RA.DI.CA. Splint Therapy in the Management of Temporomandibular Joint Displacement without Reduction.

BACKGROUND: The purpose of this study is to report clinical and instrumental changes after RA.DI.CA splint therapy for temporomandibular joint disc displacement without reduction. METHODS: Subjects affected by disc dislocation without reduction were recruited between July 2020 and May 2022 based on inclusion and exclusion criteria and treated with RA.DI.CA. splints over a period of 6 months. Clinical data were collected at each phase of the study (T0, T1, T2). Magnetic resonance imaging and electrognathography data were recorded at the beginning (T0) and at the end (T2) of the study. ANOVA with post-hoc contrasts was performed to assess differences in outcome measures over time. The Wilcoxon test was used to evaluate changes in disc-condyle angle between before- and after-treatment MRI. A two-tailed value of p < 0.05 was regarded as significant. METHODS: Ten patients completed the study. There were statistically significant differences over time for arthralgia, headache, neck pain, and mouth opening. Disc recapture and an improved quality of mandibular movement were recorded in 70% of subjects. The clinical and instrumental improvements are probably due to the orthopedic action of RA.DI.CA splint treatment, which allows for a greater degree of joint mobilization. CONCLUSIONS: The purpose of this therapy is to recover the disc position if possible and achieve an adequate joint functional adaptation that avoids the progression of the structural damage and the recurrence of symptoms.

Friedman Tongue Position and the Anthropometric Parameters in Adult Patients with Obstructive Sleep Apnea: An Observational Study.

INTRODUCTION: Obstructive Sleep Apnea Syndrome (OSAS) is a relevant public health problem; dentists can play an important role in screening patients with sleep disorders by using validated tools and referring patients to a specialist, thereby promoting an interdisciplinary approach. The aim of the study is to identify if the OSAS severity, measured by the apnea-hypopnea index (AHI), and some anthropometric measurements are associated with the Friedman Tongue Position (FTP) within a population with dysmetabolic comorbidities. MATERIALS AND METHODS: A questionnaire containing information about clinical data including height, weight, Body Mass Index (BMI), neck circumference, waist circumference, hip circumference and FTP was administered. The AHI value was measured by means of an unattended home polysomnography device. Pearson correlation coefficients were calculated, and Kruskal-Wallis, Kolmogorov-Smirnov (both nonparametric) and independence tests were performed to probe the possible relationships. The significance was set at p ≤ 0.05. RESULTS: A total of 357 subjects were analyzed. The association between the FTP and AHI was not statistically significant. On the contrary, the AHI showed a positive correlation with BMI and neck circumference. A statistically significant association between the number of subjects with a larger neck and an increasing FTP class was found. BMI, neck, hip and waist circumference was associated with the FTP scale. CONCLUSIONS: although the FTP was not directly associated with OSAS severity, there was also evidence that an FTP increase is associated with an increase in the considered anthropometric parameters, and FTP can be a clinical tool used in the assessment of risk for OSAS risk factors.

Conservative Therapies for TMJ Closed Lock: A Randomized Controlled Trial.

Background. Acute anterior disc displacement without reduction (ADDWoR) is characterized by permanent TMJ disc displacement, pain and functional limitations. Occlusal appliances (OA) are among the therapies of choice. Methods. A single-blind randomized study was carried out to compare the therapeutic success of two different types of splints in patients with ADDWoR. A total of 30 subjects were eligible for the study out of the 330 screened. Group I (n = 15) received RA.DI.CA splint therapy and Group II (n = 15) received stabilization splint therapy. Temporomandibular pain, headache, neck pain and functional excursions were evaluated at baseline (T0), after 4 weeks (T1) and after 6 months (T2). Descriptive and inferential statistics were performed. Results. There was a significant increase in maximum jaw opening and a reduction in pain in both groups (p < 0.05), except for neck pain in Group II. Significant differences in between- and within-subject factors emerged in all of the parameters evaluated, especially between T1 and T2 scores, with a greater trend of improvement in Group I than Group II. Conclusion. RA.DI.CA splints were found to be more effective for the considered sample, especially in the treatment of comorbidities and functional movements, probably due to the greater orthopedic action and joint mobilization.

OSAS Severity and Occlusal Parameters: A Prospective Study among Adult Subjects with Comorbidities.

INTRODUCTION: OSAS is an emerging public health problem. Early diagnosis in adults with comorbidities is the gold standard to avoid complications caused by a late diagnosis. The aim of the study, part of the SLeeP@SA project, was to identify within a population with dysmetabolic comorbidities the association of occlusal clinical signs, defined by orthodontic parameters, and of the anthropometric phenotype, with the severity of OSAS. MATERIALS AND METHODS: A dedicated questionnaire containing questions regarding the presence of deep bite, augmented overjet, partial edentulism, and bruxism was completed by clinic staff. OSAS was evaluated using an unattended home PSG device, which recorded the AHI value. BMI and neck circumference were also measured. The Kolmogorov-Smirnov test was performed to evaluate the association of the AHI with occlusal clinical signs. The significance was set at p ≤ 0.05. The association of AHI with BMI and neck circumference was evaluated with the Pearson correlation coefficient. RESULTS: In total, 199 subjects were evaluated. No statistically significant association between occlusal parameters and AHI was found, while the AHI showed a positive correlation with BMI and neck circumference. The neck circumference seemed to be a better clinical predictor for OSAS severity than BMI, especially for females. CONCLUSIONS: These results highlight how the orthodontic clinical data alone are not sufficient to establish an association between occlusal anomalies and OSAS severity, but further investigation involving a specialist orthodontic diagnosis is necessary.

Comparison of the Effectiveness of Three Different Acupuncture Methods for TMD-Related Pain: A Randomized Clinical Study.

PURPOSE: This study aimed to compare the effectiveness of three acupuncture methods for temporomandibular disorders- (TMDs-) related pain. MATERIALS AND METHODS: Different locations of pain, according to DC/TMD clinical assessment, were considered: temporomandibular joint (TMJ), masticatory muscles, head, and neck. Sixty patients were assigned randomly to one of three treatment groups (20 patients in each): group BA received body acupuncture, group EA received electroacupuncture, and group CA received acupuncture + cupping. The groups were compared in terms of pain (verbal numeric scale), pain-related disability (Brief Inventory Pain, BPI), and impression of the treatment's effectiveness (Patients' Global Impression of Improvement Scale, PGI-I). These were recorded before sessions of acupuncture treatment (T0), after 8 sessions of acupuncture treatment (T1), and after 4 weeks of follow-up after treatment (T2). The between-group and within-group differences in the data were analyzed statistically. The baseline characteristics were similar in all groups (p > 0.05). RESULTS: Significant improvements were noted in all types of pain compared to baseline values in all groups (all p < 0.05). No significant differences were noted in the improvement of TMDs-related pain according to the different acupuncture techniques (all p > 0.05). All acupuncture methods used resulted to be significantly effective in improving the pain-related interference in the patient's common activities and quality of life. EA resulted to be significantly more effective than BA and CA in improving the interference of pain with patients' mood (p=0.015) and quality of sleep (p=0.014). CONCLUSION: BA, EA, and CA are all effective acupuncture methods in reducing pain and pain interference with common activities and quality of life in patients affected by TMD.

COVID-19 AND DENTAL DISTANCE-BASED EDUCATION: students' perceptions in an Italian University.

BACKGROUND: The aim of the study was to analyze the perception of dental faculties students regarding the complete transition to distance-based education (DE) and the adaptation of this educational strategy, due to Covid-19 pandemic. A questionnaire to be completed anonymously was submitted online to students attending the faculties of Dentistry and Oral Hygiene at Sapienza, University of Rome, after the end of distance lessons. The collected data were processed statistically, providing descriptive data and analysis of correlation of the most significant parameters, using Chi-squared test, Cramér V and Pearson φ2, Goodman and Kruskal's γ and λ and Kendall's τb. The level of statistical significance was p < 0.05. RESULTS: A total of 314 students participated in the survey. The overall level of satisfaction on a ten- point scale was 5.39 ± 2.59 for Oral Hygiene students and 6.15 ± 2.98 for Dentistry students. The most common complaints were the lack of a structured online curriculum, less interaction with professors and a lower level of attention. On the basis of the responses, scored using Likert-type Scale, oral Hygiene students reported statistically higher level of physical fatigue(p = 0.0189), a lower level of attention (p = 0.0136) and of the quality and quantity of acquired knowledge during distance education (p = 0.0392), compared to Dentistry students. Level of perceived stress and quality and quantity of acquired knowledge (γ = 0.81 and τb =0.56) and quality and quantity of acquired knowledge and fear of a decrease in knowledge (γ = 0.76 and τb =0.54) are associated variables. CONCLUSION: Students' feedback is essential to solve the key issues emerged from the questionnaire. New educational models should be define in order to ensure that distance education could be effective, meeting the learning needs of the students, and could not be a merely "online shift" of traditional methods, used as an alternative of live education.

A Female Psoriatic Arthritis Patient Involving the TMJ.

Psoriatic arthritis (PsA) is an inflammatory chronic arthritis associated with psoriasis. Currently, data about gender differences in clinical manifestation and therapeutic outcomes of PsA are limited. Frequently, women manifest a peripheral disease while men have an axial localization. Moreover, women display higher disease activity and physical activity limitations, if compared to men. Although the involvement of the temporomandibular joint (TMJ) is quite rare, it can seriously impact the quality of life. The morpho-functional peculiarities of TMJ require a multidisciplinary approach to perform a correct diagnosis and a successful treatment. Here, we report a case of a woman affected by PsA involving TMJ treated by combining pharmacological therapy and an occlusal splint. The coordination between different specialties led to a complete remission of clinical symptoms and a regression of lesions.

Ultrashort Implants, Alternative Prosthetic Rehabilitation in Mandibular Atrophies in Fragile Subjects: A Retrospective Study.

This study aimed to evaluate the effectiveness of using ultrashort implants in the rehabilitation of jaws of fragile patients. The aim of the study was to retrospectively evaluate the survival rate of full-arch prosthetic rehabilitation on ultrashort implants, length 4 mm, 4 mm in diameter in the premolar and canine area and 4.5 mm in diameter in the molar area, with the insertion torque of 60 Nw and immediate loading. Nineteen patients were evaluated for 3 years clinically and radiographically. The significant majority of the patients at the 3 year follow-up (T4) presented a stable and functional implant-supported prothesis, and the survival rate of the implants was 85%, with a loss of 16 implants on 114 implants. The combination of the innovative implant surfaces and the correct project of the prostheses, with the related implant connection, determined a different timing in the therapy, allowing to obtain an immediate loading, which is currently demanded by patients. This and recent reports on short and ultrashort implant usage in atrophic jaws offer a good solution in critical cases. In conclusion, within the limits of the study, the full-arch rehabilitation with immediate loading on ultrashort implants showed good results with few postoperative complications and related low biological cost.

Evaluation of the efficacy of a new low-level laser therapy home protocol in the treatment of temporomandibular joint disorder-related pain: A randomized, double-blind, placebo-controlled clinical trial.

Objective: This study analyzed a home, low-level laser therapy (LLLT) protocol to manage temporomandibular joint disorders (TMJDs)-related pain.Methods: Ninety TMJD patients (12M, 78F) between 18 and 73 years were randomly subdivided into three groups. Study group (SG) received 1-week home protocol LLLT by B-cure Dental Pro: 808 nm, 5 J/min, 250 mW, 15 KHz for 8', 40 J each, over pain area, twice daily. Placebo group (PG) followed the same protocol using sham devices. Drugs group (DG) received conventional drugs. Pain was evaluated by visual analog scale (VAS) before and after therapy.Results: Statistical analysis showed that treatment was effective (F(2,83) = 4.882; p = .010). Bonferroni post-hoc analysis indicated a lower pain decrease in PG. SG registered a 34-point decrease per patient, while in PG and DG, the reduction was 25.6 and 35.3, respectively.Conclusion: The study supports the efficacy of home LLLT management of TMJD related pain.

Local Vibratory Stimulation for Temporomandibular Disorder Myofascial Pain Treatment: A Randomised, Double-Blind, Placebo-Controlled Preliminary Study.

Several methods are currently used to manage pain related to temporomandibular disorder (TMD). Vibratory stimulation is applied as a pain treatment for several musculoskeletal disorders, but it has not yet been studied in-depth for TMD symptoms. The aim of this study is to analyse the effectiveness of at-home local vibration therapy (LVT) for the management of TMDs-related myofascial pain. Methods. Fifty-four TMD patients (43 F, 11 M) with an average age of 40.7 (age range: 29-54 yr.) were randomly subdivided into two groups. The study group (AG) received 1 week of at-home LVT treatment with the NOVAFON Pro Sk2/2 : 50/100 Hz, bilaterally applied to the pain area for 16 minutes daily. The placebo group (IG) followed the same protocol using inactive devices. Temporomandibular joint pain (TMJ), muscular pain (MM), and headache (HA) were assessed. Pain was evaluated using the visual analogue scale (VAS) before (T0) and after therapy (T1). Statistical analysis and Student's t-tests were applied (statistical significance for P < 0.05). Results. AG patients reported decreased average values for all types of pain considered between T0 and T1, with a statistically significant difference for TMJ pain (P < 0.05), MM pain, and HA (P < 0.001). IG patients reported a no statistically significant decrease in the average values of MM pain and an increase in the average values of TMJ pain and HA. Conclusion. The study supports the use of local vibration therapy in the control of TMD-related TMJ pain, local muscular pain, and headache.

"RA.DI.CA." Splint for the Management of the Mandibular Functional Limitation: A Retrospective Study on Patients with Anterior Disc Displacement without Reduction.

The study aimed at assessing the effectiveness of the RA.DI.CA. splint in the management of temporomandibular joint disc displacement without reduction (ADDwoR) and jaw functional limitation. The authors developed a retrospective clinical study. A total of 2739 medical records were screened. One hundred and forty-one patients with chronic unilateral disc displacement without reduction and jaw limitation, treated with a multifunctional RA.DI.CA. splint, were enrolled. Temporomandibular pain, headache, familiar pain, neck pain, and emotional strain, maximum spontaneous mouth opening, and lateral excursions were evaluated at baseline (T0), after therapy (T1), and during the follow-up (T2). Descriptive statistical analysis was performed. Wilcoxon test assessed changes in symptomatology and functional aspects before and after treatment and between T1 and T2, with p < 0.05. Ninety-nine patients (70%) declared themselves "healed" from jaw functional limitation with no residual painful symptoms, 31 (22%) improved their symptoms and jaw function, 11 (8%) reported no changes compared to T0 and no one worsened. As for all parameters analyzed, the comparison between the ones before and after treatment was statistically significant (p < 0.05). The RA.DI.CA. splint proved to be highly performing and promoting functional and symptomatologic recovery, also in the medium and long term, through the restoration of the functional disc-condyle relationship and the healing of joint tissues.

Evaluation of Vision in Gnathological and Orthodontic Patients with Temporomandibular Disorders: A Prospective Experimental Observational Cohort Study.

OBJECTIVES: Temporomandibular disorders (TMDs), orthodontic diseases, and vision dysfunctions seem to be strictly related. The purpose of this study was to prove the relationship, to evaluate the prevalence and the distribution of vision defects in dysfunctional and orthodontic patients, and to establish the type of the relationship. MATERIALS AND METHODS: A total of 100 patients with TMDs were selected and studied through epidemiological analyses of the following factors: gnathological parameters (temporomandibular joint pathologies according to Diagnostic Criteria for Temporomandibular Disorders); occlusal and skeletal parameters (overjet, overbite, dental class, transversal discrepancies, and mandibular asymmetry); and orthoptic parameters (refractive defects and oculomotor diseases). A prospective experimental observational cohort study was conducted. A comparison with the average frequency of vision defects of the Italian population was performed. The prevalence of vision defects was evaluated. All gnathological and orthodontic parameters were associated with the orthoptic ones. A descriptive and statistical analysis of the data was carried out with the Statistical Package for the Social Sciences software; z test (P < 0.05), frequency analysis (frequency >50%), chi-square test, and Student's t test (P < 0.05) were performed. The scientific consistency was evaluated by using the scientific criteria of Bradford Hill. RESULTS: The comparison with the Italian population showed a higher frequency of refractive defects in the study sample (P < 0.001). The most frequent vision defects were phorias (92%) and tropia (3%). The increased frequency of ocular convergence reduction in the presence of disc displacement with reduction was significant (n = 28; 60%; P < 0.05). In the presence of asymmetry, low frequencies of astigmatism (n = 18; 30%) were observed compared to its absence (n = 22; 54%) (P < 0.05) and high frequencies of motor ocular deviations (n = 59; 100%) were observed compared to its absence (n = 36; 88%) (P < 0.05). In the presence of headache, low frequencies of emmetropia (n = 13; 22%) and higher frequencies of hyperopia (n = 18; 30%) were observed (P < 0.05). Two of five scientific criteria of Bradford Hill were met. CONCLUSION: It seems to emerge a possible positive relationship between TMD and vision defects. In particular, the most interesting associations were found between functional or skeletal orthognathic alterations and oculomotor dysfunctions. However, it was not possible to establish the type of relationship.

Difficult-to-treat OSAS: Combined continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) therapy. A case report.

Background: Obstructive sleep apnea syndrome and is characterized by recurrent episodes of partial or complete upper airway collapse during sleep with consequent oxygen desaturations and cardiovascular, neurological, and metabolic impairment. Clinical presentation: The authors report the case of a 66-year-old male presenting "metabolic syndrome" (obesity, impaired glucose tolerance, dyslipidemia, multi-drug treated arterial hypertension), atopy, mouth breathing due to turbinate hypertrophy, and pathological daytime sleepiness. As patient's compliance to standard continuous positive airway pressure (CPAP) therapy was poor, he was treated using low-pressure CPAP combined with a mandibular advancement device (MAD). Conclusion: In selected patients, a treatment combining CPAP and MAD might be a more tolerable alternative to CPAP alone. The improved pharyngeal patency, promoted by mandibular advancement and stretching of the pharyngeal muscles, allows operating the CPAP at lower pressures when the MAD alone is not sufficient to induce a safe sleep profile.

Okada Purifying Therapy in combination with duloxetine vs. duloxetine alone in patients with TMD and fibromyalgia: a randomized clinical study.

OBJECTIVES: This randomized study was aimed at evaluating the additional analgesic effect of Okada Purifying Therapy (OPT) when administered in combination with duloxetine in patients with Temporomandibular Disorders (TMDs) and Fibromyalgia (FM). METHODS: Patients with TMDs visited at Department of Oral and Maxillofacial Sciences, Sapienza University of Rome who were diagnosed with FM were selected for the study. The final sample was composed of 31 patients: 15 patients were treated only with duloxetine (Group I) and 16 patients underwent also OPT treatment (Group II), for eight weeks. Craniomandibular index, total tenderness score, Brief Pain Inventory Modified Short Form, Fibromyalgia Impact Questionnaire, Beck Depression Inventory and State and Trait Anxiety Inventory-1 were assessed at the beginning (T0), during the course (T1) and after therapy (T2). Descriptive and inferential statistics were performed. RESULTS: In all the data analyzed, both groups showed an improvement in particular between T0 and T1. No statistically significant differences were observed between the two groups during the trial, except for the interaction between treatment and time as to the ability of walking at the BPI-I (F=7.57, p=0.002). No side effects due to the duloxetine were recorded in group II compared to group I. CONCLUSION: The additional complementary treatment (OPT) did not appear to give the patients with TMDs and FM any further benefit but it might improve pharmacological tolerability of the traditional medication.

Application of a Systematic Protocol in the Treatment of TMDs With Occlusal Appliances: Effectiveness and Efficiency in a Longitudinal Retrospective Study With Medium-Term Follow-Up.

OBJECTIVES: This study aimed to assess effectiveness, efficiency, and feasibility of a systematic protocol for the choice and management of occlusal splints (OA) in the treatment of temporomandibular disorders (TMDs). MATERIALS AND METHODS: A longitudinal retrospective study was conducted. Two different samples, G1 + G2 (337 patients), between January 2011 and January 2014, were selected according to inclusion and exclusion criteria. G1 was composed of patients visited at Policlinico Umberto I, Head-Neck Department, Sapienza University of Rome, Italy, and patients in G2 visited at a private structure in Rome. Pain records and functionality were compared before (T0) and at the end of therapy (T1). A follow-up group, composed of 100 patients randomly selected among those who completed treatment for at least 1 year (T2), was analyzed and symptomatology records were compared. Descriptive statistical analysis was performed. RESULTS: In the entire sample, joint and muscular pain, joint noises and mandibular functionality, headache, and neck pain improved from T0 to T2. The average time for articular and muscular recovery was 6.4 months. Comparing treatment outcomes, there were not statistically significant differences between the two groups. CONCLUSIONS: Treatment outcomes using this setting of protocol showed a positive trend also in the medium term. The use of a systematic protocol seems to reduce operator-dependent factors.

Relationship between Cervical Spine and Skeletal Class II in Subjects with and without Temporomandibular Disorders.

Aim: To assess changes in the craniocervical structure and in hyoid bone position in skeletal Class II subjects with and without temporomandibular disorders (TMD). Materials and Methods: The cephalometric analysis of 59 subjects with skeletal Class II was evaluated and compared. The measurements considered were ANB as a parameter of Class II and C0-C1 distance, C1-C2 distance, craniocervical angle, and hyoid bone position for the cervical spine analysis. Patients were divided into patients with TMD (group A) and patients without TMD (group B). TMD were evaluated with Diagnostic Criteria for TMD (DC/TMD). Descriptive statistics and Pearson's and Spearman's correlation analysis, with p value <0,005, were performed. Results: C0-C1 and C1-C2 distance values and hyoid bone position resulted within the normal range in the majority of patients examined. Craniocervical angle was altered in 33 patients. The reduction of this angle with the increase of the ANB value resulted to be statistically significant in group A, according to Pearson's correlation index. No other data were statistically significant. Conclusions: The significant relationship between skeletal Class II and cervical spine cannot be highlighted. The alteration of craniocervical angle seems to be mildly present, with backward counterclockwise rotation of the head upon the neck in the sample (groups A and B). The presence of TMD as a key factor of changes in neck posture could explain the different result between the two groups about the relationship between ANB and craniocervical angle. This result should be further analyzed in order to better understand if cervical spine changes could be related to mandibular postural ones in the craniocervical space or to temporomandibular joint retropositioning, more recognizable in Class II with TMD, which could determine functional changes in other structures of this unit; neck posture could be the result of a compensatory/antalgic mechanism in response to TMD.

Evaluation of Temporomandibular Disorders and Comorbidities in Patients with Ehler--Danlos: Clinical and Digital Findings.

OBJECTIVE: The objective of this study is to recognize representative cranio-cervico-mandibular features of patients with Ehler-Danlos syndrome and associated temporomandibular disorders (TMDs), to assess a targeted and integrated treatment plan. MATERIALS AND METHODS: After a diagnosis of disease, 38 individiuals with Ehler-Danlos syndrome and temporomandibular symptomatology referred were evaluated. Gnathological evaluation, according to the Diagnostic Criteria for TMDs, and radiographic imaging was performed. In addition, digital evaluation of occlusal and muscular balance, using surface electromyography of jaw muscles, was conducted. Statistical software for data analysis - STATA (StataCorp, College station, Texas, USA) - was used. RESULTS: Most common temporomandibular dysfunctions were arthralgia, myalgia, disc displacement with reduction and subluxation. Headache and neck pain were the most frequent comorbidities. Somatization, depression, anxiety, and obsessive-compulsive behavior were the most recurrent psychological disorders. Electromyographic analysis showed out of normal range data. CONCLUSION: Early diagnosis and interception are requested to avoid injuries and repeated traumatism. Multidisciplinary treatments are available to approach all the aspects of the syndrome.

Subtyping patients with somatic tinnitus: Modulation of tinnitus and history for somatic dysfunction help identify tinnitus patients with temporomandibular joint disorders.

OBJECTIVE: Determine in a cohort of patients with normal hearing and chronic tinnitus if self-reported history for temporomandibular joint (TMJ) dysfunction and a positive modulation of tinnitus in the TMJ region could be suggestive of an underlying TMJ disorder. PATIENTS AND METHODS: The study included 226 patients presenting to the Head and Neck Service of our University Hospital. Following audiological and somatic tinnitus evaluation, patients were divided into two groups. The study group (n = 134) included subjects that met both the following criteria: A) a self-reported history for TMJ dysfunction and B) a positive modulation of tinnitus following somatic maneuvers in the TMJ region. The control group (n = 92) included patients with similar demographic and tinnitus characteristics that did not meet the proposed criteria for somatic tinnitus. Afterwards, patients underwent clinical TMJ evaluation in the Service of Clinical Gnathology of our University. RESULTS: One hundred thirty-one patients (57.9%) received a clinical diagnosis of TMJ disorder according to DC/TMD Axis I; 79.1% in the study group and 27.2% in the control group. Ninety-five (42.1%) patients were negative for TMJ disorders; 20.9% in the study group and 72.8% in the control group. A significantly higher number of TMJ disorders was found in patients in the study group compared to the control group (p<0.0001). Most patients had joint disorders (67.2%), followed by other (29.8%) and pain disorders (29%). Logistic regression analysis in the study group showed that female gender was more prevalent in patients with TMJ disorders. CONCLUSION: Our findings in patients with chronic tinnitus and normal hearing suggest that self-reported history for somatic dysfunction and modulation of tinnitus, when occurring simultaneously in the TMJ region, can be useful to preliminarily identify patients with TMJ disorders.

Digital evaluation of occlusal forces: comparison between healthy subjects and TMD patients.

AIM: Continuous technological innovation has provided the clinicians to access to a computerized device that can analyse the different characteristics of occlusal contacts. The purpose of this research was to use this device to study the occlusal forces comparing healthy subjects and TMD patients. MATERIALS AND METHODS: The study was conducted by following specific criteria to select participants; the sample was divided into two homogeneous groups: control group (CG) comprising healthy subjects, and dysfunctional group (DG) comprising TMD patients. The occlusal force analysis was performed using the computerized system T-Scan III V 5.20 T. The data were analysed with statistical methods. RESULTS: The most significant differences emerged between the groups in the average occlusal load distribution and in the location of the centre of occlusal forces (COF). In particular, compared with the CG and the functional standard, reductions in the molar field forces on the second and first molars of 27% and 6.9%, respectively, were observed in the DG. The COF was located in the most forward position in TMD patients compared with healthy subjects. CONCLUSIONS: Although the differences in the distribution of the occlusal forces and the location of the occlusal centre of gravity were significant, the relationship between occlusal contacts and TMD remains to be fully clarified. Further research is needed to investigate whether studying occlusal force distributions in both healthy subjects and TMD patients.