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1.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(2): 209-214, 2021 Apr 01.
Artículo en Chino | MEDLINE | ID: mdl-33834677

RESUMEN

OBJECTIVES: To evaluate the value of arthroscopy in the diagnosis and treatment of synovial chondromatosis of the temporomandibular joint (TMJSC). METHODS: The cases of 16 patients preliminarily diagnosed with TMJSC by magnetic resonance imaging (MRI) from July 2011 to December 2018 were analyzed retrospectively. If the diagnosis was confirmed by arthroscopy, the opening operation was performed. The preoperative MRI, arthroscopy and opening operation, postoperative pathology and postoperative MRI of confirmed cases were analyzed, and clinical follow-up was performed to evaluate the curative effect of open surgery. The degree of mouth opening and visual analogue scale (VAS) scores for pain pre-operation and during follow-up of the confirmed cases were analyzed by t-test. RESULTS: Fourteen cases of TMJSC were diagnosed by arthroscopy, consistent with the postoperative pathological diagnosis. Postoperative MRI examination showed that articular cavity lesions basically disappeared. Ten patients with synovial chondromatosis were followed-up (follow-up rate, 71.4%) from 6 months to 7 years and 8 months (average follow-up time, 17.6 months); no recurrence was found, and clinical symptoms improved by varying degrees. Before operation and at follow-up, t-test results of opening degree difference were t=7.757, P<0.05; t-test results of VAS were t=-3.274, P<0.05. CONCLUSIONS: Arthroscopy is essential in the diagnosis and treatment of TMJ synovial chondromatosis.


Asunto(s)
Condromatosis Sinovial , Trastornos de la Articulación Temporomandibular , Artroscopía , Condromatosis Sinovial/diagnóstico , Condromatosis Sinovial/cirugía , Humanos , Imagen por Resonancia Magnética , Estudios Retrospectivos , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/cirugía
2.
Prim Dent J ; 10(1): 132-140, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33722124

RESUMEN

The symptoms of TMJ Osteoarthrosis/Osteoarthritis(TMJ OA) are characteristic and in most cases specific to the disorder. There is, however, an overlap of symptoms with other TMDs.Treatment of TMJ OA is generally directed towards management of the symptoms as the temporomandibular joint does retain the capacity throughout life to repair and remodel. Non-conservative and invasive treatment is only rarely necessary.It should be remembered that the mandibular condyle retains the capacity to repair and remodel throughout life and patients should be encouraged to bear this in mind. Conservative measures are usually sufficient to treat symptoms and a period of time should be allowed to elapse before undertaking a more aggressive treatment plan, which, in the overwhelming majority of patients, will not be necessary. This disorder should be approached on the terms of 'a quality of life issue' and treatment should be directed towards patient needs.


Asunto(s)
Luxaciones Articulares , Osteoartritis , Trastornos de la Articulación Temporomandibular , Humanos , Osteoartritis/diagnóstico , Osteoartritis/terapia , Calidad de Vida , Articulación Temporomandibular , Disco de la Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia
3.
Am J Orthod Dentofacial Orthop ; 159(5): 666-681.e2, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33653641

RESUMEN

Treatment of orthodontic patients with temporomandibular disorder (TMD) is challenging for orthodontists because of the TMD signs and symptoms and unstable mandible position, which may lead to improper diagnosis and treatment design. This case report presents a 22-year-old woman with proclined maxillary incisors and TMD. First, stabilization splint therapy was implemented to eliminate temporomandibular joint pain and to obtain the stable adapted centric posture. Subsequently, orthodontic treatment was initiated on the basis of a definitive diagnosis made from the postsplint records. Temporary anchorage devices were used to intrude maxillary molars and distalize the maxillary dental arch. Favorable soft tissue, skeletal, and dental relationship were accomplished after 12 months of comprehensive orthodontic treatment. Functional occlusion was established with teeth as well as vacuum-formed retainers. Excellent posttreatment stability was maintained after a 20-month retention.


Asunto(s)
Férulas (Fijadores) , Trastornos de la Articulación Temporomandibular , Adulto , Cefalometría , Protocolos Clínicos , Femenino , Humanos , Mandíbula , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia , Adulto Joven
4.
Artículo en Inglés | MEDLINE | ID: mdl-33530378

RESUMEN

Osteogenesis imperfecta is a heterogeneous group of hereditary disorders of connective tissue diseases characterized by increased bone fragility, low growth, sometimes accompanied by abnormalities within the dentine, blue sclera, and partial or total hearing impairment. The changes may affect all joints, including the cervical spine and temporomandibular joints in the future, resulting in pain. The aim of the present study was to assess whether there is a relationship between the active range of motion of the cervical spine and the mobility of temporomandibular joints due to differential diagnosis in children with osteogenesis imperfecta, and to present a prevention algorithm for temporomandibular disorders. The study involved a group of 34 children with osteogenesis imperfecta, and the control group included 23 children (age 9.1 ± 3.8 years). Data were collected through an interview based on the author's questionnaire, and the physical examination consisted in measuring the mobility of the cervical spine using an inclinometer (Cervical Range of Motion Instrument), the Helkimo scale, and linear measurements. In children with congenital bone fragility, there were acoustic symptoms from the temporomandibular joints more often than in healthy children. A correlation was found between the mobility of the cervical spine and temporomandibular joints in the study group. In the case of detecting irregularities in the temporomandibular joints, children were ordered to perform jaw-tongue coordination exercises.


Asunto(s)
Osteogénesis Imperfecta , Trastornos de la Articulación Temporomandibular , Vértebras Cervicales , Niño , Preescolar , Humanos , Osteogénesis Imperfecta/diagnóstico , Proyectos Piloto , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología
5.
Orthod Fr ; 91(1-2): 69-81, 2020 06 01.
Artículo en Francés | MEDLINE | ID: mdl-33146135

RESUMEN

Standard TMJ is the key to the morphology of the face as it enables the occlusive function and spatially situates the chin. The diagnosis of the temporomandibular joint disorders is made intricate not only by the multifactorial etiology of these pathologies but also by the difficulty to comprehend the pain felt by the patient. Through a review of the literature and our respective practices (over 30 years) and teachings, this article surveys the main principles of temporomandibular joint disorder. As numerous writers have focused on the problems created by TMJ pathologies, it's only natural that various therapeutic approaches be suggested. What primarily matters is that they lead to a stabilization of the occlusion. As far as diagnosis is concerned, only a precise and rigorous protocol - followed by everyone - can produce a therapeutic result that would be acceptable for each patient. The orthodontist can and must be the coordinator of the cross-disciplinary team. He steps in over 72 % of temporomandibular joint disorder cases and proposes the most conservative, cheapest, and the best cost/benefit ratio for the patient.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Oclusión Dental , Humanos , Masculino , Dolor , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia
6.
Artículo en Inglés | MEDLINE | ID: mdl-33032938

RESUMEN

OBJECTIVE: Both temporomandibular disorders (TMDs) and sleep bruxism (SB) are known to be destructive to the masticatory system. However, the association between the 2 conditions is poorly understood. The aim of our study was to assess the relationship between TMD and SB through the signs and symptoms in 2 patient groups: TMD only and TMD with SB. STUDY DESIGN: A retrospective chart review was conducted from November 1, 2015, to April 1, 2018, on patients with completed International Network for Orofacial Pain and Related Disorders Methodology history questionnaires and Diagnostic Criteria for Temporomandibular Disorder clinical examinations. Fifty-two patients, including 12 with TMD only and 40 with TMD with SB, met the study criteria. Subjective descriptions and objective measurements of patient symptoms were investigated. The χ2 test and Fisher's exact test were used for statistical analysis. RESULTS: The TMD with SB group exhibited increased oral behaviors compared with the TMD-only group (P = .0004). The TMD with SB group also experienced more headaches compared with the TMD-only group (P = .045). CONCLUSIONS: Our results revealed that patients with jaw pain who self-report increased oral behaviors and/or exhibit temporal headaches should be evaluated for sleep bruxism.


Asunto(s)
Bruxismo del Sueño , Trastornos de la Articulación Temporomandibular , Dolor Facial/diagnóstico , Dolor Facial/etiología , Humanos , Estudios Retrospectivos , Autoinforme , Bruxismo del Sueño/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico
7.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 794-798, 2020 Oct 09.
Artículo en Chino | MEDLINE | ID: mdl-33045794

RESUMEN

Temporomandibular disorders (TMD) is one of the most common diseases in the orofacial region. The occurrence, development and outcome of TMD are affected by many factors. Among various risk factors, the psychological factors, especially anxiety, depression and somatic symptoms, are getting more and more attention in the etiology, diagnosis and treatment of TMD. Psychological factors are associated with the occurrence of TMD, and the accurate diagnostic criteria is conducive to the assessment of the patient's psychological state. If necessary, an appropriate psychological treatment according to a patient's psychological status can effectively improve the effect of clinical treatment. This article, based on domestic and international literatures, reviews the research progress of the correlation between the psychological factors and the etiology, diagnosis and treatment of TMD, in order to provide new ideas for clinicians to diagnose and treat TMD.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Ansiedad , Humanos , Factores de Riesgo , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia
8.
Clin Ter ; 171(5): e414-e420, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32901785

RESUMEN

OBJECTIVE: Surface Electromyography of masticatory muscles (sEMG) is used as a tool to support diagnosis and treatment of Temporomandibular disorders (TMDs). The study aimed at examining jaw muscles pattern in individuals with temporomandibular joint disc displacement with reduction (TMJ/DDR). This sort of subjects was supposed to have a different muscular pattern compared to the control group. MATERIALS AND METHODS: Sixty-four women with unilateral TMJ/DDR and forty TMD-free women underwent a sEMG assessment of masticatory muscles. Descriptive statistics were performed. Student T-Test assessed differences between the two groups. Statistical significance was set at ρ < 0.05. RESULT: The t-test showed statistically significant results only in BAR and SMI scores (ρ value < 0,0001). The other measurements did not differ between the two groups. BAR index values of all healthy subjects were within the reference range. Almost the entire TMJ/DDR group had BAR index out of reference range and anteriorly placed. CONCLUSION: Women with TMJ/DDR showed an altered recruitment of the jaw muscles, with significant difference between the activity of the couple of temporalis and the one of masseters, compared to the control group. A lower chewing efficiency was found in the DDR group compared to the control one.


Asunto(s)
Electromiografía , Disco de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/fisiopatología , Adulto , Electromiografía/métodos , Femenino , Humanos , Músculo Masetero/fisiopatología , Masticación , Músculos Masticadores/fisiopatología , Persona de Mediana Edad , Músculo Temporal/fisiopatología , Trastornos de la Articulación Temporomandibular/diagnóstico
9.
Rev. esp. cir. oral maxilofac ; 42(3): 97-106, jul.-sept. 2020. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-196625

RESUMEN

INTRODUCCIÓN: Los trastornos internos (TI) de la articulación temporomandibular (ATM) constituyen la condición clínica articular más frecuente en pacientes con trastornos temporomandibulares (TTM). Presentes hasta en un 80-90 % de los casos sintomáticos, no se sabe por qué, su presencia en sujetos asintomáticos no causa dolor ni disfunción. En contraposición, una posición normal del disco ha sido descrita en un 16-23 % de pacientes sintomáticos. OBJETIVOS: Analizar la prevalencia de TI de la ATM en sujetos voluntarios asintomáticos y qué características clínico-radiológicas podrían favorecer su presencia o desarrollo. MATERIAL Y MÉTODO: Se diseñó un estudio descriptivo, observacional, transversal. Se seleccionaron 43 sujetos de una población de 253 residentes que realizaban su formación médica especializada. El estudio fue desarrollado en varias fases. Fase I: Anamnesis y examen clínico. Empleo del índice craneomandibular de Fricton (ICM); Fase II: Adquisición y evaluación de imágenes de Resonancia Magnética (RMN). Las imágenes fueron procesadas a formato DICOM 4.0 y evaluadas por dos examinadores externos. Fase III: Análisis morfoestructural de las ATM. Las imágenes de RMN fueron analizadas empleando el programa informático Osirix® V 3.5.1. RESULTADOS: Setenta y dos articulaciones (pertenecientes a 36 sujetos) fueron finalmente analizadas. La edad media fue de 28,39 ± 3,70 años con una distribución por sexos de 47,2 % hombres y de 52,8 % mujeres. El análisis inferencial mostró resultados estadísticamente significativos en relación con las variables sexo (p = 0,021), chasquido articular (p = 0,007), valor del ICM (p = 0,000296), morfología discal (p = 1,032 X 10-8), morfología condilar (p = 2,116 X 10-8), posición condilar en el interior de la ATM (longitudes posterior y superior, p = 5,385 X 10-9; p = 0,000245, respectivamente) y morfología de la fosa articular (p = 0,024). CONCLUSIONES: Existe una elevada prevalencia de TI de la ATM en los sujetos asintomáticos analizados. Ciertos criterios clínicos (chasquido articular) y radiológicos (morfología discal alargada/doblada, cóndilo y fosa aplanados y posición más posterior y craneal del cóndilo mandibular) podrían ser considerados como predictores o relacionados con la presencia de desplazamiento discal. El ICM podría constituir una herramienta útil en el diagnóstico de patología articular de la ATM


INTRODUCTION: Internal derangements (IDs) of the temporomandibular joint (TMJ) constitute the most common clinical joint condition in patients with temporomandibular disorders (TMDs). Present in up to 80-90 % of symptomatic cases, it is not known why, its presence in asymptomatic subjects does not cause pain or dysfunction. In contrast, a normal position of the disc has been described in 16-23 % of symptomatic patients. OBJECTIVES: To analyze the prevalence of IDs of the TMJ in asymptomatic voluntary subjects and what clinical-radiological characteristics could favor their presence or development. MATERIAL AND METHODS: A descriptive, observational, cross-sectional study was designed. Fortythree subjects from a population of 253 residents who performed their training program were selected. The study was carried out in several phases. Phase I: Anamnesis and clinical examination. Use of the Fricton Cranio-mandibular Index (CMI); Phase II: Acquisition and evaluation of Magnetic Resonance Imaging (MRI). The images were processed in DICOM 4.0 format and evaluated by two external examiners. Phase III: Morpho-structural analysis of the TMJs. The MRI were analyzed using the Osirix® V 3.5.1 Software. RESULTS: Seventy-two joints (belonging to 36 subjects) were finally analyzed. The mean age was 28.39 ± 3.70 years with a distribution by sex of 47.2% men and 52.8 % women. The inferential analysis showed statistically significant results in relation to the variables sex (p = 0.021), joint click (p = 0.007), CMI value (p = 0.000296), disc morphology (p = 1.032x10-8), condylar morphology (p = 2.116x10-8) and condylar position inside the TMJ ((posterior and superior lengths, p = 5.385x10-9; p = 0.000245, respectively) and morphology of the joint fossa (p = 0.024). CONCLUSIONS: A high prevalence of IDs in asymptomatic subjects is present in our study. Certain clinical (joint clicking) and radiological criteria (an elongated or bent disc morphology, a flattened condyle and fossa and a more posterior and cranial position of the mandibular condyle) could be considered as predictors or be related to the presence of disc displacement. The CMI could be a useful tool in the diagnosis of joint pathology of the TMJ


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Trastornos de la Articulación Temporomandibular/epidemiología , Disco de la Articulación Temporomandibular/fisiopatología , Enfermedades Asintomáticas/epidemiología , Trastornos de la Articulación Temporomandibular/diagnóstico , Voluntarios Sanos/clasificación , Estudios Transversales
11.
Arq Neuropsiquiatr ; 78(7): 397-402, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32756859

RESUMEN

BACKGROUND: The relationship of bidirectional comorbidity between chronic migraine and pain in the cephalic segment led us to evaluate the improvement in reducing the pain in patients diagnosed with chronic migraine headache and awake bruxism, when undergoing treatment with a partial posterior interocclusal device designed for the management and control of awake bruxism through biofeedback. METHODS: Seventy-four patients were evaluated during the following periods: pretreatment, seven, thirty, ninety, one hundred and eighty days, and one year. The evaluation was carried out by measuring the pain in the pretreatment period and pain reduction after awake bruxism treatment, using clinical evaluation and numerical scales for pain. RESULTS: Most of the patients who complained of headache migraine pain, masticatory myofascial pain, temporomandibular joint and neck pain experienced a significant reduction in overall pain, including headaches, between t0 and t30 (p<0.0001). After 30 days of using the device, it was observed that the improvement remained at the same level without any recurrence of pain up to t90. At t180 and t360, it was observed that even with the device withdrawal (at t90) the improvement remained at the same level. CONCLUSION: The utilization of a posterior interocclusal device designed for the management and control of awake bruxism through biofeedback seems to contribute to the reduction of pain (including migraine headache) in the majority of patients, and, even with the device withdrawal (at t90), the improvement remained at the same level, suggesting the patients succeeded in controlling their awake bruxism and consequently the pains.


Asunto(s)
Bruxismo/complicaciones , Dolor Facial/complicaciones , Trastornos Migrañosos/complicaciones , Trastornos de la Articulación Temporomandibular/complicaciones , Vigilia/fisiología , Biorretroalimentación Psicológica , Bruxismo/diagnóstico , Humanos , Trastornos de la Articulación Temporomandibular/diagnóstico
12.
Arq Neuropsiquiatr ; 78(6): 321-330, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32609188

RESUMEN

BACKGROUND: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. OBJECTIVE: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. METHODS: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. RESULTS: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. CONCLUSIONS: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Neuralgia del Trigémino , Dolor Facial/diagnóstico , Dolor Facial/etiología , Dolor Facial/fisiopatología , Cefalea , Humanos , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/diagnóstico , Neuralgia del Trigémino/diagnóstico
13.
Arq. neuropsiquiatr ; 78(7): 397-402, July 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1131726

RESUMEN

ABSTRACT Background: The relationship of bidirectional comorbidity between chronic migraine and pain in the cephalic segment led us to evaluate the improvement in reducing the pain in patients diagnosed with chronic migraine headache and awake bruxism, when undergoing treatment with a partial posterior interocclusal device designed for the management and control of awake bruxism through biofeedback. Methods: Seventy-four patients were evaluated during the following periods: pretreatment, seven, thirty, ninety, one hundred and eighty days, and one year. The evaluation was carried out by measuring the pain in the pretreatment period and pain reduction after awake bruxism treatment, using clinical evaluation and numerical scales for pain. Results: Most of the patients who complained of headache migraine pain, masticatory myofascial pain, temporomandibular joint and neck pain experienced a significant reduction in overall pain, including headaches, between t0 and t30 (p<0.0001). After 30 days of using the device, it was observed that the improvement remained at the same level without any recurrence of pain up to t90. At t180 and t360, it was observed that even with the device withdrawal (at t90) the improvement remained at the same level. Conclusion: The utilization of a posterior interocclusal device designed for the management and control of awake bruxism through biofeedback seems to contribute to the reduction of pain (including migraine headache) in the majority of patients, and, even with the device withdrawal (at t90), the improvement remained at the same level, suggesting the patients succeeded in controlling their awake bruxism and consequently the pains.


RESUMO Introdução: A relação de comorbidade bidirecional entre enxaqueca crônica e dor no segmento cefálico nos levou a avaliar a melhora na redução da dor em pacientes diagnosticados com cefaleia crônica de enxaqueca e bruxismo de vigília, quando submetidos a tratamento com dispositivo interoclusal posterior parcial projetado para o manejo e o controle do bruxismo acordado através de biorretroalimentação (biofeedback). Métodos: Setenta e quatro pacientes foram avaliados durante os seguintes períodos: pré-tratamento, sete, trinta, noventa e cento e oitenta dias, e um ano. A avaliação foi realizada por meio da avaliação da dor no período pré-tratamento e redução da dor após o tratamento do bruxismo de vigília, através de avaliação clínica e escalas numéricas de dor. Resultados: A maioria dos pacientes que se queixou de dor de cabeça com enxaqueca, dor miofascial mastigatória, articulação temporomandibular e dor no pescoço sofreu uma redução significativa na dor geral, incluindo dores de cabeça, entre t0 e t30 (p<0,0001). Após 30 dias de uso do dispositivo, observou-se que a melhora permaneceu no mesmo nível, sem recorrência da dor até t90. Em t180 e t360, observou-se que, mesmo com a retirada do dispositivo (em t90), a melhoria permaneceu no mesmo nível. Conclusão: A utilização de um dispositivo interoclusal posterior projetado para o controle do bruxismo de vigília através de biofeedback parece contribuir para a redução da dor (incluindo enxaqueca) na maioria dos pacientes, e, mesmo com a retirada do dispositivo (t90), a melhora manteve-se no mesmo nível, sugerindo que os pacientes conseguiram controlar o seu bruxismo de vigília e a dor associada a esse hábito.


Asunto(s)
Humanos , Vigilia/fisiología , Dolor Facial/complicaciones , Bruxismo/complicaciones , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos Migrañosos/complicaciones , Biorretroalimentación Psicológica , Bruxismo/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico
14.
J Oral Pathol Med ; 49(6): 454-460, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32558995

RESUMEN

The International Association for the Study of Pain has released a new classification scheme for chronic pain. This classification scheme describes chronic pain as either a symptom of a disease (chronic secondary pain) or the disease itself (chronic primary pain). Chronic temporomandibular disorders have many similarities to other proposed chronic overlapping pain disorders, but are classified and managed by dental practitioners as a localized pain condition of the orofacial region. We review the literature to describe the similarities between chronic temporomandibular disorders and chronic overlapping pain disorders, and discuss how this evolving concept may affect the way that dentists approach the diagnosis and management of chronic temporomandibular disorders.


Asunto(s)
Dolor Crónico , Dolor Facial , Trastornos de la Articulación Temporomandibular , Enfermedad Crónica , Dolor Crónico/complicaciones , Dolor Crónico/diagnóstico , Dolor Crónico/terapia , Odontólogos , Dolor Facial/complicaciones , Dolor Facial/diagnóstico , Dolor Facial/terapia , Humanos , Rol Profesional , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia
15.
J Endod ; 46(10): 1530-1534, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32561237

RESUMEN

INTRODUCTION: Temporal tendonitis (TT) is an orofacial pain disorder that can refer pain to the maxillary and mandibular molars, temporomandibular joint, masticatory muscles, eye, or ear. Patients often present to a dentist or physician with complaints reflecting these referral patterns, yet many healthcare providers are unfamiliar with TT because of the scarcity of literature published on this clinical entity. This may lead to diagnostic confusion, iatrogenic harm, and prolonged patient suffering. METHODS AND RESULTS: This case report describes TT that presented as maxillary and mandibular posterior tooth pain, preauricular pain, and decreased mandibular range of motion. Patient history and examination were suggestive of TT. Local anesthetic injection adjacent to the tendon eliminated all pain complaints and improved range of motion. The patient was given education on the condition and self-care instructions. At 1-week follow-up, the patient reported resolution of her pain complaint. CONCLUSIONS: As healthcare providers familiarize themselves with appropriate diagnostic and treatment options for TT, delayed or unnecessary care can be avoided, and proper management strategies can be implemented.


Asunto(s)
Trastornos de la Articulación Temporomandibular/diagnóstico , Odontalgia , Dolor Facial , Femenino , Humanos , Mandíbula , Tendones
16.
J Oral Pathol Med ; 49(6): 461-469, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32585044

RESUMEN

After over 80 years of much obsession as well as avoidance of the subject of temporomandibular disorders (TMDs), the dental profession is still divided over what they are and how to deal with them. Over this period, nearly every discipline in dentistry has played some role in the development of this field. Unfortunately, a significant amount of this information has been based on personal opinion, experience-based philosophies, or poorly conducted research. Furthermore, each dental specialty has been responsible for contributing to the concepts of the etiology and management of TMDs with their own professional bias; for example, orthodontists describe these problems in orthodontic terms and offer orthodontic treatments or solutions for their patients. As various treatment approaches were found to be effective at least some of the time, this has further led to misinformation and confusion within the profession. Advances in research from diverse fields, including neurophysiology, pain pathophysiology, genetics, endocrinology, behavioral sciences, and psychology, have significantly altered our understanding of TMDs and how they should be managed. The rigid mechanical and dental-based model of the past has been gradually replaced by a biopsychosocial medical model for the diagnosis and treatment of TMDs as well as other acute and chronic pain disorders. This paper discusses the evolution of our understanding of TMDs since they were first described 85 years ago. Contemporary scientific findings and their implications are presented in some detail for clinicians who wish to provide the appropriate management for their orofacial pain patients.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Dolor Facial/diagnóstico , Dolor Facial/etiología , Dolor Facial/terapia , Humanos , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia
17.
Arq. neuropsiquiatr ; 78(6): 321-330, June 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1131719

RESUMEN

ABSTRACT Background: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. Objective: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. Methods: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. Results: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. Conclusions: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.


RESUMO Introdução: Instrumentos diagnósticos são necessários para a anamnese e exame da dor orofacial, auxiliando na identificação das causas potenciais de dor. Objetivo: Avaliar o Questionário da Equipe de Dor Orofacial (EDOF-HC) na abordagem e diagnóstico da dor orofacial. Métodos: Ao todo, 142 pacientes foram avaliados e classificados de acordo com os critérios da Sociedade Internacional de Cefaleias e da Associação Internacional para o Estudo da Dor. Todos foram avaliados com o questionário EDOF-HC, que consiste na anamnese orofacial e médica, além do exame físico orofacial. Os dados foram analisados estatisticamente com os testes qui-quadrado com correção de Bonferroni, ANOVA de um fator e post hoc de Tukey, além dos métodos de classificação em cluster e árvore decisória. Resultados: Houve diferenças entre os diagnósticos quanto aos descritores da dor, dor na abertura bucal máxima, número de pontos-gatilho mastigatórios e história prévia de cirurgia, o que esteve de acordo com a classificação nos diagnósticos de neuralgia do trigêmeo, síndrome da ardência bucal, disfunção temporomandibular e dor neuropática pós-traumática trigeminal. Conclusões: O Questionário da Equipe de Dor Orofacial (EDOF-HC) mostrou ser um instrumento de apoio para a avaliação da dor orofacial, útil na coleta de dados de anamnese e exame clínico dos pacientes, observando os principais sinais e sintomas relacionados aos critérios diagnósticos das condições orofaciais dolorosas mais comuns. Também é útil na avaliação de comorbidades locais e sistêmicas e contribui para o diagnóstico de condições que dependem em critérios de exclusão.


Asunto(s)
Humanos , Neuralgia del Trigémino/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico , Dolor Facial/diagnóstico , Dolor Facial/etiología , Dolor Facial/fisiopatología , Encuestas y Cuestionarios , Cefalea
18.
Ortodoncia ; 84(167): 36-41, jun. 2020. tab, ilus
Artículo en Español | LILACS | ID: biblio-1147664

RESUMEN

Los tejidos que conforman la articulación temporomandibular (ATM) pueden verse afectados como cualquier otra articulación del cuerpo. Entre los factores etiológicos, podemos nombrar los traumáticos, infecciosos, autoinmunes y oclusales. El diagnóstico de las patologías de la ATM debe incluir una completa historia clínica, estudios de laboratorios y de imágenes. El objetivo del siguiente trabajo es describir características de una serie de pacientes que concurrieron a la consulta con signos y síntomas de patologías de la ATM a un consultorio particular en el sur de la provincia de Buenos Aires. Se estudió a 30 pacientes que concurrieron a la consulta con signos y síntomas de patología de la ATM; se completaron historias clínicas, se solicitaron estudios de laboratorio para la detección de anticuerpos específicos contra bacterias y resonancia nuclear magnética. La edad promedio de la población fue de 35 años, 26 eran mujeres y 25 tuvieron resultados de estudios bacteriológicos positivos. Sobre un total de 60 articulaciones, 54 presentaron alteración en la forma y de la posición del disco articular. Se verificó la importancia en la solicitud y asociación de estudios para el diagnóstico diferencial(AU)


Asunto(s)
Humanos , Adulto , Articulación Temporomandibular , Espectroscopía de Resonancia Magnética , Trastornos de la Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Chlamydia trachomatis , Chlamydophila pneumoniae , Antiestreptolisina
19.
Acta Odontol Scand ; 78(8): 580-589, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32421379

RESUMEN

OBJECTIVE: This systematic review aimed to assess the efficacy of occlusal splints in the treatment of temporomandibular disorders (TMDs). MATERIAL AND METHODS: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Four databases (Medline via Pubmed, Web of Science, Embase and Scopus) were searched, the last search was conducted on April 2020. Randomised controlled trials (RCTs) employing the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) as diagnostic criteria and including occlusal splint as one of the experimental groups were included in the present study. The data from the included studies were extracted and assessed for risk of bias. RESULTS: Eleven studies were included. The sample size ranged from 12 to 96 subjects. The male to female ratio was 0 to 25%. The mean length of follow-up was 4 months. Occlusal splint had a positive effect on mandibular movements in all included studies. Seven studies showed a positive effect of occlusal splint on chronic pain reduction and pain intensity, while two others showed improvement of temporomandibular joint clicking sounds and locking of the jaws. Moreover, improvements in mouth opening, depression, and anxiety symptoms, were reported in four studies. CONCLUSIONS: An occlusal splint can be considered as a non-invasive treatment approach for patients with TMD, especially those with signs and symptoms of restriction of mandibular movement and pain. Moreover, the present findings highlighted an urgent need of a standardised consensus regarding the prognostic evaluation of TMD.


Asunto(s)
Ferulas Oclusales , Trastornos de la Articulación Temporomandibular , Femenino , Humanos , Masculino , Mandíbula , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia , Resultado del Tratamiento
20.
Codas ; 32(4): e20190132, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32321007

RESUMEN

PURPOSE: This study aimed at validating the MBGR Orofacial Myofunctional Assessment Protocol (MBGR Protocol) for adults with Temporal Mandibular Disorders (TMD). METHODS: The study sample was composed of 30 adults: 15 with TMD (disc displacement with reduction according to the Research Diagnostic Criteria for Temporomandibular Disorders) and 15 control individuals. The validation process encompassed the content, criterion, and construct of the protocol, as well as its inter- and intra-rater agreement levels and sensitivity and specificity values, considering a 5% statistical significance level. RESULTS: The following validities were confirmed: of content, as the MBGR Protocol covers all functional issues present in patients with TMD; of criterion, with significant correlations between the MBGR and Orofacial Myofunctional Evaluation with Scores (OMES) protocols; of construct, differentiating individuals with and without Orofacial Myofunctional Disorders (OMD) as for pain on palpation and mandible range of motion, with significant correlation between the MBGR clinical evaluation and that using a digital algometer, as well as confirmation of the instrumental assessment for the breathing mode classification. Agreement ranged from poor to very good and from reasonable to very good for the inter- and intra-rater power analyses, respectively. High sensitivity and specificity values were observed. CONCLUSION: The MBGR Protocol proved to be valid for use in adults presented with TMD with disc displacement with reduction and controls, covering all aspects that enable the analysis of OMD in these individuals.


Asunto(s)
Trastornos de Deglución/diagnóstico , Músculos Faciales/fisiopatología , Mandíbula/fisiopatología , Tamizaje Masivo/instrumentación , Trastornos de la Articulación Temporomandibular/diagnóstico , Adolescente , Adulto , Estudios de Casos y Controles , Trastornos de Deglución/fisiopatología , Femenino , Humanos , Masculino , Tamizaje Masivo/estadística & datos numéricos , Trastornos del Movimiento/diagnóstico , Trastornos del Movimiento/fisiopatología , Dimensión del Dolor , Sensibilidad y Especificidad , Trastornos de la Articulación Temporomandibular/fisiopatología , Adulto Joven
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