ABSTRACT
PURPOSE: The aim of this study is to investigate the prevalence of (TMD) as well as their potential risk factors among postgraduate students. MATERIALS AND METHODS: In this cross-sectional and correlation study, 1255 postgraduate students from different universities were recruited to answer Fonseca's anamnestic index (FAI) in addition to collected demographic data and relevant dental history. Fonseca's anamnestic index (FAI) was used to classify their TMD severity. Five hundred ninety-three participants, that had previous clinical/radiographic TMD reports, out of 1255 were included. Chi-square and fisher's exact tests investigated the relation between each predictor and TMD at P≤.05. A logistic binary regression analysis examined the model fit using -2Log likelihood and Pseudo R2 tests at P≤.05. RESULTS: Based on previous clinical/radiographic reports and on FAI, 73.4% of the participants had TMD, of which 57% had mild dysfunction, followed by moderate (31.7%), and severe (11.3%). There was a statistically significant association between sex, depression, lip/object biting and clenching with TMD (P <.001), where females were 2.302 times more likely to develop TMD than males. The combination of lip biting and clenching in a female dramatically increases the risk of TMD (-2 Log Likelihood =385.7, P<.001 and a Cox and Snell value = 0.315 and a Nagelkerke value = 0.395). CONCLUSION: TMD seems to be highly prevalent among postgraduate students in Egypt, whereby female postgraduate students who bite their lips and/or grind their teeth are particularly highly prone to the condition. Object biting and depression could be also considered as risk factors.
ABSTRACT
OBJECTIVE: Treatment of temporomandibular disc displacement with reduction is controversial. This study assesses the use of an anterior positioning splint with botulinum toxin in the lateral pterygoid muscle (BTX) for such cases. METHODS: Twelve joints were included; groups I and II received BTX injection while group II also received an anterior positioning splint. Pain scores and clicking status were recorded at regular intervals then a postoperative MRI was done after 4 months. RESULTS: Clinical improvement was noted in both groups. Mean pain scores dropped significantly and clicks in the twelve joints disappeared in 83% of group I and 33% of group II. MRIs showed significant disc position improvement with the higher mean change (1.33 ± 0.76) in group I. Group I showed better improvement of discal position and only one joint regained a click. Patients of group II reported discomfort from the splint which may have caused psychological distress and so worst pain scores. CONCLUSIONS: Group I showed slightly better results but the cost of BTX injections and the complications of the splint should be kept in mind and the decision of treatment selection made according to each condition.