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1.
Wiad Lek ; 77(3): 539-542, 2024.
Article En | MEDLINE | ID: mdl-38691797

OBJECTIVE: Aim: To evaluate the functional connection and the bioelectrical state of the m.masseter and m. sternocleidomastoid using functional tests before and after treatment. PATIENTS AND METHODS: Materials and Methods: The sample consisted of 21 individuals with temporomandibular joint dysfunction. Examinations were carried out before and after treatment using repositioning splint therapy and in seated/standing positions. RESULTS: Results: M. masseter - p=0.072 before treatment and p=0.821 after treatment. Symmetry is also maintained after treatment. After treatment, a significant difference is noted at the level of significance p<0.001 for the right chewing muscle. In seated and standing positions before treatment did not reveal a statistically significant difference (p=0.07, p=0.143) and after (p=0.272, p=0.623).M. sternocleidomastoid- p<0.001 when comparing right and left sides. After treatment, there was no difference between the right and left sides (p=0.169). No statistical difference was found when assessing indicators separately for the right and left muscles in seated and standing positions (p=0.304, p=0.611, p=0.089, p=0.869). When comparing the bioelectric potentials of the right muscle before, after treatment, a statistically significant difference was found p=0.001. CONCLUSION: Conclusions: Biostatistical analysis of the indicators of bioelectrical activity of m. masseter and sternocleidomastoid indicates no changes in muscle microvolt indicators with changes in body position in patients. However, repositioning splint therapy is associated with reduced muscle tone in initially more spasmodic muscles. It is worth noting that the symmetry of interaction between muscles improves.


Masseter Muscle , Humans , Masseter Muscle/physiopathology , Female , Male , Adult , Middle Aged , Electromyography , Temporomandibular Joint Disorders/therapy , Temporomandibular Joint Disorders/physiopathology , Young Adult
2.
J Contemp Dent Pract ; 25(3): 197-198, 2024 Mar 19.
Article En | MEDLINE | ID: mdl-38690689

How to cite this article: Mosaddad SA. Arthroscopy for the Treatment of Temporomandibular Disorders. J Contemp Dent Pract 2024;25(3):197-198. Keywords: Arthroscopy, Facial pain, Temporomandibular joint, Temporomandibular joint disorders.


Arthroscopy , Temporomandibular Joint Disorders , Arthroscopy/methods , Humans , Temporomandibular Joint Disorders/surgery , Facial Pain/surgery , Facial Pain/etiology
3.
Support Care Cancer ; 32(6): 334, 2024 May 09.
Article En | MEDLINE | ID: mdl-38722345

PURPOSE: To describe the characteristics of and the associations between health-related quality of life, pain, craniomandibular function, and psychosocial factors related to pain and fear of movement in patients with head and neck cancer. METHODS: Seventy-eight patients diagnosed with HNC were recruited. Measurements of the maximum mouth opening range and pressure pain thresholds on the masseter muscle and the distal phalanx of the thumb were conducted, as well as a battery of self-report questionnaires were administrated, including the QoL Questionnaire (EORT QLQ-H&N35), Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), the Spanish translation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD), and the short version of the Craniofacial Pain and Disability Inventory (CF-PDI-11). RESULTS: The study sample (66.7% men, mean age 60.12 [11.95] years) experienced a moderate impact on their QoL levels (57.68 [18.25] EORT QLQ-H&N35) and high kinesiophobia values (20.49 [9.11] TSK-TMD). Pain was present in 41% of the patients, but only 3.8% reported severe pain. 26.4% had a restricted mouth opening range, and 34.62% showed significant catastrophism levels. There were strong positive correlations between EORT QLQ-H&N35 and CF-PDI-11 (r = 0.81), between NRS and CF-PDI-11 (r = 0.74), and between PCS and CF-PDI-11 (r = 0.66). CONCLUSION: Patients with HNC experience negative effects in their QoL, related to their impairment in craniomandibular function. Fear of movement, pain intensity, and catastrophism are associated with poorer functionality; relationships that should be considered when attempting to improve health care.


Head and Neck Neoplasms , Quality of Life , Humans , Male , Female , Middle Aged , Head and Neck Neoplasms/psychology , Head and Neck Neoplasms/complications , Aged , Surveys and Questionnaires , Pain Measurement , Movement , Temporomandibular Joint Disorders/psychology , Temporomandibular Joint Disorders/physiopathology , Fear/psychology , Cross-Sectional Studies , Cancer Pain/psychology , Adult , Pain Threshold/psychology
4.
BMC Oral Health ; 24(1): 540, 2024 May 08.
Article En | MEDLINE | ID: mdl-38720327

OBJECTIVE: To investigate the effect of concentrated growth factor (CGF) combined with sodium hyaluronate (SH) on temporomandibular joint osteoarthritis (TMJOA). METHODS: Sixty patients with TMJOA who were diagnosed by cone-beam computed tomography (CBCT) between March 2020 and March 2023 at the Stomatological Hospital of Xi'an Jiaotong University were randomly divided into a control group (n = 30) and an experimental group (n = 30). The patients in the experimental group were treated with CGF + SH, and those in the control group were treated with SH only. The visual analogue scale (VAS) score indicating pain in the temporomandibular joint (TMJ) area; the Helkimo Clinical Dysfunction Index (Di); and changes in condylar CBCT at the first visit and 2 weeks, 3 months and 6 months after treatment were recorded. The CBCT data of the patients in the experimental and control groups were collected, and the three-dimensional CBCT image sequences were imported into Mimics Medical 19.0 software in DICOM format for condylar reconstruction. RESULTS: The VAS scores at 2 weeks, 3 months and 6 months after treatment were significantly lower in the experimental group than in the control group (P < 0.05), and the pain in the experimental group was significantly relieved. The Di was significantly lower in the experimental group than in the control group (P < 0.05), and the clinical function of the TMJ improved. After treatment, the CBCT score was significantly lower in the experimental group than in the control group (P < 0.05), and the condylar bone cortex was obviously repaired. Observation of the condylar bone cortex by three-dimensional reconstruction showed the same results as those obtained by CBCT. CONCLUSION: CGF combined with SH is effective in the treatment of TMJOA and can improve muscle pain, TMJ pain, Impaired TMJ function, Impaired range of movement, Pain on movement of the mandible and promote bone repair. THE REGISTRATION NUMBER (TRN): ChiCTR2400082712. THE DATE OF REGISTRATION: April 5, 2024.


Cone-Beam Computed Tomography , Hyaluronic Acid , Osteoarthritis , Temporomandibular Joint Disorders , Humans , Hyaluronic Acid/therapeutic use , Hyaluronic Acid/administration & dosage , Female , Male , Osteoarthritis/drug therapy , Osteoarthritis/diagnostic imaging , Temporomandibular Joint Disorders/drug therapy , Temporomandibular Joint Disorders/diagnostic imaging , Adult , Middle Aged , Pain Measurement , Intercellular Signaling Peptides and Proteins/therapeutic use , Treatment Outcome
5.
Orthod Fr ; 95(1): 19-33, 2024 05 03.
Article Fr | MEDLINE | ID: mdl-38699915

Introduction: Common Temporomandibular Disorders (TMD) involve the masticatory muscles, temporomandibular joints, and/or their associated structures. Clinical manifestations can vary, including sounds (cracking, crepitus), pain, and/or dyskinesias, often corresponding to a limitation of mandibular movements. Signs or symptoms of muscular or joint disorders of the masticatory system may be present before the initiation of orthodontic treatment, emerge during treatment, or worsen to the point of stopping treatment. How do you screen for common TMD in orthodontic treatment? Materials and Methods: The main elements of the interview and clinical examination for screening common TMD in the context of orthodontic treatment are clarified and illustrated with photographs. Moreover, complementary examinations are also detailed. Results: A clinical screening form for common TMD is proposed. A synthetic decision tree helping in the screening of TMD is also presented. Conclusion: In the context of an orthodontic treatment, the screening examination for common TMD includes gathering information (interview), a clinical evaluation, and possibly complementary investigations. The orthodontist is supported in this approach through the development of a clinical form and a dedicated synthetic decision tree for the screening of TMDs. Systematically screening for common TMD before initiating orthodontic treatment allows the orthodontist to suggest additional diagnostic measures, implement appropriate therapeutic interventions, and/or refer to a specialist in the field if necessary.


Introduction: Les dysfonctionnements temporo-mandibulaires (DTM) concernent les muscles masticateurs, les articulations temporo- mandibulaires et/ou leurs structures associées. Les manifestations cliniques peuvent être diverses : bruits (craquements, crépitements), algies et/ou dyscinésies correspondant le plus souvent à une limitation des mouvements mandibulaires. Or, des signes ou symptômes de troubles musculaires ou articulaires de l'appareil manducateur peuvent être présents avant le début de la prise en charge orthodontique, voire apparaître en cours de traitement ou s'aggraver au point de remettre en question la poursuite du traitement engagé. Comment conduire un dépistage de DTM communs dans le cadre d'une prise en charge orthodontique ? Matériel et méthodes: Les éléments essentiels de l'entretien et de l'examen clinique d'un dépistage des DTM communs dans le cadre d'une consultation d'orthodontie sont clarifiés et illustrés à l'aide de photographies. Le recours aux examens complémentaires a également été détaillé. Résultats: Une fiche clinique de dépistage des DTM communs est proposée. Un arbre décisionnel synthétique aidant au dépistage des DTM est présenté. Conclusion: Dans le cadre d'une consultation d'orthopédie dento-faciale, l'examen de dépistage des DTM communs inclut un recueil d'informations (entretien), une évaluation clinique et éventuellement des examens complémentaires. L'orthodontiste est soutenu dans cette démarche par la création d'une fiche clinique et d'un arbre décisionnel synthétique dédiés au dépistage des DTM. Effectuer systématiquement un dépistage des DTM communs avant d'initier un traitement orthodontique permettra à l'orthodontiste de proposer des moyens diagnostiques supplémentaires si nécessaire, et de mettre en place la prise en charge adéquate et/ou de référer à un spécialiste du domaine pour démarrer le traitement orthodontique dans les meilleures conditions.


Temporomandibular Joint Disorders , Humans , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Disorders/therapy , Orthodontics/methods , Physical Examination/methods , Mass Screening/methods , Decision Trees
6.
Acta Odontol Scand ; 83: 273-280, 2024 May 07.
Article En | MEDLINE | ID: mdl-38712696

OBJECTIVE: Temporomandibular joint (TMJ) pathologies are prevalent, affecting approximately 40% of the worldwide population, with nearly 80% involving intracapsular disorders. Despite this, standardized treatment protocols are lacking. This study aimed to compare the efficacy of conservative and surgical approaches in managing intracapsular TMJ disorders. METHODS: Eighty-six patients diagnosed with intracapsular TMJ disorders were included in the study, with 40 males and 46 females, averaging 52.4 ± 4.7 years. Patients were recruited from polyclinics in Beijing, China (n = 36), and Kyiv, Ukraine (n = 50). A comprehensive examination protocol was conducted, including assessment of patient complaints, medical history, jaw mobility measurements, TMJ palpation, and magnetic resonance imaging (MRI) screening. RESULTS: The main outcomes of our study revealed significant improvements in patients undergoing surgical intervention for intracapsular TMJ disorders, particularly in cases of disc displacement. Conservative mouth guard/occlusal splint treatment showed limited effectiveness, primarily improving joint effusion and disc displacement. Surgical intervention led to notable enhancements in various TMJ parameters, with significant improvements observed in joint function and pain reduction. Based on these findings, orthodontic rehabilitation was recommended to ensure long-term efficacy, focusing on optimizing occlusion and restoring TMJ function. These results highlight the importance of tailored treatment approaches for managing intracapsular TMJ disorders, emphasizing the role of surgical intervention coupled with comprehensive rehabilitation strategies. CONCLUSIONS: Future research should consider demographic factors and explore innovative examination methods, such as optical systems, to enhance understanding and management of intracapsular TMJ disorders.


Temporomandibular Joint Disorders , Humans , Temporomandibular Joint Disorders/surgery , Male , Female , Middle Aged , Adult , China , Ukraine , Magnetic Resonance Imaging , Treatment Outcome
7.
BMC Musculoskelet Disord ; 25(1): 348, 2024 May 03.
Article En | MEDLINE | ID: mdl-38702659

OBJECTIVE: To compare the treatment effectiveness of digitized and 3D-printed repositioning splints with that of conventional repositioning splints in the treatment of anterior displacement of the temporomandibular joint disc. METHODS: This retrospective study included 96 patients with disc displacement of the anterior temporomandibular joint. They were treated with either digitally designed and 3D-printed repositioning splints or traditional splints and followed up for at least six months. Changes in signs and symptoms such as pain and mouth opening before and after treatment were recorded to evaluate treatment outcomes. RESULTS: During the first month of treatment, both the digitally designed and 3D-printed repositioning splint groups (Group B) and the traditional repositioning splint group (Group A) showed significant increases in mouth opening, with increases of 4.93 ± 3.06 mm and 4.07 ± 4.69 mm, respectively, and there was no significant difference between the two groups. Both groups had a significant reduction in visual analog scale (VAS) pain scores, with Group B showing a greater reduction of 1.946 ± 1.113 compared to 1.488 ± 0.978 in Group A (P < 0.05). By the sixth month, Group B's mouth opening further improved to 38.65 ± 3.22 mm (P < 0.05), while Group A's mouth opening did not significantly improve. Regarding pain, Group A's VAS score decreased by 0.463 ± 0.778 after one month, and Group B's score decreased by 0.455 ± 0.715; both groups showed significant reductions, but there was no significant difference between the two groups. CONCLUSION: Compared with traditional repositioning splints, digitally designed and 3D-printed repositioning splints are more effective at reducing patient pain and improving mouth opening. 3D-printed repositioning splints are an effective treatment method for temporomandibular joint disc displacement and have significant potential for widespread clinical application.


Joint Dislocations , Printing, Three-Dimensional , Temporomandibular Joint Disc , Temporomandibular Joint Disorders , Humans , Male , Retrospective Studies , Female , Adult , Temporomandibular Joint Disc/physiopathology , Middle Aged , Temporomandibular Joint Disorders/therapy , Treatment Outcome , Joint Dislocations/therapy , Occlusal Splints , Young Adult , Pain Measurement , Range of Motion, Articular , Splints
8.
Clin Oral Investig ; 28(6): 302, 2024 May 07.
Article En | MEDLINE | ID: mdl-38714576

Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies. OBJECTIVE: Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients. MATERIALS AND METHODS: A cross-sectional study using secondary data analysis of 77 TMD patients and 101 controls. All participants completed questionnaires characterizing their psychometric profile (anxiety, depression, stress and catastrophizing) and sleep quality, alongside psychophysical tests for painful mechanical sensory (mechanical pain threshold (MPT), pressure pain threshold (PPT), and wind-up ratio (WUR)) and conditioned pain modulation (CPM). Participants were grouped into "High distress" or "Low distress" categories based on psychometric properties and sleep quality using hierarchical cluster and k-means analyses. Multiple linear regression evaluated the influence of TMD, age, and the distress cluster on MPT, WUR, PPT, and CPM in masseter and thenar muscles. Differences were statistically significant when p < 0.05. RESULTS: The presence of TMD was the strongest predictor of mechanical painful sensitivity in the trigeminal region (MPT[F(3,174) = 51.902;p < .001;R2 = .463]; TMD presence (ß = -.682) / PPT[F(3,174) = 15.573;p < .001;R2 = .198] TMD presence (ß = -.452), and extra-trigeminal (MPT[F(3,174) = 35.897;p < .001;R2 = .382] TMD (ß = -.647) / CPM [F(3,174) = 4.106;p < .05;R2 = .050] TMD presence (ß = .197). Furthermore, neither the high distress group nor the low distress group were able to significantly influence the variation of the values of any of the psychophysical variables evaluated (p > .05). CONCLUSIONS: There is not a significant influence of impairment clusters based on psychological variables and sleep quality on painful mechanical sensitivity and pain modulation, regardless of the presence of TMD. CLINICAL RELEVANCE: This outcome suggests that psychosocial factors and sleep quality may not play a decisive role in the sensory-discriminative aspect of pain, particularly concerning painful TMD.


Pain Measurement , Pain Threshold , Psychometrics , Sleep Quality , Temporomandibular Joint Disorders , Humans , Female , Male , Cross-Sectional Studies , Pain Threshold/physiology , Adult , Temporomandibular Joint Disorders/physiopathology , Temporomandibular Joint Disorders/psychology , Surveys and Questionnaires , Middle Aged , Facial Pain/physiopathology , Facial Pain/psychology
9.
Ned Tijdschr Tandheelkd ; 131(5): 201-208, 2024 May.
Article Nl | MEDLINE | ID: mdl-38715532

Growth disturbances of the temporomandibular Joint are characterized by mandibular asymmetry, sometimes with secondary maxillar disturbances. Although the clinical symptoms are sometimes quite severe, patients usually have no pain. There are several growth disturbances, but in this article we discuss three particular causes of facial asymmetry, namely hemimandibular growth defects; overdevelopment, underdevelopment and neoplasms of the mandibular joint. Hemimandibular overdevelopment (hyperplasia) is a growth disorder characterized by progressive asymmetry of the mandibula. Hemimandibular hypoplasia, on the other hand, is a growth disorder involving underdevelopment of the condyle mandibulae due to impingement of the growth center and ankylosing. A pronounced asymmetrical face can cause aesthetic problems and always requires diagnostics, because in addition to the hyperplasia and hypoplasia mentioned above, other causes can explain the asymmetry such as, for example, an osteoarthritis or even a tumor emanating from the base of the skull, mandibula or soft tissues.


Facial Asymmetry , Temporomandibular Joint Disorders , Temporomandibular Joint , Humans , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Disorders/etiology , Temporomandibular Joint Disorders/therapy , Facial Asymmetry/diagnosis , Facial Asymmetry/etiology , Facial Asymmetry/therapy , Mandible/abnormalities , Hyperplasia/diagnosis
10.
Ned Tijdschr Tandheelkd ; 131(5): 191-200, 2024 May.
Article Nl | MEDLINE | ID: mdl-38715531

An internal derangement of the temporomandibular joint is described as a deviation in the position or shape of the joint tissues. Such a change is only functionally manifest if it interferes with smooth movements of the jaw joint. There are a number of internal derangements associated with jaw movements in which popping jaw joint sounds can occur. Examples are an anteriorly or posteriorly displaced disc and hypermobility of the condylar head. Although most internal derangements are harmless and only cause minor discomfort to patients, disc displacements can in some cases develop into a clinical problem, for example when there is a limitation of mouth opening (so-called closed lock) or an inability to close the mouth (so-called open lock). Most patients with these conditions do not require any or only conservative treatment.


Temporomandibular Joint Disorders , Humans , Temporomandibular Joint/physiology , Temporomandibular Joint/physiopathology , Range of Motion, Articular/physiology , Joint Instability/diagnosis , Joint Dislocations/etiology , Joint Dislocations/therapy , Joint Dislocations/diagnosis
11.
Ned Tijdschr Tandheelkd ; 131(5): 217-221, 2024 May.
Article Nl | MEDLINE | ID: mdl-38715534

The temporomandibular joint is a unique and complex joint. Various imaging techniques have been developed to properly visualize this complex joint, such as conventional radiology, orthopantomography, CBCT and MRI. Imaging can contribute to the differential diagnosis of temporomandibular joint disorders. Common joint disorders are arthritis and internal derangement. Osseous changes of the temporomandibular joint can be clearly visualized with CBCT. MRI is superior for imaging the internal anatomy of the temporomandibular joint and is preferred in the context of internal derangement.


Magnetic Resonance Imaging , Radiography, Panoramic , Temporomandibular Joint Disorders , Temporomandibular Joint , Humans , Temporomandibular Joint Disorders/diagnostic imaging , Temporomandibular Joint Disorders/diagnosis , Magnetic Resonance Imaging/methods , Temporomandibular Joint/diagnostic imaging , Temporomandibular Joint/pathology , Cone-Beam Computed Tomography , Diagnosis, Differential
12.
Ned Tijdschr Tandheelkd ; 131(5): 223-230, 2024 May.
Article Nl | MEDLINE | ID: mdl-38715535

The initial treatment of symptomatic disorders of the temporomandibular joint typically consists of a conservative approach, in which medication (painkillers and muscle relaxants), orofacial physiotherapy and splints are most important. In most cases, minimally invasive treatment options, such as arthrocentesis, arthroscopy or joint injections, are only considered when conservative methods provide insufficient symptom reduction. There is, however, an ongoing debate about the optimal treatment strategy due to an increasing body of evidence concerning the superior effectiveness in symptom reduction of minimally invasive treatment options with regard to conservative treatments. If these minimally invasive treatment options are also ineffective, open joint surgery may be considered as a last option for a select group of patients.


Arthroscopy , Minimally Invasive Surgical Procedures , Temporomandibular Joint Disorders , Humans , Temporomandibular Joint Disorders/surgery , Temporomandibular Joint Disorders/therapy , Arthroscopy/methods , Treatment Outcome , Temporomandibular Joint/surgery , Arthrocentesis/methods
13.
Ned Tijdschr Tandheelkd ; 131(5): 231-234, 2024 May.
Article Nl | MEDLINE | ID: mdl-38715536

A 56-year-old woman presented with persistent unilateral gnathological complaints after replacing an amalgam restoration. The patient reported tension and pain in the right side of her jaw, along with crackling sounds in the temporomandibular joint. Physical examination revealed tenderness in the right masseter muscle and temporomandibular joint, as well as anterior disc replacement with reduction on both sides. The initial treatment focused on providing rest to the temporomandibular joint, the Yoda exercise, and later, wet-needling. Despite initially limited improvement, the symptoms persisted. This case underscores the complexity and various treatment options for temporomandibular joint issues following dental procedures.


Temporomandibular Joint Disorders , Humans , Female , Middle Aged , Temporomandibular Joint Disorders/etiology , Temporomandibular Joint Disorders/therapy , Dental Amalgam/adverse effects , Treatment Outcome , Dental Restoration, Permanent/adverse effects
14.
Sci Rep ; 14(1): 10232, 2024 05 03.
Article En | MEDLINE | ID: mdl-38702404

This study aimed to quantitatively assess three-dimensional changes in the mandibular condyle with osteoarthritis using cone-beam computed tomography (CBCT). Pre- and post-treatment CBCT images of temporomandibular joints (TMJs) from 66 patients were used to assess longitudinal changes in condylar volume within individual patients using 3D slicer software. Total volume difference (dV), net increase (dV + , bone deposition), and net decrease (dV- , bone resorption) after treatment were analyzed based on clinical and radiological factors. Condyles with surface erosion at their first visit showed significantly decreased volume after treatment compared to condyles without erosion (p < 0.05). Amounts of bone resorption and deposition were higher in condyles with surface erosion (both p < 0.01). In patients with condylar erosion, the presence of joint pain was associated with a decrease in condylar volume and an increase in net resorption (both p < 0.01). When both joint pain and condylar erosion were present, patients with parafunctional habits showed reduced condylar volume after treatment (p < 0.05). Condylar volume change after treatment was negatively correlated with the duration of pain relief (R = - 0.501, p < 0.05). These results indicate that condylar erosion and TMJ pain could be significant variables affecting TMJ volume changes after treatment. Establishing appropriate treatment strategies is crucial for managing condylar erosion and TMJ pain.


Cone-Beam Computed Tomography , Mandibular Condyle , Osteoarthritis , Humans , Cone-Beam Computed Tomography/methods , Female , Male , Mandibular Condyle/diagnostic imaging , Mandibular Condyle/pathology , Osteoarthritis/diagnostic imaging , Osteoarthritis/pathology , Middle Aged , Adult , Temporomandibular Joint/diagnostic imaging , Temporomandibular Joint/pathology , Aged , Temporomandibular Joint Disorders/diagnostic imaging , Temporomandibular Joint Disorders/pathology , Imaging, Three-Dimensional/methods
17.
BMC Oral Health ; 24(1): 447, 2024 Apr 12.
Article En | MEDLINE | ID: mdl-38609928

BACKGROUND: The Coronavirus 2019 disease (COVID-19) caused drastic changes in people's lifestyle that affected TMD characteristics through its physical and psychological influences. The aim of this study was to define the clinical and psychological characteristics of a large group of well-defined TMD patients and seek their differences between before and during the COVID-19 pandemic to establish points of care to be emphasized in the post-pandemic era. METHODS: TMD patients diagnosed by the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) aged ≥ 18 were analyzed. Samples between September, 2017 to July, 2019 (n = 455) and March, 2021 to June, 2022 (n = 338) were collected to represent before and during COVID-19, respectively. The Graded Chronic Pain Scale (GCPS) and Symptom Checklist-90-Revision (SCL-90-R) were used to evaluate disability levels and psychological status. Clinical indices were compared between COVID periods and factors related to higher pain levels were investigated according to pandemic period. RESULTS: More patients reported pain on palpation of the masticatory muscles during the pandemic (p = 0.021) while the number decreased for neck muscles (p = 0.001) and TMJ (p < 0.001) areas. Patients reporting nocturnal bruxism (23.3-29.6%) and clenching (45.1-54.7%) significantly increased during the pandemic. TMD patients with pain without disability were more common during the pandemic regardless of pain intensity (p < 0.001). The number of patients expressing interference in daily activities decreased drastically during COVID-19 regardless of disability level (p < 0.001). Factors associated with higher than moderate pain intensity (CPI ≥ 50) were insomnia (odds ratio [OR] = 1.603, p = 0.047) and somatization (OR = 1.082, p < 0.001) before the pandemic. During the pandemic, age (OR = 1.024, p = 0.007), somatization (OR = 1.070, p = 0.006), and paranoid ideation (OR = 1.117, p = 0.003) were significantly associated with higher pain intensity. CONCLUSIONS: The results of our study underline the importance of evaluating psychological profiles of TMD patients, especially somatization, paranoid ideation and psychoticism, in exceptional situations that may cause a change in individual mental status. This will lead to a better understanding of the individual TMD patient and help in planning personalized treatment strategies that will assist the patient in adjusting to changes occurring in special environments such as the COVID-19 pandemic.


COVID-19 , Chronic Pain , Temporomandibular Joint Disorders , Humans , Pandemics , Life Style
18.
Clin Oral Investig ; 28(5): 273, 2024 Apr 25.
Article En | MEDLINE | ID: mdl-38664277

OBJECTIVE: This study aimed to explore the associations of orofacial two-point discrimination (2-PD) test result with pain symptoms and psychological factors in patients with Temporomandibular Disorders (TMDs). METHODS: 193 patients with TMDs were included in this study. Patients' demographics, pain intensity, and psychological status were recorded. The 2-PDs in the bilateral temporal, zygomatic, mandibular, and temporomandibular joint (TMJ) regions of the patients were measured. Statistical analyses were conducted to observe the associations between variables. RESULTS: For Pain-related TMDs (PT) patients, Monthly Visual Analogue Scale (VAS-M) and Current Analogue Scale (VAS-C) were correlated with TMJ, zygomatic and temporal 2-PDs. Patients with PT tended to have higher TMJ 2-PDs[Right: ß = 1.827 mm, 95%CI(0.107, 3.548), P = 0.038], zygomatic 2-PDs[Right: ß = 1.696 mm, 95%CI(0.344, 3.048), P = 0.014], temporal 2-PDs[Left: ß = 2.138 mm, 95%CI(0.127, 4.149), P = 0.037; Right: ß = 1.893 mm, 95%CI(0.011, 3.775), P = 0.049]. Associations were also observed between VAS-C and TMJ 2-PDs[Left: ß = 0.780, 95%CI(0.190, 1.370), P = 0.01; Right: ß = 0.885, 95%CI(0.406, 1.364), P = 0.001], Zygomatic 2-PDs[Right: ß = 0.555, 95%CI(0.172, 0.938), P = 0.005]; VAS-M and TMJ 2-PDs[Left: ß = 0.812, 95%CI(0.313, 1.311), P = 0.002; Right: ß = 0.567, 95%CI(0.152, 0.983), P = 0.008], zygomatic 2-PDs[Left: ß = 0.405, 95%CI(0.075, 0.735), P = 0.016; Right: ß = 0.545, 95%CI(0.221, 0.870), P = 0.001], and temporal 2-PDs [Left: ß = 0.741, 95%CI(0.258, 1.224), P = 0.003; Right: ß = 0.519, 95%CI(0.063, 0.975), P = 0.026]. CONCLUSION: TMJ, zygomatic, and temporal 2-PDs were significantly associated with PT and pain intensity. Age, gender and psychological factors were not associated with orofacial 2-PDs. PT patients exhibited weaker tactile acuity compared to Non-PT patients. Further discussion on the underlying mechanism is needed. CLINICAL RELEVANCE: Orofacial tactile acuity of TMDs patients was associated with their pain symptoms, which researchers should take account into when performing 2-PD tests for TMDs patients. The 2-PD test can be considered as a potential tool along with the current procedures for the differentiations of PT and Non-PT.


Facial Pain , Pain Measurement , Temporomandibular Joint Disorders , Humans , Temporomandibular Joint Disorders/physiopathology , Temporomandibular Joint Disorders/psychology , Female , Male , Adult , Facial Pain/physiopathology , Middle Aged , Adolescent , Pain Threshold/physiology
19.
Ned Tijdschr Tandheelkd ; 131(4): 151-158, 2024 04.
Article Nl | MEDLINE | ID: mdl-38591118

What is the prevalence of temporomandibular dysfunction in patients with early rheumatoid arthritis and individuals at risk of rheumatoid arthritis? 3 groups (of 50 participants each) were examined for a possible TMD diagnosis: 1. patients with early rheumatoid arthritis, 2. at-risk individuals, and 3. healthy controls. A possible association with bruxism, determined on the basis of self-reporting and clinical features, was also examined. At-risk patients had a higher prevalence of TMD pain diagnoses compared to healthy controls (p = 0.046). Within the early rheumatoid arthritis group, seronegative patients had a higher prevalence of TMD pain diagnoses than seropositive patients (p = 0.048). No further differences in the prevalence of TMD diagnoses were found between the groups. Participants with a TMD pain diagnosis were more often diagnosed with probable sleep bruxism than those without a TMD pain diagnosis. The prevalence of TMD pain is increased in individuals at risk of rheumatoid arthritis and seronegative early rheumatoid arthritis patients, and is associated with signs of bruxism.


Arthritis, Rheumatoid , Bruxism , Sleep Bruxism , Temporomandibular Joint Disorders , Humans , Bruxism/epidemiology , Bruxism/complications , Temporomandibular Joint Disorders/epidemiology , Cross-Sectional Studies , Sleep Bruxism/epidemiology , Facial Pain/epidemiology , Facial Pain/etiology , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology
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