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Sample records for temporomandibular disorders tmd

  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. 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 ≥...... comprehensive instruments augment short and simple screening instruments for Axis I and Axis II. These validated instruments allow for identification of patients with a range of simple to complex TMD presentations....

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

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    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

  4. Management of pain in patients with temporomandibular disorder (TMD: challenges and solutions

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    Gil-Martínez A

    2018-03-01

    Full Text Available Alfonso Gil-Martínez,1–3 Alba Paris-Alemany,1–4 Ibai López-de-Uralde-Villanueva,1–3 Roy La Touche1–4 1Department of Physiotherapy, 2Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 3Hospital La Paz Institute for Health Research, IdiPAZ, 4Institute of Neuroscience and Craniofacial Pain (INDCRAN, Madrid, Spain Abstract: Thanks to advances in neuroscience, biopsychosocial models for diagnostics and treatment (including physical, psychological, and pharmacological therapies currently have more clinical support and scientific growth. At present, a conservative treatment approach prevails over surgery, given it is less aggressive and usually results in satisfactory clinical outcomes in mild–moderate temporomandibular disorder (TMD. The aim of this review is to evaluate the recent evidence, identify challenges, and propose solutions from a clinical point of view for patients with craniofacial pain and TMD. The treatment we propose is structured in a multimodal approach based on a biobehavioral approach that includes medical, physiotherapeutic, psychological, and dental treatments. We also propose a new biobehavioral model regarding pain perception and motor behavior for the diagnosis and treatment of patients with painful TMD. Keywords: biobehavioral, review, temporomandibular disorders, biobehavioral orofacial pain, multimodal approach, motor behavior, disability

  5. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group

    NARCIS (Netherlands)

    Schiffman, E.; Ohrbach, R.; Truelove, E.; Look, J.; Anderson, G.; Goulet, J.P.; List, T.; Svensson, P.; Gonzalez, Y.; Lobbezoo, F.; Michelotti, A.; Brooks, S.L.; Ceusters, W.; Drangsholt, M.; Ettlin, D.; Gaul, C.; Goldberg, L.J.; Haythornthwaite, J.A.; Hollender, L.; Jensen, R.; John, M.T.; De Laat, A.; de Leeuw, R.; Maixner, W.; van der Meulen, M.; Murray, G.M.; Nixdorf, D.R.; Palla, S.; Petersson, A.; Pionchon, P.; Smith, B.; Visscher, C.M.; Zakrzewska, J.; Dworkin, S.F.

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥

  6. 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)....

  7. Temporomandibular disorders in headache patients

    Science.gov (United States)

    Mello, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Siqueira Quintans, Jullyana-de Souza; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues

    2012-01-01

    Objective: To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its seve-rity in individuals with headache. Study Design: 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic questionnaire. The severity of TMD was defined by the temporomandibular index (TMI). Results: The TMD signs and symptoms were always more frequent in individuals with headache, especially report of pain in TMJ area (CDH, n=16; EH, n=12; WH, n=6), pain to palpation on masseter (CDH, n=19; EH, n=16; WH, n=11) which are significantly more frequent in episodic and chronic daily headache. The mean values of temporomandibular and articular index (CDH patients) and muscular index (CDH and EH patients) were statistically higher than in patients of the control group, notably the articular (CDH=0.38; EH=0.25;WH=0.19) and muscular (CDH=0.46; EH=0.51; WH=0.26) indices. Conclusions: These findings allow us to speculate that masticatory and TMJ pain are more common in headache subjects. Besides, it seems that the TMD is more severe in headache patients. Key words:Temporomandibular dysfunction, headache disorders. PMID:22926473

  8. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

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    Magee, David

    2012-01-01

    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, 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. PMID:24422022

  9. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

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    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.

  10. 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

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

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    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.

  12. Temporomandibular Disorders and Headache.

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    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.

  13. 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

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

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    Raquel Stumpf Branco

    2008-04-01

    Full Text Available INTRODUÇÃO: as disfunções temporomandibulares (DTM podem ser definidas como um conjunto de condições dolorosas e/ou disfuncionais, que envolvem os músculos da mastigação e/ou as articulações temporomandibulares (ATM. Um dos meios usados para o diagnóstico é o "Critério Diagnóstico para Pesquisa em Disfunções Temporomandibulares" (RDC/TMD. Hábitos parafuncionais são aqueles não relacionados à execução das funções normais do sistema estomatognático. O bruxismo é caracterizado por atividade parafuncional noturna involuntária dos músculos mastigatórios, enquanto o apertamento dentário é considerado uma parafunção diurna envolvendo esta musculatura, embora possa ocorrer também à noite. OBJETIVOS: o objetivo do presente estudo foi avaliar a freqüência do relato de parafunções orais diurna e/ou noturna em pacientes com DTM nos diferentes subgrupos diagnósticos do RDC/TMD. METODOLOGIA: foram utilizados dados provenientes de 217 pacientes que procuraram tratamento na Clínica de DTM e Dor Orofacial da Faculdade de Medicina de Petrópolis, sendo avaliados através do questionário e exame físico que compõem o RDC/TMD. RESULTADOS: dos 182 pacientes com DTM estudados, 76,9% relataram algum tipo de parafunção, podendo ser diurna, noturna ou a associação de ambas. A parafunção diurna foi a mais freqüentemente relatada entre os subgrupos de DTM, sendo encontrada em 64,8% dos casos contra 55,5% dos casos com relato de bruxismo. O relato de ambas as parafunções foi constatado em 43,4% dos pacientes com DTM. CONCLUSÕES: considerando cada subgrupo diagnóstico, os relatos de parafunções diurna e noturna foram mais freqüentes nos pacientes com dor miofascial.INTRODUCTION: temporomandibular disorders (TMD can be defined as a group of painful and/or dysfunctional conditions that involve masticatory muscles and/or the temporomandibular joints (TMJ. One of the methods used to the diagnostic is the "Research

  15. Orofacial myofunctional disorder in subjects with temporomandibular disorder.

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    Ferreira, Cláudia Lúcia Pimenta; Da Silva, Marco Antônio M Rodrigues; de Felício, Cláudia Maria

    2009-10-01

    To determine the frequency and degree of orofacial myofunctional disorder (OMD) in a sample of patients with temporomandibular disorder (TMD), the dental records of 240 patients with a diagnosis of TMD were reviewed. Mean patient age and mean TMD duration, gender frequency, complaints, and signs and symptoms were calculated. The results showed that the sample studied was quite characteristic of a TMD group. The presence of the following signs/symptoms was significant: muscular pain, TMJ pain, joint noise, at least one otologic symptom, headache, and neck and shoulder pain. Most subjects presented some degree of OMD, with grade high prevailing over grade low. The importance of evaluating the stomatognathic structures and functions during the clinical examination of patients with TMD is emphasized.

  16. Association between headache and temporomandibular disorder.

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    Abouelhuda, Amira Mokhtar; Kim, Hyun-Seok; Kim, Sang-Yun; Kim, Young-Kyun

    2017-12-01

    Headaches are one of the most common conditions associated with temporomandibular disorder (TMD). In the present paper, we evaluated the relationship between headache and TMD, determined whether headache influences the symptoms of TMD, and reported two cases of TMD accompanied by headache. Our practical experience and a review of the literature suggested that headache increases the frequency and intensity of pain parameters, thus complicating dysfunctional diseases in both diagnostic and treatment phases. Therefore, early and multidisciplinary treatment of TMD is necessary to avoid the overlap of painful events that could result in pain chronicity.

  17. 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.

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

    OpenAIRE

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

    2009-01-01

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

  19. 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

  20. 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

    2012-07-01

    We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD). 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. 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 headache that is changed with jaw movement, function or parafunction and (2) provocation of that headache by temporalis muscle palpation or jaw movement. Having significantly better specificity than the ICHD-II criteria A to C, the revised criteria are recommended to diagnose headache secondary to TMD.

  1. Evaluation relationship between temporomandibular joint disorder and headache: A review literature

    OpenAIRE

    Farzaneh Aghahosseini; Nafiseh Sheykhbahaei

    2017-01-01

    Background and Aims: Headache is among the most common complaints in patients suffering from temporomandibular joint disorders (TMD). Thus, it seems that evaluation of patients with headache in terms of temporomandibular joint (TMJ) disorders is necessary. In people with TMD, parafunctional activities play an important etiologic role. Considering the high prevalence of bruxism and TMDs in patients with headache, assessment the accuracy and severity of this association can play a key role in d...

  2. Gnathological splint therapy in temporomandibular joint disorder

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    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

  3. The Relationship between Osseous Changes of the Temporomandibular Joint and RDC/TMD Groups in CBCT Images

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    Mahrokh Imanimoghaddam

    2014-09-01

    Full Text Available Abstract Introduction: Temporomandibular joint disorders (TMD are the most common disorders of the jaw, and despite their clinical importance, they are not completely understood. This study was aimed to evaluate the changes of temporomandibular joint (TMJ on cone beam computed tomography (CBCT images in disc displacement vs. osteoarthritis of the TMJ. Methods: In this study, 45 patients, including 37 women and 8 men (13-89 years of age, were examined. The patients were selected based on RDC/TMD criteria and group I disorders were excluded from the study. Accordingly, group II consisted of 43 joints with jaw clicking or displaced discs, and group III comprised 46 joints with crepitus. CBCT images in sagittal, coronal, and axial sections were examined to assess osseous changes in terms of flattening, sclerosis, erosion, resorption, and osteophyte formation. Data were analyzed using statistical tests including the chi-square, Mann-Whitney, and Kolmogorov-Smirnov tests with the confidence interval of 95%. Results: Mann-Whitney test for the comparison of mean age between groups II and III was not statistically significant (p value=0.06. A significant differences was found between two (RDC/TMD groups according to the prevalence of condylar erosion, resorption, and osteophyte (p

  4. 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.

  5. Temporomandibular disorder in chronic migraine

    Directory of Open Access Journals (Sweden)

    N. V. Latysheva

    2017-01-01

    Full Text Available Rationale: For many years, temporomandibular disorder (TMD has been studied primarily by dentists and maxillofacial surgeons. However, new data is emerging that TMD is comorbid with various types of headache; however this association has not been studied in detail. Aim: To analyze TMD prevalence and clinical structure in patients with migraine. Materials and methods: We assessed 84 patients with chronic migraine (CM and 42 patients with episodic migraine (EM. TMD was diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders: Clinical Protocol and Assessment Instruments 2014. We also performed subgroup analysis for low-frequency EM (less than 4 headache days per month, LFEM vs. high-frequency EM and CM (over 10 headache days per month, HFEM + CM. Results: In both groups, myofascial pain was the most prevalent form of TMD. The prevalence of TMD was higher in CM as compared to EM (52.4% vs. 28.6%, correspondingly, р = 0.02. Even more evident differences were observed between LFEM and HFEM + CM (18.2% vs. 51.6%, correspondingly, р < 0.009. The difference was significant for painrelated TMD only. The prevalence of bruxism was comparable across LFEM and HFEM + CM (18% vs. 30.5%, correspondingly, р = 0.3 and significantly lower than TMD prevalence in HFEM + CM (30.5% vs. 51.6%, correspondingly, p = 0.005. The anxiety level in patients with and without TMD was also comparable (8.1 ± 4.1 vs. 8.3 ± 4.7, correspondingly, р = 0.8. Conclusion: CM patients have a high prevalence of pain-related TMD (52.4%. The prevalence of TMD in LFEM is comparable to that in the general population. The presence of bruxism or anxiety cannot be associated with a high TMD prevalence in our patients. In CM, pain in the masticatory muscles may be caused by anti-nociceptive dysfunction, mirroring central sensitization and disrupted descending modulation of pain.

  6. Temporomandibular disorders dysfunction in headache patients.

    Science.gov (United States)

    Melo, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Quintans, Jullyana-de Souza Siqueira; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2012-11-01

    To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its severity in individuals with headache. 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic questionnaire. The severity of TMD was defined by the temporomandibular index (TMI). The TMD signs and symptoms were always more frequent in individuals with headache, especially report of pain in TMJ area (CDH, n=16; EH, n=12; WH, n=6), pain to palpation on masseter (CDH, n=19; EH, n=16; WH, n=11) which are significantly more frequent in episodic and chronic daily headache. The mean values of temporomandibular and articular index (CDH patients) and muscular index (CDH and EH patients) were statistically higher than in patients of the control group, notably the articular (CDH=0.38; EH=0.25;WH=0.19) and muscular (CDH=0.46; EH=0.51; WH=0.26) indices. These findings allow us to speculate that masticatory and TMJ pain are more common in headache subjects. Besides, it seems that the TMD is more severe in headache patients.

  7. The cost-effectiveness of TheraBite® as treatment for acute myogenic temporomandibular disorder

    NARCIS (Netherlands)

    Heres Diddens, A.; Kraaijenga, S.; Coupe, V.; Hilgers, F.; van der Molen, L.; Smeele, L.; Retèl, V.P.

    2017-01-01

    Objective: Temporomandibular disorder (TMD) is a very common and costly pain problem concerning the temporomandibular joint. A previous study has shown that for the treatment of acute myogenic TMD, TheraBite® (TB) offers a faster and greater effect than usual care consisting of physical therapy

  8. Temporomandibular disorders in headache patients

    OpenAIRE

    Mello, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Siqueira Quintans, Jullyana-de Souza; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2012-01-01

    Objective: To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its seve-rity in individuals with headache. Study Design: 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic quest...

  9. 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.

  10. Efficacy of splint therapy for the management of temporomandibular disorders: a meta-analysis

    OpenAIRE

    Zhang, Chao; Wu, Jun-Yi; Deng, Dong-Lai; He, Bing-Yang; Tao, Yuan; Niu, Yu-Ming; Deng, Mo-Hong

    2016-01-01

    Temporomandibular disorders (TMD) are a group of clinical problems affecting temporomandibular joint (TMJ), myofascial muscles and other related structures. Splint therapy is the most commonly used approach to treatment of TMD, but its effectiveness is remains unclear. We therefore conducted a meta-analysis to evaluate the effectiveness of splint therapy for TMD in adults. The electronic databases PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov were searched for reports published up ...

  11. 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.

  12. 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 ...

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

    Directory of Open Access Journals (Sweden)

    B. Seraj

    2009-03-01

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

  14. Headache attributed to temporomandibular disorders and masticatory myofascial pain.

    Science.gov (United States)

    Hara, Kazuhiko; Shinozaki, Takahiro; Okada-Ogawa, Akiko; Matsukawa, Yumiko; Dezawa, Ko; Nakaya, Yuka; Chen, Jui-Yen; Noma, Noboru; Oka, Shunichi; Iwata, Koichi; Imamura, Yoshiki

    2016-01-01

    We investigated the temporal association between temporomandibular disorders (TMD)-related symptoms and headache during TMD treatment for patients who fulfilled the diagnostic criteria for headache attributed to TMD (HATMD) specified in the Diagnostic criteria for TMD (DC/TMD) and International classification of headache disorders (ICHD)-3 beta. The study enrolled 34 patients with HATMD induced by masticatory myofascial pain but not by temporomandibular arthralgia. Facial pain intensity, the pressure pain threshold of pericranial muscles, and maximum unassisted opening of the jaw were assessed at an initial examination and before and after physical therapy. The intensity and frequency of headache episodes and tooth contact ratio were also recorded before and after the intervention. Headache intensity and frequency significantly decreased, and these reductions were temporally related to improvements in facial pain intensity, maximum unassisted opening, and pressure pain threshold during TMD treatment. Linear regression analysis showed significant correlations between facial pain intensity and headache intensity and between tooth contact ratio and pressure pain threshold. Among patients who fulfilled the DC/TMD and ICHD-3 beta diagnostic criteria for HATMD, headache improved during TMD treatment, and the improvement was temporally related to amelioration of TMD symptoms. These findings suggest that sensitization in the central and peripheral nervous systems is responsible for HATMD. (J Oral Sci 58, 195-204, 2016).

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

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    Giovana Fernandes

    2014-01-01

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

  16. 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.

  17. Mandibular function, temporomandibular disorders, and headache in prematurely born children.

    Science.gov (United States)

    Paulsson, Liselotte; Ekberg, Ewacarin; Nilner, Maria; Bondemark, Lars

    2009-01-01

    To evaluate mandibular function, signs, and symptoms of temporomandibular disorders (TMDs) and headache in prematurely born 8- to 10-year-old children, and to compare the findings with matched full-term born controls. Seventy-three preterm children were selected from the Medical Birth Register--one group comprising 36 extremely preterm children born before the 29th gestational week, the other group 37 very preterm children born during gestational weeks 29 to 32. The preterm children were compared with a control group of 41 full-term children matched for gender, age, nationality, and living area. The subjective symptoms of TMD and headache were registered using a questionnaire. Mandibular function, signs, and symptoms of TMD and headache were registered. TMD diagnoses were set per Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD). No significant differences between groups or gender were found for TMD diagnoses according to RDC/TMD or for headache. The preterm children had smaller mandibular movement capacity than the full-term control group, but when adjusting for weight, height, and head circumference mostly all group differences disappeared. Prematurely born children of 8 to 10 years of age did not differ from full-term born children when considering diagnoses according to RDC/TMD, signs, and symptoms of TMD or headache.

  18. The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders.

    Science.gov (United States)

    Friedman, M H; Weisberg, J

    2000-07-01

    Because the concept of whiplash as a causative factor for temporomandibular disorders (TMD) is highly controversial, we decided to do a retrospective analysis of patients treated in our office who had sustained whiplash injuries and were treated for cervical and temporomandibular disorders. The records of 300 patients with TMD preceded by a motor vehicle accident were examined retrospectively. The most common presenting symptoms, in order, were: jaw pain, neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical examination, we concluded that the TMJ and surrounding musculature should be examined similarly to other joints, with no preconceived notion that TMD pathology after whiplash is unlikely.

  19. Identification of psychological comorbidity in TMD-patients.

    Science.gov (United States)

    Ismail, F; Eisenburger, M; Lange, K; Schneller, T; Schwabe, L; Strempel, J; Stiesch, M

    2016-05-01

    The aim of the current study was to access the prevalence of depression among patients with Temporomandibular Joint Disorder (TMD) compared to patients with no current TMD. Patients (92) and controls (90) answered questionnaires on subjective pain, severity of chronic pain, jaw disability, emotional well-being and depression, and a clinical examination was performed. Temporomandibular Joint Disorder patients reported higher disability of jaw function, compared to controls (p0.05). While 51% of TMD patients reported poor emotional well-being, only 7.8% of controls were affected (ppatients and not in the controls (ppatients, a higher prevalence of depression was observed in the myopathy subgroup. A regular screening for psychological problems, using standardized questionnaires, should be integrated in clinical examination of TMD patients.

  20. Temporomandibular disorders – validity of clinical diagnostics compared to magnetic resonance imaging

    OpenAIRE

    BADEL, TOMISLAV; MAROTTI, MILJENKO; SAVIĆ PAVIČIN, IVANA; DULČIĆ, NIKŠA; ZADRAVEC, DIJANA; KERN, JOSIPA

    2011-01-01

    Background and Purpose: Orthopedic examination techniques of the musculoskeletal system contribute to the successful diagnostics of temporomandibular disorders (TMD). The purpose of this study is to determine the validity of TMD clinical diagnostics by comparing the findings of manual functional analysis (MFA) and the results of MRI of temporomandibular joint (TMJ). The diagnostic significance of limited mouth opening and pain upon passive mouth opening were taken into consideration. M...

  1. 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%) (pheadaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ 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.

  2. Temporomandibular disorders after whiplash injury

    DEFF Research Database (Denmark)

    Kasch, Helge; Hjorth, Tine; Svensson, Peter

    2002-01-01

    Aims: Whiplash injury to the neck, is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies however have examined TMD-related pain in acute whiplash...... patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Methods: Prospectively, 19 acute whiplash patients exposed...... obtained at each visit. Results: One whiplash patient and I ankle-injury patient bad jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ...

  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

    2009-01-01

    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

  4. 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

  5. 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.

  6. Prevalence of temporomandibular disorders in patients with Hashimoto thyroiditis.

    Science.gov (United States)

    Grozdinska, Alina; Hofmann, Elisabeth; Schmid, Matthias; Hirschfelder, Ursula

    2018-05-17

    Autoimmune thyroid disease (AITD), also known as Hashimoto thyroiditis (HT), is a degenerative inflammatory disease with high prevalence among women and has been associated with fibromyalgia and widespread chronic pain. The goal was to determine the frequency of temporomandibular disorders (TMD) in patients with HT. In all, 119 women (age 19-60 years) were divided into a study (52 women diagnosed with HT) and a control (67 healthy individuals, of which 15 were excluded) group. Serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroglobulin (Tg) and anti-thyroid peroxidase (TPO) antibody levels were measured. The temporomandibular jaw and muscles were examined using the German Society of Functional Diagnostics and Therapy guidelines. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used to assess TMD. Standardized questionnaires, incorporating epidemiological criteria, state and treatment of the thyroid disease, Helkimo Index (HI), and Fonseca Anamnestic Index (FAI), were filled out by all patients. The two groups did not differ in terms of demographic parameters or mandibular jaw mobility. Significantly higher levels of anti-TPO and anti-Tg were attested in all subjects of the HT group. Markedly elevated prevalence of TMD was found in the HT group. Muscle pain and stiffness were found in 45 (86.5%) subjects of the HT group (p < 0.001), of whom 33 (63.4%) also had disc displacement with reposition (p < 0.001). Whereas 50% of the control group showed no TMD symptoms, all subjects in the HT group had symptoms. A significantly elevated prevalence of TMD was found in patients with HT. Thus, patients with TMD who do not respond to therapy should be referred for thyroid diagnostic workup.

  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. Gnathological splint therapy in temporomandibular joint disorder

    OpenAIRE

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

    2015-01-01

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

  9. Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents.

    Directory of Open Access Journals (Sweden)

    Fernanda Mara de Paiva Bertoli

    Full Text Available The prevalence of signs and symptoms of temporomandibular disorders (TMD increases during adolescence and adulthood. Few studies have examined TMD prevalence in Brazilian adolescents.To investigate the prevalence of TMD in Brazilian adolescents.A representative population-based sample of 934 adolescents (10-14-years-old was examined. TMD screening was performed using a questionnaire by the American Academy of Orofacial Pain. TMD diagnoses used research diagnostic criteria for temporomandibular disorders (RDC/TMD-Axis-I. Examinations were performed by a single calibrated examiner (kappa > 0.80.The prevalence of TMD symptoms was 34.9%; the most frequently reported symptoms were headache and neck ache (20.9%, followed by joint sounds (18.5%. Myofascial pain was the most prevalent type (10.3%, followed by disc displacement with reduction (8.0% and arthralgia (3.5%. There was a significant association between sex and TMD symptoms; prevalence was significantly higher in girls (RP = 1.37; 95% CI = 1.14-1.65; p = 0.001. Myofascial pain of TMD and displacement with reduction were more prevalent in girls (RP = 1.76; p = 0.007 and RP = 2.06; p = 0.004, respectively.TMD symptoms were present in 34.9% of adolescents, with myofascial pain being the most prevalent type (10.3%. TMD was significantly more common in girls. Routine pediatric dental care should include a TMD screening.

  10. 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.

  11. Development of a reliable and clinically useful Italian version of the Axis II for the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)

    OpenAIRE

    Macrì, Ludovica Antonella; Deli, Velria; Deli, Roberto

    2012-01-01

    Background: Multiple-language versions of the same psychometric instrument are increasingly needed, but simply translating an English version word-to-word into another language is not adequate to account for linguistic and cultural differences. Our aim was to alidate an Italian version of the Axis II of the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) and to test its reproducibility in order to use this important diagnostic instr...

  12. Occlusal Support and Temporomandibular Disorders Among Elderly Vietnamese.

    Science.gov (United States)

    Nguyen, Minh Son; Jagomägi, Triin; Nguyen, Toai; Saag, Mare; Voog-Oras, Ülle

    The aim of this study was to analyze the associations between missing teeth, occlusal support, and temporomandibular disorders (TMD) among elderly Vietnamese. The study consisted of 145 TMD and 112 non-TMD (control group) participants aged 65 to 74 years. TMD was evaluated using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I. An occlusal unit (OU) was defined as the cusp of a tooth coupled with the fossa of its antagonist tooth. A premolar pair was counted as one OU and a molar pair as two OUs. Dentition was divided into four occlusal support zones (OSZs) based on occluding pairs of posterior teeth by using Eichner classification: Class A had 4 OSZs, Class B had 1 to 3 OSZs or only anterior teeth, and Class C had no OSZ. The TMD group lost significantly more posterior teeth (mean ± SD 5.1 ± 4.7) than the control group (4.0 ± 3.9, P = .033). The mean ± SD OUs of the TMD and control groups were 5.1 ± 4.6 and 6.0 ± 4.3, respectively, which was nonsignificant (NS). The distribution of Class A (40.7%), Class B (40.0%), and Class C (19.3%) among the TMD group was not significantly different from the control group (50.0%, 38.4%, and 11.6%, respectively, NS). The odds of having TMD were positively associated with total unilateral loss of OUs (OR = 3.4, 95% CI = 1.2-9.4, P = .020) and total bilateral loss of OUs (OR = 2.7, 95% CI = 1.2-6.6, P = .027). Total loss of OSZs on one or both sides of the mouth were found to be predictors of TMD among elderly Vietnamese.

  13. Craniocervical posture analysis in patients with temporomandibular disorder

    OpenAIRE

    Iunes,DH; Carvalho,LCF; Oliveira,AS; Bevilaqua-Grossi,D

    2009-01-01

    OBJECTIVE: To compare head positioning and cervical spine alignment between individuals with and without temporomandibular disorders (TMDs), by means of positional evaluation using photographs, radiographs and visual observation, and to investigate whether the type of TMD influences head posture and cervical spine positioning. METHODS: Ninety randomly chosen women were diagnosed using the research diagnostic criteria for TMDs (RDC/TMD) by a trained examiner and were divided into three groups:...

  14. Headache associated with temporomandibular disorders among young Brazilian adolescents.

    Science.gov (United States)

    Franco, Ana L; Fernandes, Giovana; Gonçalves, Daniela A G; Bonafé, Fernanda S S; Camparis, Cinara M

    2014-04-01

    To verify whether headaches (HAs) are associated with temporomandibular disorders (TMD) in young Brazilian adolescents. From a population sample, 3117 public school children (12 to 14 y) were randomly invited to participate in this study. TMD was assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I, in addition to questions #3, #4, and #14 of Axis II history questionnaire. HAs were investigated with question #18 of RDC/TMD Axis II. Chronic TMD pain was considered as pain that has persisted for 6 months or more, as proposed by the International Association for the Study of Pain. The statistical analysis consisted of χ tests, odds ratio (OR), and logistic regression models, adopting a significance level of 5%. The sample included 1307 individuals (a response rate of 41.93%), and 56.8% (n=742) were girls. Overall, 330 adolescents (25.2%) were diagnosed with painful TMD and 595 (45.5%) presented with HAs. Individuals presenting with HAs were more likely to present painful TMD (OR=4.94; 95% confidence interval [CI], 3.73-6.54, P<0.001), especially combined muscle and joint painful TMD (OR=7.58; 95% CI, 4.77-12.05, P<0.001). HAs also increased the risk to a higher magnitude for chronic TMD pain (OR=6.12; 95% CI, 4.27-8.78, P<0.0001). All estimated ORs remained essentially unchanged after adjusting for sex. HAs were a potential risk factor for TMD in adolescents, and the risk was particularly higher for painful and chronic TMD. When HAs are present in young adolescents, a complete examination is strongly recommended with regard to the presence of painful TMD, and vice versa.

  15. 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 < 0.001), decreased 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.

  16. Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain.

    Science.gov (United States)

    Anderson, Gary C; John, Mike T; Ohrbach, Richard; Nixdorf, Donald R; Schiffman, Eric L; Truelove, Edmond S; List, Thomas

    2011-04-01

    The relationship of the frequency of temple headache to signs and symptoms of temporomandibular joint (TMJ) disorders (TMD) was investigated in a subset of a larger convenience sample of community TMD cases. The study sample included 86 painful TMD, nonheadache subjects; 309 painful TMD subjects with varied frequency of temple headaches; and 149 subjects without painful TMD or headache for descriptive comparison. Painful TMD included Research Diagnostic Criteria for Temporomandibular Disorders diagnoses of myofascial pain, TMJ arthralgia, and TMJ osteoarthritis. Mild to moderate-intensity temple headaches were classified by frequency using criteria based on the International Classification of Headache Disorder, 2nd edition, classification of tension-type headache. Outcomes included TMD signs and symptoms (pain duration, pain intensity, number of painful masticatory sites on palpation, mandibular range of motion), pressure pain thresholds, and temple headache resulting from masticatory provocation tests. Trend analyses across the painful TMD groups showed a substantial trend for aggravation of all of the TMD signs and symptoms associated with increased frequency of the temple headaches. In addition, increased headache frequency showed significant trends associated with reduced PPTs and reported temple headache with masticatory provocation tests. In conclusion, these findings suggest that these headaches may be TMD related, as well as suggesting a possible role for peripheral and central sensitization in TMD patients. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  17. Headache and symptoms of temporomandibular disorder: an epidemiological study.

    Science.gov (United States)

    Gonçalves, Daniela A G; Bigal, Marcelo E; Jales, Luciana C F; Camparis, Cinara M; Speciali, José G

    2010-02-01

    A population-based cross-sectional study was conducted to estimate the prevalence of migraine, episodic tension-type headaches (ETTH), and chronic daily headaches (CDH), as well as the presence of symptoms of temporomandibular disorders (TMD) in the adult population. The potential comorbidity of headache syndromes and TMD has been established mostly based on clinic-based studies. A representative sample of 1230 inhabitants (51.5% women) was interviewed by a validated phone survey. TMD symptoms were assessed through 5 questions, as recommended by the American Academy of Orofacial Pain, in an attempt to classify possible TMD. Primary headaches were diagnosed based on the International Classification of Headache Disorders. When at least 1 TMD symptom was reported, any headache happened in 56.5% vs 31.9% (P headache as the reference, the prevalence of at least 1 TMD symptom was increased in ETTH (prevalence ratio = 1.48, 95% confidence interval = 1.20-1.79), migraine (2.10, 1.80-2.47) and CDH (2.41, 1.84-3.17). At least 2 TMD symptoms also happened more frequently in migraine (4.4, 3.0-6.3), CDH (3.4; 1.5-7.6), and ETTH (2.1; 1.3-3.2), relative to individuals with no headaches. Finally, 3 or more TMD symptoms were also more common in migraine (6.2; 3.8-10.2) than in no headaches. Differences were significant for ETTH (2.7 1.5-4.8), and were numerically but not significant for CDH (2.3; 0.66-8.04). Temporomandibular disorder symptoms are more common in migraine, ETTH, and CDH relative to individuals without headache. Magnitude of association is higher for migraine. Future studies should clarify the nature of the relationship.

  18. Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD.

    Science.gov (United States)

    Cortés, Daniel; Sylvester, Daniel Cortés; Exss, Eduardo; Marholz, Carlos; Millas, Rodrigo; Moncada, Gustavo

    2011-04-01

    The aim of this study was to determine the frequency and relationship between disk position and degenerative bone changes in the temporomandibular joints (TMJ), in subjects with internal derangement (ID). MRI and CT scans of 180 subjects with temporomandibular disorders (TMD) were studied. Different image parameters or characteristics were observed, such as disk position, joint effusion, condyle movement, degenerative bone changes (flattened, cortical erosions and irregularities), osteophytes, subchondral cysts and idiopathic condyle resorption. The present study concluded that there is a significant association between disk displacement without reduction and degenerative bone changes in patients with TMD. The study also found a high probability of degenerative bone changes when disk displacement without reduction is present. No association was found between TMD and condyle range of motion, joint effusion and/or degenerative bone changes. The following were the most frequent morphological changes observed: flattening of the anterior surface of the condyle; followed by erosions and irregularities of the joint surfaces; flattening of the articular surface of the temporal eminence, subchondral cysts, osteophytes; and idiopathic condyle resorption, in decreasing order.

  19. Cross-cultural adaptation, reliability and construct validity of the Tampa scale for kinesiophobia for temporomandibular disorders (TSK/TMD-Br) into Brazilian Portuguese.

    Science.gov (United States)

    Aguiar, A S; Bataglion, C; Visscher, C M; Bevilaqua Grossi, D; Chaves, T C

    2017-07-01

    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 of movement and it is not available in Brazilian Portuguese. The purpose of this study was to culturally adapt the TSK/TMD to Brazilian Portuguese and to assess its psychometric properties regarding internal consistency, reliability, and construct and structural validity. A total of 100 female patients with chronic TMD participated in the validation process of the TSK/TMD-Br. The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test-retest), Cronbach's alpha for internal consistency, Spearman's rank correlation for construct validity and confirmatory factor analysis (CFA) for structural validity. CFA endorsed the pre-specified model with two domains and 12-items (Activity Avoidance - AA/Somatic Focus - SF) and all items obtained a loading factor greater than 0·4. Acceptable levels of reliability were found (ICC > 0·75) for all questions and domains of the TSK/TMD-Br. For internal consistency, Cronbach's α of 0·78 for both domains were found. Moderate correlations (0·40 Br scores versus catastrophising, depression and jaw functional limitation. TSK/TMD-Br 12 items and two-factor demonstrated sound psychometric properties (transcultural validity, reliability, internal consistency and structural validity). In such a way, the instrument can be used in clinical settings and for research purposes. © 2017 John Wiley & Sons Ltd.

  20. Temporomandibular disorders in adolescents with headache.

    Science.gov (United States)

    Sojka, Anna; Żarowski, Marcin; Steinborn, Barbara; Hedzelek, Wiesław; Wiśniewska-Spychała, Beata; Dorocka-Bobkowska, Barbara

    2018-02-01

    Headache is a common complaint in all age groups and is a frequent cause of medical consultations and hospitalization. The aim of this study was to evaluate the prevalence of bite and non-bite parafunctions as well as the signs and symptoms of temporomandibular disorder (TMD) in adolescents presenting with primary headaches. Parents of adolescents presented with headaches to the Department of Developmental Neurology within a 12-month period were asked to complete a questionnaire developed by the authors of this study. Of the 1000 patients evaluated, 19 females and 21 males, aged 13 to 17 years, met the inclusion criterion - a confirmed clinical diagnosis of migraine or a tension headache according to the International Classification of Headache Disorders, 2nd edition. The diagnostic algorithm of the study group consisted of a full medical history, an assessment of the occurrence of bite habits and a physical examination based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bite and non-bite parafunctions were found in 36 of the study group patients. A significant difference (p = 0.0003) between the number of bite parafunctions and non-bite parafunctions was found in females but not in males. However, bite parafunctions were more frequent in boys compared to girls (p = 0.01). Our findings suggest that it may be useful for pediatricians and neurologists to include TMD dysfunctions as a part of a standard examination of adolescents presenting with persistent headaches.

  1. 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.

  2. The headache of temporomandibular disorders.

    Science.gov (United States)

    Virdee, J

    2018-03-01

    This article endeavours to revise the key guidance and evidence on temporomandibular disorders (TMD), with a particular focus on myofascial pain. It highlights the important role that primary care dental practitioners play in providing holistic care during the patient's journey to manage this painful condition. I hope to give an insight into my own personal experiences to highlight the challenges patients can face in seeking appropriate support.

  3. The Association between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Complaints

    NARCIS (Netherlands)

    van der Meer, Hedwig A.; Speksnijder, Caroline M.; Engelbert, Raoul; Lobbezoo, Frank; Nijhuis – van der Sanden, Maria W G; Visscher, Corine M.

    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. METHODS:: Several subtypes of headaches were

  4. Association between clinical and cone-beam computed tomography findings in patients with temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Mahrokh Imanimoghaddam

    2017-08-01

    Full Text Available BACKGROUND AND AIM: The aim of this study was to assess the association between the clinical and cone-beam computed tomography (CBCT findings in relation to bony changes in patients with temporomandibular disorders (TMD. METHODS: According to the research diagnostic criteria for temporomandibular disorder (RDC/TMD, forty-one patients with type II TMD (42 TM joints and type III TMD (40 TM joints were recruited for this study. Condylar position and bony changes including flattening, sclerosis, osteophytes, resorption, and erosion of joint were evaluated by CBCT and compared with clinical findings. Data were analyzed by SPSS software. RESULTS: Condylar flattening, sclerosis, resorption, and erosion were not significantly associated with joint/masticatory muscles pain or crepitus sound. The vertical or horizontal position of the condyle showed no significant relationship with the clinical findings. Condylar osteophyte was significantly associated with pain in masticatory muscles and crepitus (P = 0.030 and P = 0.010, respectively. There was no association between the condylar range of motion and pain in joint or masticatory muscles. CONCLUSION: Condylar osteophyte was significantly associated with both masticatory muscles pain and crepitus sound. No significant relationship was found between the other temporomandibular joint (TMJ radiographic and clinical findings in patients with TMD.

  5. 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.

  6. 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

  7. Temporomandibular disorders in burning mouth syndrome patients: an observational study.

    Science.gov (United States)

    Corsalini, Massimo; Di Venere, Daniela; Pettini, Francesco; Lauritano, Dorina; Petruzzi, Massimo

    2013-01-01

    Burning Mouth Syndrome (BMS) is a chronic disease characterized by absence of any lesions and burning of the oral mucosa associated to a sensation of dry mouth and/or taste alterations. The purpose of our study is to estimate signs and symptoms of Temporomandibular Disorders (TMD) in patients with BMS and to investigate for the existence of an association between BMS and TMD. Forty-four BMS patients were enrolled; BMS subtype was established according to the classification of Lamey. After a gnathological evaluation, according to the protocol of the European Academy of Craniomandibular Disorders, patients were classified by RDC/TMD criteria. The data were compared and analyzed using a chi-square test to describe the existence of an association between BMS and TMD. 65.9% the BMS patients showed disorders classified as primary signs and symptoms of TMD according to RDC / TMD criteria, and 72.7% showed parafunctional habits. The chi-square test revealed a statistically significant association (p = 0.035) between BMS and TMD. The data suggest that there is a possible relationship not yet well understood between BMS and TMD, may be for neurophatic alterations assumed for BMS that could be also engaged in TMD pathogenesis.

  8. 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

  9. Temporomandibular disorders, sleep bruxism, and primary headaches are mutually associated.

    Science.gov (United States)

    Fernandes, Giovana; Franco, Ana Lúcia; Gonçalves, Daniela Aparecida; Speciali, José Geraldo; Bigal, Marcelo Eduardo; Camparis, Cinara Maria

    2013-01-01

    To investigate the association among temporomandibular disorders (TMD), sleep bruxism, and primary headaches, assessing the risk of occurrence of primary headaches in patients with or without painful TMD and sleep bruxism. The sample consisted of 301 individuals (253 women and 48 men) with ages varying from 18 to 76 years old (average age of 37.5 years). The Research Diagnostic Criteria for Temporomandibular Disorders were used to classify TMD. Sleep bruxism was diagnosed by clinical criteria proposed by the American Academy of Sleep Medicine, and primary headaches were diagnosed according to the International Classification of Headache Disorders-II. Data were analyzed by chi-square and odds ratio tests with a 95% confidence interval, and the significance level adopted was .05. An association was found among painful TMD, migraine, and tension-type headache (P headache (3.7; 1.59-8.75). With regard to sleep bruxism, the association was significant only for chronic migraine (3.8; 1.83-7.84). When the sample was stratified by the presence of sleep bruxism and painful TMD, only the presence of sleep bruxism did not increase the risk for any type of headache. The presence of painful TMD without sleep bruxism significantly increased the risk in particular for chronic migraine (30.1; 3.58-252.81), followed by episodic migraine (3.7; 1.46-9.16). The association between painful TMD and sleep bruxism significantly increased the risk for chronic migraine (87.1; 10.79-702.18), followed by episodic migraine (6.7; 2.79-15.98) and episodic tension-type headache (3.8; 1.38-10.69). The association of sleep bruxism and painful TMD greatly increased the risk for episodic migraine, episodic tension-type headache, and especially for chronic migraine.

  10. 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.

  11. Parapharyngeal space tumors: another consideration for otalgia and temporomandibular disorders.

    Science.gov (United States)

    Grosskopf, Courtney C; Kuperstein, Arthur S; O'Malley, Bert W; Sollecito, Thomas P

    2013-05-01

    Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head and neck neoplasms. PPS tumors are difficult to diagnose due to limited presenting signs and symptoms and because of their location deep within the neck. A 60-year-old woman presented with complaints of otalgia, which appeared to be consistent with a temporomandibular disorder (TMD). Due to disproportionate symptoms, an MRI of the temporomandibular joints was ordered. The MRI revealed a mass within the PPS, which was later diagnosed as a mucoepidermoid carcinoma. A literature search failed to reveal otalgia, and facial pain, thought to be related to a TMD, as the primary presenting symptoms of a PPS neoplasm. Patients presenting with disproportionate signs and symptoms of a TMD should be evaluated with advanced imaging to rule out occult pathology. Copyright © 2012 Wiley Periodicals, Inc.

  12. Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

    Science.gov (United States)

    Algieri, Giuseppe Maria Antonio; Leonardi, Alessandra; Arangio, Paolo; Vellone, Valentino; Paolo, Carlo Di; Cascone, Piero

    2017-04-19

    The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus".

  13. Variability of centric relation position in TMD patients.

    NARCIS (Netherlands)

    Zonnenberg, A.J.J.; Mulder, J.

    2006-01-01

    Reproducibility of the centric relation position for patients with temporomandibular disorders (TMD) is not documented in the current literature. It was the objective of this study to assess clinical variability of the centric relation position for TMD patients with a muscle-determined technique by

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

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

    International Nuclear Information System (INIS)

    Imanimoghaddam, Mahrokh; Mahdavi, Pirooze; Bagherpour, Ali; Darijani, Mansoreh; Ebrahimnejad, Hamed; Madani, Azam Sadat

    2016-01-01

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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. The temporomandibular opening index, report of headache and TMD, and implications for screening in general practice: an initial study.

    Science.gov (United States)

    Miller, Victor J; Karic, Vesna V; Ofec, Ronen; Nehete, Swati R; Smidt, Ami

    2014-01-01

    The cardinal signs and symptoms of temporomandibular disorder (TMD) are pain in joints and/or muscles, joint sounds, and limitation of movement. They are also associated with other complaints, one of which is headache. Myogenous TMD patients can be divided into those with a high and low temporomandibular opening index (TOI). These two subgroups appear to vary in several ways, including symptom severity. The objective was to assess the relationship between reported headache and TMD patients and a control group with no TMD and to compare the report of headache in high- and low-TOI myogenous TMD patients. Sixty-six patients with TMD were included in the study. Fortythree were diagnosed with myogenous TMD, 23 with arthrogenous TMD, and 20 with no TMD were included as a control. Patients reported a history of headache using a four-point Verbal Rating Scale for both severity and frequency. Multiple logistic regression analysis was performed, after adjusting for confounders of sex and age. This helped investigate the association between the study groups and reported headache. Seventeen of the myogenous TMD patients were studied further. Seven were assigned to the high and 10 to the low-TOI group. Mean ages were 38.43 years and 33.00 years respectively. The Mann Whitney test was used to examine the difference in report of headache between these two groups. 76.7% of the myogenous group, 26.1% of the arthrogenous group, and 35% of the control group reported headache. Age and myogenous TMD were significantly associated with reported headache (P = .001 and .01, respectively). Myogenous TMD is a significant risk factor (OR = 5.20, P = .01) for reported headache while arthrogenous TMD is not (OR = 0.75, P = .69) A significant difference in report of headache between the two myogenous TMD groups was found (P = .0067). The risk for reported headache is 5.20-times greater for myogenous TMD patients compared to the control group, but no difference was noted between the arthrogenous

  2. Circulating Omentin-1 and Chronic Painful Temporomandibular Disorders.

    Science.gov (United States)

    Harmon, Jennifer B; Sanders, Anne E; Wilder, Rebecca S; Essick, Greg K; Slade, Gary D; Hartung, Jane E; Nackley, Andrea G

    To investigate the relationship between omentin-1 levels and painful temporomandibular disorders (TMD). In a case-control design, chronic painful TMD cases (n = 90) and TMD-free controls (n = 54) were selected from participants in the multisite OPPERA study (Orofacial Pain: Prospective Evaluation and Risk Assessment). Painful TMD case status was determined by examination using established Research Diagnostic Criteria for TMD (RDC/TMD). Levels of omentin-1 in stored blood plasma samples were measured by using an enzyme linked immunosorbent assay. Binary logistic regression was used to calculate the odds ratios (ORs) and 95% confidence limits (CLs) for the association between omentin-1 and painful TMD. Models were adjusted for study site, age, sex, and body mass index. The unadjusted association between omentin-1 and chronic painful TMD was statistically nonsignificant (P = .072). Following adjustment for covariates, odds of TMD pain decreased 36% per standard deviation increase in circulating omentin-1 (adjusted OR = 0.64; 95% CL: 0.43, 0.96; P = .031). Circulating levels of omentin-1 were significantly lower in painful TMD cases than controls, suggesting that TMD pain is mediated by inflammatory pathways.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-07-01

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

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

    International Nuclear Information System (INIS)

    Sugiura, Masashi

    2000-01-01

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

  5. 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.

  6. Analysis of Chronic Temporomandibular Disorders Based on the Latest Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Svechtarov V.

    2015-05-01

    Full Text Available The objective of this study is to analyze the distribution of the most common diagnoses observed in patients with chronic temporomandibular disorders, based on the new diagnostic criteria (DC/TMD adopted in 2014. The previous Research Diagnostic Criteria (RDC/TMD adopted in 1992, consisted of three main groups of eight diagnostic subgroups and is currently transformed into two main groups and twelve subgroups, respectively. All subgroups correspond to the nomenclature of the ICD-10. The new clinical diagnostic indices are also modified. The analysis showed a prevalence of Pain-Related TMD compared with that of intra-articular disorders in ratio 57.89% to 42.10%. In Pain-Related TMD arthralgia was represented in 55% of cases; local myalgia - in 12%, myofascial pain - in 18%, myofascial pain with referral - in 14%, headache attributed to TMD - in 1%. In Intra-articular TMD disc displacement with reduction was found in 23% of the cases, disc displacement with reduction with intermittent locking - in 3%, disc displacement without reduction with limited opening - in 25%, disc displacement without reduction and without limited opening - in 8%. Degenerative diseases were found in 14.28%, and hypermobility and subluxations - in 26.98%. These analyzes differ and can only partly be compared with previous analyzes based on RDC system. The changes in the diagnostic criteria require new clinical studies in order to refine the picture of temporomandibular pathology in accordance with the modern views on the matter.

  7. Association between temporomandibular disorders and abnormal head postures

    Directory of Open Access Journals (Sweden)

    Evandro Francisco FAULIN

    2015-01-01

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

  8. 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.

  9. Chronic Temporomandibular Pain Treatment Using Sodium Diclofenac

    OpenAIRE

    Kurita Varoli, Fernando; Sato, Sandra; Sucena Pita, Murillo; do Nascimento, Cássio; Pedrazzi, Vinícius

    2012-01-01

    This study evaluate spontaneous pain after and before administration of sodium diclofenac, isolated or associated to carisoprodol, acetaminophen and caffeine, in chronic temporomandibular disorders (TMD) patients. Were selected eighteen volunteers, both men and women, between 35-70 years of age (mean age 50 years). The inclusion criteria was masticatory muscle pain, and the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used on the diagnose. The selection of treatm...

  10. The association of temporomandibular disorder pain with history of head and neck injury in adolescents.

    Science.gov (United States)

    Fischer, Dena J; Mueller, Beth A; Critchlow, Cathy W; LeResche, Linda

    2006-01-01

    To evaluate the risk of self-reported temporomandibular disorder (TMD) pain among adolescents in relation to previous head and/or neck injury. 3,101 enrollees (11 to 17 years of age) of a nonprofit integrated health-care system were interviewed by telephone. Two hundred four cases with self-reported TMD pain and 194 controls without self-reported TMD pain frequency-matched to the cases by age and gender completed standardized in-person interviews and physical examinations in which reports of previous head/neck injuries were recorded. Odds ratio (OR) estimates and 95% confidence intervals (CIs) of the relative risks of TMD pain associated with prior head and/or neck injuries were calculated using logistic regression. A greater proportion of subjects reporting TMD pain (36%) than controls (25%) had a history of head and/or neck injuries (OR = 1.8, 95% CI, 1.1-2.8). In a separate analysis, the presence of TMD based upon the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was assessed in relation to prior head and/or neck injury. Cases reporting TMD pain and meeting the RDC/TMD criteria for myofascial pain and/or arthralgia or arthritis were 2.0 (CI, 1.0-3.8) times more likely to have had a prior head injury than were controls with neither self-reported nor RDC/TMD pain diagnoses. The results suggest a modest association of prior head injuries with both self-reported and clinically diagnosed TMD pain in adolescents.

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

    Science.gov (United States)

    Ballegaard, V; Thede-Schmidt-Hansen, P; Svensson, P; Jensen, R

    2008-08-01

    To investigate overlaps between headache and temporomandibular disorders (TMD) in a clinical headache population and to describe the prevalence of TMD in headache patients, 99 patients referred to a specialized headache centre were diagnosed according to Research Diagnostic Criteria for TMD (RDC/TMD) and classified in headache groups according to the International Classification of Headache Disorders, second edition for headache diagnoses in a blinded design. The prevalence of TMD in the headache population was 56.1%. Psychosocial dysfunction caused by TMD pain was observed in 40.4%. No significant differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence of depression-most markedly in patients with combined migraine and tension-type headache. Our studies indicate that a high proportion of headache patients have significant disability because of ongoing chronic TMD pain. The trend to a higher prevalence of TMD in patients with combined migraine and tension-type headache suggests that this could be a risk factor for TMD development. A need for screening procedures and treatment strategies concerning depression in headache patients with coexistent TMD is underlined by the overrepresentation of depression in this group. Our findings emphasize the importance of examination of the masticatory system in headache sufferers and underline the necessity of a multidimensional approach in chronic headache patients.

  12. Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study.

    Science.gov (United States)

    von Piekartz, Harry; Pudelko, Ani; Danzeisen, Mira; Hall, Toby; Ballenberger, Nikolaus

    2016-12-01

    There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects. Cross-sectional survey. Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae. According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache. These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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    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.

  14. Use of Magnetic Neurostimulator Appliance in Temporomandibular Disorder

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    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.

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

    Directory of Open Access Journals (Sweden)

    Leticia Vilaça Willeman Bastos

    2012-02-01

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

  16. Review: Psychological intervention in temporomandibular disorders.

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    Pamela Araneda

    2013-08-01

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

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

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    Satheesh B. Haralur

    2014-01-01

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

  18. Orofacial Manifestations and Temporomandibular Disorders of Systemic Scleroderma: An Observational Study

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    Vito Crincoli

    2016-07-01

    Full Text Available Scleroderma is a disorder involving oral and facial tissues, with skin hardening, thin lips, deep wrinkles, xerostomia, tongue rigidity, and microstomia. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD in Systemic Sclerosis (SSc patients compared with healthy people. Eighty patients (6 men, 74 women fulfilling ACR/EULAR SSc Criteria were enrolled. A randomly selected group of 80 patients, matched by sex and age served as control group. The examination for TMD signs and symptoms was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD through a questionnaire and clinical examination. SSc patients complained more frequently (78.8% of oral symptoms (Xerostomia, dysgeusia, dysphagia and stomatodynia than controls (28.7% (χ2 = 40.23 p = 0.001. TMD symptoms (muscle pain on chewing, difficulty in mouth opening, headaches were complained by 92.5% of SSc patients and by 76.2% of controls (χ2 = 8.012 p = 0.005. At the clinical examination, 85% of SSc patients showed restricted opening versus 20.0% of controls (χ2 = 67.77 p = 0.001, 81.2% of SSc showed reduced right lateral excursion versus 50% of controls (χ2 = 17.316 p = 0.001; 73.8% of SSc showed limited left lateral excursion versus 53.8% of controls (χ2 = 6.924 p = 0.009; and 73.8% of SSc had narrow protrusion versus 56.2% of controls (χ2 = 5.385 p = 0.02.

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

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    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

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

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    Wen-Long Hu

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

  1. Immediate effect of nonspecific mandibular mobilization on postural control in subjects with temporomandibular disorder: a single-blind, randomized, controlled clinical trial.

    Science.gov (United States)

    Amaral, Ana P; Politti, Fabiano; Hage, Yasmin E; Arruda, Eric E C; Amorin, Cesar F; Biasotto-Gonzalez, Daniela A

    2013-01-01

    Temporomandibular disorder (TMD) is considered multifactorial and is defined as a group of pain conditions characterized by functional stomatognathic system alterations, which may be affected by or related disrupted postural control. Assess the immediate effect of nonspecific mandibular mobilization (NMM) on the postural control of subjects diagnosed or not with TMD. A simple-blind, randomized, controlled clinical trial was performed involving 50 subjects of both genders assigned to two groups: the TMD group and the control group. TMD was diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A stabilometric assessment was performed by testing subjects in a quiet stance on a dual force platform under two visual conditions (eyes open and eyes closed). The Center of Pressure (CoP)-related variables analyzed were displacement, amplitude, speed of anterior-posterior (AP) and medial-lateral (ML) displacements and CoP sway area. The mean values of each variable were compared, considering the accepted significance value of ppostural control in patients with TMD.

  2. 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 (ppain grade, self-perceived oral health status and pain duration. Conclusions: 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. Key words:Orofacial pain, temporomandibular disorders, Oral Health Impact Profile, sociodemographic variables, primary care, Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). PMID:24121906

  3. Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

    OpenAIRE

    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 control...

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

    Science.gov (United States)

    Thilander, Birgit; Bjerklin, Krister

    2012-12-01

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

  5. 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.

  6. Usefulness of posture training for patients with temporomandibular disorders.

    Science.gov (United States)

    Wright, E F; Domenech, M A; Fischer, J R

    2000-02-01

    Many practitioners have found that posture training has a positive impact on temporomandibular, or TMD, symptoms. The authors conducted a study to evaluate its effectiveness. Sixty patients with TMD and a primary muscle disorder were randomized into two groups: one group received posture training and TMD self-management instructions while the control group received TMD self-management instructions only. Four weeks after the study began, the authors reexamined the subjects for changes in symptoms, pain-free opening and pressure algometer pain thresholds. In addition, pretreatment and posttreatment posture measurements were recorded for subjects in the treatment group. Statistically significant improvement was demonstrated by the modified symptom severity index, maximum pain-free opening and pressure algometer threshold measurements, as well as by the subjects' perceived TMD and neck symptoms. Subjects in the treatment group reported having experienced a mean reduction in TMD and neck symptoms of 41.9 and 38.2 percent, respectively, while subjects in the control group reported a mean reduction in these symptoms of 8.1 and 9.3 percent. Within the treatment group, the authors found significant correlations between improvements in TMD symptoms and improvements in neck symptoms (P head and shoulder posture measurements at the outset of treatment (P Posture training and TMD self-management instructions are significantly more effective than TMD self-management instructions alone for patients with TMD who have a primary muscle disorder. Patients with TMD who hold their heads farther forward relative to the shoulders have a high probability of experiencing symptom improvement as a result of posture training and being provided with selfmanagement instructions.

  7. Evaluation of the research diagnostic criteria for temporomandibular disorders for the recognition of an anterior disc displacement with reduction

    NARCIS (Netherlands)

    Naeije, M.; Kalaykova, S.; Visscher, C.M.; Lobbezoo, F.

    2009-01-01

    The aim of this Focus Article is to review critically the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the recognition of an anterior disc displacement with reduction (ADDR) in the temporomandibular joint (TMJ). This evaluation is based upon the experience gained

  8. Body posture changes in women with migraine with or without temporomandibular disorders

    OpenAIRE

    Ferreira, Mariana C.; Bevilaqua-Grossi, Débora; Dach, Fabíola É.; Speciali, José G.; Gonçalves, Maria C.; Chaves, Thais C.

    2014-01-01

    Background: Migraine and temporomandibular disorders (TMDs) are reported to be associated. However, there are no reports on the association among migraines, TMDs and changes in body posture. Objectives : To assess changes in body posture in women suffering migraines with or without TMD compared with a control group. Method: Sixty-six women with a mean age of 18 to 45 years participated in this study. The groups were composed of 22 volunteers with migraine and TMD (MTMD), 22 volunteers ...

  9. Central Sensitization-Based Classification for Temporomandibular Disorders: A Pathogenetic Hypothesis

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    Annalisa Monaco

    2017-01-01

    Full Text Available Dysregulation of Autonomic Nervous System (ANS and central pain pathways in temporomandibular disorders (TMD is a growing evidence. Authors include some forms of TMD among central sensitization syndromes (CSS, a group of pathologies characterized by central morphofunctional alterations. Central Sensitization Inventory (CSI is useful for clinical diagnosis. Clinical examination and CSI cannot identify the central site(s affected in these diseases. Ultralow frequency transcutaneous electrical nerve stimulation (ULFTENS is extensively used in TMD and in dental clinical practice, because of its effects on descending pain modulation pathways. The Diagnostic Criteria for TMD (DC/TMD are the most accurate tool for diagnosis and classification of TMD. However, it includes CSI to investigate central aspects of TMD. Preliminary data on sensory ULFTENS show it is a reliable tool for the study of central and autonomic pathways in TMD. An alternative classification based on the presence of Central Sensitization and on individual response to sensory ULFTENS is proposed. TMD may be classified into 4 groups: (a TMD with Central Sensitization ULFTENS Responders; (b TMD with Central Sensitization ULFTENS Nonresponders; (c TMD without Central Sensitization ULFTENS Responders; (d TMD without Central Sensitization ULFTENS Nonresponders. This pathogenic classification of TMD may help to differentiate therapy and aetiology.

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

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    Maria C Gonçalves

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

  11. Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms.

    Science.gov (United States)

    Wiese, Mie; Svensson, Peter; Bakke, Merete; List, Thomas; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Wenzel, Ann

    2008-01-01

    To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings. Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed for the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatization scores, graded chronic pain, and age and gender. Coarse crepitus on opening/closing (odds ratio [OR] > or = 3.12), on lateral excursions (odds ratio > or = 4.06), and on protrusion (OR > or = 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR > or = 2.95) and so did increasing age (OR > or = 1.03 per year) and the female gender (OR > or = 2.36). Maximal assisted opening and maximal opening without pain (position (OR > or = 2.60). No other significant associations were observed. Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with a posterior condyle-to-articular tubercle relation on opening.

  12. 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.

  13. [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.

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

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    Luciano José Pereira

    2009-06-01

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

  15. Cervical posture analysis in dental students and its correlation with temporomandibular disorder.

    Science.gov (United States)

    Câmara-Souza, Mariana Barbosa; Figueredo, Olívia Maria Costa; Maia, Paulo Raphael Leite; Dantas, Isabelle de Sousa; Barbosa, Gustavo Augusto Seabra

    2018-03-01

    To evaluate the relationship between temporomandibular disorders (TMD) and craniocervical posture in the sagittal plane measured from lateral radiographs of the head. The sample was comprised of 80 randomly selected students of dentistry at the Federal University of Rio Grande do Norte. Research Diagnostic Criteria for TMD (RDC/TMD) was used to evaluate the signs and symptoms of TMD. Lateral radiographs of each individual were used to measure the position of the hyoid bone, the craniocervical angle, and the occiput-atlas distance. A chi-square test was used to evaluate the relationships between craniocervical posture measures and TMD. No relationship was found between TMD and the craniocervical posture measured by the positioning of the hyoid bone, head rotation, and the extension/flexion of the head (p > 0.05). It can be concluded, therefore, that no relationship exists between cervical posture in the sagittal plane and TMD.

  16. Temporomandibular disorders after whiplash injury: a controlled, prospective study.

    Science.gov (United States)

    Kasch, Helge; Hjorth, Tine; Svensson, Peter; Nyhuus, Lone; Jensen, Troels S

    2002-01-01

    Whiplash injury to the neck is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies, however, have examined TMD-related pain in acute whiplash patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Prospectively, 19 acute whiplash patients exposed to a motor vehicle accident involving a rear collision participated in a study of TMD. The control group consisted of 20 age- and gender-matched ankle-injury patients. Participants were seen within 4 weeks and again at 6 months post-injury. The masticatory system was examined in accordance with the research diagnostic criteria. Participants underwent structured interviews, filled out the McGill Pain Questionnaire (MPQ), and had 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 obtained at each visit. One whiplash patient and 1 ankle-injury patient had jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ, TMD symptoms and signs, MVOF and PDT were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months. 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 problems. Further studies are needed to identify which other factors may contribute to TMD pain.

  17. 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

  18. 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

  19. Magnetic Resonance Imaging-Based Prediction of the Relationship between Whiplash Injury and Temporomandibular Disorders.

    Science.gov (United States)

    Lee, Yeon-Hee; Lee, Kyung Mi; Auh, Q-Schick; Hong, Jyung-Pyo

    2017-01-01

    Whiplash injury can cause internal derangement of the temporomandibular joint (TMJ) and lead to temporomandibular disorders (TMDs). Our aim was to evaluate whether the initial clinical findings in TMD patients with whiplash injury are correlated with their magnetic resonance imaging (MRI) characteristics. This case-control study involved 219 patients (135 women, 84 men; mean age: 37.84 years) who visited our orofacial pain clinic with TMD; TMD was diagnosed using the diagnostic criteria for TMD Axis I. Patients were categorized into three groups based on the presence and type of macrotrauma: in the "wTMD" group, patients had suffered whiplash injury; patients in the "pTMD" group had post-traumatic TMD; the "iTMD" group comprised patients who had presented with TMD symptoms and had sustained no macrotrauma. We investigated the presence of disk displacement, effusion, disk deformity, and condylar degeneration, and changes in the lateral pterygoid muscle (LPM). To evaluate the severity of TMD pain and objectively analyze symptoms, we used a visual analog scale (VAS), palpation index (PI), neck PI, dysfunction index, and craniomandibular index (CMI). The VAS scores, and the severity indexes of the TMD including PI, neck PI, and CMI were highest in the wTMD patients. Atrophy of the LPM was most commonly seen in the wTMD group, as was disk deformity. In wTMD patients only, VAS score was significantly correlated with stress; it was correlated with headache in wTMD and iTMD patients. The clinical symptoms of TMD were not correlated with MRI findings in the wTMD group. However, alterations in the LPM were strongly correlated with disk displacement. If clinicians recognize alterations in the LPM and disk displacement in the TMJ, they will better understand the clinical symptoms and pathophysiology of TMD with whiplash injury. Whiplash injury may lead to TMD via different mechanisms from other macrotraumas.

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

    Science.gov (United States)

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

    2015-12-01

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

  1. Temporomandibular disorders are differentially associated with headache diagnoses: a controlled study.

    Science.gov (United States)

    Gonçalves, Daniela A G; Camparis, Cinara M; Speciali, José G; Franco, Ana L; Castanharo, Sabrina M; Bigal, Marcelo E

    2011-09-01

    Temporomandibular disorders (TMDs) are considered to be comorbid with headaches. Earlier population studies have suggested that TMD may also be a risk factor for migraine progression. If that is true, TMD should be associated with specific headache syndromes (eg, migraine and chronic migraine), but not with headaches overall. Accordingly, our aim was to explore the relationship between TMD subtypes and severity with primary headaches in a controlled clinical study. The sample consisted of 300 individuals. TMDs were assessed using the Research Diagnostic Criteria for TMD, and primary headache was classified according to International Classification for Headache Disorders-2. Univariate and multivariate models assessed headache diagnoses and frequency as a function of the parameters of TMD. Relative to those without TMD, individuals with myofascial TMD were significantly more likely to have chronic daily headaches (CDHs) [relative risk (RR)=7.8; 95% confidence interval (CI), 3.1-19.6], migraine (RR=4.4; 95% CI, 1.7-11.7), and episodic tension-type headache (RR=4.4; 95% CI, 1.5-12.6). Grade of TMD pain was associated with increased odds of CDH (Pheadache (Pheadache frequency. In multivariate analyses, TMD was associated with migraine and CDH (P=0.001). Painful TMD (P=0.0034) and grade of TMD pain (Pheadache frequency. TMD, TMD subtypes, and TMD severity are independently associated with specific headache syndromes and with headache frequency. This differential association suggests that the presence of central facilitation of nociceptive inputs may be of importance, as positive association was observed only when muscular TMD pain was involved.

  2. 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.

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

    OpenAIRE

    Di Paolo, Carlo; D'Urso, Anna; Papi, Piero; Di Sabato, Francesco; Rosella, Daniele; Pompa, Giorgio; Polimeni, Antonella

    2017-01-01

    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 group...

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

    DEFF Research Database (Denmark)

    Abrahamsen, Randi; Zachariae, Robert; Svensson, Peter

    2009-01-01

    This study investigated the effect of hypnosis in patients with temporomandibular disorders (TMD) with focus on oral function and psychological outcomes. Forty women (mean age +/- s.d.: 38.6 +/- 10.8 years) suffering from TMD (mean duration 11.9 +/- 9.9 years) were randomized to four individual 1......, psychological symptoms (Symptom Check List 60), pain coping strategies (Coping Strategies Questionnaire), sleep difficulties (Pittsburgh Sleep Quality Index) and use of analgesics. Data were analyzed with between-groups within-subjects anovas. The hypnosis group significantly reduced the daily NRS pain scores...... and anxiety (P effectively reduce some aspects of complex TMD pain....

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

    OpenAIRE

    Hamata,Marcelo Matida; Zuim,Paulo Renato Junqueira; Garcia,Alicio Rosalino

    2009-01-01

    Fabrication of occlusal splints in centric relation for temporomandibular disorders (TMD) patients is arguable, since this position has been defined for asymptomatic stomatognathic system. Thus, maximum intercuspation might be employed in patients with occlusal stability, eliminating the need for interocclusal records. This study compared occlusal splints fabricated in centric relation and maximum intercuspation in muscle pain reduction of TMD patients. Twenty patients with TMD of myogenous o...

  6. Headache and temporomandibular disorders: evidence for diagnostic and behavioural overlap.

    Science.gov (United States)

    Glaros, A G; Urban, D; Locke, J

    2007-06-01

    To assess the diagnostic and behavioural overlap of headache patients with temporomandibular disorders (TMD), individuals recruited from the general population with self-described headaches were compared with non-headache controls. The examination and diagnostic procedures in the Research Diagnostic Criteria (RDC) for TMD were applied to both sets of subjects by a blinded examiner. Following their examination, subjects used experience sampling methods to obtain data on pain, tooth contact, masticatory muscle tension, emotional states and stress. Results showed that a significantly higher proportion of the headache patients received an RDC/TMD diagnosis of myofascial pain than non-headache controls. Headache patients also reported significantly more frequent and intense tooth contact, more masticatory muscle tension, more stress and more pain in the face/head and other parts of the body than non-headache controls. These results are similar to those reported for TMD patients and they suggest that headache patients and TMD patients overlap considerably in diagnosis and oral parafunctional behaviours.

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

    Science.gov (United States)

    Chisnoiu, Andrea Maria; Picos, Alina Monica; Popa, Sever; Chisnoiu, Petre Daniel; Lascu, Liana; Picos, Andrei; Chisnoiu, Radu

    2015-01-01

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

  8. Chewing ability as a parameter for evaluating the disability of patients with temporomandibular disorders.

    Science.gov (United States)

    Kurita, H; Ohtsuka, A; Kurashina, K; Kopp, S

    2001-05-01

    Restoration of chewing ability is an important aspect of the treatment for temporomandibular disorders (TMDs). However, too little attention has been paid to it. We have used a questionnaire to evaluate and score the chewing ability of TMD patients. The questionnaire includes 19 kinds of food and a chewing task. The patient was asked if she/he experiences difficulty in enjoying eating. The aim of this study was to evaluate correlations between score of chewing ability (SCA) and other symptoms/signs of TMD. Four hundred and seventy-three consecutive TMD patients were evaluated for SCA and other symptoms/signs including temporomandibular joint (TMJ) pain, TMJ and muscle tenderness, TMJ noise (clicking and crepitus), and maximum mouth opening. The relationship between SCA and other symptoms/signs were analysed by multiple regression analysis. Score of chewing ability correlated significantly with TMJ pain and mouth opening capacity but not with TMJ noise and muscle tenderness. Age was a background factor but sex was not. The result of this study suggests that SCA correlated with dysfunction of the TMD patients. This method could be used to evaluate the ability of chewing in assessment of TMD.

  9. Are signs of temporomandibular disorders stable and predictable in adolescents with headache?

    Science.gov (United States)

    Liljeström, M-R; Le Bell, Y; Laimi, K; Anttila, P; Aromaa, M; Jämsä, T; Metsähonkala, L; Vahlberg, T; Viander, S; Alanen, P; Sillanpää, M

    2008-06-01

    The aim of the present study was to study changes in signs and symptoms of temporomandibular disorders (TMD) and factors predicting TMD signs in adolescents with and without headache. A population-based sample (n = 212) of 13-year-olds with and without headache was re-examined at the age of 16. The study included a questionnaire, face-to-face interview and somatic examination. In addition, a neurological examination, a muscle evaluation and a stomatognathic examination were performed. Significant changes were seen in TMD signs during the follow-up, but TMD signs at the end of the follow-up could not be predicted by baseline headache, sleeping difficulties, depression or muscle pain. TMD signs at the age of 16 were associated with female gender and muscle pain. We conclude that considerable changes in TMD signs occur in the follow-up of adolescents with and without headache. Headache-related TMD are not predictable in adolescents with and without headache.

  10. 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

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

    Science.gov (United States)

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

    2015-01-01

    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 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 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. this study could elucidate the important effect that headache may have on the TMD management.

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

    Directory of Open Access Journals (Sweden)

    André Luís PORPORATTI

    2015-04-01

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

  13. Cervical flexion-rotation test and physiological range of motion - A comparative study of patients with myogenic temporomandibular disorder versus healthy subjects.

    Science.gov (United States)

    Greenbaum, Tzvika; Dvir, Zeevi; Reiter, Shoshana; Winocur, Ephraim

    2017-02-01

    Temporomandibular Disorders (TMD) refer to several common clinical disorders which involve the masticatory muscles, the temporomandibular joint (TMJ) and the adjacent structures. Although neck signs and symptoms are found with higher prevalence in TMD patients compared to the overall population, whether limitation of cervical mobility is an additional positive finding in this cohort is still an open question. To compare the physiological cervical range of motion (CROM) and the extent of rotation during cervical flexion (flexion-rotation test, FRT) in people with TMD (muscular origin) and healthy control subjects. The range of motion of the neck and FRT was measured in 20 women with myogenic TMD and 20 age matched healthy controls. Women with myogenic TMD had significantly lower FRT scores compared to their matched healthy women. No difference was found between groups in CROM in any of the planes of movement. The FRT was positive (less than 32°) in 90% of the TMD participants versus 5% in the healthy control but the findings were not correlated with TMD severity. The results point out a potential involvement of the upper cervical joints (c1-c2) in women with myogenic TMD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. 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.

  15. Are Pain-Related Temporomandibular Disorders the Product of an Interaction Between Psychological Factors and Self-Reported Bruxism?

    Science.gov (United States)

    van Selms, Maurits Ka; Muzalev, Konstantin; Visscher, Corine M; Koutris, Michail; Bulut, Melike; Lobbezoo, Frank

    2017-01-01

    To investigate whether pain-related temporomandibular disorders (TMD) are the product of an interaction between psychological factors and self-reported bruxism activities. Patients referred to a specialized clinic for complaints of orofacial pain and dysfunction completed a digital questionnaire prior to the first clinical visit. The patient sample was then split into a case group consisting of 268 patients diagnosed with TMD pain according to the Diagnostic Criteria for Temporomandibular Disorders (85.8% women; mean ± standard deviation [SD] age = 40.1 ± 14.5 years) and a control group consisting of 254 patients without any pain in the orofacial area (50.8% women; 46.9 ± 13.6 years). The possible moderating roles of six psychological factors (depression, somatic symptoms, anxiety, stress, optimism, and prior psychological treatment) on the relationship between self-reported bruxism and the clinical presence of TMD pain were examined. Patients with TMD pain reported significantly more bruxism than patients without any report of orofacial pain. Furthermore, bruxism intensity was associated with a variety of psychological factors; however, there were no significant interactions between any of the psychological factors and bruxism with respect to the clinical presence of TMD pain. These findings do not support the view that the effect of bruxism on TMD pain is stronger in patients who experience higher levels of psychological distress compared to those with lower levels of distress.

  16. Temporomandibular dysfunction and headache disorder.

    Science.gov (United States)

    Speciali, José G; Dach, Fabíola

    2015-02-01

    It has been well established that primary headaches (especially migraine, chronic migraine, and tension-type headache) and temporomandibular dysfunction (TMD) are comorbid diseases, with the presence of one of them in a patient increasing the prevalence of the others. The relationship between the 2 diseases may involve the sharing of common physiopathological aspects. Studies about the treatment of this disease association have shown that a simultaneous therapeutic approach to the 2 diseases is more effective than the separate treatment of each. As a consequence, specialists in orofacial pain are now required to know the criteria for the diagnosis of headaches, and headache physicians are required to know the semiologic aspects of orofacial pain. Nevertheless, a headache may be attributed to TMD, instead be an association of 2 problems - TMD and primary headaches - in these cases a secondary headache, described in item 11.7 of the International Classification of Headache Disorders, is still a controversial topic. Attempts to determine the existence of this secondary headache with a specific or suggestive phenotype have been frustrated. The conclusion that can be reached based on the few studies published thus far is that this headache has a preferential unilateral or bilateral temporal location and migraine-like or tension-type headache-like clinical characteristics. In the present review, we will consider the main aspects of the TMD-headache relationship, that is, comorbidity of primary headaches and TMD and clinical aspects of the headaches attributed to TMD from the viewpoint of the International Headache Society and of a group of specialists in orofacial pain. This paper aims to explore our understanding of the association between TMD and headaches in general and migraine in particular. © 2015 American Headache Society.

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

    Science.gov (United States)

    Xie, Q; Li, X; Xu, X

    2013-04-01

    The aetiology of temporomandibular disorder (TMD) is multifactorial, and numerous studies have addressed that occlusion may be of great importance. However, whether occlusion plays a crucial role in the pathogenesis of TMD remains controversial. Study designs utilising animal models have been used to study the effects of artificial occlusal alterations. Experimental traumatic occlusion affects blood flow in the temporomandibular joint and results in changes in the condylar cartilage, and artificial occlusal interference induces masticatory muscle nociceptive responses that are associated with peripheral sensitisation and lead to central sensitisation, which maintains masticatory muscle hyperalgesia. The possibility that occlusal interference results in TMD has been investigated in humans using a double-blind randomised design. Subjects without a history of TMD show fairly good adaptation to interferences. In contrast, subjects with a history of TMD develop a significant increase in clinical signs and self-report stronger symptoms (occlusal discomfort and chewing difficulties) in response to interferences. Meanwhile, psychological factors appear meaningful for symptomatic responses to artificial interferences in subjects with a history of TMD. Thus, individual differences in vulnerability to occlusal interferences do exist. Although there are advantages and disadvantages to using human and animal occlusal interference models, these approaches are indispensable for discovering the role of occlusion in TMD pathogenesis. © 2013 Blackwell Publishing Ltd.

  18. Why seek treatment for temporomandibular disorder pain complaints? A study based on semi-structured interviews

    NARCIS (Netherlands)

    Rollman, A.; Gorter, R.C.; Visscher, C.M.; Naeije, M.

    2013-01-01

    AIMS: To identify potential predictors of self-reported sleep bruxism (SB) within children's family and school environments. METHODS: A Aims: To assess possible differences between care seekers and non-care seekers with temporomandibular disorder (TMD) pain complaints, by using semi-structured

  19. Auditory characteristics of individuals with temporomandibular dysfunctions and dentofacial deformities

    Directory of Open Access Journals (Sweden)

    Tatiane Totta

    2013-10-01

    Full Text Available OBJECTIVE: To investigate whether there is any relationship between otological as well as vestibular symptoms, audiological findings and type of temporomandibular disorder (articular, muscular and mixed; and to check the distribution of the temporomandibular disorders (TMD dysfunction degree in the research population. METHODS: A retrospective study involving 30 patients of both sexes, aged between 18 and 49 years old, diagnosed with TMD and dentofacial deformities, who were subject to clinical evaluation (muscle palpation, auscultation of temporomandibular joint during mandibular motion and measurement of jaw movement, audiological testing (pure tone audiometry and immittance testing and two questionnaires, one on otological and vestibular symptoms and the other on TMD anamnesis. Based on both the anamnesis questionnaire and the clinical assessment, the subjects were divided according to the type and degree of TMD dysfunction (mild, moderate and severe, and compared regarding the occurrence of auditory signs and symptoms, vestibular symptoms and audiological findings according to TMD type. RESULTS: The anamnesis questionnaire demonstrated higher prevalence (83.33% of severe TMD. Subjects with mixed TMD had more complaints about hypoacusis than those with muscular TMD (p < 0.05. The results showed no change in either audiological and immittance testing for all assessed individuals. CONCLUSION: Otological symptoms are present in subjects with TMD and dentofacial deformities, regardless of the classification of TMD (articular, muscular or mixed. Those with mixed TMD may have higher incidence of complaints about hypoacusis than subjects with muscular TMD. Further studies are needed to investigate the relationship between otological symptoms and the different types of TMD.

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

    Directory of Open Access Journals (Sweden)

    Dina H. Sugiaman

    2013-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Débora Bevilaqua-Grossi

    2007-08-01

    Full Text Available AIM: The purpose of this study was to assess in a sample of female community cases the relationship between the increase of percentage of cervical signs and symptoms and the severity of temporomandibular disorders (TMD and vice-versa. MATERIAL AND METHODS: 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. RESULTS: 43% of the volunteers demonstrated the same severity for TMD and cervical spine disorders (CSD. The increase in TMD signs and symptoms was accompanied by increase in CSD severity, except for pain during palpation of posterior temporal muscle, more frequently observed in the severe CSD group. However, increase in pain during cervical extension, sounds during cervical lateral flexion, and tenderness to palpation of upper fibers of trapezius and suboccipital muscles were observed in association with the progression of TMD severity. CONCLUSION: The increase in cervical symptomatology seems to accompany TMD severity; nonetheless, the inverse was not verified. Such results suggest that cervical spine signs and symptoms could be better recognized as perpetuating rather than predisposing factors for TMD.

  2. Motion Artifact in the MR imaging of temporomandibular disorders

    International Nuclear Information System (INIS)

    Tamamura, Kiyoharu; Miyajima, Hisashi; Nihei, Yoshinobu; Nemoto, Ryuichi; Ohno, Tomoya

    1997-01-01

    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)

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

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Svensson, Peter

    2008-01-01

    Temporomandibular disorders (TMDs) and psychological status were examined in adult patients with a deep bite and compared with an adult age- and gender-matched control group with neutral occlusion. The deep bite group consisted of 20 females (mean age 30.3 years) and 10 males (mean age 33.1 years......). The control group comprised 20 females (mean age 29.4 years) and 10 males (mean age 34.2 years). TMD examination, according to the Research Diagnostic Criteria for TMD (RDC/TMD), cephalometric lateral radiographs, registration of occlusion, and bite force were performed. To test the mean differences between...... group compared with the controls. Somatization scores were significantly higher in the deep bite group compared with the controls (P psychological...

  4. Prolotherapy: A new hope for temporomandibular joint pain

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    A Vijay Kumar

    2013-01-01

    Full Text Available The most common cause of orofacial pain is the Temporomandibular Joint Disorder (TMD, a collective term used to describe a group of medical disorders causing temporomandibular joint (TMJ pain and dysfunction. As the causes of TMD are varied and run the gamut from mechanical issues, such as disc degeneration and dislocation or erosion of the fibrocartilaginous surfaces of the condyle, fossa, and articular eminence, the treatment approaches for the chronic TMJ case are also quite varied. As surgery is considered a last resort for TMD, it is common for sufferers to seek out alternatives and one of the alternative treatments is ′Prolotherapy,′ which is also known as Regenerative Injection Therapy. This article provides an overview of this new alternative therapy.

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

    Science.gov (United States)

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

    2012-05-01

    The aims of this investigation were to report the frequency of temporomandibular disorders (TMD) diagnoses and the prevalence of self-reported awake and sleep bruxism as well as to describe the possible differences between findings of two specialised centres as a basis to suggest recommendations for future improvements in diagnostic homogeneity and accuracy. A standardised Research Diagnostic Criteria for TMD (RDC/TMD) assessment was performed on patients attending both TMD Clinics, viz., at the University of Padova, Italy (n=219; 74% women) and at the University of Tel Aviv, Israel (n=397; 79% women), to assign axis I physical diagnoses and to record data on self-reported awake and sleep bruxism. Significant differences were shown between the two clinic samples as for the frequency of TMD diagnoses (chi-square, Pbruxism items (chi-square, Pbruxism in patients with myofascial pain alone described in the other clinic sample was not replicated, suggesting that the different adoption of clinical and imaging criteria to diagnose TMD may influence also reports on their association with bruxism. From this investigation, it emerged that the features of the study samples as well as the different interpretation of the same diagnostic guidelines may have strong influence on epidemiological reports on bruxism and TMD prevalence and on the association between the two disorders. © 2012 Blackwell Publishing Ltd.

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

    NARCIS (Netherlands)

    Manfredini, D.; Lobbezoo, F.

    2010-01-01

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

  7. Superluminous Devices Versus Low-Level Laser for Temporomandibular Disorders

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    Sveshtarov Vasil

    2018-03-01

    Full Text Available The aim of this study is to compare the pain intensity reduction between the mean radiation doses per session of gallium-aluminum-arsenide (GaAIAs laser with superluminous diodes (SLD in four of the most common pain-related chronic temporomandibular disorders (TMD - local myalgia, myofascial pain, myofascial pain with a referral, and arthralgia. This study was implemented on 124 patients with pain-related temporomandibular disorders according to the DC/TMD criteria. We applied trigger point oriented near-infrared laser (785 nm, 100 s, 8 J/cm2 and SLD cluster sessions (the cluster is composed of 49 SLDs with a combination of visible red (633 nm and infrared (880 nm diodes, 200 mW, 300 s, 8 J/cm2 for the temporomandibular joints and the affected muscles. Patients were evaluated at the start of the treatment, and after the 6th session of combined phototherapy. The pain intensity scores were measured according to the Visual Analogue Scale (VAS. Our results show that the most statistically manifested pain reduction is found for the SLD dose, р = 0,000118, followed by the overall dose (laser plus SLD; р = 0,001031, and the laser dose; р = 0,030942 (ANOVA dispersion analyses. Consequently, it can be concluded that myalgia is better treated through lower doses of red light compared to infrared laser doses because SLDs combine the prooxidative effect of photons with 633 nm wavelength, a large area of exposure, sufficient tissue penetration, and some positive warming thermal impact of the SLD clusters.

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

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

    2011-01-01

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

  9. 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). © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  10. Masseter muscle surface electromyography in college students with a high degree of anxiety and temporomandibular disorder

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    Eduarda de Lima Amarante

    Full Text Available ABSTRACT Objective: to compare the electrical activity of masseter muscles, bilaterally, according to the presence or absence of Temporomandibular Disorder (TMD in college students with a high degree of anxiety. Methods: the study was conducted with a randomized sample of 31 Speech Therapy students aged between 17 and 32 years; 61.3% (n = 19 were females and 38.7% (n = 12 were males. They were divided into two groups, Group 1 (G1, comprising 11 students with TMD, and Group 2 (G2, composed of 20 students without TMD. The college students answered the State-Trait Anxiety Inventory (STAI for anxiety investigation, and were evaluated by the protocol Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD for TMD diagnosis. The evaluation of muscular electrical activity took into account the records in the conditions of rest, Sustained Maximum Voluntary Activity (SMVA and habitual chewing (HC. The data were analyzed using the version 22 IBM Statistical Package for Social Sciences (SPSS software. The statistical analysis was performed using Student t test to compare means between groups, considering < 0,05 as the significant p-value. Results: college students, of both groups, presented high levels of anxiety traits. Significant statistical differences were observed on the percentage of electrical activity of right masseter muscle in chewing function, as well as muscle fibers recruitment during chewing, which were higher on the group without TMD. Conclusion: college students with TMD and a high degree of anxiety presented lower means of masseter muscle electromyografic activity during chewing, in most conditions assessed, as compared to volunteers without TMD, except for the left masseter muscle in rest and chewing.

  11. 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

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

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    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.

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

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    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. 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).

    Science.gov (United States)

    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.

  15. Incidence of bruxism in TMD population.

    Science.gov (United States)

    Chandwani, Briesh; Ceneviz, Caroline; Mehta, Noshir; Scrivani, Steven

    2011-01-01

    The objective of the study presented here was to examine the incidence of bruxism in patients suffering from temporomandibular disorders. Two cohorts of patients suffering from temporomandibular disorders were evaluated. One group, composed of 163 patients, was asked specifically about the occurrence of bruxism, while the other group, composed of 200 patients, was not specifically asked about bruxism (self-reporting). The incidence of bruxism was only 20.5% for the group that only self-reported bruxism, while the incidence was 65% when asked specifically about bruxism. It is critical to ask specifically about bruxism. Patients are more likely to report bruxism when asked specifically about it. It is important to incorporate this as part of a TMD evaluation.

  16. Magnetic Resonance Imaging-Based Prediction of the Relationship between Whiplash Injury and Temporomandibular Disorders

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    Yeon-Hee Lee

    2018-01-01

    Full Text Available PurposeWhiplash injury can cause internal derangement of the temporomandibular joint (TMJ and lead to temporomandibular disorders (TMDs. Our aim was to evaluate whether the initial clinical findings in TMD patients with whiplash injury are correlated with their magnetic resonance imaging (MRI characteristics.Materials and methodsThis case–control study involved 219 patients (135 women, 84 men; mean age: 37.84 years who visited our orofacial pain clinic with TMD; TMD was diagnosed using the diagnostic criteria for TMD Axis I. Patients were categorized into three groups based on the presence and type of macrotrauma: in the “wTMD” group, patients had suffered whiplash injury; patients in the “pTMD” group had post-traumatic TMD; the “iTMD” group comprised patients who had presented with TMD symptoms and had sustained no macrotrauma. We investigated the presence of disk displacement, effusion, disk deformity, and condylar degeneration, and changes in the lateral pterygoid muscle (LPM. To evaluate the severity of TMD pain and objectively analyze symptoms, we used a visual analog scale (VAS, palpation index (PI, neck PI, dysfunction index, and craniomandibular index (CMI.ResultsThe VAS scores, and the severity indexes of the TMD including PI, neck PI, and CMI were highest in the wTMD patients. Atrophy of the LPM was most commonly seen in the wTMD group, as was disk deformity. In wTMD patients only, VAS score was significantly correlated with stress; it was correlated with headache in wTMD and iTMD patients. The clinical symptoms of TMD were not correlated with MRI findings in the wTMD group. However, alterations in the LPM were strongly correlated with disk displacement.ConclusionIf clinicians recognize alterations in the LPM and disk displacement in the TMJ, they will better understand the clinical symptoms and pathophysiology of TMD with whiplash injury. Whiplash injury may lead to TMD via different mechanisms from other macrotraumas.

  17. 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 headache as well as 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.

  18. Validation of the Pain Resilience Scale in Chinese-speaking patients with temporomandibular disorders pain.

    Science.gov (United States)

    He, S L; Wang, J H; Ji, P

    2018-03-01

    To validate the Pain Resilience Scale (PRS) for use in Chinese patients with temporomandibular disorders (TMD) pain. According to international guidelines, the original PRS was first translated and cross-culturally adapted to formulate the Chinese version of PRS (PRS-C). A total of 152 patients with TMD pain were recruited to complete series of questionnaires. Reliability of the PRS-C was investigated using internal consistency and test-retest reliability. Validity of the PRS-C was calculated using cross-cultural validity and convergent validity. Cross-cultural validity was evaluated by examining the confirmatory factor analysis (CFA). And convergent validity was examined through correlating the PRS-C scores with scores of 2 commonly used pain-related measures (the Connor-Davidson Resilience Scale [CD-RISC] and the Tampa Scale for Kinesiophobia for Temporomandibular Disorders [TSK-TMD]). The PRS-C had a high internal consistency (Cronbach's alpha = 0.92) and good test-retest reliability (intra-class correlation coefficient [ICC] = 0.81). The CFA supported a 2-factor model for the PRS-C with acceptable fit to the data. The fit indices were chi-square/DF = 2.21, GFI = 0.91, TLI = 0.97, CFI = 0.98 and RMSEA = 0.08. As regards convergent validity, the PRS-C evidenced moderate-to-good relationships with the CD-RISC and the TSK-TMD. The PRS-C shows good psychometric properties and could be considered as a reliable and valid measure to evaluate pain-related resilience in patients with TMD pain. © 2017 John Wiley & Sons Ltd.

  19. 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

  20. 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

  1. The potential etiologic factors influencing tinnitus intensity in patients with temporomandibular disorders.

    Science.gov (United States)

    Demirkol, Nermin; Demirkol, Mehmet; Usumez, Aslihan; Sari, Fatih; Akcaboy, Cihan

    2017-08-30

    To investigate the potential relationships between the intensity of tinnitus associated with temporomandibular disorders (TMD) and potential etiologic factors, including age, gender, freeway space, sleep bruxism (SB), joint clicking, and headache. The sample was comprised of 90 patients without any hearing loss, as confirmed by otorhinolaryngology, who self-reported subjective tinnitus and simultaneous TMD, based on the Research Diagnostic Criteria for TMD (RDC/TMD). The results showed a positive, weak correlation between the intensity of tinnitus and age (r = 0.225, p = 0.033). The presence of SB and headache were seen in higher proportions in the present sample, at 75.5% (n = 68) and 66.6% (n = 60), respectively. In a population of patients with subjective tinnitus and TMD, no significant associations were found between tinnitus intensity and age, freeway space, SB, clicking presence, and headache, though gender did show a weak correlation with tinnitus intensity.

  2. Occlusal risk factors associated with temporomandibular disorders in young adults with normal occlusions.

    Science.gov (United States)

    Wang, Chen; Yin, Xinmin

    2012-10-01

    The aim of this study was to characterize occlusal stability in young adults with temporomandibular disorder (TMD). Thirty-one patients (aged 19-31 years) with complete natural dentition and Angle class I occlusion who exhibited TMD were compared with 31 age- and sex-matched healthy control subjects. The occlusal registrations were performed using the T-Scan II occlusal imaging and analysis system. Center of occlusal force, asymmetry index of occlusal force, maximal movement of COF, premature contacts, clusion time, and disclusion time were recorded. Compared with control subjects, TMD subjects had a significantly higher frequency of premature contacts (16/32, 50.0%) and greater bilateral asymmetry in the occlusal force. Furthermore, prolonged clusion time and disclusion time also were observed in TMD subjects. These results suggest that a significant association exists between occlusal stability and TMD in young adults. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Association between temporomandibular disorders and music performance anxiety in violinists.

    Science.gov (United States)

    Amorim, M I T; Jorge, A I L

    2016-10-01

    Professional violin playing has been associated with a predisposition to develop temporomandibular disorder (TMD). There are a number of risk factors, including physical trauma from the playing posture and the presence of parafunctional habits. Music performance anxiety (MPA) may also be a factor, as it has been associated with playing-related musculoskeletal disorders (PRMD). To evaluate a possible association between the presence of TMD and the level of MPA in violin players. An observational study using a written questionnaire that retrieved data related to TMD symptoms (Fonseca Anamnestic Questionnaire), MPA level (Kenny Music Performance Anxiety Inventory, K-MPAI), instrument practice time, chinrest type, sex and age. Descriptive, bivariate and logistic regression analyses were conducted. Ninety-three professional or semi-professional violinists performing in and around Lisbon, Portugal, completed the questionnaire (73% response rate). TMD was present in 50 violinists (58%). There was a statistically significant association between the presence of TMD and high MPA levels (P < 0.001) and the most anxious violinists were six times (95% confidence interval 2.51-15.33; P < 0.001) more likely to report TMD symptoms when compared with the least anxious players. Violin players had a high prevalence of reported TMD symptoms, which was significantly associated with high MPA levels. It may therefore be necessary to address psychological and physical factors simultaneously in musicians who do not improve with physical therapy alone. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Validation of the multimedia version of the RDC/TMD axis II questionnaire in Portuguese

    Directory of Open Access Journals (Sweden)

    Ricardo Figueiredo Cavalcanti

    2010-06-01

    Full Text Available OBJECTIVE: The aim of the study was to validate the multimedia version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Axis II Questionnaire in Portuguese language. MATERIAL AND METHODS: The sample comprised 30 patients with signs and symptoms of temporomandibular disorders (TMD, evaluated at the Orofacial Pain Control Center of the Dental School of the University of Pernambuco, Brazil, between April and June 2006. Data collection was performed using the following instruments: Simplifed Anamnestic Index (SAI and RDC/TMD Axis II written version and multimedia version. The validation process consisted of analyzing the internal consistency of the scales. Concurrent and convergent validity were evaluated by the Spearman's rank correlation. In addition, test and analysis of reproducibility by the Kappa weighted statistical test and Spearman's rank correlation test were performed. RESULTS: The multimedia version of the RDC/TMD Axis II questionnaire in Portuguese was considered consistent (Crombrach alpha = 0.94, reproducible (Spearman 0.670 to 0.913, p<0.01 and valid (p<0.01. CONCLUSION: The questionnaire showed valid and reproducible results, and represents an instrument of practical application in epidemiological studies of TMD in the Brazilian population.

  5. 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 ...

  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

    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...

  7. Development of a reliable and clinically useful Italian version of the Axis II for the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD

    Directory of Open Access Journals (Sweden)

    Ludovica Antonella Macrì

    2008-06-01

    Full Text Available

    Background: Multiple-language versions of the same psychometric instrument are increasingly needed, but simply translating an English version word-to-word into another language is not adequate to account for linguistic and cultural differences. Our aim was to alidate an Italian version of the Axis II of the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD and to test its reproducibility in order to use this important diagnostic instrument in Italian patients.

    Methods: The original English-language version was translated and culturally adapted for Italian-speaking people, back-translated to English and then tested on 68 subjects: 34 TMD patients and 34 healthy subjects. Internal consistency was assessed by calculating the Cronbach coefficient alpha for the entire scale in the two samples. The reproducibility of the domains was assessed with the use of the Spearman-Brown test-retest reliability test, Wilcoxon matched pair test, Sign test and 2x2table Chi Square test according to the data types. Correlation of the initial and test-retest scores of the Axis II was measured with the Spearman rank correlation coefficient as an additional measure of reproducibility.

    Results: The Italian version of Axis II has a good eproducibility; the internal consistency (measured with he Cronbach coefficient alpha of the overall final questionnaire was excellent: 0.95.

    Conclusions: The Axis II Italian version appeared reliable and it could be useful to assess TMD patients and to standardize the data acquisition in this relevant and common disease.

  8. Headache children with temporomandibular disorders have several types of pain and other symptoms.

    Science.gov (United States)

    Liljeström, M-R; Le Bell, Y; Anttila, P; Aromaa, M; Jämsä, T; Metsähonkala, L; Helenius, H; Viander, S; Jäppilä, E; Alanen, P; Sillanpää, M

    2005-11-01

    The aim was to investigate the association between temporomandibular disorders (TMD) and overall muscle tenderness, depressive symptoms, sleep difficulties, headache frequency and related symptoms in children with primary headache in comparison with controls. Based on an unselected population sample of 1135 Finnish schoolchildren classified according to the type of headache at age 12, altogether 297 children aged 13-14 from different headache groups and healthy controls were randomly selected for an interview and clinical examinations. Children with migraine had more TMD signs than children with nonmigrainous headaches or healthy controls. High TMD total scores were associated with palpation tenderness in other parts of the body and with frequent headache attacks. We conclude that children with overall headache, migraine in particular, and high total TMD scores showed an increased overall tenderness to muscle palpation and multiply manifested hypersensitivity pain.

  9. Effect of facial massage on static balance in individuals with temporomandibular disorder - a pilot study.

    Science.gov (United States)

    El Hage, Yasmin; Politti, Fabiano; Herpich, Carolina Marciela; de Souza, Dowglas Fernando Magalhães; de Paula Gomes, Cid André Fidelis; Amorim, Cesar Ferreira; de Oliveira Gonzalez, Tabajara; Biasotto-Gonzalez, Daniela Aparecida

    2013-01-01

    The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate

  10. 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.

  11. Cervical spine dysfunction signs and symptoms in individuals with temporomandibular disorder.

    Science.gov (United States)

    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.

  12. Tinnitus in patients with temporo-mandibular joint disorder: Proposal for a new treatment protocol.

    Science.gov (United States)

    Attanasio, Giuseppe; Leonardi, Alessandra; Arangio, Paolo; Minni, Antonio; Covelli, Edoardo; Pucci, Resi; Russo, Francesca Yoshie; De Seta, Elio; Di Paolo, Carlo; Cascone, Piero

    2015-06-01

    The present study was designed to verify the correlation between tinnitus and temporomandibular joint dysfunction.86 consecutive patients were enrolled in the study, all affected by subjective tinnitus without hearing impairment, from both genders, age between 18 and 60 years old. The final number of patients included in the study was 55. All patients received a temporo-mandibular joint examination. All the patients were asked to rate the severity of their symptoms before and after treatment using a VAS scale and the Tinnitus Handicap Inventory (THI) and they followed a standardized protocol for the investigation of tinnitus. All the subjects were monitored by the same researcher and they underwent the same splint treatment. The comparison between pre- and posttreatment phase scores showed in patients with predisposition of TMD and with TMD a statistically significant decrease of THI and VAS values. The characteristics of tinnitus and the degree of response to treatment confirmed the relationship between tinnitus and TMD. The authors believe that, when the most common causes of tinnitus, such as otologic disorders and neurological diseases are excluded, it is correct to evaluate the functionality of the temporo-mandibular joint and eventually treat its pathology to obtain tinnitus improvement or even resolution. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students.

    Science.gov (United States)

    Mejersjö, Christina; Ovesson, Daniel; Mossberg, Birgitta

    2016-01-01

    The use of chewing-gum and piercing has become common among adolescents and might result in increased oral muscle activity and overloading. Aim To investigate the frequency of oral piercing and parafunctions in relation to symptoms of temporomandibular disorders (TMD) among adolescents. One hundred and twenty-four third level high school students, living either in a city or in a small town, enrolled in either science or media programmes, were included. The students completed a questionnaire regarding different parafunctions and symptoms of TMD. A clinical examination of the temporomandibular system and estimation of the tooth wear was performed in 116 students. Chewing-gum was used by 86% of the students (25% with a daily use) and 14% had an oral piercing. The science students used more chewing gum than the media students (p = 0.008), while the media students had more piercings (p headache, 18% for clicking, 7% for facial pain and 6% for difficulty to open wide. Girls reported more headaches (p = 0.007) and more severe symptoms (p = 0.003), had more medical consultations and used more analgesics (both p headache (p temporomandibular joints and muscles (both p headache and muscle tenderness (both p headache (p < 0.05) and tooth wear (p = 0.004). There is an association between use of chewing gum, nail biting, oral piercing, and symptoms of TMD.

  14. 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 (pbruxism.

  15. Migraine is the most prevalent primary headache in individuals with temporomandibular disorders.

    Science.gov (United States)

    Franco, Ana L; Gonçalves, Daniela A G; Castanharo, Sabrina M; Speciali, José G; Bigal, Marcelo E; Camparis, Cinara M

    2010-01-01

    To assess the prevalence of primary headaches (HA) in adults with temporomandibular disorders (TMD) who were assessed in a specialty orofacial pain clinic, as well as in controls without TMD. The sample consisted of 158 individuals with TMD seen at a university-based specialty clinic, as well as 68 controls. The Research Diagnostic Criteria for TMD were used to diagnose the TMD patients. HAs were assessed using a structured interview and classified according to the Second Edition of the International Classification for Headache Disorders. Data were analyzed by chi-square tests with a significance level of 5% and odds ratio (OR) tests with a 95% confidence interval (CI). HAs occurred in 45.6% of the control group (30.9% had migraine and 14.7% had tension-type headache [TTH]) and in 85.5% of individuals with TMD. Among individuals with TMD, migraine was the most prevalent primary HA (55.3%), followed by TTH (30.2%); 14.5% had no HA. In contrast to controls, the odds ratio (OR) for HA in those with TMD was 7.05 (95% confidence interval [CI] = 3.65-13.61; P = .000), for migraine, the OR was 2.76 (95% CI = 1.50-5.06; P = .001), and for TTH, the OR was 2.51 (95% CI = 1.18-5.35; P = .014). Myofascial pain/arthralgia was the most common TMD diagnosis (53.2%). The presence of HA or specific HAs was not associated with the time since the onset of TMD (P = .714). However, migraine frequency was positively associated with TMD pain severity (P = .000). TMD was associated with increased primary HA prevalence rates. Migraine was the most common primary HA diagnosis in individuals with TMD.

  16. Global body posture and plantar pressure distribution in individuals with and without temporomandibular disorder: a preliminary study.

    Science.gov (United States)

    Souza, Juliana A; Pasinato, Fernanda; Corrêa, Eliane C R; da Silva, Ana Maria T

    2014-01-01

    The aim of this study was to evaluate body posture and the distribution of plantar pressure at physiologic rest of the mandible and during maximal intercuspal positions in subjects with and without temporomandibular disorder (TMD). Fifty-one subjects were assessed by the Diagnostic Criteria for Research on Temporomandibular Disorders and divided into a symptomatic group (21) and an asymptomatic group (30). Postural analysis for both groups was conducted using photogrammetry (SAPo version 0.68; University of São Paulo, São Paulo, Brazil). The distribution of plantar pressures was evaluated by means of baropodometry (Footwork software), at physiologic rest and maximal intercuspal positions. Of 18 angular measurements, 3 (17%) were statistically different between the groups in photogrammetric evaluation. The symptomatic group showed more pronounced cervical distance (P = .0002), valgus of the right calcaneus (P = .0122), and lower pelvic tilt (P = .0124). The baropodometry results showed the TMD subjects presented significantly higher rearfoot and lower forefoot distribution than those in the asymptomatic group. No differences were verified in maximal intercuspal position in the between-group analysis and between the 2 mandibular positions in the within-group analysis. Subjects with and without TMD presented with global body posture misalignment. Postural changes were more pronounced in the subjects with TMD. In addition, symptomatic subjects presented with abnormal plantar pressure distribution, suggesting that TMD may have an influence on the postural system. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  17. Parallel Randomized Controlled Clinical Trial in Patients with Temporomandibular Disorders Treated with a CAD/CAM Versus a Conventional Stabilization Splint.

    Science.gov (United States)

    Pho Duc, Jean Marc; Hüning, Sandra Vargas; Grossi, Márcio Lima

    2016-01-01

    This parallel randomized controlled trial (RCT) compared the efficacy of a computer-aided design/computer-assisted manufacture (CAD/CAM) splint versus a conventional stabilization splint in patients with temporomandibular disorders (TMD). A sample of 48 age-matched TMD patients from the Ludwig Maximilian University Prosthodontic Department in Munich, Germany, were randomly allocated into groups 1 (CAD/CAM splint) and 2 (conventional splint). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used for TMD Axis I (groups I, II, and III) and Axis II (chronic pain grade [CPG]) diagnoses. Numeric scales (TMD/NS, 10 cm) were used to measure headaches, face pain, jaw joint pain, jaw joint noises, mastication pain, neck pain, face tension, limitation of mouth opening, complaints during mastication, and teeth sensitivity at baseline and then monthly for 9 months (T₁ to T₁₀). Optical axiography was used to measure right and left condyle movements (mm) at baseline, 3 months, and 6 months (T₁, T₄, and T₇). A total of 32 patients (drop-out rate = 33%; 68.75% women; 28.51 ± 7.13 years old), 16 per group, completed the study. RDC/TMD Axis I showed the following diagnoses: 93.75% muscle disorders, 37.75% disc displacement with reduction, 3.12% disc displacement without reduction, and 56.25% arthralgia. There was a significant reduction in 10 out of 13 items of the TMD/NS in the CAD/CAM splint versus 8 out of 13 in the conventional splint. However, no significant improvement in mandibular movements (ie, increase in range of motion and reduction in asymmetry between right and left condyles) was observed. Both treatments were equally efficacious and no difference was found between them.

  18. 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.

  19. Do women with migraine have higher prevalence of temporomandibular disorders? Mulheres com enxaqueca têm maior prevalência de disfunção temporomandibular?

    Directory of Open Access Journals (Sweden)

    Maria C Gonçalves

    2012-01-01

    Full Text Available OBJECTIVES: The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD, using the Research Diagnostic Criteria for TMD (RDC/TMD in women with episodic and chronic migraine (M and CM, as well as in asymptomatic women. METHOD: Sample consisted of 61 women, being 38 with M and 23 with CM, identified from a headache outpatient center; we also investigated 30 women without headaches for at least 3 months (women without headache group - WHG. Assessment of TMD was conducted by a physical therapist who was blind to the headache status. RESULTS: The prevalence of TMD, assessed through the RDC, was 33.3% in the WHG, 86.8% in the M group and 91.3% of the CM group. Differences were significant when comparing M and CM groups with WHG (p0.05 as well as higher risk for TMD [odds ratio (OR=3.15, 95% confidence interval (CI 1.73-5.71 and OR=3.97, 95%CI 1.76-8.94]. CONCLUSION: Women with migraine are more likely to have muscular and articular TMD, suggesting that both disorders might be clinically associated, which demonstrate the importance of physical therapy assessment in the multidisciplinary team.OBJETIVOS: Avaliar a presença de disfunção temporomandibular (DTM usando o Critério Diagnóstico em pesquisa para disfunção temporomandibular (RDC/TMD em mulheres com migrânea episódica e migrânea crônica (M e MC, bem como em mulheres sem nenhuma cefaleia. MÉTODO: A amostra foi composta por 61 mulheres, 38 com M e 23 com MC, selecionadas em um centro terciário de saúde; também foram avaliadas 30 mulheres sem nenhuma cefaleia nos últimos três meses (grupo de mulheres sem cefaleia - MSC. A avaliação da DTM foi realizada por um fisioterapeuta que não tinha conhecimento do diagnóstico das pacientes. RESULTADOS: Por meio do RDC/TMD, a frequência de DTM foi de 33.3% no grupo MSC, 86.8% no grupo M e 91.3% no grupo MC. A diferença foi significativa entre os grupos com migrânea e o grupo MSC (p0,05, bem como maior fator de

  20. Do women with migraine have higher prevalence of temporomandibular disorders? Mulheres com enxaqueca têm maior prevalência de disfunção temporomandibular?

    Directory of Open Access Journals (Sweden)

    Maria C Gonçalves

    2013-02-01

    Full Text Available OBJECTIVES: The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD, using the Research Diagnostic Criteria for TMD (RDC/TMD in women with episodic and chronic migraine (M and CM, as well as in asymptomatic women. METHOD: Sample consisted of 61 women, being 38 with M and 23 with CM, identified from a headache outpatient center; we also investigated 30 women without headaches for at least 3 months (women without headache group - WHG. Assessment of TMD was conducted by a physical therapist who was blind to the headache status. RESULTS: The prevalence of TMD, assessed through the RDC, was 33.3% in the WHG, 86.8% in the M group and 91.3% of the CM group. Differences were significant when comparing M and CM groups with WHG (p0.05 as well as higher risk for TMD [odds ratio (OR=3.15, 95% confidence interval (CI 1.73-5.71 and OR=3.97, 95%CI 1.76-8.94]. CONCLUSION: Women with migraine are more likely to have muscular and articular TMD, suggesting that both disorders might be clinically associated, which demonstrate the importance of physical therapy assessment in the multidisciplinary team.OBJETIVOS: Avaliar a presença de disfunção temporomandibular (DTM usando o Critério Diagnóstico em pesquisa para disfunção temporomandibular (RDC/TMD em mulheres com migrânea episódica e migrânea crônica (M e MC, bem como em mulheres sem nenhuma cefaleia. MÉTODO: A amostra foi composta por 61 mulheres, 38 com M e 23 com MC, selecionadas em um centro terciário de saúde; também foram avaliadas 30 mulheres sem nenhuma cefaleia nos últimos três meses (grupo de mulheres sem cefaleia - MSC. A avaliação da DTM foi realizada por um fisioterapeuta que não tinha conhecimento do diagnóstico das pacientes. RESULTADOS: Por meio do RDC/TMD, a frequência de DTM foi de 33.3% no grupo MSC, 86.8% no grupo M e 91.3% no grupo MC. A diferença foi significativa entre os grupos com migrânea e o grupo MSC (p0,05, bem como maior fator de

  1. Clinical phenotype of South-East Asian temporomandibular disorder patients with upper airway resistance syndrome.

    Science.gov (United States)

    Tay, D K L; Pang, K P

    2018-01-01

    Clinical and radiographic characteristics of a subset of South East Asian temporomandibular disorder (TMD) patients with comorbid upper airway resistance syndrome (UARS) were documented in a multi-center prospective series of 86 patients (26 men and 60 women / mean age 35.7 years). All had excessive daytime sleepiness, high arousal index and Apnoea-Hypopnoea Index (AHI) temporomandibular joint (TMJ) arthralgia while 90·7% reported sleep bruxism (SB). Unlike patients with obstructive sleep apnoea (OSA), hypertension was uncommon (4·7%) while depression was prevalent at 68·6% with short REM latency of 25% documented in 79·6% and 57·6% of these depressed patients, respectively. 65·1% displayed a posteriorly displaced condyle at maximum intercuspation with or without TMJ clicking. Most exhibited a forward head posture (FHP) characterised by loss of normal cervical lordosis (80·2%), C0-C1 narrowing (38·4%) or an elevated hyoid position (50%), and 91·9% had nasal congestion. We postulate the TMD-UARS phenotype may have originally developed as an adaptive response to 'awake' disordered breathing during growth. Patients with persistent TMD and/or reporting SB should be screened for UARS and chronic nasal obstruction, especially when they also present with FHP. The lateral cephalogram is a useful tool in the differentiation of UARS from other OSA phenotypes. © 2017 John Wiley & Sons Ltd.

  2. Prevalence of Temporomandibular Disorder in Children and Adolescents from Public Schools in Southern Portugal

    Science.gov (United States)

    Minghelli, Beatriz; Cardoso, Iara; Porfírio, Melani; Gonçalves, Roberta; Cascalheiro, Sabina; Barreto, Vera; Soeiro, Andreia; Almeida, Leandro

    2014-01-01

    Background: The prevalence of temporomandibular disorder (TMD) in children and adolescents is in the range of 6-68% and can be triggered or aggravated by emotional stress. Aim: The study was to investigate the prevalence of TMD in Portuguese children and adolescents and its association with emotional stress. Materials and Methods: The sample comprised 3,260 students aged 5-19 years. The questionnaire was used to assess the presence of TMD, and was applied in a single moment. Results: TMD was observed in 821 (25.2%) students. The most common symptoms of TMD were: if considered tense or nervous (52%), have headaches (36.8%), and habit of clenching or grinding teeth (27.3%). The girls had a 1.36 higher probability of developing TMD than boys (95% CI: 1.14-1.63; p < 0.001); moreover, students from the older age group had a 2.31 higher probability of developing the disorder (95% CI: 1.85-2.89; p < 0.001). Students who considered themselves tense or nervous presented 8.74 higher probability (95% CI: 7.03-10.86; p < 0.001) of developing TMD. Conclusion: This study showed a high prevalence of TMD in children and adolescents in southern Portugal, and revealed a significant association between this dysfunction and the levels of emotional stress. Female students, older students, and those considered tense or nervous have a higher probability of developing TMD. PMID:24741551

  3. Temporomandibular joint involvement in rheumatoid arthritis patients: association between clinical and tomographic data

    OpenAIRE

    Cordeiro, Patrícia C. F; Guimaraes, Josemar P; de Souza, Viviane A; Dias, Isabela M; Silva, Jesca N. N; Devito, Karina L; Bonato, Leticia L

    2016-01-01

    Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questio...

  4. 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.

  5. Relationship Between Orthodontics and Temporomandibular Disorders: A Prospective Study.

    Science.gov (United States)

    Antunes Ortega, Ana Carolina Bannwart; Pozza, Daniel Humberto; Rocha Rodrigues, Luciane Lacerda Franco; Guimarães, Antônio Sergio

    2016-01-01

    To investigate the possible relationship between the orthodontic treatment of Class II malocclusion and the development of temporomandibular disorders (TMD). A total of 40 patients was evaluated at four time points: the day before the start of treatment employing bilateral Class II elastics (baseline), as well as at 24 hours, 1 week, and 1 month after the start of treatment. The development of TMD pain complaints in the orofacial region and changes in the range of mouth opening were assessed at these times. Shapiro-Wilk, McNemar, and Friedman tests with 5% significance level were used to analyze the data. The treatment produced pain of a transitory, moderate intensity, but there was no significant change from baseline after 1 month. There were no restrictions in the range of jaw motion or any evidence of limitations in mouth opening. Orthodontic treatment with bilateral Class II elastics does not cause significant orofacial pain or undesirable changes in the range of mouth opening. Furthermore, this modality of orthodontic treatment was not responsible for inducing TMD.

  6. Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection

    Directory of Open Access Journals (Sweden)

    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.

  7. Inflammatory Cytokines and Sleep Disturbance in Patients with Temporomandibular Disorders.

    Science.gov (United States)

    Park, Ji Woon; Chung, Jin Woo

    2016-01-01

    To assess the degree and interrelationship of sleep disturbance and plasma cytokine levels in temporomandibular disorder (TMD) pain patients. Forty female TMD patients and 20 age-, sex-, and body mass index (BMI)-matched healthy subjects were enrolled. TMD was diagnosed using the Research Diagnostic Criteria for TMD. The TMD patients were classified as having low or high disability according to Graded Chronic Pain Scale findings. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to measure sleep quality. Plasma concentrations of interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were measured from blood samples collected between 9 am and noon. Statistical analyses included Kruskal-Wallis and one-way analysis of variance tests to compare results between different groups and multivariate general linear models to evaluate the effect of sleep status on cytokine levels. The high-disability group had the highest PSQI and ESS scores (P disability group exhibiting the highest values (P ≤ .001). The plasma cytokine levels were significantly correlated with PSQI scores (P disability level after adjusting for both sleep indices (both P disability, had elevated plasma cytokine levels and increased ESS and PSQI scores suggestive of sleep disturbance.

  8. Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences.

    Science.gov (United States)

    Troeltzsch, M; Troeltzsch, M; Cronin, R J; Brodine, A H; Frankenberger, R; Messlinger, K

    2011-06-01

    Although an interaction of malocclusion, parafunction, and temporomandibular joint disorders (TMD) can be inferred from the experience of daily practice, scientific evidence to corroborate this hypothesis does not exist. However, there are indications that TMD and headaches may be intertwined. The purpose of this study was to identify the presence or absence of an association of occlusal interferences, parafunction, TMD, or physiologic, muscular, or prosthodontic factors with the occurrence of headache. In a private practice population of 1031 subjects (436 men and 595 women, mean age 49.6 years) the demographic parameters, headache and general pain history, habits and general personal information were recorded. Clinical examination for dental, muscular, and temporomandibular joint pathology was accomplished. Data were statistically analyzed using the Mann-Whitney U, Kruskal-Wallis, and Chi-Square tests (α = .05). A multinomial logistic regression analysis was performed with respect to confounding variables. Headache affliction was found to affect women more frequently than men (1.7:1). Students and non academics were more prone to suffer from headache. Parafunction (P=.001), TMD (P=.001) and gross differences between centric occlusion and maximum intercuspation of more than a 3 mm visible track marked with 8 μm articulation foil (P=.001) significantly influenced the presence of headache. Headache intensity and frequency decreased with age. While tension-type headache was most frequently diagnosed, the parameters studied were not significantly associated with one certain headache diagnosis more frequently than others. Stomatognathic factors of TMD, parafunction, and gross differences between centric occlusion and maximum intercuspation of more than 3 mm are associated with headache. These findings should be interpreted with caution due to the cross-sectional nature of this study. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry

  9. Systematic review of reliability and diagnostic validity of joint vibration analysis for diagnosis of temporomandibular disorders.

    Science.gov (United States)

    Sharma, Sonia; Crow, Heidi C; McCall, W D; Gonzalez, Yoly M

    2013-01-01

    To conduct a systematic review of papers reporting the reliability and diagnostic validity of the joint vibration analysis (JVA) for diagnosis of temporomandibular disorders (TMD). A search of Pubmed identified English-language publications of the reliability and diagnostic validity of the JVA. Guidelines were adapted from applied STAndards for the Reporting of Diagnostic accuracy studies (STARD) to evaluate the publications. Fifteen publications were included in this review, each of which presented methodological limitations. This literature is unable to provide evidence to support the reliability and diagnostic validity of the JVA for diagnosis of TMD.

  10. Does a dose-response relation exist between spinal pain and temporomandibular disorders?

    Directory of Open Access Journals (Sweden)

    Englund Erling

    2009-03-01

    Full Text Available Abstract Background The aim of this study was to test whether a reciprocal dose-response relation exists between frequency/severity of spinal pain and temporomandibular disorders (TMD. Methods A total of 616 subjects with varying severity of spinal pain or no spinal pain completed a questionnaire focusing on symptoms in the jaw, head and spinal region. A subset of the population (n = 266 were sampled regardless of presence or absence of spinal pain. We used two different designs, one with frequency/severity of spinal pain, and the other, with frequency/severity of TMD symptoms as independent variable. All 616 participants were allocated to four groups, one control group without spinal pain and three spinal pain groups. The subjects in the subset were allocated to one control group without TMD symptoms and three TMD groups. Odds ratios (ORs were calculated for presence of frequent TMD symptoms in the separate spinal pain groups as well as for frequent spinal pain in the separate TMD groups. Results The analysis showed increasing ORs for TMD with increasing frequency/severity of spinal pain. We also found increasing ORs for spinal pain with increasing frequency/severity of TMD symptoms. Conclusion This study shows a reciprocal dose-response-like relationship between spinal pain and TMD. The results indicate that these two conditions may share common risk factors or that they may influence each other. Studies on the temporal sequence between spinal pain and TMD are warranted.

  11. 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 (peffusion 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

  12. Prediction of Splint Therapy Efficacy Using Bone Scan in Patients with Unilateral Temporomandibular Disorder

    International Nuclear Information System (INIS)

    Lee, Sang Mi; Lee, Won Woo; Yun, Pil Young; Kim, Young Kyun; Kim, Sang Eun

    2009-01-01

    It is not known whether bone scan is useful for the prediction of the prognosis of patients with temporomandibular disorders (TMD). The aim of the present study was to identify useful prognostic markers on bone scan for the pre-therapeutic assessment of patients with unilateral TMD. Between January 2005 and July 2007, 55 patients (M:F=9:46; mean age, 34.7±14.1 y) with unilateral TMD that underwent a pre-therapeutic bone scan were enrolled. Uptake of Tc-99m HDP in each temporomandibular joint (TMJ) was quantitated using a 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratios and asymmetric indices were calculated. TMD patients were classified as improved or not improved and the bone scan findings associated with each group were investigated. Forty-six patients were improved, whereas 9 patients were not improved. There was no significant difference between the two groups of patients regarding the TMJ uptake ratio of the involved joint, the TMJ uptake ratio of the non-involved joint, and the asymmetric index (p>0.05). However, in a subgroup analysis, the patients with an increased uptake of Tc-99m HDP at the disease-involved TMJ, by visual assessment, could be easily identified by the asymmetric index; the patients that improved had a higher asymmetric index than the patients that did not improve (1.32±0.35 vs. 1.08±0.04, p=0.023), The Tc-99m HDP bone scan may help predict the prognosis of patients with unilateral TMD after splint therapy when the TMD-involved joint reveals increased uptake by visual assessment

  13. Prediction of Splint Therapy Efficacy Using Bone Scan in Patients with Unilateral Temporomandibular Disorder

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Mi; Lee, Won Woo; Yun, Pil Young; Kim, Young Kyun; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)

    2009-04-15

    It is not known whether bone scan is useful for the prediction of the prognosis of patients with temporomandibular disorders (TMD). The aim of the present study was to identify useful prognostic markers on bone scan for the pre-therapeutic assessment of patients with unilateral TMD. Between January 2005 and July 2007, 55 patients (M:F=9:46; mean age, 34.7{+-}14.1 y) with unilateral TMD that underwent a pre-therapeutic bone scan were enrolled. Uptake of Tc-99m HDP in each temporomandibular joint (TMJ) was quantitated using a 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratios and asymmetric indices were calculated. TMD patients were classified as improved or not improved and the bone scan findings associated with each group were investigated. Forty-six patients were improved, whereas 9 patients were not improved. There was no significant difference between the two groups of patients regarding the TMJ uptake ratio of the involved joint, the TMJ uptake ratio of the non-involved joint, and the asymmetric index (p>0.05). However, in a subgroup analysis, the patients with an increased uptake of Tc-99m HDP at the disease-involved TMJ, by visual assessment, could be easily identified by the asymmetric index; the patients that improved had a higher asymmetric index than the patients that did not improve (1.32{+-}0.35 vs. 1.08{+-}0.04, p=0.023), The Tc-99m HDP bone scan may help predict the prognosis of patients with unilateral TMD after splint therapy when the TMD-involved joint reveals increased uptake by visual assessment.

  14. Incisal tooth wear and self-reported TMD pain in children and adolescents.

    Science.gov (United States)

    Hirsch, Christian; John, Mike T; Lobbezoo, Frank; Setz, Juergen M; Schaller, Hans-Guenter

    2004-01-01

    Incisal tooth wear may be a sign of long-term bruxing behavior. Bruxism is purported to be a risk factor for temporomandibular disorders (TMD). The aim of this population-based cross-sectional study was to determine if anterior tooth wear is associated with the self-report of TMD pain in children and adolescents. In a population sample of 1,011 children and adolescents (mean age 13.1 years, range 10 to 18 years; female 52%; response rate 85%), TMD cases were defined as subjects reporting pain in the face, jaw muscles, and temporomandibular joint during the last month according to RDC/TMD. All other subjects were considered controls. Incisal tooth wear was assessed in the clinical examination using a 0 to 2 scale (no wear, enamel wear, dentin wear) for every anterior permanent tooth. The mean wear score for the individuals was categorized into 0, 0.01 to 0.20, 0.21 to 0.40, and 0.41+. A multiple logistic regression analysis, controlling for the effects of age and gender, analyzed the association between the categorized summary wear score and TMD. Specifically, the hypothesis of a trend between higher tooth wear scores and higher risk of TMD was tested. An odds ratio of 1.1 indicated, after adjusting for gender and age, no statistically significantly higher risk of TMD pain with higher tooth wear scores. Incisal tooth wear was not associated with self-reported TMD pain in 10- to 18-year-old subjects.

  15. Temporomandibular disorder is more prevalent among patients with primary headaches in a tertiary outpatient clinic

    Directory of Open Access Journals (Sweden)

    James Felipe Tomaz-Morais

    2015-11-01

    Full Text Available Objective The aim of this study was to estimate the prevalence of signs and symptoms of temporomandibular disorders (TMD in patients with primary headaches attended in a tertiary neurology ambulatory.Method Authorized by the Ethics Committee, the present cross-sectional study was conducted with a random sample of patients screened for orofacial pain and primary headaches at a tertiary hospital in Northeast of Brazil.Results The sample consisted in 42 patients with primary headache, 59.5% male. The prevalence of > 6 TMD signs and symptoms was 54.8%. In those patients with migraine TMD was present in 71.4% and in tension-type headache in 38.1% (p = 0.030; OR = 4.1. TMD was related to the clinical status of headache associated or attributed to medication overuse (p = 0.001.Conclusion TMD has a high prevalence in patients with primary headaches (54.8%. Special attention must be given to patients with migraine and headache associated or attributed to medication overuse.

  16. The reproducibility and responsiveness of a patient-specific approach: a new instrument in evaluation of treatment of temporomandibular disorders

    NARCIS (Netherlands)

    Rollman, A.; Naeije, M.; Visscher, C.M.

    2010-01-01

    AIMS: To evaluate the choice of activities on the Patient Specific Approach (PSA) in a sample of temporomandibular disorder (TMD) patients and to determine the clinimetric properties of the visual analog scale (VAS) scores of the PSA, in terms of reproducibility and responsiveness. METHODS: At

  17. Prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients wearing bimaxillary complete dentures, removable partial dentures and in students with natural dentition.

    Science.gov (United States)

    Bordin, Thaisa B; Conci, Ricardo A; Pezzini, Maristela M G; Pezzini, Rolando P; Mendonça, Márcio J

    2013-01-01

    Temporomandibular Disorder (TMD) has attained a prominent role within the context of dental care due to its high prevalence. The aim of this study was to evaluate the prevalence of signs and symptoms of TMD in students at the State University of West of Paraná (UNIOESTE) with natural dentition, and in patients with removable partial dentures and double complete dentures. A total of 210 randomly selected individuals of both genders were evaluated, being divided into three groups: seventy students at the UNIOESTE with natural dentition (Group 1), seventy patients with removable partial dentures (Group 2) and seventy patients with bimaxillary complete dentures (Group 3). The data were collected by a single examiner using the American Academy of Orofacial Pain questionnaire for triage, where a single affirmative response to any of the situations mentioned was enough to carry out clinical evaluation. Kolmogorov Smirnov, Mann Whitney, Chi-Square, ANOVA and Tukey's statistical tests were performed. The most prevalent signs and symptoms of TMD in Group 1 were pain or difficulty in chewing or talking, perception of recent change in bite and deviations during the course of mandibular movements. In Group 2 they were perceptions of recent changes in the bite, deflections in the mandibular movements, presence of joint sounds, pain during excursive movements and muscle tenderness. The most prevalent signs and symptoms in Group 3 were limited to mouth opening and poor stability and retention of at least one of the prostheses. Group 3 also reported having received treatment for headaches or facial pain with a high prevalence. Group 2 had the highest prevalence of signs and symptoms. Prevalence was similar in Groups 1 and 3.

  18. 'Management is a black art'--professional ideologies with respect to temporomandibular disorders.

    Science.gov (United States)

    Durham, J; Exley, C; Wassell, R; Steele, J G

    2007-06-09

    To gain a deeper understanding of the range of influences on the full range of dental professionals who provide treatment for temporomandibular disorders (TMD). Qualitative semi-structured interviews. Primary and secondary care in the North and South of the United Kingdom. A criterion-based purposive sample was taken of dental practitioners, comprising primary and secondary care practitioners. In-depth interviews were conducted and data collection and analysis occurred concurrently until data saturation was achieved. DATA AND DISCUSSION: There was a reported lack of adequate remuneration for provision of treatment for TMD within primary care. This alongside the primary care practitioners' reported uncertainty in diagnosis of TMD appeared to lead to a propensity for referral to secondary care. Practitioners recognised a poor and scanty evidence base on which to base their care, and this allowed for idiosyncratic practice. Often the outcome measure for treatment was a subjective questioning of the patient focussing mainly on relief of pain. There is a need for better quality evidence on which to base TMD treatment, more continuing professional development and improvement in contracting arrangements to enable primary practitioners to feel confident in managing TMD.

  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

    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...

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

    Science.gov (United States)

    Di Paolo, Carlo; D'Urso, Anna; Di Sabato, Francesco; Pompa, Giorgio

    2017-01-01

    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. PMID:28420942

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

    Science.gov (United States)

    Di Paolo, Carlo; D'Urso, Anna; Papi, Piero; Di Sabato, Francesco; Rosella, Daniele; Pompa, Giorgio; Polimeni, Antonella

    2017-01-01

    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.

  2. Influence of culture on pain comorbidity in women with and without temporomandibular disorder-pain.

    Science.gov (United States)

    Al-Harthy, M; Michelotti, A; List, T; Ohrbach, R

    2017-06-01

    Evidence on cultural differences in prevalence and impact of common chronic pain conditions, comparing individuals with temporomandibular disorders (TMD) versus individuals without TMD, is limited. The aim was to assess cross-cultural comorbid pain conditions in women with chronic TMD pain. Consecutive women patients (n = 122) with the index condition of chronic TMD pain diagnosed per the research diagnostic criteria for TMD and TMD-free controls (n = 121) matched for age were recruited in Saudi Arabia, Italy and Sweden. Self-report questionnaires assessed back, chest, stomach and head pain for prevalence, pain intensity and interference with daily activities. Logistic regression was used for binary variables, and ancova was used for parametric data analysis, adjusting for age and education. Back pain was the only comorbid condition with a different prevalence across cultures; Swedes reported a lower prevalence compared to Saudis (P 50% due to back pain compared to Italians or Swedes (P cultures. The total number of comorbid conditions did not differ cross-culturally but were reported more by TMD-pain cases than TMD-free controls (P Culture influences the associated comorbidity of common pain conditions. The cultural influence on pain expression is reflected in different patterns of physical representation. © 2017 John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    Jerjes Waseem

    2008-10-01

    Full Text Available Abstract This review explores the aetiology of temporomandibular disorders and discusses the controversies in variable treatment modalities. Pathologies of the temporomandibular joint (TMJ and its' associated muscles of mastication are jointly termed temporomandibular disorders (TMDs. TMDs present with a variety of symptoms which include pain in the joint and its surrounding area, jaw clicking, limited jaw opening and headaches. It is mainly reported by middle aged females who tend to recognize the symptoms more readily than males and therefore more commonly seek professional help. Several aetiological factors have been acknowledged including local trauma, bruxism, malocclusion, stress and psychiatric illnesses. The Research Diagnostic Criteria of the Temporomandibular Disorders (RDC/TMD is advanced to other criteria as it takes into consideration the socio-psychological status of the patient. Several treatment modalities have been recommended including homecare practices, splint therapy, occlusal adjustment, analgesics and the use of psychotropic medication; as well as surgery, supplementary therapy and cognitive behavioural therapy. Although splint therapy and occlusal adjustment have been extensively used, there is no evidence to suggest that they can be curative; a number of evidence-based trials have concluded that these appliances should not be suggested as part of the routine care. Surgery, except in very rare cases, is discouraged since it is the most invasive alternative; recent studies have shown healthier outcome with cognitive behavioural therapy.

  4. Is the experience of pain in patients with temporomandibular disorder associated with the presence of comorbidity?

    Science.gov (United States)

    Visscher, Corine M; van Wesemael-Suijkerbuijk, Erin A; Lobbezoo, Frank

    2016-10-01

    The aim of this study was to explore the association between the presence of comorbidities and the pain experience in individual patients with temporomandibular disorder (TMD). This clinical trial comprised 112 patients with TMD pain. For all participants the presence of the following comorbid factors was assessed: pain in the neck; somatization; impaired sleep; and depression. Pain experience was evaluated using the McGill Pain Questionnaire (MPQ). For each subject the TMD-pain experience was assessed for three dimensions - sensory, affective, and evaluative - as specified in the MPQ. The association between comorbid factors and these three dimensions of TMD-pain experience was then evaluated using linear regression models. Univariable regression analyses showed that all comorbid factors, except for one factor, were positively associated with the level of pain, as rated by the sensory description of pain, the affective component of pain, and the evaluative experience of pain. The multivariable regression analyses showed that for all MPQ dimensions, depression showed the strongest associations with pain experience. It was found that in the presence of comorbid disorders, patients with TMD experience elevated levels of TMD pain. This information should be taken into consideration in the diagnostic process, as well as in the choice of treatment. © 2016 Eur J Oral Sci.

  5. 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.

  6. Static body postural misalignment in individuals with temporomandibular disorders: a systematic review

    Science.gov (United States)

    Chaves, Thaís C.; Turci, Aline M.; Pinheiro, Carina F.; Sousa, Letícia M.; Grossi, Débora B.

    2014-01-01

    BACKGROUND: The association between body postural changes and temporomandibular disorders (TMD) has been widely discussed in the literature, however, there is little evidence to support this association. OBJECTIVES: The aim of the present study was to conduct a systematic review to assess the evidence concerning the association between static body postural misalignment and TMD. METHOD: A search was conducted in the PubMed/Medline, Embase, Lilacs, Scielo, Cochrane, and Scopus databases including studies published in English between 1950 and March 2012. Cross-sectional, cohort, case control, and survey studies that assessed body posture in TMD patients were selected. Two reviewers performed each step independently. A methodological checklist was used to evaluate the quality of the selected articles. RESULTS: Twenty studies were analyzed for their methodological quality. Only one study was classified as a moderate quality study and two were classified as strong quality studies. Among all studies considered, only 12 included craniocervical postural assessment, 2 included assessment of craniocervical and shoulder postures,, and 6 included global assessment of body posture. CONCLUSION: There is strong evidence of craniocervical postural changes in myogenous TMD, moderate evidence of cervical postural misalignment in arthrogenous TMD, and no evidence of absence of craniocervical postural misalignment in mixed TMD patients or of global body postural misalignment in patients with TMD. It is important to note the poor methodological quality of the studies, particularly those regarding global body postural misalignment in TMD patients. PMID:25590441

  7. Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults.

    Science.gov (United States)

    Akhter, Rahena; Morita, Manabu; Ekuni, Disuke; Hassan, Nur Mohammad Monsur; Furuta, Michiko; Yamanaka, Reiko; Matsuka, Yoshizo; Wilson, David

    2013-02-06

    To investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD) symptoms in a young adult population in Japan. A personal interview survey was conducted on first-year university students (n = 1,930) regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender. Among the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n = 319), pain in the TMJ only (Group II, n = 21), difficulty in mouth opening only (Group III, n = 18), clicking and pain (Group IV, n = 29), clicking and difficulty in mouth opening (Group V, n = 48), difficulty in mouth opening and pain (Group VI, n = 11), and combination of three symptoms (Group VII, n = 97). The control group (n = 1,387) were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV) and tinnitus (OR = 12.1 and 13.2, respectively). TMD symptoms (Group I, II and III) were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only. TMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache.

  8. Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD.

    Science.gov (United States)

    Maffei, Carla; Mello, Marçal Motta de; Biase, Noemi Grigoletto de; Pasetti, Lilian; Camargo, Paulo A Monteiro; Silvério, Kelly Cristina Alves; Gonçalves, Maria Inês Rebelo

    2012-01-01

    To study mastication and swallowing disorders in patients with temporomandibular disorders (TMD). To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.

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

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    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.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

    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 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). 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.

  11. 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.

  12. Temporomandibular disorder-type pain and migraine headache in women: a preliminary twin study.

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    Plesh, Octavia; Noonan, Carolyn; Buchwald, Dedra S; Goldberg, Jack; Afari, Niloo

    2012-01-01

    To determine whether shared genetic influences are responsible for the association between pain from temporomandibular disorders (TMD) and migraine headache. Data were obtained from 1,236 monozygotic and 570 dizygotic female twin pairs from the University of Washington Twin Registry. TMD pain was assessed with a question about persistent or recurrent pain in the jaw, temple, in front of the ear, or in the ear. The presence of migraine headache was determined by self-report of doctor-diagnosed migraine. Univariate and bivariate structural equation models estimated the components of variance attributable to genetic and environmental influences. The best fitting univariate models indicated that additive genetic effects contributed 27% of the variance in TMD pain (95% confidence interval = 15% to 38%) and 49% of the variance in migraine headache (95% confidence interval = 40% to 57%). The best-fitting bivariate model revealed that 12% of the genetic component of TMD pain is shared with migraine headache. These preliminary findings suggest that the association between TMD pain and migraine headache in women may be partially due to a modest shared genetic risk for both conditions. Future studies can focus on replicating these findings with symptom- and diagnosis-based instruments.

  13. TMD: it's our responsibility.

    Science.gov (United States)

    Dale, R

    1999-01-01

    Temporomandibular disorder (TMD) is a reality. Surveys place the incidence at about 20-50%. For decades debate has raged as to whether this is a medical or dental problem. Scientific study of anatomy, biochemistry, physiology, and objective analysis with kinesiology, electromyography and sonography, along with case history all point to the same thing; occlusion affects the joint and the muscles. This is our profession's "crown jewel". We diagnose, construct and modify our patient's occlusion. It is about time we all agree, understand, take responsibility and start cooperating in preventing and treating this common malady that seriously affects the quality of life of many.

  14. 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.

  15. The Evaluation of Head and Craniocervical Posture among Patients with and without Temporomandibular Joint Disorders- A Comparative Study.

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    Saddu, Shweta Channavir; Dyasanoor, Sujatha; Valappila, Nidhin J; Ravi, Beena Varma

    2015-08-01

    Temporomandibular disorders (TMD) are the most common non-dental cause of orofacial pain with a multifactorial aetiology. To evaluate the head and craniocervical posture between individuals with and without TMD and its sub types by photographic and radiographic method. Thirty four TMD patients diagnosed according to Research Diagnostic Criteria for TMD's (RDC/TMD) and were divided into 2 groups: Group I (muscle disorder), Group II (disc displacement). Control group comprised of 34 age and sex matched subjects without TMD. Lateral view photographs were taken and the head posture angle was measured. Craniocervical posture was assessed on lateral skull radiograph with two angles (Craniocervical Angle, Cervical Curvature Angle) and two distances (Suboccipital Space, Atlas-Axis Distance). To compare the results, t-test was used with significance level of 0.05. Head posture showed no statistical significant difference (p > 0.05) between Group I, II and control group in both photographic and radiographic methods. The cervical curvature angle showed significant difference (p = 0.045) in Group I only. Atlas-Axis Distance was statistically significant in Group II (p = 0.001). The present study confirmed that there is a negative association of head posture and TMD whereas, cervical lordosis was present in Group I only.

  16. Familial occurrence of signs of temporomandibular disorders in headache children and their mothers.

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    Liljeström, Marjo-Riitta; Aromaa, Minna; Bell, Yrsa Le; Jämsä, Tapio; Helenius, Hans; Virtanen, Ruut; Anttila, Pirjo; Metsähonkala, Liisa; Rautava, Päivi; Alanen, Pentti; Sillanpää, Matti

    2007-06-01

    Earlier studies have provided evidence of genetic inheritance of headache, especially migraine, but no familial occurrence has been found regarding temporomandibular disorders (TMD). In adults, headache and TMD have been found to be associated with each other, but studies on children are few. The aim of the present study was to test the hypothesis that there is no association between signs of TMD in 13-year-old headache children and their mothers. The study population was a nested case-control study of the population-based Finnish Family Competence Study originally consisting of over 1000 families. A structured questionnaire was sent to the families of 6-year-old children. A clinical examination was performed in 96 children with headache and 96 pairwise controls. At the age of 13 years, 75 of these same 96 children with headache and 79 of 96 headache-free controls participated in pediatric and stomatognathic examinations. Moreover, the mothers (n=154) filled in a structured headache questionnaire and participated in the stomatognathic examination. No association between mother's and child's TMD signs was found. There was a significant association between signs of TMD and both migraine and tension-type headache in children. In mothers, the association was significant only between migraine and TMD signs. Familial occurrence of signs of TMD cannot be found in headache children and their mothers.

  17. Are intra-articular injections of hyaluronic acid effective for the treatment of temporomandibular disorders? A systematic review.

    Science.gov (United States)

    Goiato, M C; da Silva, E V F; de Medeiros, R A; Túrcio, K H L; Dos Santos, D M

    2016-12-01

    This systematic review aimed to investigate whether intra-articular injections of hyaluronic acid (HA) are better than other drugs used in temporomandibular joint arthrocentesis, for the improvement of temporomandibular disorder (TMD) symptoms. Two independent reviewers performed an electronic search of the MEDLINE and Web of Science databases for relevant studies published in English up to March 2016. The key words used included a combination of 'hyaluronic acid', 'viscosupplementation', 'intra-articular injections', 'corticosteroids', or 'non steroidal anti inflammatory agents' with 'temporomandibular disorder'. Selected studies were randomized clinical trials and prospective or retrospective studies that primarily investigated the application of HA injections compared to other intra-articular medications for the treatment of TMD. The initial screening yielded 523 articles. After evaluation of the titles and abstracts, eight were selected. Full texts of these articles were accessed and all fulfilled the inclusion criteria. Intra-articular injections of HA are beneficial in improving the pain and/or functional symptoms of TMDs. However, other drug therapies, such as corticosteroid and non-steroidal anti-inflammatory drug injections, can be used with satisfactory results. Well-designed clinical studies are necessary to identify an adequate protocol, the number of sessions needed, and the appropriate molecular weight of HA for use. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. 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.

  19. Clinical study in elderly patients with temporomandibular disorders. A comparison with patients in their 20s

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    Okazaki, Atsuko; Miyajima, Hisashi; Yagi, Minoru; Takagi, Ritsuo

    2010-01-01

    To evaluate the characteristics of temporomandibular disorders (TMD) in elderly patients, we performed a clinicostatistical study in 122 patients aged ≥60 years. Based on medical records, panoramic X-ray images, and MR images, clinical findings (sex-related differences, chief complaint, disease duration, frequency of complication, disorder type classification, joint sound (crepitation), maximum mouth opening, and occlusal support) and imaging findings (articular disc position in type IV, disc configuration, mandibular condyle bony changes) were compared between the elderly subjects and 125 patients in their 20s. As a result, significant differences were observed in disease duration, disorder type classification, and disc configuration, showing prolongation, increases in types I and IV, and an increase in cases of severe deformation, respectively, in the elderly patients. Therefore, management with consideration of these characteristics may be important in the diagnosis and treatment of TMD. (author)

  20. Influence of temple headache frequency on physical functioning and emotional functioning in subjects with temporomandibular disorder pain.

    Science.gov (United States)

    List, Thomas; John, Mike T; Ohrbach, Richard; Schiffman, Eric L; Truelove, Edmond L; Anderson, Gary C

    2012-01-01

    To investigate the relationship of headache frequency with patient-reported physical functioning and emotional functioning in temporomandibular disorder (TMD) subjects with concurrent temple headache. The Research Diagnostic Criteria for TMD (RDC/TMD) Validation Project identified, as a subset of 614 TMD cases and 91 controls (n = 705), 309 subjects with concurrent TMD pain diagnoses (RDC/TMD) and temple headache. The temple headaches were subdivided into infrequent, frequent, and chronic headache according to the International Classification of Headache Disorders, second edition (ICHD-II). Study variables included self-report measures of physical functioning (Jaw Function Limitation Scale [JFLS], Graded Chronic Pain Scale [GCPS], Short Form-12 [SF-12]) and emotional functioning (depression and anxiety as measured by the Symptom Checklist-90R/SCL-90R). Differences among the three headache subgroups were characterized by increasing headache frequency. The relationship between ordered headache frequency and physical as well as emotional functioning was analyzed using linear regression and trend tests for proportions. Physical functioning, as assessed with the JFLS (P headache frequency. Emotional functioning, reflected in depression and anxiety, was also associated with increased frequency of headache (both P Headache frequency was substantially correlated with reduced physical functioning and emotional functioning in subjects with TMD and concurrent temple headaches. A secondary finding was that headache was precipitated by jaw activities more often in subjects with more frequent temple headaches.

  1. Temporomandibular disorder in otolaryngology: systematic review.

    Science.gov (United States)

    Stepan, L; Shaw, C-K L; Oue, S

    2017-01-01

    Temporomandibular disorder poses a diagnostic challenge to otolaryngologists as orofacial pain, headache and otology symptoms are very common in temporomandibular disorder, and mimic a number of otolaryngological conditions. Missed diagnosis of temporomandibular disorder can lead to unnecessary investigation and treatment, resulting in further patient suffering. To review the current literature and propose management pathways for otolaryngologists to correctly differentiate temporomandibular disorder from other otolaryngological conditions, and to initiate effective treatment for temporomandibular disorder in collaboration with other health professionals. A systematic review using PubMed and Medline databases was conducted, and data on temporomandibular disorder in conjunction with otolaryngological symptoms were collected for analysis. Of 4155 potential studies, 33 were retrieved for detailed evaluation and 12 met the study criteria. There are questionnaires, examination techniques and radiological investigations presented in the literature to assist with distinguishing between otolaryngological causes of symptoms and temporomandibular disorder. Simple treatment can be initiated by the otolaryngologist. Initial temporomandibular disorder treatment steps can be undertaken by the otolaryngologist, with consideration of referral to dentists, oral and maxillofacial surgeons, or physiotherapists if simple pharmacological treatment or temporomandibular disorder exercise fails.

  2. Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders.

    Science.gov (United States)

    Marklund, Susanna; Wänman, Anders

    2010-09-01

    To analyze whether gender, self-reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorder (TMD) during a 2-year period. The study population comprised 280 dental students at Umeå University in Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at the start of the study. Cases with 2-year persistence of signs and symptoms of TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses. The analyses revealed that self-reported bruxism and crossbite, respectively increased the risk of the 2-year cumulative incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk of developing and maintaining myofascial pain. Signs of mandibular instability increased the risk of maintained TMD signs and symptoms during the observation period. This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

  3. Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults

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    Akhter Rahena

    2013-02-01

    Full Text Available Abstract Background To investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD symptoms in a young adult population in Japan. Methods A personal interview survey was conducted on first-year university students (n = 1,930 regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender. Results Among the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n = 319, pain in the TMJ only (Group II, n = 21, difficulty in mouth opening only (Group III, n = 18, clicking and pain (Group IV, n = 29, clicking and difficulty in mouth opening (Group V, n = 48, difficulty in mouth opening and pain (Group VI, n = 11, and combination of three symptoms (Group VII, n = 97. The control group (n = 1,387 were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV and tinnitus (OR = 12.1 and 13.2, respectively. TMD symptoms (Group I, II and III were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only. Conclusions TMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache.

  4. Cervicothoracic junction thrust manipulation in the multimodal management of a patient with temporomandibular disorder.

    Science.gov (United States)

    Jayaseelan, Dhinu J; Tow, Nancy S

    2016-05-01

    Temporomandibular disorder (TMD) is a common condition that can be difficult to manage in physical therapy. A number of interventions, such as manual therapy, therapeutic exercise, and patient education have typically been used in some combination. However, the evidence regarding thrust manipulation of not only the local but also adjacent segments is sparse. Specifically, the use of cervicothoracic (CT) junction thrust manipulation has not previously been described in the management of individuals with TMD. In this case report, CT junction thrust manipulation, in addition to locally directed manual therapy, exercise, and postural education, was associated with immediate improvements in neck and jaw symptoms and function in a complex patient with TMD. The patient was seen for seven visits over the course of 2 months and demonstrated clinically significant changes in the neck disability index (NDI), the numeric rating of pain scale (NPRS), and the global rating of change (GROC) scale. The purpose of this report is to describe the successful physical therapy management of a patient with TMD utilizing manual therapy, including CT junction thrust manipulation, education, and exercise.

  5. The "at-home LLLT" in temporo-mandibular disorders pain control: a pilot study.

    Science.gov (United States)

    Fornaini, C; Pelosi, A; Queirolo, V; Vescovi, P; Merigo, E

    2015-03-31

    The Temporo-Mandibular Disorders (TMD) are a set of dysfunctional patterns concerning the temporo-mandibular joints (TMJ) and the masticatory muscles; its main symptom is pain, probably caused by inflammatory changes in the synovial membrane, alterations in the bone marrow of the mandibular condyle and impingement and compression. The aim of this preliminary study was to investigate the effectiveness in the TMD pain reduction of a new laser device recently proposed by the commerce that, due to its reduced dimensions and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Twenty-four patients with TMD were randomly selected: the inclusion criteria for the sample was the diagnosis of mono- or bi-lateral TMD, with acute pain restricted to the joint area, associated with the absence of any muscle tenderness during palpation. The patients were randomly assigned to two groups: Group 1 (12 patients): patients receiving real LLLT (experimental group). Group 2 (12 patients): patients receiving inactive laser (placebo group). The treatment was performed once a day for two weeks with an 808 nm diode laser by the patient himself with irradiation of the cutaneous zone corresponding to the TMJ for 15 minutes each side. Each patient was instructed to express its pain in a visual analogue scale (VAS) making a perpendicular line between the two extremes representing the felt pain level. Statistical analysis was realized with GraphPad Instat Software, where Ptemporo-mandibular diseases by an at home self administered laser device. RESULTS are encouraging but they will have to be confirmed by greater studies.

  6. Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache.

    Science.gov (United States)

    Silva, Ariovaldo Alberto da; Brandão, Karina Viana; Faleiros, Bruno Engler; Tavares, Rafael Mattos; Lara, Rodrigo Pinto; Januzzi, Eduardo; Carvalho, Anísio Bueno de; Carvalho, Eliane Maria Duarte de; Gomes, João Bosco Lima; Leite, Frederico Mota Gonçalves; Alves, Betania Mara Franco; Gómez, Rodrigo Santiago; Teixeira, Antônio Lúcio

    2014-02-01

    Clinical differentiation between the primary headaches and temporomandibular disorders (TMD) can be challenging. To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (pheadache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (pheadache, and this headache was more frequent in the dental center than at the medical center.

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

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    Mayor-Olea Alvaro

    2011-05-01

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

  8. Analyzing Menton Deviation in Posteroanterior Cephalogram in Early Detection of Temporomandibular Disorder

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    Trelia Boel

    2017-01-01

    Full Text Available Introduction. Some clinicians believed that mandibular deviation leads to facial asymmetry and it also had a correlation with temporomandibular disorders (TMDs. Posteroanterior (PA cephalogram was widely reported as a regular record in treating facial asymmetry and craniofacial anomalies. The objective of this study was to analyze the relationship of menton deviation in PA cephalogram with temporomandibular disorders (TMDs symptoms. Materials and Methods. TMJ function was initially screened based on TMD-DI questionnaire. PA cephalogram of volunteer subjects with TMDs (n=37 and without TMDs (n=33 with mean age of 21.61±2.08 years was taken. The menton deviation was measured by the distance (mm from menton point to midsagittal reference (MSR horizontally, using software digitized measurement, and categorized as asymmetric if the value is greater than 3 mm. The prevalence and difference of menton deviation in both groups were evaluated by unpaired t-test. Result. The prevalence of symmetry group showed that 65.9% had no TMDs with mean of 1,815 ± 0,71 mm; in contrast, the prevalence of asymmetry group showed that 95.5% reported TMDs with mean of 3,159 ± 1,053 mm. There was a significant difference of menton deviation to TMDs (p=0.000 in subjects with and without TMDs. Conclusion. There was a significant relationship of menton deviation in PA cephalogram with TMDs based on TMD-DI index.

  9. Asymmetric activation of temporalis, masseter, and sternocleidomastoid muscles in temporomandibular disorder patients.

    Science.gov (United States)

    Ries, Lilian Gerdi Kittel; Alves, Marcelo Correa; Bérzin, Fausto

    2008-01-01

    The aim of this study was to analyze the symmetry of the electromyographic (EMG) activity of the temporalis, masseter, and sternocleidomastoid (SCM) muscles in volunteers divided into a control group and a temporomandibular disorder (TMD) group. The surface EMG recordings were made during mandibular rest position, maximal intercuspal position, and during the chewing cycle. Normalized EMG waves of paired muscles were compared by computing a percentage overlapping coefficient (POC). The difference between the groups and between the static and dynamic clenching tests was analyzed through repeated measures, ANOVA. Symmetry of the temporalis, masseter, and SCM muscles activity was smaller in the TMD group compared to the control group. The mandibular postures were also significantly different among themselves. The asymmetric activation of jaw and neck muscles was interpreted as a compensatory strategy to achieve stability for the mandibular and cervical systems during masticatory function.

  10. Temporomandibular disorders and migraine headache

    OpenAIRE

    Demarin, Vida; Bašić Kes, Vanja

    2010-01-01

    Migraine headache and temporomandibular disorders show significant overlap in the area or distribution of pain, the gender prevalence and age distribution. Temporomandibular disorders may cause headaches per se, worsen existent primary headaches, and add to the burden of headache disorders. The patients with combined migraine and tension-type headaches had a higher prevelance of temporomandibular disorders. Evidence supporting a close relationship include the increased masticatory...

  11. Temporomandibular disorders and orthodontic treatment need in orthodontically untreated children and adolescents.

    Science.gov (United States)

    Špalj, Stjepan; Šlaj, Martina; Athanasiou, Athanasios E; Žak, Irena; Šimunović, Martina; Šlaj, Mladen

    2015-03-01

    The aim of this study was to explore the association between signs and symptoms of temporomandibular disorders (TMD) and orthodontic treatment need in orthodontically untreated children and adolescents. One thousand five hundred and ninety-seven subjects aged 11-19 years, without previous orthodontic history, from sixteen randomly selected public schools in Zagreb, Croatia, were examined. Malocclusion characteristics were assessed by using the criteria proposed by Bjork et al., the Dental Aesthetic Index, and the Aesthetic Component of Index of Orthodontic Treatment Need. Data on TMD signs/symptoms and parafunctional behaviour were obtained by means of questionnaire and clinical examination, respectively. Multiple logistic regression models were used for analysis. Twenty-two percent of children and young adolescents had one or more signs of TMD, ranging from 17% in age of 11 years up to 24% in age of 19. There was poor correlation between presence of TMD and orthodontic treatment need. Multiple logistic regression models showed that Class III, crowding and spacing were related to mandibular deflection on opening. Ectopic eruption was related to TMJ clicking, and severely tipped teeth with reduced mouth opening. Headaches presented a positive relationship with reverse overjet and severe rotations, and tooth wear with crowding, spacing and lateral openbite. Age, female gender and parafunctional habits were related to several TMD signs. Although logistic regression models were statistically significant (p < 0.05) malocclusions, parafunctional behaviours, age and gender accounted for less than 20% of the variability in TMD signs/symptoms. TMD signs and symptoms seemed to be poorly related to malocclusions or treatment needs.

  12. Oral splints: the crutches for temporomandibular disorders and bruxism?

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    Dao, T T; Lavigne, G J

    1998-01-01

    Despite the extensive use of oral splints in the treatment of temporomandibular disorders (TMD) and bruxism, their mechanisms of action remain controversial Various hypotheses have been proposed to explain their apparent efficacy (i.e., true therapeutic value), including the repositioning of condyle and/or the articular disc, reduction in the electromyographic activity of the masticatory muscles, modification of the patient's "harmful" oral behavior, and changes in the patient's occlusion. Following a comprehensive review of the literature, it is concluded that any of these theories is either poor or inconsistent, while the issue of true efficacy for oral splints remains unsettled. However, the results of a controlled clinical trial lend support to the effectiveness (i.e., the patient's appreciation of the positive changes which are perceived to have occurred during the trial) of the stabilizing splint in the control of myofascial pain. In light of the data supporting their effectiveness but not their efficacy, oral splints should be used as an adjunct for pain management rather than a definitive treatment. For sleep bruxism, it is prudent to limit their use as a habit management aid and to prevent/limit dental damage potentially induced by the disorder. Future research should study the natural history and etiologies of TMD and bruxism, so that specific treatments for these disorders can be developed.

  13. A critical review of Dr. Charles S. Greene's article titled "Managing the Care of Patients with Temporomandibular Disorders: a new Guideline for Care" and a revision of the American Association for Dental Research's 1996 policy statement on temporomandibular disorders, approved by the AADR Council in March 2010, published in the Journal of the American Dental Association September 2010.

    Science.gov (United States)

    Simmons, H Clifton

    2012-01-01

    Dr. Charles Greene's article, "Managing the Care of Patients with TMDs A New Guideline for Care," and the American Association for Dental Research's (AADR) 2010 Policy Statement on Temporomandibular Disorders, published in the Journal of the American Dental Association (JADA) September 2010, are reviewed in detail. The concept that all temporomandibular disorders (TMDs) should be lumped into one policy statement for care is inappropriate. TMDs are a collection of disorders that are treated differently, and the concept that TMDs must only be managed within a biopsychosocial model of care is inappropriate. TMDs are usually a musculoskeletal orthopedic disorder, as defined by the AADR. TMD orthopedic care that is peer-reviewed and evidence-based is available and appropriate for some TMDs. Organized dentistry, including the American Dental Association, and mainstream texts on TMDs, support the use of orthopedics in the treatment of some TMDs. TMDs are not psychological or social disorders. Informed consent requires that alternative care is discussed with patients. Standard of care is a legal concept that is usually decided by a court of law and not decided by a policy statement, position paper, guidelines or parameters of care handed down by professional organizations. The 2010 AADR Policy Statement on TMD is not the standard of care in the United States. Whether a patient needs care for a TMD is not decided by a diagnostic test, but by whether the patient has significant pain, dysfunction and/or a negative change in quality of life from a TMD and they want care. Some TMDs need timely invasive and irreversible care.

  14. 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.

  15. Los trastornos temporomandibulares y la radiación láser Temporomandibular disorders and the application of laser therapy.

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    Ileana Grau León

    2007-09-01

    Full Text Available Los trastornos temporomandibulares constituyen un problema de salud mundial. Estudios epidemiológicos en relación con su prevalencia indican que más del 50 % de la población ha padecido de signos y síntomas relacionados con esta patología, entre los que se encuentran ruidos, dolor articular y limitación al movimiento. El grupo de estudio estuvo constituido por 40 pacientes con trastornos de la articulación temporomandibular (ATM, de ambos sexos y mayores de 20 años, que acudieron a consulta en la Facultad de Estomatología de La Habana. El diagnóstico se estableció por el interrogatorio y el examen clínico. Para la obtención de los datos se creó un formulario con el objetivo de evaluar la eficacia del uso del miniláser en la terapia de los trastornos de la ATM, evaluar la evolución de intensidad dolorosa presente, antes y después del tratamiento con láser y tratamiento farmacológico, así como determinar el número de aplicaciones necesarias para el alivio total o parcial del dolor y músculo con mayor afectación. La aplicación de la técnica se realizó en 2 grupos; el primero recibió terapia farmacológica activa y el segundo terapia láser. Al culminar el tratamiento se evaluaron los casos y se remitieron a la consulta de ATM para el tratamiento definitivo. Los resultados revelaron que el mayor porcentaje de los pacientes tuvo remisión total del dolor con el tratamiento con láser terapia, en relación con los que se trataron con fármacos, al igual que el índice de dolor presente.Temporomandibular Disorders (TMD are a world health problem. Epidemiological studies indicate that over 50% of population has suffered some kind of sign and sympton caused by this pathology like joint sounds, joint pain and restricted movement. The study group was composed by 40 patients of both sexes and over 20 years of age that had come to the dental service of the Faculty of Dentistry in Havana province because of their temporomandibular

  16. Diagnostic accuracy of three screening questions (3Q/TMD) in relation to the DC/TMD in a specialized orofacial pain clinic.

    Science.gov (United States)

    Lövgren, Anna; Parvaneh, Hasti; Lobbezoo, Frank; Häggman-Henrikson, Birgitta; Wänman, Anders; Visscher, Corine Mirjam

    2018-02-15

    To determine the diagnostic accuracy of three screening questions (3Q/TMD) in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized clinic. Consecutive patients, >18 years, referred with a possible TMD complaint to the Orofacial Pain and Dysfunction clinic, Academic Centre for Dentistry Amsterdam, the Netherlands, were included in the study. All patients (n = 449; mean age 44 years; 72% females), answered the 3Q/TMD and the DC/TMD questionnaire before a DC/TMD examination. The 3Q/TMD constitutes of two questions on weekly pain from the jaw, face and temple region (Q1), and on function (Q2), and one function-related question on weekly catching and/or locking of the jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard. In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an intra-articular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was high (0.83-0.94), whereas specificity was low (0.41-0.55). For the function-related question, sensitivity was low (0.48), whereas specificity was high (0.96). In a specialized pain clinic, the two pain questions (Q1, Q2) are positive in most patients with pain-related TMD. Therefore, in case of a positive response, further diagnostic procedures for TMD pain are warranted. For the functional screening question (Q3), a positive response is indicative for an intra-articular DC/TMD diagnosis, while in case of a negative outcome, an intra-articular TMD might still be present.

  17. The “at-home LLLT” in temporo-mandibular disorders pain control: a pilot study

    Science.gov (United States)

    Pelosi, A; Queirolo, V; Vescovi, P; Merigo, E

    2015-01-01

    Objectives: The Temporo-Mandibular Disorders (TMD) are a set of dysfunctional patterns concerning the temporo-mandibular joints (TMJ) and the masticatory muscles; its main symptom is pain, probably caused by inflammatory changes in the synovial membrane, alterations in the bone marrow of the mandibular condyle and impingement and compression. The aim of this preliminary study was to investigate the effectiveness in the TMD pain reduction of a new laser device recently proposed by the commerce that, due to its reduced dimensions and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Material and methods: Twenty-four patients with TMD were randomly selected: the inclusion criteria for the sample was the diagnosis of mono- or bi-lateral TMD, with acute pain restricted to the joint area, associated with the absence of any muscle tenderness during palpation. The patients were randomly assigned to two groups: Group 1 (12 patients): patients receiving real LLLT (experimental group). Group 2 (12 patients): patients receiving inactive laser (placebo group). The treatment was performed once a day for two weeks with an 808 nm diode laser by the patient himself with irradiation of the cutaneous zone corresponding to the TMJ for 15 minutes each side. Each patient was instructed to express its pain in a visual analogue scale (VAS) making a perpendicular line between the two extremes representing the felt pain level. Statistical analysis was realized with GraphPad Instat Software, where Ptemporo-mandibular diseases by an at home self administered laser device. Results are encouraging but they will have to be confirmed by greater studies. PMID:25941425

  18. Pattern analysis of patients with temporomandibular disorders resulting from unilateral mastication due to chronic periodontitis

    Science.gov (United States)

    2017-01-01

    Purpose The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. Methods Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. Results The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. Conclusions The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic

  19. Photobiomodulation versus light-emitting diode (LED) therapy in the treatment of temporomandibular disorder: study protocol for a randomized, controlled clinical trial.

    Science.gov (United States)

    Langella, Luciana G; Silva, Paula F C; Costa-Santos, Larissa; Gonçalves, Marcela L L; Motta, Lara J; Deana, Alessandro M; Fernandes, Kristianne P S; Mesquita-Ferrari, Raquel A; Bussadori, Sandra Kalil

    2018-01-26

    Temporomandibular disorder (TMD) is described as a subgroup of orofacial pain with a set of signs and symptoms that involve the temporomandibular joint, masticatory muscles, ears, and neck. TMD can occur unilaterally or bilaterally and approximately 70% of the population is affected with at least one sign. The disorder progresses with orofacial pain, muscle pain involving the masticatory and cervical muscles, joint noises (clicks and pops), joint block, mandibular dysfunction, and headache. The etiology can be abnormal occlusion and/or posture, trauma involving local tissues, repetitive microtrauma, parafunctional habits, and an increase in emotional stress. Studies have demonstrated that phototherapy is an efficient option for the treatment of TMD, leading to improvements in pain and orofacial function. The aim of the proposed study is to compare the effects of two sources of photobiomodulation in individuals with TMD. A randomized, controlled, double-blind, clinical trial is proposed, which will involve 80 individuals aged 18-65 years allocated to either a laser group or light-emitting diode (LED) group submitted to 12 sessions of phototherapy. The Research Diagnostic Criteria for TMDs will be used to evaluate all participants. Pain will be measured using the visual analog scale and maximum vertical mandibular movement will be determined with the aid of digital calipers. This study compares the effects of two modalities of laser therapy on the pain and orofacial function of patients with TMD dysfunction. Photobiomodulation and LED therapy are treatment options for reducing the inflammatory process and pain as well as inducing the regeneration of the target tissue. ClinicalTrials.gov, NCT03257748 . Registered on 8 August 2017.

  20. 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.

  1. Eagle's syndrome-A non-perceived differential diagnosis of temporomandibular disorder.

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    Thoenissen, P; Bittermann, G; Schmelzeisen, R; Oshima, T; Fretwurst, T

    2015-01-01

    This article unveils a case of the classic styloid syndrome and states that panoramic imaging and ultrasound can be an alternative to computed tomography. In addition, the endoscope-assisted extraoral approach using CT-based navigation is useful. Eagle's Syndrome is an aggregate of symptoms described by Eagle in 1937. He described different forms: the classic styloid syndrome consisting of elongation of the styloid process which causes pain. Second, the stylo-carotid-artery syndrome which is responsible for transient ischemic attack or stroke. Using the example of a 66 years old male patient suffering from long term pain, we explain our diagnostic and surgical approach. After dissecting the styloid process of the right side using an extraoral approach, the pain ceased and the patient could be discharged without any recurrence of the pain up to this point. Eagle's syndrome, with its similar symptoms, is rather difficult to differentiate from temporomandibular joint disorders (TMD), but can be easily excluded from possible differential diagnoses of TMD using panoramic radiographs and ultrasound. Making use of low cost and easily accessible diagnostic workup techniques can reveal this particular cause for chronic pain restricting quality of life. Thereby differentiation from the TMD symptomatic complex is possible. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Treatment of comorbid migraine and temporomandibular disorders: a factorial, double-blind, randomized, placebo-controlled study.

    Science.gov (United States)

    Goncalves, Daniela A G; Camparis, Cinara M; Speciali, José G; Castanharo, Sabrina M; Ujikawa, Liliana T; Lipton, Richard B; Bigal, Marcelo E

    2013-01-01

    To investigate the effectiveness of single and concomitant treatment of migraine and temporomandibular disorders (TMD) in women with the comorbidity. Eligible female patients met International Classification of Headache Disorders, second edition (ICHD-2) criteria for migraine with or without aura and the Research Diagnostic Criteria for myofascial TMD (Grade ll or lll). After a run-in period (30 days), women with both migraine and TMD were enrolled into a four-arm, double-blind, placebo-controlled, factorial study testing the separate and joint effects of a migraine treatment (propranolol 90 mg) and a TMD treatment (stabilization splint [SS]) in four groups of patients. The four treatment groups were propranolol and SS (n = 22); propranolol placebo and SS (n = 23); propranolol and non-occlusal splint (NOS) (n = 23); and propranolol placebo and NOS (n = 21). The primary endpoint for migraine was change in headache days from baseline to the third month, and the secondary endpoint was change in days with at least moderate headache in the same period. The TMD endpoints included pain threshold and mandibular vertical range of motion. Data were analyzed using analysis of variance (ANOVA, Dunn's post-hoc test) or Kruskal-Wallis test. For the primary endpoint, in intention-to-treat (ITT) analyses (n = 94), propranolol and SS were associated with a nonsignificant reduction in the number of headache days, relative to all other groups. For per-protocol (PP) Completer analyses (n = 89), differences in the number of headache days reached significance (P headache endpoints and in disability, in both ITT and PP analyses. No significant differences among groups were seen for the TMD parameters. In women with TMD and migraine, migraine significantly improved only when both conditions were treated. The best treatment choice for TMD pain in women with migraine is yet to be defined.

  3. An assessment of the usefulness of Kinesiograph as an aid in the diagnosis of TMD: a review of Manfredini et al.'s studies.

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    Cooper, Barry C; Adib, Fray

    2015-01-01

    Performing a literature review of publications by Dr. Manfredini et al. related to their temporomandibular joint (TMJ) injection therapy outcome with conclusions on the clinical utility of computerized measurement devices used in the management of temporomandibular disorders (TMDs). In addition, reviewing their published opinion on an occlusion: TMD versus a biopsychosocial paradigm for TMD. Manfredini et al. authored an article published in the Journal of the American Dental Association (JADA) 2013, "An Assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders," the most recent of 12 articles. In all studies, subjects received TMJ injections with an objective measurement outcome criterion; increased maximum mouth opening (MMO) and subjective symptom improvement of pain and chewing function. In the 2013 JADA article, the Mandibular Kinesiograph, referred to as KG, measured MMO before and after therapy. In 11 prior articles, all subject groups with limited mouth opening exhibited very significant increased MMO post-treatment, documenting treatment success using the same 2013 protocol. The 2013 study showed a 1·1 mm improved MMO, described as insignificant. The authors did not critique or explain the aberrant, skewed 2013 outcome data contrasted with their prior studies, which showed overwhelmingly significant increased MMO. Instead, they concluded that the MMO recording device was clinically useless. This motivated a literature review of the authors' TMD publications. The publications by Manfredini et al. recognized proponents of the psychosocial model of TMD, including the 2013 article, appear to be part of a campaign denying an occlusion: TMD relationship and disparaging the specific computerized measurement devices and the dentists using them in the management of their TMD patients using neuromuscular occlusion dental treatment.

  4. Prevalence of signs and symptoms indicative of temporomandibular disorders and headaches in 35-, 50-, 65- and 75-year-olds living in Västerbotten, Sweden.

    Science.gov (United States)

    Yekkalam, Negin; Wänman, Anders

    2014-08-01

    The aim of this study was to analyze and compare prevalence of signs and frequently occurring symptoms indicative of temporomandibular disorder (TMD) and headaches in 35-, 50-, 65- and 75-year-old men and women in Västerbotten County, Sweden. From a total target population of 11 324 subjects living in Västerbotten County in the year 2002, 300 individuals in each age group were randomly selected. Of these, 998 (82% response rate) answered and returned a postal questionnaire and 779 (65% response rate) individuals accepted a clinical examination. The prevalence of frequent TMD symptoms peaked among 50-year-old women and then declined. Women at this age reported significantly higher prevalence compared to men for all TMD symptoms except temporomandibular joint locking. In the 65- and 75-year-olds, the prevalence was practically equal between men and women as well as between these ages. Frequent headaches showed the highest prevalence among 35- and 50-year-old women, with a statistically significant difference between men and women of 50 years of age (p temporomandibular joint sounds (p headaches showed a similar pattern, with higher prevalence among the 35- and 50-year-old, as compared to the 65- and 75-year-old, participants. The pattern may be related to biological, psychosocial or generation-related factors.

  5. Correlação entre cefaléia e disfunção temporomandibular Correlation between headache and temporomandibular joint dysfunction

    Directory of Open Access Journals (Sweden)

    Mariana Sampaio Menezes

    2008-01-01

    Full Text Available A relação entre disfunções temporomandibulares (DTM e os diferentes tipos de cefaléias ainda não está bem compreendida, mas a dor de cabeça é provavelmente o sintoma mais comum da DTM. O objetivo deste estudo foi correlacionar cefaléia com o índice clínico de Fonseca de avaliação da DTM. Participaram 160 voluntários estudantes da Universidade Nove de Julho na faixa dos 18 aos 36 anos, sendo 80 mulheres e 80 homens. Foram aplicados dois questionários: o índice clínico de Fonseca e um questionário sobre cefaléia. Os dados foram analisados estatisticamente e o nível de significância fixado em pThe relationship between temporomandibular joint disorders (TMD and different kinds of headaches is still not well understood, though headache is probably the most common symptom of TMD. The aim of this study was to correlate headache with Fonseca's TMD clinical index. A total of 160 university students aged 18 to 36 years old were selected, half women, half men. Two questionnaires were applied to them: the Fonseca clinical questionnaire and one on headache. Data were statistically analysed and significance level set at p<0.05. Results showed a higher prevalence of TMD among female individuals with headache, but a direct relationship between headache and degree of temporomandibular joint dysfunction could not be found.

  6. Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder.

    Science.gov (United States)

    Munhoz, Wagner Cesar; Marques, Amélia Pasqual; Siqueira, José Tadeu Tesseroli de

    2004-01-01

    Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same images. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%), but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03). After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings.

  7. Jaw dysfunction is associated with neck disability and muscle tenderness in subjects with and without chronic temporomandibular disorders.

    Science.gov (United States)

    Silveira, A; Gadotti, I C; Armijo-Olivo, S; Biasotto-Gonzalez, D A; Magee, D

    2015-01-01

    Tender points in the neck are common in patients with temporomandibular disorders (TMD). However, the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with TMD still needs further investigation. This study investigated the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with and without chronic TMD. Participants. Forty females between 19 and 49 years old were included in this study. There were 20 healthy controls and 20 subjects who had chronic TMD and neck disability. Subjects completed the neck disability index and the limitations of daily functions in TMD questionnaires. Tenderness of the masticatory and cervical muscles was measured using an algometer. The correlation between jaw disability and neck disability was significantly high (r = 0.915, P cervical muscles with jaw dysfunction and neck disability showed fair to moderate correlations (r = 0.32-0.65). High levels of muscle tenderness in upper trapezius and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high levels of neck disability correlated with high levels of jaw disability. These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD.

  8. Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

    Directory of Open Access Journals (Sweden)

    Ariovaldo Alberto da Silva Júnior

    2014-02-01

    Full Text Available Clinical differentiation between the primary headaches and temporomandibular disorders (TMD can be challenging. Objectives : To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Method : Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Results : Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (p<0.001. Tension-type headache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (p<0.001. Conclusion : TMD is an important comorbidity of migraine and difficult to distinguish clinically from tension-type headache, and this headache was more frequent in the dental center than at the medical center.

  9. 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.

  10. Prevalence of whiplash trauma in TMD patients: a systematic review.

    Science.gov (United States)

    Häggman-Henrikson, B; Rezvani, M; List, T

    2014-01-01

    The purpose of this systematic review was to describe the prevalence of whiplash trauma in patients with temporomandibular disorders (TMDs) and to describe clinical signs and symptoms in comorbid TMD/whiplash compared with TMD localised to the facial region. A systematic literature search of the PubMed, Cochrane Library and Bandolier databases was carried out for articles published from 1 January 1966 to 31 December 2012. The systematic search identified 129 articles. After the initial screening of abstracts, 32 articles were reviewed in full text applying inclusion and exclusion criteria. Six studies on the prevalence of neck trauma in patients with TMD met the inclusion criteria and were included in the review. Two of the authors evaluated the methodological quality of the included studies. The reported prevalence of whiplash trauma ranged from 8·4% to 70% (median 35%) in TMD populations, compared with 1·7-13% in the non-TMD control groups. Compared with patients with TMD localised to the facial region, TMD patients with a history of whiplash trauma reported more TMD symptoms, such as limited jaw opening and more TMD pain, and also more headaches and stress symptoms. In conclusion, the prevalence of whiplash trauma is higher in patients with TMD compared with non-TMD controls. Furthermore, patients with comorbid TMD/whiplash present with more jaw pain and more severe jaw dysfunction compared with TMD patients without a history of head-neck trauma. These results suggest that whiplash trauma might be an initiating and/or aggravating factor as well as a comorbid condition for TMD. © 2014 John Wiley & Sons Ltd.

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

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    Leonardo Rigoldi Bonjardim

    2005-06-01

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

  12. Factor and Rasch analysis of the Fonseca anamnestic index for the diagnosis of myogenous temporomandibular disorder.

    Science.gov (United States)

    Rodrigues-Bigaton, Delaine; de Castro, Ester M; Pires, Paulo F

    Rasch analysis has been used in recent studies to test the psychometric properties of a questionnaire. The conditions for use of the Rasch model are one-dimensionality (assessed via prior factor analysis) and local independence (the probability of getting a particular item right or wrong should not be conditioned upon success or failure in another). To evaluate the dimensionality and the psychometric properties of the Fonseca anamnestic index (FAI), such as the fit of the data to the model, the degree of difficulty of the items, and the ability to respond in patients with myogenous temporomandibular disorder (TMD). The sample consisted of 94 women with myogenous TMD, diagnosed by the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), who answered the FAI. For the factor analysis, we applied the Kaiser-Meyer-Olkin test, Bartlett's sphericity, Spearman's correlation, and the determinant of the correlation matrix. For extraction of the factors/dimensions, an eigenvalue >1.0 was used, followed by oblique oblimin rotation. The Rasch analysis was conducted on the dimension that showed the highest proportion of variance explained. Adequate sample "n" and FAI multidimensionality were observed. Dimension 1 (primary) consisted of items 1, 2, 3, 6, and 7. All items of dimension 1 showed adequate fit to the model, being observed according to the degree of difficulty (from most difficult to easiest), respectively, items 2, 1, 3, 6, and 7. The FAI presented multidimensionality with its main dimension consisting of five reliable items with adequate fit to the composition of its structure. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  13. 18F-NaF PET/CT for the evaluation of temporomandibular joint disorder.

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    Suh, M S; Park, S H; Kim, Y-K; Yun, P-Y; Lee, W W

    2018-04-01

    To investigate the usefulness of a quantitative parameter (maximum standardised uptake value [SUVmax]) of 18 F-sodium fluoride (NaF) positron-emission tomography (PET)/computed tomography (CT) for the evaluation of temporomandibular joint (TMJ) disorder (TMD). Seventy-six TMD patients (male: female=14:62, age=40.3±17.1 years, bilateral: unilateral=40:36) with 152 TMJs were enrolled. The 18 F-NaF PET/CT parameter (SUVmax) was compared with the presence of TMJ arthralgia (arthralgic=86, non-arthralgic=66) and clinical subtypes based on the Research Diagnostic Criteria for TMD Axis I (TMD osteoarthritis=49, non-TMD osteoarthritis=67, and asymptomatic TMJ=36). Splint therapy was applied to 48 patients for 6 months without considering 18 F-NaF PET/CT findings. Post-splint therapy 18 F-NaF PET/CT was performed in 32 patients and clinical responses to the therapy were classified into improvement (n=33), no change (n=10), or aggravation (n=7) for 50 TMJs excluding asymptomatic TMJs (n=14). SUVmax was significantly greater in arthralgic TMJs than in non-arthralgic TMJs (6.62±3.56 versus 4.32±1.53, pchange in SUVmax was observed in improved (from 6.16±2.68 to 6.09±2.60, p=0.4915) and unchanged (from 6.46±4.19 to 6.77±4.32, p=0.3223) TMJs. 18 F-NaF PET/CT is a useful imaging tool for TMD evaluation because SUVmax showed a fair diagnostic performance for arthralgic TMJ and TMD osteoarthritis, and a correlation with the therapeutic response. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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

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    Paulinne Junqueira Silva Andresen Strini

    2009-10-01

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

  15. Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice

    Science.gov (United States)

    CALDAS, Waleska; CONTI, Ana Cláudia de Castro Ferreira; JANSON, Guilherme; Paulo César Rodrigues, CONTI

    2016-01-01

    ABSTRACT The relationship between Temporomandibular Disorders (TMD) and malocclusion is an extremely critical issue in dentistry. Contrary to the old concept that malocclusion causes TMD, occlusal changes, especially those observed as sudden, may be secondary and reflect joint or muscle disorders due to the obvious connection between these structures and the dental occlusion. Objectives The aim of this article is to present the most commonly occlusal changes secondary to TMD. Methods The clinical presentation of these conditions is discussed. Details regarding diagnosis, treatment, and follow-up of patients presenting TMD prior or during treatment are also presented. Conclusions All plans for irreversible therapy should be preceded by a meticulous analysis of TMD signs and symptoms in such a way that patients are not submitted to irreversible treatment, based on an untrue occlusal relationship, secondary to articular and/or muscular disorders. When present, TMD symptoms must always be controlled to reestablish a “normal” occlusion and allow proper treatment strategy. PMID:27556214

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

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    Manfredini, Daniele; Lobbezoo, Frank

    2010-06-01

    The present paper aims to systematically review the literature on the temporomandibular disorders (TMD)-bruxism relationship published from 1998 to 2008. A systematic search in the National Library of Medicine's PubMed database was performed to identify all studies on humans assessing the relationship between TMD symptoms and bruxism diagnosed with any different approach. The selected articles were assessed independently by the 2 authors according to a structured reading of articles format (PICO). A total of 46 articles were included for discussion in the review and grouped into questionnaire/self-report (n = 21), clinical assessment (n = 7), experimental (n = 7), tooth wear (n = 5), polysomnographic (n = 4), or electromyographic (n = 2) studies. In several studies, the level of evidence was negatively influenced by a low level of specificity for the assessment of the bruxism-TMD relationship, because of the low prevalence of severe TMD patients in the studied samples and because of the use of self-report diagnosis of bruxism with some potential diagnostic bias. Investigations based on self-report or clinical bruxism diagnosis showed a positive association with TMD pain, but they are characterized by some potential bias and confounders at the diagnostic level (eg, pain as a criterion for bruxism diagnosis). Studies based on more quantitative and specific methods to diagnose bruxism showed much lower association with TMD symptoms. Anterior tooth wear was not found to be a major risk factor for TMD. Experimental sustained jaw clenching may provoke acute muscle tenderness, but it is not analogous to myogenous TMD pain, so such studies may not help clarify the clinical relationship between bruxism and TMD. Copyright 2010 Mosby, Inc. All rights reserved.

  17. [Intra-articular injections of hyaluronic acid for anterior disc displacement of temporomandibular joint].

    Science.gov (United States)

    Long, X

    2017-03-09

    Anterior disc displacement (ADD) of temporomandibular joint (TMJ) is regarded as one of the major findings in temporomandibular disorders (TMD). It is related to joint noise, pain, mandibular dysfunction, degenerative change and osteoarthritis. In the mean time, the pathological changes were found in synovial membrane and synovial fluid. Hyaluronic acid is a principal component of the synovial fluid which plays an important role in nutrition, lubrication, anti-inflammation and cartilage repair. The synthesis, molecule weight, and concentration of hyaluronic acid are decreased during TMD and cause TMJ degenerative changes. The clinical conditions, pathological changes, the mechanism of action for hyaluronic acid and the treatment of anterior disc displacement of TMJ are discussed in this article.

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

    Science.gov (United States)

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

    2013-12-01

    Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance. © 2013 John Wiley & Sons Ltd.

  19. Translating the Research Diagnostic Criteria for Temporomandibular Disorders into Malay: evaluation of content and process.

    Science.gov (United States)

    Khoo, Suan-Phaik; Yap, Adrian U Jin; Chan, Yiong Huak; Bulgiba, Awang M

    2008-01-01

    To develop a Malay-language version of the Axis II Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a formal translation/back-translation process and to summarize available data about the psychometric properties of the translated scales. To cross-culturally adapt the instrument, the RDC/TMD underwent translation using a forward-backward method. Subjects were recruited to test the congruency between translated and original versions of the RDC/TMD. The psychometric properties of 3 domains (Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression) of the RDC/TMD were examined, and the literature on this topic was reviewed. All the items scored 93% to 100% congruency. Cronbach's alphas for Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression were 0.77, 0.71, and 0.88, respectively (n = 40). The test-retest reliability of scores (intraclass correlation coefficient [ICC]) and levels (Spearman's rho) for these domains showed ICCs of 0.97, 0.94, and 0.95, respectively, with a lowest ICC value of 0.84 (n = 40); the Spearman's rho values were 0.93, 0.74, and 0.74, respectively. The discriminant validity between patients with pain symptoms (n = 40) and normal pain-free controls (n = 40) were statistically significant (P cultural adaptation of the RDC/TMD into the Malay language is suitable for use in Malaysia.

  20. Are occlusal characteristics, headache, parafunctional habits and clicking sounds associated with the signs and symptoms of temporomandibular disorder in adolescents?

    Science.gov (United States)

    Lauriti, Leandro; Motta, Lara Jansiski; Silva, Paula Fernanda da Costa; Leal de Godoy, Camila Haddad; Alfaya, Thays Almeida; Fernandes, Kristianne Porta Santos; Mesquita-Ferrari, Raquel Agnelli; Bussadori, Sandra Kalil

    2013-10-01

    [Purpose] To assess the association between the oclusal characteristics, headache, parafunctional habits and clicking sounds and signs/symptoms of TMD in adolescents. [Subjects] Adolescents between 14 and 18 years of age. [Methods] The participants were evaluated using the Helkimo Index and a clinical examination to track clicking sounds, parafunctional habits and other signs/symptoms of temporomandibular disorder (TMD). Subjects were classified according to the presence or absence of headache, type of occlusion, facial pattern and type of bite. In statistical analyse we used the chi-square test and Fisher's exact test, with a level of significance of 5%. [Results] The sample was made up of 81 adolescents with a mean age of 15.64 years; 51.9% were male. The prevalence of signals/symptoms of TMD was 74.1%, predominantly affecting females. Signals/symptoms of TMD were significantly associated with clicking sounds, headache and nail biting. No associations were found between signals/symptoms of TMD and angle classification, type of bite and facial pattern. [Conclusion] Headache is one of the most closely associated symptoms of TMD. Clicking sounds were found in the majority of cases. Therefore, the sum of two or more factors may be necessary for the onset and perpetuation of TMD.

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

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    Rejane L. S. Rezende

    2013-01-01

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

  2. Impact of sound production by wind instruments on the temporomandibular system of male instrumentalists.

    Science.gov (United States)

    Pampel, Michael; Jakstat, Holger A; Ahlers, Oliver M

    2014-01-01

    Playing a wind instrument can be either a reason for overuse or a protecting factor against certain diseases. Some individuals have many findings but low morbidity while others have few findings but high morbidity. This contradictory phenomenon should be researched. The temporomandibular system (TMS) is a functional unit which comprises the mandible, associated muscles and bilateral joints with the temporal bone. The TMS is responsible for the generation of sound when wind instruments are played. Over the long-term and with intensive usage, this causes changes in the musculature and in the temporomandibular joint (TMJ) of wind musicians, often resulting in temporomandibular disorders (TMD). The aim of this study is to examine evidence that TMD constitute an occupational disease in wind musicians. TMD patients and wind musicians were examined by dental clinical functional analysis. 102 male subjects were divided into three groups: "healthy" individuals, wind musicians, and patients with TMD. Dental Examination was carried out based on focused inclusion of the research diagnostic criteria - TMD [1,7]. Findings were evaluated for statistical significance by first transferring data into a digital database [2,15], then generating T-Test und Wilcoxon-Test when non-Gaussian distribution appears and applying the Mann-Whitney rank sum test using Sigmaplot Version 1.1 software (Systat Software Inc, Washington, USA). The evaluation revealed that wind instrument musicians show a high incidence of developing TMD as the researchers found almost 100% morbidity regarding parafunctional habits and preauricular muscle pain of each adult and highly active musician. The result is highly significant (pTMS.

  3. 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.

  4. Evaluation of temporomandibular disorders in Class III patients treated with mandibular cervical headgear and fixed appliances.

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    Rey, Diego; Oberti, Giovanni; Baccetti, Tiziano

    2008-03-01

    Our aim in this study was to evaluate the prevalence of temporomandibular disorders (TMD) in Class III patients treated with mandibular cervical headgear (MCH) and fixed appliances. The sample of 75 patients included 25 patients with no previous orthodontic treatment, 25 Class I patients who had undergone orthodontic treatment with fixed appliances and without extractions, and 25 patients with dentoskeletal Class III disharmonies treated with MCH and fixed appliances. The Helkimo index was used to test the prevalence of TMD symptoms in the 3 groups. The prevalence rates of the Helkimo index in the 3 groups were compared with the z score on proportions. No statistically significant differences in the prevalence rates of the Helkimo index scores in the 3 groups were found (P = .367). Most subjects in the 3 groups had an Helkimo index of zero (66.7%). Subjects with Class III malocclusions treated with MCH and fixed appliances do not have greater prevalence of TMD symptoms than do Class I subjects treated with fixed appliances or untreated subjects.

  5. Prevalência de portadores de DTM em pacientes avaliados no setor de otorrinolaringologia Prevalence of patients harboring temporomandibular disorders in an otorhinolaryngology departament

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    Alexandra Magalhães Silveira

    2007-08-01

    Full Text Available A interação entre disfunção temporomandibular e otalgia é, mesmo nos dias atuais, motivo para especulações e hipóteses. Vários pesquisadores sugerem causas, conseqüências e supostos tratamentos. OBJETIVO: Verificar a prevalência de pacientes portadores de DTM em um serviço de otorrinolaringologia. TIPO DE ESTUDO: Este é um estudo epidemiológico do tipo descritivo com amostra transversal. MATERIAL E MÉTODO: Foram avaliados 221 pacientes do Serviço de Otorrinolaringologia do Hospital da Cidade, em Passo Fundo, Rio Grande do Sul, durante um período de dois meses. Para captação e interpretação dos dados, bem como verificação da disfunção temporomandibular, foi utilizado um questionário auto-aplicado previamente validado. RESULTADO: Após coleta e interpretação dos dados de 221 pacientes, os resultados obtidos foram: 48 pacientes (21.72% considerados como necessitando de tratamento para DTM (índice de DTM moderada e severa, dos quais 35 pertenciam ao gênero feminino (72.9% e 13 ao masculino (21.1%. Apenas 15 indivíduos do total (7.24% estavam totalmente livres de sintomas de DTM. Quanto aos demais, apresentaram: dor de cabeça (33,5%, dor no pescoço e ombro (28,5%, dor na região do ouvido (29% e ruídos articulares (25%. CONCLUSÃO: A prevalência de DTM foi de 21.72% sendo significantemente maior no gênero feminino (p: 0.0001; e as prevalências, em relação aos índices, foram: DTM ausente 37.56%; DTM leve 40.72%; DTM moderada 19%, e DTM severa 2.72%.The interaction between Temporomandibular disorders (TMD and otalgia is, even nowadays, a reason for speculation and hypotheses raising. Several researchers suggest causes, consequences and alleged treatments. STUDY DESIGN: This is an epidemiological, sectional cohort study of prevalence. AIM: The study demonstrates the prevalence of patients harboring TMDs in an otorhinolaryngology department. MATERIAL AND METHODOS: During a two-month period, 221 patients from the

  6. Analysis of the postural stability in individuals with or without signs and symptoms of temporomandibular disorder.

    Science.gov (United States)

    Ries, Lilian Gerdi Kittel; Bérzin, Fausto

    2008-01-01

    The objective of this study was to evaluate the stability and the distribution of weight of individuals with TMD (Temporomandibular Disorder) when placed in an orthostatic position. Forty female volunteers, participating in this study, were distributed into a control and a TMD group. Clinical examinations of the craniomandibular system and of the neck were performed. Postural stability was evaluated using a stabilographic platform. Through this system, the sway index (SI), the maximum medial-lateral distance (MMLD), the maximum anterior-posterior distance (MAPD) and the medial-lateral symmetry (MLS) could be determined. Tests were performed in the mandibular rest position and during isometric and isotonic contraction. The variables were analyzed through repeated measures ANOVA. The level of significance was p cervical region (p postural asymmetry, and cervical pain demonstrated a potential link with an increase in postural stability.

  7. Análise da postura cranio-cervical em pacientes com disfunção temporomandibular

    OpenAIRE

    IUNES, DH; CARVALHO, LCF; OLIVEIRA, AS; BEVILAQUA-GROSSI, D

    2009-01-01

    OBJECTIVE: To compare head positioning and cervical spine alignment between individuals with and without temporomandibular disorders (TMDs), by means of positional evaluation using photographs, radiographs and visual observation, and to investigate whether the type of TMD influences head posture and cervical spine positioning. METHODS: Ninety randomly chosen women were diagnosed using the research diagnostic criteria for TMDs (RDC/TMD) by a trained examiner and were divided into three groups:...

  8. Dysthymia increases the risk of temporomandibular disorder: A population-based cohort study (A STROBE-Compliant Article).

    Science.gov (United States)

    Lin, Shang-Lun; Wu, Shang-Liang; Ko, Shun-Yao; Lu, Ching-Hsiang; Wang, Diew-Wei; Ben, Ren-Jy; Horng, Chi-Ting; Yang, Jung-Wu

    2016-07-01

    Numerous studies have investigated the relationship between depression and temporomandibular disorders (TMD), but the conclusions remain vague. The aim of this study was to examine the causal effect between depression and TMD.The reporting of this study conforms to the STROBE statement. In this retrospective cohort study, all samples were recruited from a representative subdataset of 1 million insured persons for the year 2005 Longitudinal Health Insurance Database, who were randomly selected from all beneficiaries enrolled in the National Health Insurance program of Taiwan. We used a propensity score and stratified 926,560 patients into 2 groups (propensity1 = 588,429 and propensity2 = 338,131) and 4 cohorts (propensity1 with depression = 18,038, propensity1 without depression = 570,391, propensity2 with depression = 38,656, propensity2 without depression = 299,475) to detect the development of TMD among the depressive and nondepressive patients between 2004 and 2013.The positive correlative factors of TMD included female, total number of times seeking medical advice (TTSMA) for anxiety state, TTSMA for generalized anxiety disorder, TTSMA for mandible fracture, and TTSMA for unspecified anomaly of jaw size. The propensity2 group was represented by elder and female-predominant patients who used more psychiatric health resources. Among 3 types of depression, only dysthymia (so-called chronic depression) had a causal impact on TMD in the propensity 2 group. In the propensity 2 group, the hazard ratio of dysthymia for TMD measured by Cox's regression was 1.64 (95% confidence interval 1.28-2.09), after adjusting for demographic factors, psychiatric comorbidities, and maxillofacial confounders. The first-onset mean time of TMD as the consequence of dysthymia was 3.56 years (sd = 2.74, min = 0.08, median = 2.99, max = 9.73).This study demonstrates that dysthymia increases the risk of TMD in elderly and female-predominant patients

  9. Body posture changes in women with migraine with or without temporomandibular disorders

    Science.gov (United States)

    Ferreira, Mariana C.; Bevilaqua-Grossi, Débora; Dach, Fabíola É.; Speciali, José G.; Gonçalves, Maria C.; Chaves, Thais C.

    2014-01-01

    Background Migraine and temporomandibular disorders (TMDs) are reported to be associated. However, there are no reports on the association among migraines, TMDs and changes in body posture. Objectives To assess changes in body posture in women suffering migraines with or without TMD compared with a control group. Method Sixty-six women with a mean age of 18 to 45 years participated in this study. The groups were composed of 22 volunteers with migraine and TMD (MTMD), 22 volunteers with migraines without TMD (MG) and 22 women in the control group (CG). Static posture was assessed by photogrammetry, and 19 angles were measured. Results Postural asymmetry was observed in the face for 4 angles measured on the frontal plane in the MG group and for 4 angles of the trunk in the MG and MTMD groups with respect to CG. However, for comparisons between MTMD and CG, clinical relevance was identified for two angles of the sagittal plane (Cervical and Lumbar Lordosis, Effect Size - ES - moderate: 0.53 and 0.60). For comparisons between the MG and CG, the clinical relevance/potential was verified for three angles with moderate ES (ES>0.42). The clinical relevance when comparing MTMD and CG was identified for four angles of facial symmetry head inclination (ES>0.54) and for two angles between MG and CG (ES>0.48). Conclusion The results demonstrated the presence of postural changes compared with a control group in women with migraines with or without TMD, and there were similar clinically relevant postural changes among the patients with migraines with and without TMD. PMID:24675909

  10. Body posture changes in women with migraine with or without temporomandibular disorders

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    Mariana C. Ferreira

    2014-03-01

    Full Text Available Background: Migraine and temporomandibular disorders (TMDs are reported to be associated. However, there are no reports on the association among migraines, TMDs and changes in body posture. Objectives : To assess changes in body posture in women suffering migraines with or without TMD compared with a control group. Method: Sixty-six women with a mean age of 18 to 45 years participated in this study. The groups were composed of 22 volunteers with migraine and TMD (MTMD, 22 volunteers with migraines without TMD (MG and 22 women in the control group (CG. Static posture was assessed by photogrammetry, and 19 angles were measured. Results: Postural asymmetry was observed in the face for 4 angles measured on the frontal plane in the MG group and for 4 angles of the trunk in the MG and MTMD groups with respect to CG. However, for comparisons between MTMD and CG, clinical relevance was identified for two angles of the sagittal plane (Cervical and Lumbar Lordosis, Effect Size - ES - moderate: 0.53 and 0.60. For comparisons between the MG and CG, the clinical relevance/potential was verified for three angles with moderate ES (ES>0.42. The clinical relevance when comparing MTMD and CG was identified for four angles of facial symmetry head inclination (ES>0.54 and for two angles between MG and CG (ES>0.48. Conclusion : The results demonstrated the presence of postural changes compared with a control group in women with migraines with or without TMD, and there were similar clinically relevant postural changes among the patients with migraines with and without TMD.

  11. Association Between Severity of Temporomandibular Disorders and the Frequency of Headache Attacks in Women With Migraine: A Cross-Sectional Study.

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    Florencio, Lidiane Lima; de Oliveira, Anamaria Siriani; Carvalho, Gabriela Ferreira; Dach, Fabiola; Bigal, Marcelo Eduardo; Fernández-de-Las-Peñas, César; Bevilaqua-Grossi, Débora

    2017-05-01

    The aim of this study was to investigate the magnitude of association of the severity of temporomandibular disorders (TMDs) in women with episodic and chronic migraine. Thirty-one women with episodic migraine (mean age: 33 years), 21 with chronic migraine (mean age: 35 years) and 32 healthy controls (mean age: 31 years) were included. The Fonseca Anamnestic Index was applied to assess severity of TMDs. TMD severity was considered as follows: no TMD (0-19 points), mild TMD (20-49 points), moderate TMD (50-69 points), and severe TMD (70-100 points). To compare the proportion of TMD severity among groups, a χ 2 test was performed. Prevalence ratio (PR) was calculated to determine the association of TMD severity and both migraine groups using the control group as the reference. Women with chronic and episodic migraine were more likely to exhibit TMD signs and symptoms of any severity than healthy controls (χ 2 = 30.26; P < .001). TMD prevalence was 54% for healthy controls, 78% for episodic migraine, and 100% for chronic migraine. Women with chronic migraine exhibited greater risk of more severe manifestations of TMD than healthy controls (PR: 3.31; P = .008). This association was not identified for episodic migraine (PR: 2.18; P = .101). The presence of TMD signs and symptoms was associated with migraine independently of the frequency; however, the magnitude of the association of more severe TMD was significantly greater in chronic, but not episodic, migraine. Copyright © 2017. Published by Elsevier Inc.

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

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    Orlando Guerra Cobián

    2012-12-01

    Full Text Available Introducción: los trastornos temporomandibulares se asocian frecuentemente al hábito de masticar qat, pero se carece de estudios que detallan sus particularidades, por lo que se realiza este trabajo, con los objetivos de determinar la prevalencia de trastornos temporomandibulares en pacientes adictos al qat, identificar los hallazgos clínicos- radiográficos asociados y clasificar los trastornos temporomandibulares presentes en la población estudiada. Métodos: se realizó un estudio prospectivo, descriptivo, de corte transversal, en una muestra de 352 pacientes, del total de pacientes adictos, atendidos en el Departamento de Cirugía, Colegio Dental. Ibb,Yemen en el periodo octubre 2010-abril 2011. Se determinaron los hallazgos clínicos y radiográficos presentes, y se diagnosticó el tipo de trastorno temporomandibular. Resultados: se evidenció que estaban afectados por trastornos temporomandibulares el 55,7 % de los pacientes. Se encontró dolor articular agudo en 14,1 % y aplanamiento condilar anterior en 35,6 %. Conclusiones: los trastornos temporomandibulares afectaron más de la mitad de la población estudiada, adicta al qat. Los desórdenes en la relación cóndilo-disco fueron los más encontrados (41 %. El aplanamiento condilar anterior dominó en el análisis radiográfico.Introduction: the temporomandibular disorders has been associated frequently to the habit of chewing qat, but in previous studies, there are lack of specific details of this problem, for this reason this study is carried out ,to determine it prevalence, to identify clinical and radiografical findings associated , and to classify the temporomandibular disorders observed in the sample. Methods: a cross-sectional, descriptive and prospective study was done, in a sample of 352 patients of the total qat addicted patients which came to the Department of surgery, Dentistry College .Ibb Yemen October2010-April 2011. The clinical and radiographical findings were

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

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    Wagner SIMM

    2013-12-01

    Full Text Available Objectives: Evaluate the way the topics for the study of pain mechanisms in general, and Orofacial Pain (OFP and temporomandibular disorders (TMDs more specifically, are addressed in undergraduate courses curricula, and also to verify the existence of specialist OFP/TMD teachers in Brazilian dental schools. Methods: Between July 2010 and January 2011, course Coordinators/Directors of all dental schools duly registered at the Ministry of Education were invited to answer a questionnaire on topics related to OFP/TMD teaching in their institutions. Results: Fifty-three dental schools representatives answered the questionnaire. The study of pain mechanisms was found to cover an average of less than 10% of the courses' total time. Pharmacology, Endodontics and Physiology were identified as the departments usually responsible for addressing pain mechanisms in dental courses. Psychosocial aspects were found to occupy a very small proportion in the syllabi, while most of the content referred to biological or somatic aspects. OFP/TMD is addressed by a specific department in only 28.4% of the participating dental schools, while in most cases (46.3%, OFP/TMD is under the responsibility of the Prosthodontics department. Only 38.5% of respondents indicated that they had a specialist OFP/TMD teacher in their Schools. Conclusion: Among the Brazilian dental schools participating in the study, the teaching of OFP/TMD was found to be insufficient, segmented or with an extremely restricted focus. This initial assessment indicates that Curricular Guidelines for the study of OFP/TMD at undergraduate dental schools should be developed and implemented to facilitate their appropriate inclusion into the curricula and in specific pedagogical projects.

  14. Clinical management of chronic TMD pain.

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    Miller, D B

    1998-01-01

    Chronic Pain extracts a "penalty" on society now estimated to be well in excess of $100 million per year. The "penalty" that Chronic Pain extracts from its victims is incalculable. Chronic Pain is a major component of Temporomandibular Disorders. The current neurological theory of the mechanism of chronic TMD pain is explored along with the current modes of treatment. Pharmacological management of Chronic Pain in a clinical setting is outlined. Dentists are involved in pain management on a daily basis. Dentists treat pain both prophylacticly and in response to specific patient symptoms. Most dental treatment involves some type of pain management. We, dentists, have become very adept at managing acute pain. We have much greater difficulty managing chronic pain. The word "pain" derives from the Greek word for penalty, and appeared to them to be a "penalty" inflicted by the gods. In 1984, Bonica estimated that one-third of all Americans suffered from some kind of chronic pain at a "penalty" to society of $65 Billion annually in medical expenses and lost wages and productivity. This figure is certainly much greater now. Chronic pain can be a very complex problem that can require a multidisciplinary approach to treatment. Chronic pain in the dental setting is most frequetly caused by prolonged Temporomandibular Disorders.

  15. Counseling and oral splint for conservative treatment of temporomandibular dysfunction: preliminary study

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    Ana Paula Varela Brown MARTINS

    Full Text Available Abstract Introduction Temporoamndiular Disorders (TMD involve the masticatory muscles, temporomandibular joint (TMJ or both. The most common symptom is pain, which is usually located in the muscles of mastication, pre-auricular region, and / or ATM, especially during mandibular function. The main treatment for TMD is related to pain relief. Objective The purpose of this case report was to evaluate the reduction of pain symptoms using Visual Analogue Scale (VAS of patients with TMD treated with counseling and use of occlusal splint (OS. Material and method 16 subjects had participated in this study, that was composed by 4 appointment with 7-day interval between each (CEP FOP / Unicamp – 137/2009. In the first, an examiner used the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD to diagnose each patient and delivered a VAS to register the intensity of daily pain. In the second, counseling, molding of both dental arcs to fabricate the OS and the delivery of new VAS were performed. In the third, there was the installation and adjustment of the OS and the delivery of another scale, and in the last, possible adjustments on the OS were done. Data were analyzed by ANOVA two way and Tukey post-test at 5% significance level. Result There was significant difference when comparing the intensity of pain of individuals after installation of splint with the baseline data and after counseling (p = 0.05. Conclusion According to the result of this study, the treatment of TMD associating counseling occlusal splint is effective in reducing pain intensity.

  16. Self-reported temporomandibular disorder symptoms and severity of malocclusion in prospective orthognathic-surgical patients.

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    Svedström-Oristo, Anna-Liisa; Ekholm, Heidi; Tolvanen, Mimmi; Peltomäki, Timo

    2016-08-01

    The objective of this study is to analyze the association between self-reported symptoms of temporomandibular joint disorder (TMD) and the severity of malocclusion in prospective orthognathic-surgical patients. The subjects consisted of 50 consecutive patients (13 males and 37 females) referred to two university clinics for assessment of orthodontic-surgical treatment need. Data considering self-reported TMD symptoms were gathered using a semi-structured diary. At the first appointment, all patients rated the importance of treatment (on a scale of 1-10) and assessed self-perceived dental appearance using a VAS scale. The scale was anchored with photographs 1 and 10 from the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Study models were assessed by an experienced orthodontic specialist using the Peer Assessment Rating (PAR) index and the Index of Complexity, Outcome and Need (ICON). Association between the PAR and ICON scores and the number of reported symptoms was analyzed statistically. Seventy-one percent of patients reported experiencing TMD symptoms. The most prevalent symptoms were pain in the head and/or neck region and fatigue in the TMJ region. The number of symptoms was highest in the morning. Ninety percent of males and 86% of females rated the importance of treatment as high; males experiencing TMD symptoms tended to rate surgery as more important compared with males with no symptoms (p = 0.056). In this sample, the results cannot unambiguously confirm an association between self-reported symptoms of TMD and objectively defined severity of malocclusion.

  17. Temporomandibular disorders and chronic daily headaches in the community and in specialty care.

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    da Silva Junior, Ariovaldo Alberto; Krymchantowski, Abouch Valenty; Gomes, João Bosco Lima; Leite, Frederico Mota Gonçalves; Alves, Betânia Mara Franco; Lara, Rodrigo Pinto; Gómez, Rodrigo Santiago; Teixeira, Antônio Lúcio

    2013-09-01

    Chronic daily headaches (CDHs) are often associated with temporomandibular disorders (TMDs). However, large studies assessing the relationship were conducted in general, and not clinical, populations. Thus, clinical exams were not completed. Clinic-based studies with expert diagnosis are, in turn, often small and may not be representative. To contrast the demographic and clinical symptoms of CDH and TMD in participants within the general population relative to patients seen in a headache clinic. All inhabitants 10 years and older of a small city in Brazil were interviewed. Those with more than 15 days of headache per month were examined by a team consisting of a neurologist, a dentist, and a physical therapist. Headaches were classified as per the Second Edition of the International Classification of Headache Disorders and TMD as per the Research Diagnostic Criteria. The procedure was repeated (by the same team) with CDH sufferers consecutively seen in a headache center. Of 1605 inhabitants interviewed, 57 (3.6%) had CDH, and 43 completed all physical assessments. For specialty care group, of 289 patients, 92 had CDH, and 85 completed all assessments. No significant differences were seen for gender and age, but education level was significantly higher among those recruited at specialty care. Muscular TMD happened in 30.2% of CDH patients from the community vs 55.3% in the headache center (difference of -25.1%, 95% confidence interval of difference=-40.8% to -9.4%). No TMD happened in 41.9% of those recruited from the population relative to 20% of those in the headache center (21.9%, 95% confidence interval=6.7-37.1%). Individuals with CDH recruited from the general population are significantly less likely to have CDH relative to those selected from the headache center. Issues of generalizability are of concern when conducting clinic-based studies on the topic. © 2013 American Headache Society.

  18. Determinants of pain treatment response and nonresponse: identification of TMD patient subgroups.

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    Litt, Mark D; Porto, Felipe B

    2013-11-01

    The purpose of the present study was to determine if we could identify a specific subtype of temporomandibular disorder (TMD) pain patients that does not respond to treatment. Patients were 101 men and women with chronic TMD pain recruited from the community and randomly assigned to 1 of 2 treatment conditions: a standard conservative care (STD) condition or a standard care plus cognitive-behavioral therapy condition (STD + CBT) in which patients received all elements of STD but also received cognitive-behavioral coping skills training. Growth mixture modeling, incorporating a series of treatment-related predictors, was used to distinguish several distinct classes of responders or nonresponders to treatment based on reported pain over a 1-year follow-up period. Results indicated that treatment nonresponders accounted for 16% of the sample and did not differ from treatment responders on demographics or temporomandibular joint pathology, but that they reported more psychiatric symptoms, poorer coping, and higher levels of catastrophizing. Treatment-related predictors of membership in treatment responder groups versus the nonresponder group included the addition of CBT to STD, treatment attendance, and decreasing catastrophization. It was concluded that CBT may be made more efficacious for TMD patients by placing further emphasis on decreasing catastrophization and on individualizing care. This article provides evidence that the TMD chronic pain population is heterogeneous and that a subsample of patients will be unresponsive to standard or psychosocial approaches. The addition of CBT to treatment may be helpful for this group, but new individualized approaches will be needed to treat all patients effectively. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

  19. Upper cervical range of motion is impaired in patients with temporomandibular disorders.

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    Grondin, Francis; Hall, Toby; Laurentjoye, Mathieu; Ella, Bruna

    2015-04-01

    Clinicians increasingly suggest assessment and treatment of the cervical spine in patients with temporomandibular dysfunction (TMD); however, few studies have investigated upper cervical spine mobility in people who suffer from TMD. The purpose of this study was to investigate whether patients with TMD pain (with or without headache) present with upper cervical spine impairment when compared with asymptomatic subjects. A single blind examiner evaluated cervical range of motion (ROM) measures including axial rotation during the flexion-rotation test (FRT) and sagittal plane ROM. Twenty asymptomatic subjects were compared with 37 subjects with pain attributed to TMD, confirmed by the Revised Research Diagnostic Criteria. Subjects with TMD were divided according to the presence of headache (26 without headache TMDNHA, 11 with headache TMDHA). One-way analysis of variance and planned orthogonal comparisons were used to determine differences in cervical mobility between groups. All subjects with TMD were positive on the FRT with restricted ROM, while none were in the control group. The analysis of variance revealed significant differences between groups for the FRT F(2,54) = 57.96, Pheadache. Only subjects with TMD and headache had impairment of cervical spine sagittal plane mobility. This study provides evidence for the importance of examination of upper cervical mobility determined by the FRT in patients who suffer from TMD.

  20. Concomitant Migraine and Temporomandibular Disorders are Associated With Higher Heat Pain Hyperalgesia and Cephalic Cutaneous Allodynia.

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    Chaves, Thais C; Dach, Fabíola; Florencio, Lidiane L; Carvalho, Gabriela F; Gonçalves, Maria C; Bigal, Marcelo E; Speciali, José G; Bevilaqua-Grossi, Débora

    2016-10-01

    The aim of this study was to assess differences in the levels of hyperalgesia and cutaneous allodynia (CA) among women with migraine, temporomandibular disorders (TMD), or both. Eighty women participated in the study. Mean ages for the control group, TMD group, migraine group, and migraine+TMD group were 26.15 (95% confidence interval [CI], 28.73 to 23.57), 31.65 (95% CI, 37.82 to 25.48), 35.05 (95% CI, 40.37 to 29.73), and 34.20 (95% CI, 37.99 to 30.41) years, respectively. The 12-item Allodynia Symptom Checklist was administered to assess CA. All participants underwent the Quantitative Sensory Test to determine the cold-pain and heat-pain thresholds. Mechanical pain thresholds were assessed using Semmes-Weinstein monofilaments. One-way analysis of variance and χ tests were used for statistical analysis. Alpha was set at 0.05 level for statistical significance. For all sites evaluated, the mean cold-pain threshold values were significantly lower in the TMD, migraine, and TMD+migraine groups compared with the control group. However, the mean heat-pain threshold values in the extracephalic region were significantly smaller only for the TMD+migraine group compared with the control group (41.94°C; 95% CI, 40.54 to 43.34 vs. 44.79°C; 95% CI, 43.45 to 46.12; P=0.03). Mechanical hyperalgesia in orofacial and neck sites was significantly lower in the TMD and TMD+migraine groups compared with the control group. Mean total 12-item Allodynia Symptom Checklist score in the TMD+migraine group was significantly higher than in the migraine group (9.53; 95% CI, 7.45 to 11.60 vs. 6.95; 95% CI, 5.35 to 8.55; P=0.02). More pronounced levels of hyperalgesia and CA were found in patients with both TMD and migraine. Thus, it is suggested that the concomitant presence of TMD and migraine may be related to intensification of central sensitization.

  1. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey.

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    Karibe, Hiroyuki; Shimazu, Kisaki; Okamoto, Ayuko; Kawakami, Tomomi; Kato, Yuichi; Warita-Naoi, Sachie

    2015-01-21

    Associations between temporomandibular disorder (TMD) and psychological variables, pain conditions, and daily activities have been reported more commonly in middle-aged individuals than in children. However, to determine factor-specific preventive programs for TMD, it is important to evaluate the associations between multiple factors and TMD symptoms during childhood. The aim of this study was to assess the relationship between TMD symptoms and other orofacial pain conditions, daily activities, and trait anxiety in a population-based cross-sectional survey of Japanese children and adolescents. A total of 1,415 subjects (11-15 years old) self-reported their TMD symptoms, headache, neck pain, and toothache, and completed questionnaire scales that assessed 15 daily activities. Trait anxiety was assessed using the State Trait Anxiety Inventory for Children-Trait (STAIC-T) scale. Subjects were dichotomized into a TMD group or control group, based on whether they reported at least 1 TMD symptom: the TMD group (≥1 TMD symptom, n = 182) and the control group (no TMD symptoms, n = 1,233). Data were analyzed using the chi-square test and multivariate logistic regression analysis. The prevalence rates for headache and neck pain were significantly higher in the TMD group than in the control group (44.0% vs. 24.7% and 54.4% vs. 30.0%, respectively; both P anxiety. Diurnal clenching was strongly associated with TMD symptoms. Health professionals should carefully consider these factors when developing appropriate management strategies for TMD in children and adolescents.

  2. Correlation between facial types and muscle TMD in women: an anthropometric approach

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    Ronaldo Pacheco de ARAUJO

    2015-01-01

    Full Text Available Temporomandibular disorders (TMD affecting the articular disc and/or the facial muscles are common among the population, recording a higher incidence in women age 20-40 years. The aim of this study was to investigate the correlation between facial types and muscle TMD in women. This study comprised 56 women age 18 to 49 years, seeking treatment for TMD at the School of Medicine, Federal University of São Paulo. All of the study individuals were diagnosed with muscle TMD, based on the Research Diagnostic Criteria (RDC. Facial type was determined using the Facial Brugsch Index and classified as euryprosopic (short and/or broad, mesoprosopic (average width and leptoprosopic (long and/or narrow. The data were submitted to the Chi-square test and ANOVA-Tukey’s test to conduct the statistical analysis. The faces of 27 individuals were classified as euryprosopic (48%, 18 as mesoprosopic (32%, and 11 as leptoprosopic (20%. A statistically significant difference (Chi-square, p = 0.032 was found among the facial types, in that leptoprosopic facial types showed the lowest values for muscle TMD. A greater number (p = 0.0007 of cases of muscle TMD were observed in the 20 to 39 year-old subjects than in the subjects of other age segments. In conclusion, women with euryprosopic facial types could be more susceptible to muscle TMD. Further studies are needed to investigate this hypothesis.

  3. Study on self-assessment regarding knowledge of temporomandibular disorders in children/adolescents by Swedish and Saudi Arabian dentists.

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    Al-Khotani, Amal; Björnsson, Olof; Naimi-Akbar, Aron; Christidis, Nikolaos; Alstergren, Per

    2015-01-01

    To estimate the degree of self-assessed knowledge among dentists in Sweden and Saudi Arabia regarding temporomandibular disorders (TMD) in children and adolescents using a summative form of assessment and further to investigate the possible factors that may influence the self-assessed knowledge. A questionnaire survey covering four domains (Etiology; Diagnosis and classification; Chronic pain and pain behavior; Treatment and prognosis) regarding TMD knowledge was used. Out of 250 questionnaires (125 in each country) a total of 65 (52%) were returned in Sweden and 104 (83%) in Saudi Arabia. Self-assessed individual knowledge was significantly associated to the level of actual knowledge among the Swedish groups in the domains Etiology; Diagnosis and classification and Treatment and prognosis (p self-assessment of own knowledge between the dentists in Sweden and Saudi Arabia. The Swedish dentists have a better ability to assess their level of knowledge compared to Saudi Arabian dentists regarding TMD in children and adolescents. This difference could be related to several factors such as motivation, positive feedback, reflection, psychomotor, and interpersonal skills, which all are more dominant in the Swedish educational tradition.

  4. Comparison between the SCL-90-R and MMPI in TMD patients with psychological problems.

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    Kim, M-J; Lim, M-J; Park, W-K; Kho, H-S

    2012-03-01

    The aim of the study was to investigate the relationships between the Symptom Checklist-90-Revision (SCL-90-R) and the Minnesota Multiphasic Personality Inventory (MMPI) in temporomandibular disorders (TMD) patients with psychological problems. Subjective symptoms, objective signs, and psychological characteristics of 36 TMD patients with psychological problems were analyzed. The symptom severity index (SSI) and craniomandibular index (CMI) were used to assess subjective symptoms and objective signs of patients with TMD, respectively. The SCL-90-R and MMPI were used for psychological evaluation. The SSI was not significantly correlated with the CMI in TMD patients with psychological problems, and these indices displayed significant correlations with the SCL-90-R and MMPI in several selected subscales. The results of SCL-90-R had a limited relationship with those of MMPI in these patients. Based on the MMPI diagnosis, the SCL-90-R somatization subscale showed moderate to high sensitivity and specificity, but the SCL-90-R depression subscale showed moderate to low sensitivity and specificity. Considering the limited relationship between the SCL-90-R and MMPI in TMD patients with psychological problems, more comprehensive psychological tests are recommended when clinicians suspect patients with TMD of having accompanying psychological problems. © 2011 John Wiley & Sons A/S.

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

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    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

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

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    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

  7. A cross-sectional study of the relationship between serum sexual hormone levels and internal derangement of temporomandibular joint.

    Science.gov (United States)

    Madani, A S; Shamsian, A A; Hedayati-Moghaddam, M R; Fathi-Moghadam, F; Sabooni, M R; Mirmortazavi, A; Golmohamadi, M

    2013-08-01

    Temporomandibular disorders (TMD) are defined as clinical conditions that involve the masticatory muscles, temporomandibular joint (TMJ) or both. The aim of this study was to evaluate serum 17β-oestradiol and progesterone levels in menstruating women affected by internal derangement of the TMJ. A total of 142 women (mean age 30·2 ± 6·7) who referred to medical diagnostic laboratory of Iranian Academic Centre for Education, Culture and Research (ACECR), Mashhad Branch, were enrolled during 2007 and 2008. Forty-seven individuals had disc displacement with reduction (Group IIa) according to Research Diagnostic Criteria (RDC)/TMD Axis I diagnosis. Radioimmunoassay was used for the detection of serum 17β-oestradiol and progesterone levels in all 142 subjects. The mean progesterone level was significantly higher in control group (11·6 ± 10·4 ng mL(-1) ) compared to women with TMD (8·4 ± 6·8 ng mL(-1) , P = 0·03). No significant difference was found in two groups regarding 17β-oestradiol level. Lower progesterone level in women with TMD can suggest the more important role of this hormone in the development of the disorder. © 2013 John Wiley & Sons Ltd.

  8. A novel protocol for occlusal splint adjustment to treat TMD in sleep bruxism

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    Lilian Christyane Giannasi

    Full Text Available INTRODUCTION: Sleep bruxism (SB is a stereotypical movement disorder that is characterized by rhythmic masticatory muscle activity associated with tooth grinding and occasional jaw clenching. OBJECTIVES: The aim of this study was to determine the relief time for temporomandibular disorders (TMD, cervical and otological signs and symptoms in patients with BS treated with occlusal splints (OS for a period of 180 days. MATERIALS AND METHODS: Thirty patients, between ages 22 and 53 years old, presenting SB and TMD, including cervical and otological symptoms, were enrolled in this study. The patient’s treatment protocol consisted of using the OS applying a novel adjustment protocol. The total follow-up period was 180 days. The paired Student t-test was used to compare before and after long-term OS treatment. RESULTS: For all variables, the results were statistically significant (p < 0.001. As to the TMD symptoms, in most patients the relief of pain in masseter, temporalis, cervical and TMDs occurred in the 3rd month. Twenty percent of the patients were aware of clenching teeth while awake and reported that this parafunction decreased by the end of 6 months, and 90% reported an improvement in sleep quality as well. CONCLUSION: The use of an OS with a novel adjustment protocol was an effective treatment for TMD sign and symptoms in patients with SB.

  9. Evaluation of the signs and symptoms of temporomandibular disorders in children with headaches Avaliação dos sinais e sintomas de disfunções temporomandibulares em crianças com cefaléias

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    Fernanda Mara de Paiva Bertoli

    2007-06-01

    Full Text Available PURPOSE: The purpose of this study was to evaluate the presence of signs and symptoms of temporomandibular disorders (TMD in children with headaches in a neuropediatric ambulatory. METHOD: Fifty patients between 4 and 18 years of age were examined: 31 had headaches (24 migraine, 4 tension type and 3 unspecific headache and 19 formed the control group. The data collection was comprised of a structured questionnaire answered by the children's parents, and a subjective evaluation about the children’s emotional state. A specific questionnaire for TMD was applied, followed by a clinical dental examination of the children. As signs of TMD, mouth opening limitation, mandibular trajectory deviation in opening mouth, and joint noise were considered. As symptoms, pain on palpation of masseter and temporal muscles and on the poromandibular joint. RESULTS: A significant increase in signs and symptoms of TMD was found in patients with headaches when compared to the control group. There was also a significant difference in signs and symptoms of TMD according to age (increased with age and emotional state (tense> calm. CONCLUSION: There is a higher frequency of TMD in pediatric patients with headaches; thus, it is important to look for TMD signs and symptoms in this population.OBJETIVO: Avaliar a presença de sinais e sintomas de disfunção temporomandibular (DTM em crianças com cefaléias em um ambulatório de neuropediatria. MÉTODO: Foram examinados 50 pacientes com idade entre 4 e 18 anos, 31 com cefaléias (24 com enxaqueca, 4 com cefaléia tensional e 3 com cefaléia inespecífica e 19 do grupo controle. Os dados compreenderam um questionário estruturado respondido pelos pais e uma avaliação subjetiva sobre o estado emocional das crianças. Foi aplicado um questionário específico para DTM e realizado um exame clínico dental. Foram considerados como sinais de DTM: limitação da abertura bucal, desvio da trajetória ao abrir a boca e ru

  10. Relationship Between Symptoms of Temporomandibular Disorders and Estrogen Levels in Women With Different Menstrual Status.

    Science.gov (United States)

    Ivković, Nedeljka; Racic, Maja; Lecic, Radoslavka; Bozovic, Djordje; Kulic, Milan

    2018-03-21

    To evaluate whether serum estrogen level is associated with chronic pain, masticatory dysfunction, and depressive symptoms and/or somatization in women with temporomandibular disorders (TMD) and different menstrual cycle status. A total of 64 women were allocated into one of three groups: one composed of women with normal menstrual cycles (Group 1), one composed of pregnant women (Group 2), and one composed of women in surgical menopause (Group 3). All respondents underwent a standardized clinical examination with the Research Diagnostic Criteria for TMD (RDC/TMD). Diagnoses were generated according to Axis I, and grades of chronic pain, depressive symptoms, and somatization were evaluated according to Axis II. The level of serum estradiol was measured by using the immunofluorescent method. Analysis of variance, Kruskal-Wallis test with post hoc comparisons via series of Mann-Whitney U tests, and Spearman correlation coefficient were used for comparisons between study participants. Reported pain was decreased with the progress of pregnancy among the women from Group 2 and was the lowest at the 36th week of pregnancy. Women in surgical menopause reported higher pain intensity as well as more difficulties with chewing and eating hard and soft food compared to the other subjects. Depressive symptoms and somatization were lowest among the women with advanced pregnancy and the highest among menopausal women. TMD-related chronic pain grade, masticatory dysfunction, and depressive symptoms and somatization are the highest when the estrogen level is the lowest.

  11. Effects of massage therapy and occlusal splint therapy on mandibular range of motion in individuals with temporomandibular disorder: a randomized clinical trial.

    Science.gov (United States)

    Gomes, Cid André Fidelis de Paula; Politti, Fabiano; Andrade, Daniel Ventura; de Sousa, Dowglas Fernando Magalhães; Herpich, Carolina Marciela; Dibai-Filho, Almir Vieira; Gonzalez, Tabajara de Oliveira; Biasotto-Gonzalez, Daniela Aparecida

    2014-01-01

    The purpose of this study was to investigate the effects of massage therapy compared with occlusal splint therapy on mandibular range of motion (ROM) in individuals with temporomandibular disorder (TMD) and compare the results with ROM obtained in a group of individuals without this disorder. A blinded randomized clinical trial was conducted. Twenty-eight volunteers with TMD were randomly distributed into either a massage therapy group or an occlusal splint group. Both treatments were provided for 4 weeks. Fourteen individuals without TMD were consecutively allocated to a comparison group. Fonseca anamnestic index was used to characterize TMD and allocate the volunteers to either of the intervention groups or asymptomatic comparison group. Mandibular ROM was evaluated before and after treatment using a digital caliper. Two-way repeated-measures analysis of variance with a post hoc Bonferroni testing was used for intergroup and intragroup comparisons (level of significance was set to 5%). Cohen d was used to calculate the effect size. In the intragroup analysis, significant increases in ROM were found for all measures in both the massage and occlusal splint groups (P massage therapy and asymptomatic comparison groups (0.2 Massage therapy on the masticatory muscles and the use of an occlusal splint lead to an increase in mandibular ROM similar to that of the asymptomatic comparison group with regard to maximum active mouth opening and both right and left excursion in individuals with TMD. © 2013. Published by National University of Health Sciences All rights reserved.

  12. Temporomandibular disorders and tension-type headache.

    Science.gov (United States)

    Mongini, Franco

    2007-12-01

    Pathologies currently defined as temporomandibular disorders may be different in nature. Temporomandibular joint (TMJ) disorders and craniofacial and cervical myogenous pain (MP) are distinct pathologies but may be superimposed and share some etiologic factors. Tension-type headache (TTH) may often be associated with craniofacial and cervical pain, and the same pharmacologic and nonpharmacologic treatment may be efficacious for both. Psychiatric comorbidity (depression and/or anxiety disorder) is less frequent in sheer TMJ disorders, compared with MP and TTH. A screening for the presence of an underlying psychiatric disorder should be part of the clinical evaluation in patients suffering from headache and facial pain.

  13. Evaluation of the TMJ by means of Clinical TMD Examination and MRI Diagnostics in Patients with Rheumatoid Arthritis

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    Silke Witulski

    2014-01-01

    Full Text Available This study included 30 patients with diagnosed rheumatoid arthritis (RA and 30 test subjects without RA (control group. The objective of the study was to examine both groups for the presence of temporomandibular disorders (TMD and morphological changes of the temporomandibular joint (TMJ. All individuals were examined using a systematic detailed clinical TMD examination as well as magnetic resonance imaging (MRI. The clinical TMD examination yielded significant differences between the RA patients and the control group concerning crepitus of the TMJ, and palpation tenderness of the masticatory muscles as well as the unassisted mandibular opening. The evaluation of the MRI images for the RA group showed significantly more frequent deformations of the condyle, osteophyte formations and erosions in the condylar compacta, and degenerative changes in the spongiosa. Increased intra-articular accumulation of synovial liquid and signs of inflammatory changes of the spongiosa were only found in the RA group. Statistical analysis showed a significant correlation between crepitus and specific osteoarthrotic changes (MRI, respectively, and between crepitus and a complete anterior disk displacement without reduction (MRI. The duration of the RA disease correlated neither with the anamnestic and clinical dysfunction index by Helkimo nor with RA-specific MRI findings.

  14. Temporomandibular disorders, facial pain, and headaches.

    Science.gov (United States)

    Bender, Steven D

    2012-05-01

    Headaches and facial pain are common in the general population. In many cases, facial pain can be resultant from temporomandibular joint disorders. Studies have identified an association between headaches and temporomandibular joint disorders suggesting the possibility of shared pathophysiologic mechanisms of these 2 maladies. The aim of this paper is to elucidate potential commonalities of these disorders and to provide a brief overview of an examination protocol that may benefit the headache clinician in daily practice. © 2012 American Headache Society.

  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 craniomandibular pain and disability (p Neck disability was a significant covariate (37 % of variance) of craniomandibular pain and disability for the MP group (β = 0.62; p neck disability (β = 0.40; p craniomandibular 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. Relationship between anterior disc displacement with/without reduction and effusion in temporomandibular disorder patients using magnetic resonance imaging

    International Nuclear Information System (INIS)

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

    2013-01-01

    This study was performed to evaluate the relationship between anterior disc displacement and effusion in temporomandibular disorder (TMD) patients using magnetic resonance imaging (MRI). The study subjects included 253 TMD patients. 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 MRI findings, temporomandibular joint (TMJ) disc positions were divided into 3 subgroups: normal, anterior disc displacement with reduction (DWR), and anterior disc displacement without reduction (DWOR). The cases of effusion were divided into 4 groups: normal, mild (E1), moderate (E2), and marked effusion (E3). Statistical analysis was made by the Fisher's exact test using SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). The subjects consisted of 62 males and 191 females with a mean age of 28.5 years. Of the 253 patients, T1- and T2-weighted images revealed 34 (13.4%) normal, DWR in 103 (40.7%), and DWOR in 116 (45.9%) on the right side and 37 (14.6%) normal, DWR in 94 (37.2%), and DWOR in 122 (48.2%) joints on the left side. Also, T2-images revealed 82 (32.4%) normal, 78 (30.8%) E1, 51 (20.2%) E2, and 42 (16.6%) E3 joints on the right side and 79 (31.2%) normal, 85 (33.6%) E1, 57 (22.5%) E2, and 32 (12.7%) E3 on the left side. There was no difference between the right and left side. Anterior disc displacement was not related to the MRI findings of effusion in TMD patients (P>0.05).

  17. Temporomandibular Joint Disorder

    Science.gov (United States)

    ... Baby Bottle Tooth Decay? Pacifiers Have Negative and Positive Effects What is Dental Amalgam (Silver Filling)? Check Menstrual Calendar for Tooth Extraction Temporomandibular Joint Disorder Learn what those dental words mean. Check out how your teeth and mouth ...

  18. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    OpenAIRE

    Susan Armijo-Olivo; David Magee

    2012-01-01

    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...

  19. Análise dos índices de Helkimo e craniomandibular para diagnóstico de desordens temporomandibulares em pacientes com artrite reumatóide Analysis of helkimo and craniomandibular indexes for temporomandibular disorder diagnosis on rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Suzana C. da Cunha

    2007-02-01

    Full Text Available OBJETIVO: O estudo teve como finalidade avaliar a utilização de dois índices (Helkimo e craniomandibular para o diagnóstico da desordem temporomandibular (DTM em pacientes com Artrite Reumatóide (AR. MATERIAIS E MÉTODOS: A amostra foi de 80 pacientes divididos em dois grupos: pacientes com AR e pacientes sem AR. Em ambos os grupos os dois índices foram utilizados. No diagnóstico da DTM foram avaliados os seguintes sinais e sintomas: dor na ATM; limitação de abertura de boca e ruídos articulares. RESULTADOS: Os resultados mostram que dos pacientes com AR 87,1% eram do gênero feminino e 12,9% do masculino. Entre os pacientes sem AR, 70% eram do gênero feminino e 30% do masculino. A idade dos pacientes com AR variou de 24 a 78 anos. Entre os pacientes sem AR, a idade variou de 22 a 72 anos. Foi verificado que a prevalência de DTM foi mais elevada no grupo de pacientes com AR (98,6% - Helkimo e 87,1% - craniomandibular do que no grupo sem a doença (80% - Helkimo e 50% - craniomandibular. CONCLUSÃO: Em resumo, temos que ambos os índices são capazes de diagnosticar a desordem temporomandibular em pacientes com AR, entretanto o Índice de Helkimo é menos preciso.AIM: The aim of this study was to evaluate the use of two indexes (Helkimo and Craniomandibular for the diagnosis of temporomandibular disorder (TMD in patients with Rheumatoid Arthritis (RA. PATIENTS AND METHODS: The sample was composed of 80 patients divided into two groups: patients with RA and patients without RA. In both groups the two indexes were used. For TMD diagnosis, the following signs and symptoms were evaluated: TMJ pain, limited mouth opening and joint sounds. RESULTS: Results showed that of the RA patients, 87.1% were females and 12.9% were males. Among the patients without RA, 70% were females and 30% were males. The age of these RA patients ranged between 24 and 78 years. Among patients without RA, the age of the patients ranged between 22 and 72 years. It

  20. Association Between Chronic Tension-Type Headache Coexistent with Chronic Temporomandibular Disorder Pain and Limitations in Physical and Emotional Functioning: A Case-Control Study.

    Science.gov (United States)

    Emshoff, Rüdiger; Bertram, Felix; Schnabl, Dagmar; Emshoff, Iris

    2017-01-01

    To assess the association between chronic tension-type headache coexistent with chronic temporomandibular disorder (TMD) pain and severe limitations in physical and emotional functioning. Sample size estimation was used to determine that this case-control study should include 126 subjects. Subjects suffering from chronic TMD who were aged between 18 and 68 were recruited in routine clinical practice. Of the 126 included subjects, 63 had TMD pain associated with chronic tension-type headache (cases) and 63 had TMD pain without a history of tension-type headache (controls). Clinical diagnosis of TMD was made according to the Research Diagnostic Criteria for TMD (RDC/TMD) Axis I criteria, and clinical diagnosis of headache was made according to the International Classification of Headache (ICHD-II). RDC/TMD Axis II criteria were applied to record the scores from the Graded Chronic Pain Scale (GCPS) and the Symptoms Checklist-90-Revised Depression (SCL-DEP) and Somatization (SCL-SOM) scales. A logistic regression analysis was used to assess the relationship between TMD pain with chronic tension-type headache and high levels of depression and somatization severity as scored on the SCLDEP and SCL-SOM scales, respectively, and high pain-related disability (GCPS grade III or IV). Data were adjusted to take into account age, gender, time since TMD pain onset, chronic TMD pain intensity, and characteristic pain intensity. The presence of chronic tension-type headache was significantly associated with severe SCL-DEP (odds ratio [OR] = 7.2; P headache coexistent with chronic TMD pain and key aspects of physical and emotional functioning reflected in severe depression, severe somatization, and high pain-related disability.

  1. Masticatory Muscle Sleep Background EMG Activity is Elevated in Myofascial TMD Patients

    Science.gov (United States)

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

    2013-01-01

    Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n=124) with a demographically matched control group without TMD (n=46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artifacts were removed. Results indicated that median background EMG during these non SB-event periods was significantly higher (pcases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0–10 numerical scale) on post sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance. PMID:24237356

  2. Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls.

    Science.gov (United States)

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

    2015-10-01

    Sleep bruxism (SB), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of oro-facial problems, including temporomandibular disorders (TMD). As laboratory polysomnographic (PSG) assessment is extremely expensive and time-consuming, most research testing this belief has relied on patient self-report of SB. The current case-control study examined the accuracy of those self-reports relative to laboratory-based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD (n = 124) and a demographically matched control group without TMD (n = 46). A clinical research coordinator administered a structured questionnaire to assess self-reported SB. Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for the presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB, or severe SB, using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self-report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self-reported SB failed to significantly predict the presence or absence of either moderate or severe SB as assessed by PSG, for both cases and controls. These data show that self-report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB. Studies relying on self-report to assess SB must be viewed with extreme caution. © 2015 John Wiley & Sons Ltd.

  3. Do bruxism and temporomandibular disorders have a cause-and-effect relationship?

    Science.gov (United States)

    Lobbezoo, F; Lavigne, G J

    1997-01-01

    Controversy continues to exist over the putative role of bruxism in the etiology of temporomandibular disorders. A commonly held concept is that bruxism leads to signs and symptoms characteristic of one or more of the subdiagnoses of temporomandibular disorders, while another hypothesis suggests that bruxism is a temporomandibular disorder itself that sometimes coexists with other forms of temporomandibular disorders. Following a thorough review of the literature in this article, it is concluded that the relationship between bruxism and temporomandibular disorders is still unclear. Future research should examine longitudinal epidemiologic and clinical/experimental data to establish or refute a cause-and-effect relationship. In doing so, the existence of various sub-groups of temporomandibular disorders should be taken into account, and sleep-related bruxism should be discriminated from its daytime variant.

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

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    Patrícia Porto Loddi

    2010-06-01

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

  5. Temporomandibular joint dysfunction in various rheumatic diseases

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    F.J. Aceves-Avila

    2013-07-01

    Full Text Available Temporomandibular disorder (TMD is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA, osteoarthrosis (OA, ankylosing spondylitis (AS and systemic lupus erythematosus, and to define the limitations in everyday’s life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1 the presence of pain; 2 difficulty on mouth opening, chewing or speaking; 3 the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%. Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005. We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16% patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily.

  6. Experimental model of temporomandibular joint arthritis induced by zymozan in rats and the study of the role of nitric oxide

    OpenAIRE

    HellÃada Vasconcelos Chaves

    2006-01-01

    Temproromandibular disfunction (TMD) is related to a masticatory system disfunction which can include the temporomandibular joint (TMJ), the masticatory muscles and/or other related structures. TMJ inflammatory disorders are one of the major pathology of TMD afecting a great number of patients. Although TMJÂs inflammation and pain are important cinical entities, their mechanisms are poorly understood. The purpose of the study is to propose an experimetnal model of TMJÂs arthritis to study its...

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

    Science.gov (United States)

    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

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

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    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

  9. Magnetic resonance images of patients with temporomandibular disorders: Prevalence and correlation between disk morphology and displacement

    Energy Technology Data Exchange (ETDEWEB)

    Amaral, Ruana de Oliveira, E-mail: ruana.amaral@hotmail.com [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil); Damasceno, Naiana Nolasco de Lima, E-mail: naiananolasketi@yahoo.com.br [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil); Azevedo de Souza, Lílian, E-mail: lilianazevedo@msn.com [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil); Devito, Karina Lopes, E-mail: karina.devito@ufjf.edu.br [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil)

    2013-06-15

    Using magnetic resonance imaging (MRI), this study aimed to evaluate the morphology of the articular disc of the temporomandibular joint (TMJ) in patients with temporomandibular disorder (TMD). There were 218 TMJ of 109 assessed patients; 88 were females and 21 males, and all were diagnosed as symptomatic for temporomandibular disorder. The articular disc positions were classified in the normal position and with anterior disc displacement with and without reduction. Regarding the morphology, the discs were classified as follows: biconcave (normal), biplanar, rounded, biconvex, folded, thickening in the posterior band, thickening in the anterior band and hemiconvex. The results indicated that females were the most affected by morphological changes of the articular disc (p = 0.008/Cramer's V = 0.295). There was no statistical significance when correlating the disc morphology with the sides (right and left). There was a significant correlation between the position and morphology of the articular disc (p < 0.001/Cramer's V = 0.609), and in the normal position of the discs presenting biplanar and biconcave morphologies. In TMJ with anterior displacement of the disc with reduction (ADDR), there was a greater correlation with rounded, hemiconvex and biconvex morphologies. Already in the TMJ with displacement without reduction (ADDWR), there was a higher prevalence of folded discs. It can be concluded that morphological changes in the disc are influenced by the type of displacement, and more serious deformations are associated with ADDWR cases.

  10. Influence of sustained submaximal clenching fatigue test on electromyographic activity and maximum voluntary bite forces in healthy subjects and patients with temporomandibular disorders.

    Science.gov (United States)

    Xu, L; Fan, S; Cai, B; Fang, Z; Jiang, X

    2017-05-01

    This study aimed to investigate whether the fatigue induced by sustained motor task in the jaw elevator muscles differed between healthy subjects and patients with temporomandibular disorder (TMD). Fifteen patients with TMD and thirteen age- and sex-matched healthy controls performed a fatigue test consisting of sustained clenching contractions at 30% maximal voluntary clenching intensity until test failure (the criterion for terminating the fatigue test was when the biting force decreased by 10% or more from the target force consecutively for >3 s). The pre- and post-maximal bite forces (MBFs) were measured. Surface electromyographic signals were recorded from the superficial masseter muscles and anterior temporal muscles bilaterally, and the median frequency at the beginning, middle and end of the fatigue test was calculated. The duration of the fatigue test was also quantified. Both pre- and post-MBFs were lower in patients with TMD than in controls (P fatigue test in TMD patients was significantly shorter than that of the controls (P fatigued, but the electromyographic activation process during the fatigue test is similar between healthy subjects and patients with TMD. However, the mechanisms involved in this process remain unclear, and further research is warranted. © 2017 John Wiley & Sons Ltd.

  11. Association between periodontal disease temporomandibular disorders and rheumatoid arthritis among patients visiting rheumatology centers in Bengaluru City: A cross-sectional study

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    Vijay Kumar

    2017-01-01

    Full Text Available Introduction: Association between rheumatoid arthritis (RA, periodontitis and temporomandibular disorder (TMD can be an outcome of the existing inflammatory conditions or involvement of joints at a different level of severity. Aim: This study aims to find an association between periodontal disease and TMDs and RA among patients visiting various Rheumatology centers in Bengaluru city. Materials and Methods: A total of 100 RA patients and age- and gender-matched comparison group were recruited from various Rheumatology centers in Bengaluru city. Periodontal status and loss of attachment (LOA were measured from the World Health Organization (2013 criteria and TMDs and severity were assessed using Helkimo index (1987. Data were analyzed and comparisons were done using Chi-square test and independent t-test (P < 0.05. Correlation and association are measured through spearman's correlation and logistic regression analysis. Results: There was a significant difference regarding shallow and deep periodontal pocket depth among RA (4.62 ± 2.33, 1.48 ± 1.7 and comparison (3.48 ± 2.53, 0.83 ± 1.05 groups (P = 0.01. Impaired mobility (P = 0.012, altered function (P = 0.032, painful function (P = 0.023, muscle pain (P = 0.028, and temporomandibular joint pain (P = 0.048 differed significantly between RA group and comparison group. RA patients were more likely to suffer from TMD (OR = 4.88 and LOA (OR = 2.16 than the comparison group. Conclusion: Periodontitis and TMD are found to be associated with RA. A dental check-up for patients suffering from RA should be part of the routine RA assessment.

  12. Assessment of electromyographic activity in patients with temporomandibular disorders and natural mediotrusive occlusal contact during chewing and tooth grinding.

    Science.gov (United States)

    Fuentes, Aler D; Sforza, Chiarella; Miralles, Rodolfo; Ferreira, Cláudia L; Mapelli, Andrea; Lodetti, Gianluigi; Martin, Conchita

    2017-05-01

    The aim of this study was to investigate whether the presence of a natural mediotrusive contact influences electromyographic (EMG) pattern activity in patients with temporomandibular disorders (TMDs). Bilateral surface EMG activity of the anterior temporalis (AT), masseter (MM), and sternocleidomastoid (SCM) muscles was recorded in 43 subjects during unilateral chewing and tooth grinding. Thirteen patients had TMD and a natural mediotrusive contact (Group 1), 15 had TMD without a natural mediotrusive contact (Group 2), and 15 were healthy subjects without mediotrusive contacts (Group 3). All subjects were examined according to the Research Diagnostic Criteria for TMD (RDC/TMD). All EMG values were standardized as the percentage of EMG activity recorded during maximum isometric contraction on cotton rolls. EMG activity from all muscles measured showed no significant differences between groups during chewing and grinding. Overall, in all groups, the EMG activity during chewing was higher in the working side than the non-working side in AT and MM muscles. During grinding, these differences were only found in masseter muscles (mainly in eccentric grinding). SCM EMG activity did not show significant differences during chewing and grinding tasks. Symmetry, muscular balance, and absence of lateral jaw displacement were common findings in all groups. EMG results suggest that the contribution of a natural mediotrusive occlusal contact to EMG patterns in TMD patients is minor. Therefore, the elimination of this occlusal feature for therapeutic purposes could be not indicated.

  13. Bruxism and TMD disorders of everyday dental clinical practice.

    Science.gov (United States)

    Kapusevska, Biljana; Dereban, Nikola; Popovska, Mirjana; Nikolovska, Julijana; Popovska, Lidija

    2013-01-01

    Bruxism, as an etiological factor for the development of TMD, includes different disorders of the TMJ and the masticatory muscles, exhibiting pain and disruption of the stomatognathic functions. Our goal was to study patients with bruxism and TMD from everyday dental clinical practice, in terms of diagnosis, identification of etiological factors, classification and treatment of these disorders. We treated 120 patients, divided into 2 groups of 60 patients. The first group had disorders of the TMJ, and the second of the masticatory muscles. The groups were divided into subgroups of 20 patients with dislocation of the articular disk with or without reduction and inflammation of TMJ. The second group was organized from patients with myofascial pain, myositis and muscular trismus. Our conservative treatment consisted of patient education, NSAID, myorelaxants, fabrication of prosthetics, repositioning and stabilization splints. The progress of the patients was followed immediately after the delivery of the prosthetics and the splint, after 1, 6 and 12 months. The results showed that in patients with disorders of the TMJ there were visible signs of recovery after 6 months in 68.3% patients, and in 85% after 12 months. In the second group we achieved faster results with the elimination of symptoms. Patients with afflictions of the muscles in 88.3% of cases noticed relief of symptoms even after 6 months and in 98.3% after 12 months. As therapists we concluded that timely treated complications of bruxism and TMD prevent the destruction of the TMJ, masticatory muscles and the entire stomatognatic system.

  14. Temporomandibular disorders

    DEFF Research Database (Denmark)

    List, Thomas; Jensen, Rigmor Højland

    2017-01-01

    , limitations in jaw movement, and noise from the TMJs during jaw movements. TMD affects up to 15% of adults and 7% of adolescents. Chronic pain is the overwhelming reason that patients with TMD seek treatment. TMD can associate with impaired general health, depression, and other psychological disabilities...

  15. Rehabilitación dental y trastornos temporomandibulares en adolescentes de Puebla, México / Dental rehabilitations and temporomandibular disorders in adolescents of Puebla, Mexico

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    Gabriel Muñoz Q

    2014-05-01

    Full Text Available Objetivo: determinar el factor de riesgo para desarrollar trastornos temporomandibulares (ttm en adolescentes sometidos a rehabilitación dental. Métodos: cohorte realizada en 153 adolescentes, (52,9% mujeres y 47% hombres libres de ttm. Para diagnosticar los ttm se utilizaron los Criterios Diagnósticos para la Investigación de los ttm (cdi/ttm, para determinar caries se aplicó el índice cpod. Se formaron dos grupos, el grupo expuesto a rehabilitación dental (74, y el grupo no expuesto (79. Se realizaron seguimientos a las dos semanas, tres y seis meses de la rehabilitación dental. Se utilizó estadística descriptiva y se calculó el riesgo relativo con intervalos de confianza al 95%. Para el grupo de los expuestos, se incluyeron adolescentes libres de ttm en los que fue necesario realizar tratamiento de rehabilitación dental en órganos posteriores con caries en esmalte y dentina en fosas y fisuras. Para el grupo no expuesto, se incluyeron adolescentes pareados por edad y sexo con los expuestos, libres de ttm sin necesidades de rehabilitación dental. Resultados: la incidencia de ttm a los quince días de los expuestos (18,9% fue superior en contraste con los no expuestos (5,0%. El riesgo relativo de desarrollar ttm en los adolescentes rehabilitados con resina a las dos semanas posteriores a la rehabilitación fue de 2.412 (I.C. 95% 1.001-5,81 veces más que en aquellos que no fueron sometidos a la rehabilitación. Conclusión: la rehabilitación dental es un factor de riesgo mínimo para desarrollar ttm a corto plazo (15 días de realizado el procedimiento, dicho padecimiento inducido por la rehabilitación dental es agudo y auto limitante Objective: determine the risk factor involved with developing temporomandibular disorders (tmd in adolescents undergoing dental rehabilitation. Methodology: cohort study carried out on 153 tmd-free adolescents (52.9% women and 47% women. In order to diagnose tmds the Diagnostic Criteria for Research

  16. Pain acceptance, psychological functioning, and self-regulatory fatigue in temporomandibular disorder.

    Science.gov (United States)

    Eisenlohr-Moul, Tory A; Burris, Jessica L; Evans, Daniel R

    2013-12-01

    A growing body of evidence suggests that chronic pain patients suffer from chronic self-regulatory fatigue: difficulty controlling thoughts, emotions, and behavior. Pain acceptance, which involves responding to pain and related experiences without attempts to control or avoid them (pain willingness), and pursuit of valued life activities regardless of pain (activity engagement) has been associated with various favorable outcomes in chronic pain patients, including better psychological functioning. The study presented here tested the hypotheses that pain acceptance is associated with less psychological distress, higher psychological well-being, and reduced self-regulatory fatigue in temporomandibular disorder (TMD) patients, particularly for those with longer pain duration. Cross-sectional data were provided by 135 TMD patients during an initial evaluation at a university-based tertiary orofacial pain clinic. Results of hierarchical linear regression models indicated that, controlling for pain severity, pain willingness is associated with less psychological distress and lower self-regulatory fatigue, and activity engagement is associated with greater psychological well-being. Furthermore, the effect of pain willingness on psychological distress was moderated by pain duration such that pain willingness was more strongly associated with less psychological distress in patients with longer pain duration; this moderating effect was fully mediated by self-regulatory fatigue. These findings suggest pain willingness may buffer against self-regulatory fatigue in those with longer pain duration, and such conservation of self-regulatory resources may protect against psychological symptoms.

  17. The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure.

    Science.gov (United States)

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

    2015-02-01

    The purpose of this investigation was to establish a baseline of physical therapist education on temporomandibular disorders (TMD)-related topics during credentialed orthopedic manual physical therapy fellowship training and compare it to cervical spine disorders education. An online survey was distributed electronically to each fellowship program credentialed by the American Physical Therapy Association (APTA) and recognized by the Academy of Orthopedic Manual Physical Therapists (AAOMPT). Data were analyzed to compare overall exposure to TMD educational content, including a direct comparison of TMD and cervical spine disorders education. The response rate was 79%. Thirteen programs (87%) reported providing both didactic and clinical training on both TMD and cervical spine disorders. Didactic education for cervical spine disorders ranged from 16-20 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. Clinical education for cervical spine disorders ranged from 11-15 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. The number of hours of exposure during didactic training and the number of patients exposed to during clinical training were significantly different when comparing TMD to cervical spine disorders exposure (P<0.0001). The data indicate a lack of uniformity between credentialed fellowship programs in orthopedic manual physical therapy with respect to the extent to which programs expose trainees to evaluation and management of TMD. There is consistency in that all programs provided more training on cervical spine disorders than TMD. Despite a high level of clinical specialization, fellows-in-training receive minimal TMD education.

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

    Science.gov (United States)

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

    2014-07-01

    Temporomandibular disorders (TMDs) have a multifactorial etiology. Among others, parafunctions and oral habits have been suggested as important initiating and perpetuating factors. Playing a musical instrument that loads the masticatory system, like wind instruments and the violin or viola, has been suggested to be part of this group of etiological factors. However, the evidence base for this suggestion is lacking. Therefore, the aim of this study was to review the literature on the possible association between playing a musical instrument and developing and/or having a TMD. A PubMed search, using the query ['Music'(Mesh) AND 'Craniomandibular Disorders'(Mesh)], yielded 19 articles, 14 of which were included in this review. Six of 14 papers had a case-control or pre-test-post-test design; the remaining eight papers were case reports of expert opinions. The former papers were analysed and tabulated according to the PICO (Patient/population-Intervention-Control/comparison-Outcome/results) system; the latter ones were only summarised and tabulated. All articles with a case-control or pre-test-post-test design suggested a possible association between TMD and playing a musical instrument, especially the violin and viola. However, no clear-cut conclusion could be drawn as to whether playing a musical instrument is directly associated with TMD, or only in combination with other factors. More and better research on this topic is needed, as to enable a better counselling and possibly even a better treatment of the suffering musician. © 2014 John Wiley & Sons Ltd.

  19. Relationship between anterior disc displacement with/without reduction and effusion in temporomandibular disorder patients using magnetic resonance imaging

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

    2013-12-15

    This study was performed to evaluate the relationship between anterior disc displacement and effusion in temporomandibular disorder (TMD) patients using magnetic resonance imaging (MRI). The study subjects included 253 TMD patients. 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 MRI findings, temporomandibular joint (TMJ) disc positions were divided into 3 subgroups: normal, anterior disc displacement with reduction (DWR), and anterior disc displacement without reduction (DWOR). The cases of effusion were divided into 4 groups: normal, mild (E1), moderate (E2), and marked effusion (E3). Statistical analysis was made by the Fisher's exact test using SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). The subjects consisted of 62 males and 191 females with a mean age of 28.5 years. Of the 253 patients, T1- and T2-weighted images revealed 34 (13.4%) normal, DWR in 103 (40.7%), and DWOR in 116 (45.9%) on the right side and 37 (14.6%) normal, DWR in 94 (37.2%), and DWOR in 122 (48.2%) joints on the left side. Also, T2-images revealed 82 (32.4%) normal, 78 (30.8%) E1, 51 (20.2%) E2, and 42 (16.6%) E3 joints on the right side and 79 (31.2%) normal, 85 (33.6%) E1, 57 (22.5%) E2, and 32 (12.7%) E3 on the left side. There was no difference between the right and left side. Anterior disc displacement was not related to the MRI findings of effusion in TMD patients (P>0.05).

  20. Headache Exacerbates Pain Characteristics in Temporomandibular Disorders.

    Science.gov (United States)

    Costa, Yuri Martins; Alves da Costa, Dayse Regina; de Lima Ferreira, Ana Paula; Porporatti, André Luís; Svensson, Peter; Rodrigues Conti, Paulo César; Bonjardim, Leonardo Rigoldi

    2017-01-01

    To evaluate the impact of headache in adults with masticatory myofascial pain (MMP) on the outcome variables clinical pain (ie, self-reported pain intensity and pressure pain sensitivity), sleep quality, and pain catastrophizing. A total of 97 patients with MMP were diagnosed with co-existing headache (MMPH group, n = 50) or without headache (MMP group, n = 47) according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The outcome parameters were the Pittsburgh Sleep Quality Index (PSQI); the Catastrophizing Thoughts subscale of the Pain-Related Self-Statement Scale (PRSS-C); pressure pain thresholds (PPTs) of the masseter and anterior temporalis muscles; and self-reported facial pain intensity measured on a 0- to 10-cm visual analog scale (VAS). Student t test for independent samples (α = 1.2%) and factorial analysis of variance (ANOVA) (α = 5%) were used to analyze the data. The MMPH group showed significantly impaired sleep quality (mean ± standard deviation [SD] PSQI score 9.1 ± 3.5) compared with the MMP group (7.2 ± 3.4; P = .008). Subscale scores on the PRSS-C were significantly higher in the MMPH (2.1 ± 1.2) than in the MMP group (1.6 ± 1.4, uncorrected P = .048). Also, the PPTs (kgf/cm²) of the masseter and anterior temporalis muscles were significantly lower in the MMPH group (1.52 ± 0.53; 1.29 ± 0.43, respectively) than in the MMP group (2.09 ± 0.73; 1.70 ± 0.68, respectively; P headache patients had lower PPTs in the anterior temporalis muscle (P = .041) in comparison with non-headache patients. Co-existence of headache further exacerbates clinical characteristics in patients with painful TMD, which implies involvement of common mechanisms and pathways of vulnerability in these patients.

  1. 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

    2018-03-01

    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.

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

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    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

  3. The status of temporomandibular and cervical spine education in post-professional physical therapy training programs recognized by Member Organizations of IFOMPT: an investigation of didactic and clinical education.

    Science.gov (United States)

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

    2018-05-01

    The purpose of this investigation was to establish an international baseline of the quantity of physical therapist education on temporomandibular disorders (TMD) during post-professional Orthopedic Manual Physical Therapy (OMPT) education. An electronically distributed survey was sent to programs and data analyzed for trends, including a comparison of TMD and cervical spine disorders education. Current data were compared to pre-existing data from the United States. For the current data-set, the Mann-Whitney U test demonstrated statistical significance when comparing TMD and cervical spine disorders education for both the hours of didactic training provided ( p  didactic ( p  didactic ( p  = 0.23) or clinical education ( p  = 0.15) of cervical spine topics. These data again indicate a lack of uniformity between post-professional training programs in OMPT with respect to TMD education. There is, however, consistency in that most programs provided more training on cervical spine disorders than TMD. Based on these findings, further investigations are appropriate to determine if TMD education is adequate during post-professional OMPT education.

  4. RADIOGRAPHIC EXAMINATION OF TEMPOROMANDIBULAR DISORDERS IN CHILDREN

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    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.

  5. Temporal change in headache and its contribution to the risk of developing first-onset temporomandibular disorder in the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study.

    Science.gov (United States)

    Tchivileva, Inna E; Ohrbach, Richard; Fillingim, Roger B; Greenspan, Joel D; Maixner, William; Slade, Gary D

    2017-01-01

    While cross-sectional studies have demonstrated an association between headache and temporomandibular disorder (TMD), whether headache can predict the onset of TMD is unknown. The aims of this study were to evaluate the contribution of headache to the risk of developing TMD and describe patterns of change in headache types over time. An initially TMD-free cohort of 2410 persons with low frequency of headache completed quarterly questionnaires assessing TMD and headache symptoms over a median 3.0-year follow-up period. First-onset TMD was confirmed by clinical examination in 199 participants. Baseline reports of migraine (hazard ratio [HR] = 1.67, 95% confidence interval [CI]: 1.06-2.62) or mixed headache types (HR = 4.11, 95% CI: 1.47-11.46), or headache frequency (HR = 2.13, 95% CI: 1.31-3.48) predicted increased risk of developing TMD. In addition, headache dynamics across the follow-up period before the TMD onset were evaluated in a nested case-control study where 248 incident TMD cases were matched to 191 TMD-free controls. Both headache prevalence and frequency increased across the observation period among those who developed TMD but not among controls. Patients with TMD were more likely to experience worsening in the headache type compared with that by controls, eg, prevalence of definite migraine among TMD cases increased 10-fold. Among all headache types experienced by patients with TMD before the TMD onset, migraine had the highest odds of progression relative to remission (odds ratio = 2.8, 95% CI: 1.6-4.8), whereas for controls this ratio was significant only for the tension-type headache (odds ratio = 2.1, 95% CI: 1.2-3.9). The important clinical implication of these findings is that adequate treatment of migraine may reduce the risk for developing TMD.

  6. The efficacy of treatment performed for temporomandibular joint patients at dental school of Tehran University of Medical Sciences

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    Sahebi Majid

    2015-01-01

    Full Text Available   Background and Aims: Temporomandibular joint disorders are common problems among patients referring to dental schools and clinics. However appropriate treatment modalities are performed for the TMD patients in dental school, the results and success rate of these treatments are not studied distinctly. The aims of this study was to determine the treatment performed for temporomandibular patients at the TMJ department of Tehran University dental school in 2010-11 .   Materials and Methods: In a descriptive cross-sectional trial, 85 TMD patients treated at the TMJ department of Tehran University dental school were examined at least 3 months after the treatments. The patients demographic data ,TMD signs and symptoms and the improvements occurred in TMD disorder were determined (complete, partial and no improvement. The patients satisfaction regarding the treatment results were investigated and data were analyzed regarding the presence of different TMD signs and symptoms before and after the treatment using Mann-Whitney U test .   Results: TMJ pain (35 cases, 42.2%, click (33 cases, 39.8% and muscle tenderness (26 cases, 31.3% were the most prevalent obtained signs and symptoms. The mean age of the patients were 32.3 years old while females were the predominant group (72 cases vs.11 one. 44 individuals (53.0% were treated by splint, 11 ones (13.3% with anterior repositioning splint and 17 individuals (92.5% were managed by physiotherapy plus splint. 65 patients (87.3% were satisfied with the results and 16 ones (19.3% were not. After the treatment, patients with TMJ pain (P0.05 .   Conclusion: The results showed that the treatments presented for the TMD patients at Tehran University dental school were successful and most patients received satisfactory treatment.

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

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    Francisco Guedes Pereira de Alencar Junior

    2009-01-01

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

  8. Craniocervical posture analysis in patients with temporomandibular disorder Análise da postura cranio-cervical em pacientes com disfunção temporomandibular

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    DH Iunes

    2009-02-01

    Full Text Available OBJECTIVE: To compare head positioning and cervical spine alignment between individuals with and without temporomandibular disorders (TMDs, by means of positional evaluation using photographs, radiographs and visual observation, and to investigate whether the type of TMD influences head posture and cervical spine positioning. METHODS: Ninety randomly chosen women were diagnosed using the research diagnostic criteria for TMDs (RDC/TMD by a trained examiner and were divided into three groups: Group 1, with a diagnosis of myofascial dysfunction (group I of RDC axis I; Group 2, with mixed TMD (groups I, II and III of RDC axis I; and Control, without TMD. Following this, the participants were photographed in frontal and lateral views by a single examiner. To produce these photos, the following anatomical points were marked out on the skin: occipital protuberance, C4, C7, acromioclavicular joint and sternoclavicular joint. From these points, different angles were analyzed by means of the ALCimagem-2000 application. These same photos were then evaluated qualitatively (visual evaluation. Next, lateral teleradiography and radiography of the cervical spine was requested. The examiner was blind when analyzing the images. To compare the results, the chi-squared test and analysis of variance were used, with significance levels of 5%. RESULTS: Regardless of the method used, the results revealed that head and cervical spine posture did not differ between the groups with and without TMD, independent of the diagnostic group. CONCLUSION: The posture of individuals with myogenic or arthrogenous TMD does not differ from the posture of individuals without TMD. The presence of TMD does not influence the head and cervical spine posture.OBJETIVO: Comparar o posicionamento da cabeça e o alinhamento da coluna cervical em indivíduos com e sem DTM, por meio da avaliação postural por fotografias, radiografias e por observação visual e verificar se o tipo de DTM

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

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    Feteih Rabab M

    2006-08-01

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

  10. Psychosocial and Physical Assessment of Patients with Temporomandibular Disorders

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    Anitha B

    2004-01-01

    Full Text Available A study was conducted to assess the prevalence of psychosocial disorders in patients with TMD, and to establish correlation between these, and symptoms and physical signs of TMD. Thirty patients were included in the study. TMD history and TMJ examination findings were recorded. Subsequently psychosocial assessment was carried out. Eighteen patients were in psychiatric morbid (PM group and 12 were in psychiatric nonmorbid (PNM group. Symptoms and signs of TMD were compared between PM and PNM group. Strong association was evident between presence of psychiatric morbidity and certain parameters viz. pain duration, VAS, bruxism, mouth opening.

  11. Is playing string or wind musical instruments a risk factor for temporomandibular dysfunction? A Systematic Review.

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    Alessandro Leite Cavalcanti

    2017-11-01

    Full Text Available Aim. Medical problems specifically affecting professional musicians are commonly mentioned in the literature. The present study is aimed to evaluate, through a systematic review, the possible association between the practice of string with bow and wind musical instruments and the occurrence of Temporomandibular Dysfunction (TMD. Methods. The search for articles was conducted in PubMed/Medline, Web of Science, Scopus, Lilacs, Cochrane Library, and Open Gray databases, and there was no restriction on language or date of publication. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines were followed. The MeSH terms used were: “music”; “temporomandibular joint”; “temporomandibular joint disorders”; “temporomandibular joint dysfunction syndrome”; and “occupational diseases”. Cross-sectional studies, case-control, cohort and clinical trials were included that involved the practice of string with bow and wind musical instruments and the occurrence of Temporomandibular Dysfunction (TMD. Articles were previously selected by title and abstract. Qualitative evaluation was done through the Newcastle-Ottawa Scale. Results. The literature search identified 732 studies, of which 10 met the inclusion criteria, nine of them cross-sectional studies and one a clinical intervention study. The TMD prevalence ranged from 47.0% to 89.0%. Recruitment of participants took place in professional schools and orchestras, and in bands of professional musicians. All studies reported associations between TMD and the practice of musical instruments, and violinists presented higher prevalence rates when compared to other instrument groups. Conclusion. All studies pointed to a possible association between TMD and the practice of string and wind musical instruments. More longitudinal and clinical trials studies are needed to verify any possible interrelationship.

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

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    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.

  13. A retrospective analysis of the headache associated with temporomandibular joint disorder.

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    Ungari, C; Quarato, D; Gennaro, P; Riccardi, E; Agrillo, A; Mitro, V; Cascino, F; Reale, G; Rinna, C; Filiaci, F

    2012-11-01

    Headache is a common symptom, that can be extremely disabling, affecting 26 million of patients only in Italy. ICHD-II has reported two categories: "primary headaches" and "secondary headaches". Temporomandibular joint disorders can lead to a secondary headaches. We want to evaluate the prevalence and clinical features of headache among a series of patients having temporomandibular joint disorders and we illustrate the evolution of headache following medical treatament of temporomandibular joint (TMJ) disorders. This is a retrospective study carried out on chart review of 426 consecutive patients with various degrees of temporomandibular disorders and treated with medical devices from 2007 to 2011. Headache was reported by 73 patients (17.14%). Headache was observed in 36 of 51 patients with lock and in 32 out of 130 patients with mandibular deflections (Table I). The remaining 5 patients with headache had articular noise. Headache is not a rare finding in a population with temporomandibular dysfunctions and is more often a tension-type rather than trigeminal headache.

  14. [Whiplash lesions and temporomandibular joint disorders].

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    Gola, R; Richard, O; Guyot, L; Cheynet, F

    2004-11-01

    Attributing dysfunction of the temporomandibular joint (TMJ) to whiplash injury is a difficult problem to solve. TMJ disorders do not seem to be secondary to direct articular trauma but rather caused by a postural disorder of the cervical spine. Occlusal disorders and stress further complicate the picture. Four clinical cases illustrate a new hypothetical approach.

  15. The relationship between forward head posture and temporomandibular disorders.

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    Lee, W Y; Okeson, J P; Lindroth, J

    1995-01-01

    This study investigated the relationship between forward head posture and temporomandibular disorder symptoms. Thirty-three temporomandibular disorder patients with predominant complaints of masticatory muscle pain were compared with an age- and gender-matched control group. Head position was measured from photographs taken with a plumb line drawn from the ceiling to the lateral malleolus of the ankle and with a horizontal plane that was perpendicular to the plumb line and that passed through the spinous process of the seventh cervical vertebra. The distances from the plumb line to the ear, to the seventh vertebra, and to the shoulder were measured. Two angles were also measured: (1) ear-seventh cervical vertebra-horizontal plane and (2) eye-ear-seventh cervical vertebra. The only measurement that revealed a statistically significant difference was angle ear-seventh cervical vertebra-horizontal plane. This angle was smaller in the patients with temporomandibular disorders than in the control subjects. In other words, when evaluating the ear position with respect to the seventh cervical vertebra, the head was positioned more forward in the group with temporomandibular disorders than in the control group (P < .05).

  16. Electromyographic Activity of the Cervical Flexor Muscles in Patients With Temporomandibular Disorders While Performing the Craniocervical Flexion Test: A Cross-Sectional Study

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    Silvestre, Rony; Fuentes, Jorge; da Costa, Bruno R.; Gadotti, Inae C.; Warren, Sharon; Major, Paul W.; Thie, Norman M.R.; Magee, David J.

    2011-01-01

    Background Most patients with temporomandibular disorders (TMD) have been shown to have cervical spine dysfunction. However, this cervical dysfunction has been evaluated only qualitatively through a general clinical examination of the cervical spine. Purpose The purpose of this study was to determine whether patients with TMD had increased activity of the superficial cervical muscles when performing the craniocervical flexion test (CCFT) compared with a control group of individuals who were healthy. Design A cross-sectional study was conducted. Methods One hundred fifty individuals participated in this study: 47 were healthy, 54 had myogenous TMD, and 49 had mixed TMD. All participants performed the CCFT. Data for electromyographic activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles were collected during the CCFT for all participants. A 3-way mixed-design analysis of variance for repeated measures was used to evaluate the differences in EMG activity for selected muscles while performing the CCFT under 5 incremental levels. Effect size values were calculated to evaluate the clinical relevance of the results. Results Although there were no statistically significant differences in electromyographic activity in the SCM or AS muscles during the CCFT in patients with mixed and myogenous TMD compared with the control group, those with TMD tended to have increased activity of the superficial cervical muscles. Limitations The results obtained in this research are applicable for the group of individuals who participated in this study under the protocols used. They could potentially be applied to people with TMD having characteristics similar to those of the participants of this study. Conclusion This information may give clinicians insight into the importance of evaluation and possible treatment of the deep neck flexors in patients with TMD. However, future research should test the effectiveness of this type of program through a randomized controlled

  17. Patients profiles and outcomes of care in temporomandibular disorders

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    Su, N.

    2018-01-01

    Temporomandibular disorders (TMDs) are a frequent disease in general population. Patients with TMDs may have orofacial pain, jaw functional limitation and joint sounds, which may negatively affect patients’ physical and psychological wellbeing. Temporomandibular joint osteoarthritis (TMJ OA) and

  18. Acupuntura como recurso terapêutico na dor e na gravidade da desordem temporomandibular Acupuncture as therapeutic resource in the pain and in the severity of the temporomandibular disorder

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    Graciele da Silva Borin

    2011-09-01

    Full Text Available Este estudo avaliou o efeito da acupuntura no nível de dor e gravidade da Desordem Temporomandibular (DTM. Participaram dele 40 mulheres entre 20 e 40 anos com DTM diagnosticada pelo Research Diagnostic Criteria (RDC/TMD. A dor foi avaliada pela escala visual analógica e a gravidade da desordem pelos Índices de Disfunção Craniomandibular e de Fonseca. As 20 primeiras participantes foram submetidas a acupuntura duas vezes na semana por cinco semanas ininterruptas e, após o período, foram reavaliadas. Os dados destas participantes constituíram os resultados para o grupo acupuntura. As demais voluntárias receberam o tratamento após o primeiro grupo e seus dados, coletados no início e após cinco semanas sem tratamento, foram utilizados para controle. Na análise estatística foram levados em conta os testes de Wilcoxon para o nível de dor e Índice Craniomandibular e Teste t de Student para o Índice de Fonseca, com nível de significância de 5%. Houve redução significante no nível de dor (p=0,000 e na gravidade da DTM pelos Índices Craniomandibular (p=0,004 e de Fonseca (p=0,000 após o tratamento. O grupo controle não apresentou melhora. A efetividade da acupuntura foi demonstrada pela melhora no nível da dor e na gravidade da DTM.This study assessed the effect of acupuncture on the pain level and severity of the temporomandibular disorder (TMD. Forty women with TMD diagnosed by Research Diagnostic Criteria, from 20 and 40 years old, took part in the study. Pain was assessed by visual analogue scale and severity by the Craniomandibular Dysfunction and Fonseca Indexes. The first 20 volunteers were undergone to acupuncture twice a week for five weeks without interruption, and after they were reassessed. The results of these participants constituted acupuncture group. The other volunteers received the treatment after the first group and their data, collected in the beginning and after five weeks without treatment, were utilized as

  19. Effects of orthognathic surgery for class III malocclusion on signs and symptoms of temporomandibular disorders and on pressure pain thresholds of the jaw muscles.

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    Farella, M; Michelotti, A; Bocchino, T; Cimino, R; Laino, A; Steenks, M H

    2007-07-01

    The aim of this longitudinal study was to determine the effects of orthognathic surgery on signs and symptoms of temporomandibular disorders (TMD) and on pressure pain thresholds (PPTs) of the jaw muscles. Fourteen consecutive class III patients undergoing pre-surgical orthodontic treatment were treated by combined Le Fort I osteotomy and bilateral sagittal ramus osteotomy. The clinical examination included the assessment of signs and symptoms of TMD and the assessment of PPTs of the masseter and temporalis muscles. Anamnestic, clinical and algometric data were collected during five sessions over a 1-year period. Seven out of 14 patients presented with disc displacement with reduction at baseline, whereas four patients (two of them were new cases) did so at the end of follow up (p>0.05). None of the patients were diagnosed with myofascial pain of the jaw muscles at the beginning or end of follow up. PPTs of the masseter and temporalis muscles did not change significantly from baseline values throughout the whole study period. The occurrence of signs and symptoms of TMD fluctuates with an unpredictable pattern after orthognathic surgery for class III malocclusions.

  20. Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw?

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    Van Damme, Stefaan; Vanden Bulcke, Charlotte; Van Den Berghe, Linda; Poppe, Louise; Crombez, Geert

    2018-01-01

    Patients with chronic orofacial pain due to temporomandibular disorders (TMD) display alterations in somatosensory processing at the jaw, such as amplified perception of tactile stimuli, but the underlying mechanisms remain unclear. This study investigated one possible explanation, namely hypervigilance, and tested if TMD patients with unilateral pain showed increased attending to somatosensory input at the painful side of the jaw. TMD patients with chronic unilateral orofacial pain ( n  = 20) and matched healthy volunteers ( n  = 20) performed a temporal order judgment (TOJ) task indicated which one of two tactile stimuli, presented on each side of the jaw, they had perceived first. TOJ methodology allows examining spatial bias in somatosensory processing speed. Furthermore, after each block of trials, the participants rated the perceived intensity of tactile stimuli separately for both sides of the jaw. Finally, questionnaires assessing pain catastrophizing, fear-avoidance beliefs, and pain vigilance, were completed. TMD patients tended to perceive tactile stimuli at the painful jaw side as occurring earlier in time than stimuli at the non-painful side but this effect did not reach conventional levels of significance ( p  = .07). In the control group, tactile stimuli were perceived as occurring simultaneously. Secondary analyses indicated that the magnitude of spatial bias in the TMD group is positively associated with the extent of fear-avoidance beliefs. Overall, intensity ratings of tactile stimuli were significantly higher in the TMD group than in the control group, but there was no significant difference between the painful and non-painful jaw side in the TMD patients. The hypothesis that TMD patients with chronic unilateral orofacial pain preferentially attend to somatosensory information at the painful side of the jaw was not statistically supported, although lack of power could not be ruled out as a reason for this. The findings are discussed within

  1. Muscle Fatigue in the Temporal and Masseter Muscles in Patients with Temporomandibular Dysfunction

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    Krzysztof Woźniak

    2015-01-01

    Full Text Available The aim of this study is to evaluate muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction (TMD. Two hundred volunteers aged 19.3 to 27.8 years (mean 21.50, SD 0.97 participated in this study. Electromyographical (EMG recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany. Muscle fatigue was evaluated on the basis of a maximum effort test. The test was performed during a 10-second maximum isometric contraction (MVC of the jaws. An analysis of changes in the mean power frequency of the two pairs of temporal and masseter muscles (MPF% revealed significant differences in the groups of patients with varying degrees of temporomandibular disorders according to Di (P<0.0000. The study showed an increase in the muscle fatigue of the temporal and masseter muscles correlated with the intensity of temporomandibular dysfunction symptoms in patients. The use of surface electromyography in assessing muscle fatigue is an excellent diagnostic tool for identifying patients with temporomandibular dysfunction.

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

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

    2016-06-01

    There is little information on bruxism related to illicit drug use. Prolonged drug use may damage the stomatognathic system via oral motor overactivity. The aim of the present study was to compare the rates of bruxism and temporomandibular disorders (TMDs) between prisoners with and without drug-use disorders, to evaluate the association between methadone treatment and bruxism and to assess the possible relationship between bruxism and pain. The sample included 152 male prisoners, 69 of whom were drug users maintained on methadone. All prisoners were examined by an experienced dentist and completed a questionnaire on their oral habits, with the aim of detecting signs or symptoms of TMD and/or bruxism. Additional data were collected from medical files. The prevalence of sleep bruxism and awake bruxism, but not of TMDs, was significantly higher among drug-user than non-drug user prisoners (52.2% vs. 34.9% for sleep bruxism, 59.7% vs. 30.1% for awake bruxism, and 46.3% vs. 25.6% for TMDs, respectively). Participants with awake bruxism were statistically more sensitive to muscle palpation compared with participants with sleep bruxism [rating scores (mean ± SD): 0.32 ± 0.21 vs. 0.19 ± 0.28, respectively]. An association was found between sleep bruxism and awake bruxism. It seems that there is a direct or an indirect association between methadone maintenance treatment and sleep bruxism or awake bruxism in male prisoners. © 2016 Eur J Oral Sci.

  3. Efeito da reeducação postural global no alinhamento corporal e nas condições clínicas de indivíduos com disfunção temporomandibular associada a desvios posturais Effect of global postural reeducation on body alignment and on clinical status of individuals with temporomandibular disorder associated to postural deviations

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    Débora Basso

    2010-03-01

    Full Text Available Este estudo visou verificar o efeito da técnica de reeducação postural global (RPG nas condições físicas, psicológicas e psicossociais, assim como no alinhamento corporal, de indivíduos com disfunção temporomandibular (DTM associada a desvio postural. Participaram 20 indivíduos com DTM e com desvio postural confirmado por exame físico, avaliados, antes e depois do tratamento de RPG, pelos critérios diagnósticos de desordens temporomandibulares (RDC/TMD, na sigla em inglês e quanto às medidas angulares, por fotogrametria digital. O tratamento consistiu em 10 sessões semanais de RPG. Os resultados após o tratamento mostram, na classificação da disfunção, maior predomínio de desordens apenas musculares (em detrimento das articulares e por deslocamento de disco e redução da intensidade da dor orofacial; o percentual de indivíduos sem depressão aumentou de 10% para 35%; o percentual de indivíduos com classificação normal de sintomas físicos (excluindo itens de dor passou de 30% para 55%. Foi encontrada melhora estatisticamente significante na maioria das medidas angulares, exceto nos ângulos frontais dos membros inferiores e ângulo perna/retropé direito. O alinhamento horizontal da cabeça e as medidas de lordose cervical e lombar, com valores normais antes da RPG, não se modificaram. Conclui-se que, com o tratamento de RPG, os indivíduos apresentaram importantes melhoras dos sintomas físicos e psicológicos da DTM, assim como melhora do alinhamento e simetria corporais.The purpose of this study was to assess the effects of the technique of global postural re-education (GPR on body alignment and clinical status of individuals with temporomandibular disorder (TMD associated to postural deviations. Twenty individuals with both TMD and postural deviations confirmed by physical examination were assessed, before and after treatment, by the research diagnostic criteria for temporomandibular disorders (RDC/TMD and as to

  4. Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial.

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    von Piekartz, Harry; Hall, Toby

    2013-08-01

    There is evidence that temporomandibular disorder (TMD) may be a contributing factor to cervicogenic headache (CGH), in part because of the influence of dysfunction of the temporomandibular joint on the cervical spine. The purpose of this randomized controlled trial was to determine whether orofacial treatment in addition to cervical manual therapy, was more effective than cervical manual therapy alone on measures of cervical movement impairment in patients with features of CGH and signs of TMD. In this study, 43 patients (27 women) with headache for more than 3-months and with some features of CGH and signs of TMD were randomly assigned to receive either cervical manual therapy (usual care) or orofacial manual therapy to address TMD in addition to usual care. Subjects were assessed at baseline, after 6 treatment sessions (3-months), and at 6-months follow-up. 38 subjects (25 female) completed all analysis at 6-months follow-up. The outcome criteria were: cervical range of movement (including the C1-2 flexion-rotation test) and manual examination of the upper 3 cervical vertebra. The group that received orofacial treatment in addition to usual care showed significant reduction in all aspects of cervical impairment after the treatment period. These improvements persisted to the 6-month follow-up, but were not observed in the usual care group at any point. These observations together with previous reports indicate that manual therapists should look for features of TMD when examining patients with headache, particularly if treatment fails when directed to the cervical spine. Copyright © 2013. Published by Elsevier Ltd.

  5. Evaluation of body posture in individuals with internal temporomandibular joint derangement.

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    Munhoz, Wagner Cesar; Marques, Amélia Pasqual; de Siqueira, José Tadeu Tesseroli

    2005-10-01

    Temporomandibular dysfunctions (TMD) comprise a great number of disruptions that may affect the temporomandibular joint (TMJ), the masticatory muscles, or both. TMJ internal derangement is a specific type of TMD, of which the etiology and physiopathology are broadly unknown, but have been suggested to be linked to head, neck, and body posture factors. This study aimed at verifying possible relationships between body posture and TMJ internal derangements (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Subjects' clinical evaluations included anamnesis, stomatognatic system evaluation, and plotting analysis on body posture photographs. No statistically significant differences were found between the groups. Results do not support the assertion that body posture plays a role in causing or enhancing TMD; however, these results should be cautiously considered because of the small number of subjects evaluated and the many posture variables submitted to statistical procedures that lead to high standard deviations.

  6. 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.

  7. Association between parafunctional habit and sign and symptoms of temporomandibular dysfunction

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    Harshali Fale

    2018-01-01

    Full Text Available Introduction: Temporomandibular disorder (TMD is a group of condition affecting the temporomandibular joint, masticatory muscles, and the adjacent structures. The etiology of TMD in children and adolescents is considered multifactorial in nature and has been related to trauma, malocclusion, and parafunctional habits. Aim: The aim of this study is to find whether harmful oral habits are associated with sign and symptoms of TMD among adolescents in Wardha district. Materials and Methods: A short-span study was conducted in Wardha, Maharashtra. A self-administered based study was done among 200 adolescents which comprised of 107 females and 93 males. Data were collected using self-administered questionnaire and clinical oral examination that was conducted. The questionnaire was consist of knowledge responses (yes/no and attitude responses (never, rarely, sometimes, often, and always. Chi-square test was used to perform statistical analysis and level of significance was set at P < 0.05. Results: The main method used was self-administered questionnaires with sample characteristics of 53.5% female and 46.5% male. Population was divided into two age groups. Total number of adolescents in age Group 1 (9–14 years was 85 and age Group 2 (15–19 years was 115. Seventy-seven (38.5% adolescent reported no sign and symptoms of TMD and rest of them reported yes to at least one statement of questionnaire. Bruxism (67% was the most frequently observed habit whereas chewing gums (5% as the least observed habit. Statistically significant gender difference was not observed in the questionnaire. Higher frequency of TMD symptoms was reported in the age group of 15–19 years. Sixteen (8% subjects reported nonparafunctional habits whereas 184 (92% subjects had parafunctional habits. During clinical examination, muscle sensitivity to palpation was most frequent sign in the age of group 15–19 years with P = 0.023. Higher severity was reported are morning facial

  8. Psychoneuroimmunological disorders and temporomandibular joint pain: A review

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    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.

  9. Treatment for TMD with occlusal splint and electromyographic control: application of the FARC protocol in a Brazilian population.

    Science.gov (United States)

    Vieira e Silva, Carolina A; da Silva, Marco Antônio M Rodrigues; Melchior, Melissa de Oliveira; de Felício, Cláudia Maria; Sforza, Chiarella; Tartaglia, Gianluca M

    2012-07-01

    The purpose of this study was to apply Functional Anatomy Research Center (FARC) Protocol of TMD treatment, which includes the use of a specific type of mandibular occlusal splint, adjusted based on the electromyographic index, in a group of 15 patients with disc displacement, classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and then analyzing the results compared with the control group. The clinical evaluations were completed both before and after the treatment. Electromyographic (EMG) data was collected and recorded on the day the splint was inserted (visit 1), after one week (visit 2) and after five weeks of treatment (visit 3). The control group consisted of 15 asymptomatic subjects, according to the same diagnostic criteria (RDC/TMD), who were submitted to the same evaluations with the same interval periods as the treatment group. Immediately after splint adjustment, masseter muscle symmetry and total muscular activity were significantly different with than without the splint (p < 0.05), showing an increased neuromuscular coordination. After treatment, significant variations (p < .05) were found in mouth opening and in pain remission. There were no significant differences among the three sessions, either with or without the splint. There were significant differences between the TMD and control groups for all analyzed indices of muscular symmetry, activity and torque, with the exception of total muscular activity. The use of the splint promoted balance of the EMG activities during its use, relieving symptoms. EMG parameters identified neuromuscular imbalance, and allowed an objective analysis of different phases of TMD treatment, differentiating individuals with TMD from the asymptomatic subjects.

  10. The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders.

    Science.gov (United States)

    Ferrario, Virgilio F; Tartaglia, Gianluca M; Luraghi, Francesca E; Sforza, Chiarella

    2007-11-01

    The aim of this study was to assess the electromyographic characteristics of the masticatory muscles (masseter and temporalis) of patients with either "temporomandibular joint disorder" or "neck pain". Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 38 patients aged 21-67 years who had either (a) temporomandibular joint disorder (24 patients); (b) "neck pain" (13 patients). Ninety-five control, healthy subjects were also examined. During clenching, standardized total muscle activities (electromyographic potentials over time) were significantly different in the three groups: 75 microV/microVs% in the temporomandibular joint disorder patients, 124 microV/microVs% in the neck pain patients, and 95 microV/microVs% in the control subjects (analysis of variance, Ptemporomandibular joint disorder patients also had significantly (Pneck pain patients (87%) or control subjects (92%). A linear discriminant function analysis allowed a significant separation between the two patient groups, with a single patient error of 18.2%. Surface electromyographic analysis during clenching allowed to differentiate between patients with a temporomandibular joint disorder and patients with a neck pain problem.

  11. Prevalence Of Otologic Symptoms In Temperomandibular Disorders: 126 Case Studies [prevalência Dos Sintomas Otológicos Na Desordem Temperomandibular: Estudo De 126 Casos

    OpenAIRE

    Pascoal M.I.N.; Rapoport A.; Chagas J.F.S.; Pascoal M.B.N.; Costa C.C.; Magna L.A.

    2001-01-01

    Introduction: A presence of otologic symptoms associated to the temporomandibular disorders (TMD) is discussed since six decades ago, however its etiology still stays obscure. Study design: Prospective clinical randomized. Aim: In that study it was appraised the prevalence of otologic symptoms in TMD, the correlation with the muscular pain and the absence of posterior teeth. Material and Methods: 126 patients, presented TMD, were appraised through questionnaire about their symptoms, palpation...

  12. The severity of temporomandibular joint disorder by teeth loss in the elderly

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    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.

  13. 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

    Full Text Available Os sintomas otológicos são freqüentes em pacientes com desordem temporomandibular, e estudos são necessários para elucidar os mecanismos envolvidos. OBJETIVO: O objetivo desse estudo clínico foi investigar a associação de sintomas otológicos (otalgia, zumbido e plenitude auricular com os achados audiológicos, os outros sinais/sintomas relacionados à desordem temporomandibular, e os hábitos parafuncionais orais. FORMA DE ESTUDO: Prospectivo clínico. MATERIAL E MÉTODO: 27 pacientes com desordem temporomandibular, da Clínica de Oclusão da Faculdade de Odontologia de Ribeirão Preto da Universidade de São Paulo, responderam um questionário sobre sinais, sintomas e hábitos orais, e passaram por avaliações otorrinolaringológica e audiológica. Os dados foram analisados pelos testes Binomial, Exato de Fisher e correlação produto-momento de Pearson. O índice de significância adotado foi pThe otologic symptoms are frequents in temporomandibular disorder patients, and studies are needed to elucidate the involved mechanisms. AIM: The objective of the present study was to investigate the association of otology symptoms (otalgia, tinnitus, ear fullness with otologic findings, the other temporomandibular disorder signs and symptoms, and parafunctional habits. STUDY DESIGN: Clinical prospective. MATERIAL AND METHODS: 27 temporomandibular patients from Occlusion Clinic of the Dental School of Ribeirão Preto – University of Sao Paulo, answered a questionnaire which included questions about signs and symptoms of temporomandibular disorder and parafunctional habits; they were submitted to otorhinolaryngological and audiologic examination. The data obtained were analyzed through Binomial Test, Exact Test of Fisher and Pearson Correlation, with p value < 0.05. RESULTS: Otologic symptoms were presented in 88.88% of the patients (59.26% presented otalgia, 74.07 tinnitus and 74.07% ear fullness. There was no significance between the

  14. Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014.

    Science.gov (United States)

    Jiménez-Silva, Antonio; Peña-Durán, Consuelo; Tobar-Reyes, Julio; Frugone-Zambra, Raúl

    2017-01-01

    In order to establish a relationship between bruxism and temporomandibular disorders (TMDs), a systematic review was performed. A systematic research was performed based on PubMed, Cochrane Library, Medline, Embase, BIREME, Lilacs and Scielo data bases, between 2003 and 2014 including all languages. Descriptive clinical cases were identified. Two independent authors selected the articles. PICO format was used to analyse the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. Thirty-nine studies (n = 39) were analysed in this review. According to bruxism diagnosis, articles were grouped as follows: polysomnographic diagnosis (PSG) (n = 7), clinical diagnosis (n = 11) and survey/self-report (n = 21). Thirty-three articles (n = 33) established a positive relation between bruxism and TMD and six (n = 6) did not. Quality of evidence was low to moderate. In general, the most part of the studies showed shortcomings on their design with bias risk, and also had a low sensitivity on bruxism diagnosis. The evidence based on PSG was not as conclusive as the studies that used surveys and clinical exam to diagnosis bruxism, when bruxism was related to TMD. Sleep bruxism could be associated with myofascial pain, arthralgia and joint pathology as disc displacement and joint noises. Although the evidence at present is inconclusive and does not provide information according to the type of bruxism (bruxism sleep and wakefulness), it is possible to suggest that bruxism would be associated with TMD.

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

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    Marcelo Matida Hamata

    2009-02-01

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

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

    Science.gov (United States)

    Hamata, Marcelo Matida; Zuim, Paulo Renato Junqueira; Garcia, Alicio Rosalino

    2009-01-01

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

  17. Temporomandibular disorders in growing patients after treatment of class II and III malocclusion with orthopaedic appliances: a systematic review.

    Science.gov (United States)

    Jiménez-Silva, Antonio; Carnevali-Arellano, Romano; Venegas-Aguilera, Matías; Tobar-Reyes, Julio; Palomino-Montenegro, Hernán

    2018-05-01

    To determine if the use of orthopaedic appliances in growing patients applied to correct Class II and III malocclusion is related to the development of temporomandibular disorders (TMD). A systematic review was conducted between 1960 and July 2017, based on electronic databases: PubMed, Cochrane Library, Embase, Medline, Scopus, EBSCOhost, Scielo, Lilacs and Bireme. Controlled clinical trials (CCTs) and randomized controlled trials (RCTs) were identified. The articles were selected and analyzed by two authors independently. The quality of the evidence was determined according to the guidelines of the Cochrane Risk Bias Assessment Tool and the Cochrane Quality Study Guide. Seven articles were included, four CCTs and three RCTs. The studies were grouped according to malocclusion treatment in (a) class II appliances (n = 4) and (b) class III appliances (n = 3). The quality of evidence was low due to the high risk of bias, independent of the association reported. All studies concluded that the use of orthopaedic appliances would not contribute to the development of TMD. The quality of evidence available is insufficient to establish definitive conclusions, since the studies were very heterogeneous and presented a high risk of bias. However, it is suggested that the use of orthopaedic appliances to correct class II and III malocclusion in growing patients would not be considered as a risk factor for the development of TMD. High-quality RCTs are required to draw any definitive conclusions.

  18. A survey of influence of work environment on temporomandibular disorders-related symptoms in Japan

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    Nishiyama Akira

    2012-09-01

    Full Text Available Abstract Introduction This study aimed at identifying the factors that influence the incidence of temporomandibular disorders (TMD-related symptoms (TRS in a Japanese working population. Methods Our study subjects comprised of 1,969 employees from the same Japanese company. The subjects were assessed using a questionnaire that covered both TRS and the work environment. TRS were measured from 4 items on the questionnaire. The work environment factors recorded were the daily mean duration of personal computer use, driving, precise work, commuting, time spent at home before going to bed, sleeping, attending business meetings, and performing physical labor. Statistical analysis was performed using t-tests, Chi-square tests, and logistic regression analyses. A result with P  Results The median total score on the 4 items used to assess TRS was 5 (25% = 4, 75% = 7. Two groups were defined such that the participants scoring ≤7 were assigned to the low-TRS group and those scoring ≥8, to the high-TRS group. The high-TRS group constituted 22.6% of the subjects. Logistic regression analyses indicated that female gender and extended periods of computer use were significant contributors to the manifestation of TRS. Conclusion This questionnaire-based study showed that gender and computer use time was associated with the prevalence of TRS in this working population. Thus, evaluation of ergonomics is suggested for TMD patients.

  19. 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.

  20. Burning Mouth Syndrome and Other Oral Sensory Disorders: A Unifying Hypothesis

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    Miriam Grushka

    2003-01-01

    Full Text Available Burning Mouth Syndrome (BMS is a sensory disorder which results in constant, bilateral burning pain of the tongue, lips, and other oral mucous membranes. Atypical odontalgia (AO is another sensory disorder, usually defined as a toothache-like pain for which no dental cause can be identified. Previous literature has suggested that AO is often associated with a concomitant temporomandibular disorder (TMD. This hypothesis paper explores the possibility that BMS, AO and TMD can be related through hyperactivity of both the sensory and motor components of the trigeminal nerve following loss of central inhibition as a result of taste damage in the chorda tympani and/or the glossopharyngeal nerves.

  1. Imaging diagnosis of temporomandibular disorders (TMD). MR imaging of the disk of the temporomandibular joint

    International Nuclear Information System (INIS)

    Sano, Tsukasa; Yamamoto, Mika; Sakuma, Katsuya

    2001-01-01

    Since its introduction in the 1980s, magnetic resonance imaging has become the preferred method for diagnosing soft tissue abnormalities of temporomandibular joint (TMJ). MR imaging is non-invasive and more accurate than arthorography. In addition, it requires less operator skill and is well tolerated by patients. We are usually taking MR images of the TMJ with the fast spin echo technique that can simultaneously obtain both T2-weighted and proton density images. The purpose of this study was to determine the utility of T2-weighed and proton density images for diagnosing the disk status in TMJ, comparing the results with those obtained by T1-weighted images. We studied 104 TMJs in 52 patients with both T2-weighted and proton density images, and 80 TMJs in 40 patients with only T1-weighted images. The joints were evaluated by two oral radiologists who looked at three aspects of the joints-disk displacement, disk reduction and disk shape - giving ratings of good'' or ''fair'' in each category. Ratings of ''good'' were significant higher in all three categories in T2-weighted and proton density images than in T1-weighted images (p<0.01). Based on these results, we conclude that T2-weighted and proton density images taken with the fast spin echo technique are useful for diagnosing the disk status of the TMJ. (author)

  2. Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder Avaliação radiográfica da coluna cervical de indivíduos com distúrbios internos da articulação temporomandibular

    Directory of Open Access Journals (Sweden)

    Wagner Cesar Munhoz

    2004-12-01

    Full Text Available Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group and 20 healthy subjects (control group. Subjects were submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same im ages. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%, but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03. After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings.Apesar de a etiofisiopatologia dos distúrbios internos (DI da articulação temporomandibular (ATM ser ainda desconhecida, sugere-se que as posturas de cabeça e corpo estariam associadas a seu desencadeamento, desenvolvimento e sua perpetuação. O objetivo deste estudo foi verificar a relação entre alterações radiográficas de coluna cervical e distúrbios internos da ATM. Este estudo avaliou 30 indivíduos com distúrbios da ATM (grupo teste e 20 saudáveis (grupo controle. Os indiv

  3. COMT Diplotype Amplifies Effect of Stress on Risk of Temporomandibular Pain.

    Science.gov (United States)

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

    2015-09-01

    When measured once, psychological stress predicts development of painful temporomandibular disorder (TMD). However, a single measurement fails to characterize the dynamic nature of stress over time. Moreover, effects of stress on pain likely vary according to biological susceptibility. We hypothesized that temporal escalation in stress exacerbates risk for TMD, and the effect is amplified by allelic variants in a gene, catechol-O-methyltransferase (COMT), regulating catechol neurotransmitter catabolism. We used data from the Orofacial Pain: Prospective Evaluation and Risk Assessment prospective cohort study of 2,707 community-dwelling adults with no lifetime history of TMD on enrollment. At baseline and quarterly periods thereafter, the Perceived Stress Scale (PSS) measured psychological stress. Genotyped DNA from blood samples determined COMT diplotypes. During follow-up of 0.25 to 5.2 y, 248 adults developed examiner-verified incident TMD. PSS scores at baseline were 20% greater (P stress escalation was limited to incident cases with COMT diplotypes coding for low-activity COMT, signifying impaired catabolism of catecholamines. Cox regression models confirmed significant effects on TMD hazard of both baseline PSS (P stress showed that a postbaseline increase of 1.0 standard deviation in PSS more than doubled risk of TMD incidence in subjects with low-activity COMT diplotypes (hazard ratio = 2.35; 95% confidence limits: 1.66, 3.32), an effect not found in subjects with high-activity COMT diplotypes (hazard ratio = 1.42; 95% confidence limits: 0.96, 2.09). Findings provide novel insights into dynamic effects of psychological stress on TMD pain, highlighting that effects are most pronounced in individuals whose genetic susceptibility increases responsiveness to catecholamine neurotransmitters. © International & American Associations for Dental Research 2015.

  4. 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

    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. PMID:23593156

  5. Effect of low-level laser on healing of temporomandibular joint osteoarthritis in rats.

    Directory of Open Access Journals (Sweden)

    Ali Peimani

    2014-06-01

    Full Text Available Temporomandibular disorders (TMD are clinical conditions characterized by pain and sounds of the temporomandibular joint (TMJ. This study was designed to assess the effect of low-level laser therapy (LLLT on healing of osteoarthritis in rats with TMD.Thirty-two male Wistar rats (250-200 g were housed in standard plastic cages. After injection of Complete Freund's adjuvant into the TMJ, rats were randomly divided into two groups of 16 (case and control and anesthetized; then osteoarthritis was induced via intraarticular injection of 50 µl of Complete Freund's adjuvant; into the bilateral TMJs. In the case group, LLLT was done transcutaneously for 10 minutes daily, starting the day after the confirmation of osteoarthritis. Exposure was performed for 10 minutes at the right side of the TMJ with 880 nm low-level laser with 100 mW power and a probe diameter of 0.8 mm. Control rats were not treated with laser.After three days of treatment the grade of cartilage defects, number of inflammatory cells, angiogenesis, number of cell layers and arthritis in rats in the case group were not significantly different compared with controls (P>0.05. After seven days, the grade of cartilage defects, number of inflammatory cells, number of cell layers, and arthritis in the case group improved compared to controls (P<0.05; angiogenesis in both groups was similar.Treatment of TMD with LLLT after 7 days of irradiation with a wavelength of 880 nm was associated with a greater improvement compared to the control group.

  6. Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw?

    Directory of Open Access Journals (Sweden)

    Stefaan Van Damme

    2018-01-01

    Full Text Available Background Patients with chronic orofacial pain due to temporomandibular disorders (TMD display alterations in somatosensory processing at the jaw, such as amplified perception of tactile stimuli, but the underlying mechanisms remain unclear. This study investigated one possible explanation, namely hypervigilance, and tested if TMD patients with unilateral pain showed increased attending to somatosensory input at the painful side of the jaw. Methods TMD patients with chronic unilateral orofacial pain (n = 20 and matched healthy volunteers (n = 20 performed a temporal order judgment (TOJ task indicated which one of two tactile stimuli, presented on each side of the jaw, they had perceived first. TOJ methodology allows examining spatial bias in somatosensory processing speed. Furthermore, after each block of trials, the participants rated the perceived intensity of tactile stimuli separately for both sides of the jaw. Finally, questionnaires assessing pain catastrophizing, fear-avoidance beliefs, and pain vigilance, were completed. Results TMD patients tended to perceive tactile stimuli at the painful jaw side as occurring earlier in time than stimuli at the non-painful side but this effect did not reach conventional levels of significance (p = .07. In the control group, tactile stimuli were perceived as occurring simultaneously. Secondary analyses indicated that the magnitude of spatial bias in the TMD group is positively associated with the extent of fear-avoidance beliefs. Overall, intensity ratings of tactile stimuli were significantly higher in the TMD group than in the control group, but there was no significant difference between the painful and non-painful jaw side in the TMD patients. Discussion The hypothesis that TMD patients with chronic unilateral orofacial pain preferentially attend to somatosensory information at the painful side of the jaw was not statistically supported, although lack of power could not be ruled out as a

  7. Effect of smoking status and nicotine dependence on pain intensity and outcome of treatment in Indian patients with temporomandibular disorders: A longitudinal cohort study.

    Science.gov (United States)

    Katyayan, Preeti Agarwal; Katyayan, Manish Khan

    2017-01-01

    Evidence regarding the association of smoking with various forms of chronic musculoskeletal pain is vast, but that with temporomandibular disorders (TMD) is scarce. The aims of this study are to evaluate the effect of smoking status (SS) and nicotine dependence (ND) on TMD pain intensity and treatment outcome in an Indian population with TMD. Nine hundred and sixty-two patients with TMD were selected for this longitudinal cohort study. Lifetime SS was evaluated and patients were classified as current smokers (YS), former smokers (FS), or nonsmokers (NS). The Fagerstrom test was used to evaluate the ND of YS. Pain intensity was evaluated using visual analog scale scores. Six months posttreatment, the pain intensity was again recorded. The effect of treatment was evaluated using a global transition outcome measure and categorized as treatment success or failure. A minimum 30% reduction in pain was used as a criterion for categorizing patients as those who had gotten "better." Data obtained from the study were compared using Chi-square tests, paired samples t -tests, and one-way ANOVA tests. The criterion for statistical significance for all analyses was set at P = 0.05. Among groups of SS, YS showed the maximum pain intensity at baseline and posttreatment. The outcome of treatment was most successful in NS and least in FS. The number of patients who had gotten "better" after treatment was significantly highest in NS. There was no significant difference between groups of ND with respect to pain intensity, treatment outcome, or "better" patients. Among Indian patients with TMD, smokers reported significantly greater pain intensity and poorer response to treatment than NS. Pain intensity or treatment outcome was independent of ND.

  8. Pijnlijke temporomandibulaire disfuncties: diagnose en behandeling

    NARCIS (Netherlands)

    Lobbezoo, F.; Aarab, G.; Knibbe, W.; Koutris, M.; Warnsinck, C.J.; Wetselaar, P.; Visscher, C.M.

    2016-01-01

    Painful temporomandibular disorders (TMD pain) are common among the general population. The most common sub diagnoses are myalgia (jaw-muscle pain) and arthralgia (temporomandibular joint pain). The aetiology of TMD pain has a multifactorial nature, and its diagnosis and possible treatment often

  9. Is temporomandibular pain in chronic whiplash-associated disorders part of a more widespread pain syndrome?

    Science.gov (United States)

    Visscher, Corine; Hofman, Nico; Mes, Carola; Lousberg, Richel; Naeije, Machiel

    2005-01-01

    The prevalence of temporomandibular disorders in patients with chronic whiplash-associated disorder is a controversial issue that may be influenced by the widespread pain character and psychologic distress frequently observed in patients with chronic pain. The aim of this study was to determine the prevalence of temporomandibular disorder pain, widespread pain, and psychologic distress in persons with chronic whiplash-associated disorder pain, using a controlled, single blind study design. The prevalence of temporomandibular disorder pain in the chronic whiplash-associated disorder pain group was compared with 2 control groups: a chronic neck pain group and a no neck pain group. From 65 persons, a standardized oral history was taken, a physical examination of the neck and the masticatory system was performed, widespread pain was investigated by tender point palpation, and psychologic distress was measured with a questionnaire (SCL-90). Because the recognition of temporomandibular disorder pain and neck pain remains a matter of debate, 3 well-defined classification systems were used: one based on the oral history, a second on a combination of oral history and pain on active movements and palpation, and a third one based on a combination of oral history and function tests. Irrespective of the classification system used, the chronic whiplash-associated disorder pain group more often suffered from temporomandibular disorder pain (0.001neck pain group. Moreover, patients with whiplash-associated disorder showed more psychologic distress (0.000disorder suggests that the higher prevalence of temporomandibular disorder pain in these patients is part of a more widespread chronic pain disorder.

  10. Zumbido em indivíduos sem perda auditiva e sua relação com a disfunção temporomandibular Tinnitus in individuals without hearing loss and its relationship with temporomandibular dysfunction

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    Aline Albuquerque Morais

    2012-04-01

    Full Text Available Pesquisas apontam que disfunções da articulação temporomandibular estão freqüentemente associadas ao zumbido. OBJETIVO: caracterizar o zumbido de indivíduos com audição normal e buscar possível relação com a Disfunção Temporomandibular (DTM. Forma do estudo: prospectivo tranversal. MATERIAL E MÉTODO: participaram 20 adultos de ambos os sexos com queixa de zumbido e limiares auditivos dentro da normalidade à audiometria convencional. Foi realizada a pesquisa das características psicoacústicas do zumbido, aplicação do checklist de sinais e sintomas de DTM e aplicação do Tinnitus Handicap Inventory (THI. RESULTADOS: o zumbido de pitch agudo, contínuo e bilateral foi o mais freqüente. À acufenometria, o pitch médio do zumbido referido pelos indivíduos foi de 8,6 kHz e a loudness média foi de 14,1 dBNS. O grau do incômodo causado pelo zumbido foi leve. Observou-se que quanto mais agudo o pitch, menor foi a loudness e maior a pontuação no THI. Verificou-se que 90% dos indivíduos apresentaram pelo menos um sinal ou sintoma de DTM. CONCLUSÕES: o tipo de zumbido mais frequente é o de pitch agudo, contínuo e bilateral, 90% dos indivíduos apresentaram pelo menos um sinal ou sintoma de DTM e não há correlação do zumbido com a acufenometria, THI e checklist para DTM.Research has shown that dysfunction of the temporomandibular joint is often associated with tinnitus. AIM: to characterize tinnitus in individuals with normal hearing and search for a possible relationship with Temporomandibular Disorders (TMD. Study design: prospective and cross-sectional. MATERIALS AND METHODS: the participants included 20 adults of both genders with tinnitus and normal hearing thresholds on audiometry. We studied tinnitus psychoacoustic characteristics and employed the checklist of TMD signs and symptoms from the Tinnitus Handicap Inventory (THI. RESULTS: the high pitch, continuous and bilateral tinnitus was the most frequent. Upon

  11. Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients.

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    Paesani, D A; Lobbezoo, F; Gelos, C; Guarda-Nardini, L; Ahlberg, J; Manfredini, D

    2013-11-01

    The present investigation was performed in a population of patients with temporomandibular disorders (TMD), and it was designed to assess the correlation between self-reported questionnaire-based bruxism diagnosis and a diagnosis based on history taking plus clinical examination. One-hundred-fifty-nine patients with TMD underwent an assessment including a questionnaire investigating five bruxism-related items (i.e. sleep grinding, sleep grinding referral by bed partner, sleep clenching, awake clenching, awake grinding) and an interview (i.e. oral history taking with specific focus on bruxism habits) plus a clinical examination to evaluate bruxism signs and symptoms. The correlation between findings of the questionnaire, viz., patients' report, and findings of the interview/oral history taking plus clinical examination, viz., clinicians' diagnosis, was assessed by means of φ coefficient. The highest correlations were achieved for the sleep grinding referral item (φ = 0·932) and for the awake clenching item (φ = 0·811), whilst lower correlation values were found for the other items (φ values ranging from 0·363 to 0·641). The percentage of disagreement between the two diagnostic approaches ranged between 1·8% and 18·2%. Within the limits of the present investigation, it can be suggested that a strong positive correlation between a self-reported and a clinically based approach to bruxism diagnosis can be achieved as for awake clenching, whilst lower levels of correlation were detected for sleep-time activities. © 2013 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Koole, P; Koole, R

    2011-05-01

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

  13. MRI and CBCT image registration of temporomandibular joint: a systematic review.

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    Al-Saleh, Mohammed A Q; Alsufyani, Noura A; Saltaji, Humam; Jaremko, Jacob L; Major, Paul W

    2016-05-10

    The purpose of the present review is to systematically and critically analyze the available literature regarding the importance, applicability, and practicality of (MRI), computerized tomography (CT) or cone-beam CT (CBCT) image registration for TMJ anatomy and assessment. A systematic search of 4 databases; MEDLINE, EMBASE, EBM reviews and Scopus, was conducted by 2 reviewers. An additional manual search of the bibliography was performed. All articles discussing the magnetic resonance imaging MRI and CT or CBCT image registration for temporomandibular joint (TMJ) visualization or assessment were included. Only 3 articles satisfied the inclusion criteria. All included articles were published within the last 7 years. Two articles described MRI to CT multimodality image registration as a complementary tool to visualize TMJ. Both articles used images of one patient only to introduce the complementary concept of MRI-CT fused image. One article assessed the reliability of using MRI-CBCT registration to evaluate the TMJ disc position and osseous pathology for 10 temporomandibular disorder (TMD) patients. There are very limited studies of MRI-CT/CBCT registration to reach a conclusion regarding its accuracy or clinical use in the temporomandibular joints.

  14. Does Orthognathic Surgery Cause or Cure Temporomandibular Disorders? A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Al-Moraissi, Essam Ahmed; Wolford, Larry M; Perez, Daniel; Laskin, Daniel M; Ellis, Edward

    2017-09-01

    There is still controversy about whether orthognathic surgery negatively or positively affects temporomandibular disorders (TMDs). The purpose of this study was to determine whether orthognathic surgery has a beneficial or deleterious effect on pre-existing TMDs. A systematic review and meta-analysis were conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched 3 major databases to locate all pertinent articles published from 1980 to March 2016. All subjects in the various studies were stratified a priori into 9 categories based on subdiagnoses of TMDs. The predictor variables were those patients with pre-existing TMDs who underwent orthognathic surgery in various subgroups. The outcome variables were maximal mouth opening and signs and symptoms of a TMD before and after orthognathic surgery based on the type of osteotomy. The meta-analysis was performed using Comprehensive Meta-Analysis software (Biostat, Englewood, NJ). A total of 5,029 patients enrolled in 29 studies were included in this meta-analysis. There was a significant reduction in TMDs in patients with a retrognathic mandible after bilateral sagittal split osteotomy (BSSO) (P = .014), but no significant difference after bimaxillary surgery (BSSO and Le Fort I osteotomy) (P = .336). There was a significant difference in patients with prognathism after isolated BSSO or intraoral vertical ramus osteotomy and after combined BSSO and Le Fort I osteotomy (P = .001), but no significant difference after BSSO (P = .424) or bimaxillary surgery (intraoral vertical ramus osteotomy and Le Fort I osteotomy) (P = .728). Orthognathic surgery caused a decrease in TMD symptoms for many patients who had symptoms before surgery, but it created symptoms in a smaller group of patients who were asymptomatic before surgery. The presence of presurgical TMD symptoms or the type of jaw deformity did not identify which patients' TMDs would improve, remain the

  15. 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.

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

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    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.

  17. Reliability and validity of a new fingertip-shaped pressure algometer for assessing pressure pain thresholds in the temporomandibular joint and masticatory muscles.

    Science.gov (United States)

    Bernhardt, Olaf; Schiffman, Eric L; Look, John O

    2007-01-01

    To test in vitro and in vivo the reliability and accuracy of a new algometer, the pressure algometer for palpation (PAP), for measuring pressure pain thresholds (PPTs) and to compare its features with those of a commercially available pressure algometer. For in vitro accuracy testing, 6 repeated measurements were made at 8 defined test weights from 0.5 to 5 lb. In vivo validity testing compared the PAP to a standard instrument, the hand-held Somedic algometer, at 16 sites including the masticatory muscles, the temporomandibular joints, and the frontalis (as the control site) in 15 temporomandibular disorder (TMD) cases and 15 controls. Intraexaminer reliability was also assessed for both algometers. In vitro reliability was high, with coefficients of variation of test weights at r = .99 (P algometer. PPT values correlated moderately between the 2 devices (r ranged from 0.38 to 0.66; P algometers (P algometer showed high reliability. Concurrent validity was demonstrated by statistically significant correlations between the devices. Both showed equally high capacity for differentiating TMD cases from controls. The PAP yielded significantly higher PPTs than the Somedic algometer.

  18. High-Definition and Non-Invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD

    Science.gov (United States)

    Donnell, Adam; Nascimento, Thiago; Lawrence, Mara; Gupta, Vikas; Zieba, Tina; Truong, Dennis Q.; Bikson, Marom; Datta, Abhi; Bellile, Emily; DaSilva, Alexandre F.

    2015-01-01

    Background Temporomandibular disorders (TMD) have a relatively high prevalence and in many patients pain and masticatory dysfunction persist despite a range of treatments. Non-invasive brain neuromodulatory methods, namely transcranial direct current stimulation (tDCS), can provide relatively long-lasting pain relief in chronic pain patients. Objective To define the neuromodulatory effect of five daily 2×2 motor cortex high-definition tDCS (HD-tDCS) sessions on clinical pain and motor measures in chronic TMD patients. It is predicted that M1 HD-tDCS will selectively modulate clinical measures, by showing greater analgesic after-effects compared to placebo, and active treatment will increase pain free jaw movement more than placebo. Methods Twenty-four females with chronic myofascial TMD pain underwent five daily, 20-minute sessions of active or sham 2 milliamps (mA) HD-tDCS. Measurable outcomes included pain-free mouth opening, visual analog scale (VAS), sectional sensory-discriminative pain measures tracked by a mobile application, short form of the McGill Pain Questionnaire, and the Positive and Negative Affect Schedule. Follow-up occurred at one-week and four-weeks post treatment. Results There were significant improvements for clinical pain and motor measurements in the active HD-tDCS group compared to the placebo group for: responders with pain relief above 50% in the VAS at four-week follow-up (p=0.04); pain-free mouth opening at one-week follow-up (ppain area, intensity and their sum measures contralateral to putative M1 stimulation during the treatment week (ppain and motor measures during stimulation, and up to four weeks post-treatment in chronic myofascial TMD pain patients. PMID:26226938

  19. 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 (Ptemporomandibular 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.

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

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    Ronaldo Antônio Leite

    2013-02-01

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

  1. Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction

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    Cakur, Binali; Sumbullu, Muhammed Akif; Durna, Dogan; Akgul, Hayati Murat

    2011-01-01

    Background Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). Purpose To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. Material and Methods DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). Results In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. Conclusion The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study

  2. Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction

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    Cakur, Binali; Sumbullu, Muhammed Akif; Durna, Dogan; Akgul, Hayati Murat (Dept. of Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Ataturk Univ., Erzurum (Turkey)), email: bcakur@atauni.edu.tr

    2011-06-15

    Background Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). Purpose To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. Material and Methods DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). Results In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. Conclusion The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study

  3. Patients' Priorities and Attitudes Towards Their Temporo-Mandibular Disorders.

    Science.gov (United States)

    Kelleher, Martin; Ray-Chaudhuri, Arijit; Khawaja, Noman

    2015-08-01

    The diagnosis and appropriate management of temporo-mandibular disorders (TMDs) remains controversial. Current scientific evidence highlights the importance of psychosocial factors in sufferers and the reducing emphasis on occlusal or dental/prosthetic factors. This paper describes the findings of a survey of 211 patients reporting pain from their temporo-mandibular joint area and associated structures. This article offers busy primary dental care practitioners a cost effective questionnaire for obtaining relevant information from patients about the history of their condition and highlights what patients hope to achieve through the management of their disorder. It also emphasises the importance of communicating effectively with patients and offers practical tips for the management of TMDs in primary care.

  4. Enhancing the efficacy of treatment for temporomandibular patients with muscular diagnosis through cognitive-behavioral intervention, including hypnosis: a randomized study.

    Science.gov (United States)

    Ferrando, Maite; Galdón, María José; Durá, Estrella; Andreu, Yolanda; Jiménez, Yolanda; Poveda, Rafael

    2012-01-01

    This study evaluated the efficacy of a cognitive-behavioral therapy (CBT), including hypnosis, in patients with temporomandibular disorders (TMDs) with muscular diagnosis. Seventy-two patients (65 women and 7 men with an average age of 39 years) were selected according to the Research Diagnostic Criteria for TMD, and assigned to the experimental group (n = 41), receiving the 6-session CBT program, and the control group (n = 31). All patients received conservative standard treatment for TMD. The assessment included pain variables and psychologic distress. There were significant differences between the groups, the experimental group showing a higher improvement in the variables evaluated. Specifically, 90% of the patients under CBT reported a significant reduction in frequency of pain and 70% in emotional distress. The improvement was stable over time, with no significant differences between posttreatment and 9-month follow-up. CBT, including hypnosis, significantly improved conservative standard treatment outcome in TMD patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Proposal for a new self-compiled questionnaire in patients affected by temporo-mandibular joint disorders (TMD).

    Science.gov (United States)

    Agrillo, A; Ramieri, V; Bianca, C; Nastro Siniscalchi, E; Fatone, F M G; Arangio, P

    2010-07-01

    In this work, we propose a self-compiled questionnaire, for those patients showing dysfunctions of the temporomandibular joint. The questionnaire, composed by 33 closed multiple-choice questions, represents one of the steps in the diagnostic procedure, together with the clinical notes compiled by the medical specialist and with the other necessary diagnostic researches. It also has the purpose to make easier anamnesis and clinic procedure and gathering of all informations useful for a right clinical diagnosis, and so for an appropriate therapy.

  6. The relationship between temporomandibular dysfunction and head and cervical posture.

    Science.gov (United States)

    Matheus, Ricardo Alves; Ramos-Perez, Flávia Maria de Moraes; Menezes, Alynne Vieira; Ambrosano, Gláucia Maria Bovi; Haiter-Neto, Francisco; Bóscolo, Frab Norberto; de Almeida, Solange Maria

    2009-01-01

    This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K) statistics was used. Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

  7. Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?

    Science.gov (United States)

    Walczyńska-Dragon, Karolina; Baron, Stefan; Nitecka-Buchta, Aleksandra; Tkacz, Ewaryst

    2014-01-01

    Temporomandibular dysfunction (TMD) is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM) and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD) and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P > 0.05), cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility. PMID:25050363

  8. Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?

    Directory of Open Access Journals (Sweden)

    Karolina Walczyńska-Dragon

    2014-01-01

    Full Text Available Temporomandibular dysfunction (TMD is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P>0.05, cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility.

  9. Radiographic measurement of the cervical spine in patients with temporomandibular dysfunction.

    Science.gov (United States)

    de Farias Neto, Jader Pereira; de Santana, Josimari Melo; de Santana-Filho, Valter Joviniano; Quintans-Junior, Lucindo José; de Lima Ferreira, Ana Paula; Bonjardim, Leonardo Rigoldi

    2010-09-01

    To compare the craniocervical angles and distances between temporomandibular dysfunction (TMD) and free TMD subjects. The sample consisted of young adults, of both genders, with age ranging between 18 and 30 years. TMD diagnosis was based on the clinical criteria of the Research Diagnostic Criteria for TMD (RDC/TMD), associated with self-reported symptoms of TMD. For radiological analysis we measured three angles and two distances of craniocervical region. Of the 56 subjects, only 23 completed all stages of research, which were divided into two groups: (1) free TMD group - composed of 11 individuals; (2) TMD group - constituted of 12 subjects. The most common clinical diagnosis of TMD was arthralgia (75.0%) followed by myofascial pain without limited mouth opening (58.4%). Among the self-reported symptoms of TMD, the most frequents were facial (83.4%) and neck (66.6%) pain. Of radiological measurement, only plane atlas angle (APA) (p=0.026) and anterior translation distance (Tz C(2)-C(7)) (p=0.045) showed statistical difference between groups TMD (APA=16.7+/-1.63; Tz C(2)-C(7)=28.7+/-2.58) and free TMD (APA=21.64+/-1.24; Tz C(2)-C(7)=19.82+/-3.29). It could be verified that the symptomatic TMD patients presented a flexion of the first cervical vertebra associated with an anteriorization of the cervical spine (hyperlordosis). Copyright 2010 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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: posteopathy 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 (posteopathy 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 manipulative treatment and osteopathy in the cranial field and support the

  11. 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...

  12. 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

  13. 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.

  14. Temporomandibular disorders and headaches.

    Science.gov (United States)

    Graff-Radford, Steven B; Bassiur, Jennifer P

    2014-05-01

    Headache and temporomandibular disorders should be treated together but separately. If there is marked limitation of opening, imaging of the joint may be necessary. The treatment should then include education regarding limiting jaw function, appliance therapy, instruction in jaw posture, and stretching exercises, as well as medications to reduce inflammation and relax the muscles. The use of physical therapies, such as spray and stretch and trigger point injections, is helpful if there is myofascial pain. Tricyclic antidepressants and the new-generation antiepileptic drugs are effective in muscle pain conditions. Arthrocentesis and/or arthroscopy may help to restore range of motion. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. The relationship between temporomandibular dysfunction and head and cervical posture

    Directory of Open Access Journals (Sweden)

    Ricardo Alves Matheus

    2009-06-01

    Full Text Available OBJECTIVE: This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. MATERIAL AND METHODS: The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K statistics was used. RESULTS: Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04 and asymptomatic (p=0.02. No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. CONCLUSIONS: Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

  16. Psychological stress associated with aphthous ulcers and temporomandibular disorders

    International Nuclear Information System (INIS)

    Aslam, A.; Hassan, S.H.; Khan, D.A.; Chaudhary, M.A.G.

    2017-01-01

    To assess the prevalence of stress as an etiological factor for aphthous ulcers and temporomandibular disorders. Study Design: Cross sectional descriptive study. Place and Duration of Study: Armed Forces Institute of Dentistry Rawalpindi, from Oct 2015 to May 2016. Material and Methods: Two groups of patients were selected. Group I included 119 patients presenting with Aphthous Ulcers while group II had 64 subjects with complaints of temporomandibular disorders (TMDs). After a thorough history, Hospital Anxiety and Depression Scale (HADS) was used to assess stress in the patients. AHADS-A score of 7 was taken as significant anxiety while a HADS-D score of 7 depicted significant depression. Both groups were then subjected to laboratory examinations. Serum cortisol levels were assessed for both groups while Serum Folate, Ferritin and Vitamin B12 level for group I only. Data were analyzed using SPSS version 21 to calculate descriptive statistics including mean and standard deviations as well as frequencies and percentages. Relationship between HADS score and serum cortisol levels was assessed using Pearson's correlation coefficient. A p-value<0.05 was considered significant. Results: For TMDs, 53 (82.8%) patients were found positive for stress while for aphthous ulcers, 61 (51.3%) were positive for stress. The correlation between HADS score and serum cortisol levels was found significant for both groups at a p=<0.001. Conclusions: Patients showed a high prevalence of stress as an etiological factor for aphthous ulcers and temporomandibular disorders in a local setting. (author)

  17. Low-level laser therapy in the treatment of muscle-skelet pain in patients affected by temporo-mandibular disorders.

    Science.gov (United States)

    Basili, M; Barlattani, A; Venditti, A; Bollero, P

    2017-01-01

    The purpose of the study is to evaluate the effectiveness of Low-Level Laser Therapy in reducing joint and muscle pain in patients with acute and chronic temporomandibular dysfunction. The study was conducted on a sample of 180 patients. The sample was divided into two groups according to the time of onset of the disease: acute TMD ( 6 months). The treatment for all patients provided for the irradiation with Diode Laser Wiser Doctor Smile with tip plane wave at wavelength of 830 nm, continuous beam to 40nW diameter and radius of 6 mm. The irradiated areas were the joint area, temporal, masseter and pterygoid. The irradiation time for each zone was 60s.The protocol adopted consisted of two weekly treatment for six weeks. Pain assessment was performed using the Visual Analog Scale (VAS), in which different scores (s) depending accused of pain by the patient: s0 no pain, s1-3 mild pain, s4-6 moderate pain, s7-9 severe pain and s10 excessive pain. The pain monitoring was performed before treatment, after 15 days and after one month. The sample included 80 patients with acute TMD and 100 with chronic TMD. The sample belonging to acute TMD group before treatment, was distributed as follows: 0% in s0; 12,5% in s1-3; 31.3% in s4-6; 53.6% in s7-9 and 2.5% in s10. After 15 days the distribution was was as follows: 6.25% in s0; 47.5% in s1-3; 20% in s4-6; 26.3% in s7-9 and 0% in s10. After 30 days the sample was well distributed: 35% in s0; 45% in 1-3; 10% in s4-6; 10% in s7-9 and 0% in s10. The sample belonging to the chronic TMD group, at time zero, was as follows: 0% at s0; 48% in S1-3; 35% in s4-6; 15% in s7-9 and 2% in s10. After 15 days the distribution was: 29% in s0; 28% in S1-3; 33% in s4-6; 10% in s7-9 and 0% in s10. After 30 days the sample was well distributed: 45% in s0; 36% in S1-3; 15% in s4-6; 4% in s7-9 and 0% in s10. The Low-Level-Laser-Therapy is a valuable tool that can significantly decrease the perception of pain in patients with temporomandibular joint

  18. Cross-sectional study of anxiety symptoms and self-report of awake and sleep bruxism in female TMD patients.

    Science.gov (United States)

    Tavares, Luisa Maria Faria; da Silva Parente Macedo, Leonora Cristina; Duarte, Cristina Maria Rabelais; de Goffredo Filho, Gilberto Senechal; de Souza Tesch, Ricardo

    2016-11-01

    The aim of this study was to assess the relationship between levels of anxiety symptoms and prevalence of self-report of awake and sleep bruxism in patients with temporomandibular disorders (TMD). One hundred and eighty-one female patients, aged 19-77 years, were consecutively evaluated. The patients were selected from among those who sought treatment at the TMD and Orofacial Pain Outpatient Clinic of the Petrópolis School of Medicine. All patients completed the questionnaire and underwent clinical examination, both components of the RDC/TMD, in addition to answering questions pertaining to the assessment of levels of anxiety symptoms, taken from the Symptom Check List 90 self-report instrument. The subjects were classified according to the presence of self-reported only awake bruxism, only sleep bruxism, both, or none. A logistic regression procedure was performed to evaluate the possible association through odds ratio between anxiety symptoms and self-reported awake or sleep bruxism. The cofactors for each outcome were age, self-reported bruxism during the circadian period other than the one being evaluated, and the use of selective serotonin reuptake inhibitors. It was possible to demonstrate the presence of a positive and statistically significant relationship between anxiety levels and self-reported awake bruxism. This finding was not observed in those subjects who reported sleep bruxism. A positive relationship was found between self-reported awake bruxism and levels of anxiety symptoms, but not between sleep bruxism and anxiety.

  19. Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions.

    Science.gov (United States)

    Visscher, Corine M; Baad-Hansen, Lene; Durham, Justin; Goulet, Jean-Paul; Michelotti, Ambra; Roldán Barraza, Carolina; Häggman-Henrikson, Birgitta; Ekberg, EwaCarin; Raphael, Karen G

    2018-04-10

    Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner. The authors propose 3 domains of the Axis II assessment to be used in general oral health care: pain location (pain drawing), pain intensity and related disability (Graded Chronic Pain Scale [GCPS]), and psychological distress (Patient Health Questionnaire-4 [PHQ-4]). In the case of localized pain, low GCPS scores (0-II), and low PHQ-4 scores (0-5), patients preferably receive treatment in primary care. In the case of widespread pain, high GCPS scores (III-IV), and high PHQ-4 scores (6-12), the authors recommend referral to a multidisciplinary team, especially for patients with temporomandibular disorder (TMD) pain. The authors recommend psychological assessment at first intake of a new adult patient or for patients with persistent TMD pain. The authors recommend the pain-related disability screening tools for all TMD pain symptoms and for dental pain symptoms that persist beyond the normal healing period. A brief psychological and pain-related disability assessment for patients in primary care may help the general oral health care practitioner make tailored treatment decisions. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

  20. Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

    International Nuclear Information System (INIS)

    Castro Lopes, Sergio Lucio Pereira; Ferreira Costa, Andre Luiz; Oliveira Gamba, Thiago; Flores, Isadora Luana; Cruz, Adriana Dibo; Min, Li Li

    2015-01-01

    Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

  1. Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Castro Lopes, Sergio Lucio Pereira [Dept. of Diagnosis and Surgery, Sao Jose dos Campos Dental School, Sao Paulo (Brazil); Ferreira Costa, Andre Luiz [Dept. of Pediatric Dentistry and Orthodontics, University of Sao Paulo, Sao Paulo (Brazil); Oliveira Gamba, Thiago; Flores, Isadora Luana [Dept. of ral Diagnosis, School of Dentistry, Sao Paulo (Brazil); Cruz, Adriana Dibo [Dept. of Specific Formation, Area of Radiology, Nova Friburgo Dental School, Fluminense Federal University, Rio de Janeiro (Brazil); Min, Li Li [Laboratory of Neuroimaging, Dept. of Neurology, Faculty of Medical Sciences, Sao Paulo (Brazil)

    2015-03-15

    Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

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

    Science.gov (United States)

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

    2010-03-01

    Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy. EDP Sciences, SFODF, 2010.

  3. Temporomandibular disorders, headaches and chronic pain.

    Science.gov (United States)

    Zakrzewska, Joanna M

    2015-03-01

    Temporomandibular disorders (TMDs) are a major cause of non-dental orofacial pain with a suggested prevalence of 3% to 5% in the general population. TMDs present as unilateral or bilateral pain centered round the pre-auricular area and can be associated with clicking and limitation in jaw movements. It is important to ascertain if there are other comorbid factors such as headaches, widespread chronic pain and mood changes. A biopsychosocial approach is crucial with a careful explanation and self-care techniques encouraged.

  4. Effect of protraction facemask on the temporomandibular joint: a systematic review.

    Science.gov (United States)

    Huang, Xinqi; Cen, Xiao; Liu, Jun

    2018-03-12

    The aim of this study was to assess the influence of protraction facemask (PFM) on temporomandibular joint (TMJ) of skeletal Class III malocclusion patients. Literature searches were carried out electronically in five English and three Chinese databases (Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, Embase, MEDLINE (via Ovid), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and VIP Database). The date of the most recent search was 22 March 2017. Randomized controlled trials, controlled clinical trials, cohort studies, and before-after studies comparing the effect of PFM and other treatments on TMJ were included. The data were collected and extracted by three authors. The risk of bias in the RCTs was assessed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. For the nonrandomized studies, the risk of bias was judged with Newcastle-Ottawa Scale. For the 261 articles identified, 13 studies with 522 participants were included for the final qualitative analysis. Three studies were graded as high value of evidence, while seven studies and the other three studies were graded as moderate value and low value respectively. According to the available evidence, PFM contributed to the significant increase of CondAx-SBL and the significant decrease of CondAx-ML. Thin-plate spline (TPS) analysis showed a horizontal compression in condyles. Condyles tended to move superiorly and posteriorly. Concerning the occurrence of temporomandibular disorders (TMD), PFM was not involved in aggravating TMJ symptoms and signs. Clinical evidence suggests that PFM might contribute to the morphologic adaptation of TMJs and displacement of condyles, and PFM may well be not a risk factor for the development of TMD.

  5. 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.

  6. Evaluación de la oclusión en pacientes con trastornos temporomandibulares y desarmonías oclusales Occlusion assessment in patients with temporomandibular disorders and occlusal disharmony

    Directory of Open Access Journals (Sweden)

    Ileana Grau León

    2010-06-01

    Full Text Available Se realizó un estudio para identificar relación que existe entre los trastornos temporomandibulares y las desarmonías oclusales. Se estudiaron 40 pacientes de ambos sexos, con edades comprendidas entre 18 y 45 años, que solicitaron atención en el Servicio de Trastornos Temporomandibulares, del Departamento de Prótesis de la Facultad de Estomatología, que cumplieron los requisitos expresados para este estudio y refirieron signos y síntomas de trastornos temporomandibulares. Se analizó el comportamiento de las interferencias oclusales a los movimientos mandibulares. Se analizaron las interferencias oclusales a dichos movimientos en los modelos de estudios, montados en un articulador semiajustable. Los resultados obtenidos reflejaron un predominio en las interferencias oclusales, en los pacientes analizados con trastornos temporomandibulares. El mayor porcentaje de interferencias se encontró durante el movimiento propulsivo. Las interferencias fueron más frecuentes en el lado de no trabajo para los movimientos analizados y el grupo de molares resultó ser el más afectado, tanto para los movimientos de propulsión como de lateralidad.A study was conducted to identify the direct relation among the temporomandibular disorders and occlusal disharmonies, which always has been an attention matter by all Stomatology fields. Forty patients of both sexes were studied aged between 18 and 45 seeking care in the temporomandibular disorders service of Prosthesis Department from the Stomatology Faculty who fulfilled the expressed requirements for this type of study and presenting with signs and symptoms of temporomandibular disorders, thus we analyzed the occlusal interferences behavior to mandibular movements in study models, mounted in a semiadjustable articulator. Results obtained demonstrated predominance in occlusal interferences in study patients with temporomandibular disorders; the greater percentage of interferences was found during the

  7. Evaluation relationship between temporomandibular joint disorder and headache: A review literature

    Directory of Open Access Journals (Sweden)

    Farzaneh Aghahosseini

    2017-12-01

    Conclusion: Bruxism and temporomandibular disorders are the two main contributing factors in initiation and perpetuation of headache. Treatment of these two phenomena would be effective in the treatment of headache.

  8. Dynamic 3D FE modelling of the human temporomandibular joint during whiplash.

    Science.gov (United States)

    Pérez del Palomar, A; Doblaré, M

    2008-07-01

    Rear-end impacts account for more than one-third of vehicle accidents, and nearly 40% of these accidents produce whiplash injuries. Whiplash injury to the neck has often been considered a significant risk factor for the development of temporomandibular disorders (TMD). The objective of this study was to simulate the dynamic response of the temporomandibular joint during two types of impacts: a rear end and a frontal impact. To understand the dynamic forces acting on the joint, we extended a previous human temporomandibular joint model and analyzed the stress distributions in the soft elements of the joint. In the rear-end impact, it could be appreciated that the inertia of the mandible caused it to move posteriorly slower than the head, and this resulted in downward and forward displacements of the disc-condyle complex relative to the cranial base. Consequently, a rapid and big mouth opening occurs. In contrast, during the frontal impact, the mouth hardly opened, because the superior maxilla pushed the mandible to move together. There was not differential movement between bony components of the joint and therefore the soft tissues of the joint were not subjected to high loads. From these results, and despite the limitations of the simulations performed, we could conclude that neither a rear-end impact at low-velocity nor a frontal impact would produce damage to the soft tissues of the joint.

  9. Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial.

    Science.gov (United States)

    Gomes, Cid André Fidelis de Paula; El Hage, Yasmin; Amaral, Ana Paula; Politti, Fabiano; Biasotto-Gonzalez, Daniela Aparecida

    2014-01-01

    Temporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in the perpetuation of TMD. The aim of the present study was to investigate the effects of massage therapy, conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism. Sixty individuals with severe TMD and sleep bruxism were randomly distributed into four treatment groups: 1) massage group, 2) conventional occlusal splint group, 3) massage + conventional occlusal splint group and 4) silicone occlusal splint group. Block randomization was employed and sealed opaque envelopes were used to conceal the allocation. Groups 2, 3 and 4 wore an occlusal splint for four weeks. Groups 1 and 3 received three weekly massage sessions for four weeks. All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index. The Wilcoxon test was used to compare the effects of the different treatments and repeated-measures ANOVA was used to determine the intensity of TMD. The inter-group analysis of variance revealed no statistically significant differences in median frequency among the groups prior to treatment. In the intra-group analysis, no statistically significant differences were found between pre-treatment and post-treatment evaluations in any of the groups. Group 3 demonstrated a greater improvement in the intensity of TMD in comparison to the other groups. Massage therapy and the use of an occlusal splint had no significant influence on electromyographic activity of the masseter or anterior temporal muscles. However, the combination of therapies led to a reduction in the intensity of signs and

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

    Science.gov (United States)

    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.

  11. Myoelectric manifestations of jaw elevator muscle fatigue and recovery in healthy and TMD subjects.

    Science.gov (United States)

    Castroflorio, T; Falla, D; Tartaglia, G M; Sforza, C; Deregibus, A

    2012-09-01

    The effects of muscle pain and fatigue on the control of jaw elevator muscles are not well known. Furthermore, the myoelectric manifestations of fatigue and recovery from fatigue in the masticatory muscles are not reported in literature. The main aims of this study were (i) to evaluate the possible use of surface electromyography (sEMG) as an objective measure of fatigue of the jaw elevator muscles, (ii) to compare the myoelectric manifestations of fatigue in the temporalis anterior and masseter muscles bilaterally, (iii) to assess recovery of the investigated muscles after an endurance test and (iv) to compare fatigue and recovery of the jaw elevator muscles in healthy subjects and patients with muscle-related temporomandibular disorders (TMD). The study was performed on twenty healthy volunteers and eighteen patients with muscle-related TMD. An intra-oral compressive-force sensor was used to measure the voluntary contraction forces close to the intercuspal position and to provide visual feedback of submaximal forces to the subject. Surface EMG signals were recorded with linear electrode arrays during isometric contractions at 20%, 40%, 60% and 80% of the maximum voluntary contraction force, during an endurance test and during the recovery phase. The results showed that (i) the slope of the mean power spectral frequency (MNF) and the initial average rectified value (ARV) could be used to monitor fatigue of the jaw elevators, (ii) the temporalis anterior and masseter muscle show the same myoelectric manifestations of fatigue and recovery and (iii) the initial values of MNF and ARV were lower in patients with muscle-related TMD. The assessment of myoelectric manifestations of fatigue in the masticatory muscles may assist in the clinical assessment of TMDs. © 2012 Blackwell Publishing Ltd.

  12. Tinnitus with temporomandibular joint disorders: a specific entity of tinnitus patients?

    Science.gov (United States)

    Vielsmeier, Veronika; Kleinjung, Tobias; Strutz, Jürgen; Bürgers, Ralf; Kreuzer, Peter Michael; Langguth, Berthold

    2011-11-01

    Tinnitus is frequently associated with temporomandibular joint (TMJ) dysfunction. However, the nature of the relationship is not fully understood. Here the authors compared 30 patients with a confirmed diagnosis of temporomandibular joint dysfunction and tinnitus to a group of 61 patients with tinnitus but without any subjective complaints of TMJ dysfunction with respect to clinical and demographic characteristics. Case-control study. Tertiary referral center. Tinnitus patients with and without TMJ dysfunction presenting at the Department of Prosthetic Dentistry and th: Tinnitus Clinic at the University of Regensburg. Tinnitus patients with TMJ disorder had better hearing function (P neck movements (P = .001). Classical risk factors for tinnitus (age, male gender, hearing loss) are less relevant in tinnitus patients with TMJ disorder, suggesting a causal role of TMJ pathology in the generation and maintenance of tinnitus. Based on this finding, treatment of TMJ disorder may represent a causally oriented treatment strategy for tinnitus.

  13. 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

  14. 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.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... at baseline and at month 2 and month 6, including use of the Research Diagnostic Criteria for Temporomandibular Disorders. RESULTS: The authors screened 721 potential participants and enrolled 80 people; 52 participants completed the six-month assessment. The adjusted mean change in current pain over six...... the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. PRACTICAL IMPLICATIONS: This pilot study was a necessary step to prepare for a larger study...

  16. Multidisciplinary treatment in a patient with temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre Camara

    2015-01-01

    Full Text Available Adult patients with a multitude of problems require seamless integration of interdisciplinary protocols. This article presents a case of an adult female who reported with temporomandibular disorders, a crossbite and a Class III skeletal pattern. An interdisciplinary approach using expansion and surgery was used to treat the condition, followed by an esthetic/restorative protocol, achieving excellent results.

  17. Acupuncture Effect on Pain, Mouth Opening Limitation and on the Energy Meridians in Patients with Temporomandibular Dysfunction: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Vera LR. Zotelli

    2017-10-01

    Full Text Available Temporomandibular disorders (TMD, recognized as the most common conditions of chronic orofacial pain, have a multifactorial etiology. Acupuncture can help to relieve the pain and discomfort associated with these conditions, because it can rebalance the energy (Qi circulating in the meridians. The aim of the study was to verify the effectiveness of acupuncture in treating the pain; mouth opening limitation, and energy circulating in the meridians of patients with TMD of muscular or mixed origin. This was a controlled, randomized, double-blind clinical trial conducted at the Piracicaba Dental School (FOP/Unicamp, in Piracicaba SP, Brazil. The Treatment Group received acupuncture with real penetration of the needle, and the Placebo Group received a sham treatment without needle penetration. The acupoints used were: ST6, ST7, SI18, GV20, GB20, BL10, and LI4, during treatment performed for four weekly sessions. The TMD and mouth opening were evaluated according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC. The measurements of the energy at the meridians were performed by the Ryodoraku method, before and after acupuncture in all of the sessions in both groups. The results showed no decrease in pain in the Treatment Group when compared with the Placebo Group (p = 0.2261. There was no increase in the oral opening limit in the Treatment Group compared with the Placebo Group (p > 0.05. Regarding the energy levels, after acupuncture, there was a decrease in Yang energy in all sessions (p < 0.05, in both groups, however, only real acupuncture was effective in maintaining the Yin energy average throughout the four sessions, with significant difference between groups (p = 0.0198. In conclusion, volunteers with TMD presented a pattern of energy deficiency and the most prevalent imbalance patterns identified were in the meridians coupled to the kidney and bladder, and in the Shao Yin (heart/kidney and Shao Yang (triple

  18. Clinical evaluation of the low intensity laser antialgic action of GaAlAs (λ=785 nm) in the treatment of the temporomandibular disorders

    International Nuclear Information System (INIS)

    Sanseverino, Nelly Tichauer Maluf

    2001-01-01

    The therapy with laser emitting low intensity has been currently used in the most diverse fields of medicine as therapeutic conduct for pain. It is a non invasive, painless, non-thermal and aseptic type therapy, without any collateral effects, having a good cost/benefit relationship. However, for the therapy with low-intensity laser to result in positive effects, a correct diagnosis is fundamental, as well as a protocol of adequate application. n odontology, the majority of patients diagnosed with temporomandibular disorders (TMD), present pain and limitations in the movements of the jaw. In this work, a GaAlAs laser emitting low intensity, was used, λ=785 nm, in patients having a dysfunction of the temporomandibular joint with a complaint of pain. Twenty patients were divided into two groups. The group treated received laser therapy in the temporomandibular articulations and in the muscles affected. The dose applied was 45 J/cm 2 , while the ten patients in the control group received 0 J/cm 2 , in a total of nine applications, carried out three times a week, during three weeks. he evaluation of the patients was made through clinical examinations of manual palpation of the masseter, temporal, cervical, posterior neck and sternocleidomastoid muscles, and measurements of opening and laterality of the mouth. The results obtained showed a diminishing of the pain and an increase of the mandibular mobility in the patients treated, when compared to the control group. These results point to this therapy as being an important tool in the treatment of pain in patients with a dysfunction in the TMJ, indicating this therapeutic modality as a co-adjuvant in these treatments. (author)

  19. Patterns of Energy Imbalance of the Meridians in Patients with Temporomandibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Vera L. Rasera Zotelli

    2018-02-01

    Full Text Available Temporomandibular dysfunction (TMD is a set of changes that affects the muscles of mastication, temporomandibular joint, teeth, and associated periodontal and orofacial structures. According to Traditional Chinese Medicine, the imbalance of energy (Qi circulating in the acupuncture meridians is always the primary etiologic cause of any physical manifestation. The aim of this study was to describe the patterns of Qi imbalance in patients with TMD by means of an objective measurement. The clinical study was conducted at the Piracicaba Dental School (FOP/Unicamp, in Piracicaba-SP, Brazil. We evaluated 40 adult volunteers with TMD. The Qi measurement was carried out by the researcher using the Ryodoraku method using 24 points representing the 12 acupuncture meridians: LU9 (Taiyuan, PC7 (Daling, HT7 (Shemen, SI5 (Yanggu, TE4 (Yangchi, LI5 (Yangxi, SP3 (Taibai, LR3 (Taichong, KI3 (Taixi, BL64 (Jinggu, GB40 (Qiuxu, and ST42 (Chongyang. The average total Qi of 40 volunteers (21.7 μA ± 1.5, was below the normal range (40–60 μA and was classified as deficiency of Qi (empty. The coupled meridians that showed the highest Qi imbalance were the kidney (29.4 μA ± 2.8 and bladder (13.8 μA ± 1. The Qi planes with greatest imbalance were the Shao Yang and Shao Yin. In conclusion, volunteers with TMD presented a pattern of Qi deficiency, and the most prevalent imbalance patterns identified were in the kidney and bladder coupled meridians and in the energetic planes Shao Yin (heart/kidney and Shao Yang (triple energizer/gall bladder.

  20. Electronic System for Data Record and Automatic Diagnosis Assessment in the Temporomandibular Joint Disorders

    Czech Academy of Sciences Publication Activity Database

    Hippmann, R.; Nagy, Miroslav; Dostálová, T.; Zvárová, Jana; Seydlová, M.

    2011-01-01

    Roč. 7, č. 1 (2011), s. 11-16 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : temporomandibular joint * temporomandibular joint disorders * DentCross * electronic health record * AAOP classification Subject RIV: IN - Informatics, Computer Science http://www.ejbi.eu/images/2011-1/Hippmann_en.pdf

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence...... of depression-most markedly in patients with combined migraine and tension-type headache. Our studies indicate that a high proportion of headache patients have significant disability because of ongoing chronic TMD pain. The trend to a higher prevalence of TMD in patients with combined migraine and tension......-type headache suggests that this could be a risk factor for TMD development. A need for screening procedures and treatment strategies concerning depression in headache patients with coexistent TMD is underlined by the overrepresentation of depression in this group. Our findings emphasize the importance...

  2. The temporomandibular joint

    International Nuclear Information System (INIS)

    Campbell, W.

    1984-01-01

    Whilst the temporomandibular joint is in many ways unique, it is subject to all the diseases and disorders found in joints in other parts of the human skeleton. By far the most common disorder is injury, followed by arthropathy, acute and chronic dislocations, ankylosis, and in rare instances, neoplasms. The diagnosis and management of the temporomandibular joint are the primary responsibility of the oral surgeon. Nevertheless, this anatomical region is an area in which the cooperation of medical and dental disciplines may be required for the satisfactory conclusion of treatment. The more so when the disease process involves either associated psychosomatic illness or malignancy. The mainstay of the diagnosis is a careful radiological examination of the joint. There exists a delicate relationship between the dentition, the muscles of mastication, and the temporomandibular articulation, which is controlled by arthrokinetic reflex activity of the branches of the 5th cranial nerve. Imbalance between one or more of the components of this integrated system frequently leads to disturbances in function. Pain-dysfunction disorders constitute the larger part of temporomandibular joint disturbances generally encountered

  3. 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

  4. APLIKASI SPLIN RELAKSASI PADA GANGGUAN SENDI RAHANG SELAMA PERAWATAN ORTHODONTIK (LAPORAN KASUS)

    OpenAIRE

    R.A. Donna Pratiwi; Laura Susanti Himawan

    2015-01-01

    The increase of pain symptoms in the temporomandibular joint (TMJ) challenges the scientists to find a more effective therapy. The popular treatment of the temporomandibular disorders (TMD) are eg oclussal splints, orthodontic treatment, electromyographic biofeedback, medication, etc. Among these, splint therapy is more successful than the others, especially in dealing with pain in the TMJ. Orthodontics as a treatment for the TMD quite often creates new complains on TMJ during and/or after tr...

  5. Bone changes in the condylar head and mandibular fossa in patients with temporomandibular disorders. Helical CT observation

    International Nuclear Information System (INIS)

    Shimahara, Satoru; Ariyoshi, Yasunori; Kimura, Yoshihiro; Shimahara, Masashi

    2011-01-01

    In the present study, we investigated whether bone changes are present in sites impossible to observe by panoramic X-ray and Schuller's X-ray examination, namely the medial of the condylar head and mandibular fossa, in patients with type IV temporomandibular joint disorders. We observed the articular fossa using computed tomography, which is able to obtain detailed 3-dimensional information, in patients with type IV temporomandibular disorders. We examined 120 joints of 60 patiens who visited the Department of Oral Surgery, Osaka Medical College Hospital. Each condylar head was clearly visualized in panoramic X-ray and Schuller's X-ray examination findings, and shown to have possible changes unilaterally. Each joint was diagnosed as type IV, according to the diagnostic guidelines set by Japanese Society for Temporomandibular Joint, and further examined using helical CT. Changes in condylar head; We concluded that bone changes were present with considerable probability in the medial of condylar head in a manner similar to those found in the lateral and center of joints with type IV temporomandibular disorders. Changes in mandibular fossa; The bone changes occurred in various locations of the mandibular fossa, while they appeared significantly more frequently in the condylar head. We think that our finding will contribute to development of treatment strategies for temporomandibular disorders, as they clarify bone changes in sites previously unreported. (author)

  6. 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...

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

    Directory of Open Access Journals (Sweden)

    Ricardo Alexandre Zavanelli

    2009-01-01

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

  9. Risk factors for low molar bite force in adult orthodontic patients

    DEFF Research Database (Denmark)

    Andersen, Malene Krogh; Sonnesen, Ane Liselotte

    2013-01-01

    in intercuspidal position, and symptoms and signs of temporomandibular disorders (TMD) were evaluated by TMD screening. Associations were assessed by Spearman correlations, Wilcoxon signed-rank sum test, and multiple stepwise regression analyses. Associations were found between bite force and craniofacial...

  10. The effect of a mandibular advancement appliance on cervical lordosis in patients with TMD and cervical pain.

    Science.gov (United States)

    Santander, Hugo; Zúñiga, Claudia; Miralles, Rodolfo; Valenzuela, Saúl; Santander, Montserrat Carolina; Gutiérrez, Mario Felipe; Córdova, Rosa

    2014-10-01

    A preliminary study to compare cervical lordosis by means of cervical cephalometric analysis, before and after six months of continuous mandibular advancement appliance (MAA) use, and to show how physical therapy posture re-education would improve the cervical lordosis angle. Twenty-two female patients with temporomandibular disorders (TMD) and cervical pain with lordosis 0·05; Shapiro Wilk Test), so the paired comparison of the cephalometric measurements was made by t-test for dependent samples. Angle 1 (OPT/7CVT); angle 3 (CVT/EVT) and angle 4 (2CL/7CL) showed a significant increase in the cervical lordosis. Angle 2 (MGP/OP), angle 5 (HOR/CVT) and the distances C0-C2 and Pt-VER, presented no significant changes. The increase in cervical lordosis implies that six months of continuous MAA use, together with a program of postural re-education, promotes the homeostasis of the craniocervical system.

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

    International Nuclear Information System (INIS)

    Iizuka, Yasuyuki; Miura, Hiroyuki; Ishikawa, Fujiro; Kikuchi, Shiori; Konishi, Nobuhiro; Sakamaki, Kimio

    1996-01-01

    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)

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

    Science.gov (United States)

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

    2015-01-20

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

  13. A patient's view on the location of the temporomandibular joint.

    Science.gov (United States)

    Koole, Paul; Zonnenberg, Adriaan J J; Mulder, Jan

    2018-03-25

    Objective A survey was held to establish whether laypeople knew the location of their temporomandibular joint. Methods A sample of 61 participants, visiting their dental office for a routine check-up, was given a three-question survey of whether they knew the location of their temporomandibular joint and could point to this location. Results Thirty-eight participants answered the question affirmatively. Only 13 pointed to the correct location. Of these, six participants received consultation for TMD in the past, three participants were healthcare providers, and four participants actually had knowledge of the exact location. Out of 23 participants who did not know the location, one accidently designated the correct position. Conclusion The location of the temporomandibular joint is not a well-known site for many patients. In the presence of orofacial pain, it seems advisable to let the patient designate and record the site of the pain on a drawing on the patient chart.

  14. Calculations with off-shell matrix elements, TMD parton densities and TMD parton showers

    Energy Technology Data Exchange (ETDEWEB)

    Bury, Marcin; Hameren, Andreas van; Kutak, Krzysztof; Sapeta, Sebastian [Polish Academy of Sciences, Institute of Nuclear Physics, Cracow (Poland); Jung, Hannes [Polish Academy of Sciences, Institute of Nuclear Physics, Cracow (Poland); DESY, Hamburg (Germany); Serino, Mirko [Polish Academy of Sciences, Institute of Nuclear Physics, Cracow (Poland); Ben Gurion University of the Negev, Department of Physics, Beersheba (Israel)

    2018-02-15

    A new calculation using off-shell matrix elements with TMD parton densities supplemented with a newly developed initial state TMD parton shower is described. The calculation is based on the KaTie package for an automated calculation of the partonic process in high-energy factorization, making use of TMD parton densities implemented in TMDlib. The partonic events are stored in an LHE file, similar to the conventional LHE files, but now containing the transverse momenta of the initial partons. The LHE files are read in by the Cascade package for the full TMD parton shower, final state shower and hadronization from Pythia where events in HEPMC format are produced. We have determined a full set of TMD parton densities and developed an initial state TMD parton shower, including all flavors following the TMD distribution. As an example of application we have calculated the azimuthal de-correlation of high p{sub t} dijets as measured at the LHC and found very good agreement with the measurement when including initial state TMD parton showers together with conventional final state parton showers and hadronization. (orig.)

  15. Long-term variability of sleep bruxism and psychological stress in patients with jaw-muscle pain: Report of two longitudinal clinical cases.

    Science.gov (United States)

    Muzalev, K; Visscher, C M; Koutris, M; Lobbezoo, F

    2018-02-01

    Sleep bruxism (SB) and psychological stress are commonly considered as contributing factors in the aetiology of temporomandibular disorder (TMD) pain. However, the lack of longitudinal studies and fluctuating nature of SB, psychological stress and TMD pain have led to contradictory results regarding the association between the possible aetiological factors and TMD pain. In the present study we investigated the contribution of SB and psychological stress to TMD pain in a longitudinal study of 2 clinical TMD pain cases during a 6-week study protocol. Two female volunteers with clinically diagnosed myalgia based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) participated in the study. Questionnaires were used to record jaw-muscle pain and psychological stress experience, and an ambulatory polysomnography technique was used to record SB intensity. Visual analysis of the data reveal