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Ozmen EE, Unuvar BS. Evaluation of head posture in patients with temporomandibular joint disorders: a cross-sectional study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2025; 71:e20241474. [PMID: 40332263 PMCID: PMC12051955 DOI: 10.1590/1806-9282.20241474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Accepted: 11/23/2024] [Indexed: 05/08/2025]
Abstract
OBJECTIVE This study evaluated head posture in patients with temporomandibular joint disorders and explored the effects of postural changes on clinical parameters. METHODS In total, 81 individuals diagnosed with temporomandibular joint disorders participated in this cross-sectional prospective study. Demographics, pain status, head posture, and jaw movement data were collected. Head posture was assessed using the Posture Screen Mobile application. RESULTS Results indicated moderate negative correlations between pain and mouth opening (rho=-0.437, p<0.001) and maximum mouth opening (rho=-0.427, p<0.001). Anterior translation showed weak positive correlations with mouth opening and maximum mouth opening, while right lateral translation exhibited a weak positive correlation with pain (rho=0.264, p=0.017). Posterior angulation showed weak significant correlations with pain, mouth opening, and maximum mouth opening. CONCLUSION These findings suggest that head posture has a significant influence on temporomandibular joint disorder symptoms. Treatment strategies addressing postural abnormalities may help alleviate symptoms and enhance the quality of life in temporomandibular joint disorder patients.
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Affiliation(s)
- Elif Esra Ozmen
- Karamanoglu Mehmetbey University, Department of Oral and Maxillofacial Surgery – Karaman, Turkiye
| | - Bayram Sonmez Unuvar
- Konya Ticaret Odası Karatay University, Faculty of Health Sciences, Department of Audiology – Konya, Turkiye
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Maracci LM, Savegnago GDO, Antoniazzi RP, Marquezan M, Silva TB, Liedke GS. Influence of examiner calibration on clinical and MRI diagnosis of temporomandibular joint disc displacement: a systematic review and meta-analysis. Dentomaxillofac Radiol 2024; 53:341-353. [PMID: 38970385 PMCID: PMC11358637 DOI: 10.1093/dmfr/twae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 05/17/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVES This study aimed to verify the accuracy of clinical protocols for the diagnosis of disc displacement (DD) compared with MRI, considering examiners' calibration. METHODS PubMed, Cochrane (Central), Scopus, Web of Science, LILACS, Embase, Science Direct, Google Scholar, and DANS EASY Archive databases were searched. Two reviewers independently screened and selected the studies. A meta-analysis was conducted using the R Statistical software. Results are shown using sensitivity and specificity, and 95% confidence intervals. RESULTS Of the 20 studies included in the systematic review, only three were classified as low risk of bias. Seventeen studies were included in the meta-analysis. Compared to MRI, clinical protocols showed overall sensitivity and specificity of 0.75 (0.63-0.83) and 0.73 (0.59-0.84) for DD diagnosis, respectively. For DD with reduction, sensitivity was 0.64 (0.48-0.77) and specificity was 0.72 (0.48-0.87). For DD without reduction, sensitivity was 0.58 (0.39-0.74) and specificity 0.93 (0.83-0.97). Only 8 studies reported examiner calibration when performing clinical and/or MRI evaluation; nevertheless, calibration showed a tendency to improve the diagnosis of DD. CONCLUSION The sensitivity and specificity of clinical protocols in the diagnosis of DD are slightly below the recommended values, as well as the studies lack calibration of clinical and MRI examiners. Examiner calibration seems to improve the diagnosis of DD.
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Affiliation(s)
- Lucas Machado Maracci
- Dental Sciences Post-Graduation Program, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | | | - Raquel Pippi Antoniazzi
- Dental Sciences Post-Graduation Program, Department of Stomatology, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | - Mariana Marquezan
- Dental Sciences Post-Graduation Program, Department of Stomatology, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | - Tatiana Bernardon Silva
- Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
| | - Gabriela Salatino Liedke
- Dental Sciences Post-Graduation Program, Department of Stomatology, Federal University of Santa Maria, Santa Maria, 97105-900, Brazil
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Besirevic-Bulic F, Schmid-Schwap M, Kundi M, Sagl B, Piehslinger E. Wear Management of Colored Foils for the Assessment of Sleep Bruxism Patterns-A Prospective, Randomized Crossover Study. Diagnostics (Basel) 2023; 13:diagnostics13020172. [PMID: 36672982 PMCID: PMC9858571 DOI: 10.3390/diagnostics13020172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/21/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
The assessment of bruxism relies on clinical examinations, questionnaires, and polysomnography. The additional use of colored foils (BruxChecker®) could enable a more precise evaluation of bruxing patterns. To assess differences between use of the foils during stress periods or just on consecutive nights and to determine a reasonable duration of using the foils, 28 patients were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and were randomly assigned to wearing the 12 foils for six consecutive nights (alternately in the upper and lower jaw; "consecutive") or six nights within one month following days of high stress ("stress") in a crossover design. The sizes of the attrition areas were measured with ImageJ. Stress was evaluated using the Perceived Stress Scale. The Stress Coping Questionnaire (SVF-120) was used for assessing habitual stress coping strategies. Areas of attrition increased significantly from day 1/2 to 5/6, both for the upper and lower jaw. Molars in the mandible had significantly larger attrition areas than in the maxilla. No significant differences were detected between "consecutive" and "stress" phases. The foils were suitable for differentiating teeth more or less affected by bruxism and were able to show that areas of attrition increased with days, indicating that some adaptation takes place and several days of wearing the foils are required to show the full picture. However, no differences between low/moderate- and high-stress phases were detected.
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Affiliation(s)
- Ferida Besirevic-Bulic
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
- Correspondence:
| | - Martina Schmid-Schwap
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Michael Kundi
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Benedikt Sagl
- Center of Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Eva Piehslinger
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
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Does temporomandibular disorder correlate with menopausal symptoms? Menopause 2022; 29:728-733. [PMID: 35544600 DOI: 10.1097/gme.0000000000001962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the correlation between menopausal symptoms and pain caused by temporomandibular disorder (TMD) and the impact of sociodemographic factors on the association. METHODS In this cross-sectional study, a total of 74 women with TMD symptoms were enrolled and divided into three groups according to the Stages of Reproductive Aging Workshop + 10 (STRAW + 10) criteria: G1 (n = 25, late menopausal transition), G2 (n = 30, early postmenopause), and G3 (n = 19, late postmenopause). Sociodemo-graphic data were collected, along with data on menopausal symptoms (Blatt-Kupperman menopausal index) and TMD-induced pain (craniomandibular index). Statistical analysis was performed using a chi-squared test and linear correlation tests (Spearman and Pearson). RESULTS Analysis of the three groups showed that TMD-induced pain was more intense in G1 than in G3 (P = 0.0426, r = 0.2364, r2 = 0.05589), and menopausal symptoms correlated with the intensity of TMD-induced pain (P = 0.0004, r = 0.4020). This correlation was more significant during the late menopausal transition (G1: P = 0.0267, r = 0.4427, r2 = 0.1960). In G2, women with fewer than 4 years of schooling had a higher total Blatt-Kupperman menopausal index score (17.0 ± 85.0) and craniomandibular index (0.29 ± 0.23) than women with more than 4 years of schooling (P = 0.02 for both indices). CONCLUSIONS Our results suggest that TMD-induced pain and menopausal symptoms are correlated, and more strongly so in the late menopausal transition. Additionally, sociodemographic factors, such as schooling, have a major influence on symptoms in early postmenopause. Performing the TMD evaluation during the climacteric period may be important.
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Abdalla-Aslan R, Shilo D, Nadler C, Eran A, Rachmiel A. Diagnostic correlation between clinical protocols and magnetic resonance findings in temporomandibular disorders: A systematic review and meta-analysis. J Oral Rehabil 2021; 48:955-967. [PMID: 33966292 DOI: 10.1111/joor.13179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Our aim was to assess the diagnostic correlation between clinical protocols and magnetic resonance (MRI) findings in temporomandibular disorders (TMDs), including disc displacement with and without reduction (DDwR; DDwoR) and arthralgia. METHODS A systematic review performed in two phases according to the PRISMA checklist. Specific indexing terms were used for search of studies assessing TMDs through clinical diagnostic protocols with the aid of Research Diagnostic Criteria for TMDs or Diagnostic Criteria for TMDs. Quality assessment performed using QUADAS-2. Heterogeneity was assessed using I2 . Publication bias was assessed using funnel plots. For meta-analysis, we used random effect model or fixed effect. The main outcomes were sensitivity and specificity of clinical protocols. RESULTS Fourteen studies included in the qualitative analysis and 11 studies in the meta-analysis. None of the studies fulfilled all criteria of QUADAS-2. High heterogeneity and high publication bias were found among the studies. Clinical protocols for assessing DDwR compared with MRI showed pooled sensitivity of 66% and specificity of 72%. For DDwoR, sensitivity was 61% and specificity 98%. For arthralgia, sensitivity was 43% and specificity 68% for the presence of effusion. CONCLUSIONS This review reveals the need for studies with improved quality. Clinical protocols show poor to moderate validity in diagnosis of DDwR and DDwoR compared with MRI. No correlation was found between a clinical diagnosis of arthralgia and MRI effusion. Clinical diagnostic protocols can be used as screening tools, reserving the use of MRI for a more accurate diagnosis in patients with symptoms or dysfunction.
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Affiliation(s)
- Ragda Abdalla-Aslan
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel.,Maxillofacial Imaging, Department of Oral Medicine, Sedation and Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Dekel Shilo
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel.,Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Chen Nadler
- Maxillofacial Imaging, Department of Oral Medicine, Sedation and Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Ayelet Eran
- Radiology Department, Neuroradiology Unit, Rambam Health Care Campus, Haifa, Israel
| | - Adi Rachmiel
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel.,Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Eraslan R, Kılıç K, Etöz M, Soydan D. The evaluation of agreement between high-frequency ultrasonography and research diagnostic criteria for the diagnosis of temporomandibular joint internal derangements. J Indian Prosthodont Soc 2021; 20:387-393. [PMID: 33487966 PMCID: PMC7814687 DOI: 10.4103/jips.jips_136_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/22/2020] [Accepted: 08/31/2020] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study is to compare the diagnosis of patients with temporomandibular joint (TMJ) internal derangements which had been diagnosed using Research Diagnostic Criteria/Temporomandibular Disorders (RDC/TMD) with the dynamic high resolution sonography findings. Settings and Design Axis I section of RDC/TMD form had been applied to participants. Participants were divided into three groups as healthy TMJ, disc displacement with reduction, and disc displacement without reduction. The diagnoses had been compared with the dynamic high-resolution sonography findings. Materials and Methods Twelve of the patients had been treated with laser therapy, whereas 13 patients were treated with stabilization splint. Seventeen patients were treated with anterior repositioning splint (n = 42). After the application of different treatment modalities, the position of the articular disc had been determined with Axis I of RDC/ TMD form and dynamic high-resolution sonography. The findings were compared and statistically analyzed. Statistical Analysis Used Statistical analyses of data were analyzed with Turcosa Cloud (Turcosa Ltd Co, Turkey). Results For the right TMJ, pretreatment and posttreatment ultrasonography (USG) diagnoses and RDC/ TMD clinical diagnoses were found similar (κ = 0.125-0.008). No statistically significant relationship was found (P > 0.05). For the left TMJ, pretreatment USG diagnosis and RDC/TMD clinical diagnose were found similar (κ = 0.070). No statistically significant relationship was found (P > 0.05). For the left TMJ, posttreatment USG diagnosis and RDC/TMD clinical diagnose were compared. A statistically significant difference was found (κ = 0.256). A statistically significant relationship was found (P < 0.05). Conclusions Axis 1 of RDC/TMD form which is used for the diagnosis of internal derangements and dynamic high resolution sonography was not found in the agreement.
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Affiliation(s)
- Ravza Eraslan
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Kerem Kılıç
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Meryem Etöz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Damla Soydan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Rossini R, Grossmann E, Poluha RL, Setogutti ÊT, Dos Santos MF. Double-Needle Arthrocentesis with Viscosupplementation in Patients with Temporomandibular Joint Disc Displacement without Reduction. Clinics (Sao Paulo) 2021; 76:e2840. [PMID: 33909828 PMCID: PMC8050596 DOI: 10.6061/clinics/2021/e2840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/16/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Arthrocentesis is the simplest surgical intervention for the temporomandibular joint (TMJ). It can be performed on an outpatient basis at a low cost and with low morbidity. The objective is to release the articular disc by disrupting the adhesion formed between its surfaces and the mandibular fossa through hydraulic pressure generated by irrigation of the upper compartment of the TMJ. Viscosupplementation with hyaluronic acid during or after arthrocentesis improves clinical outcomes, increases mouth opening, and reduces pain levels. The aim of this study was to evaluate the efficiency of arthrocentesis plus hyaluronic acid viscosupplementation through clinical examination and preoperative magnetic resonance imaging in patients with unilateral disc displacement without reduction (DDwoR). METHODS This analytical retrospective cross-sectional study clinically and radiologically evaluated 72 patients of both sexes with unilateral DDwoR. The following data were collected: sex, pain, age, duration of pain, maximum mouth opening, and patient pain perception on a visual analog scale. TMJ arthrocentesis was performed only once for each of the indicated joints. Data were collected before arthrocentesis (baseline) and at 7, 14, 30, 60, 90, and 180 days after the procedure (final evaluation). RESULTS Between the baseline and final evaluation, there was a significant reduction in pain (p=0.001) and restoration of articular function. In addition, there was a significant increase in maximum mouth opening (p=0.001). CONCLUSION Patients with DDwoR undergoing arthrocentesis combined with hyaluronic acid injection showed significant improvement in the perceived pain and maximum mouth opening in the mid-term follow-up periods.
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Affiliation(s)
- Rafael Rossini
- Pos-Graduacao em Ciencias Cirurgicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR
| | - Eduardo Grossmann
- Departamento de Ciencias Morfologicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR
- *Corresponding author. E-mail:
| | | | | | - Marcos Fabio Dos Santos
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
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Sagl B, Schmid-Schwap M, Piehslinger E, Kronnerwetter C, Kundi M, Trattnig S, Stavness I. In vivo prediction of temporomandibular joint disc thickness and position changes for different jaw positions. J Anat 2019; 234:718-727. [PMID: 30786005 DOI: 10.1111/joa.12951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2019] [Indexed: 12/31/2022] Open
Abstract
Temporomandibular joint disorders (TMD) are common dysfunctions of the masticatory region and are often linked to dislocation or changes of the temporomandibular joint (TMJ) disc. Magnetic resonance imaging (MRI) is the gold standard for TMJ imaging but standard clinical sequences do not deliver a sufficient resolution and contrast for the creation of detailed meshes of the TMJ disc. Additionally, bony structures cannot be captured appropriately using standard MRI sequences due to their low signal intensity. The objective of this study was to enable researchers to create high resolution representations of all structures of the TMJ and consequently investigate morphological as well as positional changes of the masticatory system. To create meshes of the bony structures, a single computed tomography (CT) scan was acquired. In addition, a high-resolution MRI sequence was produced, which is used to collect the thickness and position change of the disc for various static postures using bite blocks. Changes in thickness of the TMJ disc as well as disc translation were measured. The newly developed workflow successfully allows researchers to create high resolution models of all structures of the TMJ for various static positions, enabling the investigation of TMJ disc translation and deformation. Discs were thinnest in the lateral part and moved mainly anteriorly and slightly medially. The procedure offers the most comprehensive picture of disc positioning and thickness changes reported to date. The presented data can be used for the development of a biomechanical computer model of TMJ anatomy and to investigate dynamic and static loads on the components of the system, which could be useful for the prediction of TMD onset.
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Affiliation(s)
- Benedikt Sagl
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Martina Schmid-Schwap
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Eva Piehslinger
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Claudia Kronnerwetter
- Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria
| | - Michael Kundi
- Institute of Environmental Health, Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria.,CD Laboratory for Clinical Molecular MR Imaging, Medical University of Vienna, Vienna, Austria
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
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Ruf S, Bock NC. Long-term (≥15 years) effects of Class II treatment: a longitudinal and cross-sectional study on signs and symptoms of temporomandibular disorders. Eur J Orthod 2018; 41:172-179. [DOI: 10.1093/ejo/cjy040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sabine Ruf
- Department of Orthodontics, University of Giessen, Germany
| | - Niko C Bock
- Department of Orthodontics, University of Giessen, Germany
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Arsan B, Köse TE, Çene E, Özcan İ. Assessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:382-391. [PMID: 28110941 DOI: 10.1016/j.oooo.2016.11.005] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 10/06/2016] [Accepted: 11/12/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate changes in the trabecular structure of the mandibular condyle in patients with temporomandibular disorders (TMDs) using fractal analysis. STUDY DESIGN A total of 100 patients ages 18 to 73 years were clinically assessed using the Diagnostic Criteria for Temporomandibular Disorders. The control group was age- and sex-matched with the patient group. Panoramic radiographs were obtained using a Kodak 8000 digital device with 73 kVp and 5 mA fixed parameters. The degree of degeneration in the mandibular condyles was calculated. Regions of interest (84 × 84 pixels) were selected within the cortical boundary of the mandibular condyle, and the fractal dimension (FD) was calculated using ImageJ version 1.48. RESULTS Radiographic degenerative changes were more frequently present and more severe in the patient group (P < .001). The mean value of FD was 1.22 ± 0.06 in the patient group and 1.25 ± 0.06 in the control group (P = .001). A significant decrease in FD was observed (P = .001) in the left temporomandibular joints of the patient group, whereas a nonsignificant decrease in FD was observed in the right temporomandibular joints (P = .073) as degenerative changes increased. CONCLUSIONS Lower FD values were associated with more severe degenerative changes in the patient group. The trabecular structure of condyles in patients with TMD exhibited decreased complexity when erosive and sclerotic changes were evident. As a result, fractal analysis enhanced the use of panoramic radiography in detecting degenerative changes in patients with TMD.
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Affiliation(s)
- Belde Arsan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Okan University, Istanbul, Turkey.
| | - Taha Emre Köse
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Erhan Çene
- Department of Statistics, Yıldız Technical University, İstanbul, Turkey
| | - İlknur Özcan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Pupo YM, Pantoja LLQ, Veiga FF, Stechman-Neto J, Zwir LF, Farago PV, De Luca Canto G, Porporatti AL. Diagnostic validity of clinical protocols to assess temporomandibular disk displacement disorders: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:572-586. [DOI: 10.1016/j.oooo.2016.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 06/15/2016] [Accepted: 07/04/2016] [Indexed: 12/30/2022]
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Gökalp H. Disc position in clinically asymptomatic, pretreatment adolescents with Class I, II, or III malocclusion : A retrospective magnetic resonance imaging study. J Orofac Orthop 2016; 77:194-202. [PMID: 27145938 DOI: 10.1007/s00056-016-0024-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 08/12/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To test the null hypothesis that children with Class I, II, and III malocclusions who have not undergone orthodontic therapy present with displaced discs. MATERIALS AND METHODS This study relied on retrospective material consisting of 76 unilateral left sagittal-oblique temporomandibular joint (TMJ) magnetic resonance imaging (MRIs) and lateral cephalometric radiographs taken in maximum intercuspal position in patients with clinically symptom-free and orthodontically untreated Class I (n = 30; 19 girls and 11 boys), Class II (n = 26; 10 girls and 16 boys), and Class III malocclusion (n = 20; 5 girls and 15 boys). The mean ages of patients with Class I, II, and III malocclusions were 10.55 ± 0.81, 11.71 ± 0.31, and 8.98 ± 1.80 years, respectively. Study groups were compared with one-way ANOVA analysis or Welch ANOVA test. Differences were evaluated via the Tukey HSD or Games-Howell test. RESULTS Disc-condyle positions were almost within normal limits in Class I malocclusion. The disc was positioned anteriorly relative to the condyle (p < 0.05) and the condyle positioned posteriorly in the glenoid fossa in Class II malocclusion (p < 0.05). The disc was positioned slightly anteriorly relative to the condyle (p < 0.05) and the condyle was positioned posteriorly in the glenoid fossa in Class III malocclusion. Disc-condyle positions were observed to be almost identical in all three malocclusion classes. CONCLUSION Disc-condyle position was nearly normal in patients with Class I malocclusion. Nevertheless, a Class II malocclusion is more apt to reveal anterior disc displacement than a Class III malocclusion.
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Affiliation(s)
- Hatice Gökalp
- Department of Orthodontics, Faculty of Dentistry, Ankara University, Beşevler, 06500, Ankara, Turkey.
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Oh JS, Kim SH, Park KN. Effects of controlled condylar rotation exercise on symmetrical mouth opening in patients with temporomandibular disorder. J Phys Ther Sci 2015; 27:1319-21. [PMID: 26157210 PMCID: PMC4483388 DOI: 10.1589/jpts.27.1319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/11/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the effects of a 4-week program of
active condylar rotation exercise on the extent of the lateral mandibular shift during
mouth opening in patients with temporomandibular disorder. [Subjects and Methods] Patients
with temporomandibular disorder (n = 12; 7 men and 5 women) were recruited. The active
range of temporomandibular motion was recorded using 3-dimensional ultrasound-based motion
analysis. The paired t-test was used to assess changes in lateral mandibular shift before
and after active condylar rotation exercise. [Results] The degree of the lateral
mandibular shift during mouth opening and the mouth opening-lateral mandibular shift ratio
were significantly lower after active condylar rotation exercise than before the exercise.
[Conclusion] Active condylar rotation exercise may effectively reduce the degree of the
lateral mandibular shift during mouth opening to produce symmetrical mouth opening in
patients with mild temporomandibular disorder.
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Affiliation(s)
- Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
| | - Si-Hyun Kim
- Kinetic Ergocise Based on Movement Analysis Laboratory, Republic of Korea
| | - Kyue-Nam Park
- Department of Physical Therapy, College of Medical Science, Jeonju University, Republic of Korea
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Mishutin EA, Geletin PN, Morozov VG. [Audiodiagnostics in examination of patients with internal TMJ derangement]. STOMATOLOGIIA 2015; 93:32-34. [PMID: 25588396 DOI: 10.17116/stomat201493632-34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the study was to assess the efficacy of audiodiagnostics in dysfunctional TMJ disorders. Thirty-four patients were included in the study. The analysis of phonograms revealed correlation of adverse sound effects with varying degrees of internal TMJ-disorder seen by MRI imaging. The study results confirm the advantages of electronic registration of TMJ sound phenomena.
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Affiliation(s)
- E A Mishutin
- Kafedra propedevticheskoĭ stomatologii Smolenskoĭ gosudarstvennoĭ meditsinskoĭ akademii
| | - P N Geletin
- Kafedra propedevticheskoĭ stomatologii Smolenskoĭ gosudarstvennoĭ meditsinskoĭ akademii
| | - V G Morozov
- Kafedra propedevticheskoĭ stomatologii Smolenskoĭ gosudarstvennoĭ meditsinskoĭ akademii
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15
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Lodetti G, Marano G, Fontana P, Tartaglia GM, Maria de Felício C, Biganzoli E, Sforza C. Surface electromyography and magnetic resonance imaging of the masticatory muscles in patients with arthrogenous temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:248-56. [DOI: 10.1016/j.oooo.2014.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
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16
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Florakis A, Fotinea SE, Yapijakis C. Subconscious temporomandibular dysfunction therapy: A new therapeutic approach for temporomandibular disorders. World J Stomatol 2014; 3:10-18. [DOI: 10.5321/wjs.v3.i1.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 09/17/2013] [Accepted: 11/21/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate a new therapeutic approach that may permanently address excessive involuntary muscle activity which causes temporomandibular disorders (TMD).
METHODS: A cohort of 69 TMD patients (33 men and 36 women, age range 14-71 years) was treated with Subconscious Temporomandibular Dysfunction (STeDy) therapy. A thick awareness splint assisted patients to gradually recognize the interdependence between psychological pressure and subconscious muscle activity. The STeDy therapy lasted for one year and involved three stages: (1) data collection including medical history, clinical examination and psychological evaluation; (2) application of the awareness splint and consultation on a monthly basis; and (3) final evaluation.
RESULTS: About 10% of patients (3 men and 4 women) quit the STeDy therapy within the first 3-6 mo due to severe health problems or psychosocial reasons. Based on the absence of objective and subjective clinical symptoms as well as on radiographic findings, the temporomandibular dysfunction treatment was successful in all remaining 62 patients that completed the year-long therapy. Symptoms, including recurrent headache, morning fatigue, clicking sound or painful temporomandibular joint disorders, were eliminated in all patients within the first six months. By completion of the STeDy therapy, all patients had learned to recognize stressful conditions and cognitively avoided displaying excessive bruxism or other subconscious activity of the stomatognathic muscles. A follow-up after at least one year indicated the permanent nature of the cognitive treatment in all patients, illustrating the fact that subconscious muscle activity due to stress plays a principal role in the great majority of TMD, at least in adults.
CONCLUSION: The STeDy therapy successfully and permanently resolved TMD problems of all patients that completed the year-long treatment.
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17
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Temporomandibular joint diagnosis: striking a balance between the sufficiency of clinical assessment and the need for imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:124-5. [PMID: 23768879 DOI: 10.1016/j.oooo.2013.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 03/05/2013] [Indexed: 11/22/2022]
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18
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Xiang Y, Zeng H, Liu X, Zhou H, Luo L, Duan C, Luo X, Yan H. Thymidine kinase 1 as a diagnostic tumor marker is of moderate value in cancer patients: A meta-analysis. Biomed Rep 2013; 1:629-637. [PMID: 24648999 DOI: 10.3892/br.2013.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 05/01/2013] [Indexed: 11/06/2022] Open
Abstract
Thymidine kinase 1 (TK1) is an enzyme involved in nucleic acid synthesis and is therefore considered to be an important tumor proliferation marker. The aim of the present study was to determine the diagnostic role of TK1 measurement in cancer. An extensive electronic search was performed in PubMed, EMBASE and the Cochrane Library using the keywords 'thymidine kinase 1' and 'tumor' and synonyms. This study was conducted as part of a project to establish evidence-based guidelines for the diagnosis and treatment of cancer. A total of 453 abstracts were screened, after which the full text of 40 studies were selected for further investigation, including screening of the references cited by studies in the original search. Fifteen studies were enrolled following full-text evaluation. The areas under the receiver operating characteristic curves for the radioenzymatic assay (REA), the chemiluminescence immunoassay (CLIA) and the total were 0.88, 0.75 and 0.8, respectively. These results were all between <0.9 and >0.7, which suggested a moderate diagnostic efficacy. The positive likelihood ratio of the CLIA method was the highest (10.229), which demonstrated that CLIA exhibited a satisfactory specificity in tumor diagnosis. However, TK1 as a single diagnostic tumor marker was not of significant value and the combination of more tumor markers in the diagnosis of tumors may be preferable.
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Affiliation(s)
- Yanqun Xiang
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510080, P.R. China
| | - Hua Zeng
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China ; Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institute, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Xiang Liu
- Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institute, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China ; Departments of Ear-Nose-Throat, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Hui Zhou
- Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institute, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China ; Gynaecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Ling Luo
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China ; Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institute, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Chaohui Duan
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China ; Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institute, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Xiaohong Luo
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China ; Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institute, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Haiyan Yan
- Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China ; Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institute, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
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