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1.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 808-814, 2019 Dec 09.
Artículo en Chino | MEDLINE | ID: mdl-31874479

RESUMEN

Temporomandibular joint (TMJ) related signs and symptoms are frequently found in adolescent and adult orthodontic patients. TMJ health has long been considered important in orthodontic treatment for many decades, and routine screening and management of TMJ problems should be emphasized in orthodontic population. This paper was to review the TMJ problems in orthodontic patients and to set the strategy in clinical orthodontics.


Asunto(s)
Maloclusión/terapia , Ortodoncia Correctiva , Trastornos de la Articulación Temporomandibular/etiología , Humanos , Gestión de Riesgos , Articulación Temporomandibular/fisiopatología
2.
Br J Oral Maxillofac Surg ; 57(10): 1153-1155, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31708222

RESUMEN

Lemierre syndrome, also known as Lemierre's disease is a rare condition that was first described by Andre Lemierre in 1936. We present a case of a 3-year-old boy who presented with ankylosis of the right temporomandibular joint (TMJ) secondary to a mastoid infection as part of Lemierre syndrome. His ankylosis resulted in restricted mouth opening, which had a considerable impact on his speech and ability to eat. Surgical treatment comprising right coronoidectomy, gap arthroplasty of the TMJ, and interpositional fat grafting, enabled him to move his jaw and function has returned. This case report highlights the consequences of Lemierre syndrome and the need for clinicians to be aware of its features and the impact it may have on patients.


Asunto(s)
Anquilosis , Síndrome de Lemierre , Trastornos de la Articulación Temporomandibular , Anquilosis del Diente , Anquilosis/etiología , Artroplastia , Preescolar , Humanos , Síndrome de Lemierre/complicaciones , Masculino , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/etiología
3.
West Afr J Med ; 36(3): 262-266, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31622489

RESUMEN

BACKGROUND: Concern over the impact of playing wind instruments on the stomatognathic system has increased in the last few decades with many health practitioners attending to an increasing number of musical instrument players. OBJECTIVE: This study assessed the effects of playing wind musical instruments on the temporomandibular joints (TMJ) of male Nigerian adults. METHODS: This was a descriptive cross-sectional study which was conducted in the Dental clinic of Aminu Kano Teaching Hospital, Kano. Fifty male Wind Instrument Players (WIPs) were recruited for the study and compared with fifty non-Wind Instrument Players (non-WIPs) of the same age, gender and environment. The temporomandibular dysfunction was assessed in both groups using Helkimo index. Reliability test demonstrated an excellent intra-rater correlation (Cronbach's Alpha; 0.98). Data was analyzed using SPSS version 17 and statistical significance set at p<0.05. RESULTS: The majority of participants in the WIP group (32, 64%) had mild to severe anamnestic dysfunction score compared with (20, 40.0%) in the non-WIP group. The difference between the two groups was statistically significant (p<0.05). The class of instruments played, number of years and frequency of play had a significant negative impact on the anamnestic dysfunction of the TMJ with statistically significant difference (p<0.05). No statistically significant differences in clinical dysfunction scores were observed in the two groups (p>0.05). CONCLUSIONS: Playing wind instruments including the class of instrument, number of years and frequency of playing affected the TMJ function, especially anamnesis. Clinical dysfunction was not affected by playing wind instruments.


Asunto(s)
Música , Enfermedades Profesionales/etiología , Trastornos de la Articulación Temporomandibular/etiología , Articulación Temporomandibular/fisiopatología , Adolescente , Adulto , Estudios Transversales , Humanos , Masculino , Nigeria/epidemiología , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/fisiopatología
5.
J Forensic Leg Med ; 68: 101861, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31493722

RESUMEN

INTRODUCTION: The evaluation of medico-legal post-traumatic events has been increasing over the last decades. This study analysed the input of dental evaluation in orofacial damage assessment, highlighting the individual's biopsychosocial model, by a serial case study. It is aimed to analyse the physical as well as the psychological repercussions of traumatic events. It also aimed to relate the type of trauma impact with the individual's sequelae. MATERIAL AND METHOD: An observational and retrospective study was carried out of Portuguese medico-legal database. A serial case study was distinguished by the direction of the impact: frontal striking, lateral striking and clashing with a bidirectional (frontal-lateral). RESULTS AND DISCUSSION: 7 cases fulfilled the inclusion criteria, as a pilot study. They have in common the involvement of the 2 lower thirds of the face, including the temporomandibular joint. The consolidation of the maxillary bone fractures does not always correspond to restituto ad integrum. CONCLUSION: The impact direction may guide clinical examination in detecting permanent impairment, emphasizing temporomandibular joint disorders, as well as their association with psychosocial repercussions. The medical-dental examination is differentiating and relevant to the accomplishment of the general objective of damage assessment.


Asunto(s)
Traumatismos Faciales/complicaciones , Traumatismos de los Dientes/complicaciones , Adolescente , Niño , Cicatriz/etiología , Restauración Dental Permanente , Traumatismos Faciales/psicología , Traumatismos Faciales/terapia , Femenino , Humanos , Masculino , Maloclusión/etiología , Maxilar/lesiones , Persona de Mediana Edad , Proyectos Piloto , Estudios Retrospectivos , Trastornos de la Articulación Temporomandibular/etiología , Traumatismos de los Dientes/psicología , Traumatismos de los Dientes/terapia , Pérdida de Diente/etiología , Adulto Joven
6.
CMAJ ; 191(33): E909-E915, 2019 08 19.
Artículo en Inglés | MEDLINE | ID: mdl-31427355

RESUMEN

BACKGROUND: Temporomandibular disorders (TMDs) are a family of pain-related disorders associated with impaired function in the jaw, temporomandibular joint and muscles of mastication. Our objectives were to evaluate the association between chronic TMD and gastresophageal reflux disease (GERD) and to determine whether mental disorders or undermined sleep mediates this association. METHODS: We conducted a case-control study involving 1522 consecutive adult patients with chronic TMD and 1522 matched controls from 2 hospitals in China. All participants were aged between 18 and 70 years and were recruited from July 2017 to April 2018 Chronic TMD was diagnosed by trained dentists using the criteria in the Orofacial Pain Prospective Evaluation and Risk Assessment Study. Trained gastroenterologists made blinded diagnoses of GERD according to the Montreal definition and classification (at least 2 d of mild symptoms, or 1 d of moderate or severe symptoms per week). We used validated questionnaires to evaluate psychological status and sleep quality. RESULTS: Of the study participants, we identified 132 patients and 61 controls with GERD. Using conditional logistic regression analysis, we identified GERD as a risk factor for TMD (odds ratio 2.74, 95% confidence interval 1.88 to 3.98). Mediation analyses identified that somatization, anxiety and undermined sleep moderately mediated the relation between TMD and GERD. INTERPRETATION: Our study suggests that symptomatic GERD is associated with chronic, painful TMD, and somatization, anxiety and undermined sleep mediate this association to a certain extent. Due consideration should be given to the evaluation and management of gastrointestinal symptoms and mental disorders in the combined therapy for painful TMD.


Asunto(s)
Reflujo Gastroesofágico/complicaciones , Trastornos Mentales/complicaciones , Trastornos del Sueño-Vigilia/complicaciones , Trastornos de la Articulación Temporomandibular/etiología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Trastornos de la Articulación Temporomandibular/psicología , Adulto Joven
7.
Arq Neuropsiquiatr ; 77(7): 478-484, 2019 07 29.
Artículo en Inglés | MEDLINE | ID: mdl-31365639

RESUMEN

OBJECTIVE: To assess the presence of bruxism and anxiety among military firefighters with frequent episodic tension-type headache and painful temporomandibular disorders (TMDs). METHODS: The sample consisted of 162 individuals aged 18 to 55 years divided into four groups. Headache was diagnosed in accordance with the International Classification of Headache Disorders-III. The Research Diagnostic Criteria for Temporomandibular Disorders questionnaire was used to classify TMDs and awake bruxism; sleep bruxism was diagnosed in accordance with the International Classification of Sleep Disorders-3; and anxiety was classified using the Beck Anxiety Inventory. In statistical models, a significance level of 95% was used. The chi-square test was used to assess anxiety. RESULTS: Associations were found among frequent episodic tension-type headache, painful TMDs, awake bruxism and anxiety (p < 0.0005). Sleep bruxism was not a risk factor (p = 0.119) except when associated with awake bruxism (p = 0.011). CONCLUSION: Anxiety and awake bruxism were independent risk factors for developing frequent episodic tension-type headache associated with painful TMDs; only awake bruxism was a risk factor for frequent episodic tension-type headache with non-painful TMDs.


Asunto(s)
Ansiedad/complicaciones , Bruxismo/complicaciones , Bomberos/estadística & datos numéricos , Personal Militar/estadística & datos numéricos , Trastornos de la Articulación Temporomandibular/etiología , Cefalea de Tipo Tensional/etiología , Adolescente , Adulto , Ansiedad/diagnóstico , Bruxismo/diagnóstico , Estudios de Casos y Controles , Enfermedad Crónica , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Autoinforme , Bruxismo del Sueño/complicaciones , Bruxismo del Sueño/diagnóstico , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/diagnóstico , Cefalea de Tipo Tensional/diagnóstico , Adulto Joven
8.
J Craniomaxillofac Surg ; 47(11): 1739-1751, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31439411

RESUMEN

OBJECTIVES: Clinical and experimental studies show that the etiology of traumatic temporomandibular joint (TMJ) fibrous ankylosis and bony ankylosis are associated with the severity of trauma. However, how the injury severity affects the tissue differentiation is not clear. We tested the hypothesis that angiogenesis affects the outcomes of TMJ trauma, and that enhanced neovascularization after severe TMJ trauma would promote the development of bony ankylosis. METHODS: Bilateral condylar sagittal fracture and discectomy were performed for each sheep, with the glenoid fossa receiving either severe trauma to induce bony ankylosis or minor trauma to induce fibrous ankylosis. At days 7, 14, 28, and 56 after surgery, total RNA was extracted from the ankylosed callus. Temporal gene expressions of several molecules functionally important for blood vessel formation were studied by real-time PCR. RESULTS: Histological examination revealed a prolonged hematoma phase and a lack of cartilage formation in fibrous ankylosis. mRNA expression levels of HIF-1α, VEGF, VEGFR2, SDF1, Ang1, Tie2, vWF, CYR61, FGF2, TIMP1, MMP2, and MMP9 were distinctly lower in fibrous ankylosis compared with bony ankylosis at several time points. CONCLUSIONS: Our study indicates that inhibition of angiogenesis after TMJ trauma might be a promising strategy for preventing bony ankylosis in the future.


Asunto(s)
Anquilosis/cirugía , Trastornos de la Articulación Temporomandibular/cirugía , Articulación Temporomandibular/lesiones , Animales , Anquilosis/etiología , Fibrosis , Cóndilo Mandibular , Ovinos , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/etiología
9.
J Mol Histol ; 50(5): 459-470, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31302828

RESUMEN

Temporomandibular joint osteoarthritis (TMJOA) is a complex inflammatory condition with multiple factors and degenerative processes co-occurring. However, its pathogenesis remains uncertain. The purpose of the study was to observe the expression of Indian hedgehog (Ihh) signal related molecules in TMJOA induced by bite-raising and to study the effect and mechanism of Ihh signaling. Our research indicated that Ihh signaling pathway can be activated in condylar cartilage induced by bite-raising. The histological analysis showed TMJOA-like structural changes of condylar cartilage in experiment groups. Ihh, Smoothened (Smo), and Gli zinc finger transcription factors-1 (Gli-1) were activated in the experimental groups, and the expression levels increased significantly over time, whereas the sham control groups showed no fluctuation. Additionally, the expression levels of matrix metalloproteinase-13 (MMP-13) and cysteinyl aspartate specific proteinase-3 (Caspase-3) in the experiment groups increased in a time-dependent manner compared with the matched sham control groups. In conclusion, our results indicated that the Ihh signaling pathway may activate the occurrence of TMJOA by mediating the hypertrophy of chondrocytes, which may be an important regulatory mechanism and potential therapeutic target in the repair of condylar cartilage.


Asunto(s)
Mordeduras y Picaduras/metabolismo , Cartílago/metabolismo , Condrocitos/patología , Proteínas Hedgehog/metabolismo , Hipertrofia , Transducción de Señal , Envejecimiento , Animales , Huesos , Osteoartritis/etiología , Osteoartritis/patología , Ratas , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/patología
10.
Ital J Pediatr ; 45(1): 88, 2019 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-31331358

RESUMEN

BACKGROUND: Acute otitis media is one of the most common infectious diseases in the paediatric age and although its complications such as acute mastoiditis have become rare thanks to improvements in therapeutic approaches, possible serious complications such as septic arthritis of the temporomandibular joint may develop. A prompt diagnosis and adequate treatment are essential to achieving the best outcome and avoiding serious sequelae. We describe a case occurring in a previously healthy 6-year-old female and review the literature currently available on this topic. CASE PRESENTATION: The patient presented a right temporomandibular septic arthritis with initial mandibular bone involvement secondary to acute otitis media. She presented with torcicollis, trismus, right preauricular swelling over the temporomandibular joint and was successfully treated with antibiotic treatment alone. CONCLUSIONS: Septic arthritis of the temporomandibular joint is a rare complication of acute otitis media or acute mastoiditis in children. It should be suspected in patients presenting with trismus, preauricular swelling or fever. No guidelines on the diagnosis and treatment of this infectious disease are currently available.


Asunto(s)
Artritis Infecciosa/etiología , Otitis Media/complicaciones , Trastornos de la Articulación Temporomandibular/etiología , Antibacterianos/uso terapéutico , Artritis Infecciosa/tratamiento farmacológico , Niño , Femenino , Humanos , Trastornos de la Articulación Temporomandibular/tratamiento farmacológico
11.
Oral Dis ; 25(7): 1759-1768, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31357246

RESUMEN

OBJECTIVES: To detect whether early growth response 1 (EGR1) in peripheral blood leucocytes (PBLs) indicates temporomandibular joint (TMJ) osteoarthritis (OA) lesions. MATERIALS AND METHODS: Egr1 mRNA expression levels in PBLs were detected in eight malocclusion patients without temporomandibular disorder (TMD) signs and 16 malocclusion patients with clinical TMD signs with (eight) or without (eight) imaging signs of TMJ OA. Twelve 6-week-old rats were randomized to a control group and a unilateral anterior crossbite (UAC) group and were sampled at 4 weeks. The Egr1 mRNA expression levels in PBLs and protein expression levels in different orofacial tissues were measured. RESULTS: Patients with TMD signs with/without TMJ OA diagnosis showed lower Egr1 mRNA expression levels in PBLs than patients without TMD signs. The lower Egr1 mRNA expression was also found in the PBLs of UAC rats, which were induced to exhibit early histo-morphological signs of TMJ OA lesions. In subchondral bone of UAC rats, EGR1 protein expression was decreased, co-localization of EGR1 with osterix or dentin matrix protein-1 was identified, and the number of EGR1 and osterix double-positive cells was reduced (all p < .05). CONCLUSION: Egr1 reduction in PBLs potentially indicates subchondral bone OA lesions at an early stage.


Asunto(s)
Cartílago Articular , Proteína 1 de la Respuesta de Crecimiento Precoz/metabolismo , Cóndilo Mandibular , Osteoartritis , Trastornos de la Articulación Temporomandibular/etiología , Animales , Cartílago Articular/metabolismo , Cartílago Articular/patología , Proteína 1 de la Respuesta de Crecimiento Precoz/genética , Maloclusión/complicaciones , ARN Mensajero , Distribución Aleatoria , Ratas , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/metabolismo , Tomografía Computarizada por Rayos X , Factores de Transcripción/análisis
12.
J Appl Oral Sci ; 27: e20180510, 2019 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-31166550

RESUMEN

INTRODUCTION: Intermaxillary fixation (IMF) is a classic method for immobilization of the mandible after mandibular fractures and corrective surgery. However, it has been suggested that IMF may be a risk for developing temporomandibular joint (TMJ)-related symptoms, especially when applied for longer periods. OBJECTIVE: To evaluate the clinical function of TMJs and masticatory muscles 10-15 years after mandibular setback surgery and subsequent six weeks of IMF. The patients' self-reported TMJ and masticatory muscle symptoms were also addressed. METHODOLOGY: Thirty-six patients (24 women and 12 men) treated with intraoral vertical ramus osteotomies and subsequent six weeks of IMF, underwent a clinical examination of TMJs and masticatory muscles 10-15 years after surgery and completed a five-item structured questionnaire reporting subjective TMJ-related symptoms. Mean age by the time of clinical examination was 34.1 years (range 27.2-59.8 years). The clinical outcome was registered according to the Helkimo clinical dysfunction index. Descriptive and bivariate statistics were performed and level of significance was set to 5%. RESULTS: Mean maximum unassisted mouth opening 10-15 years after surgery was 50.1 mm, (range 38-70 mm, SE 1.2), statistically significantly greater in men compared to women (p=0.004). Mean Helkimo dysfunction group was 1.5 (range 1-3, SE 0.10). Eighty-one percent experienced pain on palpation in either the masseter muscle, temporal muscle or both, and 31% experienced pain when moving the mandible in one or more directions. Thirty-one percent reported pain from palpating the TMJs. In the questionnaire, none reported to have pain during chewing or mouth opening on a weekly or daily basis, but 22% reported difficulties with maximum opening of the mouth. CONCLUSION: Ten to fifteen years after mandibular setback surgery the patient's mandibular range of movement is good. Despite clinically recognizable symptoms, few patients reported having TMJ- or masticatory muscle-related symptoms in their daily life.


Asunto(s)
Técnicas de Fijación de Maxilares/efectos adversos , Maloclusión de Angle Clase III/cirugía , Músculos Masticadores/fisiopatología , Maxilar/cirugía , Trastornos de la Articulación Temporomandibular/fisiopatología , Articulación Temporomandibular/fisiopatología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maloclusión de Angle Clase III/fisiopatología , Maxilar/fisiopatología , Persona de Mediana Edad , Mialgia/fisiopatología , Valores de Referencia , Autoinforme , Estadísticas no Paramétricas , Trastornos de la Articulación Temporomandibular/etiología , Factores de Tiempo , Resultado del Tratamiento
13.
Mol Med Rep ; 19(5): 4297-4305, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30942403

RESUMEN

Traumatic temporomandibular joint ankylosis (TMJA) is a common disease and disorder of the temporomandibular joint (TMJ); however, its pathogenesis has yet to be completely elucidated. In the authors' previous studies, the lateral pterygoid muscle (LPM) was confirmed to exert a function in distraction osteogenesis (DO) during the healing of a condylar fracture, which resulted in the formation of excess bone. The aim of the present study was to investigate alterations in the expression of any associated genes via an Affymetrix GeneChip method. The traumatic TMJA model was fabricated by a condylar fracture in the TMJ area of sheep with either a dissected LPM (LPD) or normal (LPN). The untreated sheep served as a control. At 4­ and 12 weeks post­surgery, the condylar zone was isolated to perform the gene chip analysis, which was performed according to a standard Affymetrix protocol. The validated genes were further evaluated by reverse transcription­quantitative polymerase chain reaction (RT­qPCR). The gene chip analysis indicated that the LPN gene expression pattern was similar compared with the DO process, while LPD was similar to that of normal bone fracture healing. The validated genes were collagen type II α1 chain, C­type lectin domain family 3 member A, interleukin 1A, cartilage oligomeric matrix protein, chondromodulin (LECT1), calcitonin receptor (CALCR), transforming growth factor (TGF)­ß1, Fos proto­oncogene (FOS), bone γ­carboxyglutamate protein and bone morphogenic protein (BMP)7, among which, BMP7, LECT1, CALCR and FOS were confirmed by RT­qPCR. In conclusion, the present study demonstrated that LPM exerts a DO effect during the pathogenesis of traumatic TMJA, which may provide a novel target for preventing TMJA.


Asunto(s)
Anquilosis/etiología , Anquilosis/patología , Músculos Pterigoideos/metabolismo , Músculos Pterigoideos/patología , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/patología , Heridas y Traumatismos/complicaciones , Animales , Biología Computacional , Modelos Animales de Enfermedad , Perfilación de la Expresión Génica , Ontología de Genes , Análisis de Secuencia por Matrices de Oligonucleótidos , Reproducibilidad de los Resultados , Ovinos , Transcriptoma
14.
J Appl Oral Sci ; 27: e20180433, 2019 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-30810641

RESUMEN

Disc displacement with reduction (DDWR) is one of the most common intra-articular disorders of the temporomandibular joint (TMJ). Factors related to the etiology, progression and treatment of such condition is still a subject of discussion. This literature review aimed to address etiology, development, related factors, diagnosis, natural course, and treatment of DDWR. A non-systematic search was conducted within PubMed, Scopus, SciELO, Medline, LILACS and Science Direct using the Medical Subjective Headings (MeSH) terms "temporomandibular disorders", "temporomandibular joint", "disc displacement" and "disc displacement with reduction". No time restriction was applied. Literature reviews, systematic reviews, meta-analysis and clinical trials were included. DDWR is usually asymptomatic and requires no treatment, since the TMJ structures adapt very well and painlessly to different disc positions. Yet, long-term studies have shown the favorable progression of this condition, with no pain and/or jaw locking occurring in most of the patients.


Asunto(s)
Luxaciones Articulares/fisiopatología , Luxaciones Articulares/terapia , Disco de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/terapia , Progresión de la Enfermedad , Humanos , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/etiología , Imagen por Resonancia Magnética , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/etiología
15.
Oral Maxillofac Surg ; 23(1): 35-45, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30729355

RESUMEN

PURPOSE: Recurrent temporomandibular joint (TMJ) dislocation can be challenging to treat and the current understanding regarding aetiology and management of this condition is limited. The aim of this paper was to conduct a systematic review regarding the management of recurrent TMJ dislocation. METHODS: A literature review was conducted using PRISMA guidelines to identify papers published between 2006 and 2016. The resultant papers were analysed. RESULTS: A total of 33 papers were found relevant to the study. Minimally invasive techniques described included autologous blood injection, which was associated with an overall success of 80% at 12 months. Other modalities investigated included OK-432 sclerotherapy, laser capsulorrhaphy, botulinum toxin of the lateral pterygoid muscle or modified dextrose. These publications show promising success rates. Surgical techniques described included disc plication, eminoplasty and eminectomy. These modalities had a similar success rate, although numbers were limited. The true incidence of recurrent TMJ dislocation is unknown and aetiology is limited to expert opinion. CONCLUSION: The current understanding of management for recurrent TMJ dislocation is limited to case series and case reports. This paper compiles the current understanding of management of recurrent TMJ dislocation. Compared to previous reviews, this paper describes some novel minimally invasive techniques with promising success in the management of recurrent TMJ dislocation.


Asunto(s)
Luxaciones Articulares/cirugía , Trastornos de la Articulación Temporomandibular/cirugía , Humanos , Luxaciones Articulares/etiología , Recurrencia , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/etiología
16.
Int J Med Sci ; 16(2): 253-263, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30745806

RESUMEN

Aims: Temporomandibular disorders (TMD) represent a heterogeneous group of inflammatory or degenerative diseases of the stomatognatic system, with algic and/or dysfunctional clinical features involving temporomandibular joint (TMJ) and related masticatory muscles. Rheumatoid Arthritis (RA) is an autoimmune polyarthritis characterized by the chronic inflammation of synovial joints and oral implications such as hyposalivation, difficulty in swallowing and phoning, feeling of burning mouth, increased thirst, loss of taste or unpleasant taste and smell, dental sensitivity. The aim of this observational study was to investigate the prevalence of TMD symptoms and signs as well as oral implications in patients with Early Rheumatoid Arthritis (ERA), that is a RA diagnosed within 12 months, compared with a control group. Methods: The study group included 52 ERA patients (11 men, 41 women) diagnosed according to the 2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis. A randomly selected group of 52 patients not affected by this disease, matched by sex and age, served as the control group. The examination for TMD signs and symptoms was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) by means of a questionnaire and through clinical examination. Results: Regarding the oral kinematics, the left lateral excursion of the mandible was restricted in statistically significant way in ERA patients (p=0.017). The endfeel values were significantly increased in ERA group (p=0.0017), thus showing the presence of a higher muscle contracture. On the other side, the study group complained less frequently (67.3%) of TDM symptoms (muscle pain on chewing, pain in the neck and shoulders muscles, difficulty in mouth opening, arthralgia of TMJ, tinnitus) than controls (90.4%) (χ2= 8.301 p=0.0039). The presence of TMJ noises was significantly lower in the study group (χ2= 3.869 p=0.0049), as well as presence of opening derangement (χ2= 14.014 p=0.0002). The salivary flow was significantly decreased in the study group respect to the control one (p<0.0001). Conclusions: The data collected show a weak TMJ kinematic impairment, a paucisymptomatic muscle contracture (positive endfeel) and a remarkable reduction of salivary flow in ERA patients. Myofacial pain (MP) evoked by palpation was more frequent and severe in the control group than in the study one, this result being highly significant.


Asunto(s)
Artritis Reumatoide/complicaciones , Enfermedades de la Boca/epidemiología , Trastornos de la Articulación Temporomandibular/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Niño , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/etiología , Trastornos de la Articulación Temporomandibular/etiología , Adulto Joven
17.
J Dent ; 82: 98-100, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30710653

RESUMEN

OBJECTIVE: To assess the relationship between Intimate partner violence (IPV) (a highly prevalent form of domestic abuse) with the subsequent development of temporomandibular joint disorder (TMD). METHODS: A retrospective open cohort study using a UK primary care database was undertaken. 18,547 women exposed to IPV were matched by age to 74,188 unexposed women. Defined through clinical codes the outcome of interest was TMD, and adjusted incidence rates (aIRR) were used to describe the relationship after considering covariates of interest. RESULTS: 94 individuals in the exposed group were clinically coded with TMD during the study period translating to an incidence rate (IR) or 1.59 per 1000 person years. This was in comparison to 342 outcomes in the unexposed group (IR 1.21 per 1000 person years). The unadjusted IRR was 1.31 (95% CI 1.04-1.65; p < 0.020) and after adjustment for important covariates increased to 1.45 (95% CI 1.14-1.84; p < 0.002). CONCLUSION: Our results suggest that the development of TMD may be associated with exposure to IPV in women. CLINICAL SIGNIFICANCE: In the first cohort to do so, we have identified a moderate association between Intimate partner violence exposure and subsequent development of TMD. This highlights an opportunity for screening of abuse in individuals presenting with TMD.


Asunto(s)
Violencia de Pareja , Trastornos de la Articulación Temporomandibular , Adulto , Estudios de Cohortes , Femenino , Humanos , Violencia de Pareja/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Trastornos de la Articulación Temporomandibular/etiología , Reino Unido/epidemiología
18.
J Oral Rehabil ; 46(5): 450-459, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30664807

RESUMEN

BACKGROUND: Diagnostic criteria reported in the expanded taxonomy for temporomandibular disorders include a standardised clinical examination and diagnosis (DC/TMD 3.B) of temporomandibular joint (TMJ) damage in patients with juvenile idiopathic arthritis (JIA); however, their validity is unknown. OBJECTIVES: To assess the validity of DC/TMD 3.B for the identification of TMJ damage in JIA-patients, using magnetic resonance imaging (MRI) as gold standard, and to investigate the relation between clinical findings and TMJ damage. METHODS: Fifty consecutive JIA patients (9-16 years) were recruited. DC/TMD 3.B were compared with TMJs MRI (100 TMJs) performed maximum at 1 month from the visit. The severity of TMJ damage was scored in four grades. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), logistic regression models with odds ratio of DC/TMD 3.B and clinical findings respect to MRI were calculated. RESULTS: The DC/TMD 3.B were inadequate in the identification of TMJ damage (sensitivity = 0.15, specificity = 0.92, PPV = 0.85, NPV = 0.28, P = 0.350). Chin deviation and TMJ crepitus were associated with worse TMJ damage (P = 0.006; P = 0.034). Reduced mouth opening (OR = 3.91, P = 0.039) and chin deviation (OR = 13.7, P = 0.014) were associated with the presence of TMJ damage. Combining "pain" (history of pain, TMJ pain, pain during movements) and "function" (TMJ crepitus, reduced mouth opening, chin deviation) clinical findings, the sensitivity and the specificity were 0.88 and 0.54. CONCLUSION: DC/TMD 3.B present a low sensitivity to diagnose TMJ damage. Chin deviation, reduced mouth opening and TMJ crepitus are associated with TMJ damage. We suggest combining "pain" and "function" findings for the evaluation of TMJ damage in JIA patients.


Asunto(s)
Artritis Juvenil/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico , Articulación Temporomandibular/patología , Adolescente , Artritis Juvenil/complicaciones , Artritis Juvenil/diagnóstico por imagen , Artritis Juvenil/fisiopatología , Niño , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Examen Físico , Reproducibilidad de los Resultados , Factores de Riesgo , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/fisiopatología
19.
J Oral Rehabil ; 46(5): 460-467, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30674069

RESUMEN

BACKGROUND: Obesity is a chronic and prevalent disorder, affecting individuals of all age. Previous evidence suggests that it is associated with some types of chronic pain, especially musculoskeletal pain. In addition, sedentarism is also associated with an increase of the inflammatory factors and chronic pain. So, we conducted a cross-sectional study to evaluate the association between obesity, sedentarism and the presence of TMD-pain in adolescents. METHODS: Temporomandibular Disorders were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Obesity was assessed by the body mass index (BMI), bioimpedance (BIA), skinfold (triceps and subscapular) and circumferences (arm and abdominal). The level of physical activity was rated according to the instrument adopted by the Brazilian National School Health Survey. Descriptive statistics, univariate logistic regression and odds ratios (OR) with 95% confidence intervals (CI) were used to study the associations of interest. RESULTS: The sample consisted of 690 individuals with a mean age of 12.7 (±0.76) years of whom 389 (56.4%) were girls. Of the total, 112 (16.2%) had TMD-pain, 110 (15.9%) were obese according to BMI, 74 (10.8%) according to BIA, and 127 (18.4%) following the skinfolds and circumferences assessments. There was no significant association between TMD-pain and obesity according to BMI (P = 0.95), BIA (P = 0.16), skinfold and circumference (P = 0.22), and neither with sedentarism (P = 0.94). CONCLUSION: Obesity and sedentarism were not associated with the presence of TMD-pain in adolescents.


Asunto(s)
Obesidad/epidemiología , Conducta Sedentaria , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología , Adolescente , Índice de Masa Corporal , Brasil/epidemiología , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Obesidad/complicaciones , Obesidad/fisiopatología , Oportunidad Relativa , Dimensión del Dolor , Prevalencia , Trastornos de la Articulación Temporomandibular/fisiopatología
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