and frequently efficacious alone or subsequent to standard psychosocial interventions. TCM is widely available throughout North America and may provide clinicians and patients with a reasonable addition or alternative to other forms of therapy

  11. The influence of cranio-cervical posture on maximal mouth opening and pressure pain threshold in patients with myofascial temporomandibular pain disorders.

    Science.gov (United States)

    La Touche, Roy; París-Alemany, Alba; von Piekartz, Harry; Mannheimer, Jeffrey S; Fernández-Carnero, Josue; Rocabado, Mariano

    2011-01-01

    The aim of this study was to assess the influence of cranio-cervical posture on the maximal mouth opening (MMO) and pressure pain threshold (PPT) in patients with myofascial temporomandibular pain disorders. A total of 29 patients (19 females and 10 males) with myofascial temporomandibular pain disorders, aged 19 to 59 years participated in the study (mean years±SD; 34.69±10.83 y). MMO and the PPT (on the right side) of patients in neutral, retracted, and forward head postures were measured. A 1-way repeated measures analysis of variance followed by 3 pair-wise comparisons were used to determine differences. Comparisons indicated significant differences in PPT at 3 points within the trigeminal innervated musculature [masseter (M1 and M2) and anterior temporalis (T1)] among the 3 head postures [M1 (F=117.78; Pcervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.

  12. Influence of craniomandibular and cervical pain on the activity of masticatory muscles in individuals with Temporomandibular Disorder.

    Science.gov (United States)

    Ries, Lilian Gerdi Kittel; Graciosa, Maylli Daiani; Medeiros, Daiane Lazzeri De; Pacheco, Sheila Cristina Da Silva; Fassicolo, Carlos Eduardo; Graefling, Bárbara Camila Flissak; Degan, Viviane Veroni

    2014-01-01

    This study aimed to establish the prevalence of pain in the craniomandibular and cervical spine region in individuals with Temporomandibular Disorders (TMD) and to analyze the effects of these disorders on the bilateral activation of anterior temporalis (AT) and masseter (MA) muscles during the masticatory cycle. The participants were 55 female volunteers aged 18-30 years. The presence of TMD and craniomandibular and cervical spine pain was evaluated by applying the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire and using a combination of tests for the cervical region. The muscle activity of AT and MA during the masticatory cycle was assessed using the symmetry and antero-posterior coefficient indices. The AT activity during the masticatory cycle is more asymmetric in individuals with TMD. The craniomandibular pain, more prevalent in these individuals, influenced these results. Individuals with TMD showed changes in the pattern activity of AT. The craniomandibular nociceptive inputs can influence the increase in asymmetry of the activation of this muscle.

  13. Arthroscopy for temporomandibular disorders.

    Science.gov (United States)

    Rigon, Marcelo; Pereira, Ligia M; Bortoluzzi, Marcelo C; Loguercio, Alessandro D; Ramos, Adilson Luiz; Cardoso, Jefferson R

    2011-05-11

    Temporomandibular disorders (TMDs) are considered a collection of disorders involving many organic, psychological and psychosocial factors. They can involve the masticatory muscles or the temporomandibular joint (TMJ) and associated structures, or both. It is estimated that 40% to 75% of the population displays at least one sign of the disease and 33% of the population reports at least one symptom. Arthroscopy has been used to reduce signs and symptoms of patients with TMD but the effectiveness has still not been totally explained. To assess the effectiveness of arthroscopy for the management of signs and symptoms in patients with TMDs. The Cochrane Oral Health Group Trials Register (to 23 December 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 4, 2010), MEDLINE via OVID (1950 to 23 December 2010), EMBASE via OVID (1980 to 23 December 2010), LILACS via BIREME Virtual Health Library (1982 to 23 December 2010), Allied and Complementary Medicine Database (AMED) via OVID (1985 to 23 December 2010), CINAHL via EBSCO (1980 to 23 December 2010). There were no restrictions regarding the language or date of publication. Randomized controlled clinical trials of arthroscopy for treating TMDs were included. Two review authors independently extracted data, and three review authors independently assessed the risk of bias of included trials. The authors of the selected articles were contacted for additional information. Seven randomized controlled trials (n = 349) met the inclusion criteria. All studies were either at high or unclear risk of bias. The outcome pain was evaluated after 6 months in two studies. No statistically significant differences were found between the arthroscopy versus nonsurgical groups (standardized mean difference (SMD) = 0.004; 95% confidence interval (CI) -0.46 to 0.55, P = 0.81). Two studies, analyzed pain 12 months after surgery (arthroscopy and arthrocentesis) in 81 patients. No statistically

  14. Assessment of Diagnosed Temporomandibular Disorders and Orofacial Pain Conditions by Predoctoral Dental Students: A Pilot Study.

    Science.gov (United States)

    Adibi, Shawn S; Kookal, Krishna Kumar; Fishbeck, Nichole M; Thompson, Chris R; Walji, Muhammad F

    2016-12-01

    Temporomandibular disorders and orofacial pain (TMD/OFP) conditions are challenging to diagnose for predoctoral dental students due to the multifactorial etiology, complexity, and controversial issues surrounding these conditions. The aim of this study was to determine if patients in the clinic of one U.S. dental school reported existing signs and symptoms of TMD/OFP, whether the dental students diagnosed the condition based on the reported signs and symptoms, and if the condition was then treated. The study was based on a retrospective analysis of electronic health record data over a three-year period. The results showed that, during the study period, 21,352 patients were treated by student providers. Of those patients, 5.33% reported signs or symptoms associated with TMD/OFP; 5.99% received a TMD/OFP diagnosis; and 0.26% received at least one form of TMD/OFP treatment that had either a diagnosis or signs/symptoms of TMD/OFP. In addition, a small percentage (0.24%) of patients with no documented diagnosis received some sort of TMD/OFP-related treatment. A randomly selected sample of 90 patient charts found that no diagnoses of TMD/OFP were recorded in any of them. The results suggested that students had only marginally diagnosed the problems. Training for students including comprehensive didactic courses and clinical experiences to gain knowledge, context, and skill may be required to ensure they reach the required level of competence and prepare them to face the diagnostic challenges of TMD/OFP after graduation.

  15. Increased pain and muscle glutamate concentration after single ingestion of monosodium glutamate by myofascial temporomandibular disorders patients.

    Science.gov (United States)

    Shimada, A; Castrillon, E E; Baad-Hansen, L; Ghafouri, B; Gerdle, B; Wåhlén, K; Ernberg, M; Cairns, B E; Svensson, P

    2016-10-01

    A randomized, double-blinded, placebo-controlled study was conducted to investigate if single monosodium glutamate (MSG) administration would elevate muscle/serum glutamate concentrations and affect muscle pain sensitivity in myofascial temporomandibular disorders (TMD) patients more than in healthy individuals. Twelve myofascial TMD patients and 12 sex- and age-matched healthy controls participated in two sessions. Participants drank MSG (150 mg/kg) or NaCl (24 mg/kg; control) diluted in 400 mL of soda. The concentration of glutamate in the masseter muscle, blood plasma and saliva was determined before and after the ingestion of MSG or control. At baseline and every 15 min after the ingestion, pain intensity was scored on a 0-10 numeric rating scale. Pressure pain threshold, pressure pain tolerance (PPTol) and autonomic parameters were measured. All participants were asked to report adverse effects after the ingestion. In TMD, interstitial glutamate concentration was significantly greater after the MSG ingestion when compared with healthy controls. TMD reported a mean pain intensity of 2.8/10 at baseline, which significantly increased by 40% 30 min post MSG ingestion. At baseline, TMD showed lower PPTols in the masseter and trapezius, and higher diastolic blood pressure and heart rate than healthy controls. The MSG ingestion resulted in reports of headache by half of the TMD and healthy controls, respectively. These findings suggest that myofascial TMD patients may be particularly sensitive to the effects of ingested MSG. WHAT DOES THIS STUDY ADD?': Elevation of interstitial glutamate concentration in the masseter muscle caused by monosodium glutamate (MSG) ingestion was significantly greater in myofascial myofascial temporomandibular disorders (TMD) patients than healthy individuals. This elevation of interstitial glutamate concentration in the masseter muscle significantly increased the intensity of spontaneous pain in myofascial TMD patients. © 2016

  16. Occupation as a potential contributing factor for temporomandibular disorders, bruxism, and cervical muscle pain: a controlled comparative study.

    Science.gov (United States)

    Emodi Perelman, Alona; Eli, Ilana; Rubin, Pessia F; Greenbaum, Tzvi; Heiliczer, Shimrit; Winocur, Ephraim

    2015-09-01

    The aim of the study was to compare the prevalence of cervical muscle pain (CMP) and myogenic temporomandibular disorders (MFP) among female dentists, high-tech workers, and a group of subjects employed in other occupations; to investigate the associations among CMP, MFP, and bruxism in those groups; and to evaluate the influence of work-related stress on MFP and CMP. Evaluation was based on clinical examinations of MFP and CMP and self-reported questionnaires concerning pain and stress. The diagnosis of sleep bruxism was adapted using the validated diagnostic criteria of the American Academy of Sleep Medicine (International Classification of Sleep Disorders (ICSD-2), 2005, Westchester, IL), whilst the diagnosis of awake bruxism was made on the basis of a questionnaire. The odds of a subject with MFP experiencing concurrent CMP or bruxism (sleep and/or awake) ranged from 2.603 to 3.077. These results suggest that high-tech workers and dentists are at greater risk for developing temporomandibular disorders (TMDs) and CMP when compared with general occupation workers, as defined in this study. Furthermore, the associations shown here between TMDs and CMP highlight the importance of palpating neck musculature as part of any routine examination of TMD. © 2015 Eur J Oral Sci.

  17. Temporomandibular Disorders and Headache.

    Science.gov (United States)

    Graff-Radford, Steven B; Abbott, Jeremy J

    2016-08-01

    Temporomandibular disorders (TMD) and primary headaches can be perpetual and debilitating musculoskeletal and neurological disorders. The presence of both can affect up to one-sixth of the population at any one time. Initially, TMDs were thought to be predominantly musculoskeletal disorders, and migraine was thought to be solely a cerebrovascular disorder. The further understanding of their pathophysiology has helped to clarify their clinical presentation. This article focuses on the role of the trigeminal system in associating TMD and migraine. By discussing recent descriptions of prevalence, diagnosis, and treatment of headache and TMD, we will further elucidate this relationship. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Improvement and care seeking for temporomandibular-pain complaints: The complexity of chronic pain

    NARCIS (Netherlands)

    Rollman, A.

    2013-01-01

    "Temporomandibular disorders" (TMD) is a collective term used to describe a group of musculoskeletal conditions occurring in the temporomandibular region. TMD shares features with other chronic musculoskeletal syndromes (such as low back pain and neck pain) including pain, limited range of motion

  19. Changes in cervical movement impairment and pain following orofacial treatment in patients with chronic arthralgic temporomandibular disorder with pain: A prospective case series.

    Science.gov (United States)

    Grondin, Francis; Hall, Toby

    2017-01-01

    The purpose of this study was to investigate the influence of isolated temporomandibular joint (TMJ) manual therapy on pain and range of motion (ROM) of the TMJ and cervical spine including flexion-rotation test (FRT) in people suffering chronic pain arising from chronic arthralgic temporomandibular disorder (TMD). An experienced clinician managed a case series of 12 patients with TMD (mean duration 28.6 months +/- 26.9). The intervention comprised four-weekly sessions of transverse medial accessory TMJ mobilization and advice. Patients were examined prior to and one-week following the intervention period. Outcome measures included jaw disability (JFLS-20), jaw pain measured by Visual Analogue Scale (VAS), maximal mouth opening ROM, cervical ROM including FRT, and pain during cervical movement. A paired t-test revealed significant improvement following the intervention in disability (p pain score at rest (p pain at rest or at maximal mouth opening, and all had a negative FRT. The effect sizes indicate a moderate to strong, clinically significant effect for all variables apart from total cervical ROM. While a case series cannot identify a cause and effect relationship, these results provide preliminary evidence for the influence of TMJ manual therapy on measures of TMD including pain, as well as upper but not whole cervical movement and associated pain in patients with a diagnosis of TMJ arthralgia.

  20. Naturalistic changes in insomnia symptoms and pain in temporomandibular joint disorder: a cross-lagged panel analysis.

    Science.gov (United States)

    Quartana, Phillip J; Wickwire, Emerson M; Klick, Brendan; Grace, Edward; Smith, Michael T

    2010-05-01

    An increasing number of prospective studies suggest a bi-directional association between the pain and sleep quality. Few of these investigations have controlled for synchronous correlations, an important source of extraneous variance in lagged associations, which may have confounded conclusions of prior investigations. Despite high rates of insomnia in temporomandibular joint disorders (TMD), no studies have examined temporal associations between naturalistic fluctuations in insomnia and pain in TMD. We conducted cross-lagged panel analysis to examine reciprocal temporal associations between 1-month changes in insomnia symptom severity and self-reported pain over 3 months among 53 TMD patients. This rigorous analytic strategy represents a comprehensive method to explore possible reciprocal temporal associations between insomnia and pain that controls for both auto- and synchronous correlations. Analyses revealed that initial-month increases in insomnia were associated with next-month increases in average daily pain, but not vice versa. The direction of the effect was such that initial-month increases in insomnia symptom severity were associated with next-month increases in average daily pain. These data suggest that naturally occurring fluctuations in insomnia symptom severity are prospectively associated with fluctuations in daily pain experience for persons with TMD. Potential mechanisms by which insomnia might influence pain in TMD and therapeutic implications of these findings are discussed. Copyright 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  1. Experimental pain sensitivity in women with temporomandibular disorders and pain-free controls: the relationship to orofacial muscular contraction and cardiovascular responses.

    Science.gov (United States)

    Mohn, Christine; Vassend, Olav; Knardahl, Stein

    2008-05-01

    Chronic pain may result both from a generalized hypersensitivity to acute pain, suggestive of central sensitization processes, and dysfunction of the endogenous pain regulatory system. One purpose of this study was to compare experimental pain sensitivity at several anatomic sites in temporomandibular disorder (TMD) patients and pain-free controls during baseline and after standardized mechanical load of the orofacial region. A second purpose was to compare the pain-modulating effects of cardiovascular responses in TMD patients and pain-free controls. Experimental pain was induced by electrocutaneous stimulation of the dorsal left hand and pressure algometry at the right masseter muscle and the sternum. The pain sensitivity of the orofacial region was manipulated by isometric contraction of the masseter muscles. Elevations of mean arterial pressure and heart rate were induced by a simulated job interview. At baseline, the TMD patients exhibited a significantly higher electrocutaneous pain threshold. Relative to the healthy controls, the TMD patients reported increased electrocutaneous and pressure pain sensitivity after isometric contraction of the orofacial region. In addition, there were correlations between mean arterial pressure and pain sensitivity in the TMD group only. Significant increases in generalized pain sensitivity occurred in the TMD group, but not in the control group, after isometric contraction of the orofacial muscles, suggestive of a central sensitization process in TMD. Moreover, only in the TMD group there were significant associations between cardiovascular responsesand pain sensitivity, challenging previous assumptions of this relationship occurring mainly in pain-free individuals.

  2. Validation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD) in patients with painful TMD.

    Science.gov (United States)

    He, Songlin; Wang, Jinhua; Ji, Ping

    2016-12-01

    The aim of the study was to validation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD) for use in patients with painful TMD. The original TSK-TMD was translated and cross-culturally adaptated following international guidelines. A total of 160 patients with temporomandibular disorders (TMD) were enrolled to fill out the scale. The internal consistency and test-retest methods were used to evaluate the reliability of the TSK-TMD. The validity of the TSK-TMD was analyzed by content validity, construct validity and convergent validity. Construct validity was assessed based on exploratory factor analysis (EFA), and convergent validity by examining the correlation between the global rating of oral health question and TSK-TMD scores. Cronbach's alpha value for the total TSK-TMD score was 0.919 and the intraclass correlation coefficient (ICC) value for the TSK-TMD was 0.797. Construct validity was assessed by EFA, extracting two factors, accounting for 71.9% of the variance. The factor loadings of all items were higher than 0.40. In terms of convergent validity, the TSK-TMD subscales showed good correlations to the global rating of oral health question. These findings show that the Chinese version of TSK-TMD has satisfactory psychometric properties and is appropriate for use in patients with painful TMD in China.

  3. The influence of cranio-cervical rehabilitation in patients with myofascial temporomandibular pain disorders.

    Science.gov (United States)

    Halmova, K; Holly, D; Stanko, P

    2017-01-01

    The aim of the study was to prove the causality between the craniocervical dysfunction and myofascial pain in the head and neck and to demonstrate the clinical value and usefulness of physiotherapy as one of the therapeutic options for myofascial pain. The group of patients diagnosed with myofascial dysfunctional pain syndrome contained 98 patients out of which 79 patients (81 %) were females and 19 patients (19 %) were males. The majority of the patients were aged between 26 and 35 years; the total age range was 14-77 years with the average of 38 years. Observed patients were subdivided into three groups. Standard therapeutic methods aimed at the temporomandibular joint were provided to the patients of the first group. The second group of the patients received therapy aimed at cervical muscles only. Complex rehabilitation was applied in the third group of patients. The most frequent method used in the evaluation of chronic musculoskeletal pain in clinical studies is the visual analogue scale (VAS). According to our results, all three groups of patients saw an improvement in pain perception, but the overall subjective remission of painful sensations in the third group took place in as many as 88 % of patients. In this group, there was a significant decrease in the tenderness of trigger points in the trapezius and sternocleidomastoid muscles. It was proved that a combination of simple relaxing and stretching exercises of cervical muscles with a standard method used in the therapy of masticatory muscles is significantly more efficient (Fig. 5, Ref. 18).

  4. Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

    OpenAIRE

    Costa, Yuri-Martins; Porporatti, Andr?-Lu?s; Calderon, Patr?cia-dos-Santos; Conti, Paulo-C?sar-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2015-01-01

    Background The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. Material and Methods A total of 1200 dental records of orofacial pain adult p...

  5. Association of pain intensity, pain-related disability, and depression with hypothalamus-pituitary-adrenal axis function in female patients with chronic temporomandibular disorders.

    Science.gov (United States)

    Jo, Kyung B; Lee, Young J; Lee, Il G; Lee, Sang C; Park, Jai Y; Ahn, Ryun S

    2016-07-01

    Patients with temporomandibular disorders (TMD) commonly experience myofascial and joint pain, pain-related disability, and other pain conditions including depression. The present study was carried out to explore the function of the hypothalamus-pituitary-adrenal (HPA) axis in relation to variables of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II and comorbid depression in female patients with TMD. Cortisol and dehydroepiandrosterone (DHEA) levels were determined in saliva samples that had been collected at various periods after waking (0, 30, and 60min) and at nighttime (2100-2200h) from 52 female patients with chronic TMD pain and age- and gender-matched controls (n=54, 20-40 years old). There were no significant differences in the levels and diurnal patterns of cortisol and DHEA secretion between groups of patients with TMD and controls. In patients, the cortisol awakening response (CAR) or diurnal cortisol rhythm were not associated with any variables of the RDC/TMD Axis II or the Beck Depression Inventory (BDI)-II total scores. However, the ratio of overall cortisol secretion within the first hour after waking (CARauc) to overall DHEA secretion during the post-waking period (Daucawk), defined as CARauc/Daucawk, was significantly associated with pain-related RDC/TMD variables (pain intensity and pain-related disability) and BDI-II total scores. Pain intensity and pain-related disability scores were also significantly associated with BDI-II total scores. These results indicated that an increase in molar cortisol/DHEA ratio due to the dissociation between cortisol and DHEA secretion was associated with pain intensity, pain-related disability, and depression in female patients with TMD. Copyright © 2016. Published by Elsevier Ltd.

  6. Temporomandibular joint disorder (review).

    Science.gov (United States)

    Dugashvili, G; Menabde, G; Janelidze, M; Chichua, Z; Amiranashvili, I

    2013-02-01

    Etiopathogenesis and clinical management of TMJD integrates a number of medical disciplines. In particular, dentistry, oral - facial surgery, neurology, rheumatology and so on. Nowadays there is no unified strategy for the management of this disease. Most cases of temporomandibular disorder (TMD) respond to simple treatment and the prognosis is good. Symptoms usually remit with simple care. In cases of secondary involvement of temporomandibular joint (TMJ), the prognosis depends on the primary disease. A comprehensive, chronological history and physical and examination of the patient, including dental history and examination, is essential to diagnose the specific condition to decide further investigations, if any, and to provide specific treatment. in severe cases, a joint consultation of a dentist, neurologist and rheumatologist is needed.

  7. Impacto da dor na vida de portadores de disfunção temporomandibular Pain impact on life of patients with temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    Anamaria Siriani de Oliveira

    2003-06-01

    Full Text Available Foi realizado um estudo do impacto da dor na vida de indivíduos portadores de disfunção da articulação temporomandibular (DTM. Foram estudados 22 pacientes (20 mulheres e dois homens, com idade média de 28 anos portadores de DTM que procuraram atendimento fisioterapêutico especializado, submetidos a uma versão brasileira do Questionário McGill de Dor (Br-MPQ, que inclui questões específicas sobre a qualidade de vida, como: 1 prejuízo social; 2 atividades da vida diária; 3 percepção do outro; 4 tolerância à dor; 5 sensação de estar doente; 6 sensação de utilidade; 7 satisfação com a vida. Os resultados mostraram que a dor da DTM prejudicou as atividades do trabalho (59,09%, da escola (59,09%, o sono (68,18% e o apetite/alimentação (63,64%. Os autores concluíram que a dor da DTM tem um impacto negativo na qualidade de vida do paciente e que o questionário empregado, embora não específico, permitiu avalia-lo adequadamente.A study on the impact of pain in patients with temporomandibular joint disorder (TMD was carried out. Twenty two patients (20 women, two men, 28 years of age on average with TMD who looked for specialized physiotherapy care were submitted to a brazilian version of McGill Pain Questionnaire (Br-MPQ, which includes questions about life quality, as follows: 1 social loss; 2 daily life activities; 3 third party’s perception; 4 pain tolerance; 5 sensation of being sick; 6 sensation of being useless; 7 life satisfaction. The results showed that pain related to the TMD significantly affected work activities (59.09%, school activities (59.09%, sleeping (68.18% and appetite/feeding (63.64%. The authors conclude that pain from TMD has a negative impact on the patients’ life quality and that, although unspecific, the questionnaire used allowed for an adequate evaluation of the impact.

  8. Diagnosis and treatment of temporomandibular disorders

    National Research Council Canada - National Science Library

    Gauer, Robert L; Semidey, Michael J

    2015-01-01

    Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, and surrounding musculature and osseous components...

  9. An investigation on the simultaneously recorded occlusion contact and surface electromyographic activity for patients with unilateral temporomandibular disorders pain.

    Science.gov (United States)

    Li, Bao-Yong; Zhou, Li-Juan; Guo, Shao-Xiong; Zhang, Yuan; Lu, Lei; Wang, Mei-Qing

    2016-06-01

    The present study examined if unilateral pain from temporomandibular disorders (TMD) was associated with the occlusion contacts and surface electromyographic (SEMG) activities of jaw-closing muscles. Eleven patients with unilateral TMD pain and 20 healthy volunteers who all had Angle's Class-I occlusions were enrolled. The numbers and load distributions of the occlusion contacts and the SEMG activities of the anterior temporalis (TA) muscles and masseters muscles (MM) during maximal voluntary clenching (MVC) in the centric and eccentric positions were simultaneously recorded on both sides. The pain was not associated with occlusal contact numbers or load distributions. The SEMG activities of the pain-side TA and bilateral MM were lower during centric MVC compared with controls. The SEMG activities of the non-pain-side TA and the normalized SEMG activities of the bilateral TAs and MMs were higher during protrusive MVC (pocclusal contacts, but the patients with TMD had TA and MM SEMG activities during different tasks that differed from controls and that did not seem related to the pain side. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Temporomandibular disorders in patients with craniocervical dystonia

    OpenAIRE

    Costa,André L.; Campos, Lidiane S.; Marcondes C. França Jr.; Anelyssa D'Abreu

    2011-01-01

    Temporomandibular disorders are a set of musculoskeletal dysfunctions within the masticatory system, with multiple etiologies. Objective: Since craniocervical dystonia can involye the same neuromuscular structure as the temporomandibular joint, we sought to assess the correlation between temporomandibular disorders and craniocervical dystonia. Method: We applied the Research Diagnostic Criteria for Temporomandibular Disorders to 42 patients with craniocervical dystonia, in order to identify o...

  11. Trigeminal electrophysiology: a 2 x 2 matrix model for differential diagnosis between temporomandibular disorders and orofacial pain.

    Science.gov (United States)

    Frisardi, Gianni; Chessa, Giacomo; Sau, Gianfranco; Frisardi, Flavio

    2010-07-01

    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 ((b)R-MEPs) tests, we investigated the functional and organic responses of healthy subjects (control group) and patients with TMD symptoms (TMD group). 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. Analysis of the ratios (expressed as percentages) between the values obtained on both sides revealed a high degree of symmetry in the (b)R-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 statistically significant difference

  12. 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.

  13. Painful temporomandibular disorders are common in patients with postural orthostatic tachycardia syndrome and impact significantly upon quality of life.

    Science.gov (United States)

    Durham, Justin; McDonald, Claire; Hutchinson, Luke; Newton, Julia L

    2015-01-01

    To explore the point prevalence of painful temporomandibular disorders (TMD) in a well-characterized clinical cohort of postural orthostatic tachycardia syndrome (PoTS) sufferers and to understand the functional and physiologic impact of this comorbidity on the patient. Patients with PoTS were retrospectively recruited from a previous study conducted in a UK hospital setting. Data had previously been collected on several parameters, including sociodemographic, physiologic, and functional. The participants were mailed a highly sensitive (99%) and specific (97%) self-report screening instrument for painful TMD. Simple descriptive statistics with Fisher Exact and Kruskal-Wallis tests were used to examine the data and draw inferences from it. A total of 36 individuals responded (69% response rate). Just under half (47%) of the sample screened positive for painful TMD. There was no significant difference between the screening result for TMD or previously reported headaches or joint pain (P quality of life as measured by the Patient-Reported Outcomes Measurement Information System, Health Assessment Questionnaire (P quality of life and should therefore be screened for at an early stage in PoTS.

  14. Nocturnal heart rate variability is lower in temporomandibular disorder patients than in healthy, pain-free individuals.

    Science.gov (United States)

    Eze-Nliam, Chete M; Quartana, Phillip J; Quain, Angela M; Smith, Michael T

    2011-01-01

    To determine whether patients with a painful myofascial temporomandibular disorder (TMD) have diminished nocturnal heart rate variability (HRV), a marker of autonomic nervous system (ANS) dysfunction, relative to healthy, pain-free controls. Participants with myofascial TMD and healthy, pain-free volunteers underwent nocturnal polysomnography studies during which HRV indices were measured. Multiple linear regression analyses were used to determine whether TMD status exerted unique effects on HRV. Ninety-five participants (n = 37 TMD; n = 58 controls) were included in the analyses. The TMD group had a lower standard deviation of R-R intervals (89.81 ± 23.54 ms versus 107.93 ± 34.42 ms, P ⋜ .01), a lower root mean squared successive difference (RMSSD) of R-R intervals (54.78 ± 27.37 ms versus 81.88 ± 46.43 ms, P pain-free controls. Further research should focus on processes that address this ANS imbalance, which may potentially lead to effective therapeutic interventions.

  15. Cervical-scapular muscles strength and severity of temporomandibular disorder in women with mechanical neck pain

    Directory of Open Access Journals (Sweden)

    Fernanda Pasinato

    Full Text Available Abstract Introduction: Changes in cervical muscle function have been observed in patients with neck pain (NP and TMD. However, the relationship between TMD severity and neck muscle strength in the presence/absence of NP is unknown. Objective: To determine the prevalence of TMD in women with and without mechanical NP and assess the cervical-scapular muscle strength and its association with TMD severity. Methods: Fifteen volunteers without neck pain (CG and 14 women with mechanical neck pain (NPG took part and were selected by the Neck Disability Index. The diagnosis and severity of TMD were determined by the Research Diagnostic Criteria for TMD and Temporomandibular Index (TI, respectively. The strength of the upper trapezius muscle, and cervical flexor and extensor muscles was measured by digital hand dynamometer. Results: 64.5% of women with NP and 33.3% without NP were diagnosed with TMD (p = 0.095. The NPG showed lower strength of the cervical flexor (p = 0.044 and extensor (p=0.006 muscles, and higher TI (p = 0.038 than in the CG. It was also verified moderate negative correlation between TI and the strength of dominant (p = 0.046, r = -0.547 and non-dominant (p = 0.007, r = -0.695 upper trapezius, and cervical flexors (p = 0.023, r = -0.606 in the NPG. Conclusion: There was no difference in the prevalence of TMD in women with and without NP. However, women with NP have lower cervical muscle strength - compared to those without NP - which was associated with greater severity of TMD. Thus, in women with NP associated with TMD, it is advisable to assess and address the severity of this dysfunction and identify the cervical-scapular muscles compromise.

  16. Vertical Craniofacial Morphology and its Relation to Temporomandibular Disorders.

    Science.gov (United States)

    Bavia, Paula Furlan; Rodrigues Garcia, Renata Cunha Matheus

    2016-01-01

    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. 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. No association between craniofacial morphology and TMD was found (P = 0.6622). However, brachyfacial morphology influences the presence of painful TMD (P = 0.0077). Craniofacial morphology is not related to temporomandibular disorders in general.

  17. Application of an oral health-related quality of life questionnaire in primary care patients with orofacial pain and temporomandibular disorders

    Science.gov (United States)

    Blanco-Aguilera, Antonio; Biedma-Velázquez, Lourdes; Serrano-del-Rosal, Rafael; González-López, Laura; Blanco-Aguilera, Elena; Segura-Saint-Gerons, Rafael

    2014-01-01

    Objectives: To examine whether patients who report orofacial pain (OP) and temporomandibular disorders (TMD) have a poorer perception of their oral health-related quality of life and, if so, to what extent, and to analyze the association between oral health perception, sociodemographic variables and reported pain duration. Study Design: 407 patients treated at the OP and TMD units in the Healthcare District of Cordoba, Spain, diagnosed following the standard criteria accepted by the scientific community – the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) – were administered the Spanish version of the Oral Health Impact Profile questionnaire (OHIP-14). Bivariate and logistic regression analyses were performed to determine the degree of association between the patients’ OHIP-14 score and pain duration, pain intensity, and various sociodemographic variables. Results: The observed distribution was 89.4% women and 10.6% men. The mean OHIP-14 score was 20.57 ± 10.73 (mean ± standard deviation). A significant association (ptemporomandibular disorders, Oral Health Impact Profile, sociodemographic variables, primary care, Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). PMID:24121906

  18. Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

    Science.gov (United States)

    Costa, Yuri-Martins; Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2016-01-01

    The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (ppalpation-induced pain (ppalpation-induced pain (ppalpation-induced pain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism.

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

    National Research Council Canada - National Science Library

    Srivastava, Rahul; Jyoti, Bhuvan; Devi, Parvathi

    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...

  20. Temporomandibular disorders: evaluation and management.

    Science.gov (United States)

    De Rossi, Scott S; Greenberg, Martin S; Liu, Frederick; Steinkeler, Andrew

    2014-11-01

    Temporomandibular disorders remain a common cause of visits to primary care physicians, internists, pediatricians, and emergency departments. Advances in the clinical diagnosis, radiographic imaging, and classification of these disorders have improved long-term management. There are several types of disorders of the masticatory muscles and the temporomandibular joint as well as associated structures and each may have a complex cause, clinical course, and response to therapy. Host susceptibility plays a role at several stages of these disorders. Future research offers greater possibility in defining this heterogeneous group of disorders and providing more focused and effective treatment strategies. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. 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

  2. Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

    Science.gov (United States)

    Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2016-01-01

    Background The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. Material and Methods A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Results Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (ppain (ppain (ppain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Conclusions Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism. Key words:Diagnosis, temporomandibular joint disorders, migraine, tension-type headache, bruxism. PMID:26615507

  3. The association between Occlusion Time and Temporomandibular Disorders.

    Science.gov (United States)

    Baldini, Alberto; Nota, Alessandro; Cozza, Paola

    2015-02-01

    Recently, some published studies show there is a multifactorial origin for Temporomandibular Disorders, but the dental occlusion's contribution to the development of Temporomandibular Disorders, and how it may influence the adaptive capacity of the Stomatognathic system, it's still unclear. The aim of this study is to evaluate the correlation between the Occlusion Time and Temporomandibular Disorders. A total of 54 patients were enrolled in the study (24 males and 30 females, mean age 27.94 ± 8.21 years). The TMD group (8 males and 10 females) consisted of subjects who presented with at least 1 of the following signs of Temporomandibular Disorders: Temporomandibular Joint sounds (clicking or crepitation), Temporomandibular Joint locking episodes, limited mandibular opening, painful limitation of mandibular movements, pain to palpation of the Temporomandibular Joint or of the masticatory muscles. The control group (16 males and 20 females) presented as free from Temporomandibular Disorders. The T-Scan III computerized occlusal analysis system was to record the subjects' Occlusion. Times during eight mandibular opening-closing movements. The two-ways ANOVA test analyzed the variations for group and sex, showing that the TMD group mean Occlusion Time (0.64 ± 0.21s) was statistically significantly longer than the control group mean Occlusion Time (0.45 ± 0.17s) (pTMJ problems has to be carefully considered as adjunctive instrumental device. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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) 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 statistically

  5. 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

  6. Current panorama of temporomandibular disorders' field in Brazil.

    Science.gov (United States)

    Machado, Naila Aparecida de Godoi; Lima, Fernanda Ferruzzi; Conti, Paulo César Rodrigues

    2014-06-01

    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. 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. 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. 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. The number of researches related to temporomandibular disorders has increased over the last ten years, as well as the number of specialization courses and the number

  7. Changes in pain intensity and oral health-related quality of life in patients with temporomandibular disorders during stabilization splint therapy--a pilot study.

    Science.gov (United States)

    Alajbeg, Iva Z; Gikić, Marijana; Valentić-Peruzović, Melita

    2014-03-01

    The aim of the study was to evaluate changes in pain intensity and self-perceived quality of life in patients with temporomandibular disorders (TMD) during stabilization splint therapy. The hypothesis was that the clinical subtype of TMD, depending on whether pain is of muscular or temporomandibular joint origin, and pain chronicity (acute vs. chronic pain) differently affect treatment response. Thirty patients were included and treated with a stabilization splint in a 6-month clinical trial. Treatment outcomes included pain-free maximal mouth opening (MO), assisted maximal MO, path of MO, asymmetry in lateral excursions, spontaneous pain intensity (visual analog scale, VAS), and self-perceived quality of life (Oral Health Impact Profile, OHIP-14). Overall, VAS and OHIP-14 scores changed significantly over time (VAS: F = 80.85, p quality of life did not differ significantly between MP and DD groups (F = 0.213, p = 0.847, effect size = 0.008), or between AP and CP patients (F = 0.816, p = 0.489, effect size = 0.029). Linear regression analysis was used to assess the contribution of each predictor variable to the explanation of the OHIP summary score variance. Results showed pain reduction (coefficient = 0.303; 95% CI: 0.120 to 0.485) and MO increase (coefficient = 0.149; 95% CI: 0.037 to 0.260) to be independent predictors of the OHIP-14 summary score changes (R2 = 0.453), whereas other variables did not affect treatment outcome as assessed by OHIP-14. In conclusion, during 6-month stabilization splint therapy, significant changes in VAS and OHIP-14 summary scores were found. However, there were no significant differences in improvement rates between subjects with acute and chronic pain. Furthermore, no significant differences in improvement rates were found depending on whether pain was of muscular or temporomandibular joint origin.

  8. The essential role of the otolaryngologist in the diagnosis and management of temporomandibular joint and chronic oral, head, and facial pain disorders.

    Science.gov (United States)

    Israel, Howard A; Davila, Laura J

    2014-04-01

    This article clarifies the current state of knowledge of chronic oral, head, and facial pain (COHFP) conditions with the inclusion of temporomandibular joint disorders as just one component of the variety of conditions that can cause head and facial pain. Obtaining an accurate diagnosis in a timely manner is extremely important because COHFP symptoms can be caused by a variety of pathologic conditions that can be inflammatory, degenerative, neurologic, neoplastic, or systemic in origin. The essential role of the specialty of otolaryngology in the diagnosis and management of patients with these complex COHFP conditions is emphasized. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders.

    Science.gov (United States)

    La Touche, R; Fernández-de-las-Peñas, C; Fernández-Carnero, J; Escalante, K; Angulo-Díaz-Parreño, S; Paris-Alemany, A; Cleland, J A

    2009-09-01

    No studies have investigated the effects of the treatments directed at the cervical spine in patients with temporomandibular disorders (TMD). Our aim was to investigate the effects of joint mobilization and exercise directed at the cervical spine on pain intensity and pressure pain sensitivity in the muscles of mastication in patients with TMD. Nineteen patients (14 females), aged 19-57 years, with myofascial TMD were included. All patients received a total of 10 treatment session over a 5-week period (twice per week). Treatment included manual therapy techniques and exercise directed at the cervical spine. Outcome measures included bilateral pressure pain threshold (PPT) levels over the masseter and temporalis muscles, active pain-free mouth opening (mm) and pain (Visual Analogue Scale) and were all assessed pre-intervention, 48 h after the last treatment (post-intervention) and at 12-week follow-up period. Mixed-model anovas were used to examine the effects of the intervention on each outcome measure. Within-group effect sizes were calculated in order to assess clinical effect. The 2 x 3 mixed model anova revealed significant effect for time (F = 77.8; P 1.0) for both follow-up periods in both muscles. The anova found a significant effect for time (F = 78.6; P 0.7). Within-group effect sizes were large (d > 0.8) for both post-intervention and follow-up periods. The application of treatment directed at the cervical spine may be beneficial in decreasing pain intensity, increasing PPTs over the masticatory muscles and an increasing pain-free mouth opening in patients with myofascial TMD.

  10. Low-level laser therapy for temporomandibular disorders (tmd) treatment: a systematic review of randomized trials

    OpenAIRE

    Leite, Priscila; Melo, Nicole; Silva, Pâmela; Montenegro, Robinsom; Bonan, Paulo; Batista, André

    2014-01-01

    AIM: Conducting a systematic review of randomized clinical trials focusing on the efficacy of LLLT on pain control in patients with TMD, diagnosed by the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). MATERIAL AND METHODS: Search was performed at PubMed/MEDLINE database with the terms: (1) “Laser AND temporomandibular disorders”; (2) “Laser AND temporomandibular disorders AND RDC/TMD”; (3) “Low-level laser therapy AND temporomandibular disorders”; (4) “Low-level laser...

  11. 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.

  12. Subtyping patients with temporomandibular disorders in a primary health care setting on the basis of the research diagnostic criteria for temporomandibular disorders axis II pain-related disability: a step toward tailored treatment planning?

    Science.gov (United States)

    Kotiranta, Ulla; Suvinen, Tuija; Kauko, Tommi; Le Bell, Yrsa; Kemppainen, Pentti; Suni, Jorma; Forssell, Heli

    2015-01-01

    To use the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II and additional pain-related and psychosocial variables to identify subtypes of TMD patients in a primary health care setting based on pain-related disability. Consecutive TMD pain patients (n = 399) seeking treatment in a primary care setting completed a multidimensional pain questionnaire. Subtyping was based on the Graded Chronic Pain Scale (GCPS), and the patients were divided into a no-disability group (0 disability points), lowdisability group (1-2 disability points), and high-disability group (3-6 disability points). Psychosocial variables included RDC/TMD Axis II variables, anxiety, tension and stress, worry, catastrophizing, coping ability, general health, and other pain problems. Subtype differences were analyzed with t test, Wilcoxon rank-sum test, ANOVA, or Kruskal-Wallis test. A further analysis with multivariable logistic model was applied. All P values from pairwise comparisons were Bonferroni adjusted. Most (61%) of the patients belonged to the no-disability group, 27% to the low-disability group, and 12% to the high-disability group. When subtypes were compared, patients in the no-disability group appeared psychosocially well-functioning, with fewer symptoms related to psychosocial distress, better ability to control pain, and fewer jaw functional limitations and other pain problems. Patients in the high-disability group reported the highest levels of symptoms of depression and somatization, sleep dysfunction, worry, and catastrophizing thoughts. The low-disability patients formed an intermediate group between the no-disability and high-disability groups. The results suggest that GCPS-related disability scoring can be used as a simple screening instrument in primary care settings to identify individuals with different, clinically relevant psychosocial subtypes.

  13. Masticatory sensory-motor changes after an experimental chewing test influenced by pain catastrophizing and neck-pain-related disability in patients with headache attributed to temporomandibular disorders.

    Science.gov (United States)

    La Touche, Roy; Paris-Alemany, Alba; Gil-Martínez, Alfonso; Pardo-Montero, Joaquín; Angulo-Díaz-Parreño, Santiago; Fernández-Carnero, Josué

    2015-03-05

    Recent research has shown a relationship of craniomandibular disability with neck-pain-related disability has been shown. However, there is still insufficient information demonstrating the influence of neck pain and disability in the sensory-motor activity in patients with headache attributed to temporomandibular disorders (TMD). The purpose of this study was to investigate the influence of neck-pain-related disability on masticatory sensory-motor variables. An experimental case-control study investigated 83 patients with headache attributed to TMD and 39 healthy controls. Patients were grouped according to their scores on the neck disability index (NDI) (mild and moderate neck disability). Initial assessment included the pain catastrophizing scale and the Headache Impact Test-6. The protocol consisted of baseline measurements of pressure pain thresholds (PPT) and pain-free maximum mouth opening (MMO). Individuals were asked to perform the provocation chewing test, and measurements were taken immediately after and 24 hours later. During the test, patients were assessed for subjective feelings of fatigue (VAFS) and pain intensity. VAFS was higher at 6 minutes (mean 51.7; 95% CI: 50.15-53.26) and 24 hours after (21.08; 95% CI: 18.6-23.5) for the group showing moderate neck disability compared with the mild neck disability group (6 minutes, 44.16; 95% CI 42.65-45.67/ 24 hours after, 14.3; 95% CI: 11.9-16.7) and the control group. The analysis shows a decrease in the pain-free MMO only in the group of moderate disability 24 hours after the test. PPTs of the trigeminal region decreased immediately in all groups, whereas at 24 hours, a decrease was observed in only the groups of patients. PPTs of the cervical region decreased in only the group with moderate neck disability 24 hours after the test. The strongest negative correlation was found between pain-free MMO immediately after the test and NDI in both the mild (r = -0.49) and moderate (r = -0.54) neck disability

  14. Application of an oral health-related quality of life questionnaire in primary care patients with orofacial pain and temporomandibular disorders.

    Science.gov (United States)

    Blanco-Aguilera, A; Blanco-Hungría, A; Biedma-Velázquez, L; Serrano-Del-Rosal, R; González-López, L; Blanco-Aguilera, E; Segura-Saint-Gerons, R

    2014-03-01

    To examine whether patients who report orofacial pain (OP) and temporomandibular disorders (TMD) have a poorer perception of their oral health-related quality of life and, if so, to what extent, and to analyze the association between oral health perception, sociodemographic variables and reported pain duration. 407 patients treated at the OP and TMD units in the Healthcare District of Cordoba, Spain, diagnosed following the standard criteria accepted by the scientific community - the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - were administered the Spanish version of the Oral Health Impact Profile questionnaire (OHIP-14). Bivariate and logistic regression analyses were performed to determine the degree of association between the patients' OHIP-14 score and pain duration, pain intensity, and various sociodemographic variables. The observed distribution was 89.4% women and 10.6% men. The mean OHIP-14 score was 20.57 ± 10.73 (mean ± standard deviation). A significant association (p<0.05) was found for gender, age, marital status, chronic pain grade, self-perceived oral health status and pain duration. The analysis of self-perceived oral health status in patients with OP and TMD, as measured by the OHIP-14, showed that oral health is perceived more negatively by women. Moreover, a one-point increase in the Chronic Pain Grade indicator increases the OHIP-14 indicator by 4.6 points, while chronic pain, defined as pain suffered by patients for one year or more, increases the OHIP-14 indicator by 3.2 points.

  15. The prevalence of temporomandibular disorders in patients with late whiplash syndrome who experience orofacial pain: a case-control series study.

    Science.gov (United States)

    Marini, Ida; Paduano, Sergio; Bartolucci, Maria Lavinia; Bortolotti, Francesco; Bonetti, Giulio Alessandri

    2013-05-01

    The authors conducted a study to compare the frequency of specific temporomandibular disorder (TMD) diagnoses in patients who had late whiplash syndrome (LWS) with that in a control group. The authors recruited 65 patients who had orofacial pain and a previous diagnosis of LWS and 65 age- and sex-matched control patients who had chronic orofacial pain without a history of whiplash injury (WI) for a case-control series study. All patients completed a questionnaire pertaining to the Research Diagnostic Criteria for Temporomandibular Disorders and underwent a clinical examination. The authors compared the frequency of TMD diagnoses in case patients with that in control patients by using a χ(2) test; they set the α level a priori at .05. The number of patients diagnosed with myofascial pain (MP) and disk displacement with reduction (DDWR) was significantly higher in the case group than in the control group (P = .002 and P = .001, respectively). The results of this study show a higher frequency of MP and DDWR in patients with LWS than in patients with chronic orofacial pain and no history of WI. Practical Implications. Clinicians should be knowledgeable about the correlation between WI and TMD so they can inform and treat patients accurately.

  16. Comprehensive treatment of temporomandibular joint disorders.

    Science.gov (United States)

    Navrátil, Leos; Navratil, Vaclav; Hajkova, Simona; Hlinakova, Petra; Dostalova, Tatjana; Vranová, Jana

    2014-01-01

    Changing lifestyles, decreasing physical activity, which is increasing the number of degenerative joint diseases of various etiology, and certain dental procedures are increasing the number of patients complaining of pain in their temporomandibular joints. The aim of the study was to assess the benefits of comprehensive physiotherapy sessions in order to decrease the number of temporomandibular joint problems, thereby improving the patient's quality of life. An examination by a dentist determined each patient's treatment plan, which consisted of a medical exam, physical therapy and education. Each form of treatment was applied 10 times at intervals of 7-14 days. The main goal of the therapeutic physical education was to redress the muscle imbalance in the mandibular joint. This was achieved by restoring balance between the masticatory muscles, along with releasing the spastic shrouds found in the masticatory muscles. The aim of education was to teach the patient exercises focused on the temporomandibular joint and masticatory muscles. The intensity of the exercises and their composition were individually adjusted and adapted to their current state. Physical therapy consisted of the application of pulsed magnetic therapy, laser therapy, and non-invasive positive thermotherapy. The above procedure was conducted on a therapeutic group of 24 patients (3 men and 20 women). In the course of therapy, there were no complications, and all patients adhered to the prescribed regime. None reported any side effects. The mean treatment duration was 123 +/- 66 days. The outcome of the therapy was evaluated as described in the methodology, the degree of pain affecting the joint, and the opening ability of the mouth. In both parameters, there was a significant decline in patient pain. In a study devoted to tactics of rehabilitation treatment for temporomandibular joint disorders, the need for comprehensive long-term therapy, involving education, and learning proper chewing habits

  17. Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine.

    Science.gov (United States)

    Cioffi, I; Farella, M; Chiodini, P; Ammendola, L; Capuozzo, R; Klain, C; Vollaro, S; Michelotti, A

    2017-05-01

    Patients with masticatory muscle pain and migraine typically report that the intensity of pain fluctuates over time and is affected by weather changes. Weather variables, such as ambient temperature and humidity, may vary significantly depending on whether the individual is outdoor or indoor. It is, therefore, important to assess these variables at the individual level using portable monitors, during everyday life. This study aimed to determine and compare the temporal patterns of pain in individuals affected with facial and head pain and to investigate its relation with weather changes. Eleven patients (27·3 ± 7·4 years) with chronic masticatory muscle pain (MP) and twenty (33·1 ± 8·7 years) with migraine headache (MH) were asked to report their current pain level on a visual analogue scale (VAS) every hour over fourteen consecutive days. The VAS scores were collected using portable data-loggers, which were also used to record temperature, atmospheric pressure and relative humidity. VAS scores varied markedly over time in both groups. Pain VAS scores fluctuate less in the MP group than in the MH group, but their mean, minimum and maximum values were higher than those of migraine patients (all P migraine present typical temporal pain patterns that are influenced in a different way by weather changes. © 2017 John Wiley & Sons Ltd.

  18. Orofacial pain and symptoms of temporomandibular disorders in Finnish and Thai populations.

    Science.gov (United States)

    Sipilä, Kirsi; Tolvanen, Mimmi; Mitrirattanakul, Somsak; Sitthisomwong, Panupen; Järvelin, Marjo-Riitta; Taanila, Anja; Anttonen, Vuokko; Lahti, Satu

    2015-07-01

    Cultural or ethnic factors may play an important role in subjects' pain reports. The aim of the study was to compare the prevalence of orofacial pain symptoms between Finnish and Thai populations. The Finnish study population comprised the Northern Finland Birth Cohort 1966, of which 5696 subjects participated in the present study. The Thai sample consisted of 1501 randomly selected people living in 10 different districts in Bangkok. Data on orofacial pain was collected based on questionnaires. After adjusting for age, gender and education, the logistic regression analysis showed that Thai subjects had an increased risk for reporting oral pain (OR = 4.5, 95% CI = 3.7-5.4), tooth pain (OR = 2.0, 95% CI = 1.8-2.4) and pain in the face (OR = 1.5, 95% CI = 1.2-1.7). It can be concluded that Thai people report more orofacial pain symptoms than Finnish subjects. Cross-cultural factors exist in the background of reporting pain symptoms in the oral and facial area.

  19. Temporomandibular disorders: the habitual chewing side syndrome.

    Science.gov (United States)

    Santana-Mora, Urbano; López-Cedrún, José; Mora, María J; Otero, Xosé L; Santana-Penín, Urbano

    2013-01-01

    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. 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. 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. 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.

  20. Temporomandibular disorders: the habitual chewing side syndrome.

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    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. Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection

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    Niv Mor

    2015-07-01

    Full Text Available This article reviews the diagnoses and treatment of temporomandibular disorders (TMD and outlines of the role of botulinum toxin (BoNT in the treatment of myofacial TMD. This manuscript includes a brief history of the use of BoNT in the treatment of pain, the mechanism of action of BoNT, and the techniques for injections, adverse effects and contraindications when using BoNT to treat mayofacial pain caused by TMD.

  2. Temporomandibular disorders, headaches, and cervical pain among females in a Sami population.

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    Storm, Christina; Wänman, Anders

    2006-10-01

    The aim of this study was to examine the prevalence and co-morbidity of long-standing, intense, and frequent symptoms of pain and dysfunction in the jaw-face, head, and cervical region among adult females drawn from the Sami population in northern Sweden. A total of 487 females, taken from the register of the Swedish Sami Parliament or registered as reindeer owners or reindeer herders in the Swedish Board of Agriculture and living in the Arctic region of northern Sweden, participated in a questionnaire study. The prevalence of pain and/or dysfunction in the jaw-face region was 32%, of headaches 61%, and of pain in the cervical region 56%. When the criterion of frequent symptoms (once a week or more often) was used, prevalence dropped to 17%, 19%, and 30%, respectively, and when that of intense symptoms, defined as 5 or more on an 11-point numerical rating scale, was added, prevalence dropped further to 8%, 11%, and 20%, respectively. The majority reported long-standing symptoms (67-98% depending on symptom). A high statistically significant relationship was found between frequent symptoms of pain and/or dysfunction in the jaw-face, frequent headaches, and frequent cervical pain (pcervical pain were frequently reported among a sample of Sami females living in the Swedish Arctic region. The prevalence of symptoms was strongly dependent on criteria of frequency and intensity.

  3. Effects of phototherapy on muscle activity and pain in individuals with temporomandibular disorder: a study protocol for a randomized controlled trial.

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    Herpich, Carolina Marciela; Leal-Junior, Ernesto Cesar Pinto; Amaral, Ana Paula; Tosato, Juliana de Paiva; Glória, Igor Phillip dos Santos; Garcia, Marília Barbosa Santos; Barbosa, Bruno Roberto Borges; El Hage, Yasmin; Arruda, Éric Edmur Camargo; Gomes, Cid Ándre Fidelis de Paula; Rodrigues, Monique Sampaio; de Sousa, Dowglas Fernando Magalhães; de Carvalho, Paulo de Tarso Camillo; Bussadori, Sandra Kalil; Gonzalez, Tabajara de Oliveira; Politti, Fabiano; Biasotto-Gonzalez, Daniela Aparecida

    2014-12-16

    According to the International Association for the Study of Pain (IASP), the term temporomandibular disorder (TMD) regards a subgroup of orofacial pain, the symptoms of which include pain or discomfort in the temporomandibular joint, ears, masticatory muscles and neck on one or both sides, as well as joint sounds, limited mandibular movements or mandibular deviation and difficulties chewing. Phototherapy, such as low-level laser therapy (LLLT) and light-emitting diode (LED) therapy, is one of the resources used to treatment muscle pain. Thus, there is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (LLLT and LED) in the same apparatus. The aim of the proposed study is to evaluate the effects of four different doses of phototherapy on pain, activity of the masticatory muscles (masseter and bilateral anterior temporal) and joint mobility in individuals with temporomandibular disorder. A further aim is to determine the cumulative effect 24 and 48 hours after a single session. A placebo-controlled, double-blind, randomized, clinical trial will be carried out involving 72 women between 18 and 40 years of age with a diagnosis of myogenous TMD. The participants will then be randomly allocated to four groups totaling 18 individuals per group. Three groups will be submitted to a single session of phototherapy with different light sources, and one group will receive placebo therapy: Group A (2.62 Joules); Group B (5.24 Joules); Group C (7.86 Joules); and Group D (0 Joules). The following assessment tools will be administered on four separate occasions (baseline and immediately after, 24 h after and 48 h after phototherapy). Pain intensity will be assessed using the visual analog scale for pain, while pain thresholds will be determined using algometer, and electromyographic (EMG) analysis on the masseter and anterior temporal muscles. The study will contribute to the practice of the evidence-based use of

  4. Is myofascial pain in temporomandibular disorder patients a manifestation of delayed-onset muscle soreness?

    NARCIS (Netherlands)

    Koutris, M.; Lobbezoo, F.; Sümer, N.C.; Atis, E.S.; Türker, K.S.; Naeije, M.

    2013-01-01

    Objective: In a study to the possible role of overuse of the jaw muscles in the pathogenesis of jaw muscle pain, we used a protocol involving concentric and eccentric muscle contractions to provoke a state of delayed-onset muscle soreness (DOMS) in the jaw muscles of healthy individuals. We tested

  5. Comparison of joint pain in patients diagnosed with and without articular disc displacement without reduction based on the Research Diagnostic Criteria for Temporomandibular Disorders.

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    Fujiwara, Masanori; Honda, Kosuke; Hasegawa, Yoko; Hasegawa, Makoto; Urade, Masahiro

    2013-07-01

    We compared joint pain (JP) in patients diagnosed with and without articular disc displacement without reduction (ADD) based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and identified the characteristics of each JP. Fifty-eight patients with restricted mouth opening and pain in temporomandibular joint (TMJ) and with a magnetic resonance imaging diagnosis of ADD were selected. Diagnosis of ADD + JP and nonADD + JP was made with the use of the RDC/TMD. A multiple regression analysis of the data disclosed a positive correlation between range of motion on maximum assisted mouth opening and visual analog scale (VAS) (severity of JP) in the ADD + JP group, and between chronic pain grade (CPG) and VAS in the nonADD + JP group. A significant difference was observed between ADD + JP and nonADD + JP groups in CPG; CPG was higher in the nonADD + JP than in the ADD + JP group. It is suggested that JP related and unrelated to ADD can indicate different types of disease. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Trastornos temporomandibulares en adictos al qat Temporomandibular disorders in qat addicted people

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    Orlando Guerra Cobián

    2012-12-01

    recorded and the temporomandibular disorders were classified. Results: 55.7% of patients were affected of temporomandibular disorders. Acute Joint pain (14.1 and anterior condylar flattening (35.6% were the most frequents. Conclusions: the Temporomandibular disorders affected more than half of the population of studied qat addicted population, with prevalence of disorders in the disc-condyle relation (41%.The anterior condylar flattening was very evident.

  7. Temporomandibular disorders: Old ideas and new concepts.

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    List, Thomas; Jensen, Rigmor Højland

    2017-06-01

    Background Temporomandibular disorders (TMD) is an umbrella term for pain and dysfunction involving the masticatory muscles and the temporomandibular joints (TMJs). TMD is the most common orofacial pain condition. Its prominent features include regional pain in the face and preauricular area, 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, and arthralgia) as well as disorders associated with the TMJ (primarily disc displacements and degenerative disease). As peripheral mechanisms most likely play a role in the onset of TMD, a detailed muscle examination is recommended. The persistence of pain involves more central factors, such as sensitization of the supraspinal neurons and second-order neurons at the level of the spinal dorsal horn/trigeminal nucleus, imbalanced antinociceptive activity, and strong genetic predisposition, which also is included in DC/TMD. Conclusion The etiology is complex and still not clearly understood, but several biological and psychosocial risk factors for TMD have been identified. Several studies indicate that patients with TMD improve with a combination of noninvasive therapies, including behavior therapy, pharmacotherapy, physical therapy, and occlusal appliances. More stringently designed studies, however, are needed to assess treatment efficacy and how to tailor treatment to the individual patient.

  8. Atypical temporomandibular joint pain: a case report.

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    Widmer, Charles G; Wold, Courtney C; Stoll, Ethan M; Dolwick, M Franklin

    2014-12-01

    Atypical temporomandibular joint (TMJ) pain can consist of an unusual intensity, location or set of pain descriptors that do not match what is traditionally observed for TMJ capsular pain, disc displacements or arthritic conditions. Presented in this case report is an atypical pain report regarding a unilateral TMJ pain as the chief complaint. An overview of typical vs atypical TMJ pain is also reviewed to highlight unusual signs and symptoms so that the clinician can identify these atypical presentations and pursue further diagnostic approaches. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. IncobotulinumtoxinA Injection for Temporomandibular Joint Disorder.

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    Patel, Amit A; Lerner, Michael Z; Blitzer, Andrew

    2017-04-01

    Temporomandibular disorder (TMD) involves dysfunction of the temporomandibular joint and associated muscles of mastication causing pain with chewing, limitation of jaw movement, and pain. While the exact pathophysiology of TMD is not completely understood, it is thought that hyperfunction of the muscles of mastication places stress on the temporomandibular joint, leading to degeneration of the joint and associated symptoms. We hypothesize that chemodenervation of the muscles of mastication with IncobotulinumtoxinA (Xeomin) will decrease the stress on the temporomandibular joint and improve pain associated with temporomandibular joint and muscle disorder (TMJD). Twenty patients were randomized to IncobotulinumtoxinA (170 units) or saline injection of the masticatory muscles. Patient-reported pain scale (0-10) was recorded at 4-week intervals following injection for 16 weeks. Patients who received saline injection initially were assessed for reduction in pain at the first 4-week interval and if still had significant pain were rolled over into the IncobotulinumtoxinA arm. Preinjection pain scores were similar between patients. While there was a statistically significant reduction in pain score in the placebo group one month, there was an overall larger drop in average pain scores in those patients injected with IncobotulinumtoxinA initially. All patients initially injected with placebo crossed over into the IncobotulinumtoxinA group. Similar results were seen when examining the composite masticatory muscle tenderness scores. There was no significant change in usage of pain medication. We demonstrate utility of IncobotulinumtoxinA in treating patients with TMD with pain despite pain medication usage and other conventional treatments.

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

    Science.gov (United States)

    Abrahamsson, Cecilia

    2013-01-01

    masticatory muscle pain on palpation after orthognathic treatment. There is insufficient scientific evidence for an effect on temporomandibular joint pain on palpation and temporomandibular joint sounds from orthognathic surgery. Further controlled, well-designed studies assessing temporomandibular disorders before and after orthognathic treatment are needed to consolidate strong evidence considering treatment outcomes. Papers II and III are studies comparing frequencies of temporomandibular disorders in patients with dentofacial deformities with a control group. The patients were referred for a combined orthodontic and orthognathic treatment to correct their malocclusion. The control group comprised individuals with normal occlusion or minor malocclusion traits not in need of orthodontic treatment. In Paper III, temporomandibular disorders were longitudinally analysed by assessing and comparing frequencies before and after orthognathic treatment. All individuals in the studies were diagnosed according to the research diagnostic criteria for temporomandibular disorders. CONCLUSIONS IN PAPERS II AND III: Patients due to be treated with orthognathic surgery had more signs and symptoms of temporomandibular disorders and a higher frequency of diagnosed temporomandibular disorders compared with the age- and gender matched control group. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, had a positive treatment outcome in respect of myofascial pain and arthralgia. After treatment the frequency of temporomandibular disorders . in the treatment group was low and at an equivalent level of that in the control group. Paper IV evaluates the self-estimated masticatory ability and the masticatory performance before and after orthognathic treatment in the same individuals as in Paper II and III. CONCLUSIONS IN PAPER IV: Masticatory ability and performance increased after orthognathic treatment. The number of occlusal contacts

  11. Potential clinical application of masseter and temporal muscle massage treatment using an oral rehabilitation robot in temporomandibular disorder patients with myofascial pain.

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    Ariji, Yoshiko; Nakayama, Miwa; Nishiyama, Wataru; Ogi, Nobumi; Sakuma, Shigemitsu; Katsumata, Akitoshi; Kurita, Kenichi; Ariji, Eiichiro

    2015-10-01

    To investigate the safety, suitable treatment regimen, and efficacy of masseter and temporal muscle massage treatment using an oral rehabilitation robot. Forty-one temporomandibular disorder (TMD) patients with myofascial pain (8 men, 33 women, median age: 46 years) were enrolled. The safety, suitable massage regimen, and efficacy of this treatment were investigated. Changes in masseter muscle thickness were evaluated on sonograms. No adverse events occurred with any of the treatment sessions. Suitable massage was at pressure of 10 N for 16 minutes. Five sessions were performed every 2 weeks. Total duration of treatment was 9·5 weeks in median. Massage treatment was effective in 70·3% of patients. Masseter muscle thickness decreased with treatment in the therapy-effective group. This study confirmed the safety of massage treatment, and established a suitable regimen. Massage was effective in 70·3% of patients and appeared to have a potential as one of the effective treatments for myofascial pain.

  12. Temporomandibular Disorders and Physical Therapy Approaches

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    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

  13. Associations of pain intensity and pain-related disability with psychological and socio-demographic factors in patients with temporomandibular disorders: a cross-sectional study at a specialised dental clinic.

    Science.gov (United States)

    Su, N; Lobbezoo, F; van Wijk, A; van der Heijden, G J M G; Visscher, C M

    2017-03-01

    The study assessed whether psychological and socio-demographic factors, including somatisation, depression, stress, anxiety, daytime sleepiness, optimism, gender and age, are associated with pain intensity and pain-related disability in patients with temporomandibular disorders (TMDs). In total, 320 TMD patients were involved in the study. The psychological status of each patient was assessed with questionnaires, including the Symptom Checklist-90 (SCL-90), Epworth Sleeping Scale (ESS), stress questionnaire and Life Orientation Test-Revised (LOT-R). TMD pain, including pain intensity and pain-related disability, was assessed with characteristic pain intensity (CPI) and disability points scales. The associations of psychological and socio-demographic factors with pain intensity and pain-related disability were assessed through logistic regression analyses. Higher pain intensity was significantly associated with more severe anxiety (P = 0·004), more severe somatisation (P associated with pain intensity (P pain-related disability was significantly associated with more severe anxiety (P associated with pain-related disability (P = 0·003). Among the psychological and socio-demographic factors in this study, somatisation was the best predictor of pain intensity, while depression was the best predictor of pain-related disability. © 2016 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.

  14. Do changes in oral health-related quality-of-life, facial pain and temporomandibular disorders correlate after treatment of severe malocclusion?

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    Silvola, Anna-Sofia; Tolvanen, Mimmi; Rusanen, Jaana; Sipilä, Kirsi; Lahti, Satu; Pirttiniemi, Pertti

    2016-01-01

    The aim was to evaluate the relationships of changes in facial pain, temporomandibular disorders (TMDs) and oral health-related quality-of-life (OHRQoL) in adults who underwent orthodontic or orthodontic/surgical treatment. Sixty-four patients (46 women, 18 men, range 18-64 years) with severe malocclusion and functional problems were treated in Oulu University Hospital. Of these, 44 underwent orthodontic-surgical and 20 orthodontic treatment. Data were collected with questionnaires and clinical stomatognathic examinations before and on average 3 years after treatment. The OHRQoL was measured with OHIP-14 (The Oral Health Impact Profile), the intensity of facial pain with the Visual Analogue Scale (VAS) and the severity of TMD with the Helkimo's anamnestic (Ai) and clinical (Di) dysfunction indices. A significant improvement was found in facial pain, signs and symptoms of TMD and OHRQoL after the treatment (p < 0.05). The decrease in VAS was associated with improvement in OHIP-14 severity (r = 0.296, p = 0.019). The correlations between changes in OHIP-14 severity and Ai and Di were not statistically significant. Treatment of severe malocclusion seemed to improve OHRQoL via decreased facial pain. Decreased facial pain was associated especially with improved OHRQoL dimensions of physical pain, physical disability and social disability.

  15. Temporomandibular disorder: otologic implications and its relationship to sleep bruxism.

    Science.gov (United States)

    Magalhães, Bruno Gama; Freitas, Jaciel Leandro de Melo; Barbosa, André Cavalcanti da Silva; Gueiros, Maria Cecília Scheidegger Neves; Gomes, Simone Guimarães Farias; Rosenblatt, Aronita; Júnior, Arnaldo de França Caldas

    2017-08-23

    Temporomandibular disorder is an umbrella term for various clinical problems affecting the muscles of mastication, temporomandibular joint and associated structures. This disorder has a multifactor etiology, with oral parafunctional habits considered an important co-factor. Among such habits, sleep bruxism is considered a causal agent involved in the initiation and/or perpetuation of temporomandibular disorder. That condition can result in pain otologic symptoms. The aim of the present study was to investigate the relationship between temporomandibular disorder and both otologic symptoms and bruxism. A total of 776 individuals aged 15 years or older from urban areas in the city of Recife (Brazil) registered at Family Health Units were examined. The diagnosis of temporomandibular disorder was determined using Axis I of the Research Diagnostic Criteria for temporomandibular disorders, addressing questions concerning myofascial pain and joint problems (disk displacement, arthralgia, osteoarthritis and osteoarthrosis). Four examiners had previously undergone training and calibration exercises for the administration of the instrument. Intra-examiner and inter-examiner agreement was determined using the Kappa statistic. Individuals with a diagnosis of at least one of these conditions were classified as having temporomandibular disorder. The diagnosis of otologic symptoms and bruxism was defined using the same instrument and a clinical exam. Among the individuals with temporomandibular disorder, 58.2% had at least one otologic symptom and 52% exhibited bruxism. Statistically significant associations were found between the disorder and both otologic symptoms and bruxism (p<0.01 for both conditions; OR=2.12 and 2.3 respectively). Otologic symptoms and bruxism maintained statistical significance in the binary logistic regression analysis, which demonstrated a 1.7 fold and twofold greater chance of such individuals have temporomandibular disorder, respectively. The logistic

  16. Dentist Practice Patterns and Therapeutic Confidence in the Treatment of Pain Related to Temporomandibular Disorders in a Dental Practice-Based Research Network.

    Science.gov (United States)

    Kakudate, Naoki; Yokoyama, Yoko; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V; Gilbert, Gregg H; Velly, Ana M; Schiffman, Eric L

    2017-01-01

    To quantify the practice patterns of Japanese dentists in the management of pain related to temporomandibular disorders (TMD) and to identify specific characteristics that are significantly associated with the decision to perform occlusal adjustment for TMD-related pain. A cross-sectional study was conducted consisting of a questionnaire survey of dentists affiliated with the Dental Practice-Based Research Network Japan (JDPBRN) (n = 148). Participants were asked how they diagnosed and treated TMD-related pain. Associations between dentist characteristics and the decision to perform occlusal adjustment were analyzed via multiple logistic regression. A total of 113 clinicians responded to the questionnaire (76% response rate), and 81% of them (n = 89) had treated TMD during the previous year. Dentists treated an average of 1.9 ± 1.8 (mean ± SD) patients with TMD-related pain per month. Most JDPBRN dentists used similar diagnostic protocols, including questions and examinations. The most frequent treatments were splints or mouthguards (96.5%), medications (84.7%), and self-care (69.4%). Occlusal adjustment for TMD-related pain was performed by 58% of the participants. Multiple logistic regression analysis identified two factors significantly associated with the decision to perform occlusal adjustment: dentist lack of confidence in curing TMD-related acute pain (odds ratio [OR] 5.60; 95% confidence interval [CI] 1.260 to 24.861) and proportion of patients with severe TMD-related pain (OR 0.95; 95% CI 0.909 to 0.999). The most common treatments for TMD-related pain were reversible treatments; however, over half of the dentists performed occlusal adjustment for TMD-related pain. The results of this study suggest that an evidence-practice gap exists for occlusal adjustment for TMD-related pain.

  17. Comparison of self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial temporomandibular disorders by age group: a prospective outcome study.

    Science.gov (United States)

    Karibe, Hiroyuki; Goddard, Greg; Shimazu, Kisaki; Kato, Yuichi; Warita-Naoi, Sachie; Kawakami, Tomomi

    2014-12-11

    Subjective symptoms of temporomandibular disorders (TMDs) have rarely been studied by age group. We aimed to compare self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial TMDs among three age groups. The study population included 179 consecutive patients (151 women and 28 men) who underwent comprehensive clinical examinations at a university-based orofacial pain center. They were classified into myofascial pain subgroups based on the Research Diagnostic Criteria for Temporomandibular Disorders. They were stratified by age group: M1, under 20 years; M2, 20-39 years; and M3, 40 years and older. The patients scored their pretreatment symptoms (first visit) and post-treatment symptoms (last visit) on a form composed of three items that assessed pain intensity and one item that assessed sleeping difficulty. Their treatment options (i.e., pharmacotherapy, physical therapy, and orthopedic appliances) and duration were recorded. All variables were compared between sexes in each group and between the age groups by using the Kruskal-Wallis test, the Mann-Whitney U test, the chi-square test, and analysis of variance (p < 0.05). No significant sex differences were found in any age group. Only sleeping difficulty was significantly different before treatment (p = 0.009). No significant differences were observed in the treatment options or treatment duration. After treatment, the intensity of jaw/face pain and headache and sleeping difficulty was significantly reduced in groups M2 and M3, but only the intensity of jaw/face pain was significantly decreased in group M1. The changes in the scores of pain intensity and sleeping difficulty were not different between the groups. Pain intensity does not differ by age group, but older patients with myofascial TMDs had greater sleeping difficulties. However, there were no differences between the age groups in the treatment outcomes. Clinicians should carefully consider the age

  18. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test

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    Letícia Bojikian CALIXTRE

    Full Text Available ABSTRACT Objective To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder (TMD. Material and Methods: Single-group pre-post test, with baseline comparison. Subjects Twelve women (22.08±2.23 years with myofascial pain and mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. Outcome measures Subjects were evaluated three times: twice before (baseline phase and once after intervention. Self-reported pain, jaw function [according to the Mandibular Functional Impairment Questionnaire (MFIQ], pain-free maximum mouth opening (MMO, and pressure pain thresholds (PPTs of both masseter and temporalis muscles were obtained. Baseline and post-intervention differences were investigated, and effect size was estimated through Cohen’s d coefficient. Results Jaw function improved 7 points on the scale after the intervention (P=0.019, and self-reported pain was significantly reduced (P=0.009. Pain-free MMO varied from 32.3±8.8 mm to 38±8.8 mm and showed significant improvement (P=0.017 with moderate effect size when compared to the baseline phase. PPT also increased with moderate effect size, and subjects had the baseline values changed from 1.23±0.2 kg/cm2 to 1.4±0.2 kg/cm2 in the left masseter (P=0.03, from 1.31±0.28 kg/cm2 to 1.51±0.2 kg/cm2 in the right masseter (P>0.05, from 1.32±0.2 kg/cm2 to 1.46±0.2 kg/cm2 in the left temporalis (P=0.047, and from 1.4±0.2 kg/cm2 to 1.67±0.3 kg/cm2 in the right temporalis (P=0.06. Conclusions The protocol caused significant changes in pain-free MMO, self-reported pain, and functionality of the stomatognathic system in subjects with myofascial TMD, regardless of joint involvement. Even though these differences are statistically significant, their clinical relevance is still questionable.

  19. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test.

    Science.gov (United States)

    Calixtre, Letícia Bojikian; Grüninger, Bruno Leonardo da Silva; Haik, Melina Nevoeiro; Alburquerque-Sendín, Francisco; Oliveira, Ana Beatriz

    2016-01-01

    To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder (TMD). Single-group pre-post test, with baseline comparison. Twelve women (22.08±2.23 years) with myofascial pain and mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. Subjects were evaluated three times: twice before (baseline phase) and once after intervention. Self-reported pain, jaw function [according to the Mandibular Functional Impairment Questionnaire (MFIQ)], pain-free maximum mouth opening (MMO), and pressure pain thresholds (PPTs) of both masseter and temporalis muscles were obtained. Baseline and post-intervention differences were investigated, and effect size was estimated through Cohen's d coefficient. Jaw function improved 7 points on the scale after the intervention (P=0.019), and self-reported pain was significantly reduced (P=0.009). Pain-free MMO varied from 32.3±8.8 mm to 38±8.8 mm and showed significant improvement (P=0.017) with moderate effect size when compared to the baseline phase. PPT also increased with moderate effect size, and subjects had the baseline values changed from 1.23±0.2 kg/cm2 to 1.4±0.2 kg/cm2 in the left masseter (P=0.03), from 1.31±0.28 kg/cm2 to 1.51±0.2 kg/cm2 in the right masseter (P>0.05), from 1.32±0.2 kg/cm2 to 1.46±0.2 kg/cm2 in the left temporalis (P=0.047), and from 1.4±0.2 kg/cm2 to 1.67±0.3 kg/cm2 in the right temporalis (P=0.06). The protocol caused significant changes in pain-free MMO, self-reported pain, and functionality of the stomatognathic system in subjects with myofascial TMD, regardless of joint involvement. Even though these differences are statistically significant, their clinical relevance is still questionable.

  20. Evaluation of correlation among sleep bruxism and depression levels, chronic pain and nonspecific physical symptoms according to axis II of the Research Diagnostic Criteria/Temporomandibular disorders

    National Research Council Canada - National Science Library

    Isabela Maddalena Dias; Ingrid Duque Maia; Lívia Marins Ramalho de Mello; Isabel Cristina Gonçalves Leite; Fabíola Pessôa Pereira Leite

    2014-01-01

    ...: The present study aimed to observe statistically the existence of a possible correlation between SB and psychological aspects studied by the Research Diagnostic Criteria/Temporomandibular disorders (RDC/TMD...

  1. Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability.

    Science.gov (United States)

    Silveira, Anelise; Armijo-Olivo, Susan; Gadotti, Inae C; Magee, David

    2014-01-01

    To compare the masticatory and cervical muscle tenderness and pain sensitivity in the hand (remote region) between patients with temporomandibular disorders (TMD) and healthy controls. Twenty female subjects were diagnosed with chronic TMD, and 20 were considered healthy. Subjects completed the Neck Disability Index and Limitations of Daily Functions in a TMD questionnaire. Tenderness of the masticatory and cervical muscles and pain sensitivity in the hand were measured using an algometer. Three-way mixed analysis of variance (ANOVA) evaluated differences in muscle tenderness between groups. One-way ANOVA compared pain sensitivity in the hand between groups. Effect sizes were assessed using Cohen guidelines. Significantly increased masticatory and cervical muscle tenderness and pain sensitivity in the hand were found in subjects with TMD when compared with healthy subjects. Moderate to high effect sizes showed the clinical relevance of the findings. The results of this study have highlighted the importance of assessing TMD patients not only in the craniofacial region but also in the neck and other parts of the body. Future studies should focus on testing the effectiveness of treatments addressing the neck and the pain sensitivity in the hand in patients with TMD.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Temporomandibular disorders: the habitual chewing side syndrome

    National Research Council Canada - National Science Library

    Santana-Mora, Urbano; López-Cedrún, José; Mora, María J; Otero, Xosé L; Santana-Penín, Urbano

    2013-01-01

    .... 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...

  4. Differences in suprathreshold heat pain responses and self-reported sleep quality between patients with temporomandibular joint disorder and healthy controls

    Science.gov (United States)

    Ribeiro-Dasilva, M.C.; Goodin, B.R.; Fillingim, R.B.

    2013-01-01

    The purpose of this study was to examine differences in heat pain threshold (HPTh) and heat pain tolerance (HPTo) between temporomandibular joint disorder (TMJD) patients and healthy controls. Using suprathreshold heat pain, this study also examined between-group (i.e. TMJD vs. healthy controls) differences in hyperalgesia and temporal summation (TS) of heat pain. Lastly, whether between-group differences in these heat pain outcomes were mediated by self-reported sleep quality was also tested. A total of 119 participants (41% TMJD) completed the current study. HPTh and HPTo responses were assessed at the ventral forearm with an ascending method of limits, while hyperalgesia and TS responses were assessed at the dorsal forearm at temperatures of 46, 48 and 50 °C. Prior to completion of heat pain procedures, participants completed the Pittsburgh Sleep Quality Index. Significant between-group differences in HPTh and HPTo were not observed. TMJD patients demonstrated significantly greater hyperalgesia than healthy controls at 46 °C only, but there were no differences for TS. Furthermore, TMJD patients reported significantly poorer sleep quality compared with healthy controls. Data analysis revealed a significant simple mediation effect whereby the presence of TMJD was strongly associated with poorer self-reported sleep quality, which, in turn, was related to enhanced hyperalgesia at 46 °C. These findings support the hypothesis that the thermal hyperalgesia demonstrated by TMJD patients may be related to poor quality of their self-reported sleep. The ability of interventions that improve sleep quality to also affect pain sensitivity is currently the topic of ongoing investigation. PMID:22344627

  5. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    OpenAIRE

    Susan Armijo-Olivo; David Magee

    2013-01-01

    ABSTRACT 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, maxima...

  6. Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration

    OpenAIRE

    Dahan, Haissam; Shir, Yoram; Velly, Ana; Allison, Paul

    2015-01-01

    Background Temporomandibular pain disorder (TMD) is a common pain condition in the face. People with TMD report multiple pain comorbidities. The presence of fibromyalgia and migraine in people with TMD is associated with an increase in TMD pain intensity and duration. However, data on the relationship between increasing number of pain comorbidities and TMD pain are rare. The aims of this study were: firstly to evaluate the extent to which increasing number of comorbidities is associated with ...

  7. 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†

    Science.gov (United States)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond; Look, John; Anderson, Gary; Goulet, Jean-Paul; List, Thomas; Svensson, Peter; Gonzalez, Yoly; Lobbezoo, Frank; Michelotti, Ambra; Brooks, Sharon L.; Ceusters, Werner; Drangsholt, Mark; Ettlin, Dominik; Gaul, Charly; Goldberg, Louis J.; Haythornthwaite, Jennifer A.; Hollender, Lars; Jensen, Rigmor; John, Mike T.; De Laat, Antoon; de Leeuw, Reny; Maixner, William; van der Meulen, Marylee; Murray, Greg M.; Nixdorf, Donald R.; Palla, Sandro; Petersson, Arne; Pionchon, Paul; Smith, Barry; Visscher, Corine M.; Zakrzewska, Joanna; Dworkin, Samuel F.

    2015-01-01

    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 ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were 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 and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project—the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search 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 any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0

  8. 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†.

    Science.gov (United States)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond; Look, John; Anderson, Gary; Goulet, Jean-Paul; List, Thomas; Svensson, Peter; Gonzalez, Yoly; Lobbezoo, Frank; Michelotti, Ambra; Brooks, Sharon L; Ceusters, Werner; Drangsholt, Mark; Ettlin, Dominik; Gaul, Charly; Goldberg, Louis J; Haythornthwaite, Jennifer A; Hollender, Lars; Jensen, Rigmor; John, Mike T; De Laat, Antoon; de Leeuw, Reny; Maixner, William; van der Meulen, Marylee; Murray, Greg M; Nixdorf, Donald R; Palla, Sandro; Petersson, Arne; Pionchon, Paul; Smith, Barry; Visscher, Corine M; Zakrzewska, Joanna; Dworkin, Samuel F

    2014-01-01

    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 ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were 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. Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project-the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search 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. The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra

  9. 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. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Pathways between temporomandibular disorders, occlusal characteristics, facial pain, and oral health-related quality of life among patients with severe malocclusion.

    Science.gov (United States)

    Rusanen, Jaana; Silvola, Anna-Sofia; Tolvanen, Mimmi; Pirttiniemi, Pertti; Lahti, Satu; Sipilä, Kirsi

    2012-08-01

    The aim of this study was to examine the pathways between temporomandibular disorders (TMDs), occlusal characteristics, facial pain, and oral health-related quality of life in patients with severe malocclusion. The study comprised 94 (34 men and 60 women, mean age 38 years) adult patients who were referred for orthodontic or surgical-orthodontic treatment. All the patients had severe malocclusion. Oral health-related quality of life was measured with the Oral Health Impact Profile-14 scale (OHIP-14), the intensity of facial pain using a Visual Analogue Scale (VAS), TMD with Helkimo's clinical dysfunction index (Di), and occlusal characteristics with the Peer Assessment Rating (PAR). A hypothetical model of the interrelationships between these factors was constructed based on the conceptual model of biological, behavioural, and psychosocial consequences of oral diseases. The associations were studied with path analysis. Women reported poorer oral health-related quality of life, higher pain levels, and had more severe TMD than men, but the gender difference was statistically significant only in pain and TMD. In contrast to the hypothetical model, among women the occlusal characteristics were not directly associated with oral health-related quality of life or facial pain. Among men, the occlusal characteristics were directly associated with oral health-related quality of life. In conclusion, patients with severe malocclusion who also have TMD and facial pain more often have impaired oral health-related quality of life. The associations of the occlusal characteristics with oral health-related quality of life differ between genders. Therefore, these associations should be studied separately among genders.

  12. 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.

  13. Review: Psychological intervention in temporomandibular disorders.

    Directory of Open Access Journals (Sweden)

    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.

  14. [Update on current care guideline: temporomandibular disorders (TMD)].

    Science.gov (United States)

    2013-01-01

    Temporomandibular disorders (TMD) are common. Usual symptoms are joint noises and pain, pain in masticatory muscles, difficulties in jaw movements and headache. Treatment of TMD includes information on the background and good response to treatment of these disorders. The patient is advised on self-care routines, including relaxing the lower jaw, massaging the masticatory muscles and hot or cold packs on painful sites. Pharmacotherapy consists of paracetamol or anti-inflammatory analgesics. Occlusal appliances, physiotherapy, cognitive therapies and acupuncture are recommended. Complicated cases not responding to treatment are referred to specialized care.

  15. Review of self-reported instruments that measure sleep dysfunction in patients suffering from temporomandibular disorders and/or orofacial pain.

    Science.gov (United States)

    Sommer, Isabelle; Lavigne, Gilles; Ettlin, Dominik A

    2015-01-01

    Patients with temporomandibular disorders (TMD) and/or orofacial pain (OFP) frequently experience poor sleep quality or suffer from comorbid sleep disorders. Study results suggest that in chronic pain patients, an improvement in sleep quality critically influences the outcomes of interventions on mood and pain. Yet, only a few studies have systematically sought to evaluate the sleep quality of TMD/OFP patients. Standardized and validated self-reported instruments designed for screening sleep disturbances or for the evaluation of treatment outcomes in this population would therefore enhance evidence and improve treatment options. The objectives of the present study were: (1) to review the self-reported instruments that measure sleep dysfunction in studies on TMD/OFP patients, by conducting a systematic literature search; (2) to evaluate their clinimetric evidence; and (3) to provide guidance for future research using such instruments. A total of 26 papers, using eight different instruments, were identified. The most frequently used questionnaires and the only ones with good clinimetric properties were the Insomnia Severity Index followed by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. They were most reliable, valid and time-effective for measuring sleep dysfunctions in patients with TMD/OFP, with only a few practical constraints. Yet, in future studies, an assessment of the relationship between sleep disturbances and chronic pain will have to include instruments measuring the effect of mediator variables such as cognitive or emotional arousal. Research is required to clarify if existing self-reported questionnaires measuring these aspects will promote further insights or if there is a need for new instruments. This future research direction would blend into the overall biopsychosocial concept of TMD/OFP diagnoses and treatment. Copyright © 2014. Published by Elsevier B.V.

  16. Neural Mechanisms of Temporomandibular Joint and Masticatory Muscle Pain: A Possible Role for Peripheral Glutamate Receptor Mechanisms

    OpenAIRE

    Lam, David K.; Sessle, Barry J; Cairns, Brian E.; Hu, James W.

    2005-01-01

    The purpose of the present review is to correlate recent knowledge of the role of peripheral ionotropic glutamate receptors in the temporomandibular joint and muscle pain from animal and human experimental pain models with findings in patients. Chronic pain is common, and many people suffer from chronic pain conditions involving deep craniofacial tissues such as temporomandibular disorders or fibromyalgia. Animal and human studies have indicated that the activation of peripheral ionotropic gl...

  17. 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.

  18. Dysregulation of the descending pain system in temporomandibular disorders revealed by low-frequency sensory transcutaneous electrical nerve stimulation: a pupillometric study.

    Directory of Open Access Journals (Sweden)

    Annalisa Monaco

    Full Text Available Using computerized pupillometry, our previous research established that the autonomic nervous system (ANS is dysregulated in patients suffering from temporomandibular disorders (TMDs, suggesting a potential role for ANS dysfunction in pain modulation and the etiology of TMD. However, pain modulation hypotheses for TMD are still lacking. The periaqueductal gray (PAG is involved in the descending modulation of defensive behavior and pain through μ, κ, and δ opioid receptors. Transcutaneous electrical nerve stimulation (TENS has been extensively used for pain relief, as low-frequency stimulation can activate µ receptors. Our aim was to use pupillometry to evaluate the effect of low-frequency TENS stimulation of μ receptors on opioid descending pathways in TMD patients. In accordance with the Research Diagnostic Criteria for TMD, 18 females with myogenous TMD and 18 matched-controls were enrolled. All subjects underwent subsequent pupillometric evaluations under dark and light conditions before, soon after (end of stimulation and long after (recovery period sensorial TENS. The overall statistics derived from the darkness condition revealed no significant differences in pupil size between cases and controls; indeed, TENS stimulation significantly reduced pupil size in both groups. Controls, but not TMD patients, displayed significant differences in pupil size before compared with after TENS. Under light conditions, TMD patients presented a smaller pupil size compared with controls; the pupil size was reduced only in the controls. Pupil size differences were found before and during TENS and before and after TENS in the controls only. Pupillometry revealed that stimulating the descending opioid pathway with low-frequency sensory TENS of the fifth and seventh pairs of cranial nerves affects the peripheral target. The TMD patients exhibited a different pattern of response to TENS stimulation compared with the controls, suggesting that impaired

  19. Temporomandibular disorders and bruxism in childhood and adolescence: review of the literature.

    Science.gov (United States)

    Barbosa, Taís de Souza; Miyakoda, Luana Sayuri; Pocztaruk, Rafael de Liz; Rocha, Camila Pinhata; Gavião, Maria Beatriz Duarte

    2008-03-01

    The aim of this article was to review the literature about temporomandibular disorders and bruxism and their relationships in children and adolescents. The literature was searched using Medline, ISI, Cochrane Library, Scielo and the Internet, from March 1970 to the end of June 2007. The inclusion criteria were: they evaluated a possible association between TMD and bruxism, and they dealt with child and/or adolescent samples. Furthermore, interim reports, related Internet sites and chapters in textbooks were considered. From 64 records found, 30 fulfilled the inclusion criteria. The prevalence of temporomandibular disorders in children and adolescent varies widely in the literature. Temporomandibular disorders are often defined on the basis of signs and symptoms, of which the most common are: temporomandibular joint sounds, impaired movement of the mandible, limitation in mouth opening, preauricular pain, facial pain, headaches and jaw tenderness on function, having mainly a mild character, fluctuation and progression to severe pain and dysfunction is rare. One of the possible causal factors suggested that temporomandibular disorders in children is a functional mandibular overload variable, mainly bruxism. Bruxism, defined as the habitual nonfunctional forceful contact between occlusal tooth surfaces, is involuntary, excessive grinding, clenching or rubbing of teeth during nonfunctional movements of the masticatory system. Its etiology is still controversial but the multifactorial cause has been attributed, including pathophysiologic, psychologic and morphologic factors. Moreover, in younger children, bruxism may be a consequence of the masticatory neuromuscular system immaturity. Complications include dental attrition, headaches, temporomandibular disorders and masticatory muscle soreness. Some studies have linked oral parafunctional habits to disturbances and diseases of the temporomandibular joint, mainly bruxism, suggesting its association with temporomandibular

  20. How can precision medicine be applied to temporomandibular disorders and its comorbidities?

    Science.gov (United States)

    Wilentz, Joan B; Cowley, Allen W

    2017-01-01

    The Eighth Scientific Meeting of The TMJ Association, Ltd. was held in Bethesda, Maryland, September 11-13, 2016. As in the past, the meeting was cosponsored by components of the National Institutes of Health with speakers invited to review the state of temporomandibular disorder science and propose recommendations to further progress. The theme of precision medicine, which aims to tailor disease treatment and prevention to match the characteristics of an individual patient (genetic, epigenetic, environmental, lifestyle) underscored the current consensus that temporomandibular disorders are no longer viewed as local conditions of jaw pain and dysfunction. Rather, they represent a complex family of biopsychosocial disorders that can progress to chronic pain, most often accompanied by one or more other chronic pain conditions. Temporomandibular disorders and these comorbidities, called chronic overlapping pain conditions, predominantly or exclusively affect women in their childbearing years and reflect central nervous system sensitization. Presenters at the meeting included leaders in temporomandibular disorder and pain research, temporomandibular disorder patients and advocates, and experts in other fields or in the use of technologies that could facilitate the development of precision medicine approaches in temporomandibular disorders.

  1. [Quality of life in patients with temporomandibular disorders].

    Science.gov (United States)

    Segù, M; Lobbia, S; Canale, C; Collesano, V

    2003-06-01

    Oral disorders have a psycho-social impact on the quality of life, that can be measured with instruments as the Oral Health Impact Profile questionnaire (OHIP). Using the OHIP, we evaluated if and how the orofacial pain can affect the quality of life in temporomandibular disorders (TMD) patients. A transversal case-control study was carried out. Study subjects were patients referred to the Section of Prosthetic Dentistry and Temporomandibular Disorders of the University of Pavia (Italy). Subjects were recruited sequentially until the target of 124. The controls were 61 "pain free" subjects, who were recruited from the same clinic. In analyzing the data, the chi squared test was used for categorical data, and t test and one-way analysis of variance were used for numerical scores. The subjects in this study were predominantly females (83.9%). The mean age of subjects was 35.1 years (standard deviation= 14.0). The most frequently reported symptoms were pain in the temporomandibular joint (TMJ) (87.1%). The data showed that orofacial pain had an important impact on daily life (pquality of life of TMD patients.

  2. Temporomandibular Joint Disorders’ Impact on Pain, Function, and Disability

    Science.gov (United States)

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

    2015-01-01

    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. PMID:25572112

  3. Self-reported impact on daily life activities related to temporomandibular disorders, headaches, and neck-shoulder pain among women in a Sami population living in Northern Sweden.

    Science.gov (United States)

    Mienna, Christina Storm; Wanman, Anders

    2012-01-01

    To analyze the influence of frequency, intensity, and duration of temporomandibular disorders (TMD), headaches, and neckshoulder pain (NSP) on Sami women's daily life. A further aim was to analyze the relationship between these symptoms and age. All 751 Sami women 21 to 70 years old registered in either the Swedish Sami Parliament's electoral register or registered as reindeer owners or herders and living north of the Arctic Circle in Sweden were sent a questionnaire regarding TMD symptoms, NSP, and headaches. In total, 487 women (65%) participated. The questionnaire focused on symptom frequency, duration, and intensity and whether these symptoms influenced activities of daily life. The symptom's interference with daily life activities was measured, respectively, with a numerical rating scale (NRS). The statistical analyses included multiple logistic regression analysis and Chi-square test. A P value symptoms in the jaw-face region to some degree disturbed their daily life, and for 6%, the interference was significant (≥ 5 on NRS). Duration of jaw pain, troublesome impaired jaw opening, and neck pain, together with a low education level, affected reports of whether symptoms of TMD influenced daily life. Almost half of the study population reported that headaches had a negative impact on their life. A similar pattern was reported for NSP. The prevalence of frequent and troublesome symptoms of TMD and headaches, but not NSP, showed a declining trend with age. TMD symptoms, headaches, and NSP negatively influence many Sami women's daily life. Factors related to pain had the greatest influence when these Sami women rated the related impairment.

  4. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Calixtre, L B; Moreira, R F C; Franchini, G H; Alburquerque-Sendín, F; Oliveira, A B

    2015-11-01

    There is a lack of knowledge about the effectiveness of manual therapy (MT) on subjects with temporomandibular disorders (TMD). The aim of this systematic review is to synthetise evidence regarding the isolated effect of MT in improving maximum mouth opening (MMO) and pain in subjects with signs and symptoms of TMD. MEDLINE(®) , Cochrane, Web of Science, SciELO and EMBASE(™) electronic databases were consulted, searching for randomised controlled trials applying MT for TMD compared to other intervention, no intervention or placebo. Two authors independently extracted data, PEDro scale was used to assess risk of bias, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) was applied to synthetise overall quality of the body of evidence. Treatment effect size was calculated for pain, MMO and pressure pain threshold (PPT). Eight trials were included, seven of high methodological quality. Myofascial release and massage techniques applied on the masticatory muscles are more effective than control (low to moderate evidence) but as effective as toxin botulinum injections (moderate evidence). Upper cervical spine thrust manipulation or mobilisation techniques are more effective than control (low to high evidence), while thoracic manipulations are not. There is moderate-to-high evidence that MT techniques protocols are effective. The methodological heterogeneity across trials protocols frequently contributed to decrease quality of evidence. In conclusion, there is widely varying evidence that MT improves pain, MMO and PPT in subjects with TMD signs and symptoms, depending on the technique. Further studies should consider using standardised evaluations and better study designs to strengthen clinical relevance. © 2015 John Wiley & Sons Ltd.

  5. Frequency of temporomandibular arthralgia among myofascial pain patients with pain on palpation of ipsilateral masseter.

    Science.gov (United States)

    da Silva Parente Macedo, Leonora Cristiana; de Goffredo Filho, Gilberto Senechal; de Souza Tesch, Ricardo; de Queiroz Farias Góes, Cristina Pessoa

    2015-07-01

    The masseter muscle is a common source of referred pain to the temporomandibular joint (TMJ), with a possibility of false positive diagnoses for arthralgia when diagnosed by research diagnostic criteria for temporomandibular disorders (RDC/TMD) clinical examination. The current study investigated the distribution of arthralgia diagnoses among individuals with myofascial pain, with or without pain on masseter palpation. The study was conducted with 255 outpatients. Clinical data and questionnaires were directly entered into software that deploys algorithms based on the diagnostic criteria of the RDC/TMD, and automatically classifies and stores the diagnosis of each patient evaluated. An association between diagnostic subgroups was verified by calculating the odds ratio (OR), and the statistical significance was tested using the Chi-square test. A higher frequency of concordance (about three times greater) between myofascial pain and arthralgia occurred when there was pain on palpation in the region of the ipsilateral masseter muscle, and the association was statistically significant. The results of this study revealed a threefold increase in the risk for the presence of temporomandibular arthralgia in cases of myofascial pain combined with pain on palpation in the region of the ipsilateral masseter muscle.

  6. Temporomandibular Disorders in Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study.

    Science.gov (United States)

    Crincoli, Vito; Di Comite, Mariasevera; Di Bisceglie, Maria Beatrice; Fatone, Laura; Favia, Gianfranco

    2015-01-01

    Psoriasis is a chronic, remitting and relapsing inflammatory disorder, involving the skin, nails, scalp and mucous membranes, that impairs patients' quality of life to varying degrees. Psoriatic arthritis is a chronic seronegative, inflammatory arthritis, usually preceded by psoriasis. Temporomandibular disorders is a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint. The aim of this study was to assess symptoms and signs of temporomandibular disorders in psoriasis patients with and without psoriatic arthritis. The study group included 112 patients (56 men, 56 women; median age 49.7±12 years) with psoriasis, 25 of them were affected by psoriatic arthritis. A group of 112 subjects without psoriasis (56 men, 56 women; median age 47.7±17 years) served as controls. Signs and symptoms of temporomandibular disorders were evaluated according to the standardized Research Diagnostic Criteria for Temporomandibular Disorders. Psoriasis patients were subgrouped according to the presence/absence of psoriatic arthritis and by gender, to assess the prevalence of traditional symptoms and signs of temporomandibular disorders. Patients with psoriasis, and to an even greater extent those with psoriatic arthritis, were more frequently affected by symptoms and signs of temporomandibular disorders, including an internal temporomandibular joint opening derangement than healthy subjects. A statistically significant increase in symptoms of temporomandibular disorders, in opening derangement, bruxism and sounds of temporomandibular joint was found in patients with psoriatic arthritis as compared with psoriasis patients without arthritis and controls. psoriasis seems to play a role in temporomandibular joint disorders, causing an increase in orofacial pain and an altered chewing function.

  7. Temporomandibular Disorders in Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study

    Science.gov (United States)

    Crincoli, Vito; Di Comite, Mariasevera; Di Bisceglie, Maria Beatrice; Fatone, Laura; Favia, Gianfranco

    2015-01-01

    AIMS: Psoriasis is a chronic, remitting and relapsing inflammatory disorder, involving the skin, nails, scalp and mucous membranes, that impairs patients' quality of life to varying degrees. Psoriatic arthritis is a chronic seronegative, inflammatory arthritis, usually preceded by psoriasis. Temporomandibular disorders is a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint. The aim of this study was to assess symptoms and signs of temporomandibular disorders in psoriasis patients with and without psoriatic arthritis. METHODS: The study group included 112 patients (56 men, 56 women; median age 49.7±12 years) with psoriasis, 25 of them were affected by psoriatic arthritis. A group of 112 subjects without psoriasis (56 men, 56 women; median age 47.7±17 years) served as controls. Signs and symptoms of temporomandibular disorders were evaluated according to the standardized Research Diagnostic Criteria for Temporomandibular Disorders. Psoriasis patients were subgrouped according to the presence/absence of psoriatic arthritis and by gender, to assess the prevalence of traditional symptoms and signs of temporomandibular disorders. RESULTS: Patients with psoriasis, and to an even greater extent those with psoriatic arthritis, were more frequently affected by symptoms and signs of temporomandibular disorders, including an internal temporomandibular joint opening derangement than healthy subjects. A statistically significant increase in symptoms of temporomandibular disorders, in opening derangement, bruxism and sounds of temporomandibular joint was found in patients with psoriatic arthritis as compared with psoriasis patients without arthritis and controls. CONCLUSIONS: psoriasis seems to play a role in temporomandibular joint disorders, causing an increase in orofacial pain and an altered chewing function. PMID:26019683

  8. Temporomandibular disorders in fibromyalgia syndrome: a short-communication.

    Science.gov (United States)

    Gui, Maísa Soares; Pimentel, Marcele Jardim; Rizzatti-Barbosa, Célia Marisa

    2015-01-01

    Fibromyalgia syndrome (FMS) is a chronic painful syndrome and the coexistence of a painful condition caused by Temporomandibular Disorders (TMD) and FMS has been frequently raised for several studies, however, more likely hypothesis is that a set of FMS characteristics may lead to the onset of TMD symptoms and they are not merely coexisting conditions. Therefore, our aim is presenting a review of literature about the relation between fibromyalgia and the signs and symptoms of temporomandibular disorders. For this purpose, a bibliographic search was performed of the period of 1990-2013, in the Medline, Pubmed, Lilacs and Scielo databases, using the keywords fibromyalgia, temporomandibular disorders and facial pain. Here we present a set of findings in the literature showing that fibromyalgia can lead to TMD symptoms. These studies demonstrated greater involvement of the stomatognathic system in FMS and myogenic disorders of masticatory system are the most commonly found in those patients. FMS appears to have a series of characteristics that constitute predisposing and triggering factors for TMD. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  9. Skeletal pattern in subjects with temporomandibular joint disorders.

    Science.gov (United States)

    Almăşan, Oana Cristina; Băciuţ, Mihaela; Almăşan, Horea Artimoniu; Bran, Simion; Lascu, Liana; Iancu, Mihaela; Băciuţ, Grigore

    2013-02-21

    To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD.

  10. TEMPOROMANDIBULAR PAIN DYSFUNCTION SYNDROME IN PATIENTS ATTENDING LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA.

    Science.gov (United States)

    Eweka, O M; Ogundana, O M; Agbelusi, G A

    2016-01-01

    Temporomandibular joint pain dysfunction syndrome (TMJPDS) is the most common temporomandibular disorder. This condition presents with symptoms of pain, restricted jaw movement and joint noise. Other symptoms include otalgia, headache, neck pain and trismus. To determine the pattern of Temporomandibular joint pain dysfunction syndrome patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria. A descriptive study of patients with signs and symptoms of Temporomandibular joint pain dysfunction syndrome attending the Oral Medicine Clinic of Lagos University Teaching Hospital. Twenty-one patients with Temporomandibular joint pain dysfunction syndrome were enrolled into the study, out of which 10(48%) were females and 11(52%) were males. The age range was 23-81years with a mean of 45.2 ± 18.9 years. Majority of the patients 20(95.2%) complained of pain around the joint, in the pre-auricular region, in the muscles of mastication and the ear. While 7(35%) complained of clicking sounds, 10(47.6%) complained of pain on mouth opening and during mastication only. In all 5(23.8%) had impaired movement of the jaws, mouth opening was normal in 18(85.7%) but reduced in 3(14.3%) patients. Over half of patients 12(57%) experienced clicking sounds, there was tenderness around the temporomandibular joint in 16(76.2%) cases, pain in the ear of 7(33.3%) patients and 13(61.9%) people presented with tenderness of the muscles of mastication. Conservative management of all the cases resulted in resolution of the symptoms. Temporomandibular joint pain dysfunction syndrome has diverse clinical presentation and though distressing, it responds to prompt and effective conservative management.

  11. 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.

  12. Dental occlusion and temporomandibular disorders.

    Science.gov (United States)

    Stone, J Caitlin; Hannah, Andrew; Nagar, Nathan

    2017-10-27

    Data sourcesMedline, Scopus and Google Scholar.Study selectionTwo reviewers selected studies independently. English language clinical studies assessing the association between temporomandibular disorders (TMD) and features of dental occlusion were considered.Data extraction and synthesisStudy quality was assessed based on the Newcastle-Ottawa Scale (NOS) and a narrative synthesis was presented.ResultsIn all 25 studies (17 case-control, eight comparative) were included. Overall there was a high variability between occlusal features and TMD diagnosis. Findings were consistent with a lack of clinically relevant association between TMD and dental occlusion. Only two studies were associated with TMD in the majority (≥50%) of single variable analyses in patient populations. Only mediotrusive interferences are associated with TMD in the majority of multiple variable analyses.ConclusionsThe findings support the absence of a disease-specific association, there is no ground to hypothesise a major role for dental occlusion in the pathophysiology of TMDs. Dental clinicians are thus encouraged to move forward and abandon the old-fashioned gnathological paradig.

  13. Neural Mechanisms of Temporomandibular Joint and Masticatory Muscle Pain: A Possible Role for Peripheral Glutamate Receptor Mechanisms

    Directory of Open Access Journals (Sweden)

    David K Lam

    2005-01-01

    Full Text Available The purpose of the present review is to correlate recent knowledge of the role of peripheral ionotropic glutamate receptors in the temporomandibular joint and muscle pain from animal and human experimental pain models with findings in patients. Chronic pain is common, and many people suffer from chronic pain conditions involving deep craniofacial tissues such as temporomandibular disorders or fibromyalgia. Animal and human studies have indicated that the activation of peripheral ionotropic glutamate receptors in deep craniofacial tissues may contribute to muscle and temporomandibular joint pain and that sex differences in the activation of glutamate receptors may be involved in the female predominance in temporomandibular disorders and fibromyalgia. A peripheral mechanism involving autocrine and/or paracrine regulation of nociceptive neuronal excitability via injury or inflammation-induced release of glutamate into peripheral tissues that may contribute to the development of craniofacial pain is proposed.

  14. Arthrocentesis and lavage for treating temporomandibular joint disorders.

    Science.gov (United States)

    Guo, Chunlan; Shi, Zongdao; Revington, Peter

    2009-10-07

    Temporomandibular joint disorders are important oral health problems, reducing the quality of life of sufferers. It has been estimated that approximately 20% to 30% of the adult population will experience temporomandibular joint dysfunction. Arthrocentesis and lavage has been used to treat temporomandibular joint disorders for about 10 years, but the clinical effectiveness of the therapy has not been summarized in the form of a systematic review. To assess the effectiveness and complications of arthrocentesis and lavage for the treatment of temporomandibular joint disorders compared with controlled interventions. The Cochrane Oral Health Group's Trials Register (to August 2009), CENTRAL (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to August 2009), EMBASE (1980 to August 2009), OpenSIGLE (to August 2009), CBMdisc (1981 to 2007 (in Chinese)) and Chinese Medical Library were searched. All the Chinese professional journals in the oral health field were handsearched and conference proceedings consulted. There was no language restriction. All randomised controlled trials (RCTs) (including quasi-randomised clinical trials) aiming to test the therapeutic effects of arthrocentesis and lavage for treating temporomandibular joint disorders. Two review authors independently extracted data, and three review authors independently assessed the risk of bias of included trials. The first authors of the selected articles were contacted for additional information. Two trials, at unclear to high risk of bias, were included in the review. The two trials, including 81 patients with temporomandibular joint disorders, compared arthrocentesis with arthroscopy. No statistically significant difference was found between the interventions in terms of pain. However, a statistically significant difference in favour of arthroscopy was found in maximum incisal opening (MIO) (weighted mean difference of -5.28 (95% confidence interval (CI) -7.10 to -3.46)).Mild and transient adverse reactions

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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

  17. Orthodontics is temporomandibular disorder-neutral.

    Science.gov (United States)

    Manfredini, Daniele; Stellini, Edoardo; Gracco, Antonio; Lombardo, Luca; Nardini, Luca Guarda; Siciliani, Giuseppe

    2016-07-01

    To assess if subjects with a clinical diagnosis of temporomandibular disorders (TMDs) have a similar prevalence of orthodontic history as a population of TMD-free individuals and to assess if those subjects who have a history of ideal orthodontics have fewer symptoms than those with a history of nonideal orthodontics. Two groups of age- and sex-matched individuals belonging to either a study ("TMD") or a control group were recruited. Subjects who underwent orthodontic treatment were classified as having a history of ideal or nonideal orthodontics based on the current presence of normal values in five reference occlusal features. The correlation with a history of orthodontic treatment was not clinically significant for any of the TMD diagnoses (ie, muscle pain, joint pain, disc displacement, arthrosis), with Phi (Φ) coefficient values within the -0.120 to 0.058 range. Within the subset of patients with a history of orthodontics, the correlation of ideal or nonideal orthodontic treatment with TMD diagnoses was, in general, not clinically relevant or was weakly relevant. Findings confirmed the substantial absence of clinically significant effects of orthodontics as far as TMD is concerned. The very low correlation values of a negative or positive history of ideal or nonideal orthodontics with the different TMD diagnoses suggest that orthodontic treatment could not have a true role for TMD.

  18. Clinical outcomes of Botox injections for chronic temporomandibular disorders: do we understand how Botox works on muscle, pain, and the brain?

    Science.gov (United States)

    Connelly, S T; Myung, J; Gupta, R; Tartaglia, G M; Gizdulich, A; Yang, J; Silva, R

    2017-03-01

    The main objective of this retrospective review was to analyze the clinical outcomes following the use of botulinum toxin (onabotulinumtoxinA, Botox) injections to relieve the symptoms of chronic temporomandibular disorders (TMD). Seventy-one patients with a diagnosis of TMD (according to the RDC/TMD international consortium) associated with or without bruxism and refractory to conventional treatment (e.g. oral appliances, physiotherapy, etc.) received Botox injections into the temporalis and masseter muscles. Subjective responses to Botox were categorized as 'beneficial' or 'not beneficial', as patient-reported outcomes based on the subjective reduction in pain and/or improvement in function. Fifty-five of the 71 subjects (77%) reported beneficial effects with Botox. Subjects with a concomitant bruxism diagnosis reported significant improvement over subjects without bruxism (87% vs. 67%; P=0.042). Subjects with stress-related psychiatric comorbidities and bruxism had a significantly higher benefit than those with stress-related psychiatric comorbidities alone (P=0.027). Patients reported less improvement if the time between the initial Botox injection and follow-up was less than an average of 5 weeks, compared to an average follow-up of 5-10 weeks (P=0.009). The subgroup TMD diagnosis and time interval post-injection are important predictors of patient-reported beneficial outcomes. Published by Elsevier Ltd.

  19. Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular disorder patients: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ana Paula de Lima FERREIRA

    Full Text Available Abstract Studies to assess the effects of therapies on pain and masticatory muscle function are scarce. Objective To investigate the short-term effect of transcutaneous electrical nerve stimulation (TENS by examining pain intensity, pressure pain threshold (PPT and electromyography (EMG activity in patients with temporomandibular disorder (TMD. Material and Methods Forty patients with myofascial TMD were enrolled in this randomized placebo-controlled trial and were divided into two groups: active (n=20 and placebo (n=20 TENS. Outcome variables assessed at baseline (T0, immediately after (T2 and 48 hours after treatment (T1 were: pain intensity with the aid of a visual analogue scale (VAS; PPT of masticatory and cervical structures; EMG activity during mandibular rest position (MR, maximal voluntary contraction (MVC and habitual chewing (HC. Two-way ANOVA for repeated measures was applied to the data and the significance level was set at 5%. Results There was a decrease in the VAS values at T1 and T2 when compared with T0 values in the active TENS group (p<0.050. The PPT between-group differences were significant at T1 assessment of the anterior temporalis and sternocleidomastoid (SCM and T2 for the masseter and the SCM (p<0.050. A significant EMG activity reduction of the masseter and anterior temporalis was presented in the active TENS during MR at T1 assessment when compared with T0 (p<0.050. The EMG activity of the anterior temporalis was significantly higher in the active TENS during MVC at T1 and T2 when compared with placebo (p<0.050. The EMG activity of the masseter and anterior temporalis muscle was significantly higher in the active TENS during HC at T1 when compared with placebo (p<0.050. Conclusions The short-term therapeutic effects of TENS are superior to those of the placebo, because of reported facial pain, deep pain sensitivity and masticatory muscle EMG activity improvement.

  20. Obesity as a risk factor for temporomandibular disorders.

    Science.gov (United States)

    Jordani, P C; Campi, L B; Circeli, G Z; Visscher, C M; Bigal, M E; Gonçalves, D A G

    2017-01-01

    We conducted a clinical cross-sectional study to evaluate the association between obesity and the presence of painful temporomandibular disorders (TMD), controlling for age, gender, presence of migraine, depression, non-specific somatic symptoms and obstructive sleep apnoea syndrome (OSAS) in an adult population. A total of 299 individuals (76·6% women) with a mean age of 36·8 ± 12·8 years were evaluated. TMD were classified using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Depression and non-specific somatic symptoms were scored by the Symptom Checklist-90, while pain and disability was rated by the Graded Chronic Pain Scale. Bioimpedanciometry (BIA) was used to assess obesity through total body fat percentage. Migraine was diagnosed according to the criteria of the International Classification of Headache Disorders-2 (ICHD-2). OSAS was classified according to the Berlin Questionnaire. We performed univariate and multivariate models, chi-square tests and odds ratios (OR) with 95% confidence intervals (CI). In the single regression analysis, TMD-pain was significantly associated with total body fat percentage (P = 0·01). In the multivariate analysis, migraine, age, non-specific somatic symptoms and OSAS showed to be stronger predictors of TMD-pain, and obesity did not retain in the regression model. The initial association found between obesity and TMD-pain is lost when it was corrected for gender, migraine, non-specific somatic symptoms and OSAS. © 2016 John Wiley & Sons Ltd.

  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

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

    Science.gov (United States)

    Mottaghi, Ahmad; Razavi, S Mohammad; Pozveh, Elham Zamani; Jahangirmoghaddam, Milad

    2011-12-01

    Temporomandibular joint is one of the most complicated joints of the body and plays an important role in the head and neck system. One of the factors affecting the temporomandibular joint and lead to temporomandibular disorder is anxiety with all the events causing it. The aim of this study was to determine a relationship between anxiety and temporomandibular disorders. In this prospective study, subjects were randomly selected. One hundred and thirty pre-university students in Isfahan were evaluated with Ketel's test of anxiety, exam stress test and temporomandibular disorder questionnaires. The evaluation was done in two stages 10 months and 1 month prior to the university entrance exam (Konkour), clinical assessments consisted of masticatory muscles and sternocleidomastoid muscle palpation, temporomandibular joint palpation for pain and noise and its movement, and mouth opening limitations. The Wilcoxon rank test and paired t-test were used to analyze the data and the P value under 0.05 was considered significant. The level of anxiety and occurrence of temporomandibular disorders were increased between two stages and had the highest level in the second stage. There was a significant increase between two stages (P<0.001). 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.

  3. 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-Hungría, Antonio; Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velázquez, Lourdes; Rodríguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael

    2016-03-01

    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. 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. 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. 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.

  4. 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.

  5. Cervical musculoskeletal impairments and temporomandibular disorders.

    Science.gov (United States)

    Armijo-Olivo, Susan; Magee, David

    2013-01-01

    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. 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. 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. 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.

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

    National Research Council Canada - National Science Library

    Maia, Mila Leite de Moraes; Bonjardim, Leonardo Rigoldi; Quintans, Jullyana de Souza Siqueira; Ribeiro, Maria Amália Gonzaga; Maia, Luiz Guilherme Martins; Conti, Paulo César Rodrigues

    2012-01-01

    ...) 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...

  7. 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.

  8. Effect of jaw-opening exercise on prevention of temporomandibular disorders pain associated with oral appliance therapy in obstructive sleep apnea patients: A randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Ishiyama, Hiroyuki; Inukai, Shusuke; Nishiyama, Akira; Hideshima, Masayuki; Nakamura, Shuhei; Tamaoka, Meiyo; Miyazaki, Yasunari; Fueki, Kenji; Wakabayashi, Noriyuki

    2017-07-01

    There are no studies on the prevention of temporomandibular joint and/or masticatory muscle pain (TMD pain) associated with oral appliance (OA) therapy in patients with obstructive sleep apnea (OSA). The aim of this study was to determine the effect of jaw-opening exercise on TMD pain associated with OA therapy in OSA patients. Twenty-five OSA patients without pain-related TMD were consecutively enrolled into a two-arm, randomized, double-blind, placebo-controlled trial. One group performed jaw-opening exercise (JE, n=13), and the other group performed placebo exercise (PE, n=12) for 1-month, and had started 2-weeks prior to insertion of an adjustable OA. TMD sign using the Research Diagnostic Criteria for Temporomandibular Disorders and TMD pain intensity using a visual analog scale (VAS) in the morning and daytime were evaluated at baseline (pre-exercise) and at 2-weeks, 1-month, and 3-months after OA insertion. Pain-related TMD was not observed in the JE-group at all evaluation periods, although one subject in the PE-group was diagnosed with arthralgia at the 1-month evaluation. The JE-group showed lower morning and daytime VAS scores than the those of the PE-group at all evaluation periods, and significant group differences were found in terms of chewing pain and jaw-opening pain in the morning at the 1-month evaluation, and of jaw-opening pain during daytime at the 3-month evaluation (Ppain associated with OA use. Therefore, jaw-opening exercise may contribute to the prevention of TMD pain. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  9. Estudo do posicionamento de língua e lábios em sujeitos com disfunção temporomandibular e dor orofacial Study of tongue and lip positions in patients with temporomandibular disorder and orofacial pain

    Directory of Open Access Journals (Sweden)

    Vivian Ferreira Matos

    2009-01-01

    Full Text Available OBJETIVO: verificar a posição de repouso de língua e lábios em sujeitos com Disfunção Temporomandibular (DTM e analisar a intensidade da dor em músculos mastigatórios. MÉTODOS: foram avaliados 44 sujeitos de ambos os sexos com média de idade de 42,52 anos. Foram realizadas três avaliações: exame clínico visual, averiguando a posição de repouso da língua, seguido de avaliação subjetiva e objetiva da dor pela Escala Visual Analógica (EVA e palpação dos músculos mastigatórios. RESULTADOS: 23 (52,27% posicionaram a língua no palato e 21 (47,73% na posição baixa. Dos sujeitos que posicionaram a língua no palato, 73,91% deles referiram dor à palpação em masseter; 56,52% na região cervical; 43,48% em temporais; 39,13% em digástricos e 52,17% em região articular. Encontraram-se relações estatisticamente significantes entre queixa subjetiva e objetiva da dor relativo aos músculos cervicais (p=0,026, temporais (p=0,019, digástricos (p=0,005 e região articular (p=0,013. Na amostra foram encontrados 88,63% de componente miálgico e 56,81% artrálgico. CONCLUSÃO: a posição não elevada da língua não se confirmou em pacientes com DTM, uma vez que a distribuição foi equitativa, com ausência de correlação entre dor e posição de língua, predomínio de lábios fechados e dores miálgicas mais freqüentes que as artrálgicas.PURPOSE: to check the habitual tongue and lips rest position in subjects with Temporomandibular Dysfunction (TMD, and to analyze their pain complaint in masticatory muscles. METHODS: 44 subjects, of both genders and mean age of 42.52 years were evaluated. Three evaluations were carried out: visual clinical examination as for tongue habitual rest position, pain complains using visual analogical scale (VAS and bilateral masticatory muscle palpation assessing pain intensity. RESULTS: 23 subjects (52.27% showed the tongue at the palatine papilla and 21 (47.73% showed in different position than

  10. Design, construction, and technical implementation of a web-based interdisciplinary symptom evaluation (WISE) - a heuristic proposal for orofacial pain and temporomandibular disorders.

    Science.gov (United States)

    Ettlin, Dominik A; Sommer, Isabelle; Brönnimann, Ben; Maffioletti, Sergio; Scheidt, Jörg; Hou, Mei-Yin; Lukic, Nenad; Steiger, Beat

    2016-12-01

    Medical symptoms independent of body location burden individuals to varying degrees and may require care by more than one expert. Various paper and computer-based tools exist that aim to comprehensively capture data for optimal clinical management and research. A web-based interdisciplinary symptom evaluation (WISE) was newly designed, constructed, and technically implemented. For worldwide applicability and to avoid copyright infringements, open source software tools and free validated questionnaires available in multiple languages were used. Highly secure data storage limits access strictly to those who use the tool for collecting, storing, and evaluating their data. Concept and implementation is illustrated by a WISE sample tailored for the requirements of a single center in Switzerland providing interdisciplinary care to orofacial pain and temporomandibular disorder patients. By combining a symptom- burden checklist with in-depth questionnaires serving as case-finding instruments, an algorithm was developed that assists in clarifying case complexity and need for targeted expert evaluation. This novel modular approach provides a personalized, response-tailored instrument for the time- and cost-effective collection of symptom-burden focused quantitative data. The tool includes body drawing options and instructional videos. It is applicable for biopsychosocial evaluation in a variety of clinical settings and offers direct feedback by a case report summary. In clinical practice, the new instrument assists in clarifying case complexity and referral need, based on symptom burden and response -tailored case finding. It provides single-case summary reports from a biopsychosocial perspective and includes graphical symptom maps. Secure, centrally stored data collection of anonymous data is possible. The tool enables personalized medicine, facilitates interprofessional education and collaboration, and allows for multicenter patient-reported outcomes research.

  11. Recognition of Temporomandibular Disorders : validity and outcome of three screening questions (3Q/TMD)

    OpenAIRE

    Lövgren, Anna

    2017-01-01

    Background Pain and dysfunction in the temporomandibular region (Temporomandibular Disorders, TMD) are common conditions in the general population with an estimated treatment need of 5-15% in the general population. However, in Sweden, traceable performed treatments are significantly lower. The reasons for this indicated under-treatment are not known. To easily detect patients with a potential TMD related condition, three screening questions, 3Q/TMD, have been introduced. The aim with this p...

  12. Symptomatology and frequent temporomandibular disorders in edentulous elderlyaccording to research diagnostic criteria (rdc/tmd).

    OpenAIRE

    Arcos, Dagoberto; Nilo, Cristián; Frugone Zambra, Raúl

    2016-01-01

    Pain in the muscles of mastication, limited opening, asymmetric jaw movement, and sounds in the TMJ, among others symptoms are some clinical characteristics of temporomandibular disorders (TMD). It is a complain in subjects of both sexes, different ages and occlusal conditions. Objective: To determine the most frequent pathology and temporomandibular symptomatology in elderly edentulous patients. Materials and Methods: 30 consecutive subjects,25 female and five men older than 65 ys (70.8±5.7)...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. VESTIBULAR SCHWANNOMA (ACOUSTIC NEUROMA) MIMICKING TEMPOROMANDIBULAR DISORDERS: A CASE REPORT

    Science.gov (United States)

    Bisi, Maurício A.; Selaimen, Caio M. P.; Chaves, Karen D.; Bisi, Melissa C.; Grossi, Márcio L.

    2006-01-01

    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. PMID:19089251

  15. Psychosocial impairment in temporomandibular disorders patients: RDC/TMD axis II findings from a multicentre study

    NARCIS (Netherlands)

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

    2010-01-01

    Objectives: The relationship between the rate of chronic pain-related disability and depression and somatization levels as well as the influence of pain duration on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis II findings were assessed in a three centre investigation.

  16. Temporomandibular disorders: a report of 124 patients.

    Science.gov (United States)

    Martins-Júnior, Reynaldo Leite; Palma, Antônio José Garcia; Marquardt, Emilio Jose; Gondin, Thais Monteiro de Barros; Kerber, Florence de Carvalho

    2010-10-14

    This study aims to present both the features of 124 consecutive patients with temporomandibular disorders (TMDs) and the results of a reversible, conservative, and low-tech treatment. One hundred fifty-eight records of consecutive patients treated in School of Dentistry at the Univag-University Center in Várzea Grande-MT, Brazil, 124 of whom were considered TMD patients, were examined. The following data were obtained: gender, age, main complaint, diagnosis, co-morbidities, type of treatment performed, and treatment results. The patients who received a successful treatment were contacted for reevaluation four to six years after the conclusion of treatment. Pain was the main complaint for 92.7 percent of the patients. The majority of patients were female (female:male ratio of 4.1:1), with a peak age range between 20 and 30 years. Roughly 59.7 percent of the patients were diagnosed as having a muscular TMD, 12.9 percent as an articular TMD, and 27.4 percent as a mixed TMD. The success rate for treatment was 91.7 percent, and there was a tendency toward the long-term maintenance of good results. The features of the 124 TMD patients treated were similar to those reported in the literature with regard to gender, age, and diagnostic prevalence. Most of the disorders were of a muscular origin, and there was a predominance of women between 20 and 30 years of age. The conservative, reversible, and low-tech treatment success rate for TMD can reach values above 90 percent. Therefore, there is no need for invasive, irreversible, expensive, or high-tech treatments for the majority of patients. The majority of TMD patients can benefit from reversible, conservative, and low-tech treatments such as parafunction control and therapeutic exercises that can be performed by any clinician once an accurate diagnosis has been made.

  17. 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.

  18. Prevalence of temporomandibular disorder signs in patients with schizophrenia.

    Science.gov (United States)

    Gurbuz, O; Alatas, G; Kurt, E

    2009-12-01

    The aim of this study was to determine the prevalence of temporomandibular disorder (TMD) signs in a group of institutionalized patients with schizophrenia. Three hundred thirty-nine patients with schizophrenia were examined and compared with 107 age-matched and gender-matched control subjects. TMD signs were evaluated according to the Research Diagnostic Criteria to assess temporomandibular joint pain to palpation, limitation of maximum mouth opening, alteration of mouth opening pathway (deviation/deflection) and temporomandibular joint noises. In addition, tooth wear was recorded for the assessment of bruxism. The prevalence of any TMD signs was observed higher (P = 0.001) in the patients with schizophrenia (284/339, 83.7%) than in the controls (72/107, 67.3%). The prevalence of more than one TMD sign was also significantly higher (P = 0.03) in the patients with schizophrenia (131/339, 38.6%) than in the controls (29/107, 27.1%). Significant differences between the two groups were apparent for joint pain on palpation (P = 0.006), deflection (P = 0.006) and joint sounds (P = 0.002). Severe tooth wear was evident in 39.2% of the patients with schizophrenia compared with 21.2% in the control group (P = 0.001). The finding of the present study showed that, compared to control population, chronically hospitalized patients with schizophrenia seem to be more prone to the development of TMD signs and severe tooth wear and bruxism.

  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. 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

  1. Long-term treatment outcome for adolescents with temporomandibular pain.

    Science.gov (United States)

    Wahlund, Kerstin; Larsson, Bo

    2017-10-26

    This study aims to evaluate long-term, self-perceived outcome in adulthood for individuals treated as adolescents for temporomandibular disorder (TMD) pain in two previous randomized controlled trials (RCTs). The study included 116 subjects (81% females) treated for frequent TMD pain in two separate RCTs 5-21 (M = 14.8, SD =4.9) years previously. Treatment consisted of occlusal appliance (OA) (n = 41, 35.3%) or relaxation training (RT) combined with information for the control (Co) group (n = 50, 43.1%), both compared to non-responders receiving additional, sequential treatment (ST) in a crossover study (n = 25, 21.6%). Participants answered a questionnaire on their experience of frequency and intensity of TMD pain impaired chewing capacity and daily social activities, help-seeking behaviour and treatment, general health, other pain, and depressive symptoms. Older participants reported lower levels of frequency and intensity of TMD pain, impairment, and depressive symptoms, as well as better general health. Females reported more frequent and more intense TMD pain, greater impairment and more often reported 'other pain' compared to males. Non-responders receiving ST experienced significantly more TMD, and other pain and higher impairment levels compared to other groups. Those treated with an OA had sought additional treatment significantly less often since the RCTs than ST and RT/Co-treated individuals. Adolescents treated with OA showed somewhat better sustained improvement over the extended follow-up period than those treated with RT/Co. Non-responders to treatment and females exhibited a poorer outcome. These groups need particular attention and extended or different treatments to achieve a better long-term outcome.

  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. © 2014 John Wiley & Sons Ltd.

  3. Pain Disorder

    Directory of Open Access Journals (Sweden)

    Carlos Capela

    2014-06-01

    Full Text Available Pain disorder is a psychiatric disorder diagnosed when the pain becomes the predominant focus of the clinical presentation and causes significant distress or impairment. Besides the high economic impact, there is a reciprocal relationship with the affective state. Pain is a subjective sensation and its severity and quality of experience in an individual is dependent on a complex mix of factors. In the treatment of acute pain, the primary purpose is pain relief, while chronic pain typically requires a combination of psychotropic drugs. In this context, it is also important to recognize and treat depression. Psychological treatments aimed at providing mechanisms to allow patients to "control and live with the pain" rather than aspire to eliminate it completely. A growing group of researchers proposes the elimination of the chapter of Somatoform Disorders and the modification of the category "psychological factors affecting a medical condition" to "psychological factors affecting an identified or feared medical condition" with clinical entities as ubchapters, largely based upon Diagnostics for Psychosomatic Research criteria.

  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. 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)....

  6. Use of Magnetic Neurostimulator Appliance in Temporomandibular Disorder

    Directory of Open Access Journals (Sweden)

    Marcelo Rossiti Florian

    2017-04-01

    Full Text Available Temporomandibular disorder (TMD is ranked the second leading cause of orofacial pain after toothache, and there is no effective standard treatment for all cases. Therefore, much research has been conducted in the therapeutic areas of TMD, such as acupuncture and electrotherapy, for this purpose. The aim of this research was to evaluate application of the neuromagnetic stimulator device Haihua model CD-9, used within the precepts of acupuncture in treating TMD-related pain symptoms and limited mouth opening. Analysis and discussion of this study were based on pain intensity index and range of mouth-opening evaluation before and after each session. Nine patients diagnosed with muscle TMD, referred by the surgery sector of Center Dental Specialties (CEO – I in Piracicaba-São Paulo participated in this research. Considering the simplicity of the technique and good results obtained, use of this device is suggested as an additional therapeutic tool for relief of TMD symptoms.

  7. Orotracheal intubation and temporomandibular disorder: a longitudinal controlled study

    Directory of Open Access Journals (Sweden)

    Cláudia Branco Battistella

    2016-04-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: To determine the incidence of signs and symptoms of temporomandibular disorder in elective surgery patients who underwent orotracheal intubation. METHODS: This was a longitudinal controlled study with two groups. The study group included patients who underwent orotracheal intubation and a control group. We used the American Academy of Orofacial Pain questionnaire to assess the temporomandibular disorder signs and symptoms one-day postoperatively (T1, and the patients' baseline status prior to surgery (T0 was also recorded. The same questionnaire was used after three months (T2. The mouth opening amplitude was measured at T1 and T2. We considered a pvalue of less than 0.05 to be significant. RESULTS: We included 71 patients, with 38 in the study group and 33 in the control. There was no significant difference between the groups in age (study group: 66.0 [52.5-72.0]; control group: 54.0 [47.0-68.0]; p = 0.117 or in their belonging to the female gender (study group: 57.9%; control group: 63.6%; p = 0.621. At T1, there were no statistically significant differences between the groups in the incidence of mouth opening limitation (study group: 23.7% vs. control group: 18.2%;p = 0.570 or in the mouth opening amplitude (study group: 45.0 [40.0-47.0] vs. control group: 46.0 [40.0-51.0];p = 0.278. At T2 we obtained similar findings. There was no significant difference in the affirmative response to all the individual questions in the American Academy of Orofacial Pain questionnaire. CONCLUSIONS: In our population, the incidence of signs and symptoms of temporomandibular disorder of muscular origin was not different between the groups.

  8. [Orotracheal intubation and temporomandibular disorder: a longitudinal controlled study].

    Science.gov (United States)

    Battistella, Cláudia Branco; Machado, Flávia Ribeiro; Juliano, Yara; Guimarães, Antônio Sérgio; Tanaka, Cássia Emi; Garbim, Cristina Talá de Souza; Fonseca, Paula de Maria da Rocha; Sanches, Monique Lalue

    2016-01-01

    To determine the incidence of signs and symptoms of temporomandibular disorder in elective surgery patients who underwent orotracheal intubation. This was a longitudinal controlled study with two groups. The study group included patients who underwent orotracheal intubation and a control group. We used the American Academy of Orofacial Pain questionnaire to assess the temporomandibular disorder signs and symptoms one-day postoperatively (T1), and the patients' baseline status prior to surgery (T0) was also recorded. The same questionnaire was used after three months (T2). The mouth opening amplitude was measured at T1 and T2. We considered a p value of less than 0.05 to be significant. We included 71 patients, with 38 in the study group and 33 in the control. There was no significant difference between the groups in age (study group: 66 [52.5-72]; control group: 54 [47-68]; p=0.117) or in their belonging to the female gender (study group: 57.9%; control group: 63.6%; p=0.621). At T1, there were no statistically significant differences between the groups in the incidence of mouth opening limitation (study group: 23.7% vs. 18.2%; p=0.570) or in the mouth opening amplitude (study group: 45 [40-47] vs. 46 [40-51]; p=0.278). At T2 we obtained similar findings. There was no significant difference in the affirmative response to all the individual questions in the American Academy of Orofacial Pain questionnaire. In our population, the incidence of signs and symptoms of temporomandibular disorder of muscular origin was not different between the groups. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Orotracheal intubation and temporomandibular disorder: a longitudinal controlled study.

    Science.gov (United States)

    Battistella, Cláudia Branco; Machado, Flávia Ribeiro; Juliano, Yara; Guimarães, Antônio Sérgio; Tanaka, Cássia Emi; de Souza Garbim, Cristina Talá; de Maria da Rocha Fonseca, Paula; Sanches, Monique Lalue

    2016-01-01

    To determine the incidence of signs and symptoms of temporomandibular disorder in elective surgery patients who underwent orotracheal intubation. This was a longitudinal controlled study with two groups. The study group included patients who underwent orotracheal intubation and a control group. We used the American Academy of Orofacial Pain questionnaire to assess the temporomandibular disorder signs and symptoms one-day postoperatively (T1), and the patients' baseline status prior to surgery (T0) was also recorded. The same questionnaire was used after three months (T2). The mouth opening amplitude was measured at T1 and T2. We considered a p value of less than 0.05 to be significant. We included 71 patients, with 38 in the study group and 33 in the control. There was no significant difference between the groups in age (study group: 66.0 [52.5-72.0]; control group: 54.0 [47.0-68.0]; p=0.117) or in their belonging to the female gender (study group: 57.9%; control group: 63.6%; p=0.621). At T1, there were no statistically significant differences between the groups in the incidence of mouth opening limitation (study group: 23.7% vs. 18.2%; p=0.570) or in the mouth opening amplitude (study group: 45.0 [40.0-47.0] vs. 46.0 [40.0-51.0]; p=0.278). At T2 we obtained similar findings. There was no significant difference in the affirmative response to all the individual questions in the American Academy of Orofacial Pain questionnaire. In our population, the incidence of signs and symptoms of temporomandibular disorder of muscular origin was not different between the groups. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  10. Temporomandibular disorders after whiplash injury

    DEFF Research Database (Denmark)

    Kasch, Helge; Hjorth, Tine; Svensson, Peter

    2002-01-01

    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......, TMD symptoms and signs, MVOF and PDT, I were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months. Conclusion: TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD...

  11. The use of superficial heat for treatment of temporomandibular disorders: an integrative review.

    Science.gov (United States)

    Furlan, Renata Maria Moreira Moraes; Giovanardi, Raquel Safar; Britto, Ana Teresa Brandão de Oliveira e; Oliveira e Britto, Denise Brandão de

    2015-01-01

    To perform an integrative review of scientific bibliographic production on the use of superficial heat treatment for temporomandibular disorders. Research strategy : Literature review was accomplished on PubMed, LiLACS, SciELO, Bireme, Web of Science, and BBO databases. The following descriptors were used: hot temperature, hyperthermia induced, heat transference, temporomandibular joint, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, and their equivalents in Portuguese and Spanish. Articles that addressed the superficial heat for the treatment of temporomandibular disorders, published in English, Spanish, or Portuguese, between 1980 and 2013. The following data were collected: technique of applying superficial heat, duration of application, stimulated body area, temperature of the stimulus, frequency of application, and benefits. initially, 211 studies were found, but just 13 contemplated the proposed selection criteria. Data were tabulated and presented in chronological order. Several techniques for superficial heat application on treatment of temporomandibular disorders were found in the literature. The moist heat was the most widely used technique. Many studies suggested the application of heat for at least 20 minutes once a day. Most authors recommended the application of heat in facial and cervical regions. The heat treatment resulted in significant relief of pain, reduced muscle tension, improved function of the mandible, and increased mouth opening.

  12. Signs and symptoms of temporomandibular disorders in women and men.

    Science.gov (United States)

    Ferreira, Claudia Lúcia Pimenta; Silva, Marco Antônio Moreira Rodrigues da; Felício, Cláudia Maria de

    2016-01-01

    Women are more likely to present temporomandibular disorders (TMD); however, studies comparing genders in Brazilian samples are rare. To analyze the proportion of men and women, as well as the association between gender and age, problem duration, and TMD symptoms in patients admitted to an university clinic for treatment. Interview and assessment data of protocols from 1,000 patients diagnosed with TMD were collected and analyzed and then divided into two groups, male (n = 177) and female (n = 823). The exploratory analysis was based on contingency tables and χ2 test was carried out. Subsequently, the logistic regression model was used and the odds ratios (OR) concerning the evaluated comparisons were calculated. Females were more prevalent in the sample, and mean ages and TMD duration were similar between the groups, with higher occurrence in young adults (19 to 40 years old). The OR values showed an association between the female gender and the signs/symptoms of pain in the temporomandibular joint, pain in the facial muscles, neck and shoulders, headache, fatigue in the muscles of mastication, otologic symptoms, and dysphonia. Women had two times higher chances of presenting these symptoms than men. In the sample of Brazilian patients with TMD, the number of women who presented a higher prevalence of painful symptoms was greater, followed by otologic symptoms and complaints of dysphonia. The prevalence of joint noise was similar in both studied groups.

  13. The relationship of temporomandibular disorders with headaches: a retrospective analysis.

    Science.gov (United States)

    Özkan, Nilüfer Cakir; Ozkan, Fatih

    2011-01-01

    The objective of this study was to retrospectively analyze the incidence of the concurrent existence of temporomandibular disorders (TMD) and headaches. Forty patients (36 female, 4 male, mean age: 29.9±9.6 years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: range of mouth opening, temporomandibular joint (TMJ) noises, pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles, and magnetic resonance imaging of the TMJ. According to patient records, a total of 40 (66.6%) patients were diagnosed with TMD among 60 patients with headache. Thirty-two (53%) patients had TMJ internal derangement (ID), 8 (13%) patients had only myofascial pain dysfunction (MPD) and 25 (41.6%) patients had concurrent TMJ ID/MPD. There were statistically significant relationships between the number of tender masseter muscles and MPD patients (p=0.04) and between the number of tender medial pterygoid muscles and patients with reducing disc displacement (RDD) (p=0.03). The TMJ and associated orofacial structures should be considered as possible triggering or perpetuating factors for headaches, especially tension-type. There might be a significant connection between TMD and headache. However, most medical and dental practitioners are unaware of this relationship. Therefore, a careful evaluation of the TMJ and associated orofacial structures is required for a correct interpretation of the craniofacial pain in headache patients, and these patients should be managed with a multidisciplinary approach.

  14. 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.

  15. Diagnostic criteria for headache attributed to temporomandibular disorders

    Science.gov (United States)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas; Anderson, Gary; Jensen, Rigmor; John, Mike T; Nixdorf, Donald; Goulet, Jean-Paul; Kang, Wenjun; Truelove, Ed; Clavel, Al; Fricton, James; Look, John

    2015-01-01

    Aims We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD). Methods In 373 headache subjects with TMD, a TMD headache reference standard was defined as: self-reported temple headache, consensus diagnosis of painful TMD and replication of the temple headache using TMD-based provocation tests. Revised diagnostic criteria for Headache attributed to TMD were selected using the RPART (recursive partitioning and regression trees) procedure, and refined in half of the data set. Using the remaining half of the data, the diagnostic accuracy of the revised criteria was compared to that of the International Headache Society's International Classification of Headache Diseases (ICHD)-II criteria A to C for Headache or facial pain attributed to temporomandibular joint (TMJ) disorder. Results Relative to the TMD headache reference standard, ICHD-II criteria showed sensitivity of 84% and specificity of 33%. The revised criteria for Headache attributed to TMD had sensitivity of 89% with improved specificity of 87% (p muscle palpation or jaw movement. Conclusion Having significantly better specificity than the ICHD-II criteria A to C, the revised criteria are recommended to diagnose headache secondary to TMD. PMID:22767961

  16. Reduced thermal threshold in patients with Temporomandibular Disorders.

    Science.gov (United States)

    Carvalho, G F; Chaves, T C; Florencio, L L; Dach, F; Bigal, M E; Bevilaqua-Grossi, D

    2016-06-01

    Many studies have demonstrated the presence of somatosensory modulation changes at different sites in patients with temporomandibular disorders (TMDs) using different modalities. However, the neck area, a well-know condition related to TMD, remains unexplored. To assess the thermal pain threshold in patients with TMD and controls at cephalic and extra-cephalic areas, including the neck. Twenty female patients with TMDs diagnosed by the Research Diagnostic Criteria for TMD (RDC/TMD) and twenty age-matched controls underwent a first interview about neck pain and disability (NDI questionnaire). A blinded evaluator assessed the thermal pain threshold for cold (CPT) and heat (HPT) stimuli in accordance with an ascending method of limits of the Quantitative Sensory Testing at the following sites: periorbital, masseter, cervical posterior and ventral forearm. The groups were compared using a t-test with α = 5%. Patients with TMDs reported pain at higher temperature for cold stimuli in all sites (P < 0·05) and at lower temperature for heat stimuli in the right periorbital site (P < 0·05) than controls. Pain and disability due tothis symptom were reported more often in the TMD group (P < 0·05). Patients with TMD have pain modulation changes in the neck area as well, especially for cold stimuli, associated with higher disability and a higher report of neck pain than controls. These findings reinforce the evidence regarding the relationship between TMDs and neck pain. © 2016 John Wiley & Sons Ltd.

  17. A Clinically Relevant Animal Model of Temporomandibular Disorder and Irritable Bowel Syndrome Comorbidity

    OpenAIRE

    Traub, Richard J; Cao, Dong-Yuan; Karpowicz, Jane; Pandya, Sangeeta; Ji, Yaping; Dorsey, Susan G; Dessem, Dean

    2014-01-01

    Temporomandibular disorders (TMD) and irritable bowel syndrome (IBS) are comorbid functional chronic pain disorders of unknown etiology that are triggered/exacerbated by stress. Here we present baseline phenotypic characterization of a novel animal model to gain insight into the underlying mechanisms that contribute to such comorbid pain conditions. In this model, chronic visceral hypersensitivity, a defining symptom of IBS, is dependent upon on three factors: estradiol, existi...

  18. 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. © 2016 John Wiley & Sons Ltd.

  19. Antioxidant capacity of synovial fluid in the temporomandibular joint correlated with radiological morphology of temporomandibular disorders.

    Science.gov (United States)

    Ishimaru, Kyoko; Ohba, Seigo; Yoshimura, Hitoshi; Matsuda, Shinpei; Ishimaru, Jun-Ichi; Sano, Kazuo

    2015-02-01

    We investigated the correlation between the antioxidant capacity of synovial fluid and radiological findings of intra-articular structures in patients with disorders of the temporomandibular joint (TMJ). We recruited 21 patients (9 men and 12 women, aged 18-84 years of age) with such disorders, excluding myofascial pain and dysfunction syndrome, or other muscular disorders. The clinical variables recorded included age, sex, interincisal distance, and visual analogue pain scores (VAS). Radiological findings were obtained from diagnostic arthrogram and cone-beam computed tomography (CT). The antioxidant capacity of the synovial fluid was measured by chemiluminescence. Eleven patients were radiologically diagnosed with closed lock, and the remaining 10 with no closed lock. An anchored intra-articular disc was most often seen on cone-beam CT (n=19) followed by perforated disc (n=7), osteoarthrosis (n=7), and anterior disc displacement without reduction (n=5). Although there were no significant differences between antioxidant capacity and age, sex, VAS, or any findings on cone-beam CT, antioxidant capacity was significantly decreased in the patients with closed lock compared with those who did not have closed lock (p=0.02). The results suggest an association between the oxidative stress of the synovial fluid and closed-lock in disorders of the TMJ. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms

    NARCIS (Netherlands)

    Meer, H.A. van der; Speksnijder, C.M.; Engelbert, R.H.; Lobbezoo, F.; Nijhuis-Van der Sanden, M.W.G.; Visscher, C.M.

    2017-01-01

    OBJECTIVES: The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. MATERIALS AND METHODS: Several subtypes of headaches

  1. Pain-related symptoms of temporomandibular disorders in the offspring of antenatally depressed mothers and depressed parents: a 31-year follow-up of the Northern Finland Birth Cohort 1966.

    Science.gov (United States)

    Pelkonen, E S J; Mäki, P H; Kyllönen, M A; Miettunen, J A; Taanila, A M; Sipilä, K K

    2013-08-01

    Temporomandibular disorders (TMDs) are clinical problems involving the masticatory muscles and temporomandibular joints (TMJs). Aspects of the aetiology of TMD are controversial. Many studies have identified an association between depression and TMD. The aim of the study was to evaluate the association between both maternal antenatal depression and parental depression during the offspring's childhood with TMD symptoms of the offspring during adulthood and to evaluate the effect of the offspring's own depression on this association. In the general population-based Northern Finland Birth Cohort 1966 (NFBC 1966), mothers of 12,058 children were asked at mid-gestation at the antenatal clinic if they felt depressed. Of these offspring who had data available on TMD symptoms in the computer-aided inquiry at the 31-year field study, a final study data of 5541 subjects was compiled. The Finnish Hospital Discharge Register was used to identify depression in the parents between the years 1972 and 1984 (when offspring were 6-18 years old). There were no statistically significant associations between TMD symptoms and maternal antenatal depressed mood. However, parental depression during the offspring's childhood associated significantly with facial pain [adjusted odds ratio (OR) = 1.64; 1.05-2.56] and with TMJ pain at jaw rest (OR = 1.81; 1.13-2.89), even after adjusting for gender, occupation of the father, family type at birth and the offspring's self-reported depression in adulthood. The risk for TMD symptoms is not elevated in the offspring of antenatally depressed mothers. Parental depression during an offspring's childhood increases the risk of pain-related TMD symptoms in their early adulthood. © 2012 European Federation of International Association for the Study of Pain Chapters.

  2. Differential Diagnostics of Pain in the Course of Trigeminal Neuralgia and Temporomandibular Joint Dysfunction

    Science.gov (United States)

    Pihut, M.; Szuta, M.; Ferendiuk, E.; Zeńczak-Więckiewicz, D.

    2014-01-01

    Chronic oral and facial pain syndromes are an indication for intervention of physicians of numerous medical specialties, while the complex nature of these complaints warrants interdisciplinary diagnostic and therapeutic approach. Oftentimes, lack of proper differentiation of pain associated with pathological changes of the surrounding tissues, neurogenic pain, vascular pain, or radiating pain from idiopathic facial pain leads to improper treatment. The objective of the paper is to provide detailed characterization of pain developing in the natural history of trigeminal neuralgia and temporomandibular joint dysfunction, with particular focus on similarities accounting for the difficulties in diagnosis and treatment as well as on differences between both types of pain. It might seem that trigeminal neuralgia can be easily differentiated from temporomandibular joint dysfunction due to the acute, piercing, and stabbing nature of neuralgic pain occurring at a single facial location to spread along the course of the nerve on one side, sometimes a dozen or so times a day, without forewarning periods. Both forms differ significantly in the character and intensity of pain. The exact analysis of the nature, intensity, and duration of pain may be crucial for the differential diagnostics of the disorders of our interest. PMID:24995309

  3. Actualización terapéutica de los trastornos temporomandibulares Updating on the treatment of temporomandibular disorders.

    Directory of Open Access Journals (Sweden)

    Indira García Martínez

    2007-09-01

    Full Text Available Se realizó una revisión bibliográfica con el objetivo de actualizar las diferentes alternativas terapéuticas que se disponen por parte de los profesionales para el tratamiento de los trastornos temporomandibulares, para lo cual los primeros esfuerzos están encaminados al alivio del dolor y al restablecimiento de la función, aunque previamente es necesario un buen diagnóstico y detección de los factores causales, enfatizando que el estrés es un elemento primordial que se debe considerar. La existencia de variados enfoques terapéuticos para los trastornos temporomandibulares queda justificada por la multifactorialidad de la etiología; las 2 alternativas más utilizadas son las férulas oclusales y el tallado selectivo. Se prefiere la fisioterapia a la quimioterapia, como coadyuvante terapéutica de los trastornos temporomandibulares, ya que disminuye el peligro de producir reacciones adversas. Solo se indicará el tratamiento quirúrgico cuando han fracasado los métodos conservadores.A literature review was made to provide updated information on the different therapeutic alternatives at the disposal of dental professionals for the treatment of termporomandibular disorders aimed at relieving pain and re-establish the functioning of the joint. However, it is necessary to firstly make a good diagnosis and then detect the causative factors, emphasizing that stress is a key element to be taken into consideration. The existence of various therapeutical approaches for temporomandibular disorders is due to the multiple factors present in the etiology; the two most used alternatives are occlusal splints and selective carving. Physiotherapy is prefered over chemotherapy, as therapeutic coadjuvant for temporomandibular disorders, because likely occurence of adverse reaction decreases. The surgical treatment will be advised only in the event of failure of standard methods.

  4. Analysis of pain in the rabbit temporomandibular joint after unilateral splint placement.

    Science.gov (United States)

    Henderson, Sarah E; Tudares, Mauro A; Gold, Michael S; Almarza, Alejandro J

    2015-01-01

    To determine whether behavioral, anatomical, and physiologic endpoints widely used to infer the presence of pain in rodent models of temporomandibular disorders (TMD) were applicable to the rabbit model of TMD associated with altered joint loading. Unilateral molar dental splints were used to alter temporomandibular joint (TMJ) loading. Changes in nociceptive threshold were assessed with a mechanical probing of the TMJ region on nine splinted and three control rabbits. Fos-like immunoreacitivty in the trigeminal subnucleus caudalis was assessed with standard immunohistochemical techniques from three splinted and six control animals. Retrogradely labeled TMJ afferents were studied with patch-clamp electrophysiologic techniques from three splinted and three control animals. Remodeling of TMJ condyles was assessed by histologic investigations of three splinted and three control animals. A Student t test or a Mann-Whitney U test was used with significance set at P joint degeneration. These compensatory changes may reflect pain-adaption processes that many patients with TMJ disorders experience.

  5. Therapeutic exercises for the control of temporomandibular disorders.

    Science.gov (United States)

    Moraes, Alberto da Rocha; Sanches, Monique Lalue; Ribeiro, Eduardo Cotecchia; Guimarães, Antonio Sérgio

    2013-01-01

    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. 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. 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. 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. 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.

  6. 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.

  7. Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients

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    Carlo Di Paolo

    2017-01-01

    Full Text Available Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs. The aim of this study was to evaluate, retrospectively, if headache influences TMD’s symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH and Group without Headache (GwoH. Descriptive statistics and Chi-square index were performed. Results. Sociodemographic (gender, marital status, and occupation and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities, and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion. This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity.

  8. Clinical Signs and Subjective Symptoms of Temporomandibular Disorders in Instrumentalists.

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    Jang, Jae Young; Kwon, Jeong Seung; Lee, Debora H; Bae, Jung Hee; Kim, Seong Taek

    2016-11-01

    Most of the reports on instrumentalists' experiences of temporomandibular disorders (TMD) have been reported not by clinical examinations but by subjective questionnaires. The aim of this study was to investigate the clinical signs and subjective symptoms of TMD in a large number of instrumentalists objectively. A total of 739 musicians from a diverse range of instrument groups completed a TMD questionnaire. Among those who reported at least one symptom of TMD, 71 volunteers underwent clinical examinations and radiography for diag-nosis. Overall, 453 participants (61.3%) reported having one or more symptoms of TMD. The most frequently reported symptom was a clicking or popping sound, followed by temporomandibular joint (TMJ) pain, muscle pain, crepitus, and mouth opening limitations. Compared with lower-string instrumentalists, a clicking or popping sound was about 1.8 and 2 times more frequent in woodwind and brass instrumentalists, respectively. TMJ pain was about 3.2, 2.8, and 3.2 times more frequent in upper-string, woodwind, and brass instrumentalists, respectively. Muscle pain was about 1.5 times more frequent in instrumentalists with an elevated arm position than in those with a neutral arm position. The most frequent diagnosis was myalgia or myofascial pain (MFP), followed by disc displacement with reduction. Myalgia or MFP was 4.6 times more frequent in those practicing for no less than 3.5 hours daily than in those practicing for less than 3.5 hours. The results indicate that playing instruments can play a contributory role in the development of TMD.

  9. Effects of exercise training and photobiomodulation therapy (EXTRAPHOTO) on pain in women with fibromyalgia and temporomandibular disorder: study protocol for a randomized controlled trial.

    Science.gov (United States)

    da Silva, Mariana Moreira; Albertini, Regiane; Leal-Junior, Ernesto Cesar Pinto; de Tarso Camillo de Carvalho, Paulo; Silva, José Antonio; Bussadori, Sandra Kalil; de Oliveira, Luis Vicente Franco; Casarin, Cezar Augusto Souza; Andrade, Erinaldo Luiz; Bocalini, Danilo Sales; Serra, Andrey Jorge

    2015-06-04

    Fibromyalgia (FM) is a syndrome most prevalent in women, in whom it is characterized mainly by chronic pain. An important issue is that many patients with FM are reported to have temporomandibular dysfunction (TMD), and the coexistence of these pathologies generates a clinical outcome of high complexity. The literature is unclear regarding an effective therapy for reducing pain in patients with both comorbidities. Exercise training and phototherapy (low-level laser therapy with light-emitting diode) are two of the approaches used to treat pain. Thus, the aim of this study is to assess the potential role of exercise training plus phototherapy in reducing chronic pain in women with FM and TMD. A further aim is to determine whether the interventions can improve quality of life and modulate endogenous serotonin. A randomized controlled clinical trial will be conducted. It will involve 60 women ≥ 35 years of age with a diagnosis of FM and TMD. After recruitment, patients will be randomly allocated to one of four groups: a control group (no intervention), a group that will receive a phototherapy intervention (PHO), a group that will be prescribed muscle-stretching, aerobic, and facial exercises (EXT), or a group that will receive phototherapy plus exercise interventions (PHO + EXT). The trial will last 10 weeks, and the following outcomes will be evaluated on two separate occasions (baseline and within 24 h after the last day of the protocol). Pain intensity will be analyzed using a visual analogue scale and the McGill Pain Questionnaire, and pain thresholds will be punctuated using a digital algometer. FM symptoms will be assessed using the Fibromyalgia Impact Questionnaire, and quality of life will be determined with the 36-item Short Form Health Survey. Serotonin levels will be evaluated in salivary samples using a competitive enzyme-linked immunosorbent assay. This is the first randomized controlled trial in which the role of phototherapy, exercise training, and a

  10. Temporomandibular Lavage Versus Nonsurgical Treatments for Temporomandibular Disorders: A Systematic Review and Meta-Analysis.

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    Bouchard, Carl; Goulet, Jean-Paul; El-Ouazzani, Mehdi; Turgeon, Alexis F

    2017-07-01

    To investigate the efficacy of temporomandibular joint (TMJ) lavage (arthrocentesis or arthroscopy) for the treatment of temporomandibular disorders in reducing pain and improving jaw motion. We performed a systematic review of the literature and meta-analysis of randomized controlled trials (RCTs) comparing TMJ lavage with conservative measures. The data sources were MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus, Web of Science, and reference lists of relevant articles. Two independent reviewers identified RCTs by using controlled vocabulary (MeSH, Emtree) and free text terms. Data extracted from the selected studies included population characteristics, interventions, outcomes, and funding sources. Risk of bias was assessed with the Cochrane Collaboration risk assessment tool for RCTs. Five studies met the inclusion criteria, for a total of 308 patients. Of these studies, 3 were categorized as having a high risk of bias and 2 had a low risk. The summary effect of the 5 studies showed a reduction in pain in the intervention group at 6 months (-0.63; 95% confidence interval [CI], -0.90 to -0.37; P < .00001; I2 = 88%) and 3 months (-0.47; 95% CI, -0.75 to -0.19; P = .001; I2 = 85%). This was not the case at 1 month. No difference in mouth opening was observed at 6 months (-0.21; 95% CI, -1.82 to 1.40; P < .80; I2 = 74%), 3 months (0.20; 95% CI, -1.81 to 2.20; P = .85; I2 = 68%), and 1 month (-1.18; 95% CI, -2.90 to 0.55; P = .18; I2 = 0%). Given the relatively small number of patients included in this meta-analysis, the high risk of bias in 3 studies, and the statistical and clinical heterogeneity of the included studies, the use of TMJ lavage for the treatment of temporomandibular disorders should be recommended with caution because of the lack of strong evidence to support its use. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Temporomandibular joint: disorders, treatments, and biomechanics.

    Science.gov (United States)

    Ingawalé, Shirish; Goswami, Tarun

    2009-05-01

    Temporomandibular joint (TMJ) is a complex, sensitive, and highly mobile joint. Millions of people suffer from temporomandibular disorders (TMD) in USA alone. The TMD treatment options need to be looked at more fully to assess possible improvement of the available options and introduction of novel techniques. As reconstruction with either partial or total joint prosthesis is the potential treatment option in certain TMD conditions, it is essential to study outcomes of the FDA approved TMJ implants in a controlled comparative manner. Evaluating the kinetics and kinematics of the TMJ enables the understanding of structure and function of normal and diseased TMJ to predict changes due to alterations, and to propose more efficient methods of treatment. Although many researchers have conducted biomechanical analysis of the TMJ, many of the methods have certain limitations. Therefore, a more comprehensive analysis is necessary for better understanding of different movements and resulting forces and stresses in the joint components. This article provides the results of a state-of-the-art investigation of the TMJ anatomy, TMD, treatment options, a review of the FDA approved TMJ prosthetic devices, and the TMJ biomechanics.

  12. Temporomandibular disorders. Part 2: conservative management

    Science.gov (United States)

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

    2014-01-01

    Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

  13. Effectiveness of osteopathic manipulative treatment versus osteopathy in the cranial field in temporomandibular disorders - a pilot study.

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    Gesslbauer, Christina; Vavti, Nadja; Keilani, Mohammad; Mickel, Michael; Crevenna, Richard

    2018-03-01

    Temporomandibular disorders are a common musculoskeletal condition causing severe pain, physical and psychological disability. The effect and evidence of osteopathic manipulative treatment and osteopathy in the cranial field is scarce and their use are controversial. The purpose of this pilot study was to evaluate the effectiveness of osteopathic manipulative treatment and osteopathy in the cranial field in temporomandibular disorders. A randomized clinical trial in patients with temporomandibular disorders was performed. Forty female subjects with long-term temporomandibular disorders (>3 months) were included. At enrollment, subjects were randomly assigned into two groups: (1) osteopathic manipulative treatment group (20 female patients) and (2) osteopathy in the cranial field group (20 female patients). Examination was performed at baseline (E0) and at the end of the last treatment (E1), consisting of subjective pain intensity with the Visual Analog Scale, Helkimo Index and SF-36 Health Survey. Subjects had five treatments, once a week. 36 subjects completed the study (33.7 ± 10.3 y). Patients in both groups showed significant reduction in Visual Analog Scale score (osteopathic manipulative treatment group: p = 0.001; osteopathy in the cranial field group: pmanipulative treatment group: p = 0.02; osteopathy in the cranial field group: p = 0.003) and a significant improvement in the SF-36 Health Survey - subscale "Bodily Pain" (osteopathic manipulative treatment group: p = 0.04; osteopathy in the cranial field group: p = 0.007) after five treatments (E1). All subjects (n = 36) also showed significant improvements in the above named parameters after five treatments (E1): Visual Analog Scale score (pmanipulative treatment and osteopathy in the cranial field as an effective treatment modality in patients with temporomandibular disorders. The positive results in both treatment groups should encourage further research on osteopathic

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

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    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.

  15. Influence of arthrocentesis irrigation volume at temporomandibular disorder treatment

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    Maysa Nogueira De Barros Melo

    2017-01-01

    Full Text Available Introduction: Temporomandibular disorder (TMD treatment varies from conservative therapy to invasive procedures such as arthrocentesis. The procedure is simple and has speed, low cost, low morbidity and good patient acceptance. Literature variations, however, have been found about the type and volume of the solution used for the irrigation of temporomandibular joint (TMJ. Subjects and Methods: The aim of this study was to compare the results provided by two different volumes of 0.9% saline solution (100 ml and 250 ml used in arthrocentesis technique for TMD treatment. It included patients unresponsive to conservative treatment. Preoperative (T0 and postoperative evaluations were performed at T1 (30th day, T2 (60th day, and T3 (90th day, in which maximal mouth opening (MMO, pain, and the presence or absence of joint sounds were recorded. Patients were randomized into two groups: 1 – submitted to arthrocentesis using 100 ml of 0.9% saline solution in TMJ and 2 – arthrocentesis performed using 250 ml of 0.9% saline solution in each TMJ. Data were submitted to descriptive and comparative analyses for each parameter per group and between groups. The effect size was calculated according to Cohen test. Minimum detectable change (MDC was obtained and the sensibility was calculated. A statistical significance of 5% was established. Group 1 obtained increase in MMO and decrease in pain (statistically significant; in Group 2, pain decreased significantly. In Group 1, clicking decreased significantly. No statistical differences were found between groups (P = 0.333. MMO and pain results exceeded MDC, and sensibility was good. Conclusion: In conclusion, arthrocentesis is effective in TMD symptoms' relief, without statistical difference between the volumes used.

  16. Multimodal physiotherapeutic approach: effects on the temporomandibular disorder diagnosis and severity

    OpenAIRE

    Freire,Ariane Bôlla; Nardi,Angélica Trevisan De; Boufleur,Jalusa; Chiodelli,Laís; Pasinato,Fernanda; Corrêa,Eliane Castilhos Rodrigues

    2014-01-01

    Introduction The temporomandibular disorder (TMD) consists of a set of signs and symptoms that affect the masticatory structures, which may cause joint and/or muscular pain. The physiotherapy approach aims at the pain relief and the functional recovery by means of several modalities.Objective To investigate the effects, short and medium-term, of a multimodal physiotherapeutic approach on TMD diagnosis and severity.Methodology Individuals with diagnosis of TMD, confirmed by the Axis I of the R...

  17. Long-term evaluation of single-puncture temporomandibular joint arthrocentesis in patients with unilateral temporomandibular disorders.

    Science.gov (United States)

    Şentürk, M F; Yıldırım, D; Bilgir, E; Fındık, Y; Baykul, T

    2018-01-01

    The purpose of this study was to evaluate the long-term effects of the single-puncture arthrocentesis (SPA) technique. Forty-two patients with unilateral temporomandibular joint disorders (TMDs) were treated by SPA. Thirty-eight of these patients completed 1-24 months of follow-up (short-term group) and 21 completed 11 months or longer of follow-up (long-term group). The two groups were evaluated statistically for pain (visual analogue scale), maximum mouth opening, lateral excursion, and protrusion. Both follow-up duration groups showed significant improvements when compared to baseline levels for almost all of the outcome variables (P<0.05). Single puncture temporomandibular joint arthrocentesis is an effective treatment method over both the short and long term. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation.

    Science.gov (United States)

    Rodriguez-Lopez, Manuel J; Fernandez-Baena, Mariano; Aldaya-Valverde, Carlos

    2015-01-01

    Temporomandibular joint syndrome, or Costen syndrome, is a clinically diagnosed disorder whose most common symptoms include joint pain and clicking, difficulty opening the mouth, and temporomandibular joint discomfort. The temporomandibular joint (TMJ) is supplied by the auriculotemporal nerve, a collateral branch of the mandibular nerve (the V3 branch of the trigeminal nerve). The aim of this study is to assess the effectiveness and safety of permanent peripheral nerve stimulation to relieve TMJ pain. This case series is a prospective study. Pain Unit of a regional universitary hospital. The study included 6 female patients with temporomandibular pain lasting from 2 to 8 years that did not respond to intraarticular local anesthetic and corticoid injections. After a positive diagnostic block test, the patients were implanted with quadripolar or octapolar leads in the affected preauricular region for a 2-week stimulation test phase, after which the leads were connected to a permanent implanted pulse generator. Results of the visual analog scale, SF-12 Health Survey, Brief Pain Inventory, and drug intake were recorded at baseline and at 4, 12, and 24 weeks after the permanent implant. Five out of 6 patients experienced pain relief exceeding 80% (average 72%) and received a permanent implant. The SF-12 Health Survey results were very positive for all specific questions, especially items concerning the physical component. Patients reported returning to normal physical activity and rest at night. Four patients discontinued their analgesic medication and 1 patient reduced their gabapentin dose by 50%. Sample size; impossibility of placebo control. Patients affected with TMJ syndrome who do not respond to conservative treatments may find a solution in peripheral nerve stimulation, a simple technique with a relatively low level of complications.

  19. Utilização de diferentes estimulações elétricas para o tratamento da dor em mulheres com disfunção temporomandibular Use of different electrical stimulations for treating pain in women with temporomandibular disorders

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    D Rodrigues-Bigaton

    2008-12-01

    Full Text Available OBJETIVO: Analisar a intensidade da dor em indivíduos com disfunção temporomandibular (DTM tratados com dez sessões de estimulação elétrica nervosa transcutânea (TENS ou estimulação elétrica de Alta Voltagem (EEAV. MÉTODOS: Foram selecionadas 24 mulheres (22,98±1,86 anos com diagnóstico de DTM, segundo o Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD, sendo 60% com diagnóstico de DTM do grupo Ia e 40% Ia e IIa. As voluntárias foram divididas em dois grupos denominados grupo TENS (GT e Grupo Alta Voltagem (GAV. Em ambos os grupos as voluntárias receberam dez aplicações da TENS (10Hz modulada em 50%, 200 µs e intensidade no limiar motor ou da EEAV (10Hz, pulsos gêmeos com 20µs cada e intervalo 100µs interpulsos gêmeos, 100Volts e pólo positivo duas vezes por semana por 30 minutos. Para mensurar a intensidade da dor, foi utilizada a escala visual analógica (EVA. Para análise estatística, utilizou-se teste t de Student e análise de regressão linear simples. RESULTADOS: Comparando-se as condições pré e pós TENS observa-se uma redução na intensidade da dor (pOBJECTIVE: To analyze pain intensity in individuals with temporomandibular disorder (TMD who were treated with ten sessions of transcutaneous electrical nerve stimulation (TENS or high voltage electrical stimulation (HVES. METHODS: Twenty-four women (22.98±1.86 years old with a diagnosis of TMD in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD were selected. 60% of the subjects had a diagnosis of TMD classified as group Ia and 40% as Ia and IIa. They were divided into two groups named the TENS group (TG and the high voltage group (HVG. Each individual received ten applications of either TENS (10Hz, modulated at 50%, 200µs and motor threshold intensity or HVES (10Hz, twin pulses of 20µs each at intervals of 100µs between the twin pulses, 100volts and positive pole twice a week for 30 minutes

  20. [Mandibular movements in speech: interference of temporomandibular disfunction according to pain indexes].

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    Bianchini, Esther Mandelbaum G; Paiva, Guiovaldo; de Andrade, Claudia Regina Furquim

    2007-01-01

    temporomandibular disorders can cause general alterations of the mandibular movements due to modification in the condition of muscles and articulations. Electrognathography, a computerized exam used to complement the diagnosis of these disorders, allows the objective delineation and record of the mandibular movements, determining their amplitude and speed. to verify the characteristics of mandibular movements of individuals with temporomandibular dysfunction and in asymptomatic individuals during speech, through computerized electrognathography, analyzing possible interferences of this dysfunction and severity implications regarding pain indexes. 135 adults were divided in four groups based on their pain indexes, using a numeric scale: zero for pain absence, one for mild pain, two for moderate pain and three for severe pain. Mandibular movements were observed during the sequential naming of balanced pictures taking in consideration the occurrence of phonemes in the Brazilian Portuguese language. Records were obtained using computerized electrognathography (BioEGN - BioPak system). the analysis of the results point that differences indicated as significant for mandibular opening amplitude and mandibular closing speed occurred between index zero and all of the other pain indexes. Regarding mandibular opening speed during speech, statistically significant differences were obtained between index zero and index three. It was observed that mandibular movements in speech are discreet, with an anteroposterior component and deviations in laterality. the presence of temporomandibular dysfunctions causes reduction in the values of maximum mandibular opening and a reduction in both mandibular opening speed and mandibular closing speed during speech The different pain indexes: mild, moderate and severe do not seem to determine larger reduction of these values.

  1. Treatment of temporomandibular myofascial pain with deep dry needling.

    Science.gov (United States)

    Gonzalez-Perez, Luis-Miguel; Infante-Cossio, Pedro; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco-Javier

    2012-09-01

    The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6.5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. We found a statistically significant relationship (p<0.01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle.

  2. Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review

    OpenAIRE

    Eduardo Machado; Daniel Bonotto; Paulo Afonso Cunali

    2013-01-01

    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 treat...

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

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    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.

  4. Orofacial injuries due to trauma following motor vehicle collisions: part 2. Temporomandibular disorders.

    Science.gov (United States)

    Epstein, Joel B; Klasser, Gary D; Kolbinson, Dean A; Mehta, Sujay A

    2010-01-01

    Temporomandibular disorders (TMDs) following motor vehicle collisions (MVCs) may result from direct orofacial trauma but also occur in patients with whiplash-associated disorder (WAD) without such trauma. TMDs may not be identified at the time of first assessment, but may develop weeks or more after the MVC. TMDs in WAD appear to occur predominantly in females and can be associated with regional or widespread pain. TMDs following MVCs may respond poorly to independent therapy and may be best managed using multidisciplinary approaches.

  5. The analysis of temporomandibular disorder based on RDC/TMD Axis I revision 2010 in dentistry students

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    Rasmi Rikmasari

    2016-07-01

    Full Text Available Introduction: Temporomandibular joint disorders is a pathologic conditions as a caused of musculoskeletal pain and dysfunction syndrome in stomatognathic system. This disorder was suffered in the population and affected the quality of life. This study was done to know how was the condition of temporomandibular joint disorders in the student of Faculty of Dentistry Universitas Padjadjaran population. Another objective of this study was the diagnosis classification of revised RDC-TMD Axis I could be applicated in Indonesian population, and to calibrate the diagnostic. Methods: The research sample was 65, with 43 female and 22 male. Result: The result showed that 50% of the student of Faculty of Dentistry Universitas Padjadjaran minimally suffered one diagnosis of temporomandibular joint disorders; with the most disorder was disc displacement with reduction, in left or right joint, followed by myofacial pain with limited opening. Conclusion: The conclusion of this research there was a high percentage of temporomandibular joint disorders in student population based on Revised Research Diagnosis Criteria for Temporomandibular Joint Disorders 2010, with the most disorder were disc displacement with reduction. So, it was important to socialize this sign and symptom of these disorders to community.

  6. Desordem Temporomandibular: relações entre sintomas otológicos e orofaciais Temporomandibular Disorder: relationship between otologic and orofacial symptoms

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    Cláudia Maria de Felício

    2004-12-01

    otologic symptoms and audiologic findings. There was significant association between otologic symptoms and jaw movements or functions (speaking, opening, closing the mouth. There was significant correlation between grade of otologic symptoms and grade of other temporomandibular disorder signs/symptoms, and between the symptom ear fullness and number of the parafunctional habits. CONCLUSION: The results provide additional support for the notion that a relationship between temporomandibular disorder and otologic symptoms does exist. In temporomandibular disorder patients, the stomatognathic system alterations, such as orofacial pain and functional difficulties, were statically associated with otologic symptoms.

  7. [Different types of injection in temporomandibular disorders (TMD) treatment].

    Science.gov (United States)

    Batifol, D

    2016-09-01

    Intramuscular injections of botulinum toxin of type A (BoNTA) can release tension from masticatory and cervical muscles. Intra-articular injections relieve pain and sometimes diminish joint clicking and locking that occur during mouth opening. Intramuscular injection of BoNTA is performed in our department since 2002. Injected muscles are masseter and temporal muscles. Later on, intra-articular injections of sodium hyaluronate were added, followed on a later stage by intra-articular injections of BoNTA for patients presenting with pain higher than 5/10 on an analogic visual scale. Eighty-five percent of the patients treated with intramuscular BoNTA injection improved. Total or partial pain relief was obtained in 95 % of the patients after intra-articular sodium hyaluronate injections. Seventy-six percent of the 56 patients treated by mean of intra-articular BoNTA injections improved, sometimes with a complete pain relief. These different techniques allow for good results, even if they do not represent a revolution in the treatment of temporomandibular disorders. In the hands of experienced practitioners, they have a low morbidity, are well accepted and are cost-effective. Copyright © 2016. Published by Elsevier Masson SAS.

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

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    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.

  9. Cervical spine alignment and hyoid bone positioning with temporomandibular disorders.

    Science.gov (United States)

    Andrade, A V; Gomes, P F; Teixeira-Salmela, L F

    2007-10-01

    The relationships between temporomandibular joint (TMJ) disorders and cervical structure dysfunctions have already been demonstrated. The aim of the present study was to investigate functional and structural alterations of the head and neck of 17 individuals with TMJ disorders (TMD group), compared with a control group of 17 asymptomatic subjects in a cross-sectional design. The outcome variables included pain on palpation of the sternocleidomastoideus, superior trapezius and subocciptal muscles, as well as radiographic measures of alignment of the cervical spine and positioning of the hyoid bone. Cervical alignment, determined by measures of the cervical curvature angle, was investigated by the Cobb method. Independent Student t-tests were used to investigate differences between groups for all outcome variables (alpha TMJ disorders, when compared with asymptomatic subjects, presented higher levels of perception of pain in all cervical muscles (P < 0.0001). No significant differences were found between groups for the cervical alignment measures. In the TMD group, the position of the hyoid bone in relation to the cervical spine did not appear to be different from the control group.

  10. Assessment of temporomandibular and cervical spine disorders in tinnitus patients.

    Science.gov (United States)

    Björne, Assar

    2007-01-01

    In treating patients with temporomandibular joint (TMJ) dysfunction it was noticed that tinnitus and vertigo were common in such patients and there was also muscular tension in jaw and neck. During treatment of these patients it was also noted that injection of lidocaine in a jaw muscle (m. pt. lat.) reduced not only their muscular problems but also that the tinnitus was reduced while the local anesthetic was active. Evaluation of 39 patients with disabling tinnitus, and all suffered from tinnitus, revealed that 10 of them had bilateral tinnitus and TMJ disorders revealed that pain in the face, temples or jaw occurred often among these patients. Many of such patients had also symptoms of cervical spine disorders, head, neck and shoulder pain, and limitations in side bending and rotation were also frequent complaints. One-third of these patients could influence tinnitus by jaw movements and 75% could trigger vertigo by head or neck movements. Treatment of jaw and neck disorders in 24 patients with Ménière's disease had a beneficial effect on not only their episodic vertigo but also on their tinnitus and aural fullness. At the 3-year follow-up, intensity of all symptoms were significantly reduced (p<0.001).

  11. Post-operative orofacial pain, temporomandibular dysfunction and trigeminal sensitivity after recent pterional craniotomy: preliminary study.

    Science.gov (United States)

    Brazoloto, Thiago Medina; de Siqueira, Silvia Regina Dowgan Tesseroli; Rocha-Filho, Pedro Augusto Sampaio; Figueiredo, Eberval Gadelha; Teixeira, Manoel Jacobsen; de Siqueira, José Tadeu Tesseroli

    2017-05-01

    Surgical trauma at the temporalis muscle is a potential cause of post-craniotomy headache and temporomandibular disorders (TMD). The aim of this study was to evaluate the prevalence of pain, masticatory dysfunction and trigeminal somatosensory abnormalities in patients who acquired aneurysms following pterional craniotomy. Fifteen patients were evaluated before and after the surgical procedure by a trained dentist. The evaluation consisted of the (1) research diagnostic criteria for TMD, (2) a standardized orofacial pain questionnaire and (3) a systematic protocol for quantitative sensory testing (QST) for the trigeminal nerve. After pterional craniotomy, 80% of the subjects, 12 patients, developed orofacial pain triggered by mandibular function. The pain intensity was measured by using the visual analog scale (VAS), and the mean pain intensity was 3.7. The prevalence of masticatory dysfunction was 86.7%, and there was a significant reduction of the maximum mouth opening. The sensory evaluation showed tactile and thermal hypoesthesia in the area of pterional access in all patients. There was a high frequency of temporomandibular dysfunction, postoperative orofacial pain and trigeminal sensory abnormalities. These findings can help to understand several abnormalities that can contribute to postoperative headache or orofacial pain complaints after pterional surgeries.

  12. TEMPOROMANDIBULAR DISORDERS IN SCUBA DIVERS DURING DIVING CERTIFICATION TRAINING PROGRAMME

    OpenAIRE

    ÖZTÜRK, Özmen; Tek, Mustafa; Seven, Hüseyin

    2013-01-01

    Objective: The design of a diving regulator's mouth-piece is known to increase the risk of a temporomandibular disorder (TMD) in SCUBA divers. The total weight of a diving regulator is reflected directly on the temporomandibular joint (TMJ) causing articular and periarticular problems. In this study, the prevalence of TMD in SCUBA divers having a training for diving certification is investigated. We also aimed to determine the factors that lead to TMD, and clarify the observation that there i...

  13. Signs and symptoms of Temporomandibular Disorders in the elderly

    OpenAIRE

    Camacho, José Gustavo Dala Déa; Oltramari-Navarro, Paula Vanessa Pedron; Navarro, Ricardo de Lima; Conti, Ana Cláudia de Castro Ferreira; Conti, Marcio Rodrigues de Almeida; Marchiori, Luciana Lozza de Moraes; Fernandes, Karen Barros Parron

    2014-01-01

    Purpose: This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. Methods: The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular ...

  14. Signs and symptoms of Temporomandibular Disorders in the elderly

    OpenAIRE

    Camacho,José Gustavo Dala Déa; Oltramari-Navarro,Paula Vanessa Pedron; Navarro,Ricardo de Lima; Conti,Ana Cláudia de Castro Ferreira; Conti,Marcio Rodrigues de Almeida; Marchiori,Luciana Lozza de Moraes; Fernandes,Karen Barros Parron

    2014-01-01

    Purpose: This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. Methods: The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a musc...

  15. The feasibility of a clinical trial of pain related to temporomandibular muscle and joint disorders: the results of a survey from the Collaboration on Networked Dental and Oral Research dental practice-based research networks.

    Science.gov (United States)

    Velly, Ana M; Schiffman, Eric L; Rindal, D Brad; Cunha-Cruz, Joana; Gilbert, Gregg H; Lehmann, Maryann; Horowitz, Allan; Fricton, James

    2013-01-01

    The authors conducted a survey to characterize the strategies used by general dentists to manage pain related to temporomandibular muscle and joint disorders (TMJDs) and to assess the feasibility of conducting a randomized controlled trial (RCT) to determine the effectiveness of these strategies. Dentists from three dental practice-based research networks (PBRNs) (The Dental Practice-Based Research Network, Practitioners Engaged in Applied Research and Learning Network and Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry) agreed to participate in this survey. Of 862 dentists surveyed, 654 were general dentists who treated TMJDs; among these, 80.3 percent stated they would participate in a future RCT. Dentists treated an average of three patients with TMJD-related pain per month. Splints or mouthguards (97.6 percent), self-care (85.9 percent) and over-the-counter or prescribed medications (84.6 percent) were the treatments most frequently used. The treatments dentists preferred to compare in an RCT were splint or mouthguard therapy (35.8 percent), self-care (27.4 percent) and medication (17.0 percent). Most general dentists treat TMJD-related pain, and initial reversible care typically is provided. It is feasible to conduct an RCT in a dental PBRN to assess the effectiveness of splint or mouthguard therapy, self-care or medication for the initial management of painful TMJD. There is an opportunity to do an RCT in a dental PBRN, which could lead to the development of evidence-based treatment guidelines for the initial treatment of TMJD-related pain by primary care dentists.

  16. The Manifestations and the Treatment of Temporomandibular Disorders in Patients with Chronic Whiplash-associated Disorders Grades 2 and 3

    OpenAIRE

    Klobas, Luciano

    2013-01-01

    The main aim of this project was to encircle the subtype of temporomandibular disorders (TMD) present in patients with chronic whiplash-associated disorders (WAD) and study the debut of TMD symptoms, the provoking factors and the outcome of conservative TMD treatments. The results could add to the aetiological discussion about TMD mainly as being part of chronic WAD pain or not. The subjects were referred patients with chronic WAD at a specialized rehabilitation centre where they were diagnos...

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

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    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.

  18. 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.

  19. Effects of orofacial myofunctional therapy on temporomandibular disorders.

    Science.gov (United States)

    de Felício, Cláudia Maria; de Oliveira, Melchior Melissa; da Silva, Marco Antonio Moreira Rodrigues

    2010-10-01

    The objectives of the current study were to analyze the effects of orofacial myofunctional therapy (OMT) on the treatment of subjects with associated articular and muscular temporomandibular disorders (TMD). Thirty subjects with associated articular and muscular TMD, according to the Research Diagnostic Criteria (RDC/TMD), were randomly divided into groups: 10 were treated with OMT (T group), 10 with an occlusal splint (OS group), and 10 untreated control group with TMD (SC). Ten subjects without TMD represented the asymptomatic group (AC). All subjects had a clinical examination and were interviewed to determine Helkimo's Indexes (Di and Ai), the frequency and severity of signs and symptoms, and orofacial myofunctional evaluation. During the diagnostic phase, there were significant differences between groups T and AC. There were no significant differences between group T and OC and SC groups. During the final phase, groups T and OS presented significant improvement, however, the group T presented better results and differed significantly from group OS regarding the number of subjects classified as Aill; the severity of muscular pain and TMJ pain; the frequency of headache and the muscles and stomatognathic functions. The group T differed significantly from the SC group but no longer differed significantly from the AC group. OMT favored a significant reduction of pain sensitivity to palpation of all muscles studied but not for the TMJs; an increased measure of mandibular range of motion; reduced Helkimo's Di and Ai scores; reduced frequency and severity of signs and symptoms; and increased scores for orofacial myofunctional conditions.

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

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    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.

  1. Effectiveness of two different splints to treat temporomandibular disorders.

    Science.gov (United States)

    Aksakalli, Sertac; Temucin, Fatih; Pamukcu, Ayca; Ezirganlı, Seref; Kazancioglu, Hakki Oguz; Malkoc, Meral Arslan

    2015-07-01

    Nearly 5% of the the world's population has temporomandibular disorder (TMD) severe enough to make them seek treatment. A third of the total population has at least one TMD symptom. There are different types of splints to treat TMD. In our study, we compared the success of two different appliances [stabilization splint (ss), nociceptive trigeminal inhibition splint (NTI)] by using Fonseca's questionnaire, the OHQoL-UK and visual analog scale (VAS). A total of 40 patients suffering from TMD were included in this study and answered questionnaires twice, at the beginning of the treatment and 3 months later. Regarding TMD alone, 39 patients (97.5%) had some degree of the disorder, 7 of of these cases being mild (17.5%), 15 moderate (37.5%), and 17 severe (42.5%). We analyzed posttreatment changes compared to baseline. Pain complaints decreased in both groups, and the OHQoL-UK revealed better quality of life after treatment. Based on the posttreatment Fonseca's questionnaires, significant changes in the patients' complaints in the group SS (p 0.05). Patients in both groups had fewer TMD complaints after TMJ treatment. According to the Fonseca's questionnaire, the patients' major TMD complaint was clenching-grinding, followed by pain in the craniomandibular joint, or earache.

  2. 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.

  3. 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/.

  4. Speech evaluation in children with temporomandibular disorders.

    Science.gov (United States)

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

    2011-10-01

    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. 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). 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. 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/.

  5. Impact of Temporomandibular Joint Pain in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Neveen Ahmed

    2013-01-01

    Full Text Available To investigate the impact of temporomandibular joint (TMJ pain on daily activities and quality of life in relation to systemic inflammatory activity in patients with rheumatoid arthritis (RA, thirty-three consecutive outpatients with RA were included. TMJ pain intensity at rest, on maximum mouth opening, and on chewing was assessed on a 0–10 numerical rating scale. TMJ palpatory tenderness, degree of anterior open bite, the impact of TMJ pain on daily activities and quality of life were also assessed. The systemic inflammatory activity was estimated by the disease activity score 28 (DAS28, blood levels of inflammatory markers and number of painful musculoskeletal regions. TMJ pain at rest, on maximum mouth opening, and on chewing as well as DAS28 was correlated with the impact of the TMJ pain on daily activities and quality of life. Partial correlations showed a significant interaction between TMJ pain on movement and DAS28 that explained the TMJ pain impact on daily activities and quality of life to a significant degree. This study indicates that both current TMJ pain intensity and systemic inflammatory activity play roles in the impact of TMJ pain on daily living and quality of life in RA.

  6. 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

    .95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were......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...... and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I...

  7. 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......, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More.......95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were...

  8. Pseudodynamic MR imaging of temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    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).

  9. Sleep bruxism and myofascial temporomandibular disorders

    Science.gov (United States)

    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

  10. Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration.

    Science.gov (United States)

    Dahan, Haissam; Shir, Yoram; Velly, Ana; Allison, Paul

    2015-01-01

    Temporomandibular pain disorder (TMD) is a common pain condition in the face. People with TMD report multiple pain comorbidities. The presence of fibromyalgia and migraine in people with TMD is associated with an increase in TMD pain intensity and duration. However, data on the relationship between increasing number of pain comorbidities and TMD pain are rare. The aims of this study were: firstly to evaluate the extent to which increasing number of comorbidities is associated with increasing TMD pain intensity and duration; and secondly to evaluate the extent to which the presence of specific comorbidities is associated with increasing TMD pain intensity and duration. The sample included 180 people seeking TMD treatment at Boston and Montreal clinics. TMD was diagnosed using the Research Diagnostic Criteria for TMD. A Numerical Pain Rating Scale assessed TMD pain intensity and participants provided their TMD pain duration in a study questionnaire. The comorbidities of migraine, chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis and restless leg syndrome were diagnosed by 5 validated diagnostic questionnaires. The associations were analyzed by linear regression, controlling for confounders. There was a positive association between the number of comorbidities present and TMD pain intensity (p comorbidities present and TMD pain duration (p pain intensity (p chronic fatigue syndrome was positively associated with TMD pain intensity (p pain duration (p pain group, whereas in the non-myofascial pain group, the relationship between number of comorbidities and TMD pain duration was the only one still present. This study shows that the number of comorbidities is positively associated with TMD pain duration and intensity. The presence of specific conditions, such as migraine and chronic fatigue syndrome, is associated with an increase in TMD intensity and duration.

  11. Deficient cytokine control modulates temporomandibular joint pain in rheumatoid arthritis.

    Science.gov (United States)

    Ahmed, Neveen; Catrina, Anca I; Alyamani, Ahmed O; Mustafa, Hamid; Alstergren, Per

    2015-08-01

    The aim was to investigate how endogenous cytokine control of tumor necrosis factor (TNF) influences temporomandibular joint (TMJ) pain in relation to the role of anti-citrullinated peptide antibodies (ACPA) in patients with rheumatoid arthritis (RA). Twenty-six consecutive patients with TMJ RA were included. Temporomandibular joint pain intensity was assessed at rest, on maximum mouth opening, on chewing, and on palpation. Mandibular movement capacity and degree of anterior open bite (a clinical sign of structural destruction of TMJ tissues) were also assessed. Systemic inflammatory activity was assessed using the Disease Activity Score in 28 joints (DAS28) for rheumatoid arthritis. Samples of TMJ synovial fluid and blood were obtained and analyzed for TNF, its soluble receptor, soluble TNF receptor II (TNFsRII), and ACPA. A high concentration of TNF in relation to the concentration of TNFsRII in TMJ synovial fluid was associated with TMJ pain on posterior palpation on maximum mouth opening. The ACPA concentration correlated significantly to the TNF concentration, but not to the TNFsRII concentration, indicating that increased inflammatory activity is mainly caused by an insufficient increase in anti-inflammatory mediators. This study indicates that TMJ pain on palpation in patients with RA is related to a deficiency in local cytokine control that contributes to increased inflammatory activity, including sensitization to mechanical stimuli over the TMJ. © 2015 Eur J Oral Sci.

  12. Efficacy of Temporomandibular Joint Arthrocentesis with Sodium Hyaluronate in the Management of Temporomandibular Joint Disorders: A Prospective Randomized Control Trial.

    Science.gov (United States)

    Gorrela, Harsha; Prameela, J; Srinivas, G; Reddy, B Vijay Baskar; Sudhir, Mvs; Arakeri, Gururaj

    2017-12-01

    This study was designed to investigate the efficacy of the temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate (SH) in the treatment of temporomandibular joint disorders. A total of sixty two TMJs in 34 males and 28 females aged 20-65 years comprised the study material. The patients' complaints were limited mouth opening, TMJ pain, and joint noises during function. Patients were randomly divided into 2 groups in which arthrocentesis plus intra-articular injection of sodium hyaluronate was performed in 1 group and only arthrocentesis was performed in the other group. Both groups contained patients with disc displacement with reduction and without reduction. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, at 1 week and 1, 3 and 6 months postoperatively. Intensity of TMJ pain was assessed using visual analog scales. Maximal mouth opening and lateral jaw movements also were recorded at each follow-up visit. Both techniques increased maximal mouth opening, lateral movements, and function, while reducing TMJ pain and noise. Although patients benefitted from both techniques, arthrocentesis with injection of SH seemed to be superior to arthrocentesis alone.

  13. Sex-specific differences in patients with temporomandibular disorders.

    Science.gov (United States)

    Schmid-Schwap, Martina; Bristela, Margit; Kundi, Michael; Piehslinger, Eva

    2013-01-01

    To explore potential differences in characteristics of patients that might account for sex-specific differences in temporomandibular disorders (TMD). A total of 502 patients presenting with TMD during 2000 to 2002 at the Outpatient Unit for Functional Disorders of the Medical University of Vienna underwent detailed evaluation of their medical history and assessment of clinical findings. The data obtained were assessed for sex-specific differences by analysis of variance and multiple regression. Overall, 404 females (mean age ± SD: 40 ± 16 years; range 12 to 96 years) and 98 males (mean age 41 ± 16 years; range 16 to 78 years) were included. Their rating of their pain on a visual analog scale (VAS) showed a significantly higher pain intensity for females than for males (P = .004). Clinical assessment showed a significantly lower degree of mouth opening for females than for males (P TMJ) and for the bite class of the patients, bite anomalies were significantly more frequent in male patients (P = .03). Palpation of masticatory muscles and the TMJ revealed significantly higher tenderness on palpation in female as compared to male patients (P = .001). Grouping by clicking, crepitation, and bruxism also showed greater pain (VAS) and more tenderness on palpation in females versus males. Females also showed peaks of prevalence of TMD in the age group below 25 years and in the group 55 to 60 years, whereas males had a more even age distribution. No external factors, such as exposure to stress, were found that moderated the sex difference. Female TMD patients showed greater pain and muscle tenderness on palpation as compared to male TMD patients. They also showed a different age distribution of prevalence of TMD. These results were independent of subjective symptoms, clinical findings, and external factors.

  14. Repeated assessment of temporomandibular joint pain : Reasoned decision-making with use of unidimensional and multidimensional pain scales

    NARCIS (Netherlands)

    Kropmans, TJB; Dijkstra, PU; Stegenga, B; Stewart, R; de Bont, LGM

    2002-01-01

    Background: There are no reports in the literature about patients with painfully restricted temporomandibular joints concerning the reliability of unidimensional and multidimensional pain scales on the basis of a generalizability and decision study. Generalizability and decision studies are designed

  15. TENS and low-level laser therapy in the management of temporomandibular disorders

    OpenAIRE

    Melissa Thiemi Kato; Evelyn Mikaela Kogawa; Carlos Neanes Santos; Paulo César Rodrigues Conti

    2006-01-01

    Pain relief and reestablishment of normal jaw function are the main goals of conservative management of Temporomandibular Disorders (TMD). Transcutaneous electrical nerve stimulation (TENS) and laser therapy are part of these modalities, although little is known about their real efficacy in controlled studies. This research compared these two treatments in a sample of 18 patients with chronic TMD of muscular origin, divided into two groups (LASER and TENS). Treatment consisted of ten sessions...

  16. 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

  17. Epidemiology and natural progression of articular temporomandibular disorders

    NARCIS (Netherlands)

    deBont, LGM; Dijkgraaf, LC; Stegenga, B

    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

  18. 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

    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 f...

  19. Orthodontics for treating temporomandibular joint (TMJ) disorders.

    Science.gov (United States)

    Luther, Friedy; Layton, Stephen; McDonald, Fraser

    2010-07-07

    Temporomandibular disorders (TMD) relate to discomfort of the temporomandibular joint (TMJ). The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual's life with phases of symptoms affecting the quality of life. In an attempt to treat this complex group of disorders many treatment modalities have been identified some of which are also considered in other Cochrane reviews. The disorder also has a normal cycle of events appearing to spontaneously improve without treatment. To establish the effectiveness of orthodontic intervention in reducing symptoms in patients with TMD (compared with any control group receiving no treatment, placebo treatment or reassurance) and to establish if active orthodontic intervention leads to TMD. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Handsearching of orthodontic journals and other related journals was undertaken in keeping with the Cochrane Collaboration handsearching programme. No language restrictions were applied. Authors of any studies were identified, as were experts offering legal advice, and contacted to identify unpublished trials. Most recent search: 13th April 2010. All randomised controlled trials (RCTs) including quasi-randomised trials assessing orthodontic treatment for TMD were included. Studies with adults aged equal to or above 18 years old with clinically diagnosed TMD were included. There were no age restrictions for prevention trials provided the follow-up period extended into adulthood. The inclusion criteria required reports to state their diagnostic criteria for TMD at the start of treatment and for participants to exhibit two or more of the signs and/or symptoms. The treatment group included treatment with appliances that could induce stable orthodontic tooth movement. Patients receiving splints for 8 to 12 weeks and studies involving surgical intervention (direct exploration/surgery of the joint and

  20. Effects of superpulsed low-level laser therapy on temporomandibular joint pain.

    Science.gov (United States)

    Marini, Ida; Gatto, Maria Rosaria; Bonetti, Giulio Alessandri

    2010-09-01

    A randomized double-blind study was conducted to compare the efficacy of superpulsed low-level laser therapy (SLLLT) with nonsteroidal anti-inflammatory drugs in the treatment of pain caused by temporomandibular joint disorders. A total of 99 patients with temporomandibular joint disorders, secondary to disc displacement without reduction or osteoarthritis were randomly divided into 3 groups. Thirty-nine patients received SLLLT in 10 sessions over 2 weeks, 30 patients received ibuprofen 800 mg twice a day for 10 days, and 30 patients received sham laser as placebo in 10 sessions over 2 weeks. Pain intensity was measured by visual analog scale at baseline, 2, 5, 10, and 15 days of treatment. Mandibular function was evaluated by monitoring active and passive mouth openings and right and left lateral motions at baseline, 15 days, and 1 month of treatment. Magnetic resonance imaging was performed at baseline and the end of therapy. Mean visual analog scale pain scores in SLLLT group was significantly lower than in nonsteroidal anti-inflammatory drug group and control group (P=0.0001) from fifth day up to the end of the observation period. As for active and passive mouth openings and right and left lateral motions, superiority of SLLLT was evident 1 month after treatment (interaction time treatment, P=0.0001). Mandibular function improved in all SLLLT patients proving the effectiveness in the treatment of pain, as demonstrated by a significant improvement in clinical signs and symptoms of temporomandibular joint disc displacement without reduction and osteoarthritis at the end of treatment and stability over a period of 1 month.

  1. Prevalence of temporomandibular joint disorder symptoms in Cibodas Maribaya Village Bandung District

    Directory of Open Access Journals (Sweden)

    Erna Kurnikasari

    2010-03-01

    Full Text Available Temporomandibular joint disorder is a stomatognathic system disorder causing mandibular function disturbance that clinically shows the following symptoms: clicking, crepitation, limited mouth opening, pain in masticatory muscles, pain in the jaw area, deviated mouth opening, ringing ear, pain around ear area, and headache. Experts stated that the prevalence of joint disorder was high. A study was conducted to the people of Cibodas Maribaya Village Bandung District who came to the Community Work event with results showing that the prevalence of clicking was 34 people or 32.4%, the deviation was found in 36 people or 34.3%, muscle pain was found in 28 people or 26.7%, a headache was found in 35 people or 33.3%, ear disorders was found in 23 people or 21.9%.

  2. A rat model of temporomandibular joint pain with histopathologic modifications.

    Science.gov (United States)

    Nicoll, Steven B; Hee, Christopher K; Davis, Martin B; Winkelstein, Beth A

    2010-01-01

    To develop a rat model of temporomandibular joint (TMJ) pain and to characterize in it the development and temporal response of behavioral hypersensitivity as well as to evaluate if and to what extent a loading protocol is associated with histological changes in the TMJ consistent with osteoarthritic pathology. A novel rat model of TMJ pain was developed using a noninvasive, mechanical loading protocol. Rats were exposed to steady mouth-opening for 7 days (2 N force, 1 hour/day), and mechanical hyperalgesia (increased pain response) was measured during the loading period and for 14 days thereafter. Histological modifications in the joint cartilage were also evaluated. Outcomes for the mouth-opening exposure were compared to age-matched controls. Thresholds for evoking responses were compared using a ranked ANOVA with repeated measures. Increased mechanical hypersensitivity in the temporomandibular region developed during daily loading and persisted even after the termination of the loading protocol. Histologic characterization revealed thinning of the cartilaginous structures of the joint and irregular zonal cellular arrangements in the condylar cartilage of rats subjected to the daily loading protocol. The injury model presented here is the first to demonstrate mechanically-induced behavioral hypersensitivity accompanied by osteoarthritic pathology in the TMJ.

  3. Analysis of pain and painless symptoms in temporomandibular joints dysfunction in adult patients.

    Science.gov (United States)

    Górecka, Małgorzata; Pihut, Małgorzata; Kulesa-Mrowiecka, Małgorzata

    2017-01-01

    Recent years have shown an increase in the number of patients reporting for treatment of pain due to musculoskeletal joint, associated with temporomandibular joint dysfunction. Therefore, studies were undertaken, aimed at analyzing the symptoms of the dysfunction, because of which patients come to the prosthetic treatment. Aim of the thesis: The aim of the study was a retrospective analysis of symptoms of temporomandibular joint dysfunction reported by patients diagnosed with this problem. The research material was a retrospective medical records of 120 patients, aged 19 to 45 years who have taken prosthetic treatment due to temporomandibular joint dysfunction in the Consulting Room in Prosthetics Department in Kraków, from June 2015 to December 2016. During the test patients, in addition to interviewing a physician, completed a personal survey in their own study. The material has been divided into I group of patients who reported pain form of dysfunction and II group, who had no symptoms of pain within the stomatognatic system. The analysis covered type of symptoms, the share of local factors (para-functions) and systemic, as well as the time a er which the patients reported for the treatment of functional disorders since the appearance of the first symptoms. Analysis of the research material showed that the main reason for reporting patients was pain in one or both temporal joints of significant intensity (5 to 8 in VAS scale,) accompanied by acoustic symptoms. A large group of questioners reported problems with the range of jaw movement and head and face pain, as well as subjective symptoms from the auditory, sight, neck, neck and shoulder areas.

  4. Diclofenac sodium as an alternative treatment of temporomandibular joint pain.

    Science.gov (United States)

    Ekberg, E C; Kopp, S; Akerman, S

    1996-06-01

    In a double-blind study, diclofenac sodium (Voltaren), 50 mg two or three times a day, was compared with placebo in 32 patients with pain localized to the temporomandibular joint (TMJ). The patients were allocated into two equally large groups. A visual analog scale was used to estimate the pretreatment degree of pain. The treatment effect was assessed as the frequency of joint and muscle pain and by the patients' own evaluation of improvement. The change in the clinical condition was assessed by tenderness to palpation of the TMJ and masticatory muscles and by mandibular mobility. The frequency of TMJ pain showed a greater reduction in the diclofenac group than in the placebo group, and there was a significant reduction of daily TMJ pain in the diclofenac group. The diclofenac group also showed a significant decrease in tenderness to palpation of the masticatory muscles in comparison with the placebo group. The patients with short duration of pain showed the best response to diclofenac. There was no evidence in this study to prove that diclofenac should be used as a primary treatment of TMJ pain, but it could be used as a complement to other treatments of acute TMJ pain.

  5. Evaluation of microcurrent electrical nerve stimulation (MENS effectiveness on muscle pain in temporomandibular disorders patients Avaliação da efetividade da estimulação neural elétrica por microcorrente (MENS na dor muscular em pacientes com desordem temporomandibular

    Directory of Open Access Journals (Sweden)

    Paulo Renato Junqueira Zuim

    2006-01-01

    Full Text Available The effect of Microcurrent Electrical Nerve Stimulation (MENS was evaluated and compared with occlusal splint therapy in temporomandibular disorders (TMD patients with muscle pain. Twenty TMD patients were divided into four groups. One received occlusal splint therapy and MENS (I; other received splints and placebo MENS (II; the third, only MENS (III and the last group, placebo MENS (IV. Sensitivity derived from muscle palpation was evaluated using a visual analogue scale. Results were submitted to analysis of variance (pA efetividade da Estimulação Neural Elétrica por Microcorrente (MENS foi avaliada e comparada à terapia por Placas Oclusais em pacientes com desordens temporomandibulares (DTM de origem muscular. Vinte pacientes foram divididos em quatro grupos. Um recebeu a terapia por placas interoclusais e MENS (I; outro, placas e MENS placebo (II, o terceiro, somente MENS (III e o último grupo, MENS placebo (IV. Os resultados obtidos foram submetidos a uma análise de variância (p<0,05. Houve redução dos níveis de dor em todos os grupos: o grupo I (placas e MENS obteve uma taxa de redução de 47,7%; o grupo II (placa e MENS placebo, 66,7%; o grupo III (MENS, 49,7% e o grupo IV (MENS placebo, 16,5%. Apesar disso, não se verificaram diferenças estatisticamente significantes entre MENS e utilização de placas interoclusais em relação à diminuição de dor muscular em pacientes com DTMs após 4 semanas.

  6. Ear pain following temporomandibular surgery originating from the temporomandibular joint or the cranial nervous tissue? A case report.

    Science.gov (United States)

    Geerse, Wouter K; von Piekartz, Harry J M

    2015-02-01

    A patient presenting with local pain and limitation of movement in the temporomandibular region following surgery of the left temporomandibular joint (TMJ) is described. Manual techniques like distraction of the TMJ combined with motor control exercises to restore TMJ function were not sufficient to relieve the patient's symptoms and her orofacial functions. However, during manual assessment and treatment of cranial nervous tissue, in this case the auriculotemporal nerve and its interface, pain was relieved and orofacial functions improved. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Signs of Bruxism and Temporomandibular Disorders among Patients with Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Gurbuz Ozlem

    2017-11-01

    Full Text Available Background/Aim: There is an abundance of data regarding temporomandibular disorders (TMD and bruxism specific to patients with bipolar disorder (BD. This study aimed to investigate the prevalence of TMD signs in subjects with and without BD. Material and Methods: The case group included 242 adult patients (103 men and 139 women with BD and and the control group included 187 subjects without BD (89 men and 98 women. The case and control groups were compared for the presence of bruxism and the signs of TMD including muscle and temporomandibular joint (TMJ tenderness to palpation, limitation of maximum mouth opening, and TMJ sounds. Results: The frequency of at least one sign of TMD was significantly higher in patients with BD (191 ⁄242, 78.9% than the control group (95 ⁄187, 50.8% (p<0.001. Statistically significant differences were found between the case and control groups in terms of joint pain on palpation (p<0.05, masseter muscle pain on palpation (p<0.01, joint clicks (p<0.001 and limited mouth opening (p<0.001. Bruxism was significantly higher in patients with BD (49.6% than the control group (19.8% (p<0.001. Conclusions: Patients with BD appear to be more prone to having TMD signs and bruxism compared to the control group, but this comorbidity should be better understood by further studies.

  8. Deglutition and temporomandibular disorders in children.

    Science.gov (United States)

    Pizolato, R A; Silva De Freitas Fernandes, F; Beatriz Duarte Gavião, M

    2009-01-01

    This study aimed to evaluate the characteristics of deglutition in children having or not temporomandibular disorders (TMD) or signs and/or symptoms of TMD. The sample comprised 152 children aged from 8 to 12 years (78 males and 74 females, mean age 10.05+/-1.39 years). The clinical signs were evaluated using the axis I of the Research Diagnostic Criteria for TMD (RDC/TMD) and the symptoms, using a questionnaire. Patients were divided into the following groups: Group TMD (N.=40), signs and symptoms of TMD (Group S and S, N.=68), signs or symptoms of TMD (Group S or S, N.=33) and without signs and symptoms (Group N, N.=11). Characteristics of orofacial structures such as occlusion, tongue, lingual frenulum, lips and mentalis muscle were evaluated. Myofunctional evaluation during deglutition with solid (bread) and liquid (water) was also performed. A high prevalence of abnormal deglutition was found, with similar proportion in groups. Alterations in lips, mentalis muscle and tongue in swallowing was significantly smaller in Group N than in the other groups. The proportions of children with lower lip interposition and lateral tongue thrust, when swallowing liquid, were significantly higher than swallowing solids. There was a smaller proportion of children in Group N with lower lip interposition when swallowing liquids. TMD or presence of signs and/or symptoms of TMD was not associated with an abnormal deglutition. Nevertheless, orofacial myofunctional alterations could be considered influencing factors on TMD, due to the high prevalence of abnormal deglutition pattern. In addition, the abnormal deglutition could be attributed to the malocclusion, mixed dentition phase and orofacial myofunctional characteristics.

  9. [Understanding and treatment strategy for disc displacement of temporomandibular disorders].

    Science.gov (United States)

    Ma, X C

    2017-03-09

    Understanding and treatment strategy for disc displacement of temporomandibular disorders (TMD) were discussed in the present review. It has been strongly recommended by the author that the treatment strategy for disc displacement, one subtype of TMD, should be mainly the reversible conservative treatment methods. The most important goal of treatment for disc displacement is to recover the mobility and function of the joint in order to improve the quality of the patient's life. Comprehensive assessments both from somatic and psychological aspects for each TMD patient are necessary, especially for the patients with chronic pain. Although the role of surgical operative treatments is very limited in the general treatment strategy for TMD, it is still important for a few patients who had definite diagnosis of intra-articular disorders, severe symptoms affecting the quality of patient's life and failed to response to the correct conservative treatments. It should be very careful to treat the TMD patients by surgical operation or irreversible occlusion treatments changing the natural denture of the patient, such as full mouth occlusional reconstruction and extensive adjustment of occlusion.

  10. Psychosocial aspects and temporomandibular disorders in dental students.

    Science.gov (United States)

    Rocha, Cibele Oliveira de Melo; Peixoto, Raniel Fernandes; Resende, Camila Maria Bastos Machado; Alves, Arthur César de Medeiros; Oliveira, Ângelo Giuseppe Roncalli da; Barbosa, Gustavo Augusto Seabra

    2017-01-01

    Dental students have high levels of anxiety that can affect not only academic performance but also increase the risk for other diseases. It is believed that the increase in the incidence of chronic orofacial pain in temporomandibular disorders (TMDs) may have an impact on the quality of life and general health of subjects. The aim of this study was to evaluate the prevalence of TMD in dental students and its association with general health, quality of life, and anxiety. Ninety students were evaluated by four questionnaires to determine the prevalence and sever-ity of TMD (Fonseca's questionnaire) and to quantify general health (General Health Questionnaire - GHQ), quality of life (World Health Organization Quality of Life - Brief version - WHOQOL-brief) and anxiety levels (State-Trait Anxiety Index - STAI). Approximately 58.9% of dental students presented TMD. Among the indicators of general health, psychologic stress (P = .010), distrust in their own performance (P = .012), and psychosomatic disorders (P = .020) showed a statistically significant difference with the presence of TMD. The four areas proposed in the questionnaire regarding quality of life, such as physical (P = .016), psychologic (P < .001), social (P = .045), and environmental (P = .017) factors also showed significant differences with the presence of TMD. A high prevalence of TMD was observed in dental students. In addition, some psychologic domains are important psychosocial indicators associated with the presence of TMDs.

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

    Science.gov (United States)

    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. © 2016 Eur J Oral Sci.

  12. Comparison of clinical findings and psychosocial factors in patients with atypical odontalgia and temporomandibular disorders.

    Science.gov (United States)

    Baad-Hansen, Lene; Leijon, Göran; Svensson, Peter; List, Thomas

    2008-01-01

    To systematically compare clinical findings and psychosocial factors between patients suffering from atypical odontalgia (AO) and an age- and gender-matched group of patients with temporomandibular disorders (TMD). Forty-six AO patients (7 men and 39 women; mean age, 56 years) were compared with 41 TMD patients (8 men and 33 women; mean age, 58 years). Mean pain intensity at the time of inclusion in the study was similar between the groups (TMD: 5.3 +/- 0.4, AO: 5.0 +/- 0.3), but pain duration was longer in AO patients (AO: 7.7 +/- 1.1 years, TMD: 4.5 +/- 0.1 years). Eighty-three percent of the AO patients and 15% of TMD patients reported pain onset in relation to dental/surgical procedures. Episodic tension-type headache (TTH) occurred equally in both groups (TMD: 46%, AO: 46%), but TMD patients more frequently experienced chronic TTH (TMD: 35%, AO: 18%), myofascial TMD (TMD: 93%, AO: 50%), and temporomandibular joint disorders (TMD: 66%, AO: 2%). Overall, TMD patients had lower pressure pain thresholds and poorer jaw function than AO patients. Mean depression and somatization scores were moderate to severe in both groups, and widespread pain was most common in TMD patients. AO and TMD share some characteristics but differ significantly in report of dental trauma, jaw function, pain duration, and pain site.

  13. Disease Phobia in Patients with Temporomandibular Joint Pain Assessed by the Illness Attitude Scale

    Directory of Open Access Journals (Sweden)

    Christos Stavrianos

    2009-01-01

    Full Text Available Disease phobia refers to a psychological state when the person continuously thinks that he/she is sick and improvement from the condition is impossible. Disease phobia in patients suffering from pain, secondary to temporomandibular disorders (TMDs, is usually the consequence of long-term problems; diagnosis and treatment of this group is a real challenge for healthcare professionals. Aim: The purpose of this prospective study was to objectively evaluate the role of Illness Attitude Scale (Kellner or IAS in measuring cancerophobia and heart disease phobia in patients suffering from pain, as a consequence of TMDs. Subjects and Methods: The cohort included 22 patients with TMDs who underwent evaluation of these phobias; pain was acute in 7 and chronic in 15. The patients were asked to complete the “Kellner” questionnaire, and this was followed by full clinical examination of the temporomandibular region. Results: When measuring the correlation between the cancerophobia and heart disease phobia patients, the outcome was found significant in the total cohort, p<0.01. Comparisons were carried out in the chronic group (n=15 and was significant (p=0.034 and r=0.549; while in the acute group no significance was identified. Conclusion: Cancerophobia and heart disease phobia in TMD patients are factors that need to be taken in consideration when managing chronic pain in this group.

  14. Relationship between clinical findings of temporomandibular disorders and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Iizuka, Yasuyuki; Miura, Hiroyuki; Ishikawa, Fujiro; Kikuchi, Shiori; Konishi, Nobuhiro; Sakamaki, Kimio [Iwate Medical Univ., Morioka (Japan). School of Dentistry

    1996-04-01

    The present study was conducted to investigate the relationship between magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) and clinical findings of patients having symptoms of temporomandibular disorders, and to consider the possibility to grasp the internal derangement of the TMJ from clinical findings. Subjects were 80 patients who visited to ask orthodontic treatment 16 males and 64 females. The average age was 22 years and 4 months. We performed a investigation of both their previous and present illness. In addition, to decide the correct condition concerning the internal derangement of the TMJ, patients were given MRI examinations (G. E. medical system Signa 1.5 Tesla) before orthodontic treatment. Results were as follows: The three symptoms of temporomandibular disorders-noise, pain, and abnormal mandibular movement, were not related to constant disk displacement. It seemed difficult to infer and obtain the diagnosis of the condition of internal derangement of the TMJ only from clinical findings. In a dental clinics having no medical imaging instrument such as MRI, it was, however, considered that the following items will make it possible to define the condition of internal derangements of the TMJ from clinical findings. As to respects concerning clinical findings, it is necessary to consider the previous illness as well as present illness. TMJ noise indicates a higher relationship to the disk displacement in MRI findings. The temporomandibular joint with plural symptoms indicated a higher incidence of disk displacement examined by MR Imaging than that with a single symptom. (author).

  15. Temporomandibular disorders: what to teach in dental school.

    Science.gov (United States)

    McKinney, J F; Mosby, E L

    1990-01-01

    Temporomandibular joint disorders continue to be a nemesis for health professionals and for patients who are afflicted. The medical/dental student must be taught to recognize this often complex disorder and be able to interact with the various disciplines within the medical/dental profession to provide the care needed. This article discusses problems and a possible approach for establishing continuity of format for classifying TM disorders so students can be taught to recognize them.

  16. 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;

  17. Temporomandibular disorders in patients with rheumatoid arthritis: A ...

    African Journals Online (AJOL)

    2015-06-05

    Jun 5, 2015 ... persisted for longer than 90 days experience a progressive. Temporomandibular disorders in patients with rheumatoid arthritis: A clinical study. C Kurtoglu, M Kurkcu1, Y Sertdemir2, S Ozbek3, CC Gürbüz. Departments of Prosthetic Dentistry and 1Oral Surgery, Faculty of Dentistry, Cukurova University,.

  18. Voice-supported Electronic Health Record for Temporomandibular Joint Disorders

    Czech Academy of Sciences Publication Activity Database

    Hippmann, R.; Dostálová, T.; Zvárová, Jana; Nagy, Miroslav; Seydlová, M.; Hanzlíček, Petr; Kříž, P.; Šmídl, L.; Trmal, J.

    2010-01-01

    Roč. 49, č. 2 (2010), s. 168-172 ISSN 0026-1270 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * structured data entry * dentistry * temporomandibular joint disorder Subject RIV: IN - Informatics, Computer Science Impact factor: 1.472, year: 2010

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

    NARCIS (Netherlands)

    Dibbets, JMH; vanderWeele, LT

    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

  20. Temporomandibular disorders in patients with rheumatoid arthritis: A ...

    African Journals Online (AJOL)

    Objectives: The aim of this study is to evaluate the prevalence and type of temporomandibular disorders (TMD) in patients with rheumatoid arthritis (RA). Materials and Methods: Fifty‑four patients having RA treatment at Cukurova University in Rheumatology Clinic were enrolled to the study. Demographic and rheumatologic ...

  1. 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

  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.......95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were...... 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...

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

    Science.gov (United States)

    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. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Magnetic resonance and sonographic imagings of masticatory muscle myalgia in temporomandibular disorder patients

    Directory of Open Access Journals (Sweden)

    Yoshiko Ariji, DDS, PhD

    2017-02-01

    Full Text Available This article reviews recently published studies investigating the MRI and sonographic diagnosis of masticatory muscle myalgia in temporomandibular disorder patients. The MRI and sonographic features of muscle after treatment are also discussed. Literature published within the last 15 years was obtained from the PubMed database using the following Mesh terms: magnetic resonance imaging (MRI or sonography, masticatory muscle pain, and treatment. MRI and sonography enable accurate visualization and evaluation of the masticatory muscles, thereby increasing our understanding of pathology and cause of pain associated with these muscles. Although therapeutic efficacy is often evaluated based on clinical findings, MR and sonographic imaging studies may also be valuable.

  5. 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

  6. Correlations between mandibular asymmetries and temporomandibular disorders (TMD).

    Science.gov (United States)

    D'Ippolito, Simona; Ursini, Roberto; Giuliante, Luca; Deli, Roberto

    2014-06-01

    Mandibular asymmetries are the fulcrum of many debates among modern orthodontists and maxillofacial surgeons. The interest is even greater when facial asymmetries are correlated to the development of TMJ symptoms and temporomandibular disorders (TMD). The aim of this study is to investigate how mandibular asymmetries constitute etiological or predisposing factors for the development of temporomandibular disorders (TMD). We considered patients with mandibular asymmetries associated with TMD. Using orthodontic or surgical-orthodontic treatment, patients experienced correction of their TMJ symptoms. Thus, mandibular asymmetries represent a major risk factor for the development of TMD. We studied a sample of 16 subjects aged between 14 and 36-years-old (11 females and 5 males) with mandibular asymmetries (81% structural asymmetry, 19% functional asymmetry). These subjects presented skeletal and dental malocclusions combined with several temporomandibular disorders, mostly due to muscle tension. In 100% of cases, patients received orthodontic treatment. We compared pre- and post-treatment postero-anterior (PA) cephalometric analyses in order to evaluate asymmetry resolution. Comparison of measurements from pre- and post-therapy PA cephalograms showed resolution of mandibular asymmetries after treatment. The treatment resolved mandibular asymmetries and completely eliminated temporomandibular symptoms. Orthodontic treatment of patients presenting mandibular asymmetry enables correction of all TMJ symptoms and TMD. Mandibular symmetries can therefore be considered to constitute etiological or predisposing factors for the development of TMD. Copyright © 2014 CEO. Published by Elsevier Masson SAS. All rights reserved.

  7. Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI.

    Science.gov (United States)

    Eberhard, L; Giannakopoulos, N N; Rohde, S; Schmitter, M

    2013-01-01

    To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers. The oblique coronal closed- and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test. The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (-16.6%). In the open-jaw position, both the medial and the lateral edges shifted medially (to 17.6% vs -23.6%, Wilcoxon matched-pair test, p pain, the disc seems to be smaller and located less medially than in healthy volunteers. The extent of the medial shift on opening was similar.

  8. 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.

  9. Signs of bruxism and temporomandibular disorders among psychiatric patients.

    Science.gov (United States)

    Winocur, Ephraim; Hermesh, Hagay; Littner, Dan; Shiloh, Roni; Peleg, Liat; Eli, Ilana

    2007-01-01

    To investigate the prevalence of bruxism and signs of temporomandibular disorders (TMDs) among psychiatric patients compared with a healthy population and to assess the effect of psychiatric medications on the parameters studied. Subjects included 77 psychiatric patients under treatment at 2 psychiatric hospitals in Israel and 50 healthy individuals (control). One experienced calibrated examiner performed the clinical examination (presence of bruxism and signs of TMD). Abnormal attrition was evident in 46.8% of the psychiatric patients compared with 20% in the controls (P prevalence of joint clicks and no association between time of receiving treatment with dopamine antagonists (or any other psychotropic drugs) and TMD signs and symptoms. The higher prevalence of bruxism and signs of TMD in psychiatric patients is a major clinical comorbidity. Whether it is a manifestation of the abnormal central nervous system of psychiatric patients or neuroleptic-induced phenomenon deserves further attention. The exact factors that affect the pain experience in these patients should be evaluated as well.

  10. [Prevalence of temporomandibular disorders in Mexican children with mixed dentition].

    Science.gov (United States)

    Ramírez-Caro, Silvia N; Espinosa de Santillana, Irene A; Muñoz-Quintana, Gabriel

    2015-04-01

    Objective To determine and compare with reports in the bibliography, the prevalence of temporomandibular disorders with an instrument validated for Mexican children with mixed dentition. Methods 150 children, from 8 to 12 years of age and of any sex who attended the pediatric stomatology clinic of the BUAP (Meritorious Autonomous University of Puebla) were included and evaluated with the diagnostic criteria for research on TTM (CDI/TTM) by a researcher who had been previously standardized (kappa=0.93). The results contrasted with reports in the bibliography. Results The prevalence of TTM was 20.7%. It was predominantly muscular (77.4%), though 33.3% showed alteration of the mouth-opening pattern, 34% showed joint noises (clicks). The most compromised mandibular function was chewing (6%). These results contrast with reports in the bibliography, specifically in terms of muscle pain sites and headaches, probably explained by different instruments used. Conclusion The prevalence of TTM is in contrast among different studies. It is necessary to place emphasis on the need to evaluate these factors during the childhood and adolescence with validated instruments.

  11. Methotrexate pharmacotherapy for implant-related temporomandibular joint pain: a case report.

    Science.gov (United States)

    Edwards, J Paul; Peterson, Erik J; Durham, Justin; Nixdorf, Donald R

    2014-08-01

    This article presents a patient experiencing several years of pain associated with bilateral failed temporomandibular joint (TMJ) Proplast/Teflon fossa prostheses. Despite surgical removal of the prostheses and comprehensive conservative management, including typical pharmacotherapy approaches for chronic pain, pain was still not relieved, and management was revised to target a putative chronic inflammatory disorder. Methotrexate was prescribed because of its known efficacy for inflammation and pain reduction in rheumatoid arthritis. Titration of methotrexate dosage over 5 months to a weekly dose of 20 mg resulted in reduced pain intensity at rest, increased pain-free maximal jaw opening, and a reduction in the sensory component of the McGill Pain Questionnaire. Maximum assisted jaw opening remained the same, as did the palpation tenderness of both TMJs and of the masseter and temporalis muscles. Methotrexate pharmacotherapy may represent a viable option when conservative treatments have failed to provide significant pain relief in patients who have had Proplast/Teflon TMJ implants. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. 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

  13. Depressive and anxiety symptoms as risk factors for temporomandibular joint pain: a prospective cohort study in the general population.

    Science.gov (United States)

    Kindler, Stefan; Samietz, Stefanie; Houshmand, Mohammad; Grabe, Hans Jörgen; Bernhardt, Olaf; Biffar, Reiner; Kocher, Thomas; Meyer, Georg; Völzke, Henry; Metelmann, Hans-Robert; Schwahn, Christian

    2012-12-01

    Previous studies have associated depression and temporomandibular joint disorders (TMDs). The temporality, however, remains to be clarified. Most patient studies have selected subjects from treatment facilities, whereas in epidemiological studies a clinical examination has not been performed. In this study the 5-year follow-up data of the population-based Study of Health in Pomerania (SHIP) were analyzed. To estimate the effect of symptoms of depression and those of anxiety on the risk of TMD pain, the Composite International Diagnostic-Screener (CID-S) and a clinical functional examination with palpation of the temporomandibular joint and the masticatory muscles were used. After exclusion of subjects having joint pain at baseline, a sample of 3,006 Caucasian participants with a mean age of 49 years resulted. Of those, 122 participants had signs of TMD joint pain upon palpation. Subjects with symptoms of depression had an increased risk of TMD joint pain upon palpation (rate ratio: 2.1; 95% confidence interval: 1.5-3.0; P joint and with muscle pain. The diagnosis, prevention, and therapy of TMD pain should also consider symptoms of depression and those of anxiety, and appropriate therapies if necessary. Depressive and anxiety symptoms should be considered as risk factors for TMD pain. Depressive symptoms are specific for joint pain whereas anxiety symptoms are specific for muscle pain, findings that deserve detailed examination. These findings may support decision-making in treating TMD. Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. Effects of several temporomandibular disorders on the stress distributions of temporomandibular joint: a finite element analysis.

    Science.gov (United States)

    Liu, Zhan; Qian, Yingli; Zhang, Yuanli; Fan, Yubo

    2016-01-01

    The aim of this study was to evaluate stress distributions in the temporomandibular joints (TMJs) with temporomandibular disorders (TMDs) for comparison with healthy TMJs. A model of mandible and normal TMJs was developed according to CT images. The interfaces between the discs and the articular cartilages were treated as contact elements. Nonlinear cable elements were used to simulate disc attachments. Based on this model, seven models of various TMDs were established. The maximum stresses of the discs with anterior, posterior, medial and lateral disc displacement (ADD, PDD, MDD and LDD) were 12.09, 9.33, 10.71 and 6.07 times magnitude of the identically normal disc, respectively. The maximum stresses of the posterior articular eminences in ADD, PDD, MDD, LDD, relaxation of posterior attachments and disc perforation models were 21, 59, 46, 21, 13 and 15 times greater than the normal model, respectively. TMDs could cause increased stresses in the discs and posterior articular eminences.

  15. Signs of temporomandibular disorders in migraine patients: a prospective, controlled study.

    Science.gov (United States)

    Stuginski-Barbosa, Juliana; Macedo, Henrique R; Bigal, Marcelo Eduardo; Speciali, José Geraldo

    2010-06-01

    To identify signs of temporomandibular disorders and cervical pain in individuals with episodic and chronic (transformed) migraine (CM), relative to controls without headaches. In this prospective, controlled, double-blind study, we examined 93 individuals divided in 3 groups: episodic migraine EM, (n=31), CM chronic migraine (n=34), and controls without migraine (n=28). We recorded signs of temporomandibular disorders, and of pain in the neck, after the protocol of Helkimo (1974). We calculated the odds ratio (OR) and confidence intervals (CI) of symptoms as a function of headache status. Data from all groups were paired and compared using the chi test. The level of significance was 5% in 2-tailed tests. Relative to controls, participants with EM and CM were significantly more likely to have tenderness in the masticatory muscles [controls=28%, migraine=54%, (OR=3.0, 95% CI=1.1-8.9), CM=73% (OR=6.9, 95% CI=2.3-21.2)], and in the temporomandibular joint [controls=25%, migraine=61%, (OR=4.7, 95% CI=1.5-14.5), CM=61% (OR=4.8, 95% CI=1.6-14.5)]. They were numerically (but nonsignificantly) more likely to have limited lateral jaw movements (CM=34%; EM=26%; NP=18%), joint sounds (CM=44%; EM=29%; NP=28%), and tenderness in neck muscles (CM=64%; EM=51%; NP=35%). In a tertiary care population, individuals with EM and CM are more likely to have tenderness at the temporomandibular joint and on the masticatory muscles, relative to controls. Studies are needed to investigate whether treatment of 1 disorder will improve the other.

  16. [Masticatory performance in adults related to temporomandibular disorder and dental occlusion].

    Science.gov (United States)

    Felício, Cláudia Maria de; Melchior, Melissa de Oliveira; Silva, Marco Antônio Moreira Rodrigues da; Celeghini, Renata Maria dos Santos

    2007-01-01

    Temporomandibular disorder and mastication. To compare subjects who present temporomandibular disorders to a control group considering mastication and to analyze the related variables. 20 subjects with temporomandibular disorder (TMD group) and 10 controls--selection based on clinical examination and anamnesis--responded to a questionnaire on the self-perception of pain severity and presence of noise in the temporomandibular joints, muscle pain, otologic symptoms, headaches, and jaw opening difficulties. The subjects were also submitted to a clinical examination regarding the number of teeth and functional occlusion--measurements of jaw opening and jaw lateral excursions, occlusal interferences, occlusal contacts of the working and non-working-side, and mastication evaluation. Mastication was evaluated in terms of time needed to eat a stuffed cookie, number of chewing strokes and type (unilateral or bilateral). The maximum force needed at first to break the cookie, verified with a TA-XT2 Texture Analyzer (Stable Micro Systems), was of 4341.8 g. The groups were compared using variance analysis and the correlations between variables were calculated using the Pearson product-moment test. Most of the control subjects presented bilateral pattern of mastication, whereas the TMD group tended to present the unilateral pattern. Masticatory type scores and laterality measurements were significantly higher in the control group. The TMD group presented higher means in terms of: age, time of chewing, number of chewing strokes and TMD severity. Chewing time and type were positively correlated with TMD severity and negatively correlated with number of occlusal interferences. In the TMD group, chewing differed from the normal physiological standard. The number of occlusal interferences and the severity of TMD were variables correlated to chewing.

  17. Dental attrition models predicting temporomandibular joint disease or masticatory muscle pain versus asymptomatic controls.

    Science.gov (United States)

    Seligman, D A; Pullinger, A G

    2006-11-01

    To determine whether patients with temporomandibular joint disease or masticatory muscle pain can be usefully differentiated from asymptomatic controls using multifactorial classification tree models of attrition severity and/or rates. Measures of attrition severity and rates in patients diagnosed with disc displacement (n = 52), osteoarthrosis (n = 74), or masticatory muscle pain only (n = 43) were compared against those in asymptomatic controls (n = 132). Cross-validated classification tree models were tested for fit with sensitivity, specificity, accuracy and log likelihood accountability. The model for identifying asymptomatic controls only required the three measures of attrition severity (anterior, mediotrusive and laterotrusive posterior) to be differentiated from the patients with a 74.2 +/- 3.8% cross-validation accuracy. This compared with cross-validation accuracies of 69.7 +/- 3.7% for differentiating disc displacement using anterior and laterotrusive attrition severity, 68.7 +/- 3.9% for differentiating disc displacement using anterior and laterotrusive attrition rates, 70.9 +/- 3.3% for differentiating osteoarthrosis using anterior attrition severity and rates, 94.6 +/- 2.1% for differentiating myofascial pain using mediotrusive and laterotrusive attrition severity, and 92.0 +/- 2.1% for differentiating myofascial pain using mediotrusive and anterior attrition rates. The myofascial pain models exceeded the > or =75% sensitivity and > or =90% specificity thresholds recommended for diagnostic tests, and the asymptomatic control model approached these thresholds. Multifactorial models using attrition severity and rates may differentiate masticatory muscle pain patients from asymptomatic controls, and have some predictive value for differentiating intracapsular temporomandibular disorder patients as well.

  18. Influencia del Estrés en la eficacia del tratamiento en pacientes con Trastornos Temporomandibulares Stress influence in efficacy of treatment in patients with temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Ileana Grau León

    2009-12-01

    Full Text Available El efecto del estrés emocional en el dolor, el sufrimiento y la conducta de dolor es significativo y debe tenerse en cuenta cuando se evalúa o se trata cualquier trastorno doloroso. El estado emocional del paciente en gran medida depende del estrés psicológico que experimente y en el momento en que se inicia el dolor puede influir enormemente en la experiencia dolorosa. El estudio fue de tipo cuasiexperimental, se consideraron 80 pacientes que fueron diagnosticados con trastornos temporomandibulares. A los pacientes participantes en el estudio les fue aplicada una escala sintomática del estrés y terapia combinada para la reducción del dolor y relajación muscular que incluyó terapia oclusal, farmacológica, sustitutiva y técnicas de autorelajación, arribando a las conclusiones que un elevado por ciento de los pacientes refirieron síntomas de estrés que se estima puede afectar negativamente los resultados del tratamiento en pacientes con trastorno tempormandibulares.Emotional stress effect on pain, suffering and pain behavior is significant and we must to consider in assessment or treatment of any painful disorder. The emotional status of patient in large extent depends of psychological stress experimented and at moment where s(? and upe(? starts off the pain may influence extremately in painful experience. A quasi-experimental study was conducted considering 80 patients diagnosed with temporomandibular disorders. In study participating patients we applied a stress symptomatic scale and combined therapy to reduce pain and the muscular relaxation included occlusal, pharmacologic, substitute therapy and self-relaxation techniques, concluding that a high percentage of patient refered to stress symptoms considered that may to affect negatively the treatment results in patients with temporomandibular disorders.

  19. Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications.

    Science.gov (United States)

    Schiffman, Eric; Ohrbach, Richard

    2016-06-01

    In this executive summary, the authors describe a protocol for assessing patients with temporomandibular disorder (TMD). It is based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications. The DC/TMD was developed using published Axis I physical diagnoses for the most common TMDs. Axis I diagnostic criteria were derived from pertinent clinical TMD signs and symptoms. Axis II consists of psychosocial and behavioral questionnaires already in the public domain. A panel of experts vetted and modified the Axis I and Axis II diagnostic protocols. Recommended changes were assessed for diagnostic accuracy by using the Validation Project's data set, which formed the basis for the development of the DC/TMD. Axis I diagnostic criteria for TMD pain-related disorders have acceptable validity and provide definitive diagnoses for pain involving the temporomandibular joint (TMJ) and masticatory muscles. Axis I diagnostic criteria for the most common TMJ intra-articular disorders are appropriate for screening purposes only. A definitive diagnosis for TMJ intra-articular disorders requires computed tomography or magnetic resonance imaging. Axis II questionnaires provide valid assessment of psychosocial and behavioral factors that can affect management of TMD. The DC/TMD provides a questionnaire for the pain history in conjunction with validated clinical examination criteria for diagnosing the most common TMDs. In addition, it provides Axis II questionnaires for assessing psychosocial and behavioral factors that may contribute to the onset and perpetuation of the patient's TMD. The DC/TMD is appropriate for use in clinical and research settings to allow for a comprehensive assessment of patients with TMD. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Fernando Kurita Varoli

    2015-01-01

    Full Text Available 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 assessment using RDC/TMD translated to Portuguese. The 3 proposed treatments were NSAID (sodium diclofenac, panacea (sodium diclofenac + carisoprodol + acetaminophen + caffeine, and a placebo. The total treatment duration was 10 days, preceded and succeeded by patients’ pain assessment. A washout interval of 11 days was established between each therapy. All participants received all treatments in different moments, in a full randomized crossover methodology. The assessment of drug therapies was performed using visual analogue scale for pain on palpation followed by 11-point numerical scale to quantify pain during treatment. Statistical analysis has shown that, after 10 days of treatment, all therapies were effective for pain relief. NSAID therapy promoted analgesia on the third day, while placebo only promoted analgesia in the eighth day. It has been concluded that sodium diclofenac used as splint adjuvant therapy, promotes significant analgesia in a shorter time.

  1. Local application of Aqua Titan improves symptoms of temporomandibular joint muscle disorder: a preliminary study.

    Science.gov (United States)

    Matsumoto, K; Tsukimura, N; Ishizuka, T; Kohinata, K; Yonehara, Y; Honda, K

    2015-04-01

    Aqua Titan (AT), comprising microscopic titanium particles dispersed in water, has been reported to have beneficial effects on muscle tissue. This study investigated the effects of local application of AT on symptoms in patients with muscle disorders of the temporomandibular joint (TMJ) compared to patients with joint disorders of the TMJ. Sixteen patients with unilateral masseter muscle pain during motion (muscle disorder group) and six patients with unilateral TMJ pain during motion (joint disorder group) applied an AT-permeated patch over the painful area every night for 2 weeks. Symptoms were evaluated clinically at the initial visit and 1 and 2 weeks later. Clinical symptoms in the joint disorder group showed no tendency towards improvement after 2 weeks. In contrast, mouth opening range with/without pain, visual analogue scale (VAS) scores for pain during mouth opening and eating, and activities of daily living (ADL) scores in the muscle disorder group were improved significantly after 2 weeks. Multiple comparison tests in the muscle disorder group showed significant improvements in the VAS for eating and ADL score after 1 week. These results suggest that the AT patch has a potential supplementary role in the treatment of patients with muscle disorders of the TMJ. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. 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.

  3. 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.

  4. Correlating cone beam CT results with temporomandibular joint pain of osteoarthritic origin.

    Science.gov (United States)

    Palconet, G; Ludlow, J B; Tyndall, D A; Lim, P F

    2012-02-01

    The purpose of this study was to determine whether bony changes in temporomandibular joint (TMJ) osteoarthritis (OA) is correlated with pain and other clinical signs and symptoms. Clinical data and cone beam CT (CBCT) images of 30 patients with TMJ OA were analysed. The criteria of Koyama et al (Koyama J, Nishiyama H, Hayashi T. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol 2007; 36: 472-477.) and Ahmad et al [Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 844-860.] were used to classify the condyles observed on the CBCT. Clinical measures included self-reported pain, mandibular range of motion, TMJ sound, pain on palpation of the TMJ and masticatory muscles, and pain on jaw function. Generalized linear modelling was used to correlate the clinical and radiographic findings and Spearman's rho was used to correlate the two classification systems. There was poor correlation between the maximum condyle change and pain rating (Koyama: r² = 0.1443, p = 0.3995; Ahmad: r² = 0.0273, p = 0.9490), maximum mouth opening (Koyama: r² = 0.2910, p = 0.0629; Ahmad: r² = 0.2626, p = 0.0951), protrusion (Koyama: r² = 0.0875, p = 0.7001; Ahmad: r² = 0.1658, p = 0.3612), right lateral motion (Koyama: r² = 0.0394, p = 0.9093; Ahmad: r² = 0.0866, p = 0.6877) and left lateral motion (Koyama: r² = 0.0943, p = 0.6494; Ahmad: r² = 0.1704, p = 0.3236). Strong correlation was observed between Koyama et al's and Ahmad et al's classifications for average (r = 0.9216, p TMJ OA.

  5. Objective and subjective assessment of masticatory function for patients with temporomandibular disorder in Korea.

    Science.gov (United States)

    Ahn, H J; Lee, Y S; Jeong, S H; Kang, S M; Byun, Y S; Kim, B I

    2011-07-01

    This study examined the differences in the masticatory function of patients with temporomandibular disorder (TMD) in Korea. The experimental groups were as follows: 23 patients with painful arthralgia classified as pain group according to the research diagnostic criteria for temporomandibular disorder (RDC/TMC) and 28 patients with pain-free disc displacement and reduction classified as clicking group. The subjects were obtained from those who had visited Yonsei University Dental Hospital from 2007 to 2008. Twenty dental students without TMD symptoms were enroled as the normal control group. The Mixing Ability Index (MAI) was used as the objective index, and the Food Intake Ability (FIA) Index, Visual Analogue Scale (VAS) and oral health impact profile (OHIP) were used as the subjective indices. The MAI, FIA and VAS were significantly lower in the pain group than in the normal and clicking groups (Pmasticatory function in patients with TMD in Korea, and the joint sound, not the masticatory function, affects the declining OHIP. © 2010 Blackwell Publishing Ltd.

  6. Women with more severe degrees of temporomandibular disorder exhibit an increase in temperature over the temporomandibular joint

    OpenAIRE

    Dibai-Filho, Almir Vieira; Costa, Ana Cláudia de Souza; Packer, Amanda Carine; de Castro, Ester Moreira; Rodrigues-Bigaton, Delaine

    2014-01-01

    Aim: The purpose of the present study was to correlate the degree of temporomandibular disorder (TMD) severity and skin temperatures over the temporomandibular joint (TMJ) and masseter and anterior temporalis muscles. Materials and methods: This blind cross-sectional study involved 60 women aged 18–40 years. The volunteers were allocated to groups based on Fonseca anamnestic index (FAI) score: no TMD, mild TMD, moderate TMD, and severe TMD (n = 15 each). All volunteers underwent infrared t...

  7. Effect of treatment of temporomandibular disorders (TMD) in patients with cervicogenic headache: a single-blind, randomized controlled study.

    Science.gov (United States)

    von Piekartz, Harry; Lüdtke, Kerstin

    2011-01-01

    The present study was comprised of 43 patients (16 men) with cervicogenic headaches for over three months, diagnosed according to the International Classification of Diagnostic Criteria of Headaches (ICDH-II). The patients were randomly assigned to receive either manual therapy for the cervical region (usual care group) or additional manual therapy techniques to the temporomandibular region to additionally influence temporomandibular disorders (TMD). All patients were assessed prior to treatment, after six sessions of treatment, and at a six-month follow-up. The outcome criteria were: intensity of headaches measured on a colored analog scale, the Neck Disability Index (Dutch version), the Conti Anamnestic Questionnaire, noise registration at the mandibular joint using a stethoscope, the Graded Chronic Pain Status (Dutch version), mandibular deviation, range of mouth opening, and pressure/pain threshold of the masticatory muscles. The results indicate in the studied sample of cervicogenic headache patients, 44.1% had TMD. The group that received additional temporomandibular manual therapy techniques showed significantly decreased headache intensities and increased neck function after the treatment period. These improvements persisted during the treatment-free period (follow-up) and were not observed in the usual care group. This trend was also reflected on the questionnaires and the clinical temporomandibular signs. Based on these observations, we strongly believe that treatment of the temporomandibular region has beneficial effects for patients with cervicogenic headaches, even in the long-term.

  8. Utility of bone SPECT in temporomandibular joint pain

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Dong Hunn; Sung, Mi Sook; Lee, Jung Whee; Chung, Soo Kyo; Shinn, Kyung Sub [College of Medicine, Catholic Univ., Pucheon (Korea, Republic of)

    1997-07-01

    Temporomandibular (TM) joint pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT. The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above the background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients (21%) out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade. II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.

  9. Management of temporomandibular joint disorders caused by complication of teeth extraction

    Directory of Open Access Journals (Sweden)

    Endang Syamsuddin

    2016-06-01

    Full Text Available Complicated tooth extractions may lead to various post-extraction complications, including Temporomandibular Joint Disorders (TMD. Despite of the rare incidence, a delayed treatment of the TMD will cause more problems in the future as well as increased morbidity rate. The purpose of the current study was to elaborate the symptoms as well as the management of TMD as a post tooth extraction complication. The types of TMD as a post tooth extraction complication includes dislocated condyle, osteoarthritis, fracture condyle and disc displacement. These type of complications may resulted from an extensive opening of the mouth as well as an over pressure on the mandible during tooth extraction. In relation to this, some of the TMD symptoms that might cause a certain level of interference for patients may include pain, limited mouth opening and joint sounds, with pain and limited mouth opening as the initial symptoms. The first measure of the pain management would be warm light compress around the TMJ followed by a soft diet for food intake. A definitive treatment should then be based on the diagnosis of the TMD. It is concluded that TMD may occur as a complication of a tooth extraction that initiated by pain and limited mouth opening. Immediate treatment would be pain relieve and load reduction of the Temporomandibular Joint by employing soft diet and mandibular movement restriction.

  10. Temporomandibular Joint Disorders as a Cause of Aural Fullness

    OpenAIRE

    Peng, Yongxin

    2017-01-01

    Objectives Temporomandibular joint disorders (TMD) are often associated with aural manifestations. However, it is not clear whether aural fullness could be induced by TMD. The purpose was to investigate the TMD and effectiveness of TMD treatments in patients with mainly or exclusively aural fullness complaint. Methods One hundred and twelve patients, who had aural fullness as the main or sole complaint, presented to the Otolaryngology Department, PLA Army General Hospital, Beijing, China, bet...

  11. TEMPOROMANDIBULAR DYSFUNCTION, STRESS AND COMMON MENTAL DISORDER IN UNIVERSITY STUDENTS

    OpenAIRE

    Augusto, Viviane Gontijo; Perina, Keity Cristina Bueno; Penha,Daniel Silva Gontijo; dos Santos, Daiane Carolina Alves; Oliveira, Val?ria Aparecida Souza

    2016-01-01

    ABSTRACT Objective: To evaluate the prevalence of temporomandibular dysfunction (TMD) and its association with perceived stress and common mental disorder (CMD) in academic students. Methods: This is s transversal observational study conducted at Universidade de Minas Gerais, Divinópolis Unit, in health science courses. To investigate the prevalence of TMD, the anamnestic index by Fonseca was used. Stress was assessed by the perceived stress scale, translated and adapted for the Brazilian...

  12. Therapeutic exercises for the control of temporomandibular disorders

    OpenAIRE

    Alberto da Rocha Moraes; Monique Lalue Sanches; Eduardo Cotecchia Ribeiro; Antonio Sérgio Guimarães

    2013-01-01

    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...

  13. Treatment needs and therapy experiences in patients with temporomandibular disorders: a retrospective survey.

    Science.gov (United States)

    Van den Berghe, Linda I; De Clercq, Elisabeth; Marks, Luc A

    2017-03-01

    This study investigated a patient population suffering from temporomandibular disorders (TMD) with respect to their need for treatment, satisfaction with the information received, and the treatment provided. A survey was sent by post to 1011 patients. Almost one-third of the patients had used analgesics prior to the start of any treatment. Having pain and functional jaw complaints was a risk factor for patients experiencing social restrictions. Subjects with severe complaints needed a range of conservative treatment modalities in combination with more follow-up appointments in agreement with the practitioners. Persons with remaining functional limitations were often unsatisfied with information and care they had received. The rate of compliance with prescribed treatment modalities and advice corresponded significantly higher with patient contentment with final outcome. Patient satisfaction is often determined by a qualitative doctor-patient relationship. The influence of complaints and pain on daily functioning was illustrated. Pain medication use at baseline seems to be predictive for persistent orofacial pain (OFP).

  14. Expression of 5-HT3 receptors and TTX resistant sodium channels (NaV1.8) on muscle nerve fibers in pain-free humans and patients with chronic myofascial temporomandibular disorders

    Science.gov (United States)

    2014-01-01

    Background Previous studies have shown that 5-HT3-antagonists reduce muscle pain, but there are no studies that have investigated the expression of 5-HT3-receptors in human muscles. Also, tetrodotoxin resistant voltage gated sodium-channels (NaV) are involved in peripheral sensitization and found in trigeminal ganglion neurons innervating the rat masseter muscle. This study aimed to investigate the frequency of nerve fibers that express 5-HT3A-receptors alone and in combination with NaV1.8 sodium-channels in human muscles and to compare it between healthy pain-free men and women, the pain-free masseter and tibialis anterior muscles, and patients with myofascial temporomandibular disorders (TMD) and pain-free controls. Methods Three microbiopsies were obtained from the most bulky part of the tibialis and masseter muscles of seven and six healthy men and seven and six age-matched healthy women, respectively, while traditional open biopsies were obtained from the most painful spot of the masseter of five female patients and from a similar region of the masseter muscle of five healthy, age-matched women. The biopsies were processed by routine immunohistochemical methods. The biopsy sections were incubated with monoclonal antibodies against the specific axonal marker PGP 9.5, and polyclonal antibodies against the 5-HT3A-receptors and NaV1.8 sodium-channels. Results A similar percentage of nerve fibers in the healthy masseter (85.2%) and tibialis (88.7%) muscles expressed 5-HT3A-receptors. The expression of NaV1.8 by 5-HT3A positive nerve fibers associated with connective tissue was significantly higher than nerve fibers associated with myocytes (P < .001). In the patients, significantly more fibers per section were found with an average of 3.8 ± 3 fibers per section in the masseter muscle compared to 2.7 ± 0.2 in the healthy controls (P = .024). Further, the frequency of nerve fibers that co-expressed NaV1.8 and 5-HT3A receptors was significantly

  15. Expression of 5-HT3 receptors and TTX resistant sodium channels (Na(V)1.8) on muscle nerve fibers in pain-free humans and patients with chronic myofascial temporomandibular disorders.

    Science.gov (United States)

    Christidis, Nikolaos; Kang, Isabell; Cairns, Brian E; Kumar, Ujendra; Dong, Xudong; Rosén, Annika; Kopp, Sigvard; Ernberg, Malin

    2014-09-26

    Previous studies have shown that 5-HT3-antagonists reduce muscle pain, but there are no studies that have investigated the expression of 5-HT3-receptors in human muscles. Also, tetrodotoxin resistant voltage gated sodium-channels (NaV) are involved in peripheral sensitization and found in trigeminal ganglion neurons innervating the rat masseter muscle. This study aimed to investigate the frequency of nerve fibers that express 5-HT3A-receptors alone and in combination with NaV1.8 sodium-channels in human muscles and to compare it between healthy pain-free men and women, the pain-free masseter and tibialis anterior muscles, and patients with myofascial temporomandibular disorders (TMD) and pain-free controls. Three microbiopsies were obtained from the most bulky part of the tibialis and masseter muscles of seven and six healthy men and seven and six age-matched healthy women, respectively, while traditional open biopsies were obtained from the most painful spot of the masseter of five female patients and from a similar region of the masseter muscle of five healthy, age-matched women. The biopsies were processed by routine immunohistochemical methods. The biopsy sections were incubated with monoclonal antibodies against the specific axonal marker PGP 9.5, and polyclonal antibodies against the 5-HT3A-receptors and NaV1.8 sodium-channels. A similar percentage of nerve fibers in the healthy masseter (85.2%) and tibialis (88.7%) muscles expressed 5-HT3A-receptors. The expression of NaV1.8 by 5-HT3A positive nerve fibers associated with connective tissue was significantly higher than nerve fibers associated with myocytes (P < .001). In the patients, significantly more fibers per section were found with an average of 3.8 ± 3 fibers per section in the masseter muscle compared to 2.7 ± 0.2 in the healthy controls (P = .024). Further, the frequency of nerve fibers that co-expressed NaV1.8 and 5-HT3A receptors was significantly higher in patients (42

  16. Interrelationship between temporomandibular joint osteoarthritis (OA) and cervical spine pain: Effects of intra-articular injection with hyaluronic acid.

    Science.gov (United States)

    Guarda-Nardini, Luca; Cadorin, Cristina; Frizziero, Antonio; Masiero, Stefano; Manfredini, Daniele

    2017-09-01

    The aim of this study was to evaluate cervical spine pain and function after five sessions of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) osteoarthritis. Forty-nine patients, (79% females, aged between 43-81 years), affected by TMJ osteoarthritis and concurrent cervical spine pain and limited function were recruited. All patients underwent a cycle of five weekly arthrocenteses and viscosupplementation with 1 ml of medium molecular weight HA according to the single-needle arthrocentesis technique. Outcome variables were TMJ pain (VAS), cervical active ranges of motion, cervical disability (NPDS), and presence of painful palpation sites. Assessments were carried out at baseline and at one, three and six months after the end of treatment protocol. A significant reduction over time was shown both in TMJ pain levels and in NPDS values with respect to baseline (p pain. These findings add to the complex amount of literature on the relationship between temporomandibular disorders and cervical spine disorders.

  17. Reevaluating Antidepressant Selection in Patients With Bruxism and Temporomandibular Joint Disorder.

    Science.gov (United States)

    Rajan, Royce; Sun, Ye-Ming

    2017-05-01

    Temporomandibular joint disorder (TMD) is a broad pain disorder that refers to several conditions affecting the temporomandibular joint of the jaw and the muscles of mastication. As with most pain disorders, a high prevalence of depression and anxiety is associated with TMD. Research has shown that selective serotonin reuptake inhibitors (SSRIs), the first-line drug therapy for major depressive disorder, may not be suitable for TMD patients because SSRIs can induce teeth-grinding, otherwise known as bruxism. This is problematic because bruxism is believed to further exacerbate TMD. Therefore, the purpose of this literature review is to better understand the mechanism of SSRI-induced bruxism, as well as discuss alternative antidepressant options for treating depression and anxiety in patients with bruxism and TMD. Alternative classes of antidepressants reviewed include serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, atypical antidepressants, and monoamine oxidase inhibitors. Findings indicate that dopamine agonists and buspirone are currently the most effective medications to treat the side effects of SSRI-induced bruxism, but results regarding the effectiveness of specific antidepressants that avoid bruxism altogether remain inconclusive.

  18. Causes of persistent joint pain after arthrocentesis of temporomandibular joint.

    Science.gov (United States)

    Honda, Kosuke; Yasukawa, Yoko; Fujiwara, Masanori; Abe, Tetsuya; Urade, Masahiro

    2011-09-01

    The present study was undertaken to elucidate the factors responsible for the failure of arthrocentesis to cure persistent joint pain in patients with nonreducing articular disc displacement in the temporomandibular joint (TMJ). Thirty-six patients with internal derangement of the TMJ were selected. Magnetic resonance imaging was used to examine the configuration and position of the articular discs, cortical changes, and bone marrow abnormalities in the condyle and the presence of joint effusion. Arthrocentesis was then performed, and the patients were followed for 6 weeks. The results were then classified as poor or improved. The effects of arthrocentesis did not depend on the configuration of the disc, disc position and motion, or bone marrow abnormalities. Joints with no or minimal amounts of joint effusion achieved a good response to arthrocentesis. Joints with erosive cortical changes of the condyle were less responsive to arthrocentesis. Persistent joint pain after arthrocentesis is generally associated with extensive amounts of joint effusion or erosive cortical changes of the condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. 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......, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More...

  20. Head and cervical posture in patients with temporomandibular disorders.

    Science.gov (United States)

    Armijo-Olivo, Susan; Rappoport, Karen; Fuentes, Jorge; Gadotti, Inae Caroline; Major, Paul W; Warren, Sharon; Thie, Norman M R; Magee, David J

    2011-01-01

    To determine whether patients with myogenous or mixed (ie, myogeneous plus arthrogeneous) temporomandibular disorders (TMD) had different head and cervical posture measured through angles commonly used in clinical research settings when compared to healthy individuals. One hundred fifty-four persons participated in this study. Of these, 50 subjects were healthy, 55 subjects had myogenous TMD, and 49 subjects had mixed TMD (ie, arthrogenous plus myogenous TMD). A lateral photograph was taken with the head in the self-balanced position. Four angles were measured in the photographs: (1) Eye-Tragus-Horizontal, (2) Tragus-C7-Horizontal, (3) Pogonion-Tragus-C7, and (4) Tragus-C7-Shoulder. Alcimagen software specially designed to measure angles was used in this study. All of the measurements were performed by a single trained rater, a dental specialist in orthodontics, blinded to each subject's group status. The only angle that reached statistical significance among groups was the Eye-Tragus-Horizontal (F = 3.03, P = .040). Pairwise comparisons determined that a mean difference of 3.3 degrees (95% confidence intervals [CI]: 0.15, 6.41) existed when comparing subjects with myogenous TMD and healthy subjects (P = .036). Postural angles were not significantly related to neck disability, jaw disability, or pain intensity. Intrarater and interrater reliability of the measurements were excellent, with intraclass correlation coefficient (ICC) values ranging between 0.996-0.998. The only statistically significant difference in craniocervical posture between patients with myogenous TMD and healthy subjects was for the Eye-Tragus-Horizontal angle, indicating a more extended position of the head. However, the difference was very small (3.3 degrees) and was judged not to be clinically significant.

  1. A relationship between amount of joint effusion, disk displacement and presence of pain in the temporomandibular joint: MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ho; Suh, Kyung Jin; Kim, Keon Woo and others [Kyungpook National Univ. College of Medicine, Taegu (Korea, Republic of)

    1997-01-01

    To correlate MR findings of amount of temporomandibular joint effusion with joint pain and disk displacement. In 57 patients, 114 temporomandibular joints with symptoms of disorder (presence of clinical pain) were imaged. Closed and open mouth sagittal spin echo (SE) T1-weighted images (WI) and fast spin echo (FSE) T2-WI were obtained. We classified the amount of joint effusion into grades. Joint effusion was classified as either Grade 1, 2 or 3, as follours : in sagittal FSE T2-WI, a long diameter of joint effusion shorter than 1/3 of the diameter of the convex margin of temporal eminence was grade 1 ; longer than 2/3 was grade 3 ; between grade 1 and 3 was grade 2. Disk displacement was classified as either with or without reduction in the open mouth position. These findings were correlated with one another and statistically analyzed. In 29 cases with joint pain (37%) and in 34 cases without pain (63%) there was no evidence of joint effusion ; there were, however, more grade 1 joint effusion cases with pain (14; 60.9%) than without pain (9; 39.1%). Cases of joint pain increased in proportion to grade of joint effusion, which was statistically significant (p < 0.05). In joints without disk displacement, the largest grouping was that which showed no effusion (39; 72.2%) ; no joints showed grade 3 effusion. Cases of joint effusion decreased in proportion to grade of effusion. In joints with disk displacement, cases of joint effusion tended to increase in proportion to the grade of effusion. MR findings of amount of temporomandibular joint effusion correlate with joint pain and anterior disk displacement.

  2. The relationship of whiplash injury and temporomandibular disorders: a narrative literature review☆

    Science.gov (United States)

    Fernandez, Charles E.; Amiri, Abid; Jaime, Joseph; Delaney, Paul

    2009-01-01

    Objective The purpose of this article is to offer a narrative review and discuss the possible relationship between temporomandibular disorders (TMDs) and whiplash injuries. Methods Databases from 1966 to present were searched including PubMed; Manual, Alternative, and Natural Therapy Index System; and Cumulative Index for Nursing and Allied Health Literature. Search terms used included whiplash injury, temporomandibular disorders and craniomandibular disorders. Inclusion criteria consisted of studies on orofacial pain of a musculoskeletal origin addressing the following topics: posttraumatic temporomandibular disorder (pTMD) incidence and prevalence, mechanism of injury, clinical findings and characteristics, prognosis (including psychologic factors). Excluded were studies of orofacial pain from nontraumatic origin, as well as nonmusculoskeletal causes including neurologic, vascular, neoplastic, or infectious disease. Results Thirty-two studies describing the effects of whiplash on TMD were reviewed based on inclusion/exclusion criteria. The best evidence from prospective studies indicates a low to moderate incidence and prevalence. Only 3 studies addressed mechanism of injury theories. Most studies focusing on clinical findings and characteristics suggest significant differences when comparing pTMD to idiopathic/nontraumatic patients. Regarding prognosis, most studies suggest a significant difference when comparing pTMD to idiopathic/nontraumatic TMD patients, with pTMD having a poorer prognosis. Conclusions There is conflicting evidence regarding the effects of whiplash on the development of TMD. Furthermore, because of lack of homogeneity in the study populations and lack of standardization of data collection procedures and outcomes measured, this review cannot conclusively resolve the controversies that exist concerning this relationship. This review of the literature is provided to clarify the issues and to provide useful clinical information for health care

  3. The relationship of whiplash injury and temporomandibular disorders: a narrative literature review.

    Science.gov (United States)

    Fernandez, Charles E; Amiri, Abid; Jaime, Joseph; Delaney, Paul

    2009-12-01

    The purpose of this article is to offer a narrative review and discuss the possible relationship between temporomandibular disorders (TMDs) and whiplash injuries. Databases from 1966 to present were searched including PubMed; Manual, Alternative, and Natural Therapy Index System; and Cumulative Index for Nursing and Allied Health Literature. Search terms used included whiplash injury, temporomandibular disorders and craniomandibular disorders. Inclusion criteria consisted of studies on orofacial pain of a musculoskeletal origin addressing the following topics: posttraumatic temporomandibular disorder (pTMD) incidence and prevalence, mechanism of injury, clinical findings and characteristics, prognosis (including psychologic factors). Excluded were studies of orofacial pain from nontraumatic origin, as well as nonmusculoskeletal causes including neurologic, vascular, neoplastic, or infectious disease. Thirty-two studies describing the effects of whiplash on TMD were reviewed based on inclusion/exclusion criteria. The best evidence from prospective studies indicates a low to moderate incidence and prevalence. Only 3 studies addressed mechanism of injury theories. Most studies focusing on clinical findings and characteristics suggest significant differences when comparing pTMD to idiopathic/nontraumatic patients. Regarding prognosis, most studies suggest a significant difference when comparing pTMD to idiopathic/nontraumatic TMD patients, with pTMD having a poorer prognosis. There is conflicting evidence regarding the effects of whiplash on the development of TMD. Furthermore, because of lack of homogeneity in the study populations and lack of standardization of data collection procedures and outcomes measured, this review cannot conclusively resolve the controversies that exist concerning this relationship. This review of the literature is provided to clarify the issues and to provide useful clinical information for health care providers managing TMD such as doctors

  4. The association between head and cervical posture and temporomandibular disorders: a systematic review.

    Science.gov (United States)

    Olivo, Susan Armijo; Bravo, Jaime; Magee, David J; Thie, Norman M R; Major, Paul W; Flores-Mir, Carlos

    2006-01-01

    To carry out a systematic review to assess the evidence concerning the association between head and cervical posture and temporomandibular disorders (TMD). A search of Medline, Pubmed, Embase, Web of Science, Lilacs, and Cochrane Library databases was conducted in all languages with the help of a health sciences librarian. Key words used in the search were posture, head posture, cervical spine or neck, vertebrae, cervical lordosis, craniomandibular disorders or temporomandibular disorders, temporomandibular disorders, and orofacial pain or facial pain. Abstracts which appeared to fulfill the initial selection criteria were selected by consensus. The original articles were retrieved and evaluated to ensure they met the inclusion criteria. A methodological checklist was used to evaluate the quality of the selected articles and their references were hand-searched for possible missing articles. Twelve studies met all inclusion criteria and were analyzed in detail for their methodology and information quality. Nine articles that analyzed the association between head posture and TMD included patients with mixed TMD diagnosis; 1 article differentiated among muscular, articular, and mixed symptomatology; and 3 articles analyzed information from patients with only articular problems. Finally, 2 studies evaluated the association between head posture and TMD in patients with muscular TMD. Several methodological defects were noted in the 12 studies. Since most of the studies included in this systematic review were of poor methodological quality, the findings of the studies should be interpreted with caution. The association between intra-articular and muscular TMD and head and cervical posture is still unclear, and better controlled studies with comprehensive TMD diagnoses, greater sample sizes, and objective posture evaluation are necessary.

  5. Clinical effectiveness of laser acupuncture in the treatment of temporomandibular joint disorder.

    Science.gov (United States)

    Huang, Yu-Feng; Lin, Jung-Chih; Yang, Hui-Wen; Lee, Yu-Hsien; Yu, Chuan-Hang

    2014-08-01

    Temporomandibular joint disorder (TMD) is a general term for diseases of the temporomandibular joint and orofacial muscles. In this study, we tested whether laser acupuncture was effective for the treatment of TMD. Twenty patients with TMD were treated with diode K-Laser (wavelength 800 nm, energy density 100.5 J/cm(2)) once a week at four acupuncture points including three standard ipsilateral local points (ST6, ST7, Ashi point) and one contralateral distal point (LI4). A 10-cm visual analogue scale (0 no pain and 10 the most severe pain) was used for measuring the pain intensity before and after the treatment. Seventeen out of 20 patients (85%) showed various degrees of pain relief after laser acupuncture treatment. The average pain score was 6.3 ± 1.6 before treatment and 2.5 ± 2.2 after treatment. Significant pain relief after laser acupuncture treatment was achieved (p = 0.0003, Wilcoxon signed rank test). The 17 patients showed an average pain relief of 63 ± 31%. There were six patients who showed no TMD symptoms after an average of four treatments of laser acupuncture. The other 11 patients showed partial relief of TMD symptoms after treatment. Although the pain was still present, it was less and was acceptable. No side effects were reported in any patients during or after laser acupuncture treatments. Laser acupuncture may be an alternative treatment modality for TMD because it is non-invasive, results in partial or total relief of pain, and has no side effects. Copyright © 2012. Published by Elsevier B.V.

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

    Science.gov (United States)

    Ferreira, Luciano Ambrosio; Grossmann, Eduardo; Januzzi, Eduardo; de Paula, Marcos Vinicius Queiroz; Carvalho, Antonio Carlos Pires

    2016-01-01

    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. To present and assess the main diagnostic imaging tests for temporomandibular disorders and rationally discuss their indication criteria, advantages, and disadvantages. 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. 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. 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. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  7. Expanding the Taxonomy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

    Science.gov (United States)

    Peck, Christopher C.; Goulet, Jean-Paul; Lobbezoo, Frank; Schiffman, Eric L.; Alstergren, Per; Anderson, Gary C.; de Leeuw, Reny; Jensen, Rigmor; Michelotti, Ambra; Ohrbach, Richard; Petersson, Arne; List, Thomas

    2014-01-01

    Background There is a need to expand the current temporomandibular disorder (TMD) 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. Methods 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 operationalize and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMD taxonomy was presented for feedback at international meetings. Results 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 operationalized diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. Conclusions The expanded TMD taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalize and test the proposed taxonomy and diagnostic criteria. PMID:24443898

  8. Oral Health-Related Quality of Life in Patients with Temporomandibular Disorders.

    Science.gov (United States)

    Almoznino, Galit; Zini, Avraham; Zakuto, Avraham; Sharav, Yair; Haviv, Yaron; Hadad, Avraham; Avraham, Hadad; Chweidan, Harry; Yarom, Noam; Noam, Yarom; Benoliel, Rafael

    2015-01-01

    To measure the oral health-related quality of life (OHRQoL) in patients with temporomandibular disorders (TMD) compared to controls and analyze its association with various demographic and clinical parameters. The survey included 187 TMD patients and 200 controls. OHRQoL was measured using the validated Hebrew version of the Oral Health Impact Profile-14 (OHIP-14). A self-report questionnaire assessed personal details, smoking habits, history of trauma and orthodontic treatment, comorbid headaches, oral habits, and pain. TMD patients were divided into diagnostic categories according to the newly recommended diagnostic criteria for TMD (DC/TMD) Axis I protocol. Differences between groups were examined with a Pearson chi-square test for categorical variables and analysis of variance (ANOVA) for continuous variables. Among TMD patients, the diagnostic categories included: (1) masticatory muscle disorders (MMD; n = 38; 20.32%), (2) isolated disorders of the temporomandibular joint (TMJ; n = 46; 24.59%), (3) patients with both MMD and TMJ (TMP; n = 103; 55.08%). Compared to controls, TMD patients exhibited worse global OHIP-14 scores (12.50 ± 8.14 vs 9.58 ± 10.00; P = .002) and worse scores in the following domains: physical pain (P < .001), psychological discomfort (P = .005), physical disability (P = .004), and psychological disability (P = .013). Among TMD patients, those categorized as TMP exhibited the highest scores in the physical pain (P = .02) domain. Previous orthodontic treatment, comorbid headache and body pain, limitations in mouth opening and lateral movement, pain, and muscle tenderness scores were found to be strongly related to the OHIP-14. TMD patients suffered from impaired OHRQoL considerably more than controls. OHRQoL in TMD patients is a multidimensional phenomenon influenced by previous orthodontic treatment, comorbid symptoms, pain, functional limitations, and muscle tenderness scores.

  9. Temporomandibular disorders and quality of life among 12-year-old schoolchildren.

    Science.gov (United States)

    da Silva, Marina de Faria; Vedovello, Silvia A S; Vedovello Filho, Mario; Venezian, Giovana C; Valdrighi, Heloísa C; Degan, Viviane V

    2017-11-01

    The aim of this study was to investigate the association between symptoms of temporomandibular disorders (TMD), quality of life, and malocclusion. A cross-sectional observational design study was utilized among 248 schoolchildren aged 12 years old. Symptoms of TMD were assessed using the Orofacial Pain and Temporomandibular Disorders Triage Questionnaire, and subjects were further evaluated as oral-health-related quality of life (CPQ11-14), tooth clenching/grinding and malocclusion (Dental Aesthetic Index). Chi-square for independence, Odds Ratio and Mann-Whitney test were used (p = 0.05) statistically. Statistically, association was detected between TMD symptoms with pain and worse quality of life (p quality of life and clenching/grinding (p = 0.0120 and 0.0007). The symptoms of TMD are associated with pain and teeth clenching, causing a negative impact on schoolchildren's quality of life; thus, a study of the TMD impact on quality of life is justified.

  10. The role of dental loss and denture status on clinical signs of temporomandibular disorders.

    Science.gov (United States)

    Sipilä, K; Näpänkangas, R; Könönen, M; Alanen, P; Suominen, A L

    2013-01-01

    Studies concerning the role of denture status on in temporomandibular disorders (TMD) are scarce. The aim of this study was to evaluate the association of tooth loss and denture status with clinical findings of TMD. The data were obtained from 6316 subjects aged ≥ 30 years from the Finnish Health 2000 Survey. The associations between clinically assessed TMD findings and number of teeth, wearing of removable dentures, need for denture repair and age of the dentures were analysed by means of chi-square test and logistic regression. Among women after adjusting for age, having fewer teeth or wearing complete dentures associated with restricted maximum interincisal distance and pain on palpation of the temporomandibular joints (TMJ) and masticatory muscles. After adding education level and depression in the model, the associations between TMJ pain and explanatory variables were weakened. Among men, having a higher number of teeth associated with occurence of TMJ crepitation. Subjective need for repair of dentures and having a denture aged ≥ 5 years associated with pain on palpation in masticatory muscles among women. Among men, both the objective and subjective need for denture repair and having at least one denture aged ≥ 5 years or been repaired during the past 5 years associated negatively with the presence of TMJ crepitation. It can be concluded that edentulousness, wearing of complete dentures and poor condition of dentures associate with pain-related TMD findings among women. Psychosocial factors have a modifying effect on these associations. © 2012 Blackwell Publishing Ltd.

  11. The effects of a global postural exercise program on temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    Alexandre Fiorelli

    Full Text Available Abstract Changes in the suboccipital muscles and the hamstrings may interfere with head posture and the biomechanics of the temporomandibular joint, both of which contribute to the severity of temporomandibular disorders (TMD. The objective of this investigation was to evaluate the effects of a global postural exercise program (GPEP on pain intensity and mouth-opening range of motion (ROM in women with TMD. The participants were comprised of 30 women with TMD who were divided into two groups: an experimental group (EG and a control group (CG. A pressure algometer was used for pain assessment and a paquimeter was used to measure ROM. The duration of the GPEP was six weeks. In the EG, there was a reduction in pain intensity and an increase in mouth-opening ROM compared to the CG. Therefore, we concluded that the GPEP was effective in relieving pain in all of the evaluated muscles and regions, and in increasing mouth-opening ROM in women with TMD.

  12. Is maximal strength of the cervical flexor muscles reduced in patients with temporomandibular disorders?

    Science.gov (United States)

    Armijo-Olivo, Susan L; Fuentes, Jorge P; Major, Paul W; Warren, Sharon; Thie, Norman M; Magee, David J

    2010-08-01

    To determine whether there was a difference in maximal cervical flexor muscle strength in subjects with temporomandibular disorders (mixed and myogenous) compared with healthy subjects. Cross-sectional study. Orthopedics/sports laboratory at the University of Alberta. Subjects (N=149) of whom 50 were healthy, 54 had myogenous temporomandibular disorders (TMD), and 45 had mixed TMD. Not applicable. Maximal cervical flexor strength, pain. There was no statistically significant difference in maximal cervical flexor strength among groups (P>.05). Subjects' body weight was significantly associated with strength. No significant association between jaw disability with maximal cervical flexor strength was found. A significant but weak association between neck disability and maximal cervical flexors strength was found. These results indicated that strength evaluation is one of several assessment factors that need to be addressed when evaluating musculoskeletal painful conditions such as TMD and neck disorders, but strength evaluation cannot be considered as a direct measure of disability. Future studies should explore evaluation of strength in other muscular groups such as cervical extensors, rotators, and lateral flexors, and also under different conditions such as rapid movements, and in patients with more severe jaw disability.

  13. Professional karate-do and mixed martial arts fighters present with a high prevalence of temporomandibular disorders.

    Science.gov (United States)

    Bonotto, Daniel; Namba, Eli Luis; Veiga, Danielle Medeiros; Wandembruck, Fernanda; Mussi, Felipe; Afonso Cunali, Paulo; Ribeiro Rosa, Edvaldo Antonio; Azevedo-Alanis, Luciana Reis

    2016-08-01

    Facial trauma in sports has been associated with temporomandibular disorders. Because of the intensity and duration of training needed for elite-level competitions, high-performance athletes can have two to five times more traumatic injuries than recreational athletes. This study aimed to investigate the prevalence of temporomandibular disorders in high-performance martial arts fighters and compare it with the prevalence in recreational athletes and non-athletes. The Research Diagnostic Criteria for Temporomandibular Disorders was used to diagnose and classify professional karate-do practitioners (group I; n = 24), amateur karate-do practitioners (group II; n = 17), high-performance mixed martial arts fighters (group III; n = 13), and non-athletes (n = 28). The groups were compared with the chi-square test and tested for the difference between two proportions using a significance level of 5% (P 0.05). A diagnosis of arthralgia from disk displacement was made more frequently in groups I (45.8%; P = 0.013) and III (38.5%; P = 0.012) than in group IV (7.1%). The chronic pain associated with TMD was low intensity and low disability. While there was a high prevalence of temporomandibular disorders in the professional athletes in our study, the prevalence of the condition in recreational athletes was similar to that in individuals who did not practice martial arts. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. THE RELATIONSHIP BETWEEN PRIMARY TEMPOROMANDIBULAR JOINT DISORDERS AND CERVICAL SPINE DYSFUNCTION

    OpenAIRE

    Reggars, John W.

    1994-01-01

    The co-existence of primary temporomandibular disorders and cervical spine dysfunction is well documented. This paper reviews the anatomy and function of the temporomandibular joint and its primary disorders with particular reference to their possible effects an the cervical spine.

  15. Temporomandibular joint disorder in systemic sclerosis: a case report

    Science.gov (United States)

    Chebbi, Raja; Khalifa, Hanen Ben; Dhidah, Monia

    2016-01-01

    Systemic sclerosis have several effects on the orofacial region such as widening of the periodontal ligament space, xerostomia and bone resorption of the mandible. We report a case of systemic sclerosis with temporomandibular joint involvement in a 45-year-old female patient accompanied by severe limited mouth opening and pain in the right and left preauricular regions and tenderness in masseter muscles with a morning stiffness of jaws.Magnetic resonance imaging showed a resorption of mandibular condylar process, with disk and joint abnormalities. PMID:28292126

  16. Effects of sleep deprivation on pain-related factors in the temporomandibular joint.

    Science.gov (United States)

    Wu, Gaoyi; Chen, Lei; Wei, Geng; Wei, Gang; Li, Ying; Zhu, Guoxiong; Zhao, Zhengwei; Huang, Fei

    2014-11-01

    The objective of this study was to investigate the effects of experimental sleep deprivation (SD) on the temporomandibular joint (TMJ) in rats by examining pain-related factors and to determine the possible involvement of estrogen and NF (nuclear factor) κB signaling in the TMJ synovial membrane. The influence of SD, conducted in rats using the modified multiple platform method, was estimated by observing behavioral manifestations and examining changes in serum hormone levels. The morphologic changes of synovial tissue were observed with light microscopy and the serum levels of estrogen were measured by radioimmunoassay. Activation of NF-κB in the synovial membrane was examined using an immunofluorescence technique, and the expression levels of interleukin (IL) 1β, IL-6, tumor necrosis factor α, cyclooxygenase 2, and inducible nitric oxide synthase were measured with real-time polymerase chain reaction. The SD group showed evidence of elevated anxiety and stress, and increased plasma levels of estradiol compared with the control group. The activity of NF-κB was significantly enhanced and translocation of NF-κB p65 was evident in the synovial membrane after SD. The expression of pain-related factors IL-1β, IL-6, cyclooxygenase-2, tumor necrosis factor α, and inducible nitric oxide synthase in the synovial membrane significantly increased after SD. These results indicate that SD increases serum levels of estrogen and induces alterations in pain-related factors in the TMJ. The NF-κB pathway has been associated with the regulation of these inflammatory cytokines and plays an important role in temporomandibular disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Biofeedback and Relaxation Therapy for Chronic Temporomandibular Joint Pain: Predicting Successful Outcomes.

    Science.gov (United States)

    Funch, Donna P.; Gale, Elliot N.

    1984-01-01

    Randomly assigned 57 patients with chronic temporomandibular joint (TMJ) pain to receive either relaxation or biofeedback therapy. Successful patients in the relaxation condition tended to be younger and had experienced TMJ pain for a shorter period of time than the successful biofeedback patients. (BH)

  18. Platelet-rich plasma for the therapeutic management of temporomandibular joint disorders: a systematic review.

    Science.gov (United States)

    Bousnaki, M; Bakopoulou, A; Koidis, P

    2018-02-01

    This systematic review aimed to investigate whether intra-articular injections of platelet-rich plasma (PRP) are beneficial for the treatment of degenerative temporomandibular disorders, such as temporomandibular joint osteoarthritis (TMJ-OA) and disc displacement with osteoarthritic lesions, when compared to other treatments, such as injections of hyaluronic acid (HA) or saline. An electronic search of the MEDLINE and Scopus databases was performed using combinations of the terms "temporomandibular" and "platelet rich plasma", to identify studies reported in English and published up until May 2017. A hand-search of relevant journals and the reference lists of selected articles was also performed. The initial screening identified 153 records, of which only six fulfilled the inclusion criteria and were included in this review. Of these studies, three compared PRP with HA, while three compared PRP with Ringer's lactate or saline. Four of the studies found PRP injections to be superior in terms of improvements in mandibular range of motion and pain intensity up to 12 months after treatment, while the remaining two studies found similar results for the different treatments. There is slight evidence for the potential benefits of intra-articular injections of PRP in patients with TMJ-OA. However, a standardized protocol for PRP preparation and application needs to be established. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. 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.

  20. Voice-related disability of Iranian patients with temporomandibular disorders.

    Science.gov (United States)

    Moradi, Negin; Sahebi, Majid; Saki, Nader; Hosseinzadeh Nik, Tahereh; Shaterzadeh Yazdi, Mohammad Jafar; Nikakhlagh, Soheila; Soltani, Majid; Naderifar, Ehsan; Derakhshandeh, Vita; Javadipour, Shiva; Mahmoodi-Bakhtiari, Behrooz

    2014-11-01

    The relationship between handicaps because of voice disorders and temporomandibular disorders (TMDs) severity was examined. Fifty-two Persian women with temporomandibular disorder (TMD) were examined by two dentists in separate sessions and the assessment protocol of the Dentistry Clinic of Tehran University of Medical Sciences was filled by both dentists and finally they gave their opinion separately about the existence of TMD and categorized the severity of TMD as mild, moderate, and severe. To assess perceived disability resulting from voice disorders in TMD patients, the voice handicap index (VHI) questionnaire was used. The total score of VHI in 80.8% of patients with TMD was equal to or more than 14.5. A significant positive relationship was found between the severity of TMD and the total score of VHI (P = 0.000, r = 0.79). It seems that a comprehensive voice assessment should be included in the evaluation of TMD, and considering different effects of voice disorders on patients' lives, a complete voice evaluation including voice-related disability is necessary to understand the nature of pathophysiology of TMD. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. Examination of a large patient population for the presence of symptoms and signs of temporomandibular disorders.

    Science.gov (United States)

    Cooper, Barry C; Kleinberg, Israel

    2007-04-01

    Temporomandibular Disorder (TMD) is a term generally applied to a condition or conditions characterized by pain and/or dysfunction of the masticatory apparatus. Its characterization has been difficult because of the large number of symptoms and signs attributed to this disorder and to variation in the number and types manifested in any particular patient. For this study, data on 4,528 patients, presenting over a period of 25 years to a single examiner for TMD treatment, was made available for retrospective analysis and determination of whether the TMD care-seeking patient can be profiled, particularly pain difficulties. All patients in this database filled out a questionnaire and were examined for the prevalence of a range of symptoms and clinical examination findings (signs) commonly attributed to TMD. There was no attempt in this study to assign patients to TMD diagnostic subcategories. The data collected were analyzed to determine which of these symptoms and signs were sufficiently "characteristic of the TMD condition" that they might be used in diagnosis, research and treatment, especially in patients needing relief from pain and discomfort. All 4,528 patients reported symptoms and all but 190 of them also showed signs upon examination. Symptoms most commonly reported on the questionnaire included (i) pain (96.1%), (ii) headache (79.3%), (iii) temporomandibular joint discomfort or dysfunction (75.0%) and (iv) ear discomfort or dysfunction (82.4%). In the 4,338 patients who showed signs, the most prevalent was tenderness to palpation of the pterygoid muscles (85.1%), followed by tenderness to palpation of the temporomandibular joints (62.4%). Pain symptoms and signs were often accompanied by compromised mandibular movements, TMJ sounds and dental changes, such as incisal edge wear and excessive overbite. Clearly prevalence of pain disclosed by the symptoms and signs examinations was high. Patients showed variable prevalence and nonprevalence of eight categories

  2. Algunas consideraciones sobre los trastornos temporomandibulares Some considerations on the temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Ileana Grau León

    2005-12-01

    Full Text Available Se realizó una revisión documental mediante revistas, libros, tesis y otros documentos en formato electrónico acerca de la epidemiología de los trastornos de la articulación temporomandibular, con el objetivo de actualizar el material existente y ampliar nuestros conocimientos sobre esta alteración. En nuestro país se han llevado a cabo en las 2 últimas décadas, varios estudios epidemiológicos sobre los trastornos temporomandibulares (TTM y se ha hecho un esfuerzo notable por esclarecer su causa. De forma general, se acepta la idea de que el origen de los disturbios funcionales del sistema estomatognático es multifactorial, pero a pesar de que tanto en niños como en adultos la prevalencia de los trastornos temporomandibulares (TTM ha sido alta, no se ha evidenciado un factor causal predominante. La literatura alude que estas disfunciones afectan a un porcentaje muy elevado de la población mundial (80 %, con una edad media de 34 años y una proporción de 3 mujeres por cada hombre. Este dato es muy interesante, porque los estudios precisan que las mujeres de edades comprendidas entre los 25 y los 35 años presentan trastornos temporomandibulares (TTM con más asiduidad.A documental review of different sources was carried out to study the disfunctions of temporal mandibular joint (TMJ with the objective of updating and enlarge our knowledge of this disorder. In or country in the last two decades several epidemiological studies about the temporal mandibular joint dysfunction were carried out. In a general wade the idea about of the origin of the functional problems of the stomatognatic system is multifactioral. But although, in children as well as in adults the prevalence of temporal mandibular dysfunction (DTM has been high, a casual predominant factor has not been evidenced. Literature states that this dysfunction affect a very high percentage of the world populations, 80 % , the mean age 34 years old and the proportion 3 woman for

  3. Temporomandibular Joint Disorders as a Cause of Aural Fullness.

    Science.gov (United States)

    Peng, Yongxin

    2017-09-01

    Temporomandibular joint disorders (TMD) are often associated with aural manifestations. However, it is not clear whether aural fullness could be induced by TMD. The purpose was to investigate the TMD and effectiveness of TMD treatments in patients with mainly or exclusively aural fullness complaint. One hundred and twelve patients, who had aural fullness as the main or sole complaint, presented to the Otolaryngology Department, PLA Army General Hospital, Beijing, China, between January 2010 and January 2015. Patients' medical history indicated that they had previously been diagnosed and treated for otitis media or sensorineural hearing loss but without positive results. Patients were subjected to pure tone audiometry and acoustic immittance screening using GSI-61 clinical audiometer and GSI TympStar middle ear analyzer respectively. Patients were examined by questionnaire, X-ray and/or computed tomography scan of temporomandibular joint. TMD was categorized according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients were then treated for TMD. All the patients showed normal eardrum and type A tympanogram. The patients of 60.7% (68/112) were classified as group I TMD disorders (muscle disorders), 34.8% (39/112) were group II (disc displacements), and 4.5% (5/112) were group III (arthralgia, osteoarthritis, and osteoarthrosis). Aural fullness was completely resolved or significantly improved in 67 and 34 patients respectively following treatments aimed at improving TMD, with a combined effectiveness of 90.2% (101/112). TMD treatments are especially effective (94.1%) in group I TMD. TMD as a potential cause of aural fullness should be considered in otolaryngology practice.

  4. [Metastases in the temporomandibular joint: a review from 1954 to 2013. Rare causes for temporomandibular disorders].

    Science.gov (United States)

    Pretzl, Christine; Lübbers, Heinz-Theo; Grätz, Klaus W; Kruse, Astrid L

    2014-01-01

    Metastatic lesions make up approximately 1% of all oral cancers.A comparatively rare location is the temporomandibular joint.Leading symptoms can be misdirecting, especially in the beginning,because they are frequently similar or even identical to those occurring in temporomandibular disorders. Therefore it can be quite difficult to confirm the diagnosis of a TMJ metastasis.delayed initiation of therapy and thus a poor prognosis are often the results. A review of the literature from 1954 to 2013 was realized and the published cases between 1954 and January 2013 were evaluated.The results were analyzed according to gender distribution, age,first symptoms, location of the primary tumor, as well as to the occurrence of malignancies in the patients' medical history. The research identified sixty-six patients. Tumors of the lung and breast were the main starting points of the metastatic spread. The histopathological workup showed above all the diagnosis of an adenocarcinoma. In all of the cases, unspecific symptoms led to the diagnosis of a metastatic disease. In the case of nonspecific TMJ affection, diagnostics should consider less-frequent diagnoses, such as the presence of metastasis.A clinical differentiation by additional symptoms like swelling, unexplained weight loss and night sweats, as well as a tumor disease in the past or failure of conservative treatment can provide additional indications. If there is reasonable suspicion,extended medical imaging and diagnostic measures must be performed to allow early treatment initiation and a better prognosis.

  5. STRATEGIES FOR COPING WITH PAIN AND PSYCHOLOGICAL DISTRESS ASSOCIATED WITH TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT

    NARCIS (Netherlands)

    JASPERS, JPC; HEUVEL, F; STEGENGA, B; DEBONT, LGM

    Objective: To analyse the relationship among a variety of emotional, cognitive, and behavioral coping strategies and pain/suffering and psychological distress in patients with temporomandibular joint (TMJ) pain. Design: Cross-sectional, correlational study. Setting: Department of Oral and

  6. Self-Reported Bruxism and Symptoms of Temporomandibular Disorders in Finnish University Students.

    Science.gov (United States)

    Huhtela, Outi S; Näpänkangas, Ritva; Joensuu, Tiina; Raustia, Aune; Kunttu, Kristina; Sipilä, Kirsi

    2016-01-01

    To evaluate the prevalence of self-reported bruxism and symptoms of temporomandibular disorders (TMD) and to investigate their association in academic and applied science university students in Finland. The data were gathered from 4,403 Finnish students included in the Finnish Student Health Survey 2012. The comprehensive questionnaire included five questions concerning bruxism and TMD symptoms. Bivariate associations between self-reported bruxism and TMD symptoms were evaluated using chi-square tests, and logistic regression model was used with age and gender as factors. Sleep bruxism was reported by 21.0% of women and by 12.5% of men, awake bruxism by 2.0% of women and by 2.8% of men, and both sleep and awake bruxism by 7.2% of women and by 3.2% of men. TMD pain was reported by 25.9% of women and by 11.4% of men and temporomandibular joint (TMJ) pain on jaw movement by 9.6% of women and by 4.2% of men. Report of sleep bruxism increased the risk for all TMD symptoms in both genders. Among women, report of awake bruxism increased the risk for TMD pain and TMJ pain on jaw movement. Reporting stress as a perpetuating factor for TMD pain increased the risk for both sleep and awake bruxism in both genders. The logistic regression analysis (including age and gender) showed that report of sleep bruxism and/or awake bruxism was associated with TMD pain (Odds Ratio [OR] = 5.71; 95% confidence interval [CI] = 4.86-6.70), TMJ pain on jaw movement (OR = 4.49; 95% CI = 3.54-5.69), and TMJ locking (OR = 2.98; 95% CI = 2.17-4.10). Bruxism and TMD symptoms are frequent in Finnish university students. Self-reported bruxism is associated with TMD symptoms, confirming earlier findings.

  7. [The relationship between symptoms and signs of temporomandibular disorders and the patients' quality of life].

    Science.gov (United States)

    Chen, Hui-min; Fu, Kai-yuan; Zhang, Zhen-kang

    2007-03-01

    To analyze the relationship between symptoms and signs of temporomandibular disorders (TMD) and the patients' quality of life (QOL). A total of 492 TMD patients were included in this study. The clinical examination results were recorded using Fricton index of temporomandibular joint function. "Visual analog scale (VAS) evaluation of QOL disturbance" was designed to quantitate patients' QOL, to evaluate the degree that the patients QOL was affected. Chewing, daily life and emotion among all 8 items of QOL were frequently affected by TMD, and joint clicking had the least influence on QOL. Intermittent closed lock had more severe interference with QOL than joint clicking only. Severe and moderate pain or limited mouth opening affected the QOL more severely than mild pain or mild limited mouth opening. The simple linear relationship between Fricton index and patients' QOL was poor (r < 0.4). Pain is the most frequently seen symptom in TMD. TMD could affect patients' QOL, including both physical and social-psychological functions. The results suggest that the patients' QOL as well as TMD symptoms and signs should be considered in the management of TMD.

  8. Temporomandibular disorders in patients with schizophrenia using antipsychotic agents: a discussion paper

    Directory of Open Access Journals (Sweden)

    de Araújo AN

    2014-03-01

    Full Text Available Arão Nogueira de Araújo,1 Marion Alves do Nascimento,1 Eduardo Pondé de Sena,1,2 Abrahão Fontes Baptista3,4 1Postgraduate Program in Interactive Processes of Organs and Systems, 2Department of Pharmacology, Institute of Health Sciences, 3Department of Biomorphology, Institute of Health Sciences, 4Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil Abstract: Patients with psychiatric problems show a tendency to develop temporomandibular disorders (TMD. Particularly, patients with schizophrenia are quite likely to have signs and symptoms of TMD due to the impairment of their oral health, the use of antipsychotic drugs, and other general health problems. In nonschizophrenic populations, TMD have been considered as the main cause of nondental pain in the orofacial region, involving mechanisms associated with changes in masticatory activity at the cortical and neuromuscular levels. Individuals with schizophrenia do not usually complain of pain, and TMD is misdiagnosed in this population. In this paper, we aimed to review the clinical aspects of TMD in people with schizophrenia on antipsychotic drug therapy. Keywords: schizophrenia, temporomandibular joint, pain, antipsychotic agents

  9. Prevalence of Temporomandibular Disorders in the Northern Finland Birth Cohort 1966.

    Science.gov (United States)

    Jussila, Päivi; Kiviahde, Heikki; Näpänkangas, Ritva; Päkkilä, Jari; Pesonen, Paula; Sipilä, Kirsi; Pirttiniemi, Pertti; Raustia, Aune

    2017-01-01

    To investigate the prevalence of temporomandibular disorders (TMD) in the 46-year-old cohort subjects from the Northern Finland Birth Cohort 1966 (NFBC 1966). Altogether, 1,962 subjects (1,050 women, 912 men) participated in a clinical medical and dental examination and responded to questionnaires in 2012 to 2013. The stomatognathic examination was performed according to a modified protocol of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pearson's chi-square test and Fisher's exact test were used to analyze the signs of TMD between genders, and logistic regression models were used to analyze the relationship between self-reported pain associated with TMD and modified DC/TMD protocol (P TMJ) (26.2%) and palpation pain in the masticatory muscles (11.2%). Women had signs of TMD more often than men (P TMJ and the most common TMD diagnosis was disc displacement with reduction. The prevalence of TMD signs among the examined cohort subjects was 34.2%. TMD was diagnosed in women more often than in men. The results are comparable with other corresponding population-based studies in adults.

  10. Cervical spine signs and symptoms: perpetuating rather than predisposing factors for temporomandibular disorders in women

    National Research Council Canada - National Science Library

    Bevilaqua-Grossi, Débora; Chaves, Thaís Cristina; de Oliveira, Anamaria Siriani

    2007-01-01

    ... and the severity of temporomandibular disorders (TMD) and vice-versa. One hundred women (aged 18-26 years) clinically diagnosed with TMD signs and symptoms and cervical spine disorders were randomly selected from a sample of college students...

  11. Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders.

    Science.gov (United States)

    Salmos-Brito, Janaina Andrade Lima; de Menezes, Rebeca Ferraz; Teixeira, Camila Epitácio Cravo; Gonzaga, Raphaella Karlla Machado; Rodrigues, Breno Henrique Mara; Braz, Rodivan; Bessa-Nogueira, Ricardo Viana; Gerbi, Marleny Elizabeth Márquez de Martínez

    2013-01-01

    The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (TMD (≥ 6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; λ = 830 nm, P = 40 mW, CW, ED = 8 J/cm(2)). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p = 0.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.

  12. 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.

  13. Cross-cultural adaptation, reliability and construct validity of the Tampa scale for kinesiophobia for temporomandibular disorders (TSK/TMD-Br) into Brazilian Portuguese

    NARCIS (Netherlands)

    Aguiar, A.S.; Bataglion, C.; Visscher, C.M.; Bevilaqua Grossi, D.; Chaves, T.C.

    2017-01-01

    Fear of movement (kinesiophobia) seems to play an important role in the development of chronic pain. However, for temporomandibular disorders (TMD), there is a scarcity of studies about this topic. The Tampa Scale for Kinesiophobia for TMD (TSK/TMD) is the most widely used instrument to measure fear

  14. Ultrasound-Guided Temporomandibular Joint Injection for Chronic Posthemimandibulectomy Jaw Pain.

    Science.gov (United States)

    Chakraborty, Arunangshu; Datta, Taniya; Lingegowda, Dayananda; Khemka, Rakhi

    2016-11-15

    Temporomandibular joint (TMJ) pain can be difficult to diagnose and treat. We describe a patient with left jaw pain after right hemimandibulectomy. The patient was initially managed conservatively, which failed to reduce pain. He was then administered inferior alveolar nerve block and TMJ injection with steroid and local anesthetic. These injections provided temporary pain relief that lasted approximately 1 month and the pain recurred. Computed tomography scan showed lateral displacement of left mandibular condyle. He was then given ultrasound-guided TMJ injection of steroid and local anesthetic. This injection provided lasting pain relief.

  15. Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Omolehinwa, Temitope T.; Mupparapu, Mel; Akintoye, SundayO. [Dept. of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia (United States)

    2016-12-15

    In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long-standing human papilloma virus (HPV-16)-positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain.

  16. Prevalence of diagnosed temporomandibular disorders among Saudi Arabian children and adolescents.

    Science.gov (United States)

    Al-Khotani, Amal; Naimi-Akbar, Aron; Albadawi, Emad; Ernberg, Malin; Hedenberg-Magnusson, Britt; Christidis, Nikolaos

    2016-01-01

    Studies have indicated that the prevalence of symptoms and signs of temporomandibular disorders (TMD) are rare early in childhood, but become more prevalent in adolescents and adulthood. To our knowledge, no study has investigated the prevalence of TMD-diagnoses in children in the general population. The aim was thus to investigate the prevalence of TMD-diagnoses among children and adolescents in the general population using the Research Diagnostic Criteria for TMD (RDC/TMD). The current cross-sectional study consisted of 456 children and adolescents, aged between 10 and 18, randomly enrolled from 10 boy's- and 10 girl's- schools in Jeddah. The participants first answered two validated questions about TMD-pain, followed by a clinical examination according to RDC/TMD. One hundred twenty-four participants (27.2 %) were diagnosed with at least one TMD-diagnosis. Myofascial pain was the most common diagnosis (15 %) followed by disc displacement with reduction, arthralgia, myofascial pain with limited mouth opening and osteoarthrosis. Children diagnosed with myofascial pain more often reported orofacial pain, headache and tooth clenching (p bruxism were associated with a TMD-pain diagnosis and disc displacement. A surprisingly low percentage of children and adolescents sought treatment by a dentist or physician for their pains.

  17. 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.

  18. 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

    and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I......, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More......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...

  19. 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...... and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I......, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More...

  20. 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.

  1. Groningen temporomandibular total joint prosthesis: an 8-year longitudinal follow-up on function and pain.

    Science.gov (United States)

    Schuurhuis, Jennifer M; Dijkstra, Pieter U; Stegenga, Boudewijn; de Bont, Lambert G M; Spijkervet, Fred K L

    2012-12-01

    Total temporomandibular joint replacement is a surgical procedure for patients with severe temporomandibular joint afflictions affecting quality of life, which have not responded beneficially to previous conventional surgery. The aim of this study was to assess the long-term outcome of the Groningen temporomandibular joint (TMJ) prosthesis in patients with chronic pain and mutilated temporomandibular joints following multiple surgical procedures, with respect to prosthesis failure, the patient's postoperative level of satisfaction and longitudinal changes in maximum mouth opening, functional mandibular impairment and pain. Eight female patients were studied in whom Groningen TMJ prostheses were inserted, two unilaterally and six bilaterally. The Groningen TMJ prosthesis was mechanically successful during 8 years of follow-up in seven out of eight patients with a disc dislocation being seen in one patient (7%). Patients were satisfied, despite the limited improvement of the maximum mouth opening, and pain scores. Although the decline of MFIQ scores during 8 years of follow-up was significant compared to baseline (p=0.027), the effects of the prosthesis on maximum mouth opening, function and pain were limited. This may be due to persistent chronic pain and the adverse effects of multiple previous surgical procedures. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Signs and symptoms of temporomandibular disorders in the elderly.

    Science.gov (United States)

    Camacho, José Gustavo Dala Déa; Oltramari-Navarro, Paula Vanessa Pedron; Navarro, Ricardo de Lima; Conti, Ana Cláudia de Castro Ferreira; Conti, Marcio Rodrigues de Almeida; Marchiori, Luciana Lozza de Moraes; Fernandes, Karen Barros Parron

    2014-01-01

    This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (ppalpation of the TMJ (p=0.0168), of masticatory muscles (pmuscles (pTMJ palpation was not significant. The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.

  3. Occlusal Grinding Pattern during Sleep Bruxism and Temporomandibular Disorder

    Directory of Open Access Journals (Sweden)

    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

  4. Arthroscopy for treating temporomandibular joint disorders.

    Science.gov (United States)

    Currie, Roger

    2011-01-01

    The Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline Embase, Lilacs, Allied and Complementary Medicine Database (AMED) and CINAHL databases were searched. In addition the reference lists of the included articles were checked and 14 journals hand searched. Randomised controlled clinical trials (RCT) of arthroscopy for treating TMDs were included. There were no restrictions regarding the language or date of publication. Two review authors independently extracted data, and three review authors independently assessed the risk of bias of included trials. The authors of the selected articles were contacted for additional information. Pooling of trials was only attempted if at least two trials of comparable protocols, with the same conditions and similar outcome measurements were available. Statistical analysis was performed in accordance with the Cochrane Collaboration guidelines. Seven RCTs (n = 349) met the inclusion criteria. All the studies were either at high or unclear risk of bias. Pain was evaluated after six months in two studies. No statistically significant differences were found between the arthroscopy versus nonsurgical groups (standardised mean difference (SMD) = 0.004; 95% confidence interval (CI) - 0.46 to 0.55, P = 0.81). Two studies analysed pain 12 months after surgery (arthroscopy and arthrocentesis) in 81 patients. No statistically significant differences were found (mean difference (MD) = 0.10; 95% CI -1.46 to 1.66, P = 0.90). Three studies analysed the same outcome in patients who had been submitted to arthroscopic surgery or to open surgery and a statistically significant difference was found after 12 months (SMD = 0.45; 95% CI 0.01 to 0.89, P = 0.05) in favour of open surgery.The two studies compared the maximum interincisal opening in six different clinical outcomes (interincisal opening over 35 mm; maximum protrusion over 5 mm; click; crepitation; tenderness on palpation in the

  5. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006-2011).

    Science.gov (United States)

    Arzi, Boaz; Cissell, Derek D; Verstraete, Frank J M; Kass, Philip H; DuRaine, Grayson D; Athanasiou, Kyriacos A

    2013-01-01

    To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders. Retrospective case series. 41 dogs and 17 cats. Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011. Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs. Results indicated that TMJ disorders were frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and signs of pain. (J Am Vet Med Assoc 2013;242:69-75).

  6. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006–2011)

    Science.gov (United States)

    Arzi, Boaz; Cissell, Derek D.; Verstraete, Frank J. M.; Kass, Philip H.; DuRaine, Grayson D.; Athanasiou, Kyriacos A.

    2013-01-01

    Objective To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders. Design Retrospective case-series. Animals 41 dogs and 17 cats. Procedures Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011. Results Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs. Conclusions and Clinical Relevance Results indicated that TMJ disorders are frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and pain. PMID:23234284

  7. Counselling and self-management therapies for temporomandibular disorders: a systematic review.

    Science.gov (United States)

    de Freitas, R F C P; Ferreira, M Â F; Barbosa, G A S; Calderon, P S

    2013-11-01

    The aim of this review was to investigate the effectiveness of counselling and other self-management-based therapies on muscle and temporomandibular joint (TMJ) pain relief and increasing the functional abilities of patients with temporomandibular disorders (TMD). A systematic literature review was conducted by three independent reviewers and included articles published up to 2012. PubMed and Cochrane Library electronic databases were used in addition to hand-searching to assess clinical outcomes for counselling and self-management approaches for TMD treatment. The review yielded 581 records that were narrowed down to 7. All included studies were classified as blind-randomized controlled clinical trials. The selected articles analysed revealed that counselling was able to improve tenderness upon masticatory muscle palpation and maximum mouth opening with and without pain in patients with TMD, with similar results to those of interocclusal appliances approaches. Thus, counselling- and self-management-based therapies could be considered a conservative low-cost and beneficial treatment alternative for treating TMD to potentially improve psychological domains and remove harmful behaviours for the control of the signs and symptoms of TMD. © 2013 John Wiley & Sons Ltd.

  8. Treatment of a case of skeletal class II malocclusion with temporomandibular joint disorder using miniscrew anchorage.

    Science.gov (United States)

    Kaku, Masato; Koseki, Hiroyuki; Kawazoe, Aki; Abedini, Sara; Kojima, Shunichi; Motokawa, Masahide; Ohtani, Junji; Fujita, Tadashi; Kawata, Toshitsugu; Tanne, Kazuo

    2011-04-01

    At the present time, there are no reports in the literature on the treatment of temporomandibular joint disorder (TMD) by intrusion of molars using mini-screws. This case report describes the treatment for a female patient, aged 19 years seven months, with a TMD and an excessive lower anterior facial height. Overjet and overbite were +5.0 mm and +0.5 mm, respectively. The patient had a history of orthodontic treatment in which her first premolars were all extracted. During the first orthodontic treatment, a clockwise mandibular rotation was observed as a result of the increase of posterior dentoalveolar height. She had temporomandibular joint (TMJ) pain during mouth opening and complained of difficulty in eating due to masticatory dysfunction. The pretreatment Schuller views of both TMJ showed a posterior condyle position. In order to correct the overjet, molar relationship and the mandibular condyle position, a miniscrew was inserted into the palatal region of the upper first molar to intrude the upper posterior teeth. As the upper molars were intruded, the overjet was decreased, and a class I molar relationship was achieved by a counterclockwise mandibular rotation. After one year of treatment, an acceptable occlusion was achieved, and the condyle moved into centric position in the glenoid fossa. The patient's teeth continued to be stable, and she had no pain in TMJ after a retention period of three years. The result of this treatment showed that molar intrusion using miniscrew anchorage is effective for treatment of a TMD patient with a posterior condyle position.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms.

    Science.gov (United States)

    van der Meer, Hedwig A; Speksnijder, Caroline M; Engelbert, Raoul H H; Lobbezoo, Frank; Nijhuis-van der Sanden, Maria W G; Visscher, Corine M

    2017-09-01

    The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. Several subtypes of headaches have been diagnosed: self-reported headache, (probable) migraine, (probable) tension-type headache, and secondary headache attributed to TMD. The presence of TMD was subdivided into 2 subtypes: painful TMD and function-related TMD. The associations between the subtypes of TMD and headaches were evaluated by single regression models. To study the influence of possible confounding factors on this association, the regression models were extended with age, sex, bruxism, stress, depression, and somatic symptoms. Of the included patients (n=203), 67.5% experienced headaches. In the subsample of patients with a painful TMD (n=58), the prevalence of self-reported headaches increased to 82.8%. The associations found between self-reported headache and (1) painful TMD and (2) function-related TMD were confounded by the presence of somatic symptoms. For probable migraine, both somatic symptoms and bruxism confounded the initial association found with painful TMD. The findings of this study imply that there is a central working mechanism overlapping TMD and headache. Health care providers should not regard these disorders separately, but rather look at the bigger picture to appreciate the complex nature of the diagnostic and therapeutic process.

  11. Quality of life and general health in patients with temporomandibular disorders

    OpenAIRE

    Resende, Camila Maria Bastos Machado de; Alves,Arthur César de Medeiros; Coelho, Lidiane Thomaz; Alchieri, João Carlos; Roncalli,Ângelo Giuseppe; Barbosa,Gustavo Augusto Seabra

    2013-01-01

    The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used f...

  12. Association Between Clinical Signs of Temporomandibular Disorders and Psychological Distress Among an Adult Finnish Population.

    Science.gov (United States)

    Tuuliainen, Lauri; Sipilä, Kirsi; Mäki, Pirjo; Könönen, Mauno; Suominen, Anna Liisa

    2015-01-01

    To evaluate the association between signs of temporomandibular disorders (TMD) and psychological distress in a general population-based sample of Finnish adults. The Health 2000 Survey was conducted in 2000-2001 by the National Institute for Health and Welfare in Finland. Of the sample of adults aged 30 or over (n=8,028), 79% participated in a clinical oral health examination, which included examination of TMD signs. The participants (n=6,155) also completed questionnaires, including the 12-item General Health Questionnaire (GHQ-12), which measured psychological distress. Associations between TMD signs and psychological distress measured by the GHQ-12 were examined in both genders. Statistical measures included chi-square tests, t tests, and logistic regression analyses. The prevalence of the TMD signs (limited opening, clicking, crepitation, temporomandibular joint [TMJ] palpation pain, and muscle palpation pain) was 11.2%, 17.6%, 10.5%, 5.1%, and 18.9% in women, and 6.1%, 12.9%, 5.3%, 2.4%, and 7.2% in men, respectively. High GHQ-12 scores, measured as continuous variables and in quartiles by distress level, were significantly associated with masticatory muscle pain on palpation in both genders (PTMJ pain on palpation in women (PTMJ crepitation in men (Pmuscle pain on palpation both in women (odds ratio [OR]=2.18; 95% confidence interval [CI]=1.6-2.9) and men (OR=2.03; 95% CI=1.3-3.1). TMD signs and psychological distress appear to be associated. However, due to the limitations of the study, the findings can be regarded as preliminary.

  13. 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

    symptoms of the patients and if they had been submitted to evaluation with a speech therapist, physiotherapist and psychological. RESULTS: feminine predominance, being 107 women (85.6% and 18 men (14.4%. Average of age: 35 year-old, being the smallest age 14 years and the largest 74 years. Relationship of temporomandibular dysfunction with the professions: 43 - (34.4% were professional with contract of employment. Complaint brought by the patient: pain in the area of temporomandibular articulation and masseter: 86 - (68.8%. Three main signs and symptoms observed in the orthodontic evaluation: pain in the temporomandibular articulation and masseter area: 98 - 78.4%; unilateral cracks: 55 - 44% and locking: 23 - 18.4%. Conduct of referrals: speech therapy 59 - (47, 2%; physiotherapy 40 (32% and psychology 53 (42.4%. CONCLUSION: in the researched sample, the prevalence of cases related to temporomandibular dysfunction was higher in the feminine gender, with pain complaint. The main signs and symptoms were: pain, unilateral crack and locking and there was a referral for multidisciplinary cares for speech therapy, physiotherapy and psychology areas.

  14. 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.

  15. Temporomandibular disorders in 19-year-old Korean men.

    Science.gov (United States)

    Choi, You-Sung; Choung, Pill-Hoon; Moon, Hyock-Soo; Kim, Seong-Gon

    2002-07-01

    The purpose of this study was to determine the prevalence and the nature of the relationships between 3 temporomandibular joint disease (TMD) symptoms and symptoms of associated structures. This study was designed to rule out the effect from the uneven composition of the samples on TMD symptoms. The samples were collected from subjects who were of the same age, gender, district, and race. Nineteen-year old men (n = 27,978) were selected and investigated by means of questionnaires and clinical examinations. The prevalence of each symptom was studied and tried to determine the effects of the TMD-associated signs on the TMD signs. The indices allocated to reflect the TMD signs and symptoms and the others were dichotomized for bivariate analysis. The predictor variables were headache, neck pain, referred pain, stress, past trauma history in the TMJ, past TMJ dislocation, bruxism, and clenching. The outcome variables were mouth opening limitation, TMJ pain on rest, and TMJ pain during function. The incidence of masticatory muscle stiffness was 17.8%; TMJ sounds, 14.3%; headache, 7.2%; neck pain, 13.5%; bruxism, 8.4%; and clenching, 9.9%. Stress occurred in 12.8%, past trauma history in 11%, and previous joint dislocation in 2.5%. The experience of dislocation in the TMJ was found to be the most important risk factor in terms of mouth opening limitation (odds ratio, 4.08, P stress in terms of mouth opening limitation. Considering referred pain can be induced by TMD, stress may be more related to mouth opening limitation (odds ratio, 2.18, P Stress was related to limitations of mouth opening, and the experience of trauma in the TMJ was found to be related to pain in the joint region. Bruxism may not be a direct risk factor in TMD, and the clenching habit found to be more harmful than bruxism. Copyright 2002 American Association of Oral and Maxillofacial Surgeons

  16. [Temporomandibular disorders and Ehlers-Danlos syndrome, hypermobility type: A case-control study].

    Science.gov (United States)

    Diep, D; Fau, V; Wdowik, S; Bienvenu, B; Bénateau, H; Veyssière, A

    2016-09-01

    The Ehlers-Danlos syndrome, hypermobility type (EDS-HT) is a rare genetic disease. Diagnosis is based on a combination of clinical criteria described in the classification of Villefranche. Diagnosis is difficult to make because of the lack of specific clinical signs and the absence of genetic testing. The EDS-TH manifests itself manly by musculoskeletal pain and joint hypermobility. Temporomandibular disorders (TMD) are also reported. Our aim was to objectify the presence and to qualify the type of TMD associated with the EDS-HT in order to propose an additional diagnostic argument. A prospective, monocenter case-control study, comparing a cohort of patients suffering from EDS-HT to a paired control group of healthy volunteers has been conducted. Clinical examination was standardized, including a general questioning, an oral examination and a temporomandibular joint examination following the TMD/RDC (temporomandibular disorders/research diagnostic criteria). Fourteen EDS-HT patients and 58 control patients were examined. The prevalence of TMDs (n=13; 92.9% vs. n=4; 6.9%; P=10(-11)) was significantly higher in the EDS-HT group. TMDs occurring in the EDS-HT group were complex, combining several mechanisms in contrast to the control group, where only one mechanism was found in all the patients (n=13; 92.9% vs. n=0; 0.0%). TMDs are strongly associated with RDS-HT. TMDs could therefore be used in the diagnosis of this disease. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Inter-tester reliability of selected clinical tests for long-lasting temporomandibular disorders.

    Science.gov (United States)

    Julsvoll, Elisabeth Heggem; Vøllestad, Nina Køpke; Opseth, Gro; Robinson, Hilde Stendal

    2017-09-01

    Clinical tests used to examine patients with temporomandibular disorders vary in methodological quality, and some are not tested for reliability. The purpose of this cross-sectional study was to evaluate inter-tester reliability of clinical tests and a cluster of tests used to examine patients with long-lasting temporomandibular disorders. Forty patients with pain in the temporomandibular area treated by health-professionals were included. They were between 18-70 years, had 65 symptomatic (33 right/32 left) and 15 asymptomatic joints. Two manual therapists examined all participants with selected tests. Percentage agreement and the kappa coefficient ( k ) with 95% confidence interval (CI) were used to evaluate the tests with categorical outcomes. For tests with continuous outcomes, the relative inter-tester reliability was assessed by the intraclass-correlation-coefficient (ICC 3,1 , 95% CI) and the absolute reliability was calculated by the smallest detectable change (SDC). The best reliability among single tests was found for the dental stick test, the joint-sound test ( k  = 0.80-1.0) and range of mouth-opening (ICC 3,1 (95% CI) = 0.97 (0.95-0.98) and SDC = 4 mm). The reliability of cluster of tests was excellent with both four and five positive tests out of seven. The reliability was good to excellent for the clinical tests and the cluster of tests when performed by experienced therapists. The tests are feasible for use in the clinical setting. They require no advanced equipment and are easy to perform.

  18. Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review.

    Science.gov (United States)

    Brantingham, James W; Cassa, Tammy Kay; Bonnefin, Debra; Pribicevic, Mario; Robb, Andrew; Pollard, Henry; Tong, Victor; Korporaal, Charmaine

    2013-01-01

    The purpose of this study was to complete a systematic review of manual and manipulative therapy (MMT) for common upper extremity pain and disorders including the temporomandibular joint (TMJ). A literature search was conducted using the Cumulative Index of Nursing Allied Health Literature, PubMed, Manual, Alternative, and Natural Therapy Index System (MANTIS), Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, Google Scholar, and hand search inclusive of literature from January 1983 to March 5, 2012. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, and physical therapies. Inclusion criteria required an extremity peripheral diagnosis (for upper extremity problems including the elbow, wrist, hand, finger and the (upper quadrant) temporomandibular joint) and MMT with or without multimodal therapy. Studies were assessed using the PEDro scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring was complete, evidence grades of "A, B, C and I" were applied. Out of 764 citations reviewed, 129 studies were deemed possibly to probably useful and/or relevant to develop expert consensus. Out of 81 randomized controlled or clinical trials, 35 were included. Five controlled or clinical trials were located and 4 were included. Fifty case series, reports and/or single-group pre-test post-test prospective case series were located with 32 included. There is Fair (B) level of evidence for MMT to specific joints and the full kinetic chain combined generally with exercise and/or multimodal therapy for lateral epicondylopathy, carpal tunnel syndrome, and temporomandibular joint disorders, in the short term. The information from this study will help guide practitioners in the use of MMT, soft tissue technique, exercise, and/or multimodal therapy for the treatment of a variety of upper extremity complaints in the context

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

    Science.gov (United States)

    Caspersen, N.; Hirsvang, J. R.; Kroell, L.; Jadidi, F.; Baad-Hansen, L.; Svensson, P.; Jensen, R.

    2013-01-01

    Introduction. Tension-Type Headache (TTH) is the most prevalent headache often associated with impaired function and quality of life. Temporomandibular Disorders (TMD) and TTH frequently coexist; characterized by pericranial tenderness and impact on daily life. We aim to apply a standardized questionnaire for TMD to characterize and analyse an eventual relation between sleep and oral health in TTH in a controlled design. Material and Methods. 58 consecutive TTH patients and 58 healthy controls were included. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, Oral Health Impact profile (OHIP) and questionnaires for sleep were applied. Results. TTH-patients had significantly higher pain scores (P quality of life (P < 0.001), and higher total sleep scores (P < 0.001) compared to controls. Conclusion. For the first time we have identified a clear relation between TTH and TMD symptoms, depression, anxiety, poor sleep, and impairments of oral function in carefully classified patients. These findings indicate a close, but incomplete, overlap between TTH and TMD. Their underlying pathophysiological mechanisms need further research. PMID:24349777

  1. Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

    Directory of Open Access Journals (Sweden)

    N. Caspersen

    2013-01-01

    Full Text Available Introduction. Tension-Type Headache (TTH is the most prevalent headache often associated with impaired function and quality of life. Temporomandibular Disorders (TMD and TTH frequently coexist; characterized by pericranial tenderness and impact on daily life. We aim to apply a standardized questionnaire for TMD to characterize and analyse an eventual relation between sleep and oral health in TTH in a controlled design. Material and Methods. 58 consecutive TTH patients and 58 healthy controls were included. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD questionnaire, Oral Health Impact profile (OHIP and questionnaires for sleep were applied. Results. TTH-patients had significantly higher pain scores (, decreased quality of life (, and higher total sleep scores ( compared to controls. Conclusion. For the first time we have identified a clear relation between TTH and TMD symptoms, depression, anxiety, poor sleep, and impairments of oral function in carefully classified patients. These findings indicate a close, but incomplete, overlap between TTH and TMD. Their underlying pathophysiological mechanisms need further research.

  2. Determination of a pressure pain threshold cut-off value for the diagnosis of temporomandibular joint arthralgia.

    Science.gov (United States)

    Cunha, C O; Pinto-Fiamengui, L M S; Castro, A C P C; Lauris, J R P; Conti, P C R

    2014-05-01

    Temporomandibular joint (TMJ) disorders are divided by the American Academy of Orofacial Pain into five categories. The most common ones are joint pain, as arthralgia and joint disorders, as disc displacements. An important clinical presentation of arthralgia is the painful tenderness to manual palpation or decreased pressure pain threshold (PPT). The authors conducted a study to determine the appropriate PPT value to discriminate asymptomatic TMJ individuals from those with moderate to severe arthralgia. Forty-nine individuals was evaluated and divided into groups: TMJ arthralgia, asymptomatic disc displacement and control group. Magnetic resonance images were obtained for all the groups, and algometry was performed on the TMJ lateral pole. Patients with arthralgia filled out a visual analogue scale (VAS). anova test with 1% of significance analysed the data. Specificity, sensitivity and ROC curve were also determined. Arthralgia group had significant lower PPT (mean of 1.07 kgf cm(-2) ) than the others. Asymptomatic disc displacement group (mean of 1.64 kgf cm(-2) ) has shown significant lower PPT than the control (mean of 2.35 kgf cm(-2) ). 89.66% of specificity and 70% of sensitivity were obtained when 1.36 kgf cm(-2) was applied to the TMJ (ROC area = 0.90). This value was considered to be the most appropriate to detected moderate to severe TMJ arthralgia. Indeed, the presence of disc displacement seems to significantly decrease PPT levels in asymptomatic subjects. The PPT value of 1.36 kgf cm(-2) can be used in the calibration procedures of the professionals involved with temporomandibular disorders and orofacial pain. © 2014 John Wiley & Sons Ltd.

  3. Women's sexual pain disorders.

    Science.gov (United States)

    van Lankveld, Jacques J D M; Granot, Michal; Weijmar Schultz, Willibrord C M; Binik, Yitzchak M; Wesselmann, Ursula; Pukall, Caroline F; Bohm-Starke, Nina; Achtrari, Chahin

    2010-01-01

    Women's sexual pain disorders include dyspareunia and vaginismus and there is need for state-of-the-art information in this area. To update the scientific evidence published in 2004, from the 2nd International Consultation on Sexual Medicine pertaining to the diagnosis and treatment of women's sexual pain disorders. An expert committee, invited from six countries by the 3rd International Consultation, was comprised of eight researchers and clinicians from biological and social science disciplines, for the purpose of reviewing and grading the scientific evidence on nosology, etiology, diagnosis, and treatment of women's sexual pain disorders. Expert opinion was based on grading of evidence-based medical literature, extensive internal committee discussion, public presentation, and debate. Results. A comprehensive assessment of medical, sexual, and psychosocial history is recommended for diagnosis and management. Indications for general and focused pelvic genital examination are identified. Evidence-based recommendations for assessment of women's sexual pain disorders are reviewed. An evidence-based approach to management of these disorders is provided. Continued efforts are warranted to conduct research and scientific reporting on the optimal assessment and management of women's sexual pain disorders, including multidisciplinary approaches.

  4. CBCT analysis of bony changes associated with temporomandibular disorders.

    Science.gov (United States)

    Talaat, Wael; Al Bayatti, Saad; Al Kawas, Sausan

    2016-03-01

    The aim of the present study was to compare cone-beam computerized tomography (CBCT) findings and joint space measurement in temporomandibular disorder (TMD) and non-TMD joints, and to correlate these findings with the clinical diagnosis. The study was conducted on patients diagnosed with temporomandibular joint (TMJ) osteoarthritis or closed lock according to the Research Diagnostic Criteria for TMDs (Group IIb, IIc, and III). CBCT and clinical records of non-TMD patients who sought treatment for purposes other than TMD were used retrospectively as a control. The following radiographic criteria were assessed: flattening, osteophyte, Ely's cyst, condylar surface irregularities, and joints' space measurements. Osteoarthritic joints had significantly more condylar irregularities (P50.0), osteophytes (P50.0), and condylar flattening (P50.003) than non-TMD joints. Osteoarthritic joints had significantlymore superior surface irregularities (P50.0) and osteophytes (P50.006) than closed lock joints.Non-TMDjoints had significantlymore joint space (5.64+1.88) compared with osteoarthritic joints (4.57+1.97), (P50.025). The correlation among TMD, osteophytes, and flattening of the condylar surface was statistically significant (r50.331, Pv0.000). Cone-beam computerized tomography findings are significantly associated with the clinical diagnosis of TMD. Osteophytes and flattening of the condylar surface are common features of TMD.

  5. Motion Artifact in the MR imaging of temporomandibular disorders

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    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)

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

    Science.gov (United States)

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

    2014-01-01

    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. PMID:24976743

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

    Science.gov (United States)

    Calixtre, Letícia Bojikian; Grüninger, Bruno Leonardo da Silva; Chaves, Thais Cristina; Oliveira, Ana Beatriz de

    2014-01-01

    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. 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. 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). 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.

  8. 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.

  9. Quality of life and general health in patients with temporomandibular disorders

    National Research Council Canada - National Science Library

    Resende, Camila Maria Bastos Machado de; Alves, Arthur César de Medeiros; Coelho, Lidiane Thomaz; Alchieri, Joõo Carlos; Roncalli, Angelo Giuseppe; Barbosa, Gustavo Augusto Seabra

    2013-01-01

    .... Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD...

  10. Dysfunctional Patients with Temporomandibular Disorders: Evaluating the Efficacy of a Tailored Treatment Protocol.

    Science.gov (United States)

    Turk, Dennis C.; And Others

    1996-01-01

    Forty-eight dysfunctional patients with temporomandibular disorders (TMD) were randomly assigned to treatments consisting of an intraoral appliance, stress management, and either nondirective supportive counseling or cognitive therapy. Results support tailored treatment of dysfunctional TMD. (KW)

  11. Association between condylar asymmetry and temporomandibular disorders using 3D-CT

    National Research Council Canada - National Science Library

    Yáñez-Vico, Rosa-María; Iglesias-Linares, Alejandro; Torres-Lagares, Daniel; Gutiérrez-Pérez, José-Luis; Solano-Reina, Enrique

    2012-01-01

    Using reconstructed three-dimensional computed tomography (3D-CT) models, the purpose of this study was to analyze and compare mandibular condyle morphology in patients with and without temporomandibular disorder (TMD...

  12. Electronic Health Record for Temporomandibular Joint Disorders – Support in Therapeutic Process

    Czech Academy of Sciences Publication Activity Database

    Hippmann, R.; Nagy, Miroslav; Dostálová, T.; Zvárová, Jana; Seydlová, M.; Feltlová, E.

    2010-01-01

    Roč. 6, č. 1 (2010), s. 27-32 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * automatic speech recognition * dental cross * temporomandibular joint * temporomandibular joint disorders * structured data entry * dentistry * data model * text-to-speech system * Research Diagnostic Criteria for TMD Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/en/ejbi/article/25-en-electronic-health-record-for-temporomandibular-joint-disorders-support-in-therapeutic-process.html

  13. Differential diagnostics of different nosological forms of the temporomandibular joint pain dysfunction syndrome

    Directory of Open Access Journals (Sweden)

    Kameneva L.A.

    2014-09-01

    Full Text Available Research objective: to carry out differential diagnostics of various nosological forms of a temporal and temporomandibular joint pain dysfunction syndrome. Material and methods. On clinical base of orthopedic odontology chair of SamSMU inspection of 244 patients with temporomandibular joint pain dysfunction syndrome was performed. Diagnostics was carried out according to the special card of inspection which was developed on orthopedic odontology chair of SamSMU and included subjective, objective and special methods of research. As a result of research it is taped: 71 — an occlusal-articulation dysfunctional syndrome, 44 — a neuromuscular dysfunctional syndrome, 76 patients have a hardly set dislocation of intra joint disk and 53 — a habitual dislocation and a subluxation of a temporomandibular joint. We used Yu.A. Petrosov's classification as it displays most precisely the processes happening at pathology of the intra joint relations. Conclusion: On the basis of the obtained data the table of differential diagnostics of various nosological forms of temporomandibular joint pain dysfunction syndrome has been made.

  14. Nonsurgical Management of Pediatric Temporomandibular Joint Dysfunction.

    Science.gov (United States)

    Scrivani, Steven John; Khawaja, Shehryar Nasir; Bavia, Paula Furlan

    2018-02-01

    Temporomandibular disorders (TMD) are a subgroup of craniofacial pain problems involving the temporomandibular joint (TMJ), masticatory muscles, and associated head and neck musculoskeletal structures. These disorders are subclassified into TMJ articular disorders and masticatory muscle disorders. Patients with TMD most commonly present with pain, restricted or asymmetric mandibular motion, and TMJ sounds during mandibular movements. The prevalence tends to increase with age. Management of TMJ articular disorders consists of a combination of patient education, home-care plan, biobehavioral therapy, physical therapy, orthotic jaw appliance therapy, pharmacotherapy, and/or surgery. The goal is to increase function, reduce pain, and improve quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Cervical spine dysfunction signs and symptoms in individuals with temporomandibular disorder.

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    Weber, Priscila; Corrêa, Eliane Castilhos Rodrigues; Ferreira, Fabiana dos Santos; Soares, Juliana Corrêa; Bolzan, Geovana de Paula; Silva, Ana Maria Toniolo da

    2012-01-01

    To study the frequency of cervical spine dysfunction (CCD) signs and symptoms in subjects with and without temporomandibular disorder (TMD) and to assess the craniocervical posture influence on TMD and CCD coexistence. Participants were 71 women (19 to 35 years), assessed about TMD presence; 34 constituted the TMD group (G1) and 37 comprised the group without TMD (G2). The CCD was evaluated through the Craniocervical Dysfunction Index and the Cervical Mobility Index. Subjects were also questioned about cervical pain. Craniocervical posture was assessed by cephalometric analysis. There was no difference in the craniocervical posture between groups. G2 presented more mild CCD frequency and less moderate and severe CCD frequency (p=0.01). G1 presented higher percentage of pain during movements (p=0.03) and pain during cervical muscles palpation (p=0.01) compared to G2. Most of the TMD patients (88.24%) related cervical pain with significant difference when compared to G2 (p=0.00). Craniocervical posture assessment showed no difference between groups, suggesting that postural alterations could be more related to the CCD. Presence of TMD resulted in higher frequency of cervical pain symptom. Thus the coexistence of CCD and TMD signs and symptoms appear to be more related to the common innervations of the trigeminocervical complex and hyperalgesia of the TMD patients than to craniocervical posture deviations.

  16. 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.

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    Brandão Filho, Rivail Almeida; Baptista, Abrahão Fontes; Brandão, Renata de Assis Fonseca Santos; Meneses, Francisco Monteiro; Okeson, Jeffrey; de Sena, Eduardo Pondé

    2015-09-17

    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 brain stimulation technique that allows the modulation of neuronal membranes. This therapy can enhance or inhibit action potential generation in cortical neurons. In some instances, medications acting in the central nervous system may be helpful despite their adverse side effects. It is important to determine if cathodal transcranial direct current stimulation over the dorsolateral prefrontal cortex, an area that modulates emotion and motor cortex excitability, has an analgesic effect on chronic temporomandibular disorders pain. The investigators will run a randomized, controlled crossover double blind study with 15 chronic muscular temporomandibular disorder subjects. Each subject will undergo active (1 mA and 2 mA) and sham transcranial direct current stimulation. Inclusion criteria will be determined by the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire, with subjects who have a pain visual analogic scale score of greater than 4/10 and whose pain has been present for the previous 6 months, and with a State-Trait Anxiety Inventory score of more than 42. The influence of transcranial direct current stimulation will be assessed through a visual analogic scale, quantitative sensory testing, quantitative electroencephalogram, and the State-Trait Anxiety Inventory score. Some studies have demonstrated a strong association between anxiety/depression and chronic pain, where one may be the cause of the other. This is especially true in chronic temporomandibular

  17. Prevalence of Temporomandibular Disorders in an Adult Brazilian Community Population Using the Research Diagnostic Criteria (Axes I and II) for Temporomandibular Disorders (The Maringá Study).

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    Progiante, Patrícia Saram; Pattussi, Marcos Pascoal; Lawrence, Herenia P; Goya, Suzana; Grossi, Patrícia Krieger; Grossi, Márcio Lima

    2015-01-01

    The primary objective of this study was to assess the prevalence of temporomandibular disorders (TMDs) and comorbid factors (sleep bruxism and headaches). This study was a cross-sectional population survey in the city of Maringá, state of Paraná, Brazil. Axes I and II of the Research Diagnostic Criteria for TMD (RDC/TMD) were used for assessment of TMD signs and symptoms. The population was users of the Brazilian public health system (SUS), of both sexes, between the ages of 20 and 65 years, and not seeking treatment for TMD. The selected population (N = 1,643) was composed mostly of (a) women (65.9%), (b) married or single individuals (90.6%), (c) Caucasians (70.1%), (d) individuals aged 32.7 ± 10.3 years, (e) individuals earning a medium income (75.1%), and (f) those who had completed a high school education or higher (79.9%). According to the chronic pain grade classification (CPG) in the RDC/TMD Axis II, 36.2% of the population had some degree of TMD pain (CPG I to IV); however, only 5.1% had severe limitation due to pain (CPG III or IV). In the RDC/TMD Axis I diagnoses, 29.5% presented with muscle disorders (group I), 7.9% with disk displacements (group II), and 39.1% with other joint disorders (group III). Headaches were present in 67.9% and awake and sleep bruxism in 30% and 33.4% of the population, respectively. The prevalence of signs and symptoms of TMD was high in this population, but with low disability; however, the proportion of patients in need of treatment was much lower.

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

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    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 (pmasticatory function.

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

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    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.

  20. The severity of temporomandibular joint disorder by teeth loss in the elderly

    Directory of Open Access Journals (Sweden)

    Indry Herdiyani

    2011-07-01

    Full Text Available Temporomandibular joint dysfunction is a term that covers a number of clinical problems that involves masticatory muscles, temporomandibular joints, and related structures, or both. Loss of tooth was an etiology of temporomandibular joint dysfunction. The purpose of this study was to obtain the description of temporomandibular joint dysfunction level that caused by tooth loss of elderly in three nursing home Bandung. This was a descriptive study using the survey method of the elderly in three nursing home Bandung. A total of 34 people consist 6 males and 28 females. The subjects were examined by symptoms of temporomandibular joint dysfunction and the dysfunction level was assessed by Helkimo Clinical Dysfunction Index. The result of this study shows that elderly in Nursing Home Bandung have mild dysfunction level was 7 (14.71%, moderate dysfunction level was 22 (64.71%, and severe dysfunction level is 5 (20.58%. It can be concluded that loss of the teeth is one of the etiologies of temporomandibular joint disorder. Based on the research conducted, it can be concluded that all elderly with teeth loss will have the temporomandibular joint disorder and the most severity happens based on teeth loss by using the Helkimo Clinical Disfunction Index score was the moderate disorder.

  1. Resilient appliance therapy of temporomandibular disorders. Subdiagnoses, sense of coherence and treatment outcome.

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    Nilsson, Håkan

    2010-01-01

    Temporomandibular disorders (TMD) with orofacial pain with or without reduced jaw function, are frequent conditions in the general population. Different factors such as tooth clenching and grinding, sometimes due to enhanced psychosocial stress, and trauma to the jaws may be important as etiologic factors. Signs and symptoms of TMD are a common cause for general practitioners to use different intraoral appliances as pain and bite-force reducing devices and for improvement of a reduced jaw function. Intraoral appliances are often used parallel to other treatment modalities. Before treatment start a thorough history taking and clinical examination is necessary for a relevant diagnosis. Sometimes the diagnostic process has to be complemented with proper radiographic imaging in order to support the diagnostic process. The overall aim of this thesis was to compare magnetic resonance imaging (MRI) findings of the TMJ on the clinically assessed diagnoses and to evaluate short- and long-term treatment outcome of a resilient intraoral appliance, in patients with TMD pain. A further aim was to study Sense of Coherence as an influencing factor on treatment outcome, on these patients. In article I the aim was to compare findings on MRI in TMD pain patients with clinical diagnoses of myofascial pain or arthralgia/osteoarthritis in combination with myofascial pain according to the Research Diagnostic Criteria for TMD (RDC/TMD). The temporomandibular joints of 60 consecutive patients, 19 with myofascial pain and 41 patients with arthralgia/osteoarthritis in combination with myofascial pain were examined clinically and with MRI. The most common MRI findings were disc displacements with or without reduction and structural bone changes. These findings were found in both pain groups, however, disc displacements were found significantly more often in patients with arthralgia/osteoarthritis in combination with myofascial pain. Joint fluid was found in both pain groups. The clinical